bluuebunny/crossref_metadata_2025_split huggingface dataset:
Enteric pathogens in severe forms of acute gastroenteritis in Ghanaian children
Authors: HORI HIROKI , AKPEDONU PATIENCE , ARMAH GEORGE , ARYEETEY MARY , YARTEY JULIANA , KAMIYA HITOSHI , SAKURAI MINORU 
Published: January 2011

AbstractDiarrheal disease is the major cause of childhood morbidity in developing countries. Although malnutrition is known as a risk factor for severe gastroenteritis, the role of enteric pathogens in the clinical severity is unclear. The present study was conducted in well nourished Ghanaian preschool children during a 3 month period of the rainy season to assess the relationship between enteric pathogens and severe gastroenteritis. Two hundred and twenty‐five children with acute gastroenteritis and 64 age‐matched control children were prospectively examined for the severity of dehydration and enteric pathogens in their stools. Of the 225 children with gastroenteritis, 69.8% (157/225) had mild dehydration and 30.2% (68/225) had severe dehydration. Bacteria were similarly isolated in stool samples from children with mild and severe dehydration and controls. Rotavirus accounted for 20.6% of children with severe dehydration and was more often isolated in stools from patients with severe dehydration than those from controls. Furthermore, the mixed infections associated with rotavirus and bacteria were more often found in patients with severe dehydration than those with mild dehydration or controls. Parasites were similarly found at low incidences among the three groups.The present study implied that rotavirus was more responsible for severe gastroenteritis than bacteria or parasites. However, factors other than enteric pathogens must be sought in a considerable number of severe cases. A large scale study throughout a year is recommended to obtain more precise information that would reflect the seasonal variation of rotavirus infections.
Giant cerebral arterial aneurysm in an infant: Report of a case and review of 42 previous cases in infants with cerebral arterial aneurysm
Authors: KASAHARA ETSUO , MURAYAMA TAKASHI , YAMANE CHIEKO 
Published: January 2011

AbstractA giant cerebral aneurysm with subarachnoidal hemorrhage in a 4‐month‐old female infant is reported. The clinical course was complicated by an electrolyte imbalance and unexpected intoxication by phenobarbital. She died as a result of the third episode of rerupture of the aneurysm on the 16th day after onset. Histological findings showed that the aneurysm was of the saccular type, 35 × 20 × 22 mm in size, arising from the basilar artery. The aneurysmal wall consisted microscopically of fibrous tissue with partial absence or fragmentation of the internal elastic lamina and muscular lamina. Forty‐three cases of cerebral aneurysms during the first year of life including the present case were summarized and it was found that they could be characterized as follows: (i) a high incidence of onset in early infancy; (ii) larger than 10 mm; (iii) a large number arose from the posterior circulation of the circle of Willis; and (iv) a poor prognosis of non‐operated groups, especially in the posterior circulation.
Neurally mediated syncope complicated with paroxysmal atrial fibrillation
Authors: KATO HITOSHI , MASUTANI SATOSHI , HOSHIYAMA MASAKI , SHIBUYA KAZUHIKO , ISODA TAKAYOSHI , HISHI TOSHIO , MURAKAWA YUJI , YANAGISAWA MASAYOSHI 
Published: January 2011

AbstractRecently, it has come to be accepted that the result of the tilt test is specific to neurally mediated syncope (vasovagal syncope). Only rarely is a case of paroxysmal atrial fibrillation without any organic diseases in childhood reported. A case reported here of a 14‐year‐old boy with neurally mediated syncope; which was complicated by paroxysmal atrial fibrillation, and which was diagnosed by performing the tilt test. Atrial fibrillation can be induced by the extraordinary stimulation of the vagal nerve during syncope. In a child, neurally mediated syncope complicated with paroxysmal atrial fibrillation has not been previously reported.
A comparison of patients with premature thelarche and idiopathic true precocious puberty in the initial stage of illness
Authors: ARITAKI SEKOIYA , TAKAGI AKIRA , SOMEYA HAYASHI , JUN LI 
Published: January 2011

AbstractA comparative study of patients with premature thelarche and patients with idiopathic true precocious puberty was conducted. The age at the first visit tended to be lower for those with precocious puberty. In comparison with normative data for children, the frequency of low birthweight and small for date (SFD) status was greater in the 55 patients with premature thelarche, but SFD was also frequent in the 18 patients with precocious puberty. The height, weight and Kaup's index were all within the normal range for these two groups. The ratios for bone age/chronologic age and bone age/height age tended to be high in both groups. In the patients with premature thelarche, the blood luteinizing hormone (LH) level showed a normal response, and the blood follicle stimulating hormone (FSH) level a hyper‐response, to stimulation with luteinizing hormone‐releasing hormone (LH‐RH). In contrast, both the blood LH and FSH levels showed a normal response to LH‐RH stimulation in most of the patients with precocious puberty, and a hyper‐response was rare among them. Although the blood estradiol (E2) level was higher in patients with precocious puberty than in those with premature thelarche, about 50% and 90% of the patients in the respective groups had normal levels. These results suggest that normal responses of blood LH and excessive responses of blood FSH to LH‐RH loading may be useful in some patients for diagnosing premature thelarche at an early stage.
Effect of oral and inhaled salbutamol in infants with bronchiolitis
Authors: CENGİZLİER REHA , SARAÇLAR YILDIZ , ADALIOǦLU GÖNÜL , TUNCER AYFER 
Published: January 2011

AbstractThe response of bronchiolitis to bronchodilator drugs is controversial. The present study was designed to evaluate the efficacy of oral or metered dose inhaler (MDI) salbutamol using a coffee cup as a spacer device in bronchiolitis. In the trial, 31 hospitalized patients between 6 and 24 months of age, who exhibited the first episode of acute bronchiolitis without any other predisposing illness such as cystic fibrosis, congenital heart disease etc., were randomly assigned to receive oral salbutamol (n=11, 0.1 mg/kg per dose, four times a day), or MDI salbutamol (n = 12, 200 μg per dose, every 3 h) or formed the control group without any bronchodilator therapy (n = 8). All of the patients were given supplemental oxygen as needed and adequate hydration was maintained. The patients were evaluated with clinical symptom scores. There were no differences in the beneficial or side effects of salbutamol, or the number of days in hospital between the treatment groups and the control group. It was concluded that there is no beneficial effect in using bronchodilators in infants with bronchiolitis. Supplemental oxygen and maintenance of normal hydration may be adequate.
A case retaining contact urticaria against egg white after gaining tolerance to ingestion
Authors: YAMADA KAZUE , URISU ATSUO , HAGA YOSHIKO , MATSUOKA HIROSHI , KOMADA HIDEKATSU , TORII SHINPEI 
Published: January 2011

AbstractA girl, 5.7 years old, gained tolerance to egg white ingestion in spite of high immunoglobulin E (IgE) antibody titers to egg white but retained contact urticaria against egg white. She developed atopic dermatitis on her face at 2 months of age and showed high IgE antibody titers to egg white and cow's milk. Accidental ingestion of egg products initiated immediate symptoms such as wheezing, urticaria, erythema and edema of the eyelids and conjunctiva three times. These symptoms were confirmed by challenge tests using boiled egg white at 3.9 years of age. She also reacted positively to a 20 min patch test on her volar arm with raw egg white. However, there were no reactions to the oral challenge test by boiled egg and freeze‐dried egg white at 5.1 and 5.7 years of age, respectively. This non‐responsiveness was confirmed by a double‐blind, placebo‐controlled food challenge using freeze‐dried egg white. Nevertheless, she showed positive reactions to a 20 min patch test with freeze‐dried egg white. Her IgE antibody titers to the egg white components including ovomucoid, ovalbumin, ovotransferrin and lysozyme as well as egg white were high from 2.9 to 5.7 years old. Her IgE antibody titers for the ovomucoid fragments digested by pepsin, chymotrypsin and trypsin were not lower than those of positive control subjects. The binding activity of IgE antibody to ovomucoid, however, decreased from 2.9 to 5.6 years as shown by radioallergosorbent test (RAST) inhibition assays. The IgE antibody showed weaker binding activity to pepsin‐ and chymotrypsin‐digested ovomucoid that were filtered through cut‐off 10 000 filter at the age of 2.1 and 5.7 years. We speculated that the maturation of secretion of digestive enzymes was involved in the mechanisms of the acquisition of tolerance to egg white ingestion in spite of the persistence of contact urticaria.
Clinical trials of new antibiotics in children in Japan
Authors: FUJII RYOCHI 
Published: January 2011

AbstractJapan is the most advanced of the industrialized nations in the development of antibiotics. Compared to the United States and countries of the European Union, there is a rich selection and availability of new and appropriate antibiotics for patients with infectious diseases in Japan that is unchallenged under a medical system where its people are all covered by a national health insurance plan. This can also be said in the area of antimicrobial treatment of children and newborns.In Japan, the turning point (T‐point), which the author defines as the point when the average life expectancy of newborns equals that of 1 year olds, was in 1970. Keeping infant deaths from infectious diseases under control was indispensable for this achievement, to which antibiotics had greatly contributed. After the T‐point, another methodology was needed in pediatrics.The situation in Japan, where most newly developed antibiotics are equipped with statements concerning methods of administration, dosage and safety for children or newborns, differs considerably from overseas situations. The procedures and methods of the clinical trials on children that were performed in strict compliance with good clinical practice are described. Trial studies cannot be performed easily in Japan.Next, the reason why the clinical trials of the antibiotics in pediatrics were performed and accurately evaluated without incident over 50 years by comparatively small numbers of specialists and facilities is described historically and retrospectively. During the 30 years since modern methods were established, clinical trials of antibiotics with children and newborns have been performed only on essential agents; about one‐half and one‐third, respectively, of the 91 new antibiotics on which clinical trials with adults were conducted. The author has recently published evaluation criteria for clinical studies on antibiotics in the pediatric field. In addition, as the trial's director/administrator, the author states his concept for future clinical development of new antibiotics for children.
Drug compliance of children and infants with oral antibiotics for pediatric use
Authors: IWAI NAOICHI 
Published: January 2011

AbstractMany oral antibiotics recently available for pediatric use are palatable and easier for children to take owing to the manufacturer's endeavor to improve the preparations. Quite a few drugs, however, still have some problems because they contain bitter active ingredients such as ester‐type β‐lactams and new macrolides. In the present paper, the current status of physicians' prescriptions are discussed, together with the guardians' contrivances for giving prescribed drugs to children and infants, and the drug compliance of pediatric patients. They are discussed in relation to the palatability or internal acceptability of the drugs, which is as important as the drug efficacy and safety. Also discussed are the physicians' countermeasures and guidance to cope with the drug non‐compliance of pediatric patients.
Carnitine depletion during total parenteral nutrition despite oral L‐carnitine supplementation
Authors: HIROSE SHINICHI , HIRATA MASAAKI , AZUMA NAOMI , SHIRAI ZENTARO , MITUDOME AKIHISA , ODA TEIICHI 
Published: January 2011

AbstractCarnitine (CAR) plays an important role in the β‐oxidation of fatty acids. Less attention, however, has been paid to CAR compared to other nutrients even in total parenteral nutrition (TPN). To examine CAR metabolism during TPN and the effect of simultaneous oral L‐CAR supplementation on CAR levels, the blood CAR level was measured in a 3‐year‐old boy receiving long‐term TPN because of short bowel syndrome. Both the total and acyl CAR in the serum were evaluated under various nutritional conditions including oral supplementation of L‐CAR. Low CAR concentrations were observed especially when lipid containing TPN regimens were in place. Oral L‐CAR supplementation was not sufficient to restore the low CAR levels in the present index patient even when the dose was increased to 120 mg/kg in accordance with the result of the L‐CAR absorption test that revealed poor intestinal absorption of this nutrient. Moreover, a markedly low CAR level was measured during the onset of sepsis in the patient, and the blood CAR was depleted when lipid metabolism was activated by lipid loading or sepsis. To date, the late effects of CAR depletion on child growth have not been well examined. It is recommended that the blood CAR level be maintained at normal levels before any prominent manifestations of the deficiency have developed. The intravenous administration of CAR appears to be necessary to supply a sufficient amount of CAR for patients with severe malabsorption.
Urinary enzyme changes in newborns with unconjugated hyperbilirubinemia
Authors: KAVUKÇU SALIH , TÜRKMEN MEHMET , POLAT MUZAFFER , FADILOǦLU MERAL , AKHUNLAR HÜLYA , ÖZKAN HASAN , ANAL ÖZDEN 
Published: January 2011

AbstractVarious changes in renal function caused by unconjugated hyperbilirubinemia in newborns have been suggested in previous reports. Disclosing an injury in renal tubulus epithelium is feasible by measurement of urinary enzymes. Thus, renal function tests and urinary enzymes in 25 term newborns with unconjugated hyperbilirubinemia were evaluated before and after phototherapy. Ten healthy term newborns without hyperbilirubinemia formed the control group. Mean values of the variables obtained before and after phototherapy in the study group and in the controls were, respectively: urine osmolality (osm/kg H2O); 0.147 ± 0.009, 0.174 ± 0.011, and 0.153 ± 0.018; endogenous creatinine clearance (mL/min per 1.73 m2): 45.7 ± 2.15, 46.0 ± 1.6 and 46.7 ± 3.9; fractional excretion of sodium (%): 1.27 ± 0.30, 0.79 ± 0.19 and 1.24 ± 0.07; tubular phosphorus reabsorption (%): 85.8 ± 3.3, 87.8 ± 2.8 and 86.6 ± 1.7; urinary N‐acetyl‐β‐D glucosaminidase/creatinine (IU/mg): 0.617 ± 0.226, 0.574 ± 0.214 and 0.619 ± 0.210; fractional excretion of alkaline phosphatase (%): 0.422 ± 0.103, 1.001 ± 0.374 and 0.596 ± 0.201; fractional excretion of lactic dehydrogenase (LDH; %): 0.102 ± 0.019, 0.121 ± 0.023 and 0.119 ± 0.041; fractional excretion of AST (%): 0.433 ± 0.127, 0.530 ± 0.113 and 0.502 ± 0.074; fractional excretion of alanine aminotransferase (ALT; %) 0.856 ± 0.413, 1.619 ± 1.076 and 1.066 ± 0.366. No significant difference was found between these values before and after phototherapy in the study group, or between the values before phototherapy in hyperbilirubinemic neonates and in the control group. In conclusion, unconjugated hyperbilirubinemia up to a serum level of 18.4 mg/dL in term neonates does not seem to result in injury of normal tubulus epithelium as shown by urinary enzyme levels.
Effect of weight changes on serum transaminase activities in obese children
Authors: TAZAWA YUSAKU , NOGUCHI HIROO , NISHINOMIYA FUJIHIKO , TAKADA GORO 
Published: January 2011

AbstractTo examine the effect of weight changes on serum transaminase activities, glutamic oxaloacetic and pyruvic transaminases (GOT/GPT), a 3‐month observation of 110 obese outpatients treated by a mild regimen for obesity was carried out. Patients were divided into two major groups, group I (n = 73) and group II (n = 37), with or without persistent elevation of serum GOT/GPT (> 30 IU/L), and retrospectively classified into four subgroups according to weight changes: group A, weight loss > 5%; group B, weight loss of < 5%; group C, an increase of < 5%; group D, an increase > 5%. In group IA, the incidence of cases with normalization of serum GOT/GPT was 70%, and was significantly greater than those of the other three subgroups, respectively (P< 0.01). The incidences of decreased serum GOT/GPT activities were observed corresponding to the degree of weight changes not only in group I (100–27%) but also in group II (100–33%). These facts indicate that a mild regimen for obese outpatients for 3 months, significantly improves serum transaminase activities in patients not only with weight reduction but also weight gain, and that fatty liver may be present even in obese children with normal serum transaminase levels. The normalization of serum GPT activity in patients with weight gain suggests the presence of another factor contributing hypertransaminasemia in pediatric obese patients.
A nationwide surveillance study of rheumatic diseases among Japanese children
Authors: FUJIKAWA SATOSHI , OKUNI MASAHIKO 
Published: January 2011

AbstractTo estimate the number of children with rheumatic diseases, a questionnaire was distributed to the pediatrics department of 1290 hospitals in Japan in June 1994. From this survey, 1606 cases with juvenile rheumatoid arthritis (JRA), 906 cases with systemic lupus erythematosus (SLE), 320 cases with dermatomyositis/polymyositis (DM/PM), 28 cases with scleroderma (PSS), 70 cases with Sjögren's syndrome (Sjs), 93 cases with mixed connective tissue disease (MCTD), 25 cases with aortitis syndrome, 20 cases with polyarteritis (PN) and 51 cases with Behçet disease were reported. The crude annual incidence rates per 100 000 among the childhood population were estimated as JRA, 0.83; SLE, 0.47; DM/PM, 0.16; PSS, 0.01; Sjs, 0.04; MCTD, 0.05; aortitis syndrome, 0.01; PN, 0.01; and Behçet disease, 0.03. The present study reveals that there are more children with rheumatic diseases than are estimated from the reported cases in the literature and the number of children who are receiving Assistance Medical Costs Insurance covered by the Japanese government.
Clinical analysis of 570 cases with juvenile rheumatoid arthritis: Results of a nationwide retrospective survey in Japan
Authors: FUJIKAWA SATOSHI , OKUNI MASAHIKO 
Published: January 2011

AbstractThe purpose of the present study was to investigate the incidence of juvenile rheumatoid arthritis (JRA) among Japanese children and to evaluate the clinical features of this disease. A questionnaire was sent to the department of pediatrics of 1290 hospitals in Japan, in 1994, asking for the number of rheumatic patients during the past 10 years. Subsequently, a second questionnaire was sent asking for the type of onset, clinical features, treatment, and other details. The results of 570 cases were obtained. Of these, 310 cases (54%) were the systemic onset type, 140 cases were the polyarticular onset type (25%), and 120 cases (21%) were the pauciarticular onset type. Hence, in the present series of children, the proportion of the pauciarticular type was less than the other two types of JRA. In the laboratory findings of the systemic onset type, hyperferritinemia and thrombocytosis were noted, in addition to leukocytosis, positive C‐reactive protein (CRP) and accentuated erythrocyte sedimentation rate (ESR). The rheumatoid factor was positive in 50% of patients with the polyarticular onset type. Chronic uveitis was recognized in 13 cases (10.8%) of the pauciarticular onset type. In four girls, uveitis started before the onset of arthritis. Nonsteroidal anti‐inflammatory drugs were used in almost one‐third of cases, and methotrexate (MTX) was used in 12.8% of cases. The quality of life of children with JRA was disturbed in almost 20% of cases. Therefore, for the early and definitive diagnosis of the systemic type of JRA, diagnostic procedures including thrombocyte counts and serum ferritin level, should be performed. In order to obtain good results and to avoid side effects, a protocol for the use of disease modifying anti‐rheumatic drugs and immunosuppressants, especially for the use of MTX, must be established.
Clinical features of Japanese children and adolescents with systemic lupus erythematosus: Results of 1980–1994 survey
Authors: TAKEI SYUJI , MAENO NOBUAKI , SHIGEMORI MASAHIKO , IMANAKA HIROYUKI , MORI HIROSUMI , NEROME YASUHITO , KANEKURA SYOKO , TAKEZAKI TOMOKO , HOKONOHARA MASASHI , MIYATA KOICHIRO , FUJIKAWA SATOSHI 
Published: January 2011

AbstractMarked advances have been made in the past decade in the management of adults with systemic lupus erythematosus (SLE). Therefore, a nationwide retrospective survey was conducted between 1980 and 1994 to investigate the clinical manifestations of SLE in Japanese children and adolescents. Questionnaires were sent to 340 hospitals. Of 405 patients reported by 176 hospitals, 373 patients, diagnosed by the criteria established by the Pediatric Study Group of the Japanese Ministry of Health and Welfare in 1985, were enrolled in the study. Forty‐nine of the 354 patients (13.8%) had relatives with a connective tissue disease within the third degree of consanguinity. The frequent manifestations in 373 patients were the presence of antinuclear antibody (98.9%), immunologic disorders (93.0%), hypocomplementemia (87.1%), malar rash (79.6%) and fever (74.0%). Lupus nephritis was present in 148 of the 309 patients (47.9%) at their first visit to a clinic, and 261 of the 373 patients (70.0%) developed renal involvement during the observation period. Of 370 patients, 92 patients (24.9%) exhibited central nervous system lupus. Of 368 patients, 192 patients (52.2%) were treated by methylprednisolone pulse therapy and 148 patients (40.2%) received immunosuppressants in combination with steroid therapy at some stage during the observation period. Survival rate at 5 years from onset was 95.9%. Management of infection, coagulopathies, and central nervous system involvement is essential to improve the prognosis of SLE in Japanese children and adolescents.