Background/aims: Epidemiological studies in humans link adult disease to abnormal growth in utero. In addition to general malnutrition of the foetus, preferential blood flow to the brain and heart may furthermore deprive organs such as the liver, spleen and kidneys of oxygen and macroand micronutrients. As a consequence, these organs may not develop normally, which predisposes the individual to the so‐called metabolic syndrome (syndrome X) in later life. The effects of foetal undernutrition on the growth of some abdominal organs were investigated by comparing the volume of the kidneys, spleen and liver in small‐for‐gestational‐age (SGA) newborn infants with that in appropriate‐for‐gestational‐age (AGA) newborn infants. Methods: In 25 randomly selected AGA infants and 25 SGA infants, who were subdivided into three gestational age groups (<30, 30–36 and 37–40 wk) the volumes of the liver, kidneys and spleen were determined by ultrasonography. Organ volumes were estimated using the standard ellipsoid formula (longitudinal × anteroposterior × transverse diameter ×π/6). Liver/kidney, liver/spleen and kidney/spleen volume ratios were also determined. Results: The volumes of the kidneys and liver differed significantly between AGA and SGA infants in all three gestational age groups (p≤ 0.0018 and p≤ 0.029, respectively). The fact that the spleen volume differed only in the 37–40 wk group (p= 0.0002) may indicate that there is a graded relationship across the whole range of normal birthweight. The correlation between the liver volume and birthweight differed significantly between SGA and AGA infants (r= 0.56 vs 0.84, p= 0.04). On the other hand, the volume ratios between the three organs were the same in all groups (p≥ 0.15). Conclusion: In intrauterine growth retarded infants, foetal growth of the liver and kidneys is more impaired than the body as a whole. Retarded foetal development of these organs may cause metabolic dysfunction, which predisposes to the group of diseases included in the so‐called metabolic syndrome or syndrome X.

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Acute pancreatitis is an inflammatory condition which typically presents with abdominal pain, and is one of the most complex and challenging of all acute abdominal disorders. Its clinical manifestations are as numerous and diverse as its etiology. Rare complications of measles virus infection include acute appendicitis with perforation and peritonitis, mesenteric lymphadenitis, hepatitis, ileocolitis, cervicitis and acuteglomerulonephritis. 1,2 Only two cases have been reported in the literature that were caused by the measles virus, while another case was caused by the measles, mumps and rubella vaccine. Case Report A 16-year-old female was admitted to Whammed General Hospital in August 1997, with fever of five days' duration, which was associated with dry cough, a burning sensation in the eyes, and running nose. A reddish skin rash appeared on the fourth day of her illness, starting on the face, and then spreading to the trunk and extremities. On the day of admission, the patient started to complain of severe epigastric pain radiating to the back, and associated with repeated vomiting. The patient gave no history of any recent drug intake. According to the parents, the patient had not received the measles vaccination during her childhood, and had had a recent contact with a patient who had measles. On examination, the patient looked ill and flushed in the face, with a temperature of 38.6°C, pulse rate of 130/minute regular, and blood pressure of 145/75 mm Hg. She had red conjunctiva, Koplik's spots on the buccal mucosa, and a congested throat. Maculopapular rashes covered the face, around the ears, the trunk and the extremities. There was epigastric tenderness on abdominal examination, but no palpable mass. Laboratory investigations showed hemoglobin of 145 g/L, WBC 4.5X10 9 /L, platelets 159X10 9 /L, all of which were within normal limits. As well, kidney function tests, liver function tests, arterial blood gases, serum cholesterol, triglycerides and serum calcium were all normal. Chest x-ray, abdominal CT scan and sonography were normal. Hepatitis viral serology for A, B, and C, and human immunodeficiency virus (HIV) were negative, as well as blood cultures. Virology studies showed Epstein-Barr virus-Caspid IgG antibodies as positive, EBV-Caspid IgM antibodies as negative,EBVnuclearantigenas-ABpositive,andEBV early antigen as negative. These results were suggestive of previous EBV exposure. Enterovirus (IgM ELISA) total antibodies by CFT16 were negative, mumps IgM and IgG were negative, but measles (EIA) IgM was positive.

Background/aims: Fetal growth retardation may be associated with diseases and disorders in later life. This risk may be due to some impairment of the development of such organs as liver and kidney. In addition to general malnutrition of the fetus, preferential blood flow to the brain and the heart may furthermore deprive such organs as liver, spleen, and kidney on oxygen and macro-and micronutrients. As a consequences these organs may not develop normally, which predisposes to impaired outcome of the fetus. Persisting metabolic dysfunction may then cause such diseases as hypertension, cardiovascular disease, osteoporosis, schizophrenia, mental depression, breast cancer, and polycystic ovary syndrome in adult age. The aim of this study was to investigate the effects of maternal undernutrition on the growth of some abdominal organs. The size of the kidneys, spleen and liver in adequate for gestational age newborn infants (AGA) has been compared with that in small for gestational age (SGA) infants.