bluuebunny/crossref_metadata_2025 huggingface dataset:
Is acid base determination an accurate predictor of pyloric stenosis?
Authors: Oakley E A , Barnett P L J
Published: March 2003

Objective: To determine if acid base status predicts which vomiting patients have pyloric stenosis.

Design: Retrospective chart review.

Setting: Tertiary paediatric hospital.

Methodology: We compared the clinical and biochemical parameters of 100 patients with a discharge diagnosis of pyloric stenosis and 84 patients of a similar age who presented to the emergency department with vomiting and who had an acid base determination. Patients were included from January 1995 to January 1997. Clinical correlates consisted of age, duration of vomiting, weight loss, gestation, and family history of pyloric stenosis. Biochemical correlates were pH, bicarbonate, base excess (BE), chloride, potassium, and sodium.

Results: Independent variables of significance were pH, BE, chloride, bicarbonate, potassium, weight loss (all of which had a P value < 0.0001), and sex (P = 0.006). Each variable was placed in a logistic regression equation with pyloric stenosis being the dominant variable. Variables of significance were pH (P = 0.0001), BE (P = 0.0001), and chloride (P = 0.009). A model for predicting pyloric stenosis using these variables was then created with pH > 7.45, chloride < 98, and BE > +3, with a positive predictive value of 88%.

Conclusion: Acid base determination is a useful screening tool when considering pyloric stenosis. This model now needs to be validated on a prospective series of patients with vomiting.
Echocardiographic evaluation of cardiac functions and left ventricular mass in children with malnutrition
Authors: Öcal B , Ünal S , Zorlu P , Tezic HT , Oğuz D
Published: March 2003

Objective: This study was undertaken to assess the left ventricular mass (LV Mass) and systolic and diastolic functions of the left ventricle in children with protein energy malnutrition (PEM).

Methodology: Thirty children, aged between 2 months and 2 years with PEM (four kwashiorkor, seven marasmic– kwashiorkor, 19 marasmus), and 17 healthy, age‐matched children, using Doppler echocardiography were studied.

Results: The mean LV Mass in the patients was lower than that in the controls (14.5 ± 5.2 vs 19.8 ± 4.7 g, P < 0.05). However, the LV Mass/body surface area was not different in the patients with PEM and in the control group (52 ± 9.2 vs 53.9 ± 8.2g/m2, P > 0.05), indicating that LV Mass was reduced in proportion to decrease in body size in malnutrition. Left ventricular septal and posterior wall thickness in PEM were also lower than that in the controls, and the most significant reduction in the LV Mass, septal and posterior wall thickness were found in the kwashiorkor group. Cardiac output was reduced in proportion to decrease in body size in the patient group (1.6 ± 0.5 vs 2.1 ± 0.8 L/min, P < 0.05), therefore cardiac index was not significantly different between the patients and the control subjects (5.9 ± 1.4 vs 5.7 ± 1.6 L/min/m2, P > 0.05). Systolic function indices including ejection fraction, fractional shortening, and diastolic function indices were not significantly different in the groups.

Conclusions: We demonstrated that LV Mass and cardiac output were reduced in proportion to decrease in body size in patients with PEM, and LV systolic and diastolic functions were preserved in atrophic hearts.
Quantifying pulmonary hypertension in ventilated infants with bronchiolitis: A pilot study
Authors: Fitzgerald D , Davis GM , Rohlicek C , Gottesman R
Published: March 2003

Objective: To determine whether previously well infants ventilated for bronchiolitis have sufficiently elevated pulmonary artery pressures (PAP) to warrant a trial of inhaled nitric oxide (iNO) therapy.

Methods: Consecutive infants mechanically ventilated for bronchiolitis were offered Doppler echocardiography between 24 and 72 h after intubation. Patients were divided into those with normal PAP, mild, moderate or severe pulmonary hypertension. Patients with at least moderate pulmonary hypertension (systolic PAP > 30 mmHg and > 50% of systemic systolic arterial pressure) were offered a 60 min trial of iNO therapy at a concentration of 20 ppm and repeat echocardiography.

Results: Six infants (four preterm, two term) were studied at a mean corrected age of 13 weeks (4, 24). Respiratory syncytial virus was confirmed on immunofluorescence of nasal secretions in five of six subjects (84%). Echocardiography was performed (mean, 5.5 days) (95%CI 3.8–7.3) after the onset of symptoms. All patients had structurally normal hearts. Four patients had mild pulmonary artery hypertension and two had normal pulmonary artery pressures. None of the patients qualified for iNO therapy. The mean (range) duration of intubation was 14 days (9–19) and the duration of hospitalization was 28 days (14–42). All patients recovered.

Conclusion: Significant pulmonary hypertension should not be presumed in previously well preterm and term infants ventilated for bronchiolitis.
Environmental triggers of type 1 diabetes
Authors: Couper JJ
Published: March 2003

Abstract: High risk HLA class II alleles account for 40% of the genetic susceptibility to type 1 diabetes in Caucasians, but the majority of the genetically predisposed do not develop the disease. This supports some environmental modification of the autoimmune destruction of β cells that precedes type 1 diabetes. Identical twin studies and geographical variation in incidence also argue for a critical role of environmental factors. Attention has been directed to the possible harmful effect of cow's milk protein (or protective effect of breast‐feeding) and enteric infections in early life. Natural history studies that follow children at increased risk of type 1 diabetes provide the best opportunity to study environmental triggers. The Australian Baby Diab Study has followed approximately 500 babies from birth who have a first‐degree relative with type 1 diabetes. No prospective association between duration of breast‐feeding or introduction of cow's milk and the development of islet autoimmunity was found. The same Australian cohort demonstrated a relationship between rotavirus infection and the first appearance or increase in islet antibodies. Enteroviral infection is seen more frequently in prediabetic children and prior to the onset of islet autoimmunity in Finnish cohorts. Environmental factors may interact. Breast milk protects against enteric infections; enteric infections in turn could increase immunity to dietary antigens by increasing intestinal permeability. It is also possible that an alteration in gut mucosal immune function in genetically susceptible individuals underlies any effect of dietary or viral proteins on the development of islet autoimmunity in early life.
Shared bathing and drowning in infants and young children
Authors: Byard RW , De Koning C , Blackbourne B , Nadeau JM , Krous HF
Published: March 2003

Objective: A study was undertaken to look at possible risks of shared bathing in early childhood.

Methods: Autopsy databases were searched at the Women’s and Children’s Hospital and State Coroner’s Office, Adelaide, Australia, from January 1963 to December 1999, the Victorian Institute of Forensic Medicine, Melbourne, Australia, from January 1991 to December 1999, and the Children’s Hospital‐San Diego, San Diego, USA, from January 1990 to December 1999, for all cases registered as drowning in children aged 2 years and under who were in a bath with another child around the time of death.

Results: A total of 17 cases were found. The age range of the victims was 8–22 months (average = 11.8 months), with a male to female ratio of 10:7. The surviving children (who were all siblings) were significantly older, with an age range of 19–48 months (average = 30.4 months), and a male to female ratio of 12:5. (The survivors were on average 18.5 months older than the victims, range = 11–32 months). In every case the children had been left unsupervised for variable periods of time.

Conclusions: These cases represented a significant component – between 22 and 58%– of bath drownings in the 2 years and under age group. It would appear that shared bathing for young children and infants may only acceptable if adult supervision is constant, and that a young sibling is not an appropriate person to look after an infant or toddler in the bath. While the risk of leaving an infant in a filled bath may be exacerbated if an older child is also present, further population‐based studies are required to examine this hypothesis.
Utility of haematological parameters and C‐reactive protein in the detection of neonatal sepsis
Authors: Manucha V , Rusia U , Sikka M , Faridi MMA , Madan N
Published: March 2003

Objective:  To evaluate various haematological parameters, individually and in combination, to formulate a haematological scoring system (HSS, defined by Rodwell et al.), which can then be used to screen for sepsis in neonates who are clinically suspected of infection.1

Methods:  The study cohort consisted of 150 neonates (from birth to 3 days old) with clinically suspected infection. Blood was collected by peripheral venepuncture in all neonates. A complete blood count, differential leucocyte count, total leucocyte count (TLC), total neutrophil count (TNC), immature neutrophil count, band form count and platelet count were performed. Immature total neutrophil count (I/T) and immature/mature neutrophil count (I/M) ratios were then obtained. C‐reactive protein (CRP) was measured semiquantitatively and blood culture and antibiotic sensitivity were performed in each case. The haematological parameters were compared individually and in combination (by HSS) with CRP.

Results:  Twenty‐one (14%) neonates had blood culture proven sepsis. On evaluation of various haematological parameters, TLC < 10 × 109/L, TNC < 8 × 109/L, I/M > 0.25, I/T > 0.14, band count > 15% and platelet count < 150 × 109 were found to have optimal sensitivities and negative predictive values (NPV). Using these values, an HSS was formulated. A haematological score ≥ 3 had a sensitivity of 86% and NPV of 96%. C‐reactive protein as a single test had a sensitivity of 76% and NPV of 96%. A combination of CRP with haematological parameters decreased the sensitivity and NPV of the HSS.

Conclusions:  A haematological score can be obtained by a complete blood count and examination of peripheral blood smear, thus permitting an objective assessment of haematological changes that occur in a neonate suspected of sepsis. C‐reactive protein does not have any advantage over HSS, either as a single test or in combination.
Effectiveness of an individualized multidisciplinary programme for managing unsettled infants
Authors: Don N , McMahon C , Rossiter C
Published: March 2003

Objective:  To ascertain the effectiveness of an individualized multidisciplinary residential programme for managing young unsettled infants and whether changes in unsettled behaviour were maintained.

Methods:  One hundred and nine clients of a Tresillian residential unit with singleton infants aged less than 20 weeks were studied before, during and after intervention. Mothers completed a 24 h infant activity record prior to admission, during the stay and 1 month after discharge. Intervention consisted of settling techniques, parent education, support and counselling.

Results:  By day 4 of admission, the mean duration of unsettled (fussing, crying) behaviour had decreased significantly and mean sleeping time and awake/content times both increased significantly (P < 0.001). These changes were maintained 1 month after discharge. Changes in behaviour were particularly marked for very unsettled infants.

Conclusions:  In the absence of formal controls, the individualized programme appears effective in managing the behaviour of unsettled infants.
Shopping trolley‐related injuries to children in New Zealand, 1988–97
Authors: Parry ML , Morrison LGL , Chalmers DJ , Wright CS
Published: March 2003

Objective: To describe the epidemiology of shopping trolley related injuries (fatalities and hospitalizations) to children in New Zealand prior to the introduction of a voluntary standard for shopping trolleys.

Methodology: To identify cases, a key word search was conducted of national mortality and hospitalization databases for the years 1988–97. Cases were limited to children under 15 years of age.

Results: For the 10 year period investigated, 282 hospitalizations and no
fatalities were identified. A significant increasing trend for hospitalizations was
detected (χ2 = 17.6, 1 d.f.; P < 0.001). Ninety‐two per cent of children hospitalized were aged under 5 years and two‐thirds were aged 2 years or younger. Ninety per cent of injuries resulted from falls from trolleys, 84% of injuries were to the head or face and 22% were rated serious (AIS‐3) on the Abbreviated Injury Scale.

Conclusions: The incidence of injuries associated with shopping trolleys increased between 1988 and 1997. Following the introduction of a voluntary standard for shopping trolleys in 1999, which included specifications for child harnesses, trends in injury should be monitored.
Growth and adrenal suppression in asthmatic children on moderate to high doses of fluticasone propionate
Authors: Wong JYW , Zacharin MR , Hocking N , Robinson PJ
Published: March 2003

Objective: Growth and adrenal suppression have been reported in asthmatic children using high‐dose inhaled fluticasone propionate (FP). Inhaled FP, given at moderate doses (250–750 μg/day), has not been documented to be associated with growth or adrenal suppression in asthmatic children until recently. We report three cases illustrating these side effects.

Methods: Growth and adrenal suppression, after the introduction of inhaled FP, were observed in three prepubertal young asthmatic children referred to our asthma clinic and growth clinic. Growth centile and velocity were assessed by longitudinal stadiometry height measurements. Early morning plasma cortisol levels, and glucagon stimulation tests were used to assess the pituitary adrenal axis.

Results: Severe growth and adrenal suppression were noted in three children while they were on moderate doses of inhaled FP. Improvements in growth and adrenal function were observed following cessation or dose reduction of inhaled FP.

Conclusions: Unexpected growth and adrenal suppression may occur in young asthmatic children using moderate doses of inhaled FP.
Sleep deprivation, disorganization and fragmentation during opiate withdrawal in newborns
Authors: O’Brien CM , Jeffery HE
Published: March 2003

Objective: To determine specific sleep characteristics in neonatal opiate withdrawal, referred to as the Neonatal Abstinence Syndrome (NAS), by measuring sleep efficiency, deprivation, disorganization and fragmentation in three groups: (i) healthy term neonates; (ii) opiate‐exposed neonates who were treated for opiate withdrawal; and (iii) a group of opiate‐exposed neonates who did not require treatment.

Methods: A cohort study recording sleep patterns of neonates at 2–10 days of age (after 36 or more weeks of gestation) was carried out. Twenty‐one neonates were exposed to opiates during pregnancy and 15 neonates were healthy controls. Sleep characteristics were predefined, and treated newborns were divided into early and stabilized treatment groups. Polygraphic recordings of sleep, movement and breathing were made continuously after a daytime feed.

Results: Sleep deprivation, disorganization and fragmentation were found in newborns with NAS and were associated with the severity of the withdrawal. Neonates treated for NAS displayed increased wakefulness during early treatment (deprivation), but were similar to controls once stabilized. Both treated and non‐treated groups had reduced amounts of quiet sleep (deprivation). Treated newborns showed an increase in indeterminate sleep (disorganization) and arousals‐to‐wakefulness (fragmentation).

Conclusion: This study determined the exact nature and degree of sleep disturbances
in newborns during acute opiate withdrawal. The findings contribute to a further
understanding of the physiology underlying neonatal opiate withdrawal and suggest
that some changes in sleep are due to opiate withdrawal but others may reflect opiate
dependency in utero.
Syncope in children and adolescents of Hong Kong
Authors: Wong KT , So LY
Published: March 2003

Objectives: Syncope occurs commonly in children and adolescents. The objectives of the present study were to quantify this occurrence locally and to examine the profiles of subjects experiencing syncope.

Methodology: A self‐administered questionnaire was filled out by students between 6 and 17 years of age from a selected school in January 1999.

Results: Out of 2574 completed questionnaires, a total of 121 subjects reported having had at least one previous episode of syncope, including 9.0% of the 15–17 years age group. The overall incidence of a first syncope in the preceding 12 months was 1.7% and was highest (3.3%) in the 15–17 years age group. No significant difference in incidence was noted between sexes. Among those who experienced syncope, 32.2% had sought medical advice and 9.1% had been admitted to hospital; 57.9% became worried, while 37.2% reported restriction of daily activities because of syncope.

Conclusion: Syncope is a common event in children and adolescents in Hong Kong. It can cause a considerable degree of anxiety and activity restriction. The impact on medical services due to syncope in Hong Kong has been substantial.
Vaccination and risk communication: Summary of a workshop, Arlington Virginia, USA, 5–6 October 2000
Authors: Leask J
Published: March 2003

Abstract: The declining incidence of vaccine‐preventable diseases has led to an increased public focus on the issue of vaccine safety. In an environment of increased consumerism, interest in alternative health practices and anti‐vaccination lobbying, media reports that call into question the safety of scheduled vaccines can significantly raise parents’ concerns. Recent media coverage of a suggested but unproved link between the measles‐mumps‐rubella vaccine and autism has highlighted the challenges of providing a consistent and co‐ordinated response. For those concerned about effectively communicating the benefits and risks of vaccination, the field of risk communication can provide helpful insights. This paper summarizes the Workshop on Vaccine Communication held in the USA during October 2000. It highlights the perspectives given by consumers, providers, journalists and risk‐communication experts and discusses implications for Australia. These centre around how government and health professionals might respond to vaccine safety scares in the public arena, and to parental concerns raised in clinical encounters. Finally, the potential risks and benefits of engaging with the anti‐vaccination lobby are outlined.
Fryns syndrome: A surviving case with associated Hirschsprung’s disease and hemidiaphragmatic agenesis
Authors: Davis C , Samarakkody U
Published: March 2003

Abstract:  Fryns syndrome is a rare autosomal recessive disorder of multiple congenital abnormalities. Major diagnostic criteria include congenital diaphragmatic hernia, distal limb and nail hypoplasia and abnormal facies. More than 70 cases have been reported since the first report in 1979, 86% of which have been associated with an early lethal outcome. We report the case of a survivor who also has associated Hirschsprung’s disease. On review of previously reported cases, defects of neuronal migration may be more common than previously recognized. The diaphragmatic hernia was repaired in two stages with a silastic patch followed by a reversed latissimus dorsi muscle flap.
Parents’ Evaluation of Developmental Status in the Australian day‐care setting: Developmental concerns of parents and carers
Authors: Coghlan D , Kiing JSH , Wake M
Published: March 2003

Objective:  To trial the Parents’ Evaluation of Developmental Status (PEDS) as an instrument for reporting developmental concerns for Australian preschool children.

Method:  A cross‐sectional survey of parents and carers of 262 children attending five day‐care centres and two kindergartens in Melbourne was conducted between October and November 1999. Parents and carers completed the written PEDS questionnaire, comprising 10 questions eliciting concerns about learning, development and behaviour, and answered questions about the acceptability and use of the PEDS.

Results:  Of 445 children, 389 were eligible for inclusion. Complete parent and carer PEDS data were available for 262 children (67% response: 47% boys; 53% girls) aged from 18 months to 5 years, 9 months. Most parents found the PEDS questionnaire easy to complete (98%) and likely to be useful to health professionals (89%). Twenty‐four children (9%) were classified as being at high‐risk of disabilities and 49 (19%) were classified as being at medium‐risk of disabilities. Parents of 125 children (48%) reported no concerns. The prevalence of parental concerns was similar to the USA norming sample. Carers reported similar prevalences of concerns. Although overall agreement was high, parent/carer κ‐values were modest, being highest for the gross motor (κ = 0.40) and social−emotional (κ = 0.37) domains.

Conclusions:  The PEDS is acceptable to parents of Australian preschool children, with a prevalence of significant concerns (i.e. children at high‐ and medium‐risk of developmental problems) that is similar to those in the USA. Further research is needed to assess what factors differentially influence whether a concern is felt in a particular domain for a particular child.
Towards the safer use of warfarin I: An overview
Authors: Gallus AS
Published: March 2003

Abstract There has been an exponential increase of warfarin usage in the community since several large and well‐designed clinical trials have consistently found that warfarin can safely prevent embolic stroke in people with atrial fibrillation. Safe and effective warfarin treatment requires a case‐by‐case evaluation of each patient’s clinical condition and risk factors for bleeding. It also demands a therapeutic partnership where patients can accept an educated responsibility for managing their own condition. This requires mutually understood plans for ongoing management, including dose adjustment and responses to under‐ or overdose and to bleeding complications.
Renal Home Support Scheme quality initiative
Authors: Griffin DENIS
Published: March 2003

Abstract In 1995 the practice of visiting home dialysis patients was challenged. In order to justify this practice, a benchmarking approach was adopted comprising a literature search, surveys of all relevant patients and their primary health carers, as well as all dialysis units in Australia. The results favoured the home visits and facilitated the establishment of a baseline standard of one home visit at least every 6 months. This standard was audited and reviewed annually. In 1996, Queensland Health launched the Renal Home Support Scheme which was targeted at improving the delivery of health care in the home, leading to efficiencies in the delivery of care to specific groups within the community such as the indigenous population. Successful submissions had to identify objectives, strategies and performance indicators that demonstrated the likelihood of success. The Renal Unit at Townsville General Hospital successfully tendered a submission to Queensland Health and the scheme was implemented in November 1996.
Resuscitations in an observation unit
Authors: Mace SE
Published: March 2003

Abstract The outcome of all resuscitations in a 20‐bed observation unit of a large teaching hospital over a 25‐month period was reviewed. Resuscitation was defined as a patient receiving one or more of the following: external chest compressions; defibrillation, assisted ventilation (e.g. intubation); and/or advanced cardiac life support drug therapy such as atropine or lidocaine for life threatening dysrhythmias including ventricular tachycardia, ventricular fibrillation, or asystole. There were nine patients out of 10 245 patients admitted to the observation unit (9/10 245 = 0.088% or approximately 0.09%) over the 26‐month period from May 1994 to July 1996 who needed resuscitation. Each patient was initially successfully resuscitated. There was only one death (1/10 245 = 0.0098% or approximately 0.01%) in the observation unit. This patient was resuscitated with return of a spontaneous pulse and blood pressure only to expire while awaiting transfer to the Intensive Care Unit (ICU). Eight of the nine patients were admitted to the ICU, four of whom later died, making a total of five deaths (5/10 245 = 0.049% or approximately 0.05%). The other four patients were discharged neurologically intact and at 1 year follow‐up were alive and doing well. Compared with resuscitation rates for the prehospital setting, the emergency department, the hospital medical/surgical floors, or the intensive care units, there is a higher successful resuscitation rate for the observation unit.
A collaborative occupational therapy and nursing approach to falls prevention in hospital inpatients
Authors: Brandis Susan
Published: March 2003

Abstract A retrospective audit of inpatient falls at the Gold Coast Hospital was conducted in August 1996. This collaborative approach of occupational therapy and nursing staff aimed to reduce the number of patients falling while they were hospital inpatients. From the first audit a number of high risk patient groups, activities and ward environments were identified and a falls prevention program implemented. A second audit conducted 2 years later demonstrated a decrease in falls and related injuries. This paper discusses the findings of the falls audit and presents the ‘Fall STOP’ falls prevention program that was initiated.
Patterns of use, attitudes and expectations of mental health staff regarding computers
Authors: Walter Garry , Cleary Michelle , Rey Joseph M
Published: March 2003

Abstract There is limited information on the views of mental health staff about computers. The present study aimed to ascertain the patterns of use, attitudes and expectations of staff from a comprehensive mental health service regarding computers before and after the purchase of new equipment and training. A questionnaire was sent to staff of the Central Sydney Mental Health Services working in sites targeted for new computer equipment and training. Most respondents, especially those with computer experience or who had worked in mental health for less than 5 years, viewed computers favourably. At the same time, half the respondents did not feel they had sufficient access to a computer at work and the vast majority had not received training as intended. Commitments to provide computer equipment and training must be followed through, otherwise staff may feel disenchanted and computers may be regarded less favourably. A measure of the positive views about computer use (‘positivity index’) developed during the course of the current study may have wider applicability.
Quality assessment in private practice: The clinician as service provider
Authors: Phelps Grant
Published: March 2003

Abstract Assessment of quality in the private practice setting may be difficult. The author has taken the view that service delivery is a key outcome of private clinician practice. A method of assessing service delivery in a private consultant physician practice setting is described.
Prevention of orthopaedic wound infections: A quality improvement project
Authors: Douglas Paul , Asimus Margo , Swan Judith , Spigelman Allan
Published: March 2003

Abstract Using clinical practice improvement methodology, a project was undertaken to reduce the incidence of surgical wound infections following elective hip and knee replacement surgery. A team was established, key measures for improvement were identified, strategies for change were developed and an action plan was implemented. Outcomes for this project included a reduction in the rate of clean surgical wound infection for joint replacement surgery from 28% to zero. Average length of stay for total hip replacement surgery was reduced from 13.9 to 9.3 days and from 14.6 to 10.4 days for total knee replacement surgery. Guidelines for patient selection were developed along with a protocol for the management of preparation to prevent urinary tract infections. Post‐discharge surveillance and a preoperative rehabilitation and exercise programme have been implemented. There is potential for wider uptake and implementation of the quality principles described herein.
Are routine chest X‐rays for students entering university worthwhile?
Authors: Sebro Kirby , Rolle Steven , Gray Sharmaine , Seecharan Samantha , Thompson Karis , Weerasena‐Nedd Kaushalya , Teelucksingh Surujpal
Published: March 2003

Abstract Mass radiographic screening for tuberculosis has lost favour in many countries. The aim of this study was to determine whether the continued practice of such screening of prospective students at the University of the West Indies was warranted by assessing the yield and the cost of the programme in our setting. In a cross‐ sectional retrospective study, 12 662 chest X‐ray reports collected over the period 1989–1997 were studied. No active case of tuberculosis was detected. Three students reported a previous history of tuberculosis and 10 students had a positive family history of tuberculosis. Three hundred and ninety‐nine clinically insignificant abnormalities were reported, such as mild scoliosis and calcified foci. Routine radiological screening of prospective students at the University of the West Indies for tuberculosis has an extremely low yield, places the students at unnecessary risk of radiation exposure and should be discontinued.
Relationship between water quality in irrigation reservoirs and land use of the watershed
Authors: Nakasone Hideo , Kuroda Hisao
Published: March 2003

In Japan, the use of constructed irrigation reservoirs for paddy cultivation has been common during the past 1300 years. The reservoir size varies widely, but many are small (irrigation ponds or Tameike in Japanese). With the introduction of modern water resource systems, these small reservoirs began to be abandoned. The irrigation reservoirs, particularly the abandoned ones, are likely to receive upstream run‐off containing high concentrations of nitrogen, leading to deterioration of water quality due to eutrophication. There are cases, however, in which the citizens residing near the abandoned reservoirs show interest in preserving them for enhancing the neighbourhood water amenity. The current study examines the results of water quality surveys conducted for 12 such reservoirs and at Lake Kasumigaura. It revealed that good watershed management practices were critical for controlling eutrophication of such reservoirs.
Response of phytoplankton to enrichment from cage fish farm waste in Alicura Reservoir (Patagonia, Argentina)†
Authors: Diaz Mónica M. , Temporetti Pedro F. , Pedrozo Fernando L.
Published: March 2003

Bioassays were undertaken in order to test the response of the natural late‐summer inoculum of the phytoplankton of a Patagonian Reservoir to the additional nutrients generated by the production of salmon in cages. The results are discussed in relation to a 7 year study of the reservoir and the possible directions of trophic development. The main consequences of fish farming activities in Alicura are likely to lead to an increase in both nutrient concentrations, algal density and phytobiomass. The composition of the sediment close to the fish farm is affected. With regard to phytoplankton, we observed changes in species composition and temporal changes in their associations. The additional nutrient sources of fish food and faeces from salmonid production create an internal load that leads to a decrease in the N/P, Si/P and Ca/P ratios of the water column. The trophic level of Alicura Reservoir remains unchanged at present and the impact of fish farming operation remains localized.
Dimensionless volatilization rate for two pesticides in a lake
Authors: Ciaravino Giulio , Gualtieri Carlo
Published: March 2003

In recent years, toxic pollution has become a relevant topic in lake management, especially in developed countries. Consequently, great effort has been made to increase our knowledge of contaminant transport and transformation phenomena, and their effects on lake water quality.

The present paper reports on the characterization of input parameters for a dimensionless steady‐state model that simulates fate processes of volatile environmental contaminants. Dimensionless volatilization rates for two pesticides, 2,3,7,8‐ tetrachlorodibenzo‐p‐dioxin (TCDD) and endrin aldehyde, in particular, are estimated using field data from almost 80 Italian lakes. Careful analyses of the results allow us to define the variation range of input parameters and introduce some simplifications into the complete solutions of the model.
Sorption of polycyclic aromatic hydrocarbons into liposomes (artificial cell membranes) and the effects of dissolved natural organic matter
Authors: Shimizu Yoshihisa , Takahashi Junichi , Matsubara Jun , Ikeda Kazuhiro , Matsui Saburo
Published: March 2003

Dissolved natural organic matter (NOM) occurs widely in the aquatic environment and affects the fate of microorganic pollutants (e.g. intake, accumulation, movement, degradation, toxicity). The effect of NOM on the intake into biota (living cells) is very important. In the present study, the effects of coexisting NOM on the intake of microorganic pollutants into aquatic biota were experimentally evaluated. The NOM was concentrated from Lake Biwa water using a reverse osmosis filtration membrane. Two polycyclic aromatic hydrocarbons (PAH; pyrene and phenanthrene) were used as representative microorganic pollutants. Liposomes were synthesized in the laboratory to simulate living cell membranes and were used to investigate the intake of microorganic pollutants into aquatic biota. The experimental results (PAH onto NOM, NOM into liposomes, and PAH into liposomes) indicated that the sorption of PAH into liposomes was suppressed, apparently by PAH binding with NOM in the aqueous phase. This suggests that the accumulation and/or toxicity of microorganic pollutants can be retarded by NOM in the aqueous environment. Moreover, the experimental results indicated that sorption into liposomes (the liposome/water sorption coefficient, Klipw) could be a better parameter for estimating the intake of microorganic pollutants into aquatic biota than the n‐octanol/water partition coefficient (Kow) in the aqueous environment.
Role of Daphnia in the decomposition of organic matter in the surface layer of Lake Biwa
Authors: Yoshimizu Chikage , Urabe Jotaro
Published: March 2003

To examine the role of Daphnia in the decomposition and elimination of organic carbon at the surface layer, organic matter from Lake Biwa was incubated with and without Daphnia at 20°C in the dark for 15 days in May, July and October. In all of the experiments, total organic carbon decreased during the incubation, regardless of treatment; however, the net effect of Daphnia on this decrease differed among experiments. Daphnia stimulated the decrease in particulate organic carbon in two out of three experiments. Bacterial abundance was higher in treatments with Daphnia than in treatments without Daphnia in all experiments. Higher bacterial abundance in treatments with Daphnia could not be explained fully by zooplankton grazing effects on phagotrophic protozoans, rather Daphnia seemed to stimulate bacterial growth by supplying substrates for that growth. The results of the present study suggest that Daphnia reduces sinking flux, not only by direct grazing, but also by the channelling of particulate organic carbon into dissolved forms that are then available for bacterial growth.
Distribution of basal ganglia lesions in Pick's disease with Pick bodies: A topographic neuropathological study of eight autopsy cases
Authors: Tsuchiya Kuniaki , Arima Kunimasa , Fukui Toshiya , Kuroiwa Toshihiko , Haga Chie , Iritani Shuji , Hirai Shigeo , Nakano Imaharu , Takemura Tamiko , Matsushita Masaaki , Ikeda Kenji
Published: March 2003

The distribution of the basal ganglia lesions, including the amygdala, striatum, and pallidum, were investigated neuropathologically in eight Japanese autopsy cases of Pick's disease with Pick bodies. The lesions were classified as mild, moderate or severe. The degree and distribution of basal ganglia lesions in all eight cases were uniform: the amygdala showed severe to moderate lesions, the caudate nucleus and putamen showed moderate to mild lesions, and the pallidum showed mild lesions. Furthermore, the lesions in the amygdala were more prominent in the basolateral group than in the corticomedial group. In Pick's disease with Pick bodies, the degree and distribution of the lesions within the basal ganglia differs from those reported in both ‘Pick's disease without Pick bodies’ and corticobasal degeneration (CBD), in which severe lesions were present in the pallidum. These neuropathological findings may contribute to the morphological differential diagnosis among Pick's disease with Pick bodies, ‘Pick's disease without Pick bodies’, and CBD.
Introduction: Pick's disease and frontotemporal dementia
Authors: Amano Naoji , Iseki Eizo
Published: March 2003

There is no universally accepted morphological definition of Pick's disease. The concept of frontotemporal dementia (FTD) was proposed by the Lund‐Manchester Group in 1994 and comprises three main subtypes: frontal lobe degeneration type, Pick type and motor neuron disease type. Subsequently, familial or hereditary FTD has been identified, and ‘FTD and parkinsonism linked to chromosome 17’ was defined in 1996. However, there are still unresolved aspects of the neuropathology of FTD. This paper describes the origin and development of the concept of FTD with special reference to the neuropathological problems.
Lateral ventricular meningioma encapsulated by the dura‐like membrane
Authors: Yoshida Kazunari , Onozuka Satoshi , Kawase Takeshi , Ikeda Eiji
Published: March 2003

The first case of a ventricular meningioma that was encapsulated by the dura‐like membrane is reported. Magnetic resonance imaging (MRI) showed a heterogeneous mass with a low intensity rim in the trigone of the right lateral ventricle of a 63‐year‐old male. Histological examination revealed that the tumor was a transitional meningioma encapsulated by a thick dura‐like membrane. Moreover, abundant clusters of the dura‐like connective tissue existed in the tumor, indicating that both the dura‐like capsule and the dura‐like clusters in the tumor were created by the tumor cells.
A case of sporadic Creutzfeldt‐Jakob disease with both plaque and synaptic‐type deposition of prion protein
Authors: Tanaka Shinichiro , Ota Makoto , Ohama Eisaku
Published: March 2003

We report a Japanese case of sporadic Creutzfeldt‐Jakob disease (CJD) with particular clinical course and neuropathological findings. A 74‐year‐old female exhibited parkinsonism and later, dementia, myoclonus as well as visual hallucinations, lacking periodic synchronous discharges in the electroencephalogram. The duration of her illness was 2 years, longer than typical CJD cases which average 8 months’ duration. Gray matter was severely affected, the Ammon’s horn and subicular cortex were well preserved and many kuru plaques were observed in the cerebellum using routine histological stainings. Immunohistochemistry for prion protein (PrP) using both formic acid and hydrolytic autoclaving pretreatment revealed numerous prion plaques throughout the brain together with intense synaptic‐type deposition of PrPCJD (abnormal isoform of PrP) in all gray matter examined, particularly in the Ammon’s horn and subicular cortex. The definite combination of these two types of stain has never been reported previously in Japan other than in Gerstmann‐Sträussler– Scheinker syndrome. Relative resistance of the Ammon’s horn and subicular cortex to the PrPCJD deposition is also discussed.
Neuropathological heterogeneity in Alzheimer’s disease: A study of 80 cases using principal components analysis
Authors: Armstrong Richard A , Nochlin David , Bird Thomas D
Published: March 2003

Three hypotheses have been proposed to explain neuropathological heterogeneity in Alzheimer’s disease (AD): the presence of distinct subtypes (‘subtype hypothesis’), variation in the stage of the disease (‘phase hypothesis’) and variation in the origin and progression of the disease (‘compensation hypothesis’). To test these hypotheses, variation in the distribution and severity of senile plaques (SP) and neurofibrillary tangles (NFT) was studied in 80 cases of AD using principal components analysis (PCA). Principal components analysis using the cases as variables (Q‐type analysis) suggested that individual differences between patients were continuously distributed rather than the cases being clustered into distinct subtypes. In addition, PCA using the abundances of SP and NFT as variables (R‐type analysis) suggested that variations in the presence and abundance of lesions in the frontal and occipital lobes, the cingulate gyrus and the posterior parahippocampal gyrus were the most important sources of heterogeneity consistent with the presence of different stages of the disease. In addition, in a subgroup of patients, individual differences were related to apolipoprotein E (ApoE) genotype, the presence and severity of SP in the frontal and occipital cortex being significantly increased in patients expressing apolipoprotein (Apo)E allele ɛ4. It was concluded that some of the neuropathological heterogeneity in our AD cases may be consistent with the ‘phase hypothesis’. A major factor determining this variation in late‐onset cases was ApoE genotype with accelerated rates of spread of the pathology in patients expressing allele ɛ4.
Cerebellar granular layer aplasia in congenital hydrocephalus
Authors: Vodovnik Aleksandar
Published: March 2003

An unusual case of cerebellar granular layer aplasia is reported. A 5‐year‐old boy was born with hydrocephalus and a peritoneal drainage shunt was placed after the delivery. Symptoms of cerebral paralysis, impaired mental function and cerebellar ataxia had developed gradually. Patient's karyotype was 46,XY. Laboratory tests for cytomegalovirus, Herpes simplex virus, Toxoplasma gondii, human immunodeficiency virus, rubella and hepatitis B virus were negative. Further laboratory investigation showed no signs of Tay‐Sachs disease, Niemann‐Pick disease, Gaucher disease, phenylketonuria, galactosemia or glycogen storage disease. No congenital malformations were traced in other family members for three generations. Radiation exposure and infections during the pregnancy were refuted.
Sporadic amyotrophic lateral sclerosis with circumscribed temporal atrophy: A report of an autopsy case without dementia and with ubiquitinated intraneuronal inclusions
Authors: Tsuchiya Kuniaki , Takahashi Matuu , Shiotsu Hidetoshi , Akiyama Haruhiko , Haga Chie , Watabiki Sadakiyo , Taki Kazuhito , Nakano Imaharu , Ikeda Kenji
Published: March 2003

This report concerns an autopsy case of amyotrophic lateral sclerosis (ALS) with circumscribed temporal atrophy. The patient was a Japanese woman without hereditary burden who was 71‐year‐old at the time of death. She developed dysarthria and gait disturbance at age 69, followed by dysphagia. A neurological examination about 1 year 11 months after the onset of the disease revealed absence of character change and of dementia. Neuroradiological examination disclosed circumscribed atrophy of the anterior part of the right temporal lobe. The patient died of respiratory failure 2 years after the disease onset. No respirator administration was performed throughout the clinical course. Macroscopically, neuropathological examination showed circumscribed atrophy of the right first temporal gyrus. Histologically, there was neuronal loss in the cerebral cortex, including the first temporal gyrus, the parahippocampal gyrus, subiculum, amygdala, substantia nigra, brain stem motor nuclei, and anterior horns of the spinal cord, in addition to loss of Betz cells, obvious degeneration of the pyramidal tracts, and the presence of Bunina bodies. Ubiquitin‐immunoreactive intraneuronal inclusions were present in the hippocampal dentate granular cells, frontotemporal cortical layer II neurons, and motor neurons in the brain stem and spinal cord. Based on these clinicopathological findings and a review of the literature, we concluded that our case was atypical ALS without dementia, showing temporal lobe atrophy macroscopically, in addition to pathological hallmarks compatible with ALS with dementia. We also note the possibility that there is a forme fruste of ALS with dementia showing no overt dementia clinically.
Heminephrectomy causes the progression of glomerulosclerosis and apoptosis in high IgA strain of ddY (HIGA) mice
Authors: Kusano H , Miyawaki S , Yoshida H , Ono T , Muso E , Sasayama S
Published: March 2003

Background: The nephron reduction in IgA nephropathy is critical for the newly established prognosis of this disease. A high immunoglobulin A inbred strain of ddY mouse (HIGA mouse) showed progressive mesangial sclerosis with elevated renal expression of transforming growth factor (TGF)‐β,1 however, the progression of the renal lesion of this mouse is relatively mild with rare association of active crescentic glomerulonephritis. However, although nephron reduction causes progressive renal injury, the modifications of glomerular lesions by nephron reduction are dependent upon the pathological background of each strain. Thus, we investigated the influence of nephron reduction by heminephrectomy on the renal lesions of the HIGA mouse.

Methods: Five‐week‐old HIGA mice were heminephrectomized (Nx), and were evaluated in comparison with a sham‐operated group (S) at 40 weeks old. Measurements of renal function, blood pressure and serum levels of immunoglobulins (IgG, IgA, and IgM) were performed. Histological findings, including glomerular enlargement, matrix expansion, immunoglobulin depositions (IgG, IgA, and IgM), expressions of cytokines (TGF‐β, TNF‐α, and IL‐6) and extracellular matrix proteins were analysed. PCNA and TUNEL stainings were performed. In addition, mRNA expressions of renin‐angiotensin systems (RAS; angiotensinogen and angiotensin converting enzyme (ACE)) were also investigated.

Results: The physiological and serological data showed no significant difference between Nx and S. In Nx, the glomerular tuft area and ratio of mesangial matrix area for one tuft were significantly increased and glomerular IgG and IgM deposits were significantly expanded in the paramesangium. However, IgA was not significantly increased. The glomerular expressions of cytokines (TGF‐β, TNF‐α, and IL‐6) and extracellular matrix proteins (fibronectin, collagen type I and IV) were significantly increased in this group. In contrast to the significant decrease of PCNA‐positive cells, TUNEL‐positive cells were significantly increased in Nx. The total mRNA expression of ACE was also significantly increased in the renal cortex of Nx.

Conclusion: Heminephrectomy of HIGA mice may be a potential model for the research into the progressive glomerulosclerosis of human IgA nephropathy. The pathological role of apoptosis is apparently involved in these disease processes, possibly through up‐regulated RAS.