We studied 3231 patients with acute central nervous system (CNS) symptoms of suspected viral origin to elucidate the current etiologic spectrum. In 46% of the cases, a viral finding was observed. Varicella-zoster virus (VZV) was the main agent associated with encephalitis, as well as meningitis and myelitis. VZV comprised 29% of all confirmed or probable etiologic agents. Herpes simplex virus (HSV) and enteroviruses accounted 11% each, and influenza A virus 7%. VZV seems to have achieved a major role in viral infections of CNS. In encephalitis in our population, VZV is clearly more commonly associated with these neurological diseases than HSV. The increase in VZV findings may in part be a pseudophenomenon due to improved diagnostic methods, however, a true increase may have occurred and the pathogenetic mechanisms behind this should be elucidated.

The spectrum of encephalitis in children has changed due to vaccination programs. The incidence, however, appears to be about the same due to increasing frequency of other associated old and new microbes.

SUMMARY The urinary and bowel control was studied of 527 children with myelomeningocele aged between four and 18 years. Information was obtained from medical records and by parent questionnaire. 44 had normal urinary control, 50 had a urinary diversion and the remaining 433 had neuropathic bladder without urinary diversion, of whom 31 per cent expressed their bladder manually and 40 per cent used clean intermittent catheterisation (CIC). 60 per cent needed assistance emptying their bladder. Children using CIC were more continent and needed less help, but were more often treated with antibiotics. Of the 527 children, 412 had disturbed bowel control. 212 evacuated their bowels manually, of whom 90 per cent needed assistance. Parents judged urinary incontinence to be very stressful for 37 per cent of the children and faecal incontinence for 33 per cent. The authors conclude that social urinary continence should be defined as the ability to keep dry for three hours or more. RÉSUMÉ Contrôle intestinal et vésical chez les enfants porteurs de spina bifida: une étude nordique Le contrôle urinaire et vésical a étéétudié chez 527 enfants avec myéloméngocèle, âgés de quartre à 18 ans. Les informations ont été obtenues à partir des dossiers médicaux et par un questionnaire proposé aux parents. 44 enfants avaient un contrôle urinaire normal, 50 présentaient une dérivation urinaire, le reste étant 433 vessies neurologiques sans dérivation urinaire; parmi ces derniers cas, la vessie était pressée manuellement dans 31 pour cent des cas et le sondage propre intermittent (CIC) était utilisé dans 40 pour cent des cas. 60 pour cent des enfants avaient besoin d'assistance pour vider leur vessie. Les enfants avec CIC étaient plus continents, demandaient moins d'aide, mais étaient plus souvent traités par antibiotiques. Parmi les 527 cas, le contrôle intestinal était perturbeé adans 412 cas. 212 enfants évacuaient leur rectum manuellement, 90 pour cent d'entre eux avaient besoin d'aide. Les parents jugeaient l'incontinence urinaire difficile à supporter chez 37 pour cent des enfants, l'incontinence rectale chez 33 pour cent. Les auteurs concluent que la continence urinaire peut être socialement définie comme une capacitéà demeurer sec trois heures ou plus. ZUSAMMENFASSUNG Darm‐ und Blasenkontrolle bei Kindern mit Myelomeningocele: eine nordeuropäische Studie Bei 527 Kindern mit Myelomeningocele im Alter zwischen vier und 18 Jahren wurden Blasen‐ und Darmkontrolle untersucht. Die Informationen wurden den Krankenakten und den Fragebögen der Eltern entnommen. 44 hatten normale Urinkontrolle, 50 hatten eine Harnableitung, und die restlichen 433 hatten eine neurogene Blase ohne Harnableitung, 31 Prozent davon drückten ihre Blase manuell aus und 40 Prozent benutzten die sterile intermittierende Katheterisierung (CIC). 60 Prozent waren bei der Blasenentleerung auf Hilfe angewiesen. Kinder, die die CIC benutzten, hatten eine bessere Kontinenz und brauchten weniger Hilfe, sie wurden aber häufiger mit Antibiotika behandelt. Von den 527 Kindern h...

Social environment seems to be the most powerful factor, predicting both IgG seroprevalence and recurrences during pregnancy.

The pathogenesis of a rare form of the ichthyotic diseases, ichthyosis hystrix Curth-Macklin, was investigated by immunohistochemistry and electron microscopy. Monoclonal antibodies (Mabs) against keratins expressed in normal basal cells (PKK2 and KA1), Mabs against keratins only present in normal fetal skin (PKK1), and Mabs against keratins 1, 2, 10, and 11 (KA5 and K8.60) were used. The Mabs reacting with normal basel cells showed an increased reaction with many cell layers. The Mab PKK1 distinctly reacted with the basal cell layer, suggesting an expression of fetal keratins. Electron microscopic study of both normal-looking and involved skin revealed the keratinization disorder characterized by tonofilament shells, perinuclear vacuoles, and binuclear keratinocytes. The results suggest that there is no prematurity of keratinization, but rather a pathological expression of specific keratin genes leading to expression of fetal keratins in this form of ichthyosis hystrix.