From March 1989 to october 1990, 35 refluxing ureters in 25 children were treated by submucosal injection of Teflon (STING). The overall success rate was 54% after the first injection. The authors detail the procedure and analyse their results which demonstrate that Teflon injection can be safe and effective treatment of vesicoureteral reflux in most cases can replace antireflux surgery.

A retrospective multicentre study of 341 children with persistent/recurrent, isolated haematuria is described. The haematuria was isolated for at least half a year in the beginning of observation. 47.8% of the patients became symptom-free. In 18.4% the haematuria remained isolated, in 13.8% it was combined with greater than 250 mg/day proteinuria greater than 2 years later. The occurrence of associated proteinuria was 8.6% between the 3rd to fifth years, and 37.0% after the 5th years. 14 cases had Alport's nephropathy. The percentage of more serious azotaemia was 1.7 (Ccreat: 10-50 ml/min/1.73 m2) and 0.3 (Ccreat: less than 10 ml/min/1.73 m2). Mortality was 0.58%, rate of hypertension 1.2%. Most of the patients who developed severe azotaemia, had persistent microscopic haematuria in the beginning. The haematuria was associated with hypercalciuria in 19.9%. In 14.3% of the overall group of patients urolithiasis developed 2-15 years after onset. All of them had hypercalciuria. Our findings suggest that symptoms of isolated haematuria may last for a long-term period and need systematic control. When proteinuria and/or hypertension associates to haematuria a worse prognosis can be expected.

A retrospective multicentre study of 341 children with persistent/recurrent, isolated haematuria is described. The haematuria was isolated for at least 6 months at the beginning of observation. The duration of follow-up was 2–5 years in 201, 5–10 years in 119, 10–15 years in 19, and over 15 years in 2 cases. Of these patients 47.8% became symptom-free. In 18.4% the haematuria remained isolated; in 13.8% it was combined with proteinuria over 250 mg/day more than 2 years later. The occurrence of associated proteinuria increased progressively with time. It was 8.6% between the 3rd and 5th years, and 37.0% after the 5th year. Renal biopsy was performed because of the symptoms of glomerular disease in 47 cases at an average time of 12 months following the appearance of proteinuria. Proteinuria appeared after a 2–5, 5–10, 10–15 and more than 15 years follow-up period in 16, 23, 6, and 2 patients respectively; 14 of them had Alport's nephropathy. The percentage of more serious azotaemia was 1.7 (creatinine clearance: 10–50 ml/min per 1.73 m2) and 0.3 (creatinine clearance: < 10 ml/min per 1.73 m2). Mortality was 0.58%. Most of the patients who developed severe azotaemia had persistent microscopic haematuria at the beginning. The prevalence of hypertension was only 1.2%. The time of its appearance was above 5 years in 2 and below 5 years in 2 cases. All these patients had chronic glomerulonephritis. The haematuria was associated with hypercalciuria in 19.9%. In 14.3% of the overall group of patients urolithiasis developed 2–15 years after onset. All of these had hypercalciuria. Our findings suggest that symptoms of isolated haematuria may last for a longterm period and need systematic control. When proteinuria and/or hypertension is associated with haematuria a worse prognosis can be expected.

Between 1970 and 1982, 41 neonates and infants with grades II and III vesicoureteral reflux (international classification) but with no medical or urological complications were treated medically and followed for an average of 7.5 years. In 33 of the 41 patients the vesicoureteral reflux resolved (group 1) and in 8 it persisted (group 2). The severity and frequency of urinary infection decreased to a greater degree in group 1 (p less than 0.0005) than in group 2 (p less than 0.05). There was no difference in endogenous creatinine clearance between the 2 groups. Comparison of kidney length and bipolar parenchymal thickness revealed that bipolar parenchymal thickness was significantly less in group 2 patients (p less than 0.01). Body weight tended to increase in both groups but it was greater in group 1. In both groups height was lower at the time of detection of reflux and it approached nearly normal values during followup. It is tempting to conclude that early recognition of mild forms of vesicoureteral reflux (grades II and III) and systematic medical treatment can preserve renal function and promote renal and somatic growth. However, this tendency is less pronounced in patients with persistent reflux.

28 diabetic children were studied. In the fasting blood samples the following substances were measured: glucose, total-cholesterol, HDL-cholesterol, trigly-ceride, N-acetyl-β-glucosaminidase and HbA1.The results obtained were the following: 1.Both fasting blood glucose and urinary glucose excretion were found to be positively related to HbA1 /r=o.77, p

The present study on 28 diabetic and 38 non-diabetic children was conducted to extend information on the usefulness of HbAIa-c measurement in assessing the effectiveness of metabolic control, and to investigate to what extent HbAIa-c and blood glucose reflect changes in plasma cholesterol, especially high density lipoprotein cholesterol. Since the activities of serum lysosomal hydrolases are reported to be increased in diabetic patients, it was of interest to examine the changes in serum N-acetyl-β-D-glucosaminidase in relation to HbAIa-c.

Summary: The newborn rabbit has been used as a model to investigate the effects of propranolol, the isomers of propranolol, and practolol on the response to cold exposure. Racemic propranolol(1 mg/kg) caused a significant drop in oxygen consumption and higher doses (2.25 and 5.0 mg/kg) abolished the rise caused by cold exposure (Table 1). This effect was not mimicked consistently by either the D or I isomer. Practolol had no significant effect at a 1.0 mg/kg dose but in the doses of 2.25 and 5.0 mg/kg completely blocked the cold-induced rise of oxygen consumption. Racemic propranolol caused an increased fall in colonic temperature which was significant when 2.25 mg/kg was used. Neither of the two propranolol isomers nor practolol had a significant effect on colonic temperature (Table 2). In contrast, both 2.25 and 5.0 mg/kg racemic propranolol and 2.25 mg/kg practolol caused a significantly greater drop in brown fat temperature than that caused by exposure to 25°. The isomers of propranolol did not affect brown fat temperature significantly (Table 3). The rise in serum free fatty acid (FFA) concentration induced by cold exposure was reduced or abolished by each drug in every dose used (Table 4). The rise in blood glucose due to cold was abolished by racemic propranolol and practolol in all doses used (Table 5). I-Propranolol significantly inhibited the rise in blood glucose from 60-90 min and caused a fall below the levels seen at 60 min. D-Propranolol had no effect on blood glucose levels. The results show that the fi blockers, propranolol and practolol, seriously compromise the response of the newborn rabbit to thermal stress. Speculation: Perinatal exposure to β blockers may compromise the metabolic response of the newborn infant to cold exposure. The mechanism of action of propranolol in this respect is nbt explained by the sum of the actions of its isomers.

The aim of this study was to clarify wether in vivo the membrane stabilizing action of β-blockers is an important factor in cold induced thermogenesis or wether this effect is mediated purely through their β-adrenergic blockade. Propranolol /±Prop/, Practolol/Pract/, or Dextroisomer-Propranolol /+Prop/ was injected intraperitoneally in doses of 1; 2,25 and 5 mg/kg into 3-6 day old rabbits /n=98/ and O2 consumption /VO2/ /colonic/Tc/ brown fat /Tb/muscle/Tm/ temperatures plasma FFA and blood glucose levels were measured at an ambient temperature /Ta/ of 35°C and 25°C before and after the administration of the drugs. VO2 at Ta 35°C was not influenced by either agents. ±prop and Pract abolished cold induced thermogenesis in 2.25 and 5 mg/kg kg doses /p < 0,001/ while +Prop depressed it only slightly. /p > 0,1/. ±Prop lowered blood glucose levels while PracT, and +Prop. had no effect. All three agents tended to depress the cold induced increase of circulating FFA. It can be concluded a / that in the newborn rabbit cold induced i.e. brown fat theraogenesis is mediated through type β1-adrenergic receptors and b,/ that the in vivo anticalorigenic action of β-blockers at these dosages appears not to be dependent on their membrane stabilizing effect.