bluuebunny/crossref_metadata_2025 huggingface dataset:
Are laboratory tests necessary in making the diagnosis of limb pains typical for growing pains in children?
Authors: ASADI‐POOYA ALI AKBAR , BORDBAR MOHAMMAD REZA
Published: November 2007

Background: The present study was conducted to determine if performing laboratory tests are necessary to exclude other possible diagnoses in a child with limb pains typical for growing pains according to history and physical examination.

Methods: A matched case–control study was carried out on children with limb pains who attended the Motahary clinic, Shiraz, Iran, in a 2 year period. The inclusion criteria were limb pains, which were recurrent and lasted for more than 3 months. The exclusion criteria were any abnormal systemic symptoms and signs, localizing signs, joint involvement; and limp or limitation of activity. The controls were clinically normal children matched for age and sex. Laboratory tests including complete blood count, erythrocyte sedimentation rate, serum calcium, phosphorus, alkaline phosphatase and rheumatoid factor were done for all patients and controls.

Results: In total, 100 patients and 150 controls were included in the study. There were no significant differences between the patients and controls with regard to all of the measured laboratory tests.

Conclusion: Growing pain is a clinical diagnosis and if precise inclusion and exclusion criteria in history and physical examination are considered, there will be no need for laboratory tests in order to make a diagnosis.
Effect of zinc sulfate on common cold in children: Randomized, double blind study
Authors: KURUGÖL ZAFER , BAYRAM NURI , ATIK TAHIR
Published: November 2007

Background: The aim of the present randomized, double‐blind, placebo‐controlled study was to determine the efficacy of zinc sulfate on the duration and severity of common cold in children.

Methods: Children presenting at least two of 10 symptoms of common cold within the 24–48 h of the onset of illness were eligible for the study. Children were randomized to receive either oral zinc containing zinc sulfate or placebo. A diary was completed to record symptoms and adverse effects. Symptoms were scored as absent (0), mild (1), moderate (2), or severe (3).

Results: One hundred and fifty children participated in the study, and 120 children were included in the final analysis. The median duration of all cold symptoms was 6 days (P = 0.20), and the median duration of nasal symptoms was 5 days in both groups (P = 0.09). However, total symptom severity scores were significantly lower in the zinc group, starting from the second day of the study. The lower scores in the zinc group were largely due to improvement of nasal symptom scores. Adverse effects were similar in both groups.

Conclusion: Zinc sulfate had no effect on the duration of cold symptoms. However, it appears to be effective in reducing the severity of the cold symptoms in healthy children.
Epidemiological study of sleep characteristics in Chinese children 1–23 months of age
Authors: JIANG FAN , SHEN XIAOMING , YAN CHONGHUAI , WU SHENGHU , JIN XINGMING , DYKEN MIKE , LIN‐DYKEN DEBORAH
Published: November 2007

Background: Sleep plays a critical role in normal development and the effects of culture upon sleep are especially important in young children. The purpose of the present paper was to determine the sleep times and the prevalence of sleep problems and co‐sleeping in children from Shanghai.

Methods: A cross‐sectional design incorporating parental self‐report was used to investigate the sleep‐related habits of 1129 children, 1–23 months of age, randomly selected from the five districts of Shanghai, China.

Results: The total sleep time (TST) of Chinese young children was less than that reported in Western populations, and the prevalence of sleep problems (65.97%) was higher than that for Western children. The sleep problems of children were significantly related to perinatal factors and certain behavior problems. The rate of bed sharing did not differ between boys and girls but significantly increased with age from 44.07% in 1‐month‐olds to 71.51% in 23‐month‐olds.

Conclusions: Sleep problems that cross cultures result from a variety of behavioral and health problems. Nevertheless, it is speculated that reduced TST in Chinese children may be related to factors unique to China, such as co‐sleeping and child‐rearing practices.
Thyroid function and volume in epileptic children using carbamazepine, oxcarbazepine and valproate
Authors: HIRFANOGLU TUGBA , SERDAROGLU AYSE , CAMURDAN ORHUN , CANSU ALI , BIDECI AYSUN , CINAZ PEYAMI , GUCUYENER KIVILCIM
Published: November 2007

Background: The aim of the present study was to investigate the effects of carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA) on thyroid function and volume in epileptic children.

Methods: Fifty‐three epileptic children (age, 3–17 years) treated with OXC (n = 10), CBZ (n = 12), or VPA (n = 31) at least for 1 year were evaluated in terms of thyroid hormones, thyroid‐stimulating hormone (TSH) levels, response to thyrotropin‐releasing hormone (TRH) stimulation test, and thyroid volumes.

Results: The patients in the OXC and CBZ groups had similar total thyroxin (TT4) and free T4 (fT4) median levels that were significantly lower than those of the VPA group (P < 0.016). Total tri‐iodothyrosin median levels were lower in the CBZ group compared to the VPA group (P < 0.016). Basal TSH levels and thyroid volumes were similar in all groups (P > 0.016). One child from the OXC group (10%), one from the CBZ group (%8.3), and six from the VPA group (19.3%) had hypothyroidic status according to the TRH stimulation test. No statistically significant correlations were found between thyroid gland volume and thyroid function variables and between anti‐epileptic drug receiving time and thyroid function or thyroid volume, respectively, in any of the groups (P > 0.05).

Conclusions: Thyroid function should be evaluated periodically in children using CBZ, OXC or VPA. The children taking VPA seems to be at greater risk compared to children onr CBZ or OXC therapy. Except for the basal TSH values in the VPA group, the parameters predictive for the subclinical hypothyroid status remain to be evaluated in further studies.
Stem cell transplantation in primary immunodeficiency disease patients
Authors: SATO TOMONOBU , KOBAYASHI RYOJI , TOITA NARIAKI , KANEDA MAKOTO , HATANO NORIKAZU , IGUCHI AKIHIRO , KAWAMURA NOBUAKI , ARIGA TADASHI
Published: November 2007

Background: Primary immunodeficiency diseases (PID) are rare but have a high associated risk of death from overwhelming infection in early childhood. Stem cell transplantation (SCT) can be curative for PID, but standardized protocols for each disease have not yet been established.

Methods: Between May 1995 and May 2005, nine patients diagnosed with a PID received SCT at the Department of Pediatrics, Hokkaido University Hospital. The median age of the patients (eight boys and one girl) was 1.0 year (range: 6 months–4 years). Five patients had Wiskott–Aldrich syndrome (WAS), three had severe combined immunodeficiency (SCID), and one had X‐linked hyper‐IgM syndrome (X‐HIGM). Four patients received bone marrow transplantation (BMT), and five received cord blood stem cell transplantation (CBSCT). All patients, including those with SCID, received a conditioning regimen: six (WAS and X‐HIGM) received a myeloablative conditioning regimen, and three (SCID) received a reduced‐intensity conditioning regimen.

Results: All the patients are alive and have stable, complete chimerism, based on a median follow‐up period of 4 years. Moreover, all patients have good immune reconstitution, and none required immunoglobulin replacement therapy. Two patients had significant acute graft‐versus‐host disease (GVHD), and three patients had chronic GVHD. Four of the nine patients developed cytomegalovirus (CMV) infection after SCT.

Conclusion: The transplantation procedures appear to have provided a permanent cure in nine PID patients. Early diagnosis and prompt performance of SCT with an optimal donor and conditioning regimen contributed to the favorable outcomes.
Predictive factors for organic central precocious puberty and utility of simplified gonadotropin‐releasing hormone tests
Authors: CHOI JIN‐HO , SHIN YOUNG‐LIM , YOO HAN‐WOOK
Published: November 2007

Background: The aim of the present study was to determine whether the clinical presentation of patients with central precocious puberty (CPP) permits differentiation between idiopathic and organic forms, and to examine whether luteinizing hormone (LH) determination in single blood sample after gonadotropin‐releasing hormone (GnRH) administration is sufficient to diagnose CPP.

Methods: Potential clinical and laboratory predictors for the presence of central nervous system (CNS) abnormalities were assessed. Sensitivities and specificities of LH and follicle‐stimulating hormone (FSH) levels at 0, 15, 30, 60, 90 and 120 min were compared after GnRH stimulation.

Results: In 45 girls with signs of breast development, 26 were diagnosed as having CPP. The age of onset in patients with organic CPP was 4.75 ± 2.01 years (range 1.2–7.1 years, median 5.0 years), whereas the age in patients with idiopathic CPP was 7.09 ± 0.87 years (range 5.0–7.9 years, median 7.0 years). This parameter is the only one showing statistical significance. In addition, the specimen at 30 min after GnRH stimulation yielded highest sensitivity for the diagnosis of CPP.

Conclusions: The earlier the onset of disease, the higher the possibility of presence of CNS lesion. According to the mean GnRH‐stimulated LH levels and sensitivity at each time, a single blood sample obtained for LH determined after GnRH administration at 30 min can be used to diagnose CPP.
Elevation of serum stem‐cell factor in postoperative biliary atresia
Authors: HONSAWEK SITTISAK , CHONGSRISAWAT VORANUSH , VEJCHAPIPAT PAISARN , THAWORNSUK NUTCHANART , TANGKIJVANICH PISIT , POOVORAWAN YONG
Published: November 2007

Background: Biliary atresia (BA) is one of the most common causes of neonatal cholestasis. Stem‐cell factor (SCF) has been implicated in the development of fibrosis in various diseases. The objective of the present study was to examine the significant role of SCF in BA.

Methods: Fifty‐seven pediatric patients with BA after Kasai operation and 30 healthy children were recruited. The mean ages of BA patients and controls were 6.1 ± 0.6 years and 6.1 ± 0.7 years, respectively. The patients were categorized into two groups according to their serum levels of total bilirubin (TBil < 2 mg/dL, no jaundice vs TBil ≥ 2 mg/dL, persistent jaundice) and alanine aminotransferase (ALT < 100 vs ALT ≥ 100 U/L). The serum SCF levels were determined on commercially available enzyme‐linked immunosorbent assay.

Results: The mean serum SCF level of the BA children was higher than that of normal controls (748.3 ± 17.9 pg/mL vs 582.2 ± 17.3 pg/mL; P < 0.001). Subsequent analysis demonstrated that the BA patients with serum ALT ≥ 100 U/L had significantly greater levels of serum SCF compared to those with serum ALT < 100 U/L (796.5 ± 22.6 pg/mL vs 694.7 ± 25.0 pg/mL, respectively; P = 0.002). In addition, serum SCF levels were significantly elevated in the patients with portal hypertension (PH) compared with those without PH (810.0 ± 18.8 pg/mL vs 634.1 ± 20.1 pg/mL, P < 0.001).

Conclusion: The current study showed that BA patients had higher serum SCF levels compared with controls. The significant elevation in SCF levels is associated with the presence of PH and the degree of hepatic injury. These findings suggest that SCF may play a part in the pathogenesis of hepatic fibrosis in BA patients after Kasai procedure.
Addition of sufentanil to bupivacaine in caudal block effect on stress responses in children
Authors: EROL ATILLA , TUNCER SEMA , TAVLAN AYBARS , REISLI RUHIYE , AYSOLMAZ GÖKHAN , OTELCIOGLU SEREF
Published: November 2007

Background: The aim of the present randomized study was to determine the effect of adding sufentanil to bupivacaine, compared with bupivacaine alone in caudal block, on the surgical stress response in children.

Methods: The children were premedicated with midazolam 0.5 mg/kg. All children received induction with nitrous oxide and sevoflurane. Anesthesia was maintained with the same volatile agents in the both groups. The children were randomly allocated to two groups. Group I received bupivacaine alone (n = 17) and group II received bupivacaine + sufentanil (n = 16). Caudal block was performed with 0.25% bupivacaine 2 mg/kg (group I) or 0.25% bupivacaine 2 mg/kg with sufentanil 0.5 μg/kg (group II) after induction of anesthesia. Blood samples were obtained after induction of anesthesia (T0) to measure baseline concentrations of cortisol, prolactin, glucose and insulin. Additional samples were obtained 30 min after the start of surgery (T1), and 60 min after the end of surgery (T2).

Results: All of the basal values (T0) were within the normal ranges of the authors’ laboratory for children of this age group and there were no differences between the groups (P > 0.05). In both groups, glucose concentration increased at T1, compared with T0 and T2 (P < 0.05). The glucose concentration was unchanged at T2 compared with T0 in both group (P > 0.05). In both groups, prolactin concentration increased at T1, compared with T0 and decreased at T2, compared with T1 (P < 0.05). Cortisol decreased at T1 and T2, compared with T0 in both groups. (P < 0.05). Insulin concentration remained unchanged at T0 and T2, but increased slightly at T1 in both groups (P > 0.05). There were no significant differences in plasma prolactin, cortisol, glucose and insulin levels between the two groups at T1 and T2 (P > 0.05).

Conclusion: There is no advantage in adding 0.5 μg/kg sufentanil to bupivacaine over bupivacaine alone in the caudal block, with regard to the surgical stress response in children.
Epidural air associated with spontaneous pneumomediastinum in children: Uncommon complication?
Authors: KONO TATSUO , KUWASHIMA SHIGEKO , FUJIOKA MUTSUHISA , KOBAYASHI CHIE , KOIKE KAZUTOSHI , TSUCHIDA MASAHIRO , SEKI ICHIRO
Published: November 2007

Background: The purpose of the present study was to evaluate the incidence of epidural air associated with spontaneous pneumomediastinum in children.

Methods: The subjects consisted of 25 boys and 17 girls with an age range of 3–14 years (mean age: 8.5 years) who underwent chest computed tomography (CT) for evaluation of spontaneous pneumomediastinum. The CT scans and medical records were reviewed retrospectively.

Results: Of the 42 patients, four (9.5%) had intraspinal air on CT. The air was interpreted as epidural in every patient. The small number of patients with epidural air meant that there was no significant difference in age, gender, or clinical manifestations between groups with and without epidural air. Subcutaneous emphysema was identified in all four patients with epidural air versus 18 out of 38 patients (47%) without epidural air. The patients with epidural air did not have any neurologic symptoms. Irrespective of the presence or absence of epidural air, every patient had a favorable outcome without any serious complications.

Conclusion: In patients with spontaneous pneumomediastinum, epidural air may be more common than was previously realized. It is suggested that an air leak may spread from the mediastinum into the epidural space via the cervical fascial planes and neural foramina.
Human milk reduces the risk of retinal detachment in extremely low‐birthweight infants
Authors: OKAMOTO TOSHIO , SHIRAI MASARU , KOKUBO MASAYO , TAKAHASHI SATORU , KAJINO MAYUMI , TAKASE MASASHI , SAKATA HIROSHI , OKI JUNICHI
Published: November 2007

Background: Retinopathy of prematurity (ROP) is a major cause of blindness in children. Because the use of oxygen is a known risk factor for development of ROP, supplemental oxygen is used carefully. However, it does not necessarily reduce the morbidity of ROP‐induced blindness. The aim of the present study was to identify the possible risk factors for progression to retinal detachment, a most relevant cause of visual impairment, in extremely low‐birthweight infants (ELBWI).

Methods: The medical records of the 42 ELBWI who were admitted to the neonatal intensive care unit in Asahikawa Kosei Hospital from April 1999 to March 2004 were retrospectively reviewed. Seven infants (16.7% of the ELBWI) developed retinal detachment and two of them became blind. Perinatal and postnatal variables in these infants with retinal detachment were compared with those in infants without retinal detachment.

Results: A striking difference in the daily intake of human milk was found between the infants with or without retinal detachment when their gestational ages at birth were matched. The infants without retinal detachment were fed more human milk (67–83% volume of total nutritional intake) as compared to those with retinal detachment (24–38% volume of total nutritional intake) at a specific postnatal period, 5–7 weeks postnatal age.

Conclusions: Human milk may contain some beneficial factors to reduce the severity of ROP. Identifying these factors in human milk may contribute to development of a strategy to rescue premature infants from blindness.
Nosocomial Gram‐positive bacterial infections in children: Results of a 7 year study
Authors: CELEBI SOLMAZ , HACIMUSTAFAOGLU MUSTAFA , OZDEMIR OZLEM , OZAKIN CUNEYT
Published: November 2007

Background: The aim of the present paper was to determine the rate of culture‐proven nosocomial infections and evaluate the episodes of nosocomial Gram‐positive (GP) bacterial infections in pediatric patients.

Methods: The data of children with positive culture, who were diagnosed as having nosocomial infection on the Centers for Disease Control and Prevention criteria, were examined and only the patients with nosocomial GP bacterial infections were included in the study.

Results: Between January 1997 and January 2004 a total of 836 episodes of nosocomial GP bacterial infections were observed. The most frequently seen nosocomial GP bacterial infections were primary bloodstream infections (BSI; 43%), ventriculoperitoneal shunt infections (18%), and nosocomial pneumonias (11%). Coagulase‐negative staphylococci (CONS; 46%) were the most common nosocomial GP bacteria isolated, followed by Staphylococcus aureus (33%). Methicillin resistance rates for CONS and S. aureus were 85% and 25.2%; respectively. The mortality rate was 4% of all children with nosocomial GP bacterial infections in the present study.

Conclusion: In the present patients primary BSI were the most common nosocomial GP bacterial infections and CONS were the most frequent GP pathogen isolated. Antimicrobial resistance in GP isolates is an increasing problem.
Mycophenolate mofetil therapy for children with intractable nephrotic syndrome
Authors: OKADA MITSURU , SUGIMOTO KEISUKE , YAGI KAZURO , YANAGIDA HIDEHIKO , TABATA NOBUTADA , TAKEMURA TSUKASA
Published: November 2007

Background: Cyclosporin A (CyA) can suppress relapses and reduce proteinuria in frequent‐relapse nephrotic syndrome (FRNS) and steroid‐resistant nephrotic syndrome (SRNS). However, some patients remain resistant to CyA therapy. The purpose of the present paper was to evaluate mycophenolate mofetil (MMF) treatment in pediatric patients with CyA‐resistant intractable nephrotic syndrome.

Methods: MMF therapy was given to 11 patients with FRNS who had relapse despite CyA therapy, and one patient with SRNS who had been receiving combined therapy using steroid and CyA until immediately before the start of MMF. MMF was administered at a daily dose of 750–1000 mg/m2 in two divided doses.

Results: Ten of the 11 patients with FRNS were able to maintain remission. Among them, seven patients remained relapse free for 1 year, and two patients had a decrease in the frequency of relapse after initiation of MMF therapy. One patient, however, had repeated cycles of remission and relapse, and was considered resistant to MMF therapy. The total prednisolone dose during the period from month 6 to month 12 after the start of MMF therapy was significantly lower than that during the 6 month period before the start of MMF therapy. The patient with SRNS, who had not achieved remission despite CyA administration, had complete remission on MMF. No serious adverse effects were seen in any of the present patients.

Conclusion: MMF could be useful in CyA‐treatment‐refractory FRNS and CyA‐resistant SRNS.
Utility of diagnostic tests for detection of Helicobacter pylori in children in northeastern Mexico
Authors: MENDOZA‐IBARRA SANDRA IVETH , PEREZ‐PEREZ GUILLERMO IGNACIO , BOSQUES‐PADILLA FRANCISCO JAVIER , URQUIDI‐RIVERA MARTHA , RODRÍGUEZ‐ESQUIVEL ZULMA , GARZA‐GONZÁLEZ ELVIRA
Published: November 2007

Background: The presence of Helicobacter pylori in pediatric population has been associated with recurrent abdominal pain (RAP), although this association is unclear. One of the major problems in studying the role of H. pylori in RAP is that methods used to detect the bacteria in children have poor sensitivity and specificity. The aims of the present study were to determine the prevalence of H. pylori in pediatric patients with RAP in northeastern Mexico and to assess the diagnostic utility of invasive tests and serology in this population.

Methods: A total of 40 patients (mean age, 7.9 years; range 2–16 years; F: M, 0.81), who underwent an endoscopy procedure for RAP, were studied. The presence of H. pylori was assessed using invasive diagnostic tests (culture, rapid urease test, polymerase chain reaction and histology) and one non‐invasive test: determination of IgG antibodies. The prevalence of H. pylori in the present group and the diagnostic utility for each test were evaluated.

Results: The prevalence of H. pylori in the present pediatric group with RAP was 12.5–42.5% depending on the criteria of positivity used. The non‐invasive methods (serology) had acceptable values in sensitivity and specificity in comparison with invasive tests.

Conclusions: This is the first report on prevalence of H. pylori in pediatric patients with RAP from the northeastern region of Mexico. The prevalence of H. pylori was low compared with the adult population in the same geographic region. Serology had the best diagnostic utility.
Hemodynamic features of congenital aortic valve stenosis with patent ductus arteriosus in children
Authors: XIE CHUNHONG , XIA CHENGSEN , ZHAO ZHENGYAN , ZHOU YINBAO
Published: November 2007

Background: The aim of the present paper was to investigate the hemodynamic features of congenital aortic valvar stenosis (AS) associated with patent ductus arteriosus (PDA), and to develop information to guide management of AS with coexistent PDA.

Methods: Hemodynamic measurements were performed in eight of 11 patients with AS before and following transcatheter closure of a PDA. Doppler cardiac ultrasound and chest X‐rays were performed during follow up.

Results: In each of the 11 patients, aortic valve gradient was markedly reduced following transcatheter ductal closure. In only one of them was balloon aortic valvuloplasty necessary.

Conclusion: Aortic valve gradient was markedly overestimated before closure of PDA. The significance of this finding has focused on selecting appropriate management so that a PDA is not overlooked when intervention for AS is performed.
Stromal cell‐derived factor‐1α improves infarcted heart function through angiogenesis in mice
Authors: SASAKI TAKASHI , FUKAZAWA RYUJI , OGAWA SHUNICHI , KANNO SHIGETO , NITTA TAKASHI , OCHI MASAMI , SHIMIZU KAZUO
Published: November 2007

Background: Local delivery of stromal cell‐derived factor‐1α (SDF‐1) has been demonstrated to improve hind limb ischemia through enhanced neovascularization in animals. It was hypothesized that local administration of SDF‐1 also contributes to neovascularization of ischemic heart.

Method: Acute myocardial infarction was created by left coronary artery ligation in C57BL/6J mice. Immediately after infarction induction, mice were treated by injection directly into the center of ischemic myocardium either with saline (control group) or SDF‐1 (SDF‐1 group). Cardiac function was measured on echocardiogram 2 and 4 weeks after infarction. On week 4 mice were killed to evaluate infarction size and capillary vessel density. To determine the contribution of bone marrow cells to angiogenesis, the same procedures were performed on C57BL/6J chimeric mice reconstituted with green fluorescent protein‐positive bone marrow cells.

Results: Fractional shortening was greater in the SDF‐1 group at 4 weeks (0.31 ± 0.06% vs 0.23 ± 0.03%, P = 0.037). The infarct area was smaller in the SDF‐1 group compared to the control group (9.31 ± 2.76% vs 18.07 ± 5.69%, P = 0.028). Green fluorescent protein‐positive cells accumulated predominantly at the peri‐infarction site, and were located with the capillary vessels. Capillary vessel density was significantly increased in the SDF‐1 group (13.08 ± 4.11 vessels/mm2 vs 34.50 ± 7.59 vessels/mm2, P = 0.014).

Conclusions: SDF‐1 protects against deterioration of cardiac function after acute myocardial infarction by promoting angiogenesis. The safety and long‐term prognosis of this treatment remains to be determined.
Are foot posture and functional health different in children with growing pains?
Authors: EVANS ANGELA MARGARET , SCUTTER SHEILA DOREEN
Published: November 2007

Background: The aim of the present paper was to investigate and compare findings of foot posture and functional health between groups of children aged 4–6 years with and without leg pain (described as “growing pains”). The null hypothesis: that there is no difference in measures of either foot posture or functional health between groups of children with and without leg pain.

Methods: A stratified random sample of children was obtained. The children were identified with and without leg pain using a validated questionnaire for parents. The examiner was blind to the children’s pain status. The schools and child care centers were from each geographical quadrant of metropolitan Adelaide and a northern rural region of South Australia. One hundred and eighty children (94 boys, 86 girls) entered and completed the study. Children whose parents returned a completed questionnaire and consent form were entered into the study. All participants were assessed by the one examiner. The foot posture measures used were those found to be most reliable in previous studies and for which the intra‐rater reliability of the examiner was ascertained.

Results: Initial analysis of foot posture measures between the leg pain and no leg pains groups indicated a statistically significant result for the measure of navicular height, but only on the left side (P =  0.033). Logistic regression modeling showed that navicular height (left foot only) was positively yet weakly related to growing pains (odds ratio, 1.072; 95% confidence interval: 0.991–1.160) and the effect was not significant (P =  0.08). Measures of functional health returned many statistically significant yet weakly correlated relationships.

Conclusions: The null hypothesis of the present study was supported in terms of clinical significance. While the foot posture measure of navicular height on the left foot was statistically significant it was not predictive for growing pains nor clinically significant as a measure between groups. The present study does not support the anatomical theory for growing pains and does not find a meaningful relationship between foot posture or functional health measures and leg pain in young children.
Study of Japanese encephalitis and other viral encephalitis in Nepali children
Authors: RAYAMAJHI AJIT , SINGH RUPA , PRASAD RAJNITI , KHANAL BASUDHA , SINGHI SUNIT
Published: November 2007

Background: A hospital‐based prospective cross‐sectional study was conducted in children aged 1 month–14 years to identify the proportion of viral encephalitis due to Japanese encephalitis (JE) and compare the clinico‐laboratory profile and outcome of JE with that of other viral encephalitis (non‐JE).

Methods: All probable cases of viral encephalitis on clinical and laboratory evaluation were confirmed as JE on anti‐JE IgM in cerebrospinal fluid (CSF) and/or serum. Patients not having anti‐JE IgM in CSF and/or serum were diagnosed as having non‐JE.

Results: Of 94 cases, 58 were JE and 36 non‐JE. Although practice of rearing pigs at home was associated with JE (P = 0.0001), significantly higher serum creatinine, protein, aspartate aminotransferase and CSF protein levels were observed in non‐JE. Longer duration of fever was associated with complete recovery in JE whereas shorter duration of fever was associated with recovery in non‐JE. Risk of neurological sequelae (P = 0.01), especially hemiparesis (P = 0.03) was significantly more in JE. Sequelae were observed at 6 weeks follow up in 18.8% of JE and 13.9% of non‐JE.

Conclusion: JE was the most common cause of viral encephalitis in eastern Nepal and should be suspected in encephalitic patients having pig rearing at home and neurological sequelae. Although duration of hospitalization and complication were higher in JE, final outcome was similar to non‐JE. Longer duration of fever in JE and shorter duration of fever in non‐JE correlated with recovery, while altered sensorium and focal neurological deficit were independent predictors of sequelae at 6 weeks only in JE and not in non‐JE.
Residual activity of clomeprop and its downward movement under laboratory conditions
Authors: MURANO HIROTATSU , KOBAYASHI KATSUICHIRO , FUJIHARA SHINSUKE
Published: November 2007

The relationship between the behavior of clomeprop ([RS]‐2‐[2,4‐dichloro‐m‐tolyloxy]propionanilide) and its residual phytotoxic activity in the soil was investigated in the laboratory with special emphasis on the concentration in the soil water. The phytotoxic activity of clomeprop on radish seedlings (Raphanus sativus L. var. radicula cv. Akamaruhatsukadaikon), as the test plant, became greater with time after application but the inhibition was different between the two soils, which had different properties. The amount of 2‐(2,4‐dichloro‐3‐methylphenoxy)propionic acid (DMPA), a hydrolyzed and active metabolite of clomeprop, in the soil water and total soil increased with time, corresponding to the decrease in the amount of clomeprop under non‐water leakage conditions. The residual phytotoxic activity of clomeprop in the soil was more highly correlated with the concentration of DMPA in the soil water than with the amount of DMPA in the total soil. In addition, a leaching column test was conducted with clomeprop and DMPA. The DMPA easily moved downward and the concentration in the soil water in the upper layer decreased with time after application. It is supposed that the downward movement of DMPA was one of the factors influencing the lasting effect of clomeprop in the field.
Growth parameters enhancing the competitive ability of corn (Zea mays L.) against weeds
Authors: MOHAMMADI GHOLAM R.
Published: November 2007

In order to determine which plant growth parameters enhanced the competitive ability of corn (Zea mays) against weeds, a field study was conducted at the Agricultural Research Farm, Razi University, Kermanshah, Iran. A factorial experiment based on a randomized complete block design with four replications was used. The factors consisted of weed treatments (including weedy and weed‐free during all of the growing season) and corn cultivars (including KSC 260, KSC 302, KSC 500, KSC 647, KSC 700, and KSC 704). The plant growth parameters under study consisted of height, plant dry weight, the number of tillers, leaf area index, specific leaf area, crop growth rate, relative growth rate, and net assimilation rate. The results indicated that the cultivars, KSC 700 and KSC 704, had the highest competitive ability and the cultivars, KSC 302 and KSC 260, had the lowest competitive ability. The competitive ability of the cultivars, KSC 500 and KSC 647, was intermediate. All of the growth parameters under study, except the number of tillers, indicated a positive and significant correlation with competitive ability, and the relative growth rate showed the highest correlation. Variable selection using the stepwise multiple linear regression method revealed that, among the growth parameters under study, both the relative growth rate and the specific leaf area were the best predictors of corn cultivar competitiveness.
Less hazardous alternative herbicides to control weeds in immature oil palm
Authors: WIBAWA WAHYU , MOHAMAD ROSLI , OMAR DZOLKHIFLI , JURAIMI ABDUL SHUKOR
Published: November 2007

In 2002, the Malaysian government had banned the use of the hazardous herbicide, paraquat. Most growers perceive that paraquat is the most effective herbicide and provides the fastest mode of action to control weeds. An experiment was conducted at MAB Agriculture‐Horticulture, Sepang, Selangor, Malaysia, from February 2004 to February 2005 to evaluate the efficacy and ability of the less hazardous herbicides, glufosinate ammonium and glyphosate, as an alternative to the hazardous herbicide, paraquat, in controlling weeds in immature oil palm (<3 years old). The results showed that paraquat needed high rates, 600 and 800 g ha−1, to control weeds effectively. However, lower rates of glufosinate ammonium (200 g ha−1) and glyphosate (400 g ha−1) gave excellent weed control. The results showed that the efficacy of glufosinate ammonium and glyphosate were much better than paraquat. The results also showed that, with no direct contact with the plants, paraquat, glufosinate ammonium, and glyphosate had no adverse effect on the vegetative and generative growth of oil palm in this study. These results proved that the less hazardous herbicides, glufosinate ammonium and glyphosate, could be used as an alternative to paraquat to control weeds in immature oil palm.
Antithrombin improves fetal condition in women with severe pre‐eclampsia before 32 weeks of gestation; a randomized, double‐blind, placebo‐controlled trial
Authors: Sameshima Hiroshi , Kodama Yuki , Ikenoue Tsuyomu , Kajiwara Yayoi
Published: November 2007

Aim:  To see if antithrombin (AT) supplementation improved fetal outcomes in early onset (<32 weeks) severe pre‐eclampsia.

Methods:  A subgroup re‐analysis of an original randomized controlled trial of AT in pre‐eclampsia between 24 and 35 weeks of gestation was performed. Either AT (3000 IU/day, n = 42) or placebo (Albumin 582 mg/day, n = 42) were administered for 7 days. Fetal weight gain, biophysical profile score and fetal heart rate monitoring were evaluated during the treatment week and until delivery. Comparisons were performed by intent‐to‐treat and relative risk (RR) and 95% Confidence Intervals (CI) were obtained.

Results:  In each group, 27 women (64%) completed the allocated intervention. AT significantly decreased the worsening of the fetal biophysical profile score or fetal heart rate monitoring (RR 0.24, 95% CI 0.07–0.8), increased the incidence of estimated weight gain >15 g/day during the intervention week (3.1, 1.0–9.9), and prolonged gestational age to ≥34 weeks (3.6, 1.05–12.6), however infant mortality rates did not differ between the two groups. No adverse events related to AT were observed.

Conclusions:  Supplementation of AT preserves fetal biophysical condition and weight gain in early onset severe pre‐eclampsia and most likely prolongs pregnancies ≥34 weeks of gestation.
Clinical significance of pregnancies with circumvallate placenta
Authors: Suzuki Shunji
Published: November 2007

Aim:  This study examined the clinical significance of patients complicated by circumvallate placenta in comparison with patients with a normal placenta.

Methods:  Data were collected from 139 singleton deliveries complicated by circumvallate placenta and from 7666 unaffected controls managed at Japanese Red Cross Katsushika Maternity Hospital between 2002 and 2005.

Results:  The incidence of premature delivery, oligohydramnios, non‐reassuring fetal status on cardiotocogram, placental abruption and intrauterine fetal death in patients complicated by circumvallate placenta were significantly higher than those in control patients. The odds ratio of placental abruption in patients complicated by circumvallate placenta was 13.1 (95% confidence limits: 5.65–30.2).

Conclusion:  A circumvallate placenta is associated with a higher incidence of serious perinatal complications such as placental abruption.
Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion
Authors: Abd‐El‐Maeboud Karim H. I. , Ghazy Abbas A. S. , Nadeem Amr A‐A. , Al‐Sharaky Amr , Khalil Alaa‐Eddin I.
Published: November 2007

Aim:  To evaluate the effect of vaginal pH on the efficacy of misoprostol for induction of midtrimester abortion.

Methods:  The study comprised 110 women, with a gestational age of 14–26 weeks, with a missed abortion as an indication for the induction of abortion. On admission, the vaginal pH was measured and two groups were generated: (A) those with pH < 5 (n = 63); and (B) those with pH ≥ 5 (n = 47). All of the women received intravaginal misoprostol tablets moistened with 3 mL of 5% acetic acid, 200 μg every 4 h for a maximum of 5 doses within 24 h. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 h and if no response was achieved, this was considered a failure of therapy.

Results:  All patients aborted within 48 h. A significant positive correlation between vaginal pH and the misoprostol application‐abortion interval was found. The mean induction‐abortion interval was significantly shorter in group A compared to group B (12.1 vs 23.6 h, P < 0.001), with abortion rates at 24 h being 100% and 63.8%, respectively. Moreover, a significantly lower dose of misoprostol was used in group A with a lower incidence of fever and abdominal pain.

Conclusion:  Vaginal pH influences the efficacy of misoprostol administered vaginally for the induction of midtrimester abortion. The presence of this relationship, despite premoistening misoprostol with an acidifying agent, suggests that the effect of vaginal pH might extend beyond affecting the pharmacokinetics of the drug.
Prevention of adhesion formation following ovarian surgery in a standardized animal model: Comparative study of Interceed and double layer Surgicell
Authors: Ates Ugur , Ata Baris , Ortakuz Serpil , Seyhan Ayse , Urman Bulent
Published: November 2007

Aim:  Comparison of antiadhesive performances of double layer Surgicell and single layer Interceed following ovarian surgery in a rabbit model.

Methods:  Prospective randomized controlled trial performed at the animal laboratory of a university. Thirty‐nine New Zealand White female rabbits of reproductive age were included. Ovaries were bivalved with a no. 15 scalpel. One of the ovaries was covered with a single layer of Interceed while the other was covered with a double layer of Surgicell. In the control group no adhesion barriers were used. Four weeks later adhesions were scored macroscopically. Following oophorectomy specimens were evaluated microscopically for mesothelial proliferation. The macroscopic adhesion score according to Blauer's criteria and the number of mesothelial cell layers were compared.

Results and Conclusion:  The control group had significantly higher adhesion scores than the barrier groups. Macroscopic adhesion scores were not different among the barrier groups. The average number of mesothelial cell layers was 1.77 ± 2.68, 1.69 ± 2.58 (range 0–8) and 2.04 ± 2.84 (range 0–10) for ovaries in the control, Interceed and Surgicell groups, respectively: the difference was not significant. Our results demonstrate that a double layer of Surgicell is as effective as Interceed in reducing postoperative adhesion formation in a rabbit model.
Metabolic syndrome in females with polycystic ovary syndrome and International Diabetes Federation criteria
Authors: Bhattacharya Sudhindra M.
Published: November 2007

Aim:  To find out the incidence of metabolic syndrome (MS) in females with polycystic ovary syndrome (PCOS) and to assess the metabolic risk factors as per the definition of International Diabetes Federation.

Methods:  One hundred and seventeen females (39 adolescents and 78 adults) diagnosed with PCOS underwent assessments clinically and by appropriate laboratory tests for the evidence of MS, as per the criteria laid down by International Diabetes Federation.

Results:  MS was diagnosed in 54 cases (46.2%), of which 43.6% were adolescents and 47.4% were adults (difference not statistically significant). MS in females with PCOS had significantly higher body mass index compared to those who did not have MS, irrespective of age. Abnormalities in both the lipids were more common than fasting glucose abnormalities.

Conclusion:  MS was found in 46.2% of females with PCOS, with both adolescents and adults being similarly affected. Dyslipidaemia is more common than impaired fasting glucose and finding one risk factor should prompt the clinician to search for other risk factors. All females with PCOS should undergo periodic screening for MS.
Reduced insulin‐induced phosphatidylinositol‐3‐kinase activation in peripheral blood mononuclear leucocytes from patients with Alzheimer's disease
Authors: Castri Paola , Iacovelli Luisa , De Blasi Antonio , Giubilei Franco , Moretti Arianna , Capone Francesca Tari , Nicoletti Ferdinando , Orzi Francesco
Published: November 2007

The epidemiological finding of an increased risk of dementia in patients with diabetes mellitus has raised the hypothesis that a dysfunction of the insulin receptors plays a role in the pathogenesis of Alzheimer's disease (AD). A possible link is suggested by the evidence that the insulin‐stimulated phosphatidylinositol‐3‐kinase (PI‐3‐K)/phospho‐Akt pathway negatively controls the glycogen synthase kinase‐3β. The activation of this enzyme mediates the hyperphosphorylation of the tau protein, a relevant step in the formation of the neurofibrillary tangles associated with AD. We hypothesized that the neurodegeneration associated with AD is related to an impairment of the intracellular signalling stimulated by insulin receptors. To test this hypothesis we assessed the PI‐3‐K/phospho‐Akt pathway following in‐vitro challenge with insulin in peripheral blood mononuclear cells from subjects with AD (n = 20) and controls (n = 20). We found that the stimulation of PI‐3‐K is blunted in patients with AD with respect to control. The reduction did not correlate with the extent of cognitive decline or with scores at neuropsychological tests exploring attention, memory, language or visuospatial abilities. The study supports the hypothesis that an impaired control of glycogen synthase kinase‐3β activity by insulin receptor‐mediated signalling plays a role in the pathogenesis of AD, facilitating tau protein phosphorylation and neurofibrillary tangle formation.
Neuroprotectant minocycline depresses glutamatergic neurotransmission and Ca2+ signalling in hippocampal neurons
Authors: González José Carlos , Egea Javier , Del Carmen Godino María , Fernandez‐Gomez Francisco J. , Sánchez‐Prieto José , Gandía Luís , García Antonio G. , Jordán Joaquín , Hernández‐Guijo Jesús M.
Published: November 2007

The mechanism of the neuroprotective action of the tetracycline antibiotic minocycline against various neuron insults is controversial. In an attempt to clarify this mechanism, we have studied here its effects on various electrophysiological parameters, Ca2+ signalling, and glutamate release, in primary cultures of rat hippocampal neurons, and in synaptosomes. Spontaneous excitatory postsynaptic currents and action potential firing were drastically decreased by minocycline at concentrations known to afford neuroprotection. The drug also blocked whole‐cell inward Na+ currents (INa) by 20%, and the whole‐cell Ca2+ current (ICa) by about 30%. Minocycline inhibited glutamate‐evoked elevation of the cytosolic Ca2+ concentration ([Ca2+]c) by nearly 40%, and K+‐evoked glutamate release from synaptosomes by 63%. Minocycline also depressed the frequency and amplitude of spontaneous excitatory postsynaptic currents, but did not affect the whole‐cell inward current elicited by γ‐aminobutyric acid or glutamate. This pharmacological profile suggests that the neuroprotective effects of minocycline might be associated with the mitigation of neuronal excitability, glutamate release, and Ca2+ overloading.
Mucus secretion and transport in amphioxus larvae: organization and ultrastructure of the food trapping system, and implications for head evolution
Authors: Lacalli Thurston
Published: November 2007

A low‐to‐medium power transmission electron microscopy survey of the larval head of amphioxus was used to re‐examine the position and constituent cell types of the mucus‐secreting organs involved in feeding. Previously unreported features include cells with fibril‐filled paraciliary processes in the recessed (pit) portion of the preoral organ, which probably assist in generating the mucus string produced by this structure, and the cell responsible for driving the current through the club‐shaped gland, which appears to depend on a mechanism analogous to Archimedes’ screw. Pharyngeal structures are dramatically repositioned during larval growth and metamorphosis. Mapping these changes shows that they are most easily explained if the positioning of the mouth is not directly controlled by the mechanism used to pattern the rest of the ventral pharynx. This accords with the predictions of the dorsoventral inversion hypothesis, which requires that an originally dorsal mouth in the inverted chordate ancestor be secondarily shifted to the ventral surface. It is argued here, on this basis, that the repositioning of the larval mouth in amphioxus, from the left side to the ventral midline, represents a partial recapitulation of past evolutionary events.
The biogeography of the beachflea, Orchestia gammarellus (Crustacea, Amphipoda, Talitridae), in the North Atlantic with special reference to Iceland: a morphometric and genetic study
Authors: Henzler Christine M. , Ingólfsson Agnar
Published: November 2007

The beachflea [Orchestia gammarellus (Pallas)] is a trans‐Atlantic amphipod inhabiting the littoral fringe. In Iceland, its distribution is temperature‐limited; it has recently colonized Iceland's relatively warm south‐western coast, and in the cooler north‐west, several small populations inhabit isolated warm springs. We address two questions: (i) Do the warm spring populations show evidence of long‐term residence in Iceland, or of recent colonization? (ii) For the new south‐western Icelandic populations, can the source population be determined? We sequenced COI for 22 populations in Iceland, Nova Scotia, the Faroe Islands, the British Isles, Norway and Sweden. Morphometric analysis of a subset of populations assessed 16 continuous and five discrete characters. Genetically, we found a star phylogeny: a common haplotype was found at all sites except two neighbouring warm spring populations, and all haplotypes were within two base pairs of this common haplotype. Morphometrically, almost all populations examined differed significantly in some characters; however, the warm spring populations differed slightly more from each other than did other populations. Although the origins of the Icelandic populations could not be well resolved, our data are consistent with a recent European origin.