bluuebunny/crossref_metadata_2025 huggingface dataset:
ATP modulates sulfobromophthalein uptake in rat liver plasma membrane vesicles
Authors: TORRES ADRIANA MÓNICA
Published: March 2008

The hepatic uptake of the bilirubin‐bilirubin‐sulfobromophthalein (BSP) group of organic anions is a carrier‐mediated process and is accounted for by at least four distinct plasma membrane proteins (bilitranslocase, BSP/bilirubin‐binding protein, organic anion‐binding protein and the organic anion transport protein). In order to investigate the regulation of basolateral organic anion uptake, BSP transport was measured in rat basolateral liver plasma membrane vesicles in the presence of ATP. ATP significantly stimulated the electroneutral uptake of BSP with an increment in Vmax compared with control (1.57±0.14 vs 0.73±0.06 nmol BSP/mg protein per 15 s, respectively; P< 0.001) while the apparent Km was not changed significantly (12±1 vs 12±2 μmol/L). The stimulatory effect was dose‐dependent for ATP (Km 1.01±0.37 mmol/L). ATP had no detectable effect on the electrogenic component of BSP transport. Other nucleotides (ADP, AMP, GTP) and non‐hydrolysable ATP did not enhance BSP uptake, suggesting that ATP hydrolysis was necessary for the effect. This was supported by the lack of effect on BSP uptake when ATP was added in the presence of vanadate. The addition of phorbol‐12‐myristate 13‐acetate, an activator of protein kinase C (PKC), increased BSP uptake in a dose‐dependent manner in the presence, but not in the absence, of ATP. Incubation of vesicles with staurosporine, an inhibitor of PKC activity, resulted in a dose‐dependent inhibition of ATP‐sensitive BSP transport. These data indicate that electroneutral BSP hepatic uptake is modulated by ATP. The effect is related to ATP hydrolysis and involves the activity of PKC.
Clinicopathological significance of intestinal and diffuse types of gastric carcinoma in Taiwan Chinese
Authors: WU CHEW‐WUN , TSAY SHYH‐HAW , HSIEH MAO‐CHIH , LO SU‐SHUN , LUI WING‐YIU , P'ENG FANG‐KU
Published: March 2008

The present study sought to evaluate the clinicopathological features of our gastric cancer patients in terms of a modified Lauren's histological classification and compared the results with those from studies from Japan and Western countries. A total of 536 consecutive patients with gastric cancer were treated surgically between December 1987 and December 1993. A clinicopathological analysis was only performed for intestinal types (IT) and diffuse types (DT) of gastric cancer because patients falling into the ‘other’ category were too small to produce meaningful data. Of 536 cases of gastric cancer, 268 (50%) were IT, 231 (43.1%) were DT and 37 (6.9%) were of the other type. The overall IT:DT ratio was 1.2. Gastric cancer patients with IT (in contrast to DT) were characterized by older age, male dominance, smaller tumours, the tumour often being located in the lower and upper third of the stomach and less peritoneal metastasis. In both sexes, the peak incidence of gastric cancer patients was in the age group 65–74 years. Men had higher proportions of IT carcinoma than women. The IT:DT ratio for men and women was 1.4 and 0.4, respectively. Although the increased ratio of IT:DT paralleled the advance of age in both sexes, the transitional age (the age at which the IT:DT ratio exceeds 1.0) in male patients (age group 51–64 years) was earlier than for female patients (age group 65–74 years). Patients with IT gastric cancer had a significantly better survival rate than those with DT. However, the type of carcinoma (IT or DT) was not an independent predictor of survival. These data indicate that gastric cancer in Taiwan Chinese has different biological behaviour in terms of IT and DT. The clinicopathological features in IT and DT carcinoma are similar to studies from Japan and from Western countries.
Helicobacter pylori infection delays the healing of acetic acid‐induced gastric ulcer in Japanese monkeys
Authors: KODAMA REIJI , FUJIOKA TOSHIO , SHUTO RYUSUKE , KUBOTA TOSHIHIRO , NASU MASARU
Published: March 2008

To clarify the relationship between Helicobacter pylori and the healing of gastric ulcers, we investigated the healing of acetic acid‐induced gastric ulcers in the antral mucosa of Japanese monkeys (n=5) infected with H. pylori and in control monkeys without H. pylori infection (n=6). Using H. pylori‐infected Japanese monkeys as an experimental model, gastric ulcers were induced endoscopically with acetic acid. Healing of ulcers and factors that influenced healing were studied. Continuous colonization with H. pylori was confirmed in the infected group throughout the observation period; no H. pylori were isolated from the gastric mucosa of the control group. White scarring was not observed in any infected monkeys 4 weeks after ulcer formation, but was observed in one (20%) of five monkeys at 6 weeks and in all five monkeys eight weeks after ulcer formation. In the control group, white scarring was observed in one (16.7%) of six monkeys at 4 weeks and in six monkeys at 6 (P< 0.01 vs infected group) and 8 weeks. The ammonia concentration of the gastric secretions and the grade of inflammation were significantly increased in the H. pylori‐infected group compared with the control group (P< 0.01 and P< 0.001, respectively). The volume of intracellular PAS‐positive substance was decreased (P< 0.025–0.01) at the ulcer margin in the infected group compared with the ulcer margin in the control group. The proliferation of gastric epithelial cells was markedly accelerated at the ulcer margin in the infected group compared with the ulcer margin in control group (P< 0.025–0.01). Our results strongly suggest that H. pylori infection delays the healing of gastric ulcers.
Reversal of altered intestinal mucosal immunity in rats fed elemental diet by supplementation of oleic acid
Authors: SERIZAWA HIROSHI , MIURA SOICHIRO , IMAEDA HIROYUKI , TANAKA SHIN , KIMURA HIROYUKI , TSUZUKI YOSHIKAZU , JING‐YANG HAN , TODA KYOKO , HAMADA YOSHIKI , TSUCHIYA MASAHARU , ISHII HIROMASA
Published: March 2008

We have previously demonstrated that elemental diet (ED) induces decreased lymphocyte transport in intestinal lymph and significant changes in T cell subsets and the number of IgA‐containing cells in gut‐associated lymphoid tissues of rats. In order to examine whether the low fat content contributes to the induction of immunological changes in gut‐associated lymphoid tissues, the effects of additional fatty acid in the ED were investigated. Rats were divided into four groups: elemental diet alone, elemental diet supplemented with 5% oleic acid (OA), elemental diet with 10% OA and conventional diet as a control. These diets were given at the same daily calorie intake for 4 weeks. The flow rate of intestinal lymph showed no significant difference between the four groups. However, lymphocyte flux as well as the percentage of CD3+ and CD4+ cells were significantly greater in the control and the 10% OA groups than in the ED and 5% OA groups. Intestinal lymph showed decreased concentrations of IgG and IgA in the ED group, whereas the addition of 10% OA significantly attenuated the decrease in these levels. In mesenteric lymph nodes, the CD4+/CD8+ ratio was significantly decreased in the ED group, but 10% OA reversed this change. Immunohistochemical analysis of the ileal mucosa showed that in the ED group the population of CD4+ cells was decreased, while the number of CD8+ cells was increased. Supplementation of OA to ED produced similar stepwise attenuation of the changes in lymphocyte subpopulations in the lamina propria, while the 10% OA group reached levels that were not statistically different from controls. In the elemental diet, group, there was a significant decrease in immunoglobulin‐containing cells of the IgA class in the lamina propria of the intestine. Similarly, the addition of OA induced dose‐dependent recovery in the number of IgA‐containing cells. These results suggest that a low dietary concentration of fat may be closely related to changes in lymphocyte transport in intestinal lymph and mucosal immunity of intestinal mucosa induced by the feeding of a long‐term ED.
Differential diagnosis of gall‐bladder masses using colour Doppler ultrasonography
Authors: HIROOKA YOSHIKI , NAITOH YASUO , GOTO HIDEMI , FURUKAWA TSUYOSHI , ITO AKIHIRO , HAYAKAWA TETSUO
Published: March 2008

To evaluate the diagnostic accuracy of colour Doppler ultrasonography in the differential diagnosis of gall‐bladder lesions, we studied colour Doppler flow imaging of gall‐bladder masses in 75 patients with gall‐bladder masses, including 26 patients with cancer, 18 with benign polyps, 10 with adenomyomatosis and 21 with pseudo‐tumorous sludge and 28 healthy subjects as controls. The presence of a colour signal, pattern of the colour signal, blood flow velocity and resistive index (RI) within lesions were assessed using colour Doppler ultrasonography. In cancerous lesions, the colour signal pattern was diffuse or arborizing (sensitivity 90.5% (19/21); specificity 62.5% (10/16)) and the velocity and RI were (mean ± s.d.) 39.0 ± 12.4 cm/s and 0.62 ± 0.12, respectively, which was significantly different (P< 0.01) compared with controls (11.4 ± 2.5 and 0.75 ± 0.03, respectively). The colour signal pattern obtained from polyps was linear at their base in 62.5% (10/16) of cases, but the velocity (13.6 ± 5.5) and RI (0.74 ± 0.08) did not differ from those of the controls. Lesions other than cancer and polyp had no colour signal. There were overlaps in the values of velocity and RI between malignant and benign lesions. When 20 cm/s for velocity and 0.65 for RI were used as the respective cut‐off values, the sensitivity and specificity of this method in the diagnosis of malignant lesions was 95.2% (20/21) and 87.5% (14/16) for velocity and 66.7% (14/21) and 87.5% (14/16) for RI, respectively. In a prospective study consisting of 10 patients with cancer and 21 patients with polyps, the sensitivity and specificity were 90 and 66.7% for the colour signal, 100 and 100% for velocity and 80 and 90.4% for RI, respectively. In conclusion, colour Doppler ultrasonography can be useful in the diagnosis of gallbladder masses in combination with conventional ultrasonographic findings of gall‐bladder masses, especially in the differentiation of cancers from benign lesions.
Case Report: Giant choledochal cyst
Authors: HOLLAND ANDREW JA , CHILDS PHILIP A.
Published: March 2008

We report an adult female with a rare giant choledochal cyst. The patient presented following a normal pregnancy with the classical triad of an abdominal mass associated with jaundice and right upper quadrant abdominal pain. The cyst was excised using an intramural technique and biliary reconstruction achieved with a Roux‐en‐Y hepaticojejunostomy. Our patient has remained well with no evidence of malignancy over a 12 year review period. The aetiology and current management of this condition are discussed.
A commentary on: Career paths for basic scientists in medical research
Authors: RAMM GRANT A.
Published: March 2008

For basic scientists, the choice of starting a career in medical research is one made through a genuine interest in understanding the human disease processes and a desire to be at the forefront of new knowledge acquisition. However, more often than not, this decision is made without a great understanding of the career path one must follow to be successful in medical research or of the potential hurdles that may lay in wait in attaining one's career goals. The present paper outlines the optimum career path a basic scientist may follow through the National Health and Medical Research Council of Australia career awards and fellowship schemes. The document also highlights a number of potential problems in the career progression of basic scientists to Research Fellow, which appear to be due, in part, to the lack of appropriate fimding to support these schemes.
Myths and realities in clinical research
Authors: WARD M.
Published: March 2008

It is often argued that clinicians should be more actively involved in research and that this inactivity is due to shortage of time and funds. This may be so, but more important and less obvious constraints are the differences in the philosophical foundations of clincial practice and research. Researchers must strive to abolish uncertainty, to be unwaveringly committed to truth and to rid themselves of all bias. Clincians, in contrast, must frequently manage patients in the absence of certainty, handle truth creatively and be willing to be biased on their patients’ behalf as part of a professional obligation. These differences constitute powerful selection pressures for individuals with particular skills, personalities and sources of job satisfaction. Clinical practice and research are instrinsically different activities and it is probably unreasonable to expect an individual talented in one to be similarly expert in the other.
PEPTIC ULCER: PATHOGENSIS, HEALING AND ANTI‐ULCER DRUGS
Authors: GANE E. , SUTTON MM , PYBUS J. , HAMILTON I.
Published: March 2008

Abstract  To investigate the possible absorption and deposition of bismuth or aluminium from agents used in the treatment of peptic ulcers, we have measured levels of bismuth and aluminium in the liver tissue of 15 patients undergoing elective liver biopsy and in the cerebrospinal fluid (CSF) of 15 patients undergoing elective myelography after administration of standard therapeutic doses of tripotassium dicitrato bismuthate (TBS), sucralfate or aluminium hydroxide for 1 month. Aliquots of liver or CSF were separated and levels of both aluminium and bismuth were assayed in each sample by atomic absorption spectrophotometry. The group who received TBS had significantly higher liver bismuth levels than the other two treatment groups, but there was no significant difference in CSF bismuth levels among the three groups. There was no significant difference in either liver or CSF aluminium levels among the three treatment groups. We conclude that tissue accumulation of bismuth may occur after short‐course therapy with colloidal bismuth, although there is no evidence of CNS accumulation of bismuth in the present study.
Reduction of intestinal apo A‐IV mRNA levels in the cirrhotic rat
Authors: SEISHIMA MITSURU , USUI TOSHIO , NAGANAWA SATOSHI , NISHIMURA MASATO , MORIWAKI HISATAKA , MUTO YASUTOSHI , NOMA AKIO
Published: March 2008

In the present study, intestinal apo A‐IV synthesis was investigated using a carbon tetrachloride (CCl4)‐induced cirrhosis rat model. Triglyceride (TG) content in rat cirrhotic liver was increased markedly by 170% (P< 0.001) and apo B was increased by 20% (P<0.05) compared with control levels. These results reflected the steatotic change in the liver. In contrast, TG levels in the small intestine of cirrhotic rats decreased significantly (P<0.01). In addition, intestinal apo A‐IV (jejunum P< 0.001; ileum P< 0.01) and its mRNA levels (jejunum P< 0.01; ileum P< 0.05) were also reduced. The decreased apo A‐IV content in the jejunum was confirmed by immunohistochemical analysis. These results indicate that intestinal apo A‐IV synthesis in cirrhosis is suppressed, at least under the condition of an overnight fast. Therefore, decreased intestinal apo A‐IV synthesis may relate to the decreased ability to absorb fat in cirrhosis, but a fat‐loading study will be necessary to confirm this hypothesis. It is unknown from the present study why serum apo A‐IV level is not significantly decreased, despite a reduction in apo A‐IV synthesis. The clearance of apo A‐IV by the liver may be delayed or apo A‐IV synthesis may be rather markedly enhanced during fat absorption in liver cirrhosis.
Case report: Lymphangioma of the oesophagus endoscopically resected
Authors: SUWA TATSUSHI , OZAWA SOJI , ANDO NOBUTOSHI , SHINOZAKI HIROHARU , TSUJITSUKA KAZUYUKI , MIKI HIROTAKA , MAKUUCHI HIROYASU , KITAJIMA MASAKI
Published: March 2008

Lymphangioma of the oesophagus is an extremely rare entity, with only nine cases having been reported worldwide. We report on a 52‐year‐old woman with oesophageal lymphangioma, diagnosed using endoscopic ultrasonography and endoscopically resected. No case of malignant transformation of the lymphangioma has been reported in the literature. Endoscopic resection seems to be a minimally invasive method that is appropriate both for the removal of the tumour and precise diagnosis.
Relationship between age and clinical characteristics of patients with gastric cancer
Authors: LO SU‐SHUN , WU CHEW‐WUN , HSIEH MAO‐CHIH , KUO HSU‐SUNG , LUI WING‐YIU , P'ENG FANG‐KU
Published: March 2008

The relationship between the prognosis and age of patients with gastric cancer is controversial. To evaluate whether there is a biological characteristic specific to the age of patients, we examined the clinical characteristics of patients with gastric cancer with special reference to their age. Based on a prospective database, a retrospective study of 419 patients who underwent radical gastrectomy for cure in the past 6 years was conducted. Clinical characteristics including gender, gross appearance of the tumour (Borrmann's classification, tumour location), histopathology (depth of tumour invasion, lymph node status, Lauren's classification and degree of tumour cell differentiation) and TNM tumour stage were analysed in six different age groups (< 39, 40–49, 50–59, 60–69, 70–79, > 80 years). The mean age of the 419 patients was 64.6 years (range from 26–91) and the peak age incidence of gastric cancer (46.3%) was in the 60–69 year old age group. The male: female ratio was 4.6: 1 on the whole and male gender predominated at ages > 60. The proportion of diffuse type tumours (68.4%) by Lauren's criteria in the young age group (< 39 yrs) decreased with age (25% in the > 80 years group; P<0.001). Similarly, the proportion of poorly‐differentiated tumours (89.5%) in the young age group (< 39 yrs) decreased with advancing age (P<0.001). These findings suggest that both diffuse type and poorly‐differentiated tumours predominate in younger patients and, without considering the factor of delay in diagnosis, may explain the poorer prognosis demonstrated in younger patients.
Hepatocyte volume as an indicator of hepatic functional reserve in cirrhotic patients with liver tumours
Authors: MATSUI Y. , TU W. , KITADE H. , NAKAGAWA A. , KAMIYA T. , KWON A‐H , UETSUJI S. , KAMIYAMA Y.
Published: March 2008

Using computed tomography (CT), measurements of whole liver volume have been used for the assessment of pre‐operative functional reserve in cirrhotics. However, measurements of hepatocyte volume, which exclude stromal fibrous tissue, are considered to more directly reflect hepatic functional reserve. We investigated the relationship between total hepatocyte volume and each of the parameters of conventional liver function. Indocyanine green (ICG) tests and blood analyses for the assessment of liver function were performed prior to surgery in cirrhotic patients with liver tumours. Pre‐operative liver volume was determined by integrating images of each liver area obtained by CT. Liver area was measured by an image processing program that traced the profile of the liver image while excluding the tumorous area. Sections of normal tissue stained by the haematoxylin‐eosin method, were obtained from the resected liver. Using these sections, a hepatocyte area: whole tissue area ratio was calculated using the image processing program, by tracing the profiles of the hepatocyte nodules. The total volume of hepatocytes was then calculated by multiplying the liver volume by this ratio. The hepatocyte volume per unit bodyweight was significantly correlated with ICG tests and with many other parameters of normal liver function. However, the liver volume per unit bodyweight was correlated only with the plasma ICG disappearance rate and with the blood platelet count. These observations suggest that the functional reserve of the cirrhotic liver is assessed more precisely by hepatocyte volume than by liver volume.
Inflammatory Bowel disease in Saudi Arabia: Presentation and initial management
Authors: ISBISTER WILLIAM H , HUBLER MATTHIAS
Published: March 2008

Non‐specific Inflammatory Bowel disease (IBD) is infrequently seen in the Arabs of the Arabian Peninsula. This paper documents the presentation and initial management of 101 such Arabs treated for inflammatory bowel disease between 1976 and 1994. Medical records were examined and patients were classified according to the Organisation Mondiale de Gastroenterologie diagnostic scoring system. Sixty‐seven patients had mucosal ulcerative colitis, 28 Crohn's disease (CD) and six indeterminate colitis; age range 2–71 years. Three patients had a family history of (IBD). The diagnosis was made by a combination of the patients’ history, physical, radiological, endoscopic and histological examination; however, eight patients were not examined endoscopically and one in four patients was not biopsied at presentation. Thirty‐nine patients did not receive any treatment prior to referral. One in three patients was first treated as inpatients. Giardia, Amoeba, Salmonella, Shigella or Schistosoma were detected in the stools of 36 patients at presentation. Following appropriate treatment, these infections were eliminated but the patients’ symptoms persisted. Six patients who were thought to have gastrointestinal tuberculosis were subsequently diagnosed with CD. Ten patients had extraintestinal manifestations of their IBD and 11 had side effects (osteoporosis, Cushingoid features and growth retardation) from steroid treatment at other hospitals. Diagnosis was often delayed because infectious diarrhoea was common and awareness was low. Patients were referred late and some had developed complications of therapy.
Evidence of transmission of hepatitis B virus to spouses from sequence analysis of the viral genome
Authors: HUO TEH‐IA , WU JAW‐CHING , HUANG YI‐HSIANG , YANG UENG‐CHENG , SHEEN I‐JANE , CHANG FULL‐YOUNG , LEE SHOU‐DONG
Published: March 2008

Heterosexual contact is one of the common routes of transmission for hepatitis B virus (HBV) among adults in Taiwan, but only a few studies have provided direct evidence at the level of the HBV genome of infected couples with acute non‐fulminant hepatitis to document a common source. By cloning and sequencing polymerase chain reaction‐amplified HBV‐DNA, we analysed the sequences of the conserved region of the surface gene (nucleotide (nt) 305–513, representing 6.5% of the viral genome) of HBV in five HBV‐infected index patients, their spouses and four randomly selected HBV carriers as controls. Risk factors associated with acute HBV infection in index cases were sexual contact with their spouses within 3 months before the onset of hepatitis. For all five couples, the HBV‐infected index patient and the spouse shared a 100% sequence homology of HBV‐DNA. In contrast, there was significantly more variation (mean heterogeneity 6.1%, range 1–13.9%) in the amplified region between the five couples and between each couple and the controls (P < 0.001). This study demonstrated that sequence analyses can correlate well with epidemiological findings and confirm the value of the molecular approach for linked infections of HBV through heterosexual contact between spouses. Susceptible adults should receive vaccination.
The comparative potency of cholesterol crystallization‐effector proteins in supersaturated model bile systems: Association with vesicle transformation
Authors: HATTORI YOSHIHIRO , TAZUMA SUSUMU , YAMASHITA GUNJI , KAJIYAMA GORO
Published: March 2008

Various proteins which affect cholesterol crystallization are known to be present in bile, although the relative potency of their action is yet to be established. In this study, we evaluated the comparative potency of nucleating‐effector proteins using a recently developed method for quantitative assessment of vesicle transformation in supersaturated model bile systems, to partially characterize mechanisms of their action. Concanavalin A‐bound glycoproteins isolated from human gall‐bladder bile shortened cholesterol crystallization time by 40% and increased cholesterol growth rate and final crystal mass by 161 and 19%, respectively, when compared to the control. In addition, immunoglobulins isolated from human gall‐bladder bile increased cholesterol growth rate by 9%, but showed no significant effect on cholesterol crystallization time and final crystal mass. In contrast, human serum apolipoproteins A‐I and B reduced cholesterol growth rate by 26 and 31% and reduced final crystal mass by 12 and 21%, but did not affect cholesterol crystallization time. Gel permeation chromatography revealed that proteins were distributed to both vesicles and bile salt micelles, but that no marked redistribution of lipids was caused by addition of these proteins. Furthermore, no significant difference in crystal structure was observed by video‐enhanced contrast microscopy. These results indicate that nucleatingeffector substances tested in this study may modulate vesicular cholesterol‐holding capacity, thus affecting cholesterol crystallization. Such modulation is based upon the protein‐vesicle association which defines the physico‐chemical metastability of vesicular cholesterol.
THE RESULTS OF TREATMENT AND SOME OF THE DIAGNOSTIC DIFFICULTIES IN A SERIES OF 142 INTRACRANIAL TUMOURS IN INFANTS AND CHILDREN*
Authors: SCHREIBER M. SOFER
Published: March 2008

EDITORIAL SYNOPSIS

This report analyses a series of 142 infants and children with intracranial tumours classified according to type and site of origin. Brief case reports illustrate some of the diagnostic difficulties and the outcome in each group provides a guide to prognosis. The experience gained is summarized in helpful observations and recommendations.
THE RELATIONSHIP BETWEEN BIRTH WEIGHT AND GESTATIONAL AGE IN AN AUSTRALIAN HOSPITAL POPULATION
Authors: KITCHEN W. H.
Published: March 2008

SYNOPSIS

The neonate whose birth‐weight diverges widely from the average for the period of gestation is subject to special hazards. Acceptable local standards of weight are required to identify these infants at risk. A chart of intrauterine weight, based on data from 2637 patients, is presented together with details of the hospital population and the methods used in selecting the patients. The influence of certain complications during pregnancy is briefly discussed.
A DIFFICULTY IN CONFIRMING 21 HYDROXYLASE DEFICIENCY IN A NEONATE WITH CONGENITAL ADRENAL HYPERPLASIA
Authors: RUDD B. T. , GALAL O. M. , McARTHUR R. G.
Published: March 2008

SYNOPSIS

The pattern of steroid excretion of a female infant with congenital adrenal hyperplasia was examined on the fifth day of life.

The absence of pregnanetriol and the pattern of steroid excretion indicated a 3β‐ol‐de‐hydrogenase deficiency; DHA and other androgens were excreted as sulphate (solvolysable) conjugates. On the other hand, the presence of 11‐oxygenated steroids in the urine did not support this diagnosis. The detection of significant quantities of reducing steroids excreted as sulphate conjugates, suggested that either the corticosterone or cortisol pathway was partially open.

An ACTH stimulation test at 3 1/2 months of age while the patient was receiving dexamethasone, revealed significant quantities of pregnanetriol in the urine, and a decrease of those steroids excreted in the neonatal period. It is suggested that the ACTH test is a valuable aid in the post neonatal period in the diagnosis of difficult cases of congenital adrenal hyperplasia.
THE SIGNIFICANCE OF ABNORMAL GLUCOSE TOLERANCE IN CHILDHOOD*
Authors: COURT J. M.
Published: March 2008

SYNOPSIS

This paper refers to 13 children who were found to have glycosuria on routine testing of urine, but who had no symptoms referable to diabetes. Each child had one or more abnormal glucose tolerance tests on initial testing, but further observations revealed continuing glucose in only 1 child, and normal glucose tolerate in all those retested.

The significance of abnormal glucose tolerance ni children without symptoms referabale to diabetes, is discussed. Treatment appropriate to diabetes mellitus is not recommended in the absence of clinical symptoms and with only the evidence of one abnormal glucose tolerance test. Further observations during succeeding months should first be made.
A NEURO‐DEVELOPMENTAL APPROACH TO THE TREATMENT OF CEREBRAL PALSY A PRELIMINARY REPORT*
Authors: REYE CORRIE
Published: March 2008

SYNOPSIS

An attempt has been made to assess the value of a neuro‐developmental approach in the treatment of children with cerebral palsy. Some‘facilitation’techniques used to encourage automatic postural reactions are mentioned and it is emphasized that these patterns are more easily established in the very young before the increased tone or fluctuation of tone has become well established.
THE DISTURBANCES OF VENTILATION IN ACUTE VIRAL BRONCHIOLITIS
Authors: PHELAN P. D. , WILLIAMS H. E. , FREEMAN M.
Published: March 2008

SYNOPSIS

Respiratory function studies have been performed on 24 infants with acute viral bronchiolitis. The results of these have demonstrated increased thoracic gas volume and total pulmonary resistance, and decreased dynamic compliance. These changes have reverted to normal within 7 to 10 days of the onset of the illness.
INTRAVENOUS GAMMA GLOBULIN THERAPY OF IMMUNOGLOBULIN DEFICIENCY DISEASES*
Authors: SIMONS M. J. , SCHUMACHER M. J. , FOWLER R.
Published: March 2008

SYNOPSIS

The effect of the intravenous administration of gamma globulin modified by treatment with pepsin and low pH, (I.V.G.G.), has been described. This material has been administered, as routine therapy, to 6 children with immunoglobulin abnormalities. Adequate serum IgG levels were obtained and maintained because the I.V.G.G. could be given in higher dosage than that uusally employed with the intramuscular preparation. Occurrence of untoward reactions to I.V.G.G. were observed and found to be rate dependent. Careful medical supervision is therefore essential during the entire course of the therapy.
TRANSIENT INFANTILE CYANOSIS IN A DIAPHORASE‐DEFICIENT MALE
Authors: HARPER MARGARET A. , ROBIN HELEN , HARLEY J. D.
Published: March 2008

SYNOPSIS

A male infant was cyanosed for the first 3 months of life, associated with methaemo‐globin concentrations which fell from 15% of the total haemoglobin concentration initially to near‐normal levels. Large cephalhaematomata were present at birth. The child developed normally except for left‐handedness and retardation of speech development. At 3 years, the methaemoglobin concentration was 3%, and the erythrocytic diaphorase activity approximately 40‐50% of normal. Family studies suggested that the patient was heterozygous for an autosomal mutant gene. The pathogenesis of methaemoglobinaemia in diaphorase deficiency is discussed.
SEASONAL WAVES OF ASTHMA — A GEOGRAPHICAL COMPARISON
Authors: DERRICK E. H.
Published: March 2008

SYNOPSIS

Admissions for asthma to children's hospitals in Brisbane, Sydney, Adelaide and Melbourne for the 3 years 1955‐58 showed a series of seasonal waves. Most of these occurred at related times in all 4 centres, implying that some important precipitating factors operate over a wide geographical range. Spring waves usually appeared successively in Brisbane, Sydney, Adelaide and Melbourne, with an over‐all interval from north to south of about 4 weeks; they occurred in the grass pollen season, particularly in Adelaide and Melbourne, but there are some reservations in accepting pollens as a full explanation. In February‐March, large waves occurred in all 4 centres in 1957, and minor waves in some centres in 1956 and 1958; they were probably related to the spread of infections in young children that follows the opening of the school year. Autumn waves, when present, tended to begin at the same time in the different centres; they were greater and more prolonged in Brisbane than elsewhere.
HISTAMINE BINDING IN SERUM OF CHILDREN WITH ASTHMA
Authors: FREEMAN MAVIS
Published: March 2008

SYNOPSIS

Investigations of sera from asthmatic patients have been undertaken in an attempt to discover basic differences from normal sera.

Asthmatic sera are predominantly histaminopexy negative, that is, they do not combine with histamine in vitro. The sera of normal children show the opposite effect.

The protein fraction responsible for binding histamine, plasmapexin, has been shown to be associated with gamma globulin.
RHEUMATOID ARTHRITIS IN CHILDHOOD A STUDY OF 60 CASES
Authors: ROBINSON M. J.
Published: March 2008

SYNOPSIS

A series of 60 children with rheumatoid arthritis has been analysed. The cases are classified as ‘infantile’, ‘adult’ and ‘intermediate’ and the presentation, clinical features, results of investigation are presented. The prognosis is good and only 7 have any significant disability. A further 7 appear to have active disease with an as yet undetermined outcome.
STUDIES OF AUSTRALIAN ABORIGINAL CHILDREN: STREPTOCOCCAL INFECTION, HEART REACTIVE ANTIBODY AND SUBCLINICAL RHEUMATIC CARDITIS
Authors: JOSE D. G. , WELCH J. S.
Published: March 2008

SYNOPSIS

Elevated erythrocyte sedimentation rates in Australian Aboriginal school children in Queensland indicated a significant incidence of chronic active inflammation. The characteristics of the abnormal group, when compared with suitable controls, were relative retardation of growth, enteric parasites, respiratory infections, elevated serum immunoglobulins G and M, and high carrier rates of group A steptococci. Associated findings suggest that subclinical chronic rheumatic carditis is present in a large number of Aboriginal school children.
DISSEMINATED INTRAVASCULAR COAGULATION
Authors: EKERT H.
Published: March 2008

SYNOPSIS

The occurrence of this condition in a variety of infections and diseases in childhood is described in the light of the clinical, laboratory and autopsy findings in 7 children. The screening tests available are described, and the difficulties of interpretation are discussed, particularly the mechanisms which may be responsible for the paradox of coexisting haemorrhagic and hypercoagulable states.
VARIATIONS IN THE LEVEL OF SERUM PHENYLALANINE WITH AGE
Authors: PITT D. B.
Published: March 2008

SYNOPSIS

The level of phenylalanine in the serum is highest in the first 2 years of life, i.e. a mean of 42.05 mgm/100ml. and thereafter the mean level is about 27.72 mgm/100 ml. This is related to a greater requirement of phenylalanine during the period of maximum growth.
ANTIBIOTIC SPRAY DURING AND AFTER CLOSURE OF MYELOMENINGOCELES
Authors: FORMBY D. , BUISSON J.
Published: March 2008

SYNOPSIS

Infection plays a major part in morbidity and mortality of neonates with meningomyelocele. A control series is constructed to demonstrate the value of an antibiotic spray during and after closure of the lesion.
PERCUTANEOUS RENAL BIOPSY IN CHILDHOOD*
Authors: ROY L. P.
Published: March 2008

SYNOPSIS

The results of 109 percutaneous renal biopsies are described. Tissue for diagnosis was obtained in 100 (91.5%) and there were no complications. The indications for biopsy were mainly for the diagnose and prognosis of acute glomerulonephritis, and for the histological diagnosis in the nephrotic syndrome, recurrent haematuria, and acute or chronic renal failure. Biopsy was also performed on a small number of patients with such problems as proteinuria of unknown aetiology, persistent haematuria in the Henoch‐Schönlein syndrome, and lead poisoning with renal insufficiency.

It is suggested that with adequate precautions percutaneous renal biopsy is a valuable and safe procedure.
THE PREDICTION OF ADULT STATURE IN TALL GIRLS
Authors: ROCHE A. F. , WETTENHALL H. N. B.
Published: March 2008

SYNOPSIS

The mean error of prediction of mature height in 29 untreated tall girls was similar to that reported for normal children. There was no real tendency to overpredict or under‐predict for the group as a whole. There was, however, a real tendency to overpredict at skeletal ages of 14 years and over, and a definite tendency to underpredict in girls who were retarded skeletally. Predictions should be based on the skeletal age of the hand‐wrist, excluding the carpals, or on the skeletal age of the knee.
A SURVEY OF CHILDREN AND ADOLESCENTS ON QUEENSLAND ABORIGINAL SETTLEMENTS, 1967*
Authors: JOSE D. G. , SELF M.H.R. , STALLMAN N. D.
Published: March 2008

In this survey of health in Aboriginal children on 12 settlements and missions in Queensland, the reported births and deaths suggest an infant mortality rate six times higher than the Queensland average, with diarrhoeal disease, respiratory infection, and diseases of the neonatal period accounting for 75% of infant deaths.

Children in the post‐weaning period showed retardation of growth, anaemia, and frequent respiratory or enteric infection. The prevalence of hookworm infection has, on the evidence of this and other studies, fallen to low levels, but other enteric parasites were common in this age group.

Middle‐ear deafness and rheumatic heart disease are major problems of Aboriginal school children. Hepatomegaly of unknown aetiology was found in all the age groups studied.

Laboratory studies showed elevated total serum protein and γ‐globulin fractions, elevated erythrocyte sedimentation rates in many asymptomatic children and, in a limited study, a high prevalence of eosinophilia. Marked geographical variation was found in the occurrence of cold agglutinins, and antibody to group A and B arboviruses. Serclogical reactions for treponemal infections indicated a low prevalence in these communities.

General improvement in the health of Aboriginal children and adolescents in the last decade has resulted from control of many diseases, but there are still high morbidity and mortality rates in infants and young children.
CHANGES IN DISC ELECTROPHORETIC PATTERNS IN GLOBULINS IN SERUM OF CHILDREN WITH ASTHMA
Authors: FREEMAN MAVIS
Published: March 2008

The aim of this investigation was to study types of protein in asthmatic sera in relation to allergy. There are differences in the serum of some patients with asthma when compared with normal controls. There is an increase in the slow alpha globulin fraction, demonstrable by acrylamide gel electrophoresis. Similar changes have been reported in sera from patients with tuberculosis, pneumonia and bronchiectasis. Sera from patients with chronic infections also show intense gamma globulin bands.
LACTOSE DIGESTION AND BREAST FEEDING: A NUTRITIONAL SURVEY IN AUSTRALIAN ABORIGINAL INFANTS
Authors: ELLIOTT R. B. , MAXWELL G. M. , KNEEBONE G. M. , KIRKE D. K.
Published: March 2008

The quantity and quality of breast milk available to Australian Aboriginal infants after the first 6 months of life, are probably less than European counterparts. The weight of the individual child is closely related to the intake of milk, and the ability to increase the blood glucose after oral lactose loading appears in these infants to decline with age, but in the individual, the decline is not related to the intake of milk.
PARATYPHOID IN A 13 YEAR OLD GIRL
Authors: ZENTNER G.
Published: March 2008

SYNOPSIS

A 13‐year‐old English migrant girl was admitted to a surgical ward with the clinical picture of an acute abdomen. Several features of her presentation were, however, a little unusual, and in fact she was shown to be suffering from paratyphoid fever.

The frequency of the enteric fevers and their importance in our community is mentioned, and some of the clinical features are briefly discussed.
THE FIRST KILOGRAM: III. MILK INTAKE AND PROTEIN ALLOWANCES OF LOW BIRTH WEIGHT BABIES CONSUMING POOLED HUMAN MILK
Authors: STEVENS L. H.
Published: March 2008

SYNOPSIS

The mean daily intake of pooled human milk (containing 1.84 ± 0.24 g% protein) was measured during the first and successive postnatal weeks in infants of low birth weight. By the end of the second postnatal week this feeding provided a protein allowance of 3 to 5 gm/Kg/day, largely independent of the infant's sex and perinatal history.
PORTAL HYPERTENSION IN CHILDHOOD
Authors: McEWIN G. R.
Published: March 2008

SYNOPSIS

All cases of portal hypertension seen at the Adelaide Children's Hospital over a 19‐year period have been studied.

The causes were noted, and the cases placed in one of two groups: pre‐ or postsinusoidal.

The results showed that the two groups differed in their mode of presentation and in the results of investigations. This condition is rare in childhood and the prognosis is poor, but in patients with the presinusoidal type of obstruction in whom a shunt procedure was performed, the prognosis was better when the operation could be delayed unil late childhood or early adolescence.
URINARY CANDIDIASIS FOLLOWING THE HAEMOLYTIC URAEMIC SYNDROME
Authors: HOBDAY J. D.
Published: March 2008

SYNOPSIS

This case report describes the persistence of urinary infection due to Candida albicans for 7 months after successful treatment for the haemolytic uraemic syndrome. Acute systemic dandidiasis, rare in childhood, has features that resemble the haemolytic uraemic syndrome, and the relationship between these two conditions is discussed.
CLINICAL AND PATHOLOGICAL ASPECTS OF CENTRAL NERVOUS SYSTEM INVOLVEMENT IN THE HAEMOLYTIC URAEMIC SYNDROME
Authors: ROONEY J. C. , ANDERSON R. McD. , HOPKINS I. J.
Published: March 2008

Synopsis

Major clinical neurological features were seen in 13 of 25 consecutive patients with the haemolytic uraemic syndrome (HUS). Convulsions were present in 11 of these patients Hemiparesis, aphasia, coma, and decerebrate spasms were other manifestations and these were associated with a mortality of 90% compared with an overall mortality of 45%. Two case histories are given in which neurological involvement was the presenting and predominant clinical feature. Neuropathological examination showed hypoxic and/or ischaemic lesions and cerebral oedema as the most frequent changes, but did not reveal distinctive vascular lesions similar to those seen in the kidney. The diagnosis of HUS should be considered in severe acute and subacute encephalopathies of obscure origin in childhood.
CYTOGENICS OF 271 MONGOLS
Authors: SUTHERLAND G. R. , WIENER S.
Published: March 2008

SYNOPSIS

The cytogenic findings in 271 mongols are described and discussed. The cases were ascertained by routine referral and also by total ascertainment studies of institutionalised mongols. 23 of the 271 did not have regular mongol karyotypes. It is suggested that all mongols should be referred for chromosomal studies.
ARTERIALIZATION OF CAPILLARY BLOOD: HISTAMINE IONTOPHORESIS IN ENDOTOXIN SHOCK
Authors: DEAN MARGARET E.
Published: March 2008

SYNOPSIS

Values of pO2 obtained from capillary blood by histamine iontophoresis were compared with arterial values both before and after the induction of endotoxin shock in the experimental animal. Capillary blood pO2 levels were found to compare favourably with arterial blood levels in both circumstances. It is suggested that arterialisation of capillary blood by histamine iontophoresis could be used to determine pO2 levels in the acutely ill child when arterial blood is not readily available.
STRANGULATION OF THE LEFT VENTRICLE FOLLOWING HERNIATION THROUGH A CONGENITAL DEFECT IN THE PERICARDIAL SAC
Authors: DADDS V. , MASTERS P. L.
Published: March 2008

SYNOPSIS

An apparently healthy 4 year old boy complained of sudden, persistent, severe back pain associated with vomiting and peripheral circulatory failure. The radiological findings were puzzling and he died, undiagnosed, 36 hours after the onset of symptoms. Necropsy revealed significant cardiac hypertrophy in addition to the findings described in the title.

The mechanism of the strangulation and the advisability of prophylactic repair of partial pericardial defects are discussed.
INFECTED CEPHALHAEMATOMA
Authors: TAN K. L.
Published: March 2008

SYNOPSIS

A cephalhaematoma is a frequent complication of the process of birth, and very rarely becomes infected. Two cases of infected cephalhaematoma, both by gram negative organisms, are presented and the problem of infection in cephalhaematomas is reviewed.
THE MANAGEMENT OF HIRSCHSPRUNG'S DISEASE IN THE NEONATE
Authors: BOWRING A. C. , KERN I. B.
Published: March 2008

SYNOPSIS

Most cases of Hirschsprung's disease can be detected in the newborn period at which time the mortality is highest. Our experience with 24 consecutive cases in the newborn is discussed and in the management of aganglionosis in this age group the approach to diagnosis and treatment should be one of urgency; laparotomy should be done with frozen sections available and, if possible, with the bowel previously deflated; a Sieber‐Kiesewetter operation is recommended and the colon distal to the colostomy should be cleared of faeces before the patient is discharged from hospital.
GALL BLADDER DISEASE IN CHILDHOOD
Authors: NATAR G.
Published: March 2008

SYNOPSIS

A retrospective study of 18 children with gall bladder disease reveals some differences in the clinical features in childhood and suggests that the condition may be more common than generally believed. A higher index of suspicion might lead to earlier diagnosis in children with undiagnosed pain.
ASSESSMENT OF IRON DEFICIENCY IN CHILDREN WITH CONGENITAL HEART DISEASE
Authors: LOVRIC V. A. , CELERMAJER J. M. , LAMMI A. T.
Published: March 2008

SYNOPSIS

In a prospective study of children aged 6 to 36 months attending the congenital heart clinic, possible underlying iron deficiency was investigated before and after a course of iron therapy. The data obtained with a new fragiligram technique, compared with haemoglobin measurements, clearly show the superiority of the former in assessing iron deficiency, when the haemoglobin levels are in the accepted normal range.
HYPERTENSION DUE TO RADIATION NEPHRITIS IN A CHILD
Authors: LEDITSCHKE J. F. , COOKE R. A.
Published: March 2008

SYNOPSIS

A 3 1/2 year old girl received irradiation therapy to the abdomen, including both renal areas, following the surgical removal of a ganglioneuroblastoma. 8 1/2 years later, she developed hypertension which was cured by the removal of the radiation damaged kidney. Radiation nephritis is discussed along with other possible causes of the raised blood pressure.
SPONDYLO‐METAPHYSEAL DYSPLASIA
Authors: GALATIUS‐JENSEN F. , KOZLOWSKI K.
Published: March 2008

SYNOPSIS

A case of 7 year old Danish girl with spondylo‐metaphyseal dysplasia is reported. The disease is characterised clinically by shortening of stature and thoracic kyphosis. The radiographic pattern of the vertebral column, metaphyses and round bones of the hands and feet, is diagnostic in this syndrome. Degenerative bone changes supervene early in adult life.
YOLK SAC TUMOUR OF THE OVARY
Authors: ABERDEEN J. D. , SANTAMARIA J. N.
Published: March 2008

SYNOPSIS

This is a report of a rare, very malignant ovarian tumour occurring in a 12 year old Italian girl.

An aggressive approach was adopted which included excision of the primary tumour under cover of chemotherapy, followed by a second exploratory laparotomy, and excision of a single pulmonary metastasis.
A REVIEW OF CHEST X‐RAYS OF CENTRAL AUSTRALIAN ABORIGINAL INFANTS AND CHILDREN
Authors: HILLER H. G.
Published: March 2008

SYNOPSIS

A 6 year retrospective study of the chest X‐rays, and the relevant reports, of aboriginal infants and children was undertaken. All films had been taken at the Alice Springs Hospital, and a comparative reassessment of the films and the original reports was carried out. All other information obtainable from the films was also studied.