bluuebunny/crossref_metadata_2025 huggingface dataset:
Liver involvement in epidemic haemorrhagic fever: In situ hybridization, immunohistochemical and pathological studies
Authors: SUN HUI‐CHEN , DENG PING‐FEI , WANG CHUN‐JIE , JIA TAI‐HE , LAI JIA‐QI , ZHANG WEN , WANG XIAO‐XU , XIU HE‐MING
Published: March 2008

In the present study, liver biopsy specimens from 37 patients with epidemic haemorrhagic fever (EHF) were investigated by using light and electron microscopy, immunohistochemistry for the EHF virus envelope protein G2 and in situ hybridization (ISH) for EHF viral RNA. Immunostaining and in situ hybridization were both positive, and a few of the aetiological agents, the EHF virus (EHFV) particles, were found individually within the dilated Golgi cisternae and vesicles, and the dilated rough endoplasmic reticulum of the hepatocyte. The pathological alterations of the liver cells infected with EHFV were: hepatocellular degeneration, cytoplasmic vacuolation, and spotty necrosis; moreover, zonal necrosis was present and adjacent to the narrowed and occluded sinusoids. In degenerated and spotty necrotic cells, the positive signals from of ISH for EHFV RNA and those from immunostaining for the virus protein were both stronger than those in the zonal liver cell necrosis area. The results showed that hepatocellular degeneration and spotty necrosis might be directly related to the virus and its duplication inside the liver cells, while the zonal necrosis was ischaemic and thought to be caused by microcirculation dysfunction.
Recent advances in the pathophysiology of portal hypertension
Authors: TSAI YANG‐TE , LIN HAN‐CHIEH , LEE SHOU‐DONG
Published: March 2008

Portal hypertension is a common complication of chronic liver disease. Increased resistance to portal blood flow through a cirrhotic liver initiates the development of portal hypertension. In addition, alteration of neural and humoral regulations, endothelins, and stellate cells all contribute to the increased intrahepatic resistance. Moreover, the collateral circulation represents an additional site of increased resistance to portal blood flow. Increased splanchnic blood flow appears to play an important role in the maintenance of chronic portal hypertension. Several mechanisms have been proposed to explain this haemodynamic derangement including increased circulating vasodilators, endothelial‐derived vasodilators, and decreased vascular reactivity to vasoconstrictors. Finally, the development of portal hypertension induces peripheral arterial vasodilatation. The arterial vasodilatation may result in an increase in vascular underfilling which in turn leads to sodium retention and plasma volume expansion. The increased plasma volume is necessary for the development of increased cardiac output and the full expression of hyperdynamic circulation in portal hypertension.
Short‐term effect of portal vein arterialization on hepatic protein synthesis and endotoxaemia after extended hepatectomy in dogs
Authors: OGATA AKIRA , MIYAZAKI MASARU , OHTAWA SATORU , OHTSUKA MASAYUKI , NAKAJIMA NOBUYUKI
Published: March 2008

To assess the effect of partial portal arterialization on the remaining liver after usually lethal extended hepatectomy, 30 mongrel dogs underwent 84% partial hepatectomy and were divided into three groups as follows: group 1, 84% partial hepatectomy (n= 10); group 2, 84% partial hepatectomy and splenectomy (n= 10); group 3, 84% partial hepatectomy and splenectomy and splenic artery—vein (A‐V) shunt (n= 10). Another five dogs were pre‐operatively killed normal controls. Portal vein flow (PVF) decreased to about 60% in groups 1 and 2, but PVF in group 3 was maintained at the preoperative level. Oxygen saturation of portal vein blood increased markedly, to between 83% (group 1) and 88% (group 3). Portal vein pressure (PVP) increased in groups 1 and 2 by 1.6 to 1.7 times the preoperative value, but no significant difference in PVP, serum aspartate aminotransferase (AST) and arterial ketone body ratio was found between the three groups. Plasma endotoxin levels after 84% partial hepatectomy were significantly lower in group 3 than in groups 1 and 2. Both of hepatocellular and secretory protein synthesis were enhanced in group 3 compared with the other two groups. These results suggest that partial portal arterialization using a splenic A‐V shunt might bring about a beneficial effect on remaining liver function after extended hepatectomy.
Racial differences in Helicobacter pylori seroprevalence in Singapore: Correlation with differences in peptic ulcer frequency
Authors: KANG JY , YEOH KG , HO KY , GUAN R , LIM TP , QUAK SH , WEE A , TEO D , ONG YW
Published: March 2008

The aim of this study was to determine, first, whether racial differences exist in the seroprevalence of Helicobacter pylori infection in Singapore, and second, whether these differences correlate with racial differences in peptic ulcer frequency. A commercial serological test for immunoglobulin (Ig)G antibody to H. pylori which was 90% sensitive and 83% specific in our population was used to screen 403 adult blood donors of Chinese, Malay and Indian origin, aged between 15–60 years. Serum specimens from 84 paediatric patients admitted to the Paediatrics Department, National University of Singapore, with non‐gastroenterological illnesses were also tested. In all three races, seroprevalence of H. pylori increased with age. Indians have the highest prevalence of infection followed by Chinese and Malays. Peptic ulcer prevalences are known to be highest in Chinese, followed by Indians and Malays. The Malays have the lowest prevalence of H. pylori and peptic ulcer among the three races in Singapore. Indians have a higher prevalence of H. pylori antibodies but a lower frequency of peptic ulcer than the Chinese. Racial differences in peptic ulcer frequency between Chinese and Indians are not explained by the prevalence of H. pylori infection; other environmental or genetic factors may be involved.
Oesophageal cancer associated with other primary cancers: A study of 31 patients
Authors: KOIDE NAOHIKO , YAZAWA KAZUYUKI , KOIKE SHOICHIRO , ADACHI WATARU , AMANO JUN
Published: March 2008

The aim of this study was to investigate the characteristics of oesophageal cancer associated with other primary cancers and the survival rate after surgery for the patients with these cancers. Of 202 patients with oesophageal cancer treated in the Second Department of Surgery, Shinshu University School of Medicine between 1981 and 1995, 31 patients (15.3%) had oesophageal cancer associated with other primary cancers. Twenty‐one synchronous and 10 metachronous associated cancers were found and 25 of them were resected. Early‐stage oesophageal cancer was much more frequent in the associated cases than in the non‐associated cases. The stomach was the most frequently associated organ. The numbers of cases with triple and quadruple cancers were three and one, respectively. Three of these cases had intervals of over 6 years between tumours. Three cases with other primary cancers which had intervals of over 7 years after oesophagectomy were found, and two were carcinomas of the reconstructed gastric tube. In the outcome after surgery for oesophageal cancer, there was no difference between the associated and the non‐associated cases, and also no difference between the synchronous and metachronous associated cases. Regarding the five‐year and 10‐year survival rates after surgery for the first cancers, the synchronous cases had a poorer outcome than did the metachronous cases. In conclusion, oesophageal cancer with other primary cancers is not always rare, and its outcome is not poor compared with that of the non‐associated cases. These patients may achieve survival by early detection of both lesions and positive treatment. It is important to consider the risk of other primary cancers after oesophagectomy, and the success of the reconstructed gastric tube should be followed by endoscopy.
Cytotoxic T lymphocyte clone specific for autologous human hepatocellular carcinoma cell line SUHC‐1
Authors: YOSHIZAWA KANAME , OTA MASAO , KIYOSAWA KENDO
Published: March 2008

We established a cytotoxic T lymphocyte (CTL) clone directed against an autologous hepatocellular carcinoma (HCC) cell line SUHC‐1 which had been established in our department from a patient with HCC associated with hepatitis C virus infection. The CTL clone lysed autologous SUHC‐1 cells but did not lyse autologous Epstein‐Barr (EB) virus‐transformed B cells, natural killer (NK) cell‐sensitive erythroleukaemia cell line K562, the NK‐resistant B cell line Daudi, or allogeneic HCC cell lines, Hep‐G2, Hep‐3B, Mahlavu and PLC/PRF/5. The CTL clone expressed CD3 and CD8 molecules. The cytotoxic activity of the clone was inhibited by anti‐CD3, anti‐CD8 and anti‐histocompatibility antigen (HLA) class I monoclonal antibodies. These results indicated that the CTL clone recognized HCC tumour antigen in an HLA class I‐restricted manner. Furthermore, we investigated the T cell receptor (TCR) gene usage of the CTL clone. The CTL clone expressed TCRαβ. We searched for expression of TCR variable (V) α and β regions and sequenced complementary determining region (CDR) 3 of the clone. The clone expressed Vα14, junctional (J) region α9.7 and Vβ7, Jβ2.1. The amino acid sequence of the N region of the α chain was S‐P‐G‐G‐G‐G‐A‐D‐G‐L‐T and of the N‐D‐N region of the β chain was S‐W‐T‐G‐A‐S‐T‐D‐T‐Q‐Y. These results suggested that HLA class I‐restricted CTL play an important role in the elimination of human HCC cells.
Clinical significance of serum hyaluronic acid as a fibrosis marker in chronic hepatitis C patients treated with interferon‐α: Histological evaluation by a modified histological activity index scoring system
Authors: NINOMIYA TOSHIAKI , YOON SEITETSU , HAYASHI YOSHITAKE , SUGANO MASAHIKO , KUMON YOSHIKO , SEO YASUSHI , SHIMIZU KEIICHI , KASUGA MASATO
Published: March 2008

Abstract The aim of the present study was to investigate the histological changes effected by interferon (IFN) treatment and to evaluate the clinical significance of serum hyaluronic acid (HA) as a marker of fibrosis. Forty‐nine patients with chronic hepatitis C treated with IFN‐α were divided into three groups according to the existence of viraemia: sustained complete responders (CR), complete responders with relapse (PR) and non‐responders (NR). Needle biopsy sections of the liver taken before and at the end of IFN treatment were assessed according to the modified histological activitindex (HAI) scoring system. Serum fibrosis markers, including HA, were measured at needle biopsies. Biopsies of CR at the end of treatment showed a significant improvement in fibrosis and necroinflammatory scores. More significant correlation was observed between fibrosis scores and serum levels of HA before IFN treatment (r= 0.607, P < 0.0001) than those between fibrosis scores, on the one hand, and pepride of type III procollagen (PIIIP; r= 0.531, P= 0.0004) or type IV collagen 7S domain (type IV‐C; r= 0.241, P= 0.1062) on the other. Moreover, serum HA levels fell significantly in patients in whom fibrosis improved (P= 0.011). This is the first paper describing the advantages of the modified HAI scoring system over others in estimating the effect of IFN‐α; the results also indicate that serum HA can be useful in monitoring liver fibrosis in chronic hepatitis C patients treated with IFN‐α.
Bile acids influence hepatic chemiluminescence in normal and oxidative‐stressed rats†
Authors: NAKASHIMA TOSHIAKI , MATSUMOTO NINKO , NAKAJIMA YOSHIKI , ISHIKAWA HIROKI , MITSUYOSHI HIRONORI , INABA KOJI , SAKAI MOTONARI , SAKAMOTO YOSHIKUNI , MATSUMOTO MASAYUKI , SHIMA TOSHIHIDE , KASHIMA KEI , KITAYOSHI TADAHITO , SHIMAMOTO NORIO
Published: March 2008

The aim of the present study was to clarify whether bile acids influence chemiluminescence (CL) in the liver in vivo. Hepatic CL was determined on the surface of the liver of anaesthetized rats by using a photon counter. In normal rats, hepatic CL was significantly decreased 30 min after enteral administration of chenodeoxycholic acid (CDCA) or deoxycholic acid (DCA), but returned to its initial level 3 h later, after part of the CDCA administered was metabolized. Ursodeoxycholic acid (UDCA) and cholic acid had no effect on CL. In contrast, hepatic CL was markedly increased 30 min after CDCA or DCA administration in rats given either buthionine sulphoximine (BSO), an inhibitor of γ‐glutamylcysteine synthetase, or diethyldithiocarbamate (DDC), an inhibitor of both superoxide dismutase and glutathione peroxidase. Chenodeoxycholic acid further increased the CL of BSO‐ or DDC‐treated rats during inhalation of oxygen via a tracheal cannula. Coadministration of UDCA eliminated the effects of CDCA on the hepatic CL of normal and BSO‐ or DDC‐treated rats with or without oxygen inhalation. We conclude that cytotoxic bile acids, such as CDCA, increase CL in the antioxidants‐depleted or oxidative‐stressed liver in vivc, but that UDCA prevents CDCA from developing CL.
Macrophage and hepatic stellate cell responses during experimental hepatocarcinogenesis
Authors: JOHNSON SARAH J , BURR ANDREW W , TOOLE KIERAN , DACK CLARE L , MATHEW JOSEPH , BURT ALASTAIR D
Published: March 2008

The aim of the study was to assess the monocyte/macrophage and hepatic stellate cell responses during experimental diethylnitrosamine (DEN)‐induced hepatocarcinogenesis. Diethylnitrosamine (50mg/L) was administered to 39 rats for 10 weeks; liver tissue was obtained at weeks 10, 16 and 19. In this model, necroinflammatory damage occurs during the period of DEN administration but thereafter subsides; dysplastic nodules and carcinomas subsequently develop. Monocytes/macrophages were detected immunohistochemically using ED1 and ED2 monoclonal antibodies; hepatic stellate cells (HSC) were detected using antibodies to α‐smooth muscle actin (α‐SMA) (activated HSC) and glial fibrillary acidic protein (GFAP). Parenchymal ED1‐ and ED2‐positive monocytes/macrophages and α‐SMA‐positive HSC increased at week 10 when there was ongoing DEN‐induced necroinflammatory activity. ED1‐ and ED2‐positive cells were also prominent at weeks 16 and 19, particularly around the periphery of dysplastic and carcinomatous nodules, with occasional macrophages between dysplastic hepatocytes. α‐SMA‐positive HSC were present within sinusoids between dysplastic cells and were more abundant at weeks 16 and 19 than in control or week 10 animals. Activated HSC were prominent in fibrous septa around and within dysplastic and carcinomatous nodules at weeks 16 and 19. In contrast, GFAP‐positive HSC did not accumulate in developing septa or within dysplastic and carcinomatous nodules. We have demonstrated changes in the monocyte/macrophage and HSC populations during the development of hepatocellular dysplasia and carcinoma at time points when there is little necroinflammatory activity; this may therefore represent a host response to hepatocyte dysplasia. The HSC activation may be mediated, in part, by monocyte/macrophage‐derived factors, but we speculate that it may also result from direct stimulation by factors released from dysplastic hepatocytes.
Percutaneous endoscopic gastrostomy feeding in AIDS*
Authors: CROTTY BRENDAN , MCDONALD JENNIFER , MIJCH ANNE M , SMALLWOOD RICHARD A
Published: March 2008

Reduced energy intake is the most important reason for weight loss in advanced human immunodeficiency virus (HIV) infection. From January 1989 to August 1995 enteral feeding via a percutaneous endoscopic gastrostomy tube (PEG) was offered to all human immunodeficiency virus(HIV)/AIDS patients attending Fairfield Hospital, Melbourne who were unable to maintain 85% ideal body weight. A total of 71 patients received enteral feeding (1000–2000 kcal/day) for a median period of 161 days (range 4–644 days). Fifty‐one (72%) patients gained 5.8 ± 4.4kg (range 0.4 ‐ 19.2kg). Nine gained 10 kg or more. The median time to maximum weight was 74 days after PEG insertion. Those who gained weight had a longer median survival, but this difference was not statistically significant (210 vs 109 days, P=0.07). The only predictor of weight gain was a CD4 count greater than 100/μL. Patients who gained weight reported improved quality of life and increased independence. However, early complications, especially wound infection, were common. Although these data have been gathered retrospectively, our experience suggests that enteral feeding can maintain or improve nutritional status and may improve quality of life in advanced HIV infection.
CASE REPORT: Spontaneous isolated mesenteric fibromatosis presenting as megaduodenum
Authors: CHEN YI‐JEN , TAM KA‐WAI , CHEN CHING‐SHYANG , WU CHIH‐HSIUNG , CHEN SOUL‐CHIN , CHAN WING P , FANG CHIA‐LANG , LIU JEAN‐DEAN , PAN SHIANN
Published: March 2008

A case of spontaneous isolated mesenteric fibromatosis presenting as megaduodenum is reported. The lesion was small, only 2 cm in its greatest diameter. However, because of its location near the ligament of Treitz and because of its characteristic infiltrative growth pattern, the tumour involved the distal duodenum and resulted in acute angulation and obstruction early in its course. We successfully resected the mass and the patient is in fair physical condition 6 months after operation.
CASE REPORT; Haemangioma of the small intestine complicated by protein‐losing gastroenteropathy
Authors: SASAKI MASAYA , NAKAMURA FUMIYASU , KOYAMA SHIGEKI , FUJIYAMA YOSHIHIDE , BAMBA TADAO , OKABE HIDETOSHI
Published: March 2008

We report a case of haemangioma of the small intestine complicated by protein‐losing gastroenteropathy. A 32‐year‐old female had suffered from hypoproteinaemia for 6 years, but the cause of this condition had not been determined. On diagnosis and therapy for hypoproteinaemia, intra‐operative endoscopy and histological examination were performed and she was subsequently diagnosed with capillary haemangioma of the small intestine. Angiography was not useful for the detection of capillary haemangioma of the small intestine in this case. Although intestinal haemangioma is an important cause of gastrointestinal bleeding, protein loss is an extremely rare complication and this case is the first to be reported in Japan.
Amount of Helicobacter pylori in gastric mucus during anti‐H. pylori treatment
Authors: FURUTA TAKAHISA , TAKASHIMA MISAKO , FUTAMI HAJIME , ARAI HAJIME , HANAI HIROYUKI , KANEKO EIZO
Published: March 2008

Helicobacter pylori is present in infected patients not only on the gastric epithelial cell surface but also in gastric mucus. We developed a competitive polymerase chain reaction (cPCR) method for quantitative measurement of H. pylori in gastric mucus. The aim of this study was to determine the number of H. pylori in gastric mucus before and after anti‐H. pylori treatment. Patients with duodenal ulcer were treated with lansoprazole alone (n=11) or lansoprazole and amoxycillin (n=12). The amount of H, pylori in gastric mucus was measured over time by a cPCR assay. Helicobacter pylori infection was also tested for using histology, culture, and the rapid urease test (RUT). Although most patients treated with lansoprazole alone had become H. pylori‐negative by the end of treatment when tested by histology, RUT, and culture, a large number of H. pylori organisms were found in the gastric mucus at that time by cPCR. These patients returned to being H. pylori positive 1 to 12 months later on the basis of histology, RUT, and culture. However, cPCR results indicated eradication of H. pylori by the end of treatment in eight of the 12 patients treated with lansoprazole and amoxicillin, and these patients remained H. pylori negative on histology, RUT, culture, and cPCR 1 to 12 months later. Testing for H. pylori in gastric mucus is thus useful for precise determination of the success or failure of H. pylori eradication therapy.
Tamoxifen inhibits colorectal cancer metastases in the liver: A study in a murine model
Authors: KURUPPU DARSHINI , CHRISTOPHI CHRIS , BERTRAM JOHN F , O'BRIEN PAUL E
Published: March 2008

Liver metastases account for over 70% of deaths resulting from colorectal carcinoma, with survival rates varying between 6–18 months. At present, surgical resection offers the only hope for a cure, while chemotherapy, focal destructive techniques and selective internal radiation offer palliative care. Tamoxifen, a non‐steroidal anti‐oestrogen is primarily known for treating oestrogen receptor (ER)‐positive breast cancer. Some studies suggest that tamoxifen may have beneficial effects in malignancies other than breast cancer. These inhibitory effects, which have been shown to be independent of the ER, highlight new mechanisms of therapeutic action. Using an intrasplenic animal model we report the efficacy of tamoxifen on experimental liver metastases. In this model, a dimethyl hydrazine‐induced colon carcinoma cell suspension is introduced into the portal circulation via the spleen, which results in secondary tumour deposits in the liver in virtually all animals. Tamoxifen was administered at a dose of 1 mg/kg suspended in 1.0% methyl cellulose. The control group received an equal volume of the vehicle. The reagents were administered s.c. on the day of metastases induction and were continued daily over a 4 week period. The effect of tamoxifen on tumour growth was assessed by stereology and bromodeoxyuridine immunohistochemistry at selected time points. Data were assessed by a multiple analysis of variance where P < 0.05 was considered significant. In the control group the volume of metastases increased from 44 ± 41 mm3 at day 10 to 517 ± 380 mm3, 1394 ± 598 mm3 and 2082 ± 675 mm3 by days 16, 22 and 28, respectively. Daily administration of tamoxifen exerted an inhibitory effect on tumour growth during the first 3 weeks, recording a volume of 421 ± 299 mm3 by day 22 compared with the control group at that time point (P= 0.00004). The inhibitory effect diminished by the fourth week recording a tumour volume of 1344 ± 674 mm3 by day 28. Inhibition of tumour growth at day 22 coincides with a reduction of cells in the S phase of the cell cycle. The percentage of brdU‐positive nuclear profiles in metastases of tamoxifen‐treated mice at 3 weeks was 35.87 ± 5.60% compared with 48.01 ± 3.96% in the control group (P=0.001). These data suggest that tamoxifen has a potent inhibitory action on colorectal liver metastases by exerting an effect on cell proliferation.
Tiaprofenic acid inhibits mucosal prostaglandin E2 synthesis without delaying experimental gastric ulcer healing
Authors: HAYLES CAMERON D , ANDREWS FIONA J , O'BRIEN PAUL E
Published: March 2008

Increasing evidence suggests that non‐steroidal anti‐inflammatory drugs (NSAID) differ in gastrotoxicity. This study aimed to compare the effects of a short‐acting NSAID, tiaprofenic acid, with indomethacin on experimental gastric ulcer healing in a rat model. Similar anti‐inflammatory and prostaglandin‐inhibitory doses of indomethacin (1mg/kg) and tiaprofenic acid (2mg/kg) were administered to rats with acetic acid‐induced ulcers. After 2 weeks treatment, rats were killed and ulcer size determined. In addition, histological sections of ulcers were assessed for ulcer contraction and mucosal regeneration. The degree of inhibition of prostagiandin E2 (PGE2) synthesis was 72% at 2h after tiaprofenic acid and 64% at 2h after indomethacin administration, respectively. Rats treated with indomethacin for 2 weeks had significantly larger ulcers, both macroscopically and microscopically, than controls. Rats treated with tiaprofenic acid for 2 weeks had ulcers of a similar size to those of controls. Indomethacin‐treated ulcers showed a failure in mucosal regeneration. Tiaprofenic acid‐treated ulcers had significantly more regeneration than indomethacin‐treated ulcers. We conclude that tiaprofenic acid inhibits mucosal prostaglandin levels but does not inhibit experimental gastric ulcer healing. These findings suggest that inhibition of PGE2 synthesis is not the only factor in generating gastrotoxicity and that a shift to low gastrotoxic NSAID may be clinically worthwhile.
CASE REPORT: Successful obliteration of a bleeding duodenal varix using endoscopic ligation
Authors: YEH YU‐YUN , HOU MING‐CHIH , LIN HAN‐CHIEH , CHANG FULL‐YOUNG , LEE SHOU‐DONG
Published: March 2008

The occurrence of duodenal varices is rare and experience in the control of haemorrhage from duodenal varices is limited. A 69‐year‐old man with hepatocellular carcinoma presenting with upper gastrointestinal bleeding is reported. Emergency upper gastrointestinal endoscopy indicated one varix 1.5 cm in diameter with white nipple sign at the anterior wall of the duodenal bulb. Endosonography confirmed the diagnosis of duodenal varix. The patient was treated with endoscopic ligation and follow‐up endoscopy showed complete eradication of duodenal varix 3 weeks later.
Oesophageal hiatal hernia‐induced hydropneumothorax
Authors: FUKUDA TORU , YOKOI YUKIO , TAKIURA FUMIAKI , WATANABE SUMIO
Published: March 2008

The patient presented with acute and constant abdominal pain. He had had a lobectomy of the left lung three months before. On the 4th day in hospital the pain increased and he went into temporary shock. The next day a hydropneumothorax and incarcerated stomach were revealed by chest X‐ray and computed tomography. He was transferred to the University Hospital immediately and underwent an operation. The diagnosis was an incarcerated para‐oesophageal hernia with hydropneumothorax and perforation of the stomach. As a para‐oesophageal hernia may be fatal, is important to diagnose and treat it early.
Atypical, cytoplasmic and perinuclear anti‐neutrophil cytoplasmic antibodies in patients with inflammatory bowel disease
Authors: FRENZER ANDREAS , FIERZ WALTER , RUNDLER EVA , HAMMER BRUNO , BINEK JANEK
Published: March 2008

Atypical, cytoplasmic and perinuclear anti‐neutrophil cytoplasmic antibodies (x‐, c‐ and pANCA, respectively) are associated with a variety of inflammatory diseases, including inflammatory bowel disease (IBD). Anti‐neutrophil cytoplasmic antibodies are more common in patients with ulcerative colitis (UC) than in patients with Crohn's disease (CD). Most publications only refer to p‐ and cANCA in relation to IBD. We have prospectively evaluated the reactivity of sera from 58 patients with IBD and 10 healthy controls against human neutrophils with emphasis on the distinction of the ANCA types. The sera were incubated with ethanol‐ and formaldehyde‐fixed granulocytes to differentiate between c‐, p‐ and xANCA. The results showed that 10 of 24 patients with UC were positive for ANCA, whereas only one of 34 patients with CD was ANCA positive. These results correspond to a sensitivity of 42%, a specificity of 97%, a negative predictive value of 91% and a positive predictive value of 75% in UC. Of the 11 ANCA‐positive sera, two showed a cytoplasmic staining pattern, three showed a perinuclear and six an atypical staining pattern. The disease activity was not correlated to either the ANCA titre or to the presence of ANCA in the serum. In conclusion, ANCA are of limited value in differentiating between UC and CD. Because the majority of ANCA in patients with IBD are xANCA, these ANCA should be explored by not only incubating on ethanol‐fixed granulocytes, but also on formaldehyde‐fixed granulocytes.
Effect of Isoxsuprine on Secretion of Pulmonary Phospholipids in Fetal Rabbits
Authors: CORBET A. J. S. , FLAX PHILLIS , ALSTON CHERYL , RUDOLPH A. J.
Published: March 2008

Corbet, A. J. S., Flax, P., Alston, C., and Rudolph, A. J. (1979). Aust. Paediatr. J., 15, 7–9. Effect of isoxsuprine on secretion of pulmonary phospholipids in fetal rabbits. Isoxsuprine, a beta‐adrenergic agonist, was injected in fetal rabbits of 26.5 days gestation, and 2.5 hours later the lungs were lavaged and the fluid analysed for total phospholipids. A significantly greater return than in saline injected controls suggested that secretion of pulmonary phospholipids may be stimulated by isoxsuprine.
A Bibliography of Australian Paediatrics 1846–1900 PART III
Authors: SIMPSON SHEILA , TOVELL ANN , GANDEVIA B.
Published: March 2008

Part 1, 1846–1879, Aust. Paediatr. J., 1978 14 page 23, Gilibee, W. should read Gillbee, W. All references including and after Gillbee, W. as above, should be under the following heading:

Australian Medical Journal, Melbourne. 1856–1878, n.s. 1879–1895. In 1896 the Australian Medical Journal amalgamated with the Intercolonial Quarterly Journal of Medicine‐and Surgery as the Intercolonial Medical Journal of Australasia.

Part 2, 1880–1900, Aust. Paediatr. J., 1978, 14, page 95, title should read “A Bibliography of Australian Paediatrics, 1846–1900”

MELBOURNE MEDICAL RECORD, FORMERLY MEDICAL RECORD OF AUSTRALIA 1861/62–1877 (not all issues available)
Birth Injury With Unusual Clinical Features Simulating Werdnig Hoffmann Disease
Authors: KOLBER S. , ANDERSON R. McD. , CAMPBELL P. E. , ROY R. N. D.
Published: March 2008

Kolber, S., Anderson, R. McD., Campbell, P. E., and Roy, R. N. D. (1979).
Aust. Paediatr. J., 15, 47–48. Birth Injury with unusual features simulating Werdnig Hoffmann disease. The clinical and pathological details of a newborn with cerebral birth injury are presented. This case is presented because of the unusual finding of prolonged tongue fasciculation 3 hours after a short period of hypoxic hypoglossal nuclear damage. The pathological distinction between birth injury and Werdnig Hoffmann disease in general and in this particular case is discussed. The case illustrates the value of autopsy examination in resolving diagnostic difficulties particularly when there are genetic implications.
Total Parenteral Nutrition of Premature Infants 2. Requirement for Micronutrient Elements
Authors: JAMES B. E. , HENDRY P. G. , MacMAHON R. A.
Published: March 2008

James, B. E., Hendry, P. G., and MacMahon, R. A. (1979), Aust. Paediatr. J., 15, 67–71. Total parenteral nutrition of premature infants. 2. Requirement for micronutrient elements. By using metabolic balance studies we have investigated the ability of 5 small premature infants, fed intravenously with a formula based on L amino acid isomers, to retain 5 essential micronutrients (Fe, Zn, Cu, Mn, Cr).

For each element there was a significant correlation between the input and retention and, by analogy with fetal growth, tentative recommendations have been made for the rate of infusion of these elements into very low birthweight infants.
Nutritional Studies During Early Childhood I. Energy and Nutrient Intake
Authors: BOULTON T. J. C. , COOTE L. M.
Published: March 2008

Boulton, T. J. C., and Coote, L. M. (1979). Aust. Paediatr. J., 15, 72–80. Nutritional studies during early childhood. I. Energy and nutrient intake. The results are reported of a prospective, longitudinal, nutritional study of 391 infants, who were representative of the Adelaide population. The results include a description of the change in pattern of milk and solid food in‐take, the percentage contribution from carbohydrate, fat, and protein, and its relationship to the type of diet the child was having through infancy. The energy intake of these food classes is described, and the relationship to both the contribution from each nutrient group, and the type of milk formula used is described for each age studied.

It is proposed that these studies on normal Australian children provide evidence of the inter‐related nature of the qualitative and quantitative aspects of diet during infancy, and may form a basis for further studies on the relationships between nutrition and the growth of fatness, variation in blood pressure, and nutritional influence on lipoprotein metabolism.
Enumeration of Mucus‐Containing Cells, Mast Cells and Eosinophils in Nasal Smears From Atopic Children
Authors: KEMP A. S. , HOLSMAN P. D.
Published: March 2008

Kemp, A. S., and Holsman, P. D. (1979).
Aust. Paediatr. J., 15, 166–167. Enumeration of mucus‐containing cells, mast cells and eosinophils in nasal smears from atropic children. The nasal smear cyctology from a group of immediate hypersensitivity skin test positive children with the symptom of recurrent wheeze was compared with that of a group of skin test negative children. Mucus‐containing cells, eosinophils and mast cells were quantitated. Eighteen of the twenty smears from the skin test positive children showed increased numbers of at least one cell type. It is concluded that abnormal nasal cytology is a common finding in atopic children with recurrent wheeze and that nasal pathology may be reflected in increased numbers of mucus‐containing cells, mast cells or eosinophils.
Rapid Diagnosis of Rotavirus Infection: Comparison of Electron Microscopy and Enzyme Linked Immunosorbent Assay (Elisa)
Authors: ROBERTON D. M. , HARRISON M. , HOSKING C. S. , ADAMS L. C. , BISHOP R. F.
Published: March 2008

Roberton, D. M., Harrison, M., Hosking, C.S., Adams, L. C. and Bishop, R. F. (1979).
Aust. Paediatr. J., 15, 229–232. Rapid diaggnosis of rotavirus infection: Comparison of electron microscopy and enzyme linked immunosorbent assay (ELISA). Commonly used methods for detecting rotavirus antigen in stool are either relatively insensitive (counter‐immuno‐electrophorosis) or suitable only for research laboratories (electron microscopy). In this paper we describe an enzyme linked immunosorbent assay that compares favourably with electron microscopy in terms of sensitivity and is adaptable for use in hospitals or for epidemiological studies in the field.
Cow's Milk Protein Sensitive Enteropathy (CMPSE): An Important Cause of Protracted Diarrhoea in Infancy
Authors: IYNGKARAN N. , ROBINSON M. J. , DAVIS K. A. , SUMITHRAN E. , KUMAR M. V. , ONG T. H. , YADAV M. , BOEY C. G. , LAM S. K. , PUTHUCHEARY S. D.
Published: March 2008

Iyngkaran, N., Robinson, M. J., Davis, K. A., Sumithran, E., Kumar, M. V., Ong, T. H., Yadav, M., Boey, C. G., Lam, S. K. and Puthucheary, S. D. (1979). Aust. Paediatr. J., 15, 266–270. Cow's milk protein sensitive enteropathy (CMPSE): an important cause of protracted diarrhoea in infancy. Twenty‐six infants with protracted diarrhoea were studied, and 21 were found to have cow's milk protein sensitive enteropathy. Associated secondary sugar intolerance was present in the majority of these infants, but the symptoms did not improve with a lactose‐free, cow's milk protein containing formula. Eleven infants tolerated and thrived well on a lactose and cow's milk protein‐free formula. Ten infants required total parenteral nutrition for periods of 1 to 3 weeks before they tolerated a lactose and cow's milk protein‐free formula orally. This limited study suggests that cow's milk protein sensitive enteropathy may be a major cause of protracted diarrhoea in infancy and that exclusion of cow's milk protein as well as lactose from the diet is essential in the nutritional rehabilitation of these infants. With careful manipulation of these special formulae the need for total parenteral nutrition may be obviated in many infants with protracted diarrhoea.
Aplasia of the First and Second Branchial Arches
Authors: WOON K. Y. , TAN K. L.
Published: March 2008

Woon, K. Y. and Tan, K. L. (1979). Aust. Paediatr. J., 15, 275–277. Aplasia of the first and second branchial arches. A case with the very rare syndrome of otocephaly is reported. It is possible to diagnose this condition in‐utero by radiography. Since this is a lethal condition, remedial action can be taken in early pregnancy.
Trends in paediatric care
Authors: KEWLEY GEOFFREY D.
Published: March 2008

This paper reviews reports and trends in paediatric care in Australia and overseas. In particular it looks at changes in primary care and in the management of community problems in paediatrics.
Neuro‐developmental assessment of the preterm neonate
Authors: BURNS YVONNE R.
Published: March 2008

The increasing number of surviving very small and high risk pre term neonates necessitates an understanding of neuro‐developmental assessment of these infants. Some relevant aspects of development are reviewed, and the many factors which may influence the type and quality of response during assessment are discussed. A rationale and method of assessment is presented and the interpretation of results discussed.
Scrotal involvement in Henoch Schonlein syndrome
Authors: PREBBLE JEFFREY J.
Published: March 2008

Three patients with Henoch Schonlein syndrome who had scrotal involvement are presented. This unusual feature must be distinguished from testicular torsion. An approach to diagnosis and management is discussed.
A critical appraisal of myelography at the Royal Children's Hospital, Brisbane, 1977–1979
Authors: MILLER M. N. , MASEL J. P.
Published: March 2008

ABSTRACT. A total of 54 myelograms were performed at the Royal Children's Hospital Brisbane over a three year period 1977 to 1979. These cases are reviewed. The relevant clinical features, the underlying pathology and the myelographic appearances are discussed. Myelography was of most value in the diagnosis and characterisation of intraspinal space occupying lesions. The presence of abnormal neurological signs was found to be significantly correlated with an abnormal myelogram.
Developmental screening in infancy — a critical appraisal of its value
Authors: CARMICHAEL ALLAN , WILLIAMS HOWARD E.
Published: March 2008

ABSTRACT. Developmental screening of 304 infants was assessed by comparing Denver Developmental Screening Test (DDST) results with clinical assessment of developmental delay at 42 weeks of age. It was shown that DDST screening was effective, but largely unnecessary for the majority of infants with major delays as these infants had been identified in the perinatal period and were being followed up. DDST screening also yielded few false positive results but failed to detect many infants with minor delays.

Developmental screening tests, including the DDST, applied as isolated examinations in infant populations are not recommended as many of the conditions being screened for are inadequately understood, their natural history unknown and the need for intervention and treatment unproven. However, all families with young children should be under regular health surveillance whereby the health, growth and development of infants and the way parents rear them is assessed and parents appropriately advised.
Massive pulmonary haemorrhage: a cause of sudden unexpected deaths in severely growth retarded infants
Authors: SLY PETER D. , DREW JOHN H.
Published: March 2008

ABSTRACT. To determine aetiological factors a seven year review of massive pulmonary haemorrhage (MPH) was performed at the Mercy Maternity Hospital, Melbourne and compared with 26,208 consecutive live births. Statistically significant correlations were found between MPH and prematurity, birth asphyxia, hyaline membrane disease, breech delivery, multiple births, fetal growth retardation, Caesarean delivery, and the presence of a patent ductus arteriosus. MPH was associated with a mortality of 92.6%.

Three severely growth retarded infants with unexpected MPH are presented. These cases indicate that severe intrauterine hypoxia is a major factor predisposing to MPH. Clinicians should be alert for the possibility of MPH in severely growth retarded infants and with vigilance and anticipation a more favourable outcome may be possible.
A simple method of duodenal juice collection in association with small bowel biopsy in children
Authors: FORD RODNEY P. K.
Published: March 2008

ABSTRACT. A simple method of obtaining duodenal juice in association with small bowel biopsy is described. A conventional adult feeding tube is attached to the semi‐stiff biopsy capsule tubing and carried into position by the capsule. This method enables several millilitres of duodenal fluid to be obtained in a few minutes and the biopsy to be taken with one intubation.
Infant botulism in Australia — a case report
Authors: SHIELD LLOYD K. , WILKINSON RUSSELL G. , RITCHIE MARGARET , KORMAN STANLEY
Published: March 2008

ABSTRACT. The syndrome of infant botulism was first recognised in late 1975 and the majority of cases reported have been from the United States of America. One case has been reported from the United Kingdom and one from Canada.

A three‐month‐old male infant from Victoria, Australia presented with constipation, marked hypotonia, limb weakness, ptosis, facial weakness and inability to suck and swallow. These abnormalities resolved and he returned to normal over the ensuing months.

A diagnosis of infant botulism was confirmed after the isolation of Clostridium botulinum type B from the faeces.

Infant botulism has now been recognised in four different countries and it is likely than with increasing awareness of this striking clinical syndrome, more cases will be identified.
Temperament in Australian infants
Authors: OBERKLAID FRANK , PRIOR MARGOT , GOLVAN DEBORAH , CLEMENTS ANTHONY , WILLIAMSON AUDREY
Published: March 2008

A convenience sample of 240 infants aged 4–8 months was studied to evaluate the suitability of a revised version of Carey's Infant Temperament Questionnaire (ITQ) for an Australian population. Data analyses indicated all item/dimension correlations significant at P<0.01 or better, satisfactory internal consistency of the instrument as measured by alpha coefficients, and test retest reliability of 0.79. Infants rated as having a ‘difficult’ temperament were significantly more likely to be reported as having problem behaviours. Significant differences were found between Australian and American inlants on three of the nine temperament dimensions — rhythmicity, activity and intensity. The results of this study indicate that this revised ITQ is suitable for use with Australian infants.
Clinical experience with systemic vasodilator therapy in the newborn infant
Authors: BUTT W. , BOHN D. , WHYTE H.
Published: March 2008

Newborn infants with impaired myocardial performance may not respond to inotropic drugs and volume loading. Vasodilator therapy was tried in 10 such patients and in most there was improvement in peripheral perfusion, blood pH, arterial oxygenation, blood pressure and urine output. No complications of these drugs were detected. Vasodilator therapy has a role in the management of the acutely sick newborn infant with clinical signs of low cardiac output.
Low birthweight and mortality in Australian Aboriginal babies at the Royal Darwin Hospital: A 15 year study
Authors: GOGNA N. K. , SMILEY M. , WALKER A.C. , FULLERTON P.
Published: March 2008

Abstract A retrospective analysis was made of all births at the Royal Darwin Hospital from 1 January 1969 to 31 December 1983. The births were divided into weight categories and racial groups (Aboriginal and non‐Aboriginal).

The study showed that there was a 23.2% incidence of low birthweight (LBW) babies (less than 2500 g) in Aboriginals compared with an incidence of 6.4% in non‐Aboriginals. It was found that Aboriginals had a better chance of surviving the neonatal periods than non‐Aboriginals of the same birthweight for all birthweights up to 2500 g. It is suggested that this occurred because most LBW Aboriginals were more mature than their birthweight would have suggested.

The perinatal and neonatal mortality, however, remains high in the Aboriginal babies and this can also be attributed to the high incidence of LBW babies in this group, and perhaps to the limited use of antenatal care by the Aboriginal mothers.
Childhood Kaposi's sarcoma in Papua New Guinea
Authors: SENGUPTA S. K. , EDWARDS K. , BLAIR A. , HAMILTON D. R. , NIBLET J. S.
Published: March 2008

Abstract In the country of Papua New Guinea, with its diverse population of nearly 3 million people, some disease patterns have a strange similarity to those seen in tropical Africa. Kaposi's sarcoma is a condition which is commonly seen in adult males; childhood Kaposi's sarcoma is relatively uncommon. Six cases, all males, aged from 6 months to 12 years have been detected since 1978. The primary organ involvement included skin in four cases, oral cavity in one case and lymph node in one case. The varied clinico‐pathological features are described. This is the first report of such cases from Papua New Guinea.
An immunogenetic study of juvenile chronic arthritis
Authors: MANNERS P. J. , DAWKINS R. L. , McCLUSKEY J. , HEWSON P. H.
Published: March 2008

Abstract Ninety‐seven patients from Western Australia and Victoria suffering from juvenile chronic arthritis (JCA) for longer than 1 year were studied with particular reference to immunogenetic markers in the sub‐groups of the disease. In the pauci‐articular group, the antigens DR5, DR8 and BW35 were increased in frequency. The phenotypes within the sub‐groups appeared distinctive despite the absence of any increase in the frequency of single antigens. Complement allotyping did not prove to be different from controls or within the sub‐groups for JCA.

This study supports the concept that patients with JCA have specific genetic characteristics and that sub‐groups of the disease are genetically distinct.
Adrenocortical responsiveness in neonates weaned from the ventilator with dexamethasone
Authors: ARNOLD J. D. , LESLIE G. I. , WILLIAMS G. , RACK P. , SILINK M.
Published: March 2008

Adrenocortical responsiveness was assessed in eight very low birthweight neonates who had bronchopulmonary dysplasia and had been weaned from mechanical ventilation using dexamethasone. Three of the eight infants did not respond to ACTH stimulation during the first week after cessation of dexamethasone, but all three responded normally when retested at least 1 month later. The present authors have thus demonstrated that some infants have at least temporary adrenocortical unresponsiveness after prolonged courses of glucocorticoid therapy, and suggest that adrenocortical function should be assessed in all infants who are weaned from mechanical ventilation using dexamethasone.
Successful management of late presentation neonatal oesophageal atresia with distal tracheo‐oesophageal fistula and significant pulmonary complications
Authors: YADAV K. , NAYAR P. M. , PATEL R. V.
Published: March 2008

The successful management of a neonate presenting with oesophageal atresia and a distal tracheo‐oesophageal fistula on the twelfth day of life is described. This case is the most delayed diagnosis associated with survival known to have been reported. There were significant pulmonary complications at presentation and initial treatment was by gastrostomy under local anaesthesia, followed by a delayed primary repair.
Haemoptysis: A case report with tetralogy of Fallot with absent pulmonary valve leaflets and anomalous origin of left pulmonary artery
Authors: EVERETT D. S. , ADAMS A. P. , MARTIN A.
Published: March 2008

A 6 month old female child with tetralogy of Fallot with absent pulmonary valve leaflets and anomalous origin of left pulmonary artery was admitted to hospital with a mild adenoviral lower respiratory tract infection. She had a large haemoptysis 1 week after admission, and recovered with simple supportive measures. This case illustrates a previously unreported complication of a rare anomaly.
The dangers of premature extubation after severe birth asphyxia
Authors: FLETCHER J. , SHANN F. , DUNCAN A.
Published: March 2008

Abstract The records of all 91 neonates with asphyxia who were referred to the Royal Children's Hospital in 1982 and 1983 were reviewed and information was obtained on their subsequent neurological outcome. Thirty children had been extubated after their initial resuscitation, before transfer to the Royal Children's Hospital; 21 of these children had been extubated despite the fact that they had taken more than 5 min to take their first breath, and 11 (52%) of them died (while none of the nine infants who breathed within 5 min died). A paediatrician was involved with two‐thirds of the 21 children who were extubated despite having more than 5 min to breathe. Twelve children required cardiac massage; seven of them were extubated and then reintubated before transfer, and six of the seven infants died. These findings suggest that many paediatricians are not aware of the importance of continuing ventilatory support in neonates who have suffered a severe asphyxial insult. Asphyxiated babies who require cardiac massage, and babies who do not start breathing within 5 min of birth, should not be extubated as soon as they have established regular respiration; they should remain intubated and be transferred to an intensive care unit.