bluuebunny/crossref_metadata_2025 huggingface dataset:
Protection Against Pertussis by Acellular Pertussis Vaccines (Takeda, Japan): Household Contact Studies in Kawasaki City, Japan
Authors: Kato Tatsuo , Goshima Toshiro , Nakajima Natsuki , Kaku Hirofumi , Arimoto Yutaka , Hayashi Fumie
Published: October 2007

To evaluate the vaccine efficacy of an acellular pertussis vaccine which has been in clinical use in Japan since 1981, a retrospective study was performed by a questionnaire survey of secondary pertussis attacks through family contact in 146 children with pertussis diagnosed in the period from January 1981 through May 1988. In this study, acellular vaccine made by Takeda Pharmaceutical Company, which contains a high level of FHA (filamentous hemag‐glutinin), a low level of PT (pertussis toxin) and a small amount of agglutinogen, was evaluated. Secondary pertussis attacks through family contact were found in 17 of 29 siblings (58.6%) not immunized with pertussis vaccine. On the other hand, 27 siblings immunized with Takeda's acellular vaccine were exposed to pertussis through family contact and a secondary attack was seen in only one of them (3.7%). The present study revealed an efficacy rate of 93.7% for Takeda's acellular pertussis vaccine.
Comparison of Acyclovir and Vidarabine in Immunocomtxomised Children with Varicella‐Zoster virus Infection
Authors: Kunitomi Taiji , Akazai Ayumi , Ikeda Masanori , Oda Megumi , Kodani Nobuyuki
Published: October 2007

Intravenous acyclovir and vidarabine were compared in the treatment of varicella‐zoster virus (VZV) infection in 25 immunocompromised children ‐ 13 with acute lymphocytic leukemia, three with other types of cancer, two with immunodeficiency and in seven undergoing prednisolone treatment. Thirteen had varicella and 12 had herpes zoster. Acyclovir was given intravenously to five patients with varicella and to four with herpes zoster at a dose of 5–10 mg/kg every eight hours. Vidarabine was given intravenously to eight patients with varicella and to eight with herpes zoster at a dose of 10 mg/kg/day. In varicella, vidarabine significantly shortened the time from the start of treatment to cessation of new lesion formation compared with acyclovir. However, there was no significant difference in time to complete crusting between the two treatments. In herpes zoster, acyclovir significantly shortened the time from the onset of the skin lesions to complete crusting. A slight raise of GOT in two cases was reported. While acyclovir and vidarabine were equally effective for VZV infection, in herpes zoster acyclovir was more effective.
Antibody‐Dependent Cellular Cytotoxicity and Natural Killer Activity Against HTLV‐1 Infected Cells
Authors: Kunitomi Taiji , Takigawa Hirotoshi , Sugita Makio , Nouno Shin , Suemune Masayuki , Inoue Masakatsu , Kodani Nobuyuki , Oda Megumi , Ikeda Masanori
Published: October 2007

Antibody‐dependent cellular cytotoxicity (ADCC) and natural killer (NK) ativity were examined using MT‐2 cells persistently infected by HTLV‐1 as target cells, and mononuclear cells as effector cells, from helathy one‐week‐old newborn babies, infants, children and adults. More than 10% of ADCC was observed in 17 newborn babies out of 22 (77.3%) and in all 67 healthy one‐month‐old babies to adults, by adding serum from anti‐HTLV‐1 positive carriers. When anti‐HTLV‐1 negative serum was added, less than 10% of ADCC was observed. If infants without anti‐HTLV‐1 antibodies were breast‐fed they had the possibility of HTLV‐1 vertical transmission. There was no significant decrease in NK activity between 90 healthy newborn babies, infants, children, or adults. These results suggest that ADCC and NK activity protect against the transmission of HTLV‐1 from mother to child.
Age‐Related Changes in Urinary Growth Hormone Level and Its Clinical Application
Authors: Nukada Osamu , Moriwake Tadashi , Kanzaki Susumu , Katayama Masahiro , Higuchi Johji , Kimoto Hiroshi
Published: October 2007

In order to establish the normal range of urinary growth hormone (GH) level for age and sex, which is important in the clinical application of urinary GH to diagnosis, we measured GH in the first morning urine specimens of 270 normal subjects aged 3 to 20 years. Urinary GH levels in patients wit documented GH deficiency were compared with those of the normal controls. In normal subjects, urinary GH levels showed a statistically significant change with age. They were relatively high in infancy and mid‐puberty, reaching a peak at 11 to 12 years in girls and at 13 to 14 years in boys. Urinary GH levels in patients with complete GH deficiency were apparently lower (<‐2.0SD) than those of the normal hildren, while the levels in patients withpartial GH deficiency overlapped with the normal range. When assessing GH secretion by using urinary GH measurement, consideration of age and sex is required, since the level changes isgnificantly wit these factors.
Supraventricular Tachycardia in Acquired Rubella Infection: A Case Report
Authors: Fukushige Junichiro , Kuroiwa Tyuji , Ueda Kohji , Miyazaki Chiaki , Takagi Seiichirou
Published: October 2007

A 6‐year‐old boy developed supraventricular tachycardia nine days after onset of the exanthem of clinical rubella. The diagnosis of rubella virus infection was confirmed serologically. Except in the neonatal period,

only eight cases of cardiac involvement in acquired rubella infection have been previously reported. During epidemics.

rubella virus infection should be considered in patients who manifest cardiac symptoms and signs of unknown etiology.
Antibiotic Susceptibility of Type b Haemophilus influenzae and Streptococcus pneumoniae, and Antibiotic Concentration in Cerebrospinal Fluid
Authors: Fujita Kozo , Zhang Dao‐hua , Sakata Hiroshi , Murono Koichi , Kakehashi Hitoshi , Yoshioka Hajime
Published: October 2007

Antibiotic susceptibilities of 38 type b Haemophilus influenzae and 28 Streptococcus pneumoniae strains isolated from cerebrospinal fluid, blood and other specimens between 1973 and 1988 were studied. Minimal inhibitory concentrations (MICs) of ampicillin against 10 β‐lactamase positive and 28 negative H. influenzae isolates were 32–64 and 0.25 μg/ml, respectively. The MIC of chloramphenicol against one of the β‐lactamase positive H. influenzae strains was 8 but MICs against the rest of the organisms were 0.5–1 μg/ml. MICs of cefotaxime, ceftriaxone and cefuroxime against all H. influenzae strains were 0.016, 0.008 and 0.5 μg/ml, respectively. No S. pneumoniae isolates were resistant to penicillin G and MICs of this drug were 0.016–0.032 μg/ml. MICs of cefotaxime, ceftriaxone and cefuroxime against all S. pneumoniae strains were 0.016–0.032, 0.016–0.032 and 0.032–0.063 μg/ml, respectively. MICs of chloramphenicol against 15, 4 and 9 of S. pneumoniae isolates were 2, 8 and 16 μg/ml, respectively. Antibiotic concentrations in the cerebrospinal fluid of patients with bacterial meningitis after intravenous administration of ampicillin (50–70 mg/kgx4/day), penicillin G (31–63 mg/kgx4/day), cefotaxime (50 mg/kgx4/day) and chloramphenicol (25 mg/kgx4/day) were 4.70±1.83 (n=11), 0.57±0.32 (n=7), 4.97±2.60 (n=9) and 8.52±3.54 μg/ml (n=3), respectively. The initial choice of antibiotics in older children with bacterial meningitis is a combination of ampicillin (75 mg/kgx4/day) and cefotaxime (50 mg/kgx4/day) to cover ampicillin‐resistant H. influenzae, S. pneumoniae, and Listeria monocytogenes in Japan. These antibiotics should be changed according to the causative organisms and their antibiotic susceptibilities.
Vascular Abnormalities in Congenital Cutis Laxa ‐ Report of Two Cases‐
Authors: Tsuji Atsutoshi , Yanai Jun , Miura Takuma , Shirai Yasuo , Osano Mitsuru , Hosoda Yasuhiro , Sato Masaaki , Asaishi Takasumi , Oda Yutaka , Hajikano Hiroshi
Published: October 2007

Two cases of Japanese girls with congenital cutis laxa associated with cardiovascular abnormalities are described. Case 1: A 12‐year‐old girl has been under our observation from the age of 6 months. Cardioangiogram revealed dilatation of the ascending aorta, meandering of the descending aorta and the coronary arteries, coiling of the carotid and innominate (brachiocephalic) arteries, and hypoplasia of the pulmonary arteries. Case 2: A 2.8/12‐year‐old girl died after our follow‐up from the age of 3 months. The cause of death was congestive heart failure secondary to peripheral stenosis of the pulmonary arteries. In both cases, skin biopsy revealed a decreased number of elastic fibers and an increased amount of acidic mucopolysaccharides. The same histological features were observed in the pulmonary arteries and other arteries as well. Electron microscopic findings were diffuse thinning of elastic fibers and reduced elastic content. The high blood level of elastase (167.8 μg/l) in case 1 may cast a light on the unknown etiology of the disease.
Prophylaxis in Childhood Asthma
Authors: Noche Miguel L.
Published: October 2007

Opinions on the pathogenesis of bronchial asthma have changed considerably in recent years. An immunologic mechanism to explain the state of bronchial hyperresponsiveness in asthmatic patients was not widely accepted in the past. However, with increasing knowledge of immunologic, biochemical and neurogenic mechanisms, a better understanding of the pathophysiology of asthma has evolved. This has encouraged investigators to develop new drugs to control asthmatic symptoms. The treatment of asthma consists of measures to control acute attacks and to prevent recurrences. We try to present in this paper a comprehensive review of asthma prophylaxis in children. This includes environmental control, parent/patient education, physiotherapy/psychotherapy, allergy extract immunotherapy and drug prophylaxis. The pharmacologic actions, advantages and disadvantages of drugs used for prophylaxis are discussed. A double‐blind investigation on the safety and efficacy of Ketotifen among Filipino asthmatic patients demonstrated beneficial results compared with other countries. An algorithm of the use of various drugs in the prophylaxis of childhood asthma is presented.
Respiratory Symptoms and Asthma in Primary School Children in Kuala Lumpur
Authors: Omar Azizi Haji
Published: October 2007

In a Cross‐sectional Study of 7 to 12‐year‐old primary school children in Kuala Lumpur, the prevalence of chronic cough and/or phlegm, persistent wheeze, and doctor‐diagnosed asthma were 8.0%, 8.0% and 8.7%, respectively. The prevalence of asthma (defined as persistent wheeze and/or doctor‐diagnosed asthma) was 13.8%, 4.3% experienced at least one episode of chest illness that resulted in inactivity for at least 3 days in the previous year. The mean age of commencement of symptoms in the doctor‐diagnosed asthma group was 2.75 years. The prevalence of chronic cough and/or phlegm and persistent wheeze were highest among Indian children (p<0.05). More Malays had been diagnosed as having asthma than the other ethnic groups but the differences were not statistically significant. The patients' fathers' low levels of education were associated with chronic cough and/or phelgm (p<0.05) but not with other complaints. Asthma was significantly more common among boys than girls. No age differences were noted. Further analysis showed that persistent wheeze and doctor‐diagnosed asthma were associated with increased likelihood of other respiratory illnesses or doctor‐diagnosed allergy before the age of 2 years.
Urinary Dicarboxylic Acids in X‐Linked Adrenoleukodystrophy
Authors: Kodama Soichi , Nishio Hisahide , Nakajima Toshihiro , Nakamura Hajime
Published: October 2007

The urinary excretion of dicarboxylic acids in X‐linked adernoleukodystrophy (X‐ALD) was studied. The dicarboxylic acid profile in X‐ALD did not show any specific pattern, unlike Zellweger syndrome and neonatal adernoleukodystrophy. Medium‐chain dicarboxylic acids with an even number of carbon atoms (adipic, suberic, sebacic) and an odd number of carbon atoms (pimelic, azelaic) were excreted within the normal ranges. Dicarboxylic acids with more than 10 carbon atoms were not found. Thes findings may be due to the normal beta‐oxidation system of dicarboxylic acids in X‐ALD.
Flowcytometric Analysis of DNA Pattern of Cells Derived from Xeroderma Pigmentosum A– Hypersensitivity to Vincristine, Etoposide and Methotrexate–
Authors: Ohta Shigeru , Shimada Morimi , Matsukawa Seiji , Taga Takashi , Yamazaki Syosaku
Published: October 2007

Xeroderma pigmentosum complementation gropu A(XPA) is one of the DNA repair deficient syndromes. The cell biological features of XPA were examined by flowcytometry using Epstein Barr (EB) virus‐transformed lymphoblastoid cells. Cellular sensitivity to vincristine (VCR), etoposide (VP‐16) and methotrexate (MTX) were assayed by DNA pattern changes by flowcytometry. Recently, ataxia‐telangiectasia (AT), one of the same kindof disorder, has been reported to have an increased sensitivity to VCR and VP‐16. Howerver, AT showed some resistance ot MTX according to other reports. Our results showed that XPA had an; increased sensitivity to VCR and also to VP‐16. Moreover, different from AT, XPA showed some sensitivity to MTX. Thus there is some cell biological similarity between XPA and AT, as well as some difference of the abnormality in the DNA repair pathway.
Prevalence of Paragonimus westermani in Some Ulchin School Children
Authors: Shin Dong‐hak
Published: October 2007

In order to estimate the prevalence of paragonimus westermani among the school children in Ulchin county, Kyungpook Province, five primary schools were selected for sampling. The children were first examined using an intradermal test with Paragonimus antigen, Lot No. 890417, and then examined for Paragonimus eggs from suuta and stools collected from the intradermal‐positive cases. In a total of 382 children examined, 53 cases or 13.9 percent revealed positive reactions for Paragonimus westermani. The sex specific rate of infection was a little higher in boys than in girls. The age specific rate of Paragonimus westermani infections varied from age to age. Paragoniums westermani was most prevalent in the 8‐year‐old group in both sexes and showed about the same proportion among boys and girls of each age group. A comparison of the reliability for the detection of Paragonimus eggs from intradermal positive cases in this study showed that the sputum test was more sensitive than the stool test. Summarizing the results, this study indicates that the prevalence of Paragonimus westermani is still high and the endemic foci of the fluke exists in Ulchin county, Kyungpook Province, Korea.
Treatment of Pediatric Malignant Tumors with VP‐16
Authors: Ito Masahiro , Kamiya Hitoshi , Sakurai Minoru , Akiyama Yuichi , Mikawa Haruki , Kawa Keisei , Tujino Giichi , Ueda Kazuhiro , Miyazaki Sumio
Published: October 2007

The West Japan Pediatric Oncology Group studied the treatment of pediatric malignant tumors with VP‐16 from December 1984 to March 1988. Study subjects were divided into two groups. One group received only VP‐16, while the other received VP‐16 combined with other anti‐tumor agents. VP‐16 evaluation was possible in a total of 116 cases. The efficacy rate was calculated by considering both complete and partial remission as effective. The efficacy rate for VP‐16 alone was 87.5% for primary cases of ANLL and 100% for primary cases of histiocytosis. The efficacy rates for combination therapy were as follows: 92.6% for primary cases of ANLL, 66.7% for primary cases of histiocytosis, 45.5% for relapsed cases of ANLL and 66.7% for relapsed cases of ALL. Bone marrow suppression was seen in the form of leukopenia and thrombocytopenia for 2 to 3 weeks after VP‐16 administration. Alopecia, mucositis and gastrointestinal symptoms were also observed, but they presented no significant problem. From our results, we believe that chemotherapy including VP‐16 is effective for remission induction therapy in primary cases of ANLL and for salvage therapy in relapsed leukemia. Additionally, VP‐16 is considered to be effective for the treatment of histiocytosis.
Intrauterine Chlamydia Trachomatis Infection in a Premature Infant
Authors: Niwa Atsuko , Ohtsuka Harumi , Inoue Tekao , Noguchi Hiroshi , Hashizume So
Published: October 2007

Intrauterine Chlamydia trachomatis infection was strongly suspected in a premature infant born in the 32nd week of gestation. The membranes were artificially ruptured at the time of delivery. This infant showed a high titer of specific IgM antibody to Chlamydia trachomatis at one hour after birth. He showed mild respiratory distress and was treated with oral erythromycin for three weeks. He was discharged home at the age of 46 days.
Reye and Reye‐like Syndromes: Result of a Pilot Stud in Peninsular Malaya, 1986
Authors: Sinniah D. , Sinniah R. , Yap Y. F. , Singh Mahinder , George R. , Lim N. L. , Balakrishnan S. , D'Cruz F. , Ariffin Wan , Kaur Pyar , Yeo T. C. , Mohan Jai , Yogeswary S. , Paranjothy M.
Published: October 2007

A pilot epidemiologic study of all cases of Reye and Reye‐like syndromes was undertaken at 8 representative major hospitals in Peninsular Malaya from January 1st to December 31st 1986. The cases were classified as definitive Reye's syndrome, clinical Reye's syndrome and encephalo‐hepatopathies. Less than 50% of cases reviewed fulfined the National Center for Disease Control criteria for clinical Reye's syndrome. Causes of Reye‐like syndromes/encephalo‐hepatopathies included fulminant hepatitis, Japanese B encephalitis, dengue, septicaemia, and complex febrile fits. It was not possible to differentiate clinical Reye's syndrome from the other encephalo‐hepatopathies by either the clinical features (except for jaundice) or biochemical parameters. Liver biopsy is necessary for a definitive diagnosis of Reye's syndrome in Malaysia, because of the high prevalence of Reye‐like diseases. The mortality rate in the 2 groups of patients is similar. Ingestion of salicylates was not found to be significantly associated with Reye and Reye‐like syndromes in this study.
Factors in Serum and Cerebrospinal Fluid from Children with Viral Encephalopathies Impair Glucose Transport
Authors: Aiyathurai Eric J. , Candlish John K.
Published: October 2007

Since glucose transport appears to be inhibited in viral infections, we looked for inhibitors in cerebrospinal fluid (CSF) and serum of children with febrile convulsions (FC) and Singapore syndrome (SS). When incubated with rat and human adipocytes both fluids from FCs inhibited the utilization of glucose supplied in the medium as exhibited by decreased synthesis of triglycerides. Sera in the acute stage of the illness were more inhibitory than those from convalescents. There was competition between 3–0 methyl glucose and the CSF factors suggesting competitive inhibition at the plasma membrane. This may be due to anti‐idiotypic antibodies. The likelihood of a second inhibitor is suggested by (1) the inhibitory activity of the larger of two fractions (about 80,000 molecular weight, corresponding to albumin) obtained in gel filtration chromatography of pooled CSF and (2) failure to observe a decrease in inhibitory activity with recovery from SS following management with hyperglycaemia‐producing infusions. These observations are consistent with glycated albumin as a possible factor. Further characterization is called for to ascertain the genesis of viral encephalopathies.
Continuous Monitoring of Intracranial Pressure in Reye's Syndrome ‐ 5 Years Experience
Authors: Chi Ching‐Shiang , Law King‐Lee , Wong Tai‐Tong , Su Gwo‐Yuan , Lin Nung
Published: October 2007

Monitoring of intracranial pressure (ICP) and efforts to keep the ICP below the critical level are vital in the treatment of Reye's syndrome. Continuous monitoring of ICP was carried out in 21 cases of Reye's syndrome who were at or beyond stage III at the time of admission to the Veterans General Hospital, between January 1981 and August 1986. Seventeen had ICP ranging from 15mmHg to 67mmHg. Three patients died, 1 in stage V with an ICP of 67mmHg received a craniectomy, and 2 others were in stage IV with ICP's of 66mmHg and 25mmHg, respectively. The fatality rate was 14% (3/21). Among 18 patients, 5 had moderate psychomotor retardation (PMR), 4 had severe PMR and 2 had mild PMR. The remaining 7 patients survived without sequelae. Blood exchange transfusion could further reduce ICP and seemed to improve neurologic outcome. Blood ammonia higher than 400μg% is indicative of a bad prognosis. Hyperventilation was the most rapid and effective means of reducing moderate degrees of increased ICP. During intensive supportive care, we also found that coughing, endotracheal intubation, seizures, asynchronous respiration to an artificial respirator, suction of the airway and any painful stimulation caused further increases in ICP and worsened the situation. Care should be given to avoid these factors.
Treatment of Reye's Syndrome at Sumber Waras Hospital
Authors: Wulur H. , Kho L.K.
Published: October 2007

Since 1974 we have seen 320 cases of Reye's syndrome in our department. There were 163 boys and 157 girls of a mean age of 20 months. While the number of Reye's syndrome patients admitted increased from 1979 to 1982, it has declined since 1984. Two different approaches to management were used. Prior to 1976 only simple supportive measures were given: Intravenous 10% dextrose solution and electrolytes (Darrow‐glucose solution) in equal amounts at a rate of 50–100ml/kg/day with or without dexamethasone (0.5 mg/kg/day). From 1976, in addition, measures were taken to lower the intracranial pressure by infusing mannitol 1–2 gm and glycerol 1 g/kg given at a frequency related to the severity of the illness, i.e., for grade II, the above combination was given 8 hourly, for grade III 6 hourly, and for grades IV and V 4 hourly, while for grade I only fluid and electrolytes were given. In all cases, clinical progress was closely followed. Intravenous dexamethasone was also given at a dose of 0.5 mg/kg/day. The fatality rate was 50 to 60% prior to 1976 and has fallen to around 20% at present. In contrast to reports from Western countries, we observed more convulsions, respiratory infections and gastrointestinal disorders but less vomiting and no chicken‐pox.
Teratogenic Effects of Sodium Valproate in the Jcl: ICR Mouse Fetus
Authors: Sonoda Tohru , Ohdo Shozo , Ohba Ken‐ichi , Okishima Takahiro , Hayakawa Kunio
Published: October 2007

Sodium valproate was administered to Jc1:ICR mice in order to evaluate its teratogenicity. A single dose of 600 mg/kg of sodium valproate was injected intrapentoneally on gestational day 6, 7, 8 or 9. On day 18 of gestation, dams were laparotomized, and live fetuses were inspected for the presence of external and internal abnormalities. Exencephaly and urogenital abnormalities showed the highest frequency in the group treated on day 8, being recognized in about 60% and 10% of live fetuses, respectively. Cardiovascular abnormalities were found in the highest frequency in the group treated on day 7 (in about 30% of live fetuses). Incidence of tail abnormality was found to increase with delay in day of drug administration. Other abnormalities observed were cleft palate and digital malformation. Our study showed that a constellation of major abnormalities similar to the congenital valproate syndrome suspected in humans could be produced in the Jc1:ICR mouse fetus.
Decreased Plasma Catecholamine and Renin Activity in Children with Difficulty Waking Up in the Morning
Authors: Uchiyama Makoto
Published: October 2007

Plasma catecholamine concentration (CAT: adrenalin and noradrenalin) and plasma renin activity (PRA) were measured in 26 children, aged 10 to 15 years, who had difficulty waking up in the morning. CAT, which was examined only in the supine position in control children, and PRA, which was examined before and after standing for 15 min, were significantly lower than in age‐matched control children. These results suggest that low CAT and PRA may contribute to difficulty waking up in the morning in childhood.
Adrenoleukodystrophy Associated with Cerebral Arteriovenous Malformation
Authors: Kubota Masaya , Kurihara Eiji , Yonezawa Mihoko , Mizuno Yoshihiko , Tamagawa Kimiko , Komiya Kazuhiko , Suzuki Yasuyuki
Published: October 2007

Adrenoleukodystrophy (ALD) is now considered to be an X‐linked recessive peroxisomal disorder. We report the case of a patient with ALD associated with a left parietal arteriovenous malformation (AVM) who deteriorated progressively six months after recovery from a hemorrhage of the AVM. Serial CT scans and MR imagings showed progressive demyelination spreading from the affected area. This case suggests that local brain damage due to AVM hemorrhage may accelerate the progress of demyelination.
Juvenile Nephronophthisis Diagnosed from Glucosuria Detected by Urine Screening at School
Authors: Tsukahara Hirokazu , Kikuchi Kiyoshi , Mikawa Haruki , Fujisawa Shinichi , Yoshimoto Masahiro , Sudo Masakatsu
Published: October 2007

We describe the case of an 11‐year‐old girl in whom glucosuria detected by urine screening at school was the first clue to the diagnosis of juvenile nephronophthisis (JN). On admission, she showed renal failure with combined proximal and distal tubular defects and progressive deterioration of renal function. JN should be considered in children with glucosuria.
Diagnosis of Iliopsoas Pyomyositis by Ultrasonography and CT
Authors: Matsuda Masahiro , Tagaya Mitsuru , Kikawa Yoshiharu , Shigematsu Yosuke , Konishi Yukuo , Sudo Masakatsu
Published: October 2007

A patient with iliopsoas muscle pyomyositis was successfully treated with intravenous antibiotics alone. The diagnosis was made by ultrasonography and X‐ray computed tomography after five days of spiking fevers. Ultrasonography and X‐ray computed tomography revealed swelling of the muscle body but no abscess formation. We emphasize the usefulness of early diagnostic imaging to allow conservative treatment of iliopsoas muscle pyomyositis.
The Transmission of Ambient Noise and Self‐generated Sound in the Human Body
Authors: Yamanouchi Itsuro , Fukuhara Hiroatsu , Shimura Yoko
Published: October 2007

It is commonly understood that ambient noise and sounds produced by a pregnant woman herself are propagated into the body and reach the unborn child in the uterus. However, it would be unethical to study the propagation of sound to the fetus directly, so the present study, which aimed to clarify this process from an acoustical point of view, used the stomach as a model of the womb. The following points were demonstrated:

For sound waves in the stomach, no interference such as occurs outside the body was observed. However, in the range 2 to 3 kHz, a resonance peak was visible, which was probably due to the gastric air space.

Observing an average spectrum of songs showed that the sound pressure level (SPL(dB)) in the medium to lower range (below 3 kHz) tended to be higher in the stomach than outside.
Screening for Proteinuria and Hematuria in School Children—Methods and Results—
Authors: Murakami Mutsumi
Published: October 2007

In Japan, a urinalysis method in which the first morning urine sample is examined twice (Tokyo method) is currently widespread in the urine screening of school children Mass screening of elementary school and junior high school children for urinary abnormalities using this method yielded a positive prevalence of proteinuria, hematuria and both abnormalities of approximately 0.08%, 0.5% and 0.03%, respectively, for elementary school children and corresponding values of approximately 0.4%, 0.9% and 0.08%, respectively, for junior high school students. These prevalence values may vary depending upon conditions of urine collection, conditions of preservation and transport of urine samples, time interval between collection and testing, testing facility, reagent strips and criteria for evaluation of test results. Since attempts at detection of renal disease through examination of urine tend to yield excess positive rates with an abundance of false‐positives and false‐negatives, the reliability of such testing is reduced unless it is performed correctly under strictly controlled conditions. In order to overcome these difficulties it is mandatory that the entire urinalysis system has a high degree of accuracy.
Screening for Bacteriuria in Japanese School Children
Authors: Litaka Kikuo , Sakai Tadasu , Oyama Kouji , Izawa Tadashi , Igarashi Sumiko
Published: October 2007

Bacteriuria was screened among 28,202 healthy school children, 14,575 boys and 13,627 girls, by dipstick and dipslide methods and also by pour plate culture. The prevalence of bacteriuria was 0.06% in boys and 0.52% in girls after the third screening. A high rate of false negative results with the dipstick test and a high rate of false positive results with the dipslide culture method using Microstix‐3 were observed. About 60% of screened children continued to have bacteriuria persistently for 9 months after the third screening, which was followed by monthly urine cultures. Anomalies of the urinary tract were detected in 9 of 26 children with persistent bacteriuria.
Screening for Proteinuria and Hematuria in School Children—Is It Possible to Reduce the Incidence of Chronic Renal Failure in Children and Adolescents?
Authors: Ito Katsumi , Kawaguchi Hiroshi , Hattori Motoshi
Published: October 2007

In this study we evaluated the incidence of chronic renal failure in children with asymptomatic proteinuria and/or hematuria detected by a mass screening program in school and kindergarten. A total of four thousand and three children, aged from 2 to 18 years old was referred to our institute between 1977 and 1990. Of them, 4 cases were AGN, 8 cases Alports' syndrome, 7 cases FGN, 7 cases F(s)GS, 3 cases HSPN, 148 cases IgA nephropathy, 12 cases MN, 24 cases MPGN (including 7 cases of focal type MPGN), 1 case lupus nephritis, and others. Of these children 2 of 8 cases of Alports' syndrome, one of 7 cases of FGS, 6 of 148 cases of IgA nephropathy and none of 24 cases of MPGN developed chronic renal failure. It is true that the incidence of chronic renal failure in children with various kinds of renal disease detected by a mass screening program is lower than that of symptomatic children, However, since we do not have yet any specific treatment in most cases and also since the follow‐up period is not long enough, the definite conclusion that a mass screening program can alter the prognosis of children with renal diseases cannot be drawn except for some particular lesions such as MPGN, especially the focal type. Further study including a much larger population of patients is necessary.
Descriptive Epidemiology of Non‐Insulin Dependent Diabetes Mellitus Detected by Urine Glucose Screening in School Children in Japan
Authors: Owada Misao , Hanaoka Yoko , Tanimoto Yumi , Kitagawa Teruo
Published: October 2007

During the period from 1974 through 1988, we annually examined approximately 225,000 to 386,400 school children residing in Tokyo for glycosuria to detect juvenile diabetes. If the first test was positive for glucose, glycosuria was confirmed by a second test. In children who gave a positive result in both the first and second tests 0‐GTT were performed. All 124 patients were diagnosed as NIDDM according to the criteria of the WHO Report on Diabetes of 1985. The incidence of NIDDM in children in Japan has increased in recent years and from 1984 to 1986 was approximately 3.8 per 100,000 per year. The frequency of NIDDM increases with age up to 14 years. In about 84% of cases, the body weight at diagnosis is more than 20% above the ideal weight and the height is often above average. There is a high frequency in families with a history of diabetes. Diet and exercise therapy in newly diagnosed patients irrespective of the presence or absence of obesity may result in remission, but some cases may require insulin therapy or oral administration of a hypogly cemic drug to obtain a better glycemic control. Children with NIDDM are more likely to be complicated by incipient retinopathy within two years after diagnosis than those with IDDM. Therefore, it is important to keep strict glycemic control to prevent diabetic complications in NIDDM children just as in juvenile onset IDDM.
Deletion Pattern in the 21‐Hydroxylase Gene Detected by Polymerase Chain Reaction
Authors: Kinoshita Ei‐ichi , Matsumoto Tadashi , Kondoh Tatsuro , Yoshimoto Masaaki , Niikawa Norio , Tsuji Yoshiro
Published: October 2007

In order to detect deletion mutation and/or gene conversion in the 21‐hydroxylase (21‐OH) gene, we adopted the polymerase chain reaction (PCR) method followed by electrophoresis. Two pairs of synthesized primers, Ta/lb and 2a/2b, each corresponding to the sequence at the 5′ portion of the 21‐OH gene, were set for PCR. Taq l digestion of amplified DNA from normal individuals using Ta/lb as primers gave the following three fragments: an active 21‐OH gene‐derived 559 bp fragment, and pseudogene‐derived 364 and 195 bp fragments. Of 16 patients with 21‐hydroxylase deficiency (21‐OHD) studied, 6 (37%) lacked the 559 bp fragment. These 6 patients also lacked both the 331 and 117 bp Mval fragments of the PCR product which were obtained with the primers 2a/2b, both being derived from the active 21‐OH gene. These results indicate that 6 of the 16 patients have either deletion of the 21‐OH gene or conversion of the gene to its tandemly located pseudogene. The method described here provides a rapid diagnosis of 21‐OHD.
Acute Tubulointerstitial Nephritis in Two Siblings and Concomitant Uveitis in One
Authors: Morino Masaaki , Inami Kiyoshi , Kobayashi Toshiki , Yanagisawa Kurumi , Maeda Kazuichi
Published: October 2007

Two sisters with acute tubulointerstitial nephritis (ATIN) are reported. The elder sister had concomitant uveitis which recurred twice. The younger sister became ill five years after the onset in the elder. Both patients had identical HLA haplotypes and also suffered from mild chronic sialoadenitis. A renal biopsy specimen of the elder sister showed not only marked interstitial infiltration of immunoglobulin‐containing mononuclear cells but also immune‐complex‐related glomerulonephritis. The younger sister had immune complexes in the serum. These findings suggest that glomerulonephritis and uveitis may be secondary phenomena of ATIN with participation of circulating immune complexes. Once the uveal involvement has occurred, uveitis may undergo relapses without any renal manifestations.
A Case Report of Paroxysmal Nocturnal Hemoglobinuria in a Child
Authors: Higashigawa Masamune , Murata Hiroaki , Iguchi Kosei , Sakurai Minoru
Published: October 2007

A ten‐year‐old boy with paroxysmal nocturnal hemogulobinuria (PNH) is described. Although hemolytic anemia was evident, Ham's test was negative and the erythorocyte acetylcholinesterase (ACHE) activity was normal at the first admission. The diagnosis of hemolytic anemia of unknown etiology was made. Methylprednisolone pulse therapy was started, but could not prevent the hemolytic crises associated with infections. Twelve months later Ham's test turned positive and ACHE activity decreased. The diagnosis of PNH was confirmed. As the disease is insidious in onset, we emphasize that a high index of suspicion and Ham's test and sucrose water test repeated at regular intervals are required to avoid missing the diagnosis.
Perinatal Morbidity of Infants of Diabetic Mothers
Authors: Hoshi Jun , Nishida Hiroshi , Takahashi Naoto , Kabe Kazuhiko , Watanabe Yoko , Arai Toshihiko , Yamada Takako , Yamaguchi Kiyoko , Sakamoto Shouichi
Published: October 2007

Along with the recent progress in controlling the diabetic state during pregnancy, the number of diabetic pregnancies in our country has been increasing. It is not appropriate to apply White's classification to Japanese pregnant women, because more than two‐thirds are NIDDM and it is not easy to clarify their duration of illness. Neonatal complications were analyzed in 160 infants of diabetic mothers (IDMs) who were admitted to Tokyo Women's Medical College over the past five years. All were inborn except four. Neonatal outcomes of IDDM and NIDDM were not statistically different. The overall incidence of neonatal complications in IDMs was 66%, and there were no neonatal deaths. Offspring whose mothers had been suffering from retinopathy were likely to be premature and light‐for‐date infants. A planned pregnancy in diabetic women is likely to decrease neonatal complications. The cooperative total care of diabetic mothers and their offspring by respective specialists, namely endocrinologists, obstetricians and neonatologists is essential for the better prognosis of infants of diabetic mothers.
Ocular Granulocytic Sarcoma in Childhood Acute Myelogenous Leukemia
Authors: Kalmanti Maria , Anagnostou D. , Liarikos S. , Pappas I. , Dimitriou E. , Eliopoulos G. , Kalmantis Th.
Published: October 2007

We report two children of Greek origin with granulocytic sarcoma of the orbit and acute myelogenous leukemia. In the first case the orbital tumor was the initial manifestation of the disease, while the other occurred during hematological remission.
Doppler Echocardiographic Evaluation of an Infant with HCM during ACTH Therapy
Authors: Kobae Hidehiko , Yoshinaga Masao , Oku Shozo , Haraguchi Tsutomu , Inoue Hiroyuki , Miyata Koichiro
Published: October 2007

Adrenocorticotropic hormone (ACTH) therapy is useful in the treatment of patients with West syndrome, and hypertrophic cardiomyopathy (HCM) in association with ACTH therapy has recently been reported. We describe the Doppler echocardiographic evaluation of an infant who had West syndrome and HCM. ACTH therapy produced increases in the interventricular septal thickness, the pressure gradient of the left ventricular outflow tract, and the heart rate. Doppler echocardiographic examination was found to be much more sensitive for monitoring the cardiac changes than either 2‐dimensional echocardiography or the heart rate.
Steroid Therapy for Bronchopneumonia in Chronic Granulomatous Disease
Authors: Narita Mitsuo , Shibata Mutsuo , Togashi Takehiro , Tomizawa Kazuhiro , Matsumoto Shuzo
Published: October 2007

In general, immunosuppressive agents such as corticosteroids are considered to be a contraindication for immunocompromised hosts with an active infection. Recently, however, a few cases have been reported where the obstructive lesions caused by the excessive inflammation in chronic granulomatous disease were successfully resolved with corticosteroids, resulting in a remission of the infection. As we have also experienced a case in which oral corticosteroid used in combination with antibiotics had a beneficial effect on an intractable respiratory tract infection which occurred in a patient with chronic granulomatous disease, we present the case report. Although it may be very difficult to determine the candidates, we consider that in selected cases a corticosteroid therapy with concomitant use of antibiotics will be a choice for the treatment of intractable infections in chronic granulomatous disease.
The Clinical Use of Multichannel Surface Electromyography
Authors: Kumagai Komei , Yamada Masafumi
Published: October 2007

Surface EMG motor unit action potentials (MUAPs), recorded with “array” or “matrix” types of electrodes, can be seen to propagate from the motor end plates in both directions along the muscle fibers. We attempted to obtain diagnostic information in muscle disease by using the multichannel surface EMG. The subjects examined were 28 normal controls (5–40 years old), seven patients with myopathy and three patients with neuropathy. The tibialis anterior and the biceps brachii muscles were investigated at weak and moderate contraction levels. In normal muscles, the mean muscle fiber conduction velocity increased with muscle force. In four of seven cases with myopathy, the conduction velocities were reduced compared to normal subjects (p<0.01), and there was little or no correlation between the conduction velocity and muscle force. In Duchenne muscular dystrophy, abnormal propagation patterns of MUAPs were obtained. The conduction velocities were within the normal range in the muscles of patients with neuropathy. However, abnormal MUAPs, giant and fasciculation potentials, and diminished discharge patterns of motor units (MUs) were detected during voluntary contraction and at rest in neuropathy.
Congenital Muscular Dystrophies ‐Problems of Classification
Authors: Lenard Hans‐Gerd
Published: October 2007

The classification of congenital muscular dystrophies (CMD), based on perceived clinical and morphological similarities or differences, is controversial. CMD without cerebral involvement has sometimes been divided into a mild and a severe form. This distinction is, however, arbitrary and not uncontested. Whether Ullrich's disease, formerly called atonic‐sclerotic dystrophy, is a disease entity and if so, whether it is a primary muscle disorder, is uncertain. CMD without cerebral involvement is inherited in an autosomal recessive fashion in the great majority of cases. CMDs with cerebral involvement are usually classified into at least three forms: the Fukuyama type of CMD, occurring almost exclusively in Japanese patients; CMD with hypomyelination, sometimes also called the occidental type of cerebromuscular dystrophy; and Walker‐Warburg syndrome. Muscle‐eye‐brain disease, described in a number of Finnish patients, may or may not belong in this last category. In CMD with cerebral involvement inheritance is also autosomal recessive. It is possible that single sporadic cases are pheno‐copies due to infectious or other exogenous causes. Reports of clinical and morphological findings from an increasing number of patients show a high degree of variability within and, on the other hand, certain similarities between the forms of CMD with cerebral involvement. In addition, neuroradiological changes are also found with increasing frequency in CMD patients without clinical neuropsychological abnormalities. It is not unreasonable to speculate that molecular genetic techniques will reveal in the near future a variable defect in one gene locus or defects in a few gene loci as the cause of the various clinical forms of CMDs.
Fukuyama Type Congenital Progressive Muscular Dystrophy
Authors: Osawa Makiko , Arai Yumi , Ikenaka Harumi , Murasugi Hiroko , Sugahara Nobuko , Sumida Sawako , Okada Noriko , Shishikura Keiko , Suzuki Haruko , Hirayama Yoshito , Hirasawa Kyoko , Fukuyama Yukio , Tsutsumi Atsuko , Ito Keiko , Uchida Yukio
Published: October 2007

Clincopathological features of Fukuyama type congenital muscular dystrophy (FCMD), a combination of brain malformation and muscular dystrophy with facial muscle and CNS involvement and high prevalence in Japan, are reviewed. Evidence of progressive dystrophy, negative correlations between muscle enzyme levels and age and CT numbers of muscle and age, are presented. Skeletal muscle histopathology is reviewed. Febrile illness‐induced transient exacerbation of muscle weakness is reported. Characteristic brain malformations, e.g. micropolygyria, other dysgenesis, are reviewed. Their severity correlated with maximal mental and motor function. The etiology and significance of low density areas (LDA) in white matter on CT, possibly reflecting delayed or abnormal myelination, and ventricular dilatation are discussed. Spontaneous LDA improvement makes hydrocephaly unlikely. Ophthalmological differential diagnosis from Santavouri disease and Walker‐Warburg syndrome, characterized by visual disturbance/glaucoma and microphthalmia/anterior chamber defects, respectively, is discussed. A single defective gene, manifesting as a metabolic error, may produce CNS and ocular defects as well as muscle degeneration in FCMD.
Recent Advances in Childhood Diarrhoeal Diseases
Authors: Gracey Michael
Published: October 2007

Over the past 20 years there have been many important advances in knowledge about diarrhoeal diseases of children. Of these, the development of oral rehydration therapy (ORT), has been outstanding. This is based on the observation that intestinal sodium transport is enhanced by glucose transport in the small intestine and that this sodium‐coupled mechanism for glucose and water transport remains intact in the enterotoxigenic diarrhoeas despite the net secretory effects of bacterial enterotoxins on the small intestinal epithelium. The World Health Organisation has adopted ORT and strongly promoted its application for treatment of diarrhoeal diseases, particularly in developing countries. This has resulted in a drop in diarrhoeal disease mortality and the application of this treatment has been described in an Editorial in the Lancet us“potentially the most important medical advance this century” [1].
Mass Protection Program of Perinatal Hepatitis B Virus Infection in Japan and Impact of an Optional Booster Vaccination on Its Efficacy
Authors: Tajiri Hitoshi , Kozaiwa Kosuke , Harada Tokuzo , Ozaki Yoshikazu , Miki Kazunori , Shimizu Kazuo , Okada Shintaro
Published: October 2007

We assessed the efficacy of a government‐sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow‐up procedures in such infants, including an evaluation of anti‐HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti‐HBs was higher in the standard group than in the follow‐up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti‐HBs response. In conclusion, we recommend that a follow‐up blood test to confirm a response of anti‐HBs to HBV vaccine should be performed at 4–8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy.
C3 Deposition in IgA Nephropathy in Children and Adolescents
Authors: Hara Masanori , Yoshida Reiko , Inaba Susumu , Higuchi Akira , Suzuki Yoshifumi , Okada Toshio , Tanizawa Takakuni
Published: October 2007

The aim of this study was to assess the significance of C3 deposition in IgA nephropathy in children and adolescents. One hundred and two patients aged 5–21 years (57 male and 45 female) were studied. The findings of C3 deposition were classified into 8 groups by immunofluorescent (IF) pattern and intensity as follows: group MC3+ (N = 12): mesangiocapillary pattern and 3+ in intensity; group MC2+ (N = 13): mesangiocapillary and 2+; group MC1 + (N = 4): mesangiocapillary and 1 +; group M3+ (N = 11): mesangial and 3+; group M2+ (N = 24): mesangial and 2+; group M1 + (N=18): mesangial 1 +; group S (N = 12): only segmentally positive; and group N (N = 8): negative. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration, and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, fibrous crescents, adhesion and tubulo‐interstitial change). IF findings were scored semiquantitatively and laboratory findings were also studied. The following results were obtained: 1) The scores of total activity index in MC groups were higher than in the M, S or N groups, and the greater the degree of C3 deposition, the higher the score; 2) Such result was not evident in the chronicity index; 3) High IF scores of IgG and IgM were found in the MC3+ and MC2+ groups; 4) Hematuria was more severe in MC3+ and MC2+ than in other groups, and proteinuria was more prominent in the MC than other groups. Thus the degree of C3 deposition was parallel with histological activity and urinary findings.