bluuebunny/crossref_metadata_2025 huggingface dataset:
Significance of Diabetes Camps in IDDM Treatment Management
Authors: Maruyama Hiroshi , Miki Eishi
Published: October 2007

Care of diabetic children should include home or self care. To teach these children, diabetic camps play a major role in overall treatment of diabetes.Present conditions of Japanese diabetic children's camps were investigated. The authors have worked for many years at diabetes camps, and have developed a prototype teaching system. Camp doctors and staffs meet once a year and exchange information. There are 25 nationwide camps in Japan this year, and 948 patients with diabetes mellitus, most of them IDDM, have been able to attend the camps. All of these camps have a diabetes study class, with training of skills in respect to diabetes treatment, checking and management of diabetic states in individuals, physical training, psychological therapy, recreation, and so on.
A Marked Decrease of Endogenous and Activated Natural Killer Cell Activities in Childhood Acute Lymphoblastic Leukemia
Authors: Kawai Hiroshi
Published: October 2007

Natural killer cell activity was studied in 40 children with acute lymphoblastic leukemia by 51 Cr‐release assay using K562 target cells. NK cell activity of ALL at the time of onset or relapse was 9.0 ±4.9% specific lysis (n = 20), being depressed as compared with the normal value of 47.2 ± 5.7% (p < 0.01). The decrease of NK cell activity was also present in the remission phase: % specific lysis was 23.5 ± 9.2% (n = 25). The decrease was still recognized among most of the off‐therapy patients. In vitro studies demonstrated that, among the conventional anti‐leukemic agents, prednisolone, arabinosylcytosine and daunorubicin depressed NK cell activity. The anti‐leukemic agents appear to contribute at least in part to the impaired NK cell activity in ALL. The continuous decrease of NK cell activity even after the cessation of antileukemic therapy, however, cannot be explained by their effects alone, suggesting that the NK cell impairment is one of the characteristic features of ALL. NK cells responded to interferon (IFN) but their activated activity was still below the normal endogenous activity, and they did not respond to an IFN inducer of poly I:C at the time of onset or relapse. In remission phase, NK cells responded to both IFN and poly I:C and their activated activity reached the normal endogenous level. These results certainly demonstrated a marked decrease of NK cell activity in ALL.
Clinicl Significance of Mesangial IgM Deposits in Minimal Change Nephrotic Syndrome
Authors: Ueda Norishi , Yasaki Takehiko , Niinomi Yukihiko , Nonoda Toru , Ohnishi Masazumi , Iwayama Seizo , Mizuno Aiko , Ito Shigemitsu
Published: October 2007

The clinicopathologic features and the response to corticosteroid therapy were compared in 9 patients with minimal change nephrotic syndrome (MCNS) and diffuse mesangial IgM deposits (Group I) and in 32 of those without IgM deposits (Group II).

However, serum IgM levels in Group I in both relapse and remission were significantly higher than those of Group II and controls (p<0.001).

In Group I mesangial IgM deposits were diffuse in 9 (100%), mesangial C1q was present in 4, IgA and fibrinogen were each observed in 1, respectively. Electron dense deposits in the mesangium were also present in 2 to 5 patients in Group I.

No significant differences were found between the two groups in age of onset, sex ratio, laboratory data except for serum IgM level, duration before biopsy, follow‐up periods, outcome, and response to steroid therapy.

Our data suggest that a more severe degree of either impairment of mesangial clearance of IgM or overproduction of IgM may be involved in patients with MCNS and mesangial IgM deposits but that these patients could not be considered a distinct group of patients.
A Clinicl Picture of Aseptic Meningitis as Portrayed from a Study of 150 Patients During Three‐Year Observation
Authors: Yui Ikuko , Watanabe Jun , Takeuchi Yoshinao
Published: October 2007

One‐hundred and fifty patients with aseptic meningitis were studied in order to investigate their clinical manifestations and cerebrospinal fluid (CSF) contents. The patients were classified according to causative organisms and/or associated diseases. Hypoglychorrhachia was found in nearly half of the total CSF samples from patients with mumps meningitis. A coxsackie virus was isolated from a CSF specimen from one patient who had typical meningeal signs but had no pleocytosis (so‐called meningism).
Kawasaki Disease and Agranulocytosis
Authors: Kawano Yoshifumi , Hosoya Ryohta , Yamamoto Keiko , Nishimura Kozo
Published: October 2007

Kawasaki disease associated with agranulocytosis was observed in a one‐year‐old girl. The agranulocytic state continued for a month, and granulocyte transfusions were required. We discuss the relation between agranulocytosis and drugs, viral infections, Kawasaki disease, etc. The systemic vasculitis of Kawasaki disease seems to be the cause of the bone marrow disturbance.
Metabolism: The Role of Haemophilus lnfluenzae in Lower Respiratory Infections in Childhood
Authors: Uehara Suzuko , Terashima Itaru , Nakamura Akira , Kurosaki Tornomichi , Sugaya Naoko , Okimoto Yuri , Himi Kyoko
Published: October 2007

In pediatrics, the offending microorganisms in lower respiratory infections have not yet been established. Our data based on 1,898 patients with lower respiratory tract disorders in children (1965–1979) demonstrated that washed sputum is of practical value in establishing the etiological diagnosis of bronchopulmonary infections in children. The criteria for the determination of the dominant or offending pathogens are presented.

H. influenzae was found to be the leading organism, especially in patients having a recurrent or protracted course: its incidence was 64.1% in chronic bronchitis, 24.5% in recurrent or protracted bronchitis, 21.7% in pneumonia and 15.0% in acute bronchitis. H. influenzae seemed most significant in aggravating the signs and symptoms accompanying the infection. Recent bacteriological study of washed sputum (1980–1981) revealed an increasing frequency of H. influenzae as a causative agent.

Ampicillin‐resistant H. influenzae strains have been demonstrated since 1976, and constituted 13.5% of 154 strains, while chloramphenicol‐resistant strains remained at 2.5% in 1982. The biotypes of ampicillin‐sensitive and resistant strains included not only types I and II but types III to v.
Clincial Applications of Respriratory Muscle Electromyographic Activity: (I) Relations Between Forced Expiratory Volume and Expiratory EMG in Asthma
Authors: Obata Toshihiko , Hornma Lkuo , Likura Yoji
Published: October 2007

Abstracts

Forced expiratory volume (FEV) and electromyographic activity (EMG) of expiratory muscles were measured in patients with asthma. EMGs of expiratory muscles were recorded from the 8th intercostal space at the anterior axillary line with surface electrodes. Relations between FEV and EMG were compared during asthma attacks and after inhaling a bronchodilator. This method has two advantages in the evaluation of asthma treatment. First; one can determine whether a subject, during an asthma attack, could exhale maximally before and after inhalation of a bronchodilator, second; pre‐ and post‐treatment expiratory force can be compared. A more reliable indication of the effectiveness of treatment can thus be obtained.
A Case of Mixed Bacterial Meningitis Associated with a Congenital Spinal Epidermoid
Authors: Takahashi Chizuko , Tono‐oka Tatsuhito , Nakanishi Masanori , Imai Ko
Published: October 2007

A case of mixed bacterial meningitis with congenital spinal epidermoid is reported. E. coli and S. faecalis were isolated simultaneously from the cerebrospinal fluid of a 14‐month‐old girl who had a continuing fever for 5 days. The clinical response was very poor, whereas bacteria detected showed high sensitivity in vitro to the antibiotics used clinically. Thus a myelography and a CT scanning of the lumbosacral region were performed one month after admission, when a spinal epidermoid was forced, containing an abscess connected to a thin dermal sinus which could not be recognized macroscopically. The patient recovered completely after surgical treatment.
Severe Protracted Diarrhoea of Infancy
Authors: Milla Peter J.
Published: October 2007

Severe protracted diarrhoea of infancy (SPDI) remains a major problem in diagnosis and management. The commonest diagnoses are coeliac disease, disaccharide intolerance, and cow's milk protein intolerance, but a wide variety of other inherited, congenital, infective and immunological disorders should be sought. The pathophysiology of the progression of the diarrhoeal illness, which may be trivial at onset, to a severe life threatening disease is discussed. In approximately 30% of cases a diagnosis cannot be established; in those with a familial basis a defect in cell differentiation and replication may be operative and results in a high (80%) mortality rate. In non‐familial SPDI the mortality rate is low and response to an oligoantigenic diet excellent, suggesting that sensitisation to dietary antigens plays an important role. The devastating effect of protracted diarrhoea on the neonate and young infant is due to the increased nutritional demands of rapid growth occurring at a time when intestinal absorptive processes are as yet poorly developed.
Diagnosis and Morphological Classification of Pulmonary Arteriovenous Fistula by 99mTc MAA
Authors: Tsuji Atsutoshi , Yanai Jun , Komai Takayuki , Sato Masaaki , Asaishi Takasumi , Kijimoto Chuichi , Ishida Haruo
Published: October 2007

Pulmonary A‐V fistula was diagnosed and classified morphologically based on the pattern of time‐activity curves by 99m Tc MAA. If the diameter of the fistula is large, macro‐albumin easily reveals a shunt. If the iistula has the form of an “aneurysm,” the degree of shunt is generally slight.
Susceptibility of Group B Streptococci to 30 Antibiotic Including New Cephalosporins.
Authors: Fujita Kozo , Murono Ko‐ichi , Sakata Hiroshi , Yoshioka Hajime
Published: October 2007

The in vitro susceptibility of 32 group B streptococci, isolated from infants with systemic infections, to 30 antibiotics including new cephalosporins was studied. Benzylpenicillin, having the minimal inhibitory concentration (MIC) of 0.063 μg/ml, was the most active agent among the penicillins tested, and ampicillin, having an MIC of 0.063–0.125 μg/ml, was almost as active as benzylpenicillin. Cephalosporins had a wide range of activities, but such cephalosporins as cefmenoxime (MIC of 0.032–0.063 μg/ml), cefuroxime, cefotaxime and ceftriaxone (MIC of 0.063–0.125 μg/ml), were equally or more active than benzylpenicillin or ampicillin. Latamoxef with an MIC of 8–16 μg/ml was least active among the cephalosporins tested. Kanamycin and amikacin, having MICs of 128 or more than 128 μg/ml, were far less active than gentamicin (MIC of 8–32 μg/ml) and tobramycin (MIC of 16–32 μg/ml). 31 and 72% of isolates were resistant to chloramphenicol and tetracycline respectively, but only one strain was resistant to erythromycin and lincomycin. The strains resistant to tetracycline and chloramphenicol were prevalent in the subtypes III and III/R group B streptococci.
Hypereosinophilia Secondary to Varicella in a Hyperimmunoglobulinemia E Syndrome
Authors: Matsumoto Tomoaki , Miyamoto Yoshiyuki , Miura Kazunori
Published: October 2007

A seven‐year‐old boy with hyperimmunoglobulinemia E (HIE) syndrome showed hypereosinophilia up to 49,000 per cubic millimeter (cumm) in his convalescence from a severe and protracted attack of varicella. Hypereosinophilia persisted for 40 days. Eosinophils seen in the bone marrow as well as in the peripheral blood were morphologically normal and a majority of them in the marrow were maturated. Since eosinophilia after varicella is not common, it is suggested that the pathogenesis of eosinophilia observed in this case may be associated with impaired immunity of HIE syndrome. Further studies on a large number of cases are necessary to confirm this.
An Outbreak of Echovirus 11 Meningitis in a Newborn Nursery
Authors: Yamanaka Reiko , Suzuki Toshihisa , Okamoto Yoshiaki , Oda Kazumasa
Published: October 2007

In the summer of 1981 an outbreak of echovirus 11 meningitis in a newborn nursery occurred in a general hospital near Tokyo. Ten newborn infants developed febrile illness in a period of 20 days. Nine babies out of ten were diagnosed as aseptic meningitis according to the CSF findings. Virus isolation was successful in 50% (3/6 cases) in the CSF, 80% (4/5 cases) in the stool and 20% (1/5 cases) in the throat swab. Echovirus 11 was proven to be the responsible agent.

Clinical manifestations of aseptic meningitis were mild and nonspecific, except in one premature baby which had apnea and exanthema. Mean febrile period was 4.1 days. Pleocytosis of the CSF, dominant in polymorphonuclear cells, was observed in 6/9 cases. EEG about one month after onset revealed abnormal or borderline findings in 6/9 cases.

In a community outbreak of echovirus. infection, newborn babies in nurseries are threatened with both horizontol and vertical transmission of virus.
GENERAL ASPECTS: Overviews of School Health Education in Japan
Authors: Segami Kiyotaka
Published: October 2007

In school education in Japan it is characteristically assumed that basic contents of schoolbooks and curricula are to be based on the Course of Study, as the Standard of curriculum for school education, which derives from the School Education Law and other relevant legislation. Health education articulated in the Course of Study is required, for the sake of comprehensiveness, to be applied through all school activities and health‐related subjects. Items of health‐related subjects are arranged without duplication, but continuity in ordered school levels is insisted upon. By means of health instruction and guidance pupils and students are expected to be motivated to change their unhealthy life‐style and to practise a healthier one.
Cytochrome B558 Component of O‐2M Generating Oxidase in the Neutrophils From Patients With Chronic Granulomatous Disease
Authors: Takayanagi Naoki , Niida Yuichi , Chiba Shunzo , Nakao Tooru
Published: October 2007

Cytochrome b558 is probably a component of an electron transport chain which is called NADPH oxidase. Cytochrome b558 from the neutrophils of two male patients with chronic granulomatous disease (CGD) and their parents was studied. One of the CGD patients had decreased amounts of cytochrome b558, The α‐band of light absorption of cytochrome b558 at 558 nm was found as a trace, and the peak of the γ‐band was shifted to 420 nm, whereas the normal γ‐band is at 426 nm. Intermediate amounts of cytochrome b558 were present in his mother, whereas his father had a normal amount. Another patient had normal peaks of α‐ and γ‐bands of cytochrome b558. Thus, abnormalities in NADPH oxidase of the two patients were different.
Hyper IgE Syndrome in Japan: A Summary of the Clinical and Immunological Features of 40 Patients
Authors: Yanagi Tadamichi , Tsuji Yoshiro
Published: October 2007

The authors analyze and discuss the clinical and immunological features of hyper IgE syndrome in 40 patients suffering from the disease in Japan. There was no geographical difference observed and the sexual difference was in a ratio of 2 men to 1 woman. The syndrome appears early in infancy and begins mostly with skin lesions. The age at diagnosis is given in Fig. 1. Staphylococcus aureus is detected in every case as the pathogenic microorganism. Although the majority of the cases are of superficial infections, some cases are severe or of deep infections which become critical.

The serum IgE levels are above 1,000 IU/ml in all cases and often allergic diseases are a complication. Neutrophil chemotactic defect is considered a secondary defect because a decreased in vitro chemotaxis may turn to normal skin window tests in vivo.

These results indicate that lesions in lymphocytes and polymorphonuclear cells (PMNs) are not a complete defect but an incomplete defect or quantitative decline.

While lymphocyte and PMN functions are damaged to various extents, the decrease or defect in the specific protective function against staphylococcus aureus is discussed.

With the abnormal IgE production, specific IgE antibodies to staphylococcus aureus are produced as well as IgE antibodies to other allergens with frequent chances of sensitization.
Natural Killer Cell Activity in Children With Acute Lymphoblastic Leukemia
Authors: Horikoshi Tamaki , Tasaka Hideko , Mashiba Harukazu , Hiyoshi Yasuhiko , Ikuno Yoshiko
Published: October 2007

Thirty‐four children with acute lymphoblastic leukemia (ALL) and 45 normal children as controls were tested for natural killer (NK) cell activity in vitro using the K‐562 cell line as target cell.

In the group of patients off all chemotherapy, the levels of NK cell activity were found to be comparable to normal controls. The levels of activity in the intermittent chemotherapy group were higher than or the same as those of normal controls. Low levels of NK cell activity were observed, shortly after intermittent chemotherapy. Patients who had more than two remissions had levels of NK cell activity comparable to normal controls. In contrast, low levels of NK cell activity were found in patients shortly before relapse, but returned to normal levels after achieving complete remission. Significant differences in the clinical stages between relapse and remission were found by paired t‐test analysis (0.02 < p < 0.05).
Growth Hormone in Children With Congenital Rubella Syndrome
Authors: Ueda Kohji , Tokugawa Ken , Watanabe Noriaki
Published: October 2007

Six 10‐year‐old boys with congenital rubella syndrome (CRS) were studied for their growth hormone levels as well as other endocrinological functions. All cases were observed to show normal responses after the insulin, arginine, or the propranolol‐glucagon tolerance tests. The other hormonal values were also observed to be normal. These results suggested that the postnatal growth retardation observed in CRS is not due to an endocrinological abnormality.
Influence of Breast Feeding on Neonatal Behavior
Authors: Maekawa Kihei , Nara Takahiro , Hoashi Eiichi
Published: October 2007

Forty‐six normal newborn infants were studied at the age of 6 to 7 days. Each infant was at first breast fed and at the next session was given a bottle feeding of the same amount of expressed breast milk on the same day. The neonatal behavior was assessed over two three‐hour periods following each feeding, during which continuous polygraphic recordings and observations were made. Our study consisted of four steps: an expressed breast milk bottle feeding (step 1), an equal holding time period (step 2), an equal sucking time period (step 3), and an equal holding and sucking time period using two kinds of bottles (step 4). Infants who were breast fed had a longer period of quiet sleep and slow heart rate in active sleep compared with those who were bottle fed.

In step 4, there were no significant differences in the amount of quiet sleep and low heart rate in active sleep between breast and bottle feeding. From our results, each component of breast feeding alone such as the breast milk itself, the holding time, or the time for sucking does not have any specific positive influence on neonatal behavior.

Rather, the study suggests that the total mother‐infant interaction during breast feeding results in positive influences on neonatal behavior.
Clinical Application of High‐Resolution Chromosome Banding
Authors: Takano Takako
Published: October 2007

A high‐resolution banding technique has become indispensable in the study of patients with both congenital abnormalities and malignant diseases and has been used in various fields. A small chromosomal change is hard to detect, unless a sophisticated technique is used. In the present paper, our experience of small structural changes in a chromosome in the case of Prader‐Willi syndrome, retinoblastoma and aniridia‐Wilms' tumor association are summarized and briefly reviewed in the light of current high‐resolution techniques, including the acridine orange technique developed by ourselves.
Gastrin Secretion in Infancy and Childhood|Part I: Response to a Gastrin Secretion Test and G‐Cell in Infantile Hypertrophic Pyloric Stenosis
Authors: Mayama Haruki
Published: October 2007

To examine the etiological role of gastrin in infantile hypertrophic pyloric stenosis (IHPS), fasting levels of serum gastrin and the response in the serum levels of this hormone to oral milk feeding were investigated in 10 infants with IHPS aged 18 to 125 days before treatment (untreated group) and in the convalescent stage (improved group) following conservative management. Distribution of the antral gastrin cells (G‐cell) was also studied electron microscopically. Seven pairs of the parents of patients investigated took part in the fasting serum gastrin measurement to investigate the genetic effects.

Mean fasting serum gastrin concentration was significantly elevated in patients of the untreated group (254±44 pg/ml, p<0.05) and in patients of the improved group (191±35 pg/ml, p<0.05) compared with the mean value (115±20 pg/ml) for the control group (n=6). The maximum peak gastrin response and the duration of hypergastrinemic response to milk feeding in order of magnitude or length were observed in the untreated, improved and control groups. There was no difference of numbers of antral G‐cell among the 3 groups but G‐cells of untreated patients tended to have vacuoles near the Golge apparatus which is consistent with hyperfunction of the cell. Hypergastrinemia was found in 4 out of 7 mothers (54.3%), 2 of whom were extremely hypergastrinemic (329 pg/ml, 732 pg/ml), and in 3 out of 7 fathers (42.8%) including 2 pairs of the parents (28.5%). These results support the view that gastrin may play a role together with the genetic endowment within a susceptible population in the pathogenesis of IHPS.
Gastrin Secretion in Infancy and Childhood|Part 2: Gastrin Secretion in Gastrointestinal Diseases
Authors: Mayama Haruki
Published: October 2007

Serum gastrin levels were measured radioimmunologically in 123 patients with various gastrointestinal diseases to study the pathophysiological role in the diseases.

In winter diarrhea, mean fasting gastrin level tended to be slightly higher in the severer patients but the difference from the control level were not statistically significant. After test meal, however, mean serum gastrin level increased rapidly and reached a peak by after 10 minutes followed by levelling off for 20 minutes. This result may suggest that a feedback mechanism between the secretion of gastrin and secretin is disturbed in the disease.

In bacillary dysentery, mean fasting serum gastrin levels in the acute stage did not differ from that of controls.

Mean fasting serum gastrin levels in neonatal hepatitis and chronic hepatitis of school children were significantly lower but the level in congenital biliary atresia was not different as compared to those of age‐matched controls. Further investigation of gastrin metabolism in liver may be needed.

In duodenal ulcer, mean fasting serum gastrin level was not different statistically from the control value but mean gastrin response to feeding was significantly greater and longer than that of controls. This abnormality of gastrin release in children with duodenal ulcer may have a significant role in the pathogenesis of the disease.

In superior mesenteric artery syndrome, mean fasting gastrin level was significantly lower than that of controls and mean serum gastrin responses to test meal both in sitting and prone positions were significantly lower than those of controls. No statistical difference was found when the response were compared between in a sitting and prone positions. The hypogastrinemic response to meal in patients with this order was probably considered to be due to impaired function of G‐cells which was caused by dilatation of the stomach and/or duodenum resulting in the mucosal damage.

The increment of gastrin secretion following glucocorticoid administration was found in children with anaphylactoid purpura and the effect was confirmed in rats. This results suggest that the so‐called steroid ulcer may partly be caused by steroid induced gastrin hypersecretion.
A Case of Coombs‐Negative Autoimmune Hemolytic Anemia, Possibly Caused by Influenza Vaccination
Authors: Tsuchiya Hiroyuki , Ishii Toshinori , Fujiwara Hirokazu , Matsuda Ichiro
Published: October 2007

We report a case of Coombs‐negative autoimmune hemolytic anemia (AIHA), possibly caused by influenza vaccination. The patient received influenza vaccine twice preceding the onset. Although his Coombs' test was negative, the concentration of IgG on erythrocytes showed a level as high as those of patients with Coombs‐negative AIHA previously reported. This surface IgG might play a main role in hemolysis. The reversed OKT4+/OKT8+ ratio of his peripheral blood lymphocytes and the high level of circulating immune complex (CIC) concentrations which were observed might reflect an aberrant response of the immune system to vaccination. He received a blood transfusion only once, and recovered from the disease gradually without further specific treatment.
Prevention of HBV Mother ‐ Infant Transmission
Authors: Yano Michitami , Tajima Heiichiro
Published: October 2007

In Japan, the national counterplan for prevention of mother‐infant hepatitis B virus (HBV) transmission with HB vaccine was established in 1985 after 10 years of clinical trials with human hepatitis B immunoglobulin (HBIG). The preventing method is based on passive‐active prophylaxis with HBIG and HB vaccine, and only infants from HBe antigen‐positive mothers can receive this administration.

We compared the effectiveness of several methods of administration of HBIG and HB vaccine for 1199 infants. The rate of infants who became HBV carrier state was 6% out of all the subjects. The prophylaxis in which infants were injected with HBIG just after delivery and with HB vaccine as soon as possible after birth was superior to the others in protective efficacy. The infants injected just after delivery showed no harmful effects.

These results suggest the possibility and necessity of improved administration methods which will reduce the stress for infants and economic burden for their parents.
Detection of Rotavirus from Stools by Latex Agglutination Test
Authors: Ushijima Hiroshi , Shinozaki Tatsuhiko , Kim Bosu , Araki Kazuko , Fujii Ryochi , Kohno Hideki
Published: October 2007

Abstracts

Latex agglutination (LA) reagents were prepared using antisera against human rotaviruses (Wa and S2 strains). A commercially available LA test (Rotalex) using antisera against calf rotavirus was also used. Semititrations of rotavirus antigens were compared by three LA tests on 110 stools of children with acute gastroenteritis which had been previously determined rotavirus‐positive by electron microscopy and polyacrylamide gel electrophoresis of genome RNA. LA tests showed diversity of subgroups. The three LA tests reported in this study are concluded to be useful for clinical application in spite of a few exceptions in semititration.
Antimicrobial Chemotheraphy of Infections due to Pseudomonas aeruginosa
Authors: Nishimura Tadafumi
Published: October 2007

Aminoglycosides, β‐lactam antibiotics such as piperacillin, ticarcillin and mezlocillin, and cefoperazone, cefsulodin and ceftazidime, and imipenem have excellent antipseudomonal activity and have proved useful for the control of Pseudomonas aeruginosa infections. These infections include septicemia, meningitis, pneumonia, urinary tract infection, skin and soft tissue infection and postoperative infection. The aminoglycosides are notable for their synergistic activity with β‐lactams, but serum concentrations of aminoglycosides must be carefully monitored to avoid nephrotoxic and ototoxic side effects. Cross‐resistance also poses special problems among the aminoglycosides, but amikacin and some dibecacin derivatives are potently active against organisms resistant to other aminoglycosides. Carbenicillin and sulbenicillin are usually given in massive dose because their MICs are high, and this can be detrimental to patients with salt intolerance. Fosfomycin also has a high sodium content. Among the cephalosporins, cefoperazone is expecially effective against biliary tract infection; ceftazidime and cefsulodin are active against Pseudomonas aeruginosa resistant to aminoglycosides. This paper summarizes the antipseudomonal activities of various Kinds of antibiotics and discusses some problems in the actual chemotherapy of Pseudomonas aeruginosa infections.
The Present Status of Sepsis of Children and Its Chemotherapy in Japan
Authors: Meguro Hidenori , Fujii Ryochi
Published: October 2007

The present status of etiology and chemotherapy of sepsis of children in Japan is reported. In newborns and infants less than 3 months of age, the most common pathogens in sepsis and purulent meningitis are Escherichia coli and group B Streptococci, although Staphylococcus aureus becomes the second most important bacteremic pathogen after the 3rd day of life. In order infants and children, S. aureus, Haemophilus influenzae and Streptococcus pneumoniae are the most common bacteremic pathogens. Listeriosis is increasing in Japan, yet is responsible for only 1.4% of cases of purulent meningitis and 0.5% of sepsis in children at present.

The chemotherapy of sepsis and purulent meningitis has been changed from the old standard ampicillin therapy (with gentamicin in neonates) to mono‐therapy with a new cephem, especially cefotaxime in Japan, since over 50% of strains of E. coli are already resistant to ampicillin.
Prophylactic Antibiotic Usage in Children
Authors: Akita Hironobu , Sunakawa Keisuke , Ichihashi Yasuo
Published: October 2007

As a result of recent striking progress in the development of antibiotics, some infectious diseases which had been considered to be intractable have come to be curable. However, there are still quite a few infectious diseases which occur comparatively rarely, but once they attack humans the condition becomes severe and treatment is very difficult. When it is possible to prevent these infections by prophylactic administration of antibiotics, such administration should be performed. The antibiotic employed for this purpose should have the strongest available antibacterial activity against the target bacteria and a clear prophylactic effect which has already been proven. In addition, it is also necessary that the antibiotic does not change the normal bacterial flora, which plays an important role in body defense mechanisms against infections. The drug also must not cause any serious side effects.

We discuss the prophylactic administration methods which are actually being practiced in pediatrics. That is, the actual state of the latest methods of prophylactic antibiotic administration is described together with new findings regarding infections by group A hemolytic streptococci, meningitis (Neisseria meningitidis and H. influenzae), tuberculosis, endocarditis, infections in newborns (gonorrheal ophthalmia and infections by group B hemolytic streptococci), recurrent infections (otitis media and urinary tract infections) and infections in compromised hosts (especially infections by Pneumocystis carinii).
Safety Assurance in Antimicrobial Therapy
Authors: Yoshioka Hajime , Fujita Kozo , Sakata Hiroshi
Published: October 2007

The toxicity of penicillins and cephalosporins per se is low but they cause hypersensitivity reactions in some patients. These antibiotics also disturb the ecological balance of the normal flora and lead to antibiotic associated colitis or other systemic superinfections in immunocompromised hosts. Aminoglycosides are oto‐ and nephrotoxic, erythromycin estolate causes sometimes liver function abnormalities, and clindamycin in particular causes pseudomembranous colitis. Chloramphenicol has been associated with aplastic anemia and gray baby syndrome, and tetracycline with discoloration of the teeth of infants.

To avoid adverse effects and to assure the safety of antimicrobial therapy, one should avoid unnecessary antibiotic administration, and make the duration of antibiotic therapy as short as possible. Blood levels of chloramphenicol or aminoglycosides have to be monitored in cases with lowered renal function and in prolonged therapy.
Antibiotic Chemotherapy and the Hemorrhagic Tendency
Authors: Sunakawa Keisuke , Iwata Satoshi , Sato Yoshitake , Shiro Hiroyuki , Kusumoto Yutaka , Oikawa Tadao , Ichihashi Yasuo
Published: October 2007

The objective of the present research was to investigate the mechanism of the hemorrhagic tendency known to be associated with the administration of antibiotics. To do this from the viewpoints of the supply and utilization of vitamin K, studies were carried out in newborn infants and in germ‐free mice. The reasons for the selection of newborns were that their intestinal bacterial flora is easily changed by the administration of antibiotics and that it is easy to monitor their oral food intake. Germ‐free mice were selected because they do not have intestinal bacteria.

Forty newborn infants were each given one of the antibiotics latamoxef (LMOX), cefmenoxime (CMX), cefotaxime (CTX) and ceftazidime (CAZ), and the establishment of most bacteria in the intestinal tract was delayed, with the exception of the enterococci, and sometimes S. epidermidis, which are insensitive to these antibiotics.

PIVKA II, which is an indicator of vitamin K deficiency, was detected in 72% of the patients treated with LMOX and in 48% of the CMX‐treated patients. Conversely, all 16 patients who were treated with either CTX or CAZ were negative for PIVKA II. The correlation between the incidence of a positive result for PIVKA II and the oral food intake was investigated. It was found that 11 of 16 infants (68%) fed no milk or fed breast milk became positive for PIVKA II. In contrast, only 4 (16%) of 24 infants fed formula milk became positive for PIVKA II.

The importance of the intestinal bacteria and the oral food intake was confirmed by the fact that the hepaplastin test value was prolonged when methyltetrazolyl‐thiomethyl (MTT) was administered to germ‐free mice and to normal mice on a vitamin‐K‐free diet.

On the basis of these experimental findings, it is surmised that the association between antibiotic therapy and the development of a hemorrhagic tendency is a result of a complex interaction of various factors, i.e., a decrease in oral food intake, a decrease in the count of the normal bacterial flora of the intestinal tract, and the presence of an MTT group in the structure of the administered antibiotic.
Genetic Relatedness Among Human Rotaviruses in Tokyo
Authors: Ushijima Hiroshi , Kim Bosu , Araki Kazuko , Shinozaki Tatsuhiko , Fujii Ryochi
Published: October 2007

The relation between RNA hybridization and electropherotypes of rotavirus from stools in Tokyo was studied. Tritiated UTP labeled probes of three different serotypes and electropherotypes showed no relation between hybridization ratio and electropherotypes. Samples of “long” pattern of electropherotypes hybridized to the probe of “short” as to the probes of “long.”
The Nature and Molecular Weight of the Circulating Immune Complex in Glomerulonephropathy Associated With Hepatitis B Virus Infection
Authors: Furuse Akio , Hattori Shinzaburo , Karashima Shinnyo , Matsuda Ichiro
Published: October 2007

Circulating immune complex (CIC) in patients with hepatitis B virus associated glomerulonephropathy was fractionated into two parts by sucrose gradient ultracentrifugation. A CIC of higher molecular weight (more than 900,000 daltons) consisted of hepatitis B virus surface antigen (HBsAg), and one of lower molecular weight (between 900,000 and 66,000 daltons) consisted of hepatitis B virus e antigen (HBeAg). The patients with membranous glomerulonephropathy (MGN) had much more CIC of higher than of lower molecular weight, while deposits in the glomerular basement membrane were stained with anti‐HBeAg but not with anti‐HBsAg. A patient with minimal changes had only higher molecular weight CIC and no deposits in the kidney. Our results suggest that lower molecular weight CIC containing HBeAg may play an important role in the development of MGN.
Effect of Plasma Infusion on Plasma Apolipoprotein Levels and Lipoprotein Composition in Patients With Abetalipoproteinemia
Authors: Maesaka Hatae , Kodama Tatsuhiko , Sugai Kenji , Suwa Seizo , Itakura Hiroshige , Takaku Fumimaro
Published: October 2007

In order to clarify the disturbance of plasma lipoprotein metabolism and the effect of supplement therapy, changes occurring in plasma lipoprotein composition and apoprotein levels after plasma infusion were studied in two sibling patients with classical abetalipoproteinemia. The patients' plasma completely lacked both apoproteins B100 and B48. After infusion of 10 ml per kilogram of body weight of normal plasma, the plasma apoprotein B level increased to 11 and 13 mg/dl and the half‐life of apoprotein B to 10h and 6h respectively in the two brothers. In contrast, the plasma apoprotein E level decreased slightly or remained unchanged. On sodium dodecylsulfate polyacrylamide gel electrophoresis, apoprotein B appeared in the low‐density lipoprotein fraction and the content of apoprotein E in the high‐density lipoprotein fraction decreased. The mean particle size of high‐density lipoprotein decreased on analysis by high‐performance liquid chromatography. These results indicate that the catabolic rate of apoprotein B at low plasma levels (<15 mg/dl) is rapid in total apoprotein B deficiency, and suggest that plasma infusion may normalize apoprotein E distribution and metabolism.
A Case of Precocious Pseudopuberty Associated With Ovarian Follicular Cyst
Authors: Tsubouchi Kohji , Tanaka Hiroshi , Kobayashi Hiroko , Yasuda Masanori , Nakashima Yoshiki , Orii Tadao
Published: October 2007

A case of precocious pseudopuberty associated with a follicular cyst in the ovary is described. A five‐year‐and‐month‐old Japanese girl had breast enlargement, areolar pigmentation and intermittent genital bleeding. On laparotomy, bilateral ovarian cysts were found. The left cyst (4.0 times 4.0 times 3.5 cm) was far larger than the right (1.5 times 1.3 times 1.3). The fluid in the left cyst contained a high concentration of estrogens. Therefore, the main cause of the precocious puberty was thought to be the left cyst. It was clearly detected by ultrasonography and computed tomography only when the signs of precocious puberty were remarkable and the serum estrogen level was increased; however, the right one could not be detected throughout the observation. We consider that in the case of intermittent puberty a functioning ovarian cyst can be identified more easily when the signs of precocious puberty are remarkable and the serum estrogen level is increased.
Early Phase of Juvenile IDDM–Environmental and Genetic Intervention–
Authors: Kitagawa Teruo , Fujita Hidehiro , Tsukasa Shintaro , Hanaoka Yoko , Uragami Tatsuhiko
Published: October 2007

The clinical appearance in the early phase of two cases of juvenile IDDM detected by urine glucose screening are described. Their postprandial blood glucose and HbAj were maintained without insulin therapy for several months below 180 mg/dl and 8.7% respectively. At three and six months after diagnosis both cases became ketoacidotic and their glucose tolerance deteriorated with a marked decrease of postprandial serum CPR level.

There was no high insulin requirement with low CPR level at the time of diagnosis in 12 such patients with the above mentioned slow onset type IDDM. The insulin requirement steadily increased and serum CPR decreased from 12 months after diagnosis. The so‐called honeymoon period was not observed in this group.

However, at the time of diagnosis in 24 patients with typical abrupt onset IDDM, there was a high insulin dose requirement with a low level of postprandial CPR value followed by an early decline in the insulin requirement with a temporary increase of CRP value.

HLA‐DR4 or DRW9 or both were more freqently observed in patients with abrupt onset type IDDM than in slow onset type IDDM. It may probably be that genetic background as well as environmental factors affect the clinical picture in the early phase of IDDM in children.
High Risk Screening of Adenosine Deaminase and Purine Nucleoside Phosphorylase Deficiency in Japan
Authors: Kishi Takamasa , Sakura Nobuo , Ito Kazuhiko , Usui Tomofusa
Published: October 2007

Seventy‐three patients with immunodeficiency syndromes or frequent infections were screened for adenosine deaminase (ADA) and purine nucleoside phosphorylase (PNP) deficiency by the dried blood spot paper method. Among 23 patients with combined immunodeficiency, five patients with ADA deficiency were detected. In the light of the incidence of primary immunodeficiencies and financial limitation, it seems to be adequate to put screening for ADA & PNP deficiency in force for all infants with signs of an immune defect.
Prediction of Starting Dose for Conventional Insulin Treatment (Using the Practical Closed‐Loop System)
Authors: Miyamoto Shigeki , Sasaki Nozomu , Nakajima Hironori
Published: October 2007

This study was undertaken in 10 newly diagnosed diabetic children to assess the usefulness of the practical closed‐loop system in determining insulin doses in conventional treatment. During application of this system of continuous intravenous insulin infusion, the infusion dose was changed according to the hourly monitored blood glucose values. Conventional insulin treatment was started, based on the daily insulin profile obtained by the practical close‐loop system. This consisted of two daily injections of a mixture of short‐ and intermediate‐acting insulins. There was no significant difference in mean blood glucose, M‐value or mean amplitude of glycemic excursions between the two treatments.

Compared with the previous insulin regimen in which conventional insulin treatment was performed following the initial treatment for diabetic ketoacidosis without this practical closed‐loop system, good glycemic control was obtained in a shorter period by using this system.

Thus, the practical closed‐loop system could be helpful in predicting the starting insulin dose for conventional insulin treatment.
Clinical and Postmortem Findings of Two Cases With Karyotype: 48, XXX, +18
Authors: Sonoda Tohru , Ohdo Shozo , Madokoro Harumichi , Akimoto Kaoru , Ohba Ken‐ichi
Published: October 2007

Clinical and postmortem findings of two cases with karyotype: 48, XXX, +18 are presented. In both patients the usual characteristics of trisomy 18 were found. Case 1 was complicated with congenital esophageal atresia, hypoplastic left auricle with external auditory canal atresia, left congenital dislocation of hip, and left club foot. The patient died on the 9th day after birth. Autopsy revealed mitral atresia, aortic stenosis, ventricular septal defect, patent ductus arteriosus, coarctation of aorta, bicuspid aortic and pulmonary valves, patent foramen ovale, and congenital esophageal atresia (type C). Case 2 died on the 8th day after birth. Postmortem examination revealed ventricular septal defect, but there was no other noteworthy malformation. Dermatoglyphic findings were more prominent on the right hand than the left. The severity of malformations may be biased to either the right or the left side.
Kabuki Makeup Syndrome Associated With Megaureter
Authors: Iwama Yoshihiko , Sugiyama Setsuo , Kaiga Kazuhiro , Eguchi Mitsuoki , Furukawa Toshiharu
Published: October 2007

A case of Kabuki makeup syndrome associated with megaureter and L‐shaped kidneys is described. This is the first report of Kabuki makeup syndrome with urinary tract anomaly.
Association of Severe Microcephaly, Short Palpebral Fissures, Micrognathia, Growth Retardation and Early Death: A New Syndrome
Authors: Madokoro Harumichi , Ohdo Shozo , Sonoda Tohru , Ohba Kenichi , Hayakawa Kunio
Published: October 2007

Four siblings presenting a combination of severe microcephaly, short and laterally downward slanting palpebral fissures, hypertelorism, micrognathia, and growth retardation are reported. The proband had congenital heart disease complicating these characteristic symptoms. The parents were not consanguineous. The karyotypes of the proband and parents were normal. The faces of three brothers of the proband were very much like that of the proband, but tvjo of them had cleft palates. Although it was confirmed that one of the three brothers did not have congenital heart disease, its presence in the other two could not be ascertained. All three older brothers died within one month after birth.
Growth and Maturation in the Male Genitalia From Birth to Adolescence I. Change of Testicular Volume
Authors: Fujieda Kenji , Matsuura Nobuo
Published: October 2007

Testicular volumes of Japanese males from birth to adolescence were studied in cross‐sectional series. Maturational events of testicular volumes occurred in the two periods during early infancy and adolescence. The testicular volumes during the first three months of life were slightly greater than later in infancy. Thereafter there was very little increase in testicular volumes from the age 1 to 10 years. After 11 years there was a sudden increase in size. The mean volumes increased from 6.5 cm3 at the age of 11 years to 36.7 cm3 at 14 years. The largest increment was observed between 13 and 14 years of age and between pubic hair stages I and II. Reaching testicular volumes of 6.5 cm3 was found to be a landmark of the earliest sign of puberty. The age at which pubertal development was initiated varied between the ninth and the fourteenth year of life.
Developmental Disorders in Histidinemia—Follow‐up Study of Language Development in Histidinemia —
Authors: Ishikawa Michiko
Published: October 2007

To investigate the relationship between histidinemia and developmental disorders, a longitudinal study was performed in 26 patients. Neuropsychological and psychological testing was carried out. The results indicate the range of DQ and IQ for these subjects, and suggest an autistic tendency and poor language/ visual abilities. Abnormal EEG patterns were observed.

The relationship between histidinemia and brain dysfunction is descussed.
Auditory Brainstem Response in Leigh's Syndrome
Authors: Kaga Makiko , Naitoh Haruko , Nihei Kenji
Published: October 2007

Leigh's syndrome is a clinically heterogeneous disorder with a variety of biochemical bases. It is classified as one type of the mitochondrial encepha‐lomyopathies (MEMs). Serial auditory brainstem responses (ABRs) in eight patients with clinically diagnosed Leigh's syndrome are reported. Abnormalities of ABRs were detected in the early stages of the disease in all patients. Severely abnormal wave configuration associated with prolonged wave latency was detected in patients with apnea and/or other symptomatology involving the brainstem. Patients with cortical involvement had markedly abnormal ABRs in which only waves I and/or V were present. In those patients whose clinical symptoms were less severe, the ABR was mildly abnormal. Changes in the ABR did not consistently reflect clinical exacerbations and remissions. ABRs were useful in the classification of Leigh's syndrome and in judging the severity of the disease process. ABRs can be used as a supplementary diagnostic procedure in Leigh's syndrome.