bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhanced levels of C‐X‐C chemokine, human GROα, in Helicobacter pylori‐associated gastric disease*
Authors: SUZUKI HIDEKAZU , MORI MIKIJI , SAKAGUCHI AYA ANGELICA , SUZUKI MASAYUKI , MIURA SOICHIRO , ISHII HIROMASA
Published: March 2008

C‐X‐C Chemokines play an important role for neutrophil extravasation through microvessels. Although the level of interleukin (IL)‐8 is known to increase in the Helicobacter pylori‐infected gastric mucosa, another C‐X‐C chemokine, GROα, has not been evaluated in the H. pylori‐associated gastric mucosal injury. The present study was designed to investigate gastric contents of GROα in relation to those of IL‐8 in the gastric mucosa of H. pylori‐infected peptic ulcer patients. Thirty‐eight patients with gastric ulcer and 41 with gastritis underwent endoscopy with informed consent and 49 were found to be H. pylori positive and 30 H. pylori negative. Biopsies from the gastric corpus were performed in each patient to examine the H. pylori colonization by bacterial culture, the rapid urease test and histological specimens as well as measurement of the contents of human GROα and IL‐8. Helicobacter pylori infection was eradicated in 21 patients by triple therapy (lansoprazole 30mg, amoxycillin 2.0g, clarithromycin 600 mg; 2 weeks). The samples for GROα and IL‐8 assay were homogenized in 0.02% aprotinin containing phosphate‐buffered solution and the mucosal contents of GROα and IL‐8 in the supernatants were quantified by sandwich enzyme immunoassay methods. The levels of GROα and IL‐8 in H. pylori‐positive gastric mucosa were significantly higher than those in the H. pylori‐negative mucosa. There was a significant linear correlation between the levels of GROα and IL‐8 (r= 0.798, P < 0.01). After the eradication of H. pylori by the triple therapy, the levels of GROα and IL‐8 were significantly decreased. The GROα showed an increase in the H. pylori‐positive gastric mucosa in a similar fashion as IL‐8 contents, suggesting a pathogenetic role for GROα in H. pylori‐associated gastric mucosal injury.
What's new in colorectal cancer screening?
Authors: FROMMER DJ
Published: March 2008

There is now good evidence from case‐control studies and randomized controlled trials that screening average‐risk subjects for colorectal cancer using faecal occult blood tests reduces mortality. There is limited data indicating that screening sigmoidoscopy can also achieve this. There is no evidence yet that screening by colonoscopy or double contrast barium enema can reduce mortality. Calculations of cost‐effectiveness suggest that all of the above strategies should be economically worthwhile but there is no convincing evidence to suggest that one strategy is markedly more cost‐effective than the others. Further data on several aspects of screening are required before any decisions are made on which form(s) of screening should be offered nationwide.
Chronic hepatitis virus infection in children
Authors: CHANG MEI‐HWEI
Published: March 2008

Hepatitis B and C viruses (HBV and HCV) are the two main hepatitis viruses causing chronic liver diseases in children. In hyperendemic areas, nearly half of the primary infection in chronic HBV carriers occurs during the perinatal period through the transmission from hepatitis B e antigen (HBeAg)‐positive mothers. The other half are from horizontal transmission mainly through intrafamilial spread or injection using unsterilized needles. During the natural course of chronic HBV infection, spontaneous HBeAg/anti‐HBe seroconversion occurs very rarely (2% annually) before 3 years of age. After 3 years of age, the HBeAg seroconversion rate increases gradually to 5% per year. Those with mothers who are hepatitis B carriers tend to clear HBeAg slower than those whose mothers are non‐carriers. Transplacental HBeAg may cause T cell tolerance in infected children. Universal HBV immunization programmes have been effective in reducing the hepatitis B carrier rate more than 10‐fold, and the incidence of hepatocellular carcinoma in children has also been decreased significantly. Hepatitis C virus infection occurs mainly in high‐risk children, such as those who received blood products (blood diseases, malignancies, post‐open heart surgery etc.), children of HCV‐infected mothers, and in hyperendemic areas, from injection using unsterile needles. Mother‐to‐infant transmission occurs on average in 5% of infants of viraemic mothers. The maternal HCV‐RNA titre is the most important factor determining the infectivity. Chronicity developed in 60–80% of HCV‐infected children. Although transient or persistent elevation of aminotransferases occurs frequently in chronically HCV‐infected children, liver histology showed minimal or mild changes only. The most prevalent genotype of HCV in children is Ib. Screening of the blood products for HCV antibody has markedly reduced the rate of HCV infection in children at risk. However, vaccine development is needed to prevent mother‐to‐infant transmission and other routes of infections.
Low‐dose recombinant interferon therapy in anti‐HBe‐positive chronic hepatitis B in Asian Indians*
Authors: GUPTAN RAJ KUMAR C , THAKUR VARSHA , MALHOTRA VEENA , SARIN SHIV K
Published: March 2008

ABSTARACT

Approximately 15% of Indian patients with hepatitis B virus (HBV)‐related chronic liver disease (CLD) have infection with precore mutant forms. These patients are likely to have an aggressive course. There are equivocal reports of success with interferon therapy of mutant infection in the West. This therapy has not been evaluated in precore mutant‐related CLD in Asian Indians. Eighteen patients (mean age 38.2 ± 12 years, M: F: 17: 1) with biopsy proven CLD and precore mutant HBV infection (hepatitis B surface antigen (HBsAg) positive, hepatitis B e antigen (HBeAg) negative, anti‐HBe positive, HBV‐DNA positive) were included. Interferon alpha 2b was given at 3 mIU on alternate days for 4 months. Serology, determination of HBV‐DNA (both by dot‐blot hybridization and polymerase chain reaction) and liver biopsy were repeated after completion of the therapy. Response to interferon therapy was defined as loss of HBV‐DNA by dot‐blot hybridization. Thirteen (72.2%) patients responded to the treatment (responders). Mean alanine aminotransferase levels (83 ± 12 vs 55 ± 29 IU/L, P < 0.01) and the histological activity index (15 ± 1.4 vs 12 ± 1.3, P < 0.01) significantly decreased in the responders compared with initial values. Serum albumin levels also improved at the end of the therapy (3.5 ± 0.4 g/dL vs 3.8 ± 0.4 g/dL, P= 0.07). During follow up, seven of the 13 (54%) responders relapsed; cirrhotics relapsed more often than chronic hepatitis patients (P < 0.05). All 18 patients, however, continued to be HBV‐DNA positive at the end of follow up. This study concluded that:

1. Interferon therapy is beneficial, albeit to a limited extent, in HBV precore mutant‐related chronic liver disease in Asian Indians.

2. It is ineffective in eliminating the mutant HBV infection, which explains the high relapse rate.

3. Prolonged low‐dose interferon therapy alone or in combination with newer nucleoside analogues should be evaluated in these patients.
Analysis of the 13C‐urea breath test for detection of Helicobacter pylori infection based on the kinetics of Δ‐13CO2 using laser spectroscopy
Authors: TANAHASHI TOSHIHITO , KODAMA TADASHI , YAMAOKA YOSHIO , SAWAI NAOKI , TATSUMI YOSHIHIDE , KASHIMA KEI , HIGASHI YOJI , SASAKI YASUHITO
Published: March 2008

We have previously reported on laser spectroscopy as a simple alternative to mass spectrometry. To validate a simplified 13C‐urea breath test (UBT) with laser spectroscopy for the detection of Helicobacter pylori in clinical use, we evaluated the optimal time of breath sample collection. The 13C‐UBT was carried out on each of 102 infected and 70 non‐infected subjects (32 without eradication and 38 after eradication therapy). Breath samples were taken at five time points within 60 min followed by 100 mg of 13C‐urea administration. The ratio of 13CO2 to 12CO2 was measured using laser spectroscopy and the recovery of tracer in the exhaled breath was calculated. Results were compared with histological and culture examinations of gastric biopsies to establish the infection status. For statistical evaluation of 13C‐UBT, the optimal timing of breath sample collection was examined on the basis of the kinetics of Δ‐13CO2. In 32 H. pylori‐negative patients (without therapy), the mean ± 2SD of Δ‐13CO2 was at its minimum 20 min after urea ingestion whereas in H. pylori‐positive patients, the mean ± SD Δ‐13CO2 was maximum at 20 min. In addition, receiver operating characteristic (ROC) curve analysis showed that the cut‐off value was estimated between 2.5–3.0 per mil (‰) at 20 min before therapy. Based on the histology and culture results, the sensitivity, specificity and positive and negative predictive values were 98.0%, 100%, 100% and 94.1%, respectively. In conclusion, 13C‐UBT with laser spectroscopy is a non‐invasive, simple, sensitive and specific test to determine H. pylori status. Our findings suggest that in clinical use, measurements made at 20 min after substrate administration could be recommended for most sensitive and specific 13C‐UBT results.
Efficacy of hypothermic perfusion using University of Wisconsin solution in extended hepatectomy with hepatic inflow occlusion in a canine model
Authors: OHYA TOSHIHIRO , OHWADA SUSUMU , KAWASHIMA YOSHIYUKI , TANAHASHI YOSHIFUMI , TAKAHASHI TORU , ICHIKAWA HIDEAKI , TOMIZAWA NAOKI , MORISHITA YASUO
Published: March 2008

This study was designed to elucidate the efficacy of University of Wisconsin (UW) solution for preventing liver injury, when used as a hypothermic perfusate infused into the systemic circulation during extended hepatectomy with hepatic inflow occlusion. Adult mongrel dogs (9.5–17.5 kg, n= 14) were subjected to 75% hepatectomy under 60 min hepatic inflow occlusion. The animals were divided into two groups. The UW group (n= 7) underwent hypothermic perfusion using 4°C UW solution (core temperature of the liver: 12.3±0.2°C). The control group designated as the Ringer's lactate (LR) group (n= 7) underwent hypothermic perfusion using 4°C LR solution. The perfusate was introduced into the systemic circulation via the hepatic vein. Blood from the hepatic vein was sampled, and alanine amino‐transferase, purine nucleoside phosphorylase activities and the ammonia concentration were measured. The 7 day survival rate was higher in the UW group than in the LR group. The parameters of liver function were less significantly altered in the UW group than in the LR group. The plasma ammonia concentration was significantly (P<0.05) lower 6h after reperfusion in the UW group than in the LR group. A small volume of hypothermic perfusion of the liver using UW solution was safe if it returned to systemic circulation. Hypothermic perfusion of the liver using UW solution may be effective for preventing hepatic tissue injury during extended hepatectomy with hepatic vascular occlusion.
GENETIC ASPECTS OF INTESTINAL SUCRASE‐ISOMALTASE DEFICIENCY
Authors: KERRY K. R. , TOWNLEY R. R. W.
Published: March 2008

SYNOPSIS

Disaccharidase levels in duodenal biopsy specimens from parents and siblings of 4 children presenting with symptoms of intestinal sucrase and isomaltase deficiency have been compared with those from a group of normal adults and children. The data obtained indicate a recessive mode of inheritance of this double enzyme deficiency.

It is suggested that intestinal sucrase‐isomaltase deficiency might not be rare, and the means by which the homozygotes and heterozygotes for this disorder could be identified by quantitative disaccharidase assay, are proposed.
THE INVESTIGATION OF DISORDERS OF CALCIUM METABOLISM IN CHILDHOOD
Authors: McCREDIE D. A. , McINTYRE I. P.
Published: March 2008

SYNOPSIS

Tests used in the investigation of Ca metabolism are discussed and the techniques and precautions described in some detail. A brief account is given of the conditions studied and of how these tests have proved useful in diagnosis and management. Particular reference is made to the use of blood and urine levels, Ca absorption studies, intravenous infusion of Ca and of bone biopsy.
THE USE OF A MEDIUM CHAIN TRIGLYCERIDE DIET IN CHYLOPERITONEUM
Authors: GRACEY M. , GOOCH PATRICIA M.
Published: March 2008

SYNOPSIS

The use of a medium chain triglyceride diet in a child with tuberculosis and chyloperitoneum is reported for the first time. The rationale and apparent therapeutic success of the diet are discussed.
THE DIAGNOSIS OF BACTERIURIA BY BLADDER PUNCTURE IN INFANCY AND CHILDHOOD
Authors: SHANNON F. T. , SEPP E. , ROSE G. R.
Published: March 2008

Experience with supra‐pubic aspiration of urine in two hundred and thirty infants and children suggests that this is a safe and reliable technique. Bacteriological examination of urine obtained in this manner, contrasted with concurrent specimens obtained by more orthodox techniques, indicates that the latter may give false evidence of infection in over 60% of specimens.
HYPOKALAEMIA AS A CONSISTENT FEATURE OF FULMINANT MENINGOCOCCAL SEPTICAEMIA
Authors: MAUGER D. C.
Published: March 2008

SYNOPSIS

The records of 25 consecutive children with meningococcal septicaemia in the years 1964–1969 have been reviewed. Those with hypotension developed hypokalaemia within 6 hours after admission.

It is suggested that vigorous potassium therapy may be required to prevent the effects of hypokalaemia on cardiac contractility, and on cardiac rhythm in the digitalised patient.
NEUROLOGIC HANDICAPS AFTER LOW OESTRIOL EXCRETIONS IN PREGNANCY
Authors: BUTLER I. J. , HOPKINS I. J. , SMITH M. A.
Published: March 2008

SYNOPSIS

In a retrospective follow‐up study of 50 pregnancies with low urinary excretion of oestriol, there were 6 neonatal deaths; 5 of 23 survivors who could be traced had definite neurological handicaps, and 6 had minor abnormalities of uncertain significance. There was a high incidence of retardation of infra‐uterine growth.

Other causes of low oestriol excretion (maternal hypo‐adrenalism, hepatic and renal insufficiency, and anencephaly) were also encountered. Prospective and controlled studies are required to study further the relationship of low urinary oestriol excretion to neurologic handicap, and the value of the test in assessing the need for obstetric intervention.
THE ROTHMUND‐THOMSON SYNDROME: Case Report of an Unusual Syndrome
Authors: OATES R. K. , LEWIS M. B. , WALKER‐SMITH J. A.
Published: March 2008

SYNOPSIS

A child with the clinical features of the Rothmund‐Thomson syndrome was first seen with recurrent chest infections and elevated sweat electrolytes, but these reverted to normal. The features of the syndrome and the causes of elevated sweat electroylte levels are discussed.
THE FAECAL EXCRETION OF LOW MOLECULAR WEIGHT FATTY ACIDS IN PREMATURE BABIES
Authors: ANYON C. P. , CLARKSON K. G.
Published: March 2008

Synopsis

A study of the excretion of low‐molecular weight fatty acids in the faeces of 10 premature babies is presented. It is suggested that the differences demonstrated at different ages are due to the presence of fermentation of carbohydrate in the bowel early in life, and that this process gradually disappears as artificially fed babies become more mature.
BILATERAL CONGENITAL CHOANAL ATRESIA ASSOCIATED WITH ANOMALIES OF THE FOREGUT
Authors: BUCKFIELD P. M. , HOLDAWAY M. D. , HOROWITZ S. , KEAN M. R.
Published: March 2008

Synopsis

3 patients with bilateral osseous congenital choanal atresia (CCA) are described. In each instance there were associated anomalies of the foregut. The necessity for early diagnosis of bilateral CCA is discussed. Management involves decisions about the timing and type of surgery to remove the obstruction. A method of ensuring an adequate airway until an infant can withstand surgery is described and an operative technique for removal of the obstruction via the anterior nares, which gave good results in 2 out of the 3 patients, is outlined.
THE SECULAR TREND IN THE AGE OF MENARCHE IN AUSTRALIAN SCHOOLGIRLS
Authors: HARPER JULIET , COLLINS J. K.
Published: March 2008

SYNOPSIS

Statistics derived from a sample of 1391 schoolgirls drawn from both state and private schools showed the mean age of menarche to be 12.65 years. Selected schools were included to give a representative sample in terms of geographical and social class distribution. The onset of puberty was found to be normally distributed within the age range 9 years to 15 years 8 months. After an examination of the results of previous Australian studies, evidence was found which suggested a secular trend in the onset of puberty with fluctuations paralleling times of economic crisis.
OBSERVATIONS ON THE PROGNOSIS AND COURSE OF THE IDIOPATHIC RESPIRATORY DISTRESS SYNDROME
Authors: CORBET A. J. S. , BURNARD E. D.
Published: March 2008

SYNOPSIS

In a group of dyspnoeic babies, the great majority suffering from hyaline membrane disease, blood gas measurements were made at regular intervals and analysed with respect to prognosis and also to the natural history of the illness. A good indication of the prognosis was obtained from considerations of both the birth weight, and certain blood gas criteria in the first 12 hours of life.
SCREENING FOR AMINOACIDURIA: A CRITICAL EVALUATION OF FOUR TECHNIQUES AND A SURVEY OF A MENTALLY RETARDED POPULATION*
Authors: TIPPETT PATRICIA A. , DANKS D. M. , DIMECH LINDA
Published: March 2008

SYNOPSIS

Ascending and descending chromatography on paper, ascending chromatography on prepared thin‐layer plates, and high voltage electrophoresis (HVE) on paper, were compared to determine the methods of choice for the detection of aminoaciduria in the newborn community of Victoria (70,000 per year) and among babies with suggestive symptoms (up to 100–200 per week). All methods were found reproducible and of very similar cost (7.3 cents to 9.9 cents per sample). HVE was clearly the most sensitive method and appears to be the best methods for testing symptomatic patients. However, the work load involved in community screening is more readily handled by thin‐layer chromatography which proved more sensitive than paper chromatography.

An HVE survey of 1,067 mentally retarded children and 725 children of low normal and borderline intelligence confirmed the presence of 21 patients with phenylketonuria, 1 with tyrosinaemia, 4 with various forms of cystinuria and 2 with sarcosinaemia.
PITFALLS IN THE PRENATAL DIAGNOSIS OF TAY‐SACHS DISEASE
Authors: MICHAEL C. A. , HAHNEL R. , HOCKEY A. , WYSOCKI S.
Published: March 2008

SYNOPSIS

A case report of an error in the prenatal diagnosis of Tay‐Sach's disease is presented. It is emphasised that errors can occur in the biochemical investigation of hexosaminidase A in cultural amniotic fluid cells and results may be falsely regarded as excluding the diagnosis. It is suggested that more reliance should be placed on the examination of fresh amniotic fluid when prenatal diagnosis is undertaken.
PAROTID SEROUS HYPERSECRETION IN CYSTIC FIBROSIS
Authors: BLOMFIELD JEANETTE , ALLARS HELEN M. , RUSH ANNE R. , LENNEP E. W. VAN , BROWN J. M.
Published: March 2008

SYNOPSIS

Citric acid‐stimulated parotid saliva was collected from 42 patients with cystic fibrosis (CF) and from 40 control subjects.

Despite considerable overlap of the values from the CF and the control group, the mean concentrations of calcium, amylase and protein were statistically significantly elevated in the CF patients. Five of the CF patients showed marked parotid serous hypersecretion.

Parotid saliva samples with elevated protein concentrations became turbid on cooling to 20°. By electron microscopy, the turbid material had the appearance of a colloidal suspension of coalescing droplets.
IMMUNOBIOLOGY OF CHILDHOOD DISEASES
Authors: JOSE DAVID G.
Published: March 2008

SYNOPSIS

A large part of clinical paediatrics deals with infectious disease, inflammatory conditions, allergy, auto‐immune disease and cancer. The immune system plays a critical role in these diseases and in addition presents a perplexing number of conditions arising from defects in the immune system itself. This review seeks to highlight immune mechanisms in selected diseases of children and to explore the clinical value of these mechanisms in terms of diagnostic or therapeutic application. Some of the principles and mechanisms involved in immune defence have been previously considered (Jose, 1973).
BALANCED (2q‐; 14q+) TRANSLOCATION
Authors: FITZGERALD MARGARET G.
Published: March 2008

SYNOPSIS

A child presented at 6 years of age with virilization presumed due to maternal progesterone therapy during pregnancy. She was found to have a balanced translocation involving chromosomes 2 and 14.
FEMINIZING ADRENAL ADENOMA IN A FIVE YEAR OLD BOY
Authors: LEDITSCHKE J. F. , ARDEN F.
Published: March 2008

SYNOPSIS

This is the sixth recorded case of a feminizing adrenal tumour in a boy. He presented with bilateral gynaecomastia, advanced bone age, and elevated urinary ketosteroids and oestrogens. The breast changes and hormone values returned to normal following removal of a large left adrenal tumour. The prognosis is discussed in relation to the previously reported cases in children and adults.
Balance Studies of Nine Elements during Complete Intravenous Feeding of Small Premature Infants1
Authors: JAMES B. E. , MacMAHON R. A.
Published: March 2008

James, B. E. and MacMahon, R. A. (1976).
Aust. paediat. J., 12, 154–162. Balance studies of 9 elements during complete intravenous feeding of small premature infants. During the course of a study of complete intravenous feeding of premature infants weighing less than 1,050 g, metabolic balance studies were performed on 4 surviving infants for 5 major nutrient elements: sodium, potassium, calcium, magnesium and phosphorus; and 4 trace elements: iron, zinc, copper and manganese. These studies determined the amounts retained when these elements were given intravenously.

There was a significant correlation between the input and retention of each of these elements except zinc, and the data obtained have been used to derive tentative recommendations for the rate of infusion of these elements into the small premature infant.
Autoantibodies, Immunoglobulins and Hepatitis B Antigen in Children with Chronic Liver Disease
Authors: DUBOIS R. S.
Published: March 2008

Dubois, R. S. (1976).
Aust. paediat. J., 12, 163–166. Autoantibodies, immunoglohulins and hepatitis B antigen in children with chronic liver disease. Smooth muscle antibody, mitochondrial antibody, serum immunoglobulin levels and hepatitis‐B antigen (HBAg) were measured in the sera of 20 children with extra‐hepatic biliary atresia, 8 with intra‐hepatic biliary atresia and 6 with post‐hepatitic (neonatal) cirrhosis. Smooth muscle antibody was not found in any patient with post‐hepatitic cirrhosis, but was present in 4 of 20 patients with extra‐hepatic and in 4 of 8 with intra‐hepatic biliary atresia. Serum immunoglobulins, particularly IgA. were elevated in the presence of cirrhosis. Serum IgA was markedly elevated in those infants with hepatic decompensation. No patient had mitochondrial antibody, despite the presence of prolonged extra‐ or intra‐hepatic biliary obstruction. HBAg was negative in all patients.
Effect of Posture on the Presence of Fat in Tracheal Aspirate in Neonates
Authors: HEWITT VALERIE M.
Published: March 2008

Hewitt, V. M. (1976).
Aust. paediat. J., 12, 267–271. Effect of posture on the presence of fat in tracheal aspirate in neonates. To determine whether aspiration in neonates is influenced by nursing posture, tracheal aspirate was obtained from 86 milk‐fed infants in the special‐care nurseries and examined for fat‐filled macrophages. These were present in 7 of 22 infants nursed prone (32%), 13 of 18 nursed supine (77%), and 28 of 46 whose posture was varied (61%). The results obtained in the prone group were significantly different from either of the other 2 groups (p< 0.025) and supports the hypothesis that nursing infants in the prone position lessens the risk of milk aspiration.
Diagnosis of 11β Hydroxylase Deficiency in Two Children with Congenital Adrenal Hyperplasia
Authors: KREUTZMANN D. , VINES R.H. , HENSLEY W.J. , SILINK M.
Published: March 2008

Kreutzmann, D., Vines, R. H., Hensley, W. J., and Silink, M. (1979).
Aust. Paediatr. J., 15, 36–38. Diagnosis of 11β Hydroxylase deficiency in two children with congenital adrenal hyperplasia: In 1956, Eberlein and Bongiovanni showed that 11 deoxycortisol was the main plasma steroid in patients with congenital adrenal hyperplasia (CAH) due to 11β Hydroxylase deficiency. Only recently with the development of radio‐immunoassay technique has it been possible to readily measure this steroid in plasma of children. In this paper we report the results of plasma and urinary determinations from investigations on two brothers with CAH leading to a diagnosis of 11β Hydroxylase deficiency.
Hereditary Hyperammonaemic Syndromes — A Six Year Experience
Authors: HAAN E. A. , DANKS D. M. , HOOGENRAAD N. J. , ROGERS J. G.
Published: March 2008

Haan, E. A., Danks, D. M., Hoogenraad, N. J., and Rogers, J. G. (1979).
Aust. Paediatr. J., 15, 142–146. Hereditary hyperammonaemic syndromes. A six year experience. Over a six year period (1973–1978) we have managed 13 children with hereditary hyperammonaemia. Nine of these had ornithine transcarbamylase deficiency. Early recognition and treatment of hyperammonaemia is necessary for salvage of infants capable of survival. In children whose disease is lethal, aetiologic diagnosis should be made for the purposes of genetic counselling, carrier detection and prenatal diagnosis.
Glucose Tolerance in Very Low Birthweight Infants
Authors: YU V. Y. H. , JAMES B. E. , HENDRY P. G. , MacMAHON R. A.
Published: March 2008

Yu, V. Y. H., James, B. E., Hendry, P. G. and MacMahon, R. A. (1979).
Aust. Paediatr. J., 15, 147–151 Glucose tolerance in very low birthweight infants. The carbohydrate intake and incidence of hyperglycaemia were reviewed in 40 very low birthweight infants with a birthweight of less than 1200g who were randomly assigned to total parenteral nutrition (TPN) or oral (MILK) feeding regimens during the first two weeks after birth. With increasing glucose tolerance after birth, the carbohydrate intake was increased from a mean intake of 8g/kg.d on Day 1 to 17g/kg.d in the TPN group and 12g/kg.d in the MILK group by the second week; the lower intake in the latter group was due to a restricted intake rather than decreased glucose tolerance. Twenty‐seven per cent of the infants had moderate or severe hyperglycaemia in the first week compared with 13% in the second week, in spite of the higher carbohydrate intake in the latter period. All hyperglycaemic episodes were corrected promptly without obvious serious sequelae by decreasing the rate of carbohydrate intake. The rational approach to carbohydrate administration in the very low birthweight infant includes the calculation of carbohydrate intake in terms of g/kg.d (rather than arbitrary concentrations given at variable rates based on fluid requirement), a constant infusion at a steady rate, and the close monitoring of blood glucose to establish glucose tolerance limits which increase with postnatal age.
Iatrogenic Hazards of Neonatal Intensive Care in Extremely Low Birthweight Infants
Authors: YU V. Y. H. , HEWSON P. H. , HOLLINGSWORTH E.
Published: March 2008

Yu, V. Y. H., Hewson, P. H. and Hollingsworth, E. (1979). Aust. Paediatr. J., 15, 233–237. Iatrogenic hazards of neonatal intensive care in extremely low birthweight infants. The history of neonatal paediatrics has evidenced over‐enthusiasm in the introduction of innovations in management which are almost always accompanied by unforseen hazards. We have scrutinised present practices in the intensive care of 55 infants weighing < 1000 g at birth, which might be responsible for the current trends in iatrogenic disease patterns. Umbilical arterial catheterization was associated with a 29% complication rate. Hyperoxia was documented in 81% of infants during oxygen therapy. Retrolental fibroplasia was present in 1 survivor. Blood sampling for microbiochemical and haematological monitoring increased the need for replacement blood transfusions. Postnatally acquired cytomegalovirus infection occurred in 4 infants, 3 of whom were probably infected from transfused blood. Complications associated with current nutritional management included hyperglycaemia, hypocalcaemia and hyponatraemia. Iatrogenic factors might have contributed to the occurrence of necrotizing enterocolitis, patent ductus arteriosus and cholestatic jaundice. We conclude that current neonatal intensive care practices need ongoing scrutiny and great caution should be taken in introducing new advances.
Role of Autonomic Nervous System Controlling Secretion Of Pulmonary Phospholipids in the Rabbit at Birth
Authors: CORBET A. J. S. , FLAX PHYLLIS , 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, 238–242. Role of autonomic nervous system controlling secretion of pulmonary phospholipids in the rabbit at birth. Saline, propranolol or atropine was injected into 29.5 day fetal and newborn rabbits, and after 15 minutes they were sacrificed at delivery or allowed to breath room air for a further 45 minutes. Then the lungs were lavaged with physiological saline and measurements made of total phospholipid in lavage fluid. From the lungs of nonbreathing fetal and newborn rabbits injected with saline, propranolol or atropine, recovery of phospholipid was a mean of 5.0, 4.2 and 5.2 micrograms per gram dry lung weight per gram body weight respectively. Breathing for 45 minutes was associated with an increase to mean values of 7.6 p <0.05), 6.7 (p<0.05) and 5.6 micrograms per gram dry lung weight per gram body weight respectively. These results were interpreted to mean that the normal increase of pulmonary phospholipid secretion associated with the onset of breathing at birth could be inhibited by atropine, but not by propranolol. This suggests that the secretory process associated with breathing is under control of the parasympathetic nervous system.
Some Statistical and Climatological Aspects of the Incidence of the Sudden Infant Death Syndrome
Authors: DEACON E. L. , O'REILLY M. J. J. , WILLIAMS A. L.
Published: March 2008

Deacon, E. L., O'Reilly, M. J. J. and Williams, A. L. (1979).
Aust. Paediatr. J., 15, 248–254. Some statistical and climatological aspects of the incidence of the sudden infant death syndrome. SIDS data for the Statistical Divisions of Melbourne (1973–77) and Brisbane (1968–77) show there to be only a small seasonal variation in the deaths of infants 2–13 weeks of age, but for the older cases the variation is much stronger, particularly in the Melbourne area. There is no evidence of any time‐clustering of deaths in the 2–13 weeks age group in either area, nor is there in the 14–25 weeks age group in Melbourne's colder months. Consistent with a random process, the variance of Brisbane's annual number of cases from the 10‐year mean is close to that for a Poisson distribution. In conjunction with published data for other communities. It is found that the incidence of SIDS correlates closely with a climatic index in terms of mean annual percentage of cold‐wet weather. This suggests a connection with the amount of respiratory infection in the general population, but other factors may be involved, such as time spent outdoors.
Fasting plasma glucose in children
Authors: BROWN T.C.K. , CONNELLY JOHN F. , DUNLOP MARJORIE E. , McDOUGALL PETER N. , TIBBALLS JAMES
Published: March 2008

Fasting plasma glucose levels were measured in samples taken preoperatively in 116 patients, it was found that mean plasma glucose levels increased with age and that there was no relationship between the period of fasting and plasma glucose concentrations. Fewer children had levels below 3 mmols/l than in other reported series.
The paediatrician and the sexually abused child
Authors: CONNELL HELEN M.
Published: March 2008

Sexual abuse is an aspect of cruelty to children which merits greater scientific attention. It has potential for damaging the mental health of the victim and intergenerational cycles of this behaviour pattern may develop. The paediatrician is in a position to detect children at risk and may be able to intervene.

Three types of sexual abuse are described (i) single sexual attacks which may be accompanied by physical violence: (ii) sexual exploitation of children for financial gain, and (iii) longstanding sexual relationships, generally between girls and father figures; these are far the most common.

Although it is hard to separate the effects of premature sexual experience from other adverse environmental influences. the child victim of longstanding sexual abuse emerges immature, with considerable confusion as to her role in the family, and with constricted personality development. Her primary motivation is attention seeking, and she adopts sexual activity with an adult as a means of survival in often deplorable conditions. The sensitivity of management following the assault being made public is an important factor in determining eventual adjustment.
Lobar emphysema complicating hyaline membrane disease
Authors: MITCHELL J. K. , MELLIS C. M.
Published: March 2008

A pre‐term infant with severe hyaline membrane disease (HMD), requiring intubation and mechanical ventilation, who developed bronchopulmonary dysplasia (BPD), which was followed by lobar emphysema in the right lower lobe is presented. Surgical removal of the right lower lobe led to prompt improvement in the oxygen requirements and subsequent recovery of the infant's respiratory distress. Pathology revealed marked stenosis of the right lower lobe bronchus and air‐trapping, without destruction of alveoli. The lobar bronchus contained adequate cartilage, but deficient muscle at the site of stenosis. It seems likely that this bronchial stenosis, and resultant lobar emphysema was not congenital, but was a complication of HMD, BPD or therapy.
Neonatal jaundice in twins
Authors: Tan K. L.
Published: March 2008

Bilirubin levels in Chinese homozygous twins who were clinically well at delivery with no evidence of isoimmunization or the twin transfusion syndrome were studied.

It was demonstrated that order of delivery, birth weight or haemoglobin level of the twins did not seem to have any significant effect on the bilirubin levels in the first week of life. The bilirubin levels were in fact similar to those of singletons.

Twinning does not seem to have any significant effect on the bilirubin levels of newborn infants.
HLA system in Chinese children with insulin‐dependent diabetes mellitus
Authors: LEE BEE WAH , CHAN SON HA , TAN SIOK HOON , WONG HOCK BOON , TAN CHENG LIM
Published: March 2008

ABSTRACT. HLA in 12 unrelated Chinese paediatric patients with insulin dependent diabetes mellitus (IDDM) were found to have an increased frequency of BW22, B17 and AW33.

BW22 was observed in 5/12 (41.7%) of IDDM patients compared to 40/330 normal unrelated Chinese controls (p < 0.005, RR = 5.2). AW33 and B17 were observed in 6/12 (50.0%) and 7/12 (58.3%) of IDDM patients respectively, compared to 36/330 and 46/330 in the normal controls respectively (AW33: corrected p < 0.0026, RR = 8.2, B17: corrected p < 0.0026, RR = 8.6). HLA B8, B15 and B18 did not demonstrate any significant association with IDDM in this series of patients. The results of this study further emphasize the well recognized race specificity in HLA antigen distribution in normal population as well as disease states.
Intravenous verapamil in the treatment of paroxysmal supraventricular tachycardia in children
Authors: LEITNER R. P. , HAWKER R. E. , CELERMAJER J. M.
Published: March 2008

ABSTRACT. Fifty‐four spontaneous episodes of paroxysmal supraventricular tachycardia (PSVT) in 23 patients, varying in age from one day to fourteen years, were treated with intravenous verapamil according to a specific protocol.

Stable sinus rhythm was obtained promptly with no side effects in 76% of episodes. There was no response in 9%; an unstable rhythm in 7.5%; and severe side effects (hypotension, sinus bradycardia and cardio‐respiratory arrest) in 7.5%. All severe side effects were associated with larger than recommended doses of verapamil.

Intravenous verapamil reverted 100% of all episodes of idiopathic PSVT in eight patients; 83% of episodes in five patients with congenital heart disease; and only 57% of episodes in nine patients with Wolff‐Parkinson‐White syndrome. It was ineffective in one neonate who had had intra‐uterine SVT.
Henoch‐Schönlein purpura — a surgical review
Authors: HARVEY JOHN G. , COLDITZ PAUL B.
Published: March 2008

A review of the complication associated with Henoch‐Schonlein purpura is presented with particular reference to those requiring surgical management. Gastrointestinal involvement occurred in 105 patients and was complicated by Intussusception in three patients and by perforation in one. Laparotomy was undertaken In to patients. Involvement of the scrotum and testis occurred in 29 patients and suggested torsion of the testis on occasion. Renal involvement occurred in 45 patients and was associated with renal impairment in six. Recommendations for the management of surgical complications are discussed.
Review of thoracic neuroblastoma
Authors: GOON H. K. , COHEN D. H. , HARVEY J. G.
Published: March 2008

Twenty‐seven cases of thoracic neuroblastoma were reviewed. Thirteen cases (48%) survived, 11 for more than 2 years and two for more than 14 months. Surgery is the treatment of choice and complete excision appears to give the best result. However, radical surgery is discouraged if the tumour is not readily removable. The use of chemotherapy and radiotherapy should be limited to Stage III and Stage IV disease and for palliation of soft tissue and bony secondaries. The clinical presentation was generally non‐specific with respect to the final diagnosis in this series. Significantly raised catecholamines were seen in 13 of 16 patients assessed (81%). Prognosis was related to the age at diagnosis, stage of disease and the histological type. The better prognosis seen in thoracic neuroblastoma in comparison with abdominal neuroblastoma may be related to the earlier presentation of the disease and the higher incidence of better differentiated tumours in the thorax. There appears to be an unknown additional factor that confers a better prognosis in patients under 1 year old.
Testicular relapse in childhood acute lymphoblastic leukaemia in Malaysia, 1967–82
Authors: LIN HAI‐PENG , TAIB NORAZIZAH M. , SINGH PERDAMEN , SINNIAH D. , LAM KHUAN‐LENG
Published: March 2008

From 1967–82,9 children with testicular relapse (TR) of acute lymphoblastic leukaemia (ALL) were diagnosed out of 99 boys treated, an incidence of 9.1%. The median time from the onset of ALL until diagnosis was 28 months (range 3–41 months). All were asymptomatic; six were detected on routine examination while three were diagnosed only on biopsy. Routine biopsy prior to stopping chemotherapy is useful in detecting occult TR. Biopsies should be done on both the testes regardless of the clinical findings. The age, leucocyte count and hepatosplenomegaly at diagnosis of ALL were not found to be significant factors in influencing relapse. Eight‐children were in bone marrow remission at the time of TR, but three had preceding or concurrent meningeal leukaemia while in the other five the testis was the first and only site of relapse. Radiotherapy was effective in local disease control but failed to prevent bone marrow relapse in all except two patients despite continuation of chemotherapy. The median time from onset of TR until bone marrow relapse was 7 months (range 3–13 months) and the median time until death, was 11 months (range 6–18 months). The frequency of testicular relapse may be related to the intensity of either the initial induction therapy or the consolidation chemotherapy. Further studies are required to determine whether the incidence of testicular relapse will decline with more intensive early treatment.
Primary health care for Indo‐Chinese children in Australia
Authors: CHAK STANLEY , NIXON JAMES , DUGDALE ALAN
Published: March 2008

This study reports the detailed analysis of 61 consecutive presentations by recent immigrants from Indo‐China to the Casualty Department of a modern Australian Children's Hospital. The parents/guardians were interviewed either in the Casualty Department or in their homes. Indo‐Chinese children coming to a Casualty Department manifested the same age distribution and spectrum of illnesses that is seen in the general Australian paediatric population. However, significantly fewer presentations to hospital occurred due to accidents/trauma when the group was compared with the general population attending the Casualty Department. Only 21%‐of the Vietnamese and Cambodian families can communicate satisfactorily with hospital staff without interpreter help. Fifty‐one per cent of parents reported that they did not have enough English for a medical interview without an interpreter. Twenty‐eight per cent did riot have enough English to communicate at all. Parents of Vietnamese children reported that on occasions they had not sought medical care for their children because of language difficulties. Many families do not know that an Interpreter Service is available, and many believe that access to such a service is available only through a doctor. Many of these children also use traditional Chinese remedies in the context of their contemporary Australian lives. We have found no evidence that this practice causes late presentation with deleterious effects, or any evidence that it compromises modern ‘Western’ treatment.
Ultrasonic fetal weight estimation in multiple and singleton pregnancy
Authors: LUKACS HEATHER A. , MacLENNAN ALASTAIR H. , VERCO PETER W.
Published: March 2008

Thirty‐five multiple and 168 singleton fetal weight estimations were made in an Australian population using the tables of Warsof et a/.,1 which have been computed from a North American population. The estimated fetal weights were compared to the actual birth weights within 96 h of estimation. Con‐elation coefficients of the actual birth weight with the estimated fetal weight for the total group, singleton and multiple pregnancies respectively, were 0.967,0.969 and 0.933. The percentages of estimated fetal weights falling within 10% of the actual birth weight were for the three groups, 79.3%, 77.9% and 85.7% respectively. Individual weight sub‐groups, <1500g, 1500–2500g, 2500–4000g and >4000g, showed correlation coefficients of 0.84,0.838. 0.839 and 0.759 respectively, which compare favourably to published studies of North American populations using this method. It is concluded that ultrasonic fetal weight estimation using the North American computerized tables of Warsof et al.1 is appropriate for an Australian population and is valid for both singleton and multiple pregnancies.
Fetal urinary tract abnormalities detected on maternal ultrasound
Authors: FORD W. D. A. , AHMED S. , VERCO P. W. , JUREIDINI K. F.
Published: March 2008

Twenty‐one cases of fetal urinary tract abnormalities were detected on maternal ultrasound in a 5 year period. Six fetuses died and 13 of the 15 surviving cases have had corrective urological surgery, usually during the neonatal period. Maternal ultrasound provides advanced warning of major urinary tract abnormalities in the newborn. Therefore, appropriate investigations and medical management can be instituted early and potentially destructive urological lesions can be corrected as soon as possible. As yet, antenatal intervention does not seem to be warranted as the most common cause of bilateral upper tract dilatation in the surviving cases in this series was primary reflux, and In the cases that died the urinary abnormalities were not salvagable.
Strangulated umbilical hernia in infancy
Authors: JEANS P. L. , WRIGHT J. E.
Published: March 2008

This is a case report of a 3‐month‐old infant with strangulation of the intestinal contents of an umbilical hernia.

There are only 11 other reported cases of this rarity and the conservative attitude to infant umbilical hernias should continue.
Non‐organic failure to thrive
Authors: OATES R. KIM
Published: March 2008

Abstract Non‐organic failure to thrive is a clinical diagnosis which should be considered in parallel with other causes of failure to thrive in infants. It has not been resolved as to whether the condition is due to a lack of stimulation or to deprivation of calories, although both these factors, as well as a contribution from the child in some cases, are likely to be responsible. There is no typical profile of the parent whose child develops non‐organic failure to thrive. The condition can occur in all social classes but is more common in situations of poverty, poor marital relationships, chaotic family lifestyle and when there is a history of deprivation in the parents' own childhood. Although the majority of these children eventually show catch‐up growth, long‐term follow‐up studies show a high incidence of emotional and cognitive problems. Treatment should go beyond nutritional rehabilitation in the hospital and should include practical, supportive help for the mother together with measures to improve the level of stimulation and the quality of interpersonal relationships for the child.
Progressive dystonia with marked diurnal fluctuation in a Chinese family
Authors: CHAN‐LUI W. Y. , LOW L. C. K.
Published: March 2008

Abstract Two children in a Chinese family with progressive dystonia with marked diurnal variation in symptoms are described. Treatment with L‐dopa resulted in complete disappearance of symptoms in one patient and marked improvement in the other patient.
Serratia: a problem in a neonatal nursery
Authors: FITZGERALD PHILOMENA , DREW JOHN H. , KRUSZELNICKI IRMA
Published: March 2008

We have noted an increased incidence of Serratia species isolates in our Special Care Nursery recently and have reviewed our experience over the 7 year period from 1976 to 1982. Fifty newborn infants had strains of Serratia isolated, 30 of which were found in 1982. Two strains of Serratia species were isolated: Serratia marcescens in 46 newborn infants and Serratia liquefaciens in six, with both types being found in two infants. All isolates were sensitive initially to gentamicin, kanamycin sulphate, chloramphenicol and co‐trimoxazole. However, resistance was documented subsequently to each of these antibiotics. Only 64% of isolates only were sensitive initially to ampicillin; 27% subsequently developed resistance Recent isolates were sensitive to cefotaxime sodium.

Twenty‐nine infants (58%) were colonized, and 1.6 (32%) had minor infections such as conjunctivitis. However in five infants (10%) life threatening illness occurred. Of the five infants with serious infection two had meningitis and three were septicaemtc; one infant died. In both infants with meningitis difficulty was experienced in eradicating the organism and porencephaly developed in both.
Transcutaneous oxygen monitoring in acute asthma
Authors: BOURCHIER DAVID , DAWSON KENNETH P.
Published: March 2008

Arterial blood oxygen tensions (Pao2) were compared with simultaneously obtained transcutaneous oxygen measurements (Tco2) in 15 children during an acute asthma attack and in 18 children with an illness other than asthma. A close correlation between Tco2 and Pao2 was obtained in the non‐asthmatic group but not in the asthmatics. It is suggested that impaired cutaneous blood flow may explain this poor correlation.
A case of agammaglobulinaemia complicated by meningoencephalitis due to Echo virus 27
Authors: FARMER KEITHA , MacARTHUR B. A. , DeZOETE J. ANNE , CROXSON MARGARET C.
Published: March 2008

A boy with agammaglobulinaemia diagnosed and treated from the age of 3 years 2 months developed encephalitis at 4 years 3 months. The illness showed a remitting but deteriorating course until death aged 6 years 5 months. Echo virus type 27 was isolated from the cerebrospinal fluid during the terminal illness. The virus was not isolated from five earlier cerebrospinal fluid samples nor was virus detected in a temporal lobe biopsy.