bluuebunny/crossref_metadata_2025 huggingface dataset:
Possible Role of Streptococcus Pyogenes in Mucocutaneous Lymph Node Syndrome
Authors: Akiyama Takehisa , Osawa Nobutaka , Yashiro Kimio , Hiraishi Satoshi
Published: October 2007

Migration inhibitory factor (M1F)‐induced activity of patients with mucocutaneous lymph node syndrome (MCLS) to antigens associated with Streptococcus pyogenes infection was compared to that of control populations consisting of children with illnesses not related to streptococcal infections (group A), and of patients with streptococcal pharyngitis (group B), with the following results.

1. Though a consiaerable number of patients in the acute state of MCLS failed to respond to antigens consisting of (1) a coccus preparation of S. pyogenes (Picibanil), (2) streptococcal pyrogenic exotoxin (SPE) and (3) an extract from cells of a virally transformed human B‐cell line, a complete restoration of their responsiveness was observed in parallel with the decrease of fever.

2. While almost all patients of group A were refractory not only to Picibanil and SPE but also to the extract from the transformed human cells, some children with infections due to intracellular microbes showed responsiveness to the extract from the transformed cells.

3. In group B, some patients showed a marked responsiveness and the other a complete refractoriness to these antigens throughout the observation period.

These results raise the possibility that S. pyogenes may play a principal role in the pathogenesis of MCLS.
SCREENING SYSTEM: The Heart Disease Screening System for School Children in Japan and Its Results
Authors: Hosaki Junro
Published: October 2007

The heart disease screening system for school children in Japan is useful for early detection of children with heart disease, and for their daily health care. In particular, the heart disease screening system using an electrocardiogram and/or phonocardiogram is an excellent one for finding atrial septal defect, pulmonic stenosis, idiopathic cardiomyopathy and arrythmia.

Recently, computer‐assisted electrocardiogram and phonocardiogram automatic analysis equipment for heart disease screening of school children has been developed, and a screening system using this equipment has been instituted.
SCREENING SYSTEM: Screening for Asymptomatic Hematuria and Proteinuria in School Children ‐ Relationship between Clinical Laboratory Findings and Glomerular Pathology or Prognosis ‐
Authors: Kitagawa Teruo
Published: October 2007

Early morning urine is collected at home and urinalysis is performed at a clinical laboratory. Simple dipstick methods are used for the detection of proteinuria and hematuria. When the urine tests are positive, a second test is performed in the same manner. When the urine abnormalities are persistently encountered, urine sediments are checked under the microscope and diagnostic steps are taken to determine the cause of the urine abnormalities. A study of the diagnosis and prognosis of the asymptomatic proteinuria and hematuria detected by urine screening was performed with the collaboration of eight different hospitals. Correlations between renal pathology or prognosis and urinary findings or other laboratory data in 170 patients who had renal biospy were studied. Cases with asymptomatic hematuria without proteinuria tended to have a better prognosis, with the pathology of minor abnormality or focal segmental proliferative lesions. In cases with marked proteinuria and hematuria diffuse proliferative lesions including membranoproliferative glomerulonephritis (MPGN) were frequently observed. Renal pathology suggesting a poor prognosis was not uncommon in the cases with marked proteinuria and hematuria. The above observations were confirmed by a 5‐year follow‐up study in 141 cases.
CONTROL AND DAILY CARE OF SICK CHILDREN AT SCHOOL: Management of Children with Chronic Disease at School—Renal Disease
Authors: Murakami Mutsumi , Ueda Yutaka , Murakami Katsuyoshi
Published: October 2007

Management of children with renal disease at school in Japan is characterized by urine screening at school. The fact that many children with minimal hematuria, who are unlikely to have any disease, were detected by such screening is cited as a demerit of mass urine screening. However, the number of children undergoing dialysis began to decrease, as shown in Fig. 4, in 1977, three years after urine screening at school began to be carried out [8]. In addition, surveys of long‐term school absentees in Osaka showed a gradual decrease in absence due to renal disease; the rates of 52.4 and 53.8 out of every 100,000 for elementary school children and junior high school children, respectively, in 1979 decreased to 39.3 and 42, respectively, in 1983 [2]. This fact, which cannot be explained merely by advances in technique of treatment for renal disease, represents an advantage of mass urine screening that more than offsets any disadvantage.
Two Unusual Cases of Congenital Rubella Syndrome Associated with Acute Myelocytic Leukemia or chilaiditi's Syndrome
Authors: Hokama Tomiko , Hirayama Kiyotake
Published: October 2007

In the Ryukyu Islands of Japan, an extensive epidemic of rubella occurred from the end of 1964 until the beginning of 1965. Approximately 400 children with congenital rubella syndrome were born in 1965 [1]. Two boys with unusual associated problems are reported in this paper. One case was complicated with leukemia and the other with Chilaiditi's syndrome.
Serum Levels of Thyroid Hormones, Thyroxine‐Binding Globulin and Thyrotropin in Arterial and Venous Cord Blood in Newborn Infants Are Identical
Authors: Ono Seigo , Jitosho Tamotsu , Miyata Koichiro , Matsuda Kazuhiro , Ikenoue Tsuyomu , Otsuji Shogo
Published: October 2007

Thyroxine, tri‐iodothyronine, reverse tri‐iodothyronine, free tri‐iodothyronine, free thyroxine, tri‐iodothyronine resin uptake, thyrotropin, thyroxine‐binding globulin and free thyroxine index in both arterial and venous cord blood of 20 normal full‐term newborn infants were investigated. There was little difference in the values in arterial and venous cord blood in all examinations.

The results suggest that venous cord blood, which is more easily obtainable in sufficient quantity than arterial cord blood, and arterial cord blood are equally useful in the determination of thyroid function in the newborn infant.
Whole Blood Chemiluminescence As an Acute Phase Reactant
Authors: Tono‐oka Tatsuhito , Matsumoto Takahide , Taguchi Yuichi , Nakanishi Masanori , Imai Ko
Published: October 2007

Chemiluminescent response of whole blood was estimated as a function of acute phase reactant and compared with ESR and CRP in various types of pediatric patients with fever. 0.1 ml of whole blood was used as the material, and two parameters concerning the phagocytic function of whole blood were used: (1) Peak CL; total phagocytic function of whole blood reflecting the number of granulocytes in a specimen and their function; (2) Peak CL per 103 whereas viral infections consisting of upper respiratory infection, varicella and systemic bacterial infections showed an increased peak CL, not only due to the increased number of granulocytes, but also due to the enhanced CL response of the granulocytes themselves (thus peak CL per 103 PMN was laso increased), whereas viral infections consisting of upper respiratory infection, varicella and mumps, and acute leukemia in the active stage did not have a remarkable influence on the two parameters. In many types of febrile illness peak CL/103 PMN was significantly correlated with ESR and CRP, but not with granulocyte counts. ESR and CRP also did not correlate with granulocyte counts. Thus it was confirmed that the whole blood CL method is useful as a quick test with a small amount of specimen for evaluating febrile patients; concerning the intensity of inflammation as well as phagocyte (granulocyte) functions.
Simulation of the Clinical Course of Viral Hepatitis and Its Immunological Treatment
Authors: Sakurai Michiro , Shiraki Kazuo , Kawamura Noboru , Kaihara Shigekoto
Published: October 2007

An analysis of the variations in the clinical course of hepatitis B (HB) was attempted with mathematical simulation. Hepatitis B could be regarded as an ecosystem consisting of liver cell, hepatitis B virus and immunity, which were integrated by Dudley's hypothesis. The reason for the variations in the clinical course of hepatitis B were found to be the variations of immunological power destroying liver cells and of the absorption of HB virus.

Non‐A non‐3 hepatitis with recurrent aggravation was also studied. The effect of treatment with transfer factor and interferon for chronic hepatitis were simulated, and the dynamics of these treatments were analyzed.
Recent Advances in Infantile Spasms Research in Finland
Authors: Riikonen Raili
Published: October 2007

Data on incidence, etiology, therapy and prognosis of infantile spasms are reviewed. Infants with infantile spasms have a lower CSF GABA concentration than other epileptics. In a large proportion of cases the etiological factors of infantile spasms can now be elucidated with some certainty. Especially, the new neuroradiological and virological methods have enabled a more accurate diagnosis. There have been changes in the etiological pattern over the years. The optimal dosage and duration of ACTH or glucocorticoid therapy have not been established. In the Finnish study the large ACTH doses (120–160 IE) generally used in many Nordic European countries did not carry a better prognosis than the smaller doses (20–40 IE). Therapeutic response showed no correlation with the Cortisol secretion rate but the infants who responded well had a high dehydroepiandrosterone‐androstenedione concentration ratio. Side‐effects of ACTH therapy are relatively common and more common with large doses than with smaller ones. The most common side‐effects are infections and arterial hypertension. There were disturbances of calcium and phosphate metabolism during ACTH therapy. Severe nephrocalcinosis was seen in some infants at autopsy. Fluid disturbances were common at termination of ACTH therapy. ACTH therapy causes adrenal hyporesponsiveness. The therapy should be modified to improve the prognosis.
Comparison of Q(R) to T Peak Time in Right and Left Precordial Leads in Children
Authors: Awa Shoichi , Yanagawa Yukishige , Hishi Toshio , Akagi Michio , Dodo Hidemi
Published: October 2007

An electrocardiographic measurement useful in the diagnosis of right ventricular overload, involving precordial T waves, is presented. The longest Q(R) to T peak interval from V3R to V4(V5) was longer than or identical with the same interval in both V5 and V6(V7) when hemodynamic right ventricular overload was present. Sensitivity was greater when volume overload was present than with pure pressure overload. In contrast to the non‐specificity of the vectorcardiographic horizontal T loop, inscription and contour, the newly presented corresponding electrocardiographic parameter proved to be a simple, sensitive and specific discriminator of right ventricular overload. Discrepancy in diagnostic usefulness between the two systems (EKG versus VKG) is discussed in terms of proximity effects in precordial leads.
Classification of Diabetes Mellitus by Studies of C‐Peptide Secretory Capacity
Authors: Teshirogi Tadashi , Hosoi Hiroeki , Ohki Yukashi , Kagoshima Toshio
Published: October 2007

Residual pancreatic B‐cell function was investigated in children with diabetes mellitus in whom classification of the type of disease was difficult at the first visit.

Intravenous glucagon tests were performed at the first visit and subsequently, the C‐peptide responses compared.

Based on our data on a limited number of patients, we propose C‐peptide concentrations of 3.0 to 3.5 ng/ml at the peak or at 6 min after injection of glucagon, as the critical level which distinguishes non‐insulin dependent from insulin‐dependent diabetes mellitus.

However, the degree of obesity, clinical stage and other factors also need to be considered in the classification of diabetes mellitus.
High‐Dose Gammaglobulin Therapy in Six Children with Newly Diagnosed Insulin‐Dependent Diabetes Mel I it us
Authors: Urakami Tatsuhiko , Hanaoka Yoko , Fujita Hidehiro , Kitagawa Teruo
Published: October 2007

We treated six newly diagnosed children with insulin‐dependent diabetes mellitus (IDDM) with high‐dose gammaglobulin therapy in a clinical trial of immunomodulation. Approximately 400 mg/kg/day of polyethylene glycol‐treated gammaglobulin was given by intravenous injection for four to five days.

After the initial therapy, four out of six patients showed an elevation of serum CPR and a decline of their insulin requirements; this indicates an improvement of insulin secretory function of pancreatic beta cells.

A second course of gammaglobulin was given to four patients one year after the initial therapy, and the same results were observed in two out of four patients.

These results suggest that high‐dose gammaglobulin might provide some protection against the deterioration of endogenous insulin secretion in children with IDDM.
Improvement of Initial Remission Rate by Introduction of CSII
Authors: Tanae Ayako , Kagawa Jiro , Nozaki Kae , Hashimoto Nobuko , Hibi Itsuro
Published: October 2007

We studied 65 insulin‐dependent diabetic children and adolescents diagonosed during the period 1976–86 to find out the occurrence and duration of postini‐tial remission, the relationship between the remission behaviour and the initial treatment introduced by continuous subcutaneous insulin infusion (CSII), the favoring factors and the prognostic value of remission. A postinitial remission occurred in 36 patients (55.4%) being complete in only two boys (3.1%). The mean duration was 10.8 months and median was 7.8 months: the shortest period one month and the longest 36 months. On the other hand, remission occurred in 16 out of 19 patients (84.2%) with CSII and 15 out of 37 patients (40.5%) with conventional treatment (CT) as initial treatment. The mean duration of remission was 14.6 ± 10.6 months in the CSII group and 6.8 ± 4.7 months in the CT group. Further, our study proved a significant increase of urinary C‐peptide excretion in the patients with CSII during their remission. Through our study in comparison with CT, we were able to see an improvement in the remission rate by introducing the CSII for a short term in the initial treatment and it led us to realize that what caused it was the recovery of endogeneous insulin secretion capacity.
Residual Pancreatic Beta‐Cell Function in Insulin‐Dependent Diabetes Mellitus
Authors: Amemiya Shin , Higashida Kohsuke , Fujimoto Masatoshi , Asayama Kohtaro , Ichimura Kazuyoshi , Kusano Shoichi , Ohyama Kenji , Kato Kiyohiko
Published: October 2007

It is recognized that residual pancreatic /3‐cell function may play a role in the control of blood glucose in patients with insulin‐dependent diabetes mellitus (IDDM). Since modern therapy is concerned with the possibility of recovery of pancreatic β‐cell function, we need to identify the secretagogue of choice in the various phases of IDDM.

Eleven patients with IDDM underwent four different stimulation tests of (3‐cell function over two weeks. The tests were i.v. arginine (ATT), oral glucose (o‐GTT), i.v. glucagon (GCT) and i.v. tolubutamide (TTT). One patient had the tests repeated four times over two years after the onset.

Among the tests, ATT and o‐GTT produced the largest response ofC‐peptide. The response to GCT was small in comparison. TTT had no significant effect. The present study suggests that ATT or o‐GTT or both are useful in the evaluation of endogenous insulin secretion during follow‐up of IDDM. On the other hand, GCT can only be used as a simple screening method for residual ß‐cell function and is not sufficient for quantitative measurement in IDDM.
A Case of Congenital Myopathy without Specific Features
Authors: Tachi Nobutada , Hosoya Shizue , Watanabe Mutsuko , Wakai Shuji , Minami Ryoji
Published: October 2007

We report a 4‐year‐6‐month‐old boy with congenital myopathy without specific features. He showed delayed motor milestones, gaining head control at four months, and walking without support at one year six months. He was not a floppy infant after birth. Physical examination disclosed a myopathic face and muscle atrophy, predominantly in the proximal muscles, particularly in the scapular and pelvic girdles. A proximal muscle biopsy showed a mild variation in fiber size without any specific structural abnormality. Fiber type analysis showed type 2B fiber smallness. We compare our case with previously reported cases of minimal change myopathy (congenital myopathy without specific features).
Treatment of Acute Asthma in Children
Authors: Bierman C. Warren , Pearlman David S. , Pierson William E. , Shapiro Gail G. , Furukawa Clifton T.
Published: October 2007

Acute severe asthma in children should be managed by immediate attention to the patient's clinical condition. Careful observation, the use of sequential pulmonary function tests and appropriate blood gas studies will facilitate evaluation of severity. Therapy should be directed at the reversal and7sol;or correction of these abnormalities as well as anticipation of early treatment of potential complications. By the aggressive management of this condition, the incidence of complications can be reduced, the length of hospital stay shortened and substantial morbidity and possible mortality minimized.
Recovery Period of Hypersecretion of Thyroid‐Stimulating Hormone in Patients with Congenital Hypothyroidism Treated with Thyroid Hormone
Authors: Sato Hirokazu , Inomata Hiroaki , Sasaki Nozomu , Niimi Hiroo , Nakajima Hironori
Published: October 2007

The recovery periods of serum thyroid stimulating hormone (TSH) were studied in patients with congenital hypothyroidism found on neonatal screening. L‐T4 was administered at 37.8 ± 15.1 days of age (M ± SD), and serum T4, T3, and TSH concentrations were measured. After L‐T4 therapy with 10 µg/kg, the serum TSH levels decreased to below 10 µU/ml in five patients within a week, and in another two patients, within two weeks, and in the total number of 12 patients out of 15 (80%), by one month.

These results suggest that the recovery of serum TSH occurs rapidly in hypothyroid infants. Thus, the serum TSH concentration may be a good measurement for assessing the adequacy of thyroid hormone therapy from early infancy in patients with congenital hypothyroidism.
A Simplified Master's Two‐Step Test for Preschool Children: A Preliminary Report
Authors: Yoshinaga Masao , Oku Shozo , Chin Shoho , Mizumoto Yuji , Iwayama Kiyoko , Yamamoto Eiji , Inoue Hiroyuki , Suenaga Shinji , Nomura Yuichi , Aihoshi Sogo , Ohkawa Shunya
Published: October 2007

To investigate a simplified Master's two‐step test (MTT) for preschool children aged 4 to 6 years exercise tests with new stairs, with risers 18 cm and 20 cm high, were employed. The subjects were 162 preschool children who were divided into four groups according to the height of the riser and the number of steps taken (60 and 72 steps per 3 minutes).

In these tests, the 4‐year‐old children obtained similar mean heart rates immediately after exercise (156.9 to 161.6 BPM) in spite of different exercise tests, and the 5‐ and 6‐year‐old children obtained significantly higher mean heart rates (166.0 and 162.1 BPM, respectively) in the test with a 20 cm riser taking 72 steps. If a single protocol is to be used for children aged 4 to 6, the test with a 20 cm riser and taking 72 steps seems to be the best with reference to the achieved heart rates and performance ratios.
Morphologic Studies of the Liver and Bile Ducts in Biliary Atresia
Authors: Ohi Ryoji , Chiba Tsuneo , Endo Naobumi
Published: October 2007

We studied 233 patients with biliary atresia seen between 1953 and 1985. Specimens of the extrahepatic bile ducts and liver which were taken at the time of corrective operation were examined histologically. We noted the presence of inflammation in the extrahepatic bile ducts, which confirmed in retrospect the necessity for early operation. The results of these studies are discussed in connection with the pathogenesis, pathophysiology and clinical features of this disease.
Electrocardiographic Standard for the Diagnosis of Right Ventricular Hypertrophy in Complete Right Bundle Branch Block
Authors: Tsuji Atsutoshi , Osano Mitsuru , Morikawa Yoshiyuki , Sato Masaaki , Asaishi Takasumi
Published: October 2007

It is generally considered that in complete right bundle branch block, the electrocardiographic standard for the diagnosis of right ventricular hypertrophy is not applicable.

According to Cohen's criteria, right ventricular overload exists if thallium‐201 myocardial perfusion demonstrates the right ventricular wall, and in this light we attempted to reassess the validity of the electrocardiographic standard for right ventricular hypertrophy.

Twenty‐three children with complete right bundle branch block (abbreviated as CRBBB) were evaluated. The agreement and disagreement ratios of the electrocardiographic standard with Cohen's criteria was 20/23 and 3/23 respectively. Even in patients without intracardiac anomalies, right ventricular overload was suspected by Cohen's criteria.

The electrocardiographic standard was in agreement with Cohen's criteria in most of these patients.
Transesophageal Atrial Pacing in Paroxysmal Supraventricular Tachycardia in Infants and Children
Authors: Fujiseki Yoshiki , Okuno Masahiko , Fujino Hidetoshi , Hattori Masanori , Nonomura Kazuo , Shimada Morimi
Published: October 2007

Fourteen patients with paroxysmal supraventricular tachycardia (PSVT) underwent serial electrophysiologic studies using transesophageal atrial pacing (EPS‐EP), to determine the predictive value of this method in the selection of antiarrhythmic therapy and to study the mechanism of the tachycardia.

In each patient, PSVT could be reproducibly initiated by burst and/or programmed stimuli. After control EPS‐EP, the effects of several drugs (diltiazem, disopyramide, propranolol, digoxin, procainamide and verapamil) on the ability to initiate PSVT or to bring about “tachycardia zone” were examined. The mechanisms of PSVT were also investigated using an esophageal electrode, EPS‐EP, and Ca++‐antagonists.

Drug responses were variable but in most cases tachycardia could not be initiated after drug administration. Four types of supraventricular tachycardia are described. In eight out of nine patients, good therapeutic control was obtained. This study shows that serial EPS‐EP can provide rapid identification of appropriate antiarrhythmic therapy, and is useful in studying the mechanism of PSVT.
Congenital Subclavian Arterial Stenosis
Authors: Nogami Tetsuo , Sato Hideo , Hirano Takeki , Horigome Hitoshi , Ijima Hiroshi , Takita Hitoshi
Published: October 2007

We describe a 2‐year‐old boy with a non‐palpable right radial pulse associated with underdevelopment of the arm. An arteriogram showed a narrowing of the distal part of the right subclavian, axillary and brachial arteries, and poor collateral circulation. This patient illustrates a rare cause of an absent radial pulse, other than Takayasu's disease.
Turner's Syndrome with Agenesis of the Corpus Callosum, Hashimoto's Thyroiditis and Horseshoe Kidney
Authors: Araki Kumiko , Matsumoto Kenji , Shiraishi Taisuke , Ogura Hideo , Kurashige Takanobu , Kitamura Isamu
Published: October 2007

We present a 14‐year‐old girl with Turner's syndrome, agenesis of the corpus callosum, Hashimoto's thyroiditis and horseshoe kidney. She was admitted to our hospital because of short stature. She had some of the somatic stigmata of Turner's syndrome, was slightly mentally retarded, but had no neurological abnormalities. Chromosome study showed a 45, x karyotype. Her thyroid function was normal, but both the antithyroglobulin and antimicrosomal antibody titers were elevated, suggesting lymphocytic chronic thyroiditis. An intravenous pyelogram and an abdominal CT scan showed a horseshoe kidney. CT scan of the brain showed agenesis of the corpus callosum.

As far as we are aware, this is the first report of Turner's syndrome with agenesis of the corpus callosum, Hashimoto's thyroiditis and horseshoe kidney.
Effect of Cornstarch Formula in an Infant with Type I Glycogen Storage Disease
Authors: Ogata Tsutomu , Matsuo Nobutake , Ishikawa Kazuo , Araki Kiyoshi
Published: October 2007

In order to cope with profound hypoglycemia in an infant with type I glycogen storage disease receiving nocturnal intragastric infusion, we administered cornstarch formula every four hours at 14 months of age. Following the cornstarch therapy, fasting blood glucose in creased from 39.3±4.0 to 83.5±4.0 mg/dl (p<0.01), σ insulin during oral glucose tolerance test (2.5 g/kg) increased from 76 to 191 µU/ml, 24‐hour urinary C‐peptide excretion increas ed from 31.0±4.7 to 47.4±55.2 µg/g/‐creatinine(p<0.05), plasma somatomedin‐C increased from 0.13 to 0.43 U/ml, and length increased from the 3rd percentile to the range between the 10th and the 25th percentile.

The results indicate that cornstarch formula may prevent the precipitous hypoglycemia that occurs during the day in an infant with type I glycogen storage disease on nocturnal in tragastric infusion. Increased insulin and/or somatomedin‐C secretion appears to be responsible for the improvement in linear growth of the infant.
Continuous Nasogastric Infusion of Prostaglandin E2 in Ductus‐Dependent Congenital Heart Disease
Authors: Komiyama Osamu , Osano Mitsuru. , Oikawa Tadao , Morikawa Yoshiyuki , Kojima Yoshifumi , Murai Takayasu , Ishihara Jun , Tokumura Mitsuaki , Taguchi Nobuhiko
Published: October 2007

Prostaglandin E2 (PGE2) was infused continuously through a nasogastric gavage tube in four infants with pulmonary atresia. The drug was given at a rate of 12.5–160 µg/kg/h. The duration of therapy was 7–123 days. The effects and side effects seen by this method were similar to those seen in the conventional multiple dose regimen. This method was an effective and simple way of maintaining the ductus arteriosus open, especially for a long period of time.
Automated BET, Blood Pressure, and IVH
Authors: Funato Masahisa , Shimada Seiichi , Tamai Hiroshi , Taki Hideo , Yoshioka Yasushi
Published: October 2007

An automated apparatus for blood exchange transfusion (BET) has been devised with a two‐site technique for peripheral artery and vein, utilizing an Atom infusion pump. With this apparatus, we have successfully performed exchange transfusions 189 times in 110 infants with birth weights ranging from 530 g to 4,000 g within the past four years.

Evaluating the influence of this method on the circulatory system, the variation in blood pressure (BP) during exchange transfusions was consecutively measured 29 times in 16 infants (14 cases by indirect method and two cases by direct method). The BP was very stable, without any significant change in the mean and the coefficient variation (CV) before, during and after the transfusion (Systolic BP: 59.3±11.9, 60.1±11.9, and 60.3±12.1 mmHg; p: n. s., CV: 7.8±4.1, 8.1±3.8, and 7.7±4.1%; p: n. s., respectively).

Further, in evaluating the influence of the method on the occurrence of intraventricular hemorrhage (IVH), brain ultrasonography was performed in 20 extremely premature infants of less than 1,500 g in birth weight prior to and following the exchange transfusion. There was no significant occurrence or exacerbation of IVH. by the method itself (IVH Grade 0: 15 cases, Grade 1: 4 cases, Grade 2: 1 case).

We believe that this automated method may be more stable as it relates to variation of systemic BP and that the occurrence of IVH especially in extremely premature infants may be less likely with the automated method than with the use of Diamond's method, since it is isovolemic in procedure.
Nosocomial Infection by Rotavirus and Adenovirus Within One Month
Authors: Ushijima Hiroshi , Shinozaki Tatsuhiko , Araki Kazuko , Kondo Yasuo , Kobayashi Masaaki , Abe Toshiaki
Published: October 2007

We experienced a small outbreak of acute gastroenteritis in December 1985 in hospitalized children. Two different serotypes of rotavirus and two serotypes of adenovirus were found by molecular epidemiological and serological studies. Four patients were considered to have two serotypes of rotavirus. The results showed that a single strain of a virus was not always the cause of nosocomial infection.
Respiratory Syncytial Virus Infection in Infants with Congenital Heart Disease and Treatment with Human Leukocyte lnterferone
Authors: Chiba Yasuo , Mito Kazuaki , Suga Kazuhiro , Honjo Takashi , Sawada Yohko , Tsuda Tetsuya , Ikeda Kazuo , Minagawa Tomonori
Published: October 2007

Between 1980 and 1986, we observed lower respiratory‐tract infection caused by respiratory syncytial virus (RSV) in 19 infants and young children with various forms of congenital heart disease. Of these, seven patients who presented with a severe illness were treated with intramuscular injections of 0.5 to 1 times 106 IU per day of human leukocyte interferon (IFN) for three to five days. Intrinsic IFN activity developed before treatment in three subjects. Viral isolation studies showed active RSV infection prior to treatment, and no infectious RSV was recovered one to four days after treatment. Although there were no obvious changes in the clinical course after IFN therapy, no deaths related to RSV infection occurred. Analysis of the different types of congenital heart disease showed that ventricular septal defect and/or patent ductus arter‐iosus with pulmonary hypertension were associated with the most severe RSV illness. The therapeutic value of IFN may improve in this group of subjects if it is given without delay.
Transmission Electron Microscopic Studies on StreptococcaI Aerosol Infection
Authors: Haraguchi Tsutomu , Yoshinaga Masao , Inoue Hiroyuki , Kawakami Kiyoshi , Hokonohara Masashi , Miyata Koichiro
Published: October 2007

To investigate the initial focus of streptococcal invasion, aerosol‐induced infection in rabbits that resembled natural infection was examined by transmission electron microscopy (TEM). Group A type 12 streptococci were adjusted to a concentration of 108‐109 colony forming units (CFU)/ml in saline. The rabbits were exposed to the aerosolized suspension for about two hours and sacrificed at two hours to 14 days after the exposure. Pharyngeal mucous membranes, palatine tonsils and tracheas were observed by TEM.

Bacterial attachment was recognized on the tonsillar surface epithelium and abnormalities such as vacuolization of cytoplasm and an increased number of plasma cells were observed in the tonsillar medulla. In addition, specialized epithelial cells included micropinocytotic vesicles with spherical substances similar to those of the bacteria.

The micropores of tonsillar crypts are considered to be the pathway of infiltrating cells and initial focus of foreign antigens at present. These findings suggested that tonsils have an important function as the initial focus of invasion of streptococci.
Proximal 3p Deletion: Case Report and Review of the Literature
Authors: Naritomi Kenji , Hirayama Kiyotake , Sameshima Koji , Ohdo Shozo
Published: October 2007

A boy with severe growth and psychomotor retardation, facial dysmorphism, a large atrial septal defect, limitation of joint movement and hearing impairment is described. High‐resolution banding chromosome analysis showed interstitial deletion of the proximal segment of chromosome 3: 46, XY, del(3)(p12p14.2) de novo. The deleted chromosome 3 was of paternal origin as judged from Q‐banding polymorphisms. Delineation of proximal 3p deletion syndrome is proposed by summarizing the clinical and cytogenetical findings of the present and previously reported five patients.
Treatment Outcome of Maternal Phenylketonuria
Authors: Koch Richard , Wenz Elizabeth , Bauman Cindy , Friedman Eva G. , Azen Colleen , Fishler Karol , Heiter William
Published: October 2007

Our experience to date with 40 pregnancies in 13 women with hyperphenylalaninemia indicates that to prevent mental retardation in their children, maternal phenylalanine levels of 120–600 umol/L are needed, in addition to a newborn screening program. While treatment results to date are preliminary, it appears that the phenylalanine‐restricted diet is of value and should be instituted as soon as pregnancy is planned by phenylketonuric women. There is much to be learned by study of these women and referral to a collaborating center in the National Maternal PKU Collaborative Study is recommended.
Treatment Outcome of Maple Syrup Urine Disease
Authors: Snyderman Selma E.
Published: October 2007

Treatment results in maple Syrup urine disease can be good if therapy is started before 10 days of age, if there is meticulous control of the plasma branched chain amino acid levels and if relapses are treated immediately.
Outcome of Displacement Bone Marrow Transplantation for Inborn Errors of Metabolism
Authors: Hobbs J.R.
Published: October 2007

The concept of displacement bone marrow transplantation arose from our work at Westminster 1970–1973, by which time we had extended the donors from matched siblings to other family and unrelated donors. DBMT is not a panacea, but can be applied to about 7% of understood inborn errors, where it is possible to devise in vitro tests to predict in vivo donor effects. Its use to install donor bone marrow as a component factory for the life of the recipient, and the importance of immunoprophylaxis are summarised. Worthwhile correction has been achieved for 48 previously fatal genetic diseases, partial correction for another five, but there has been failure for three diseases. Some 80% of our patients were not found in known families and could not have been prevented.
Effector Mechanisms against Neuroblastoma Cells and Their Modulation by Lymphokines
Authors: Iwami Tetsuro , Yamashita Uki , Nakamura Hiroshi , Yamagishi Minoru
Published: October 2007

The susceptibility of four neuroblastoma (NB) cell lines, SKN‐DZ, GOTO, IMR‐32, and NB‐1 to natural killer (NK) cells and cytotoxic T cells (CTL) and its modulation by lymphokines were studied using a 51 Cr‐release assay in vitro. The cytotoxic activity against 4 NB cell lines differed very much from person to person. However, the activity from every donor was significantly enhanced by culturing of peripheral blood lymphocytes (PBL) with lymphokines, interleukin‐2 (IL2) or interferon (IFN), for 12 hours. Cold target inhibition assay revealed that the cytotoxic activity of IL2– or IFN‐treated cells against NB cell lines was nonspecific and was inhibited by NK‐sensitive K562. In addition, the CTL were not induced by culturing of PBL with mitomycin C‐treated NB cell lines for five days, even in the presence of IL2. These results suggest that it is not cytotoxic T cells but NK cells that are important as effector cells to NBs and that the increase in NK cell activity due to lymphokines may be of profound biological significance in immune surveillance of NBs.
Clinical Improvement with DMSO Treatment in a Patient with Niemann‐Pick Disease (Type C)
Authors: Sakuragawa Norio , Ohmura Kiyoshi , Suzuki Kikuo , Miyazato Yoshino
Published: October 2007

A girl aged 8 years and 10 months with Niemann‐Pick disease (type C) presented with severe psychomotor deterioration, frequent seizures and hepatosplenomegaly. A brain CT showed marked cortical atrophy and moderate ventricular dilatation. A bone marrow smear showed foamy cells. Enzyme studies using fibroblasts showed a partial deficiency of acid sphingo‐myelinase which became normalized by DMSO treatment in cultured fibroblasts. The patient has been treated with DMSO orally for the past two years. Clinically, she has shown slight improvement in response to her surroundings. However, the spleen and liver have decreased in size markedly and recently are not palpable under the costal margins. Seizure frequency has decreased despite a tapering off of one of the anticonvulsants. The EEG's show marked improvement because the fast theta wave has become predominant in background activities and spindles show a good morphological configuration. Cortical atrophy on the CT has not progressed during the two years of treatment. No side effects have been observed clinically or in laboratory studies. We interpret that DMSO treatment shows beneficial clinical effects in a Niemann‐Pick patient (type C).
A Patient with Ring 9 Chromosome 46, XY, r(9)(p24.1q34.3)
Authors: Kasa Noriyoshi , Kasai Ryozo
Published: October 2007

We report the case of a male infant with a 46, XY, r(9)(p24.1q34.3) karyotype. He had developmental retardation and many dysmorphic features, such as trigonocephaly, ante‐verted nostrils, micrognathia, abnormal auricles, short neck, cardiopathy and increased frequency of digital whorls, in common with those of monosomy 9p syndrome.

The normal activity of erythrocyte AK1 in this patient suggests that the locus of AK1 can be confined to 9q34.1→39q34.3 instead of the formerly assigned locus of 9q34.
Infantile Autism and the Fragile X Syndrome in Japanese Children
Authors: Madokoro Harumichi , Ohdo Shozo , Sonoda Tohru , Ohba Ken‐ichi , Tanaka Hiroshi , Hayakawa Kunio
Published: October 2007

A total of 97 children with infantile autism, 85 boys and 12 girls, were screened for the fragile X chromosome. They ranged in age from 2 to 14 years with an average of 5 5/12 years. There were two fra(X) positive boys and no such girls. (Acta Paediatr Jpn 1989; 31: 163 ‐ 165)
Carboxyhemoglobin Measurements in the Diagnosis of ABO Hemolytic Disease
Authors: Uetani Yoshiyuki , Nakamura Hajime , Okamoto Osamu , Yamazaki Takemi , Vreman Hendrik J. , Stevenson David K.
Published: October 2007

To assess hemolysis in hyperbilirubinemic infants with ABO isoimmunization, we measured the carboxyhemoglobin (HbCO) concentrations in full‐term infants with ABO isoimmunization during the first week of life. Two groups of infants, ABO compatible (n=34) and ABO incompatible (n=30), were further divided into two groups with and without hyperbilirubi‐nemia. All the infants from ABO incompatible pregnancies showed a positive indirect Coombs' test. The groups with hyperbilirubinemia included infants with maximum serum total bilirubin levels about 15 mg/dL and infants treated by phototherapy or exchange transfusion. In the ABO incompatible infants, the HbCO levels in those with hyperbilirubinemia were significantly higher than in infants without hyperbilirubinemia during the first week after birth (p < 0.01 at 24, 72, 120 hours after birth, respectively). The levels of HbCO in the ABO incompatible infants with hyperbilirubinemia were significantly higher compared with the levels in the ABO compatible infants with hyperbilirubinemia (p < 0.05 at 24 hours, p < 0.01 at 72 and 120 hours after birth, respectively). HbCO measurement may facilitate the early diagnosis of hemolytic disease and the prediction of jaundice caused by ABO isoimmunization.
Sonographic Measurement of the Volume of the Thyroid Gland in Healthy Children
Authors: Ueda Daisuke
Published: October 2007

This study was designed to establish the nod size of the thyroid gland in children. Realtime ultrasound images of the thyroid gland in 126 healthy children were analyzed to determine the thyroid gland volume. Assuming each lobe to be a prolated spheroid, the long axis diameter (Dl), short axis diameter (D2) and thickness (D3) were measured. The volume of each lobe (V) was estimated, using a standard geometric formula: V = D1 × D2 × D3 ××π/6. The total volume of the thyroid gland was calculated as the sum of each lobe. The thyroid gland volumes were correlated with age, height, weight and body surface area. Correlation with height (r = 0.82, p <0.01) was as good as or better than with the other variables. Mean thyroid gland volumes as a function of height were obtained. No significant difference was observed between males and females in each height group (p>0.05).
Maternal Health, Breast‐Feeding and Infant Nutrition in Australian Aborigines
Authors: Gracey Michael
Published: October 2007

Undernutrition is widespread in Australian Aboriginal infants and children and is associated with high rates of infections, particularly of the respiratory and gastrointestinal systems. Maternal ill health and under nutrition seem to be neglected factors which contribute to the high incidence of low birth weight in Aboriginal babies and to their poor growth in the first five years of life. More effective preventive programmes are needed to help overcome these problems.
Breast‐Feeding Practices in Rural Karnataka (India) with Special Reference to Lactation Failure
Authors: Benakappa D.G. , Raju Manikya , Shivananda  , Benakappa Asha D.
Published: October 2007

A survey was done in a remote rural area of Karnataka with a questionnaire. Overall 274 lactating mothers from a population of 10,000 were interviewed, to know the practices of breast‐feeding with special reference to lactation failure. It was found that the majority of the mothers (97.0%) in rural areas breast‐feed. Lactation failure is not a problem. 58.4% reject colostrum but know the advantages of breast‐feeding while a small number of mothers (19.8%) start supplementary feeds by three months of age. However, 80.3% of mothers breast‐feed up to 12 months. Burping (44.53%) and proper posturing (92%) of the child is not being practiced. Initiation of breast‐feeding within 4–6 hours was noted only in 8.03% of mothers whereas 53.07% of mothers and 9.72% of mothers started sugar water and castor oil as prelacteal feedings respectively. It is interesting to note that grandparents (21.9%) and awillary nurse midwives (21.9%) are the chief influencers of breast‐feeding.
Lymphocytes after Autologous and Allogenic Bone Marrow Transplantation
Authors: Nonoyama Shigeaki , Minakuchi Jun‐ichi , Takase Kozo , Okawa Hiroji , Yata Jun‐ichi , Ohira Matsuo , Nishihira Hirokazu , Onozawa Yosuke , Sakamaki Hisashi , Imai Kuniyuki
Published: October 2007

Lymphocyte reconstitution after bone marrow transplantation (BMT) was analyzed using two‐color flowcytometry in 18 patients and the differences between allogenic and autologous BMT were studied. The CD8 (+) CDllb (+) and CD8 (+) Leu7 (+) suppressor sub sets were increased while the CD4 (+) 2H4 (+) suppressor inducer subset was decreased in both groups after BMT. These variations of suppressor associated subsets persisted for more than 100 days and were considered to be related to immunologic abnormalities in post‐BMT patients. In addition, Ia (+) T cells were increased in both autologous and allogenic BMT patients. Thii increase appears not to be caused by reaction to allo‐antigens, but rather reflects the reconstitution of the lymphocyte system after BMT. In contrast, the CD16 (t) NK cell subset was increased specifically in allogenic BMT patients and only for a short time following transplantation.
Mean Cellular Volume of Urinanry Red Blood Cells in Investigation of Hematuria
Authors: Tsukahara Hirokazu , Yoshimoto Masahiro , Morikawa Kiyoshi , Okada Toshiharu , Kuroda Mitsuhiko , Sudo Masakatsu
Published: October 2007

The mean cellular volume (MCV) of urinary red blood cells (RBCs) of pediatric patients with glomerular (group I; n = 52) and nonglomerular (group II; n = 21) hematuria was determined using an automated bloodell analyzer. Group I patients had a significantly lower MCV than group II (61 ± 8 w. 88 ± 15 μm3, mean ± SD; p<0.001). With a MCV of 75 μm3 taken as the dividmg line between glomerular and nonglomerular hematuria, correct assessment of the site of bleeding was made in 67 of the 73 (92%) patients studied. Determination of the MCV of urinary RBCs is a simple noninvasive test for localizing the site of hemaw in pediatric patients.
Automated Exchange Transfusion and Exchange Rate
Authors: Funato Masahisa , Shirnada Seiichi , Tarnai Hiroshi , Taki Hideo , Yoshioka Yasushi
Published: October 2007

An automated blood exchange transfusion (BET) with a two‐site technique has been devised by Goldmann et al and by us, using an infusion pump. With this method, we successfully performed exchange transfusions 189 times in the past four years on 110 infants with birth weights ranging from 530 g to 4,000 g. The exchange rate by the automated method was compared with the rate by Diamond's method. Serum bilirubin (SB) levels before and after BET and the maximal SB rebound within 24 hours after BET were: 21.6 ± 2.4, 11.5 ± 2.2, and 15.0 ± 1.5 mg/dl in the automated method, and 22.0 ± 2.9, 11.2 ± 2.5, and 17.7 ± 3.2 mg/dl in Diamond's method, respectively. The result showed that the maximal rebound of the SB level within 24 hours after BET was significantly lower in the automated method than in Diamond's method (p<0.01), though SB levels before and after BET were not significantly different between the two methods. The exchange rate was also measured by means of staining the fetal red cells (F cells) both in the automated method and in Diamond's method, and comparing them. The exchange rate of F cells in Diamond's method went down along the theoretical exchange curve proposed by Diamond, while the rate in the automated method was significantly better than in Diamond's, especially in the early stage of BET (p<0.01). We believe that the use of this automated method may give better results than Diamond's method in the rate of exchange, because this method is performed with a two‐site technique using a peripheral artery and vein.
A Case of Multiple Infantile Fibromatosis of Unclassified Type
Authors: Matsuo Muneaki , Mura Satoru Naka , Matsuo Makoto , Hamasaki Yuhei , Miyazaki Sumio , Watanabe Teruo
Published: October 2007

We report an unusual case of fibromatous disease in infancy, diagnosed as a multiple infantile fibromatosis of unclassified type. Histologically, the tumors are composed of a mixture of fibrous component and mature adipose tissue. The clinical manifestations resemble those of infantile myofibromatosis. The symptoms, including size and number of tumors, have not been progressive for one year.
Bacterial Meningitis Caused by Veillonella Parvula
Authors: Nukina Sadayuki , Hibi Aki , Nishida Kanichiro
Published: October 2007

A three‐year‐old girl injured her right eyelid with a toothbrush. The wound was sutured. Swelling of the eyelid, high fever and vomiting developed in spite of oral antibiotics for seven days. The findings of the cerebrospinal fluid (CSF) were white blood cells (WBC) 26,368/mm3 (90% polymorphs), protein 127 mg/d, and sugar 0 mg/dl. Although Cram negative organisms were seen on the smear, aerobic culture was sterile. Later culture of CSF on admission grew anaerobic bacteria: Veillonella parvula. Intravenous administration of penicillins with cefotaxime (CTX), or of fosfomycin (FOM) were ineffective. Chloramphen‐icol (CP) cured the patient without neurological sequelae. There were no abnormal findings on brain CT scan. This is the first report of Veillonella meningitis. V. parvula appeared to have invaded the CSF from the abscess of the eyelid. It is necessary to consider anaerobic meningitis when there is a preceding pyogenic infection in the head.
Hepatitis B Infection in Infants After Neonatal Immunization
Authors: Ip Henrietta MH , Wong Vivian CW , Lelie P Nico , Reesink Henk W. , Schaasberg Wim , Yeung CY , Ma HK
Published: October 2007

A double‐blind randomized placebo‐controlled study to prevent hepatitis B infection in 235 babies born to chronic hepatitis B, HBeAg carriers was carried out. Babies in three treatment groups all received heat‐inactivated hepatitis B vaccine. In addition multiple doses of HBIG and a single dose of HBIG were given in pups I and II respectively. After three years of follow‐up, 4/60 (Group I), 3/64 (Group II), and 1/64 (Group III) developed chronic infection. For those who escaped chronic infection, other hepatitis events also occurred. They were transient HBs‐antigenaemia, anti‐HBc conversion and significant rise in anti‐HBs titre without seroconversion for anti‐HBc. It was deduced that 30% of babies born to hepatitis carriers are naturally protected from chronic infection. Immunization, with vaccine only, protects another 46%. The addition of single and multiple doses of HBIG protects another 10% and 5%, respectively. 2% acquired intrauterine infection and 7% failed to respond to the most intensive immunization schedule.