bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatic Proteins in Regenerating Liver
Authors: IWAI MASAKI , KASHIWADANI MOTOMU , HARADA YOSHIKI , TADA KAZUNOBU , ISHII YASUTAKA , KITAGAWA YOSHIHIRO , NAKASHIMA TOSHIAKI , OKANOUE TAKESHI , KASHIMA KEI , IBATA YASUHIKO
Published: March 2008

Abstract  Albumin immunoreactivity in the liver was examined on days 2, 5 and 10 after two‐thirds partial hepatectomy by light and ultrastructural immunoperoxidase methods and the ultrastructural area of the rough endoplasmic reticulum (ER) in hepatocytes was measured. Albumin immunoreactivity was seen in the rough ER and Golgi apparatus of all hepatocytes in the hepatectomized liver and ultrastructural analysis showed a significantly greater area of rough ER on day 5 than on days 2 or 10. Albumin mRNA was studied by the in situ hybridization technique using radioisotopes and their numbers were determined visually. Albumin mRNA was present as grains in all hepatocytes and the grains varied in number during regeneration of the liver, being more abundant on day 5 than on days 2 or 10. The activity of [3H]‐leucine incorporated into albumin synthesis, an indicator of translational activity, was higher on days 5 and 10 than on day 2 and was highest on day 5. In conclusion, albumin synthesis varied during liver regeneration after partial hepatectomy, being reduced at the peak of cell proliferation on day 2 and being most active on day 5.
Ursodeoxycholic Acid
Authors: TANAKA KATSUAKI , KONDO MASAAKI , SAKAGUCHI TAKASHI , SAITO SATORU , ARATA SHINJU , IKEDA MASANORI , KITAMURA TAKEHIKO , MORIMOTO MANABU , SEKIHARA HISAHIKO
Published: March 2008

Abstract  Ursodeoxycholic acid (UDCA) has recently been combined with interferon (IFN) in the treatment of individuals with chronic hepatitis C. However, whether its addition results in a long‐term favourable response to IFN remains unclear. A prospective randomized trial of IFN alone versus IFN plus UDCA was therefore undertaken in 52 patients with chronic hepatitis C. All patients received a 24 week course of IFN‐α (6 × 106 U/day for 2 weeks and then three times a week for 22 weeks) and half also received UDCA (600 mg/day) with IFN and then alone for 48 additional weeks. Normalization of serum alanine transaminase (ALT) concentrations at 0, 24 and 48 weeks after cessation of IFN therapy was apparent in 77, 42 and 42% of patients in the IFN‐alone group and in 77, 54 and 42% of patients in the IFN plus UDCA group, respectively. There was no significant difference between the two groups with regard to response rate to IFN and the addition of UDCA to IFN treatment had no significant effect on hepatitis C virus (HCV) viraemia. During the follow‐up period, 10 of 20 patients with normal serum ALT at the end of IFN treatment relapsed in the IFN‐alone group compared with 11 of 20 patients in the IFN plus UDCA group. Among these relapsed patients, serum ALT concentration was significantly lower in the IFN plus UDCA group than in the IFN‐alone group during the follow‐up period. Twenty‐four weeks after cessation of IFN therapy, the percentage of patients with HCV‐RNA in their serum who showed a normalization of serum ALT concentrations was significantly higher in the IFN plus UDCA group than in the IFN‐alone group (44 vs 6%). Thus, although the addition of UDCA was not associated with a favourable long‐term response to HCV viraemia, it did reduce the risk and the severity of relapse following the cessation of IFN therapy.
Gastric Secretion
Authors: TAKEUCHI K. , TAKEHARA K. , KATO S. , ASADA Y. , YASUHIRO T.
Published: March 2008

Abstract  The effect of repeated administration of the nitric oxide synthase inhibitor NG‐nitro‐l‐arginine methyl ester (l‐NAME) on gastric HCO‐3 secretion was examined using ex vivo chambered stomachs of anaesthetized rats. Intravenous administration of l‐NAME (5 mg/kg) increased gastric HCO‐3 secretion with a concomitant rise in arterial blood pressure (BP). The HCO‐3 stimulatory action of l‐NAME diminished when rats were pretreated with l‐NAME (20 mg/kg, p.o., twice daily) for 1 or 3 days and an inverse relationship was found between the degree of secretory stimulation and the period of pretreatment. The increased BP response to l‐NAME was also significantly lessened following repeated pretreatment; basal BP showed a stepwise increase during repeated pretreatment and did not change at all in response to i.v. l‐NAME after 3 days pretreatment. When ΔHCO‐3 output induced by i.v. l‐NAME was plotted against ΔBP (from basal values) during repeated pretreatment with l‐NAME, a significant relationship was found between these two factors. The reduction in the HCO‐3 secretory response to l‐NAME was restored when animals were pretreated with l‐arginine (500 mg/kg, i.p., twice daily) together with l‐NAME. However, prostaglandin E2 (300 μg/kg, i.v.) caused a gastric HCO‐3 secretory response similar to l‐NAME, regardless of whether rats had been pretreated with l‐NAME or not. In contrast, the attenuation by l‐NAME of the acid (0.2 mmol/L HCl)‐induced gastric hyperaemic response was not influenced by repeated pretreatment with l‐NAME. We conclude that repeated p.o. pretreatment with l‐NAME reduces the HCO‐3 stimulatory action of i.v. l‐NAME and that this phenomenon may be explained by the lack of further elevation of BP in response to i.v. l‐NAME following repeated pretreatment with this agent. Thus, the stimulation of HCO‐3 secretion by i.v. l‐NAME may be causally related with increased BP in response to this agent.
Prolonged bleeding time: A new clinical manifestation of hepatocellular carcinoma?
Authors: CHU CHI‐JEN , LEE FA‐YAUH , HWANG SHINN‐JANG , HSU WAN‐CHING , TSAI YANG‐TE , LIN HAN‐CHIEH , LI CHUNG‐PIN , WANG SUN‐SANG , LEE SHOU‐DONG
Published: March 2008

The association between prolonged bleeding time and hepatocellular carcinoma (HCC) has not been well studied. We investigated whether bleeding time is prolonged in cirrhotic patients with HCC and studied the role of clinical characteristics, tumour size, and laboratory data in predicting bleeding time prolongation. After excluding patients that presented with blood dyscrasia and uraemia, 58 cirrhotic patients with HCC, 106 cirrhotic patients without HCC, and 44 age‐ and sex‐matched healthy subjects were included in the study. Bleeding time, imaging studies, clinical characteristics and biochemical data were obtained for every patient. Cirrhotic patients with and without HCC had longer bleeding times (554±68 and 535±32s, respectively) compared with healthy controls (357±13s, P < 0.05). Hepatocellular carcinoma patients with a large tumour burden (> 5 cm in diameter) had a significantly longer bleeding time than those patients without (663±105 vs 376±23s, respectively, P < 0.05). After excluding patients with a platelet count ≤ 80 000/mm3, cirrhotic patients classified as Child‐Pugh's grading A and with a large tumour burden had longer bleeding times (580±87s) than patients with a small tumour burden (≤ 5 cm in diameter) and cirrhotic patients without HCC (371±22 and 416±29s, respectively, P < 0.05). In cirrhotic patients with HCC, higher serum bilirubin levels, a Child‐Pugh's grading C, and a tumour size > 5 cm in diameter were found to be significant predictors for prolonged bleeding time on univariate analysis. On multivariate analysis, both tumour size > 5 cm in diameter and a Child‐Pugh's grading C (odd's ratio, 95% confidence interval and P value were measured as 38.5, 2.8–534.7, < 0.001, and 10.5, 0.9–117.6, 0.02, respectively) were the significant independent predictors. A significant correlation existed between tumour diameter and bleeding time (r= 0.44, P < 0.01). In conclusion, these results suggest that prolonged bleeding time may be categorized as a new clinical manifestation in patients with HCC. In addition to cirrhosis, HCC itself may also participate in the pathogenesis of bleeding time prolongation.
Laparoscopic prediction of hepatocellular carcinoma in cirrhosis patients
Authors: KAMEDA YOSHIO , ASAKAWA HIDEKI , SHIMOMURA SOHJI , SHINJI YOSHITAKE
Published: March 2008

Previously, laparoscopic studies have not been successful in predicting the occurrence of small hepatocellular carcinoma because cirrhotic patients had not been separated into groups of those who developed small hepatocellular carcinoma under 3 cm in diameter, and those who did not. Retrospective examination with better separation of the two groups gave improved results. Of the 26 laparoscopic findings, only the presence of large complex regenerative nodules was closely associated with the occurrence of subclinical small hepatocellular carcinoma. The study of other cirrhotic patients with and without large complex regenerative nodules gave a cumulative hepatocellular carcinoma occurrence rate of 73% for patients who had these nodules by the third year after laparoscopy. In contrast, the rate for patients without such nodules was 6%, showing a significant difference (P < 0.05) between the two groups. We concluded that the laparoscopic finding of large complex regenerative nodules of liver cirrhosis can be used to predict the occurrence, or a complication, of subclinical small hepatocellular carcinoma.
Effect of shunt surgery on spleen size, portal pressure and oesophageal varices in patients with non‐cirrhotic portal hypertension
Authors: SHARMA BC , SINGH RP , CHAWLA YK , NARASIMHAN KL , RAO KLN , MITRA SK , DILAWARI JB
Published: March 2008

Shunt surgery is considered to be the treatment of choice in patients with non‐cirrhotic portal hypertension. There is little data on the effect of side‐to‐side lieno‐renal (SSLR) shunt on oesophageal variceal size, splenic size and splenic pulp pressure (SPP) in patients with non‐cirrhotic portal hypertension. We evaluated pre‐ and postoperatively endoscopic grading of varices, splenic size and SPP for predicting shunt patency in 86 patients with non‐cirrhotic portal hypertension: 56 with extrahepatic portal venous obstruction (EHPVO) and 30 with non‐cirrhotic portal fibrosis (NCPF). The EHPVO patients with patent shunts (n= 47) showed significant reduction in SPP (pre‐operative 43.56±7.9 vs postoperative 29.96±7.7 cm of saline), splenic size (6.5±2.8 vs 4.00±2.6 cm below costal margin) and varices grades (2.96±0.5 vs 0.92±0.8). Patients with blocked shunt (n= 9) did not show significant reduction in SPP and varices grades. However, there was reduction in spleen size (8.6±3.0 vs 6.3±4.3). In the NCPF group, 28 had patent shunts and showed significant reduction in SPP (46.3±13.5 vs 33.8±7.6 cm of saline), splenic size (9.1±3.3 vs 6.8±4.6 cm below costal margin) and varices grades (2.8±0.7 vs 1.05±0.96). As only two patients with NCPF had blocked shunts, no statistical comparison between patients with patent and patients with blocked shunts could be done. In conclusion, following SSLR, there is a significant reduction in SPP and varices grades in patients with patent shunts. Endoscopic grading of varices can be used to predict shunt patency. However, spleen size is not a good criteria for predicting shunt patency.
Review: Chemotherapy, irradiation and their roles in the management of oesophageal cancer
Authors: BLAZEBY JANE M , ALDERSON DEREK
Published: March 2008

The role of multimodality therapy in the treatment of oesophageal cancer has been extensively investigated in many longitudinal studies and randomized trials. Despite some promising results, no clear beneficial evidence has consistently been produced. At present it cannot be routinely recommended outside the context of controlled clinical trials.
The recto‐anal inhibitory reflex: Abnormal response in diabetics suggests an intrinsic neuroenteropathy†
Authors: DEEN KEMAL I , PREMARATNA RANJAN , FONSEKA MAHILAL MD , DE SILVA H JANAKA
Published: March 2008

As electrical stimulation of the rectum has been shown to result in reflex internal sphincter inhibition mediated by intrinsic nerves, we aimed to evaluate the integrity of these nerves in the rectum of diabetic patients. Anal canal pressure, recto‐anal inhibitory reflex (RAIR) and continence were evaluated in 30 diabetic patients (male: female 13: 17, median age 57 years, range 37–70) and these data were compared with similar data obtained from 22 age‐ and sex‐matched healthy controls (male: female 9: 13, median age 51 years, range 19–65 years). Median duration of diabetes was 8 years (range 3–30). Twelve (40%) of the 30 diabetics had impaired continence for gas (n= 12) and liquid faeces (n= 3). None of the controls had incontinence. Median maximum resting anal canal pressure (MRP) was: patients 30 mmHg (range 20–75 mmHg) versus controls 40 mmHg (range 20–105 mmHg, P= 0.61). Median maximum squeeze pressure (MSP) was 65 mmHg (range 30–150 mmHg) in patients versus 84mmHg (range 35–230 mmHg) in controls (P= 0.59). Median threshold rectal mucosal electrosensation (RMES‐T) was 27 mA (5–40 mA) in patients versus 13 mA (5–28 mA) in controls (P = 0.03). Maximum tolerable rectal mucosal electrosensation was 40 mA (20–60) in patients versus 20 mA (10–30), in controls (P= 0.042, all comparisons using the Wilcoxon rank test). Recto‐anal inhibitory reflex was present in eight, abnormal in five (one incontinent) and absent in 17 (11 incontinent) diabetics, while it was present in 18 and abnormal in four controls (test of proportion, P= 0.031). Blood glucose in diabetics on the day of the procedure was 98 mg/dL (70–165 mg/dL). Rectal mucosal electrosensitivity and RAIR were impaired in significantly more patients with diabetes than controls, implying impairment of intrinsic neuronal function. The recto‐anal inhibitory reflex was either impaired or absent in all diabetic patients with incontinence.
Association of mutations in the core promoter and precore region of hepatitis virus with fulminant and severe acute hepatitis in Japan
Authors: ARITOMI TOMOYUKI , YATSUHASHI HIROSHI , FUJINO TATSUYA , YAMASAKI KAZUMI , INOUE OSAMI , KOGA MICHIAKI , KATO YUJI , YANO MICHITAMI
Published: March 2008

It was recently reported that mutations in the precore and core promoter region of hepatitis B virus (HBV) are associated with fulminant hepatitis. The aim of this study was to investigate the association of mutations in the precore and core promoter region of HBV with fulminant and severe acute hepatitis. We studied Japanese patients with acute HBV infection, including seven patients with fulminant hepatitis, 12 with severe acute hepatitis and 41 with acute self‐limited hepatitis. The presence of HBV mutants was examined by using a point mutation assay to detect a G to A transition at position 1896 in the precore region and an A to T transition at position 1762 and a G to A transition at position 1764 in the core promoter region. Significant differences in the proportion of mutations in the precore or core promoter region were present between patients with fulminant hepatitis and self‐limited acute hepatitis (7/7 (100%) vs 4/41 (9.8%), P < 0.01) and between severe acute hepatitis and self‐limited acute hepatitis (6/12 (50.0%) vs 4/41 (9.8%), P < 0.01). The frequency of mutation increased proportionately with the severity of disease in patients with acute HBV infection. Fulminant hepatitis B in Japan is closely associated with mutations in the core promoter and precore gene of HBV. Point mutation assays for HBV precore and core promoter analysis may be useful to predict the outcome of liver disease in patients with acute HBV infection.
FORMIMINOGLUTAMIC ACID (FIGLU) EXCRETION TEST WITHOUT HISTIDINE LOADING AS A DIAGNOSTIC AID IN PAEDIATRIC HAEMATOLOGY
Authors: LOVRIC V. A. , KENRICK K. G.
Published: March 2008

SYNOPSIS

The FIGLU excretion without histidine loading has been used in the diagnosis of folic acid deficiency in children. The test requires only a random urine sample, and has been found to be reliable, the results having a better correlation than the usual microbiological assessment of serum folate activity.
BRACHMANN‐DE LANGE SYNDROME: A report of four cases
Authors: CHOO P. B. , BIANCHI G. N.
Published: March 2008

SYNOPSIS

This uncommon syndrome is characterized by severe physical and mental retardation associated with a typical appearance.

Four patients, considered to be examples of this syndrome, are described, and information from 5 autopsies in the literature, together with the autopsy findings in one of the authors' cases, provide a basis for discussion of the abnormalities in this syndrome.
CEREBRAL GIGANTISM IN CHILDHOOD A report of two further cases
Authors: TURNER ELIZABETH K. , SLOAN L. E. G.
Published: March 2008

EDITORIAL SYNOPSIS

The clinical histories and features are presented of 2 girls considered to be examples of the recently described syndrome of ‘cerebral gigantism’ in childhood. Both girls showed excessive growth, some features of acromegaly, mental retardation, epilepsy, and visual defects, none of which appeared to be progressive.
HEAD CIRCUMFERENCE, LENGTH AND PLACENTAL WEIGHT OF INFANTS IN AN AUSTRALIAN HOSPITAL POPULATION
Authors: KITCHEN W. H.
Published: March 2008

SYNOPSIS

The published standards for head circumference, length and placental weight of infants at various gestations are not necessarily applicable to Australian patients. The difficulties and errors in data collection are discussed. Charts of head circumference and length of infants between 26 and 44 weeks of gestation are given in the familiar percentile form and also a similar chart of placental weight from 24 to 44 weeks of gestational age.
THE INFLUENCE OF MATERNAL ETHNIC ORIGIN AND PREGNANCY COMPLICATIONS ON BIRTH WEIGHT
Authors: FITZGERALD D. , KITCHEN W. H.
Published: March 2008

SYNOPSIS

The Australian population now includes many recent immigrants from the Mediterranean region who are noticeably short in stature. The influence on birth weight of maternal racial origin and a number of associations and complications of pregnancy is analysed statistically. Infants born to recent arrivals from Greece and Italy are heavier than average if born between 30 and 40 weeks of gestation, but beyond this maturity they are smaller than average. The effects of complications of pregnancy on the birth weight are in agreement with accepted opinions.
NASAL COLUMNAR CELL EXFOLIATION IN THE ASTHMATIC; THE EFFECTS OF INFECTION AND ALLERGY*
Authors: GLASS R. D. , ARCHER PATRICIA D.
Published: March 2008

SYNOPSIS

A pilot study was undertaken to determine whether degenerative changes in exfoliated nasal columnar epithelium would provide a useful marker of respiratory infection. The method was considered to be of no value. An incidental finding was that columnar cell exfoliation occurred more frequently in certain allergic subjects.
STRANGULATED INGUINAL HERNIA IN THE NEONATAL PERIOD
Authors: CARTLEDGE J. McP.
Published: March 2008

SYNOPSIS

In the course of 11 years, 2,015 children were operated upon for an inguinal hernia at the Alder Hey Children's Hospital. Of these, 140 (7%) were strangulated, and 33 (1.6%) were less than one month old.

Reduction of the strangulated hernia by taxis was successful in 14 cases, unsuccessful in 6, and was not attempted in 13 because of signs of intestinal obstruction, or because the inguinal swelling was extremely tender. There was no relationship between length of history and the success or failure of taxis.

Gangrene of the intestine requiring resection occurred in only one child, in another the related testicle was infarcted, and in 5 others the testis was engorged but viable.

There were 2 deaths, neither of which was directly due to the hernia.
CONGENITAL RUBELLA IN A MOTHER AND SON
Authors: MENSER MARGARET A. , SLINN ROBYN F. , DODS L. , HERTZBERG R. , HARLEY J. D.
Published: March 2008

SYNOPSIS

The mother of a male infant with proven congenital rubella has bilateral cataracts and dermatoglyphic abnormalities. She has always been regarded as a victim of congenital rubella and no other cause for her cataract formation is identifiable. The mother has a high titre of rubella‐virus haemagglutination‐inhibition antibody and her infant had rubella viuria. The significance of these findings is discussed.
ARTIFICIAL VENTILATION IN THE MANAGEMENT OF RESPIRATORY INSUFFICIENCY IN ACUTE BRONCHIOLITIS
Authors: PHELAN P. D. , WILLIAMS H. E. , STOCKS J. G. , FREEMAN MAVIS
Published: March 2008

SYNOPSIS

Nine patients who developed severe respiratory insufficiency as a consequence of acute viral bronchiolitis were artificially ventilated. Seven of the patients are now alive and well. One died because the procedure was undertaken as a last desperate measure when irreversible damage had occurred; the other died as a result of a blockage in a nasotracheal tube.
THE EFFECT OF PETROLEUM DISTILLATES ON LUNG SURFACTANT
Authors: KEEN T. E. B.
Published: March 2008

SYNOPSIS

The effect of 3 types of petroleum distillates on the pulmonary surfactant layer was examined by pressure volume studies on the rat lung. The results indicate that when small doses of each of the distillates are introduced into the trachea, they produce a marked change in the surface properties of the lining of the lung and that this is dependent on the dose. The inhalation of vapours and aerosols was ineffective, and relatively large intravenous doses of distillate were required to consistently produce changes in the lung. There was no evidence that distillate absorbed from the gut could cause any alteration in pulmonary stability. The effects of these 3 substances on the lung were similar and in each case the lung recovered its normal surface properties within 48 hours despite the presence of discrete macroscopic areas of damage in the lung.

The findings suggest that the initial acute symptoms and signs are the result of damage to the pulmonary surfactant layer and aspiration is the only important cause of this type of pulmonary damage.
CREATION OF ATRIAL SEPTAL DEFECTS BY THE BALLOON CATHETER TECHNIQUE IN INFANTS WITH COMPLETE TRANSPOSITION OF THE GREAT VESSELS*
Authors: VENABLES A. W.
Published: March 2008

SYNOPSIS

The use of a balloon catheter to create an atrial septal defect, devised by Rashkind (1966), provides at least temporary palliation in infants with complete transposition. The results of 12 completed procedures are compared with experience of surgery in the same unit. The main problem was atrial perforation which occurred 3 times in the 14 occasions in which the balloon catheter was introduced into the heart. Despite this the procedure offers the opportunity to increase the salvage of hypoxic infants with complete transposition of the great vessels.
RECURRENT PAROTITIS AND SIALECTASIS
Authors: JONES P. G. , HILLER H. G.
Published: March 2008

SYNOPSIS

A review of a group of 35 children with proven sialectasis has shown that a conservative approach is justified, for the prognosis is on the whole good. Sialography per se leads to improvement in a number of patients, and in the remainder spontaneous improvement can also be expected. In 25% of cases of sialectasis, the gland returned to normal.
SOME FACTORS THAT INFLUENCE THE BACTERIOLOGICAL DIAGNOSIS OF URINARY INFECTION
Authors: COOPER R. G.
Published: March 2008

SYNOPSIS

Colony counting is an integral part of the diagnosis of urinary infection and several factors may influence the colony count. A study of the relative influence of laboratory error, delay in culture, and the care taken in collection of the specimen, suggested that the most important determinant of an accurate colony count was the care with which the specimen was collected.
PILOMATRIXOMA: A not uncommon Hamartoma of Infancy and Childhood
Authors: JONES P. G. , CAMPBELL P. E.
Published: March 2008

SYNOPSIS

With few exceptions, accounts of this symptomless subcutaneous lesion have been concerned with the unique histological features and its occurrence in adults. This report of 37 pilomatrixomas in 35 children draws attention to the incidence in the paediatric age group and to the clinical features which are so constant and characteristic that the correct diagnosis can, in almost all cases, be made before excision.
ACUTE PYRIDIUM POISONING
Authors: SOUTTER G. B. , HARLEY J. D. , WALKER‐SMITH J. A.
Published: March 2008

SYNOPSIS

A 2 year old female infant was admitted with a short history of vomiting yellow‐brown material and passing yellow urine. Acute poisoning with Pyridium was suspected on clinical grounds and later demonstrated chemically. She developed methaemoglobinaemia which responded well to methylene blue intravenously and saline enemata. She also had evidence of haemolysis and transient renal toxicity, but she made a complete recovery.
STUDIES OF RESPIRATORY FUNCTION IN INFANTS WITH RECURRENT ASTHMATIC BRONCHITIS
Authors: PHELAN P. D. , WILLIAMS H. E.
Published: March 2008

SYNOPSIS

Respiratory function studies were performed on a number of occasions on 11 infants with recurrent asthmatic bronchitis. The results demonstrated that the major abnormality was an increase in pulmonary resistance. Orciprenaline was shown to have no consistent effect on the increased pulmonary resistance.
DIAGNOSIS OF LEFT HEART HYPOPLASIA*
Authors: MAXWELL G. M.
Published: March 2008

SYNOPSIS

The condition known as the syndrome of ‘left‐heart hypoplasia’ is a common and lethal form of congenital heart disease with an early onset of symptoms, principally cyanotic attacks, dyspnoea, a ‘shock‐like’ state and congestive cardiac failure. There is a high incidence of hypothermia and of aberrations in blood pressure in the series of infants described.
FOETAL TRANSFUSION AND NEONATAL DIALYSIS
Authors: LEWIS C. J. , STEVENS L. H.
Published: March 2008

SYNOPSIS

Knowledge of the place and the hazards of intra‐uterine transfusion in the severely erythroblastotic foetus, and of the management after delivery, is steadily growing. This procedure was undertaken in an infant who was subsequently delivered at 34 weeks' gestation by emergency Caesarean section following the development of foetal distress. Respiratory distress developed soon after birth and he remained anuric during the 12 days that he survived. An exchange transfusion to ‘wash out’ maternal antibody, and a peritoneal dialysis to combat severe hyperkalaemia were undertaken at the age of 3 hours and 4 days respectively. At post‐mortem, the kidneys were found to be nonviable. The early post‐natal events were monitored by observations of the electrolytes and the acid‐base balance; the fluids used in dialysis and the dialysates were also analysed. These observations are reported and their implications are discussed.
CONGENITAL LOBAR EMPHYSEMA ETIOLOGICAL STUDIES
Authors: CAMPBELL P. E.
Published: March 2008

SYNOPSIS

The cartilage in the bronchi of 12 cases of congenital lobar emphysema has been examined using 3 techniques: a) microdissection, b) serial macroscopic slices and c) serial histological sections. The first technique is considered to be the best for it enables the cartilage content of the entire bronchial tree to be clearly seen, and focal or generalised deficiencies can be identified. In all 12 cases the amount of cartilage in the bronchi was significantly less than in normal controls and it is postulated that this deficiency is the fundamental abnormality in congenital lobar emphysema.
DIAZOXIDE IN THE TREATMENT OF GLYCOGENOSIS DUE TO DEFICIENCY OF DEBRANCHER ENZYME*
Authors: Yu J. S.
Published: March 2008

SYNOPSIS

Diazoxide was used to correct severe hypoglycaemia in an 18 month old infant with probable debrancher enzyme deficiency. No significant complications were noted after an 8 month course of treatment and there were no changes in liver function tests. The modes of action of diazoxide are discussed.
EPILEPSY PRECIPITATED BY BATHING: WATER‐IMMERSION EPILEPSY
Authors: KEIPERT J. A.
Published: March 2008

SYNOPSIS

An infant presented at the age of 5 months with a recent onset of epileptic seizures, each precipitated by partial immersion in water during bathing. Sensory precipitation epilepsy due to water immersion is a rare disorder, and only 2 previous case reports have been found. The case history is presented and the condition discussed.
THE MEASUREMENT OF PULMONARY OEDEMA IN CHILDREN*
Authors: McCREDIE R. M.
Published: March 2008

The indicator dilution principle has been used for many years to study flow and volume within the circulation (Hamilton, Moore, Kinsman and Spurling, 1931‐32). The application of these techniques with diffusible indicators for measuring extravascular fluid volumes was first suggested by Chinard in 1951. Such a method for measuring pulmonary extravascular fluid volume (PEV) has been used in the assessment of pulmonary oe***ma in both animals and in man (Anthonisen and Crone, 1956: Chinard, 1951: Chinard, Enns and Nolan, 1962: Levine, Mellins and Fishman, 1965: Lilienfield, Freis, Partenope and Morowitz, 1955; McCredie, 1967: Pearce, Yamashita and Beazell, 1965: Ramsey, Puckett, Jose and Lacel, 1964).
LEUCOCYTE DEATH IN GENERALIZED VIRUS INFECTION*
Authors: SMITH H.
Published: March 2008

SYNOPSIS

The blood of a neonate with generalized virus infection, most likely due to herpesvirus hominis, contained dead leucocytes in large numbers. Virus within leucocytes was demonstrated by electron microscopy. The febrile and phagocytic responses to the presence of the dead leucocytes were poor. The possible significance of the findings is discussed.
CUSHING'S SYNDROME IN A THREE MONTH OLD GIRL
Authors: DREHER G. H. , WILLIAMS S. W. , HOWARD R. N. , CAMPBELL P. E. , DAVIES H. E. , McCARTHY N.
Published: March 2008

SYNOPSIS

This paper describes the rare occurrence of Cushing's syndrome in a female infant aged eleven weeks. An adrenal adenoma was found to be the cause, and its removal was followed by a return to a normal appearance.

This patient is the first with this condition seen in this age group at the Royal Children's Hospital since 1948. The Hospital's experience with adrenal tumours since that time is also presented, together with a review of the recent literature.
A SURVEY OF AUSTRALIAN CHILDREN FOR ASYMPTOMATIC URINARY INFECTION
Authors: COOPER R. G.
Published: March 2008

Cells and bacteria were studied in urine samples from children in whom there was no reason to suspect infection in the urinary tract. The study confirms the fact that criteria for the diagnosis of urinary infection in adults cannot be applied unreservedly to children. The survey showed an incidence of bacteriuria of 0.5% and an incidence of microscopic haematuria of 1.0% in girls, and an incidence of possible urinary tract disease in 0.47% of the boys.
ACCIDENTAL SALT POISONING IN A HOSPITAL NURSERY*
Authors: GAUTHIER B. , FREEMAN R. , BEVERIDGE J.
Published: March 2008

In a suburban hospital in Sydney, salt was accidentally used instead of sugar in the preparation of feeds intended for a number of babies. Five babies were involved in the ensuing epidemic of hypernatraemia; 4 died and one, less severely affected, made a complete recovery. Three of the babies who died were of low birth weight and they presented with symptoms different from those previously described, in that they had diarrhoea, manifested no thirst, and had neither muscular twitchings nor convulsions. Overlapping of the sutures was striking in all cases.

Ingestion of an excessive quantity of salt causes hypertonicity of the extracellular fluid which largely explains the disorders involved in hypernatraemia.

It is suggested that salt should not be stored in an area where infants' formulae are prepared.
THE ACTION OF ENVIRONMENTAL FACTORS IN HYPERTROPHIC PYLORIC STENOSIS
Authors: HOBDAY J. D.
Published: March 2008

The second of two monozygous twin boys had perinatal anoxia and spastic diplegia, and developed hypertrophic pyloric stenosis at eight weeks. The coincidence of these conditions, together with the absence of both conditions in the twin, suggests that anoxia may be important in precipitating pyloric stenosis in hereditarily disposed infants. Previous work showing an increased incidence of pyloric stenosis in first born children may indicate a similar precipitating factor.
PERFORATION OF THE BOWEL DURING BARIUM ENEMA REDUCTION OF INTUSSUSCEPTION IN INFANTS
Authors: DOUGLAS B. S.
Published: March 2008

Two cases of extravasation of barium into the peritoneum following the reduction of an intussusception by barium enema are described. Some of the causes and consequences of this unusual complication are discussed.
THE CLINICAL AND PHYSIOLOGICAL MANIFESTATIONS OF THE ‘INFANTILE’ LARYNX: NATURAL HISTORY AND RELATIONSHIP TO MENTAL RETARDATION
Authors: PHELAN P. D. , GILLAM G. L. , STOCKS J. G. , WILLIAMS H. E.
Published: March 2008

51 infants with stridor due to an infantile larynx are reviewed. 4 were mentally retarded in varying degrees and in 3 of them there was an obvious cause for this, unrelated to the infantile larynx. The prognosis of the condition would appear to be good, both for physical and for mental development. The stridor usually disappeared by 2 years of age. Respiratory function studies demonstrated a marked increase in inspiratory resistance.
HYPSARRHYTHMIA DEVELOPING IN HOSPITAL: RECOVERY WITH EARLY TREATMENT
Authors: OATES R. K. , STAPLETON THOMAS
Published: March 2008

SYNOPSIS

A child admitted to hospital with a fractured skull had a normal EEG. While in hospital, he developed the clinical and electroencephalographic features of hypsarrhythmia. Treatment with corticotrophin controlled the seizures, the EEG reverted to normal, and the child's subsequent mental and motor development has been satisfactory.
PROBLEMS IN THE DIAGNOSIS AND MANAGEMENT OF HEPATOBLASTOMA 1
Authors: MACMAHON R. A. , LAMBERT T. F. , BEVAN MARY
Published: March 2008

SYNOPSIS

Hepatoblastomas have no specific symptoms and present with hepatomegaly. The only hope of cure is complete surgical resection of the tumour and this may not be possible by the time of diagnosis. 3 cases are presented to illustrate the problems of diagnosis, prognosis and treatment. Early diagnosis will only be possible by examination of the abdomen of every infant, seen by a doctor, no matter what the problem, and improvement in the cure rates will only be possible by a radical surgical approach to the treatment of this tumour.
OSTEOGENESIS IMPERFECTA CONGENITA
Authors: TAN K. L. , TOCK E. P. C.
Published: March 2008

Synopsis

Osteogenesis imperfecta congenita is a very rare condition. Among 184,311 deliveries over a 5 year period (1965–1969) there were encountered only 3 cases which demonstrated varying degrees of severity of the condition.

The incidence, pathological and genetic bases, diagnosis and management of osteogenesis imperfecta congenita are discussed.
THE CLINICAL GROWTH OF INFANTS AND CHILDREN WITH VENTRICULAR SEPTAL DEFECTS1
Authors: MENAHEM S.
Published: March 2008

SYNOPSIS

A study was undertaken of the relationship of the haemodynamic disturbance of ventricular septal defects to the growth of affected subjects. Stunting was observed, particularly with respect to weight, and occurred mainly but not exclusively in subjects with a large defect. Some subjects already exhibited stunting at birth with evidence of intrauterine growth retardation. By 3 to 12 months of age, the differences in growth between the subjects became marked. There was some improvement subsequently, related in part to improvement in the haemodynamic disturbance.

The pertinent literature is reviewed and the possible mechanisms of the multiple factors involved in the growth retardation are discussed.
NEONATAL HOMEOSTASIS: THE ROLE OF DIETARY COMPOSITION, GROWTH AND RENAL REGULATION
Authors: STEVENS L. H. , SAVAGE D. C. L.
Published: March 2008

SYNOPSIS

The relative importance of growth, composition of the diet, and renal function in maintaining internal stability during the first 2 critical weeks when the newborn baby is endeavouring to adapt to his new environment has been investigated. The technique used was serial daily metabolic balance studies in normal premature babies, in oedematous premature babies, oedematous premature babies with respiratory distress, dysmature babies, infants of diabetic mothers, and full term infants fed pooled human milk.
CORD SERUM IMMUNOGLOBULIN LEVELS IN ‘SMALL‐FOR‐DATES’BABIES*
Authors: JONES W. R.
Published: March 2008

SYNOPSIS

IgG, IgM and IgA levels were determined in the cord serum of 23 babies who were both ‘small‐for‐dates’and clinically dysmature. The results confirm that there are abnormalities of humoral immunity in a small proportion of these babies.
SCREENING OF IMMUNOLOGICAL COMPETENCE IN CHILDREN
Authors: STERN L. M. , FORBES I. J.
Published: March 2008

SYNOPSIS

Experience of a comprehensive screening of 72 children for immunological function is presented. Cellular immunity was assessed by testing for delayed hypersensitivity to Candida, Streptococcus and mumps, as well as in vitro testing of lymphocyte transformation in the presence of phytohaemagglutinin. Humoral function was assessed by measuring immuno‐globulin levels and titres before and after immunisation with tetanus toxoid and Salmonella typhi monovalent vaccine. The routine presented is safe and convenient; results are available within 3 weeks.
THE EFFECT OF COELIAC DISEASE ON THE MOTHER‐CHILD RELATIONSHIP
Authors: GARDINER A. , PORTEOUS N. , WALKER‐SMITH J. A.
Published: March 2008

SYNOPSIS

The mother‐child relationship was studied in 28 children with coeliac disease. It was found that there was a high incidence of emotional symptoms in these children, namely withdrawal, irritability and ‘clingingness.’Accompanying these symptoms in the children there was a significant disturbance of the mother‐child relationship, with maternal anxiety, maternal depression and maternal preoccupation. These symptoms in the mother and child disappeared or greatly improved once the child had responded to a gluten‐free diet, except when the mother was already emotionally disturbed before the onset of the child's illness.
CEBOCEPHALY: A REPORT OF FIVE POST‐MORTEM CASES AND A REVIEW OF LITERATURE1
Authors: FATT CHAN YING
Published: March 2008

SYNOPSIS

There appears to be a high incidence in Singapore of this rare congenital anomaly. Although the population consists of Malays, Chinese, Indians, Europeans and others, all 5 cases reported were offspring of Chinese. The aetiology is unknown and the condition is only of theoretical interest as there is no method of management or treatment. Most cases die early.
CONSERVATIVE MANAGEMENT OF GUILLOTINE AMPUTATION OF THE FINGER IN CHILDREN
Authors: DOUGLAS B. S.
Published: March 2008

SYNOPSIS

A prospective study has shown that the guillotine amputation of the finger in small children can be treated conservatively by dressing only and that there is no need for hospital admission or operation for this condition.
BLOOD LEVELS OF HEXACHLOROPHENE IN NEONATES
Authors: ABBOTT L. M. , BUCKFIELD P. M. , FERRY D. G. , MALCOLM D. S. , McQUEEN E. G.
Published: March 2008

SYNOPSIS

Blood levels of hexachlorophene have been estimated in newborn infants treated with hexachlorophene for prophylaxis of staphylococcal colonisation. Blood levels after repeated application seemed sufficient to cause some concern and a modified regime of application on the first day of life has been substituted. Even on this regime, blood levels in a small premature infant gave rise to some concern.
RENAL DISEASE AND GOITRE: A NEW SYNDROME OF PRIMARY AMYLOIDOSIS
Authors: COOKE R. A. , CHAMPNESS L. T.
Published: March 2008

SYNOPSIS

8 children suffering from renal disease and goitre, both due to primary amyloidosis, are reported as a readily recognisable syndrome in Papua‐New Guinea and are presented as a syndrome which does not appear to have been previously recognised anywhere else in the world.
THE PRACTICAL MANAGEMENT OF ENCOPRESIS
Authors: CONNELL HELEN M.
Published: March 2008

The encopretic child is an unpopular but not uncommon patient. By the time he is referred for psychiatric help, his soiling has usually become a complex issue of psychological and physiological disturbance in which parental attitudes play an important part. The aetiology of the condition is discussed in some detail and the practical plan of management described has proved successful in a small number of “hard core” cases. Since this does not involve complex psychotherapeutic techniques, it is suggested that it could be carried out in any paediatric hospital setting, thus avoiding the long waiting list so often associated with psychiatric referral.
TRIAL OF GAVISCON IN THE TREATMENT OF GASTRO‐OESOPHAGEAL REFLUX OF INFANCY
Authors: WELDON A. P. , ROBINSON M. J.
Published: March 2008

SYNOPSIS

A group of 18 infants with uncomplicated gastro‐oesophageal reflux has been managed using a new proprietary preparation— Gaviscon.® All of the infants had a good symptomatic response to the treatment.
LATE PRESENTATION OF STRICTURE OF THE AQUEDUCT OF SYLVIUS
Authors: LEWIS ELIZABETH
Published: March 2008

SYNOPSIS

8 children with insidious onset of manifestations of stricture of the Aqueduct of Sylvius in later childhood are reported. These children present with raised intracranial pressure, without lateralising signs, thus mimicking tumours, and the radiological features are those of raised intracranial pressure.

Stricture of the Aqueduct is one of the commoner causes of this “midline syndrome”, and compared with the other causes, its treatment is simple and the prognosis good.
PERINATAL ASPECTS OF MATERNAL AUTOIMMUNE DISEASE*
Authors: JONES W. R. , STOREY B.
Published: March 2008

SYNOPSIS

A study has been made of the foetal outcome in 38 pregnancies complicated by maternal autoimmune disease over a 10 year period at a Sydney hospital. The diseases included thyrotoxicosis, idiopathic thrombocytopaenic purpura, myasthenia gravis, systemic lupus erythematosus and scleroderma. The occurrence of perinatal manifestations of these maternal disorders is of importance both in the paediatric management of such cases and in the study of aetiological factors in autoimmune disease.
PHENYLKETONURIA: REDUCTION OF SERUM LEVELS OF PHENYLALANINE FOLLOWING ORAL ADMINISTRATION OF B‐2 THIENYLALANINE
Authors: KRIPS CAROL , LINES D. R.
Published: March 2008

SYNOPSIS

8 mentally retarded but otherwise healthy phenylketonuric individuals were given two oral loads of phenylalanine (100 mgm/Kg). One of these loads was accompanied by β‐2‐thienylalanine (20 mgm/Kg). Blood levels of phenylalanine in the 6 hours after the two phenylalanine loads were compared. β‐2‐thienylalanine reduced the levels of phenylalanine in every case.

This suggests that if the phenylketonuric child were to take an appropriate amount of β‐thienylalanine with meals, he might be able to eat more phenylalanine, and this would allow a considerably more liberal diet.

As diet has been shown to be a dominant factor in the emotional climate of families of phenylketonuric children, this stress would be considerably reduced. Thus, the administration of β‐thienylalanine might lead to a more normal social development of the patient.
DYGGVE DISEASE
Authors: BARYLAK A. , KOZLOWSKI K.
Published: March 2008

SYNOPSIS

A case of a 5 year old Polish girl with Dyggve disease is reported. The radiographic pattern of the vertebral column and pelvis is diagnostic in this syndrome. The course of the disease in infancy and in adult life is at present unknown.
PLASMA LIPID VALUES IN CHILDHOOD OBESITY
Authors: COURT J. M. , DUNLOP MARJORIE , LEONARD R. F.
Published: March 2008

SYNOPSIS

A study was made on 129 obese children to assess the relation of fasting plasma concentrations of cholesterol and triglyceride with clinical features of obesity.

Mean values for both plasma cholesterol (195 mg/dl) and triglyceride (77 mg/dl) did not differ from those found in non‐obese children. Greater than expected numbers of children however were found with raised values of either cholesterol or triglyceride. Three children were found to have familial Type II hyperlipoproteinaemia, and eighteen were found to have a fasting triglyceride of greater than 120 mg/dl. No correlation was found between plasma cholesterol values and clinical features of obesity, but significant correlation was found between plasma triglyceride values and degree and duration of obesity, particularly amongst those children whose obesity started after the first year of life.
INTRAUTERINE INTRAVENTRICULAR HAEMORRHAGE AND DISSEMINATED INTRAVASCULAR COAGULATION IN A TRIPLET PREGNANCY
Authors: THOMAS D. B.
Published: March 2008

SYNOPSIS

A case of intrauterine DIC and IVH in association with a macerated sibling in a triplet pregnancy is described. Circumstantial evidence suggests that this could have been due to the transfer of thromboplastic material from the macerated foetus to one of the liveborn siblings, and would imply that there was a vascular communication across the chorionic barrier, as they were of different sexes.
PRENATAL VIRAL INFECTION WITH PARTICULAR REFERENCE TO CYTOMEGALOVIRUSES
Authors: HAYES KATHLEEN
Published: March 2008

SYNOPSIS

“In terms of the potential number of individuals affected, inapparent and latent viral infections may prove to be the most important group of deleterious agents which are congenitally acquired”.
DIARRHOEA IN MALNOURISHED CHILDREN
Authors: BURKE VALERIE , GRACEY MICHAEL
Published: March 2008

SYNOPSIS

Malnutrition and diarrhoeal disease are common in young Australian Aborigines and help determine their poor health standards. The clinical features found in these children show close similarities to those in children in pre‐industrialized communities. The factors involved in the pathogenesis of diarrhoea in these individuals are complex; they include histological damage to the small bowel epithelium; disaccharidase deficiency, bacterial contamination of the upper gut and a high incidence of intestinal infections and infestations. These all corroborate evidence for the well known synergism of nutrition and infection.
BREAST FEEDING AND THE PAEDIATRICIAN
Authors: ISBISTER CLAIR
Published: March 2008

SYNOPSIS

The paediatrician is in a favoured position in many ways. Our speciality concerns the whole child from conception. We are aware of the human relationships within families, most of all the mother‐child relationship, and we see the effect of cultural change on the rearing of children.

A study of maternal attitudes to breast feeding and reasons for failure is presented. It appears that most women are willing to start breast feeding, but if they encounter problems, particularly in the maternity hospital, and wean before 6 weeks, they are unlikely to try again. It is therefore in this period that every effort should be made to provide competent help and education for primiparous women. The paediatrician can with advantage become involved in education in preparation for parenthood, the training of nurses, establishing co‐operation with obstetricians, and in supervising and updating hospital routines, for which some suggestions are made.

The baby's own parents and human milk have scientifically proven advantages; they should not be abandoned because of the failure of a minority, but rather assisted professionally to succeed.
IN VITRO ACTIVITY OF LYMPHOCYTES FROM CHILDREN WITH PRENATAL CYTOMEGALOVIRUS INFECTION
Authors: GIBAS HALINA , HAYES KATHLEEN
Published: March 2008

SYNOPSIS

In vitro response of lymphocytes to phytohaemagglutinin (PHA) was normal or above normal in 9 children with prenatal cytomegalovirus (CMV) infection, and in 2 infants with early postnatal CMV infection.

Increased activity of unstimulated lymphocytes was found in some infants with prenatal CMV, and in both infants with postnatal CMV. However, lymphocytes of some control infants also showed this phenomenon, which was common in the first 2 months of life, and was not found after 6 months of age.