Background: The wheezing infant is a common but difficult patient to approach diagnostically. The prevalence of immunoglobulin (Ig) G subclass deficiency in wheezing infants is still controversial.
Recently, a novel viral agent, hepatitis G virus, was identified by independent researchers from the serum of patients with liver disease, and termed GBV-C or HGV. At present, GBV-C and HGV are considered to be separate isolates of the same virus; however, the role of this virus in acute and chronic liver disease remains uncertain. Although vertical transmission is known to be one of the routes of transmission, the prevalence of GBV-C/HGV viremia in pregnant Japanese women is unknown. Thus, we determined this prevalence using the reverse transcription polymerase chain reaction (RT-PCR).
Background: The function of CD48, one of the pan leukocyte cell surface antigens, is not yet well understood. CD48 was recently shown to enhance the CD30-mediated activating signal to B lymphocytes. As CD48 is one of the activation antigens of monocytes, neutrophils and lymphocytes, a change of its expression on the cells could be expected in infectious diseases.Methods and results: Leukocytes from 27 healthy controls and 97 patients with various infectious diseases were stained with anti-CD38 antibody and analyzed by flow cytometry. On monocytes and neutrophils, the CD38 expression was increased in all of the patients with varicella, measles, rubella, infectious mononucleosis, streptococcus tonsillitis, sepsis and appendicitis. On lymphocytes, a significant increase of CD38 was also detected in the patients with the same diseases, except those with sepsis or appendicitis. The normalization of increased CD48 expression was confirmed on monocytes at the convalescent phase.Conclusion: These data suggest that CD48 expression on leukocytes reflects the disease activity of infectious diseases, especially of viral infections.
Pediatrics InternationalVolume 40, Issue 3 p. 293-293 Successful control of persistent hyperinsulinemic hypoglycemia of infancy with a high dextrin formula Akira Ehara, Corresponding Author Akira Ehara Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanAkira Ehara MD,33–2 Honcho Hakodate, Hokkaido, JapanSearch for more papers by this authorMaki Takahashi, Maki Takahashi Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorKazumi Nobumoto, Kazumi Nobumoto Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorTakeshi Kida, Takeshi Kida Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorSusumu Mizukami, Susumu Mizukami Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorMasahiro Hagisawa, Masahiro Hagisawa Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorYutaka Yamada, Yutaka Yamada Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this author Akira Ehara, Corresponding Author Akira Ehara Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanAkira Ehara MD,33–2 Honcho Hakodate, Hokkaido, JapanSearch for more papers by this authorMaki Takahashi, Maki Takahashi Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorKazumi Nobumoto, Kazumi Nobumoto Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorTakeshi Kida, Takeshi Kida Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorSusumu Mizukami, Susumu Mizukami Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorMasahiro Hagisawa, Masahiro Hagisawa Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this authorYutaka Yamada, Yutaka Yamada Department of Pediatrics, Hakodate Chuo General Hospital, Hokkaido, JapanSearch for more papers by this author First published: 09 October 2007 https://doi.org/10.1111/j.1442-200X.1998.tb01932.xCitations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article.Citing Literature Volume40, Issue3June 1998Pages 293-293 RelatedInformation
A male infant with bilateral small kidneys associated with both proximal and distal tubular dysfunction, who showed chronic renal failure soon after birth, is reported. He was also noted to have both proximal and distal type of renal tubular acidosis. The small kidneys were thought to be due to renal hypodysplasia associated with bilateral severe vesicoureteral reflux, by radiological findings. An alkalization therapy with chemoprophylaxis seemed to be of benefit in slowing the progression of renal failure in this case.
We report a 3‐month‐old girl with Costelio syndrome complicating fatal hypertrophic obstructive cardio‐myopathy. She had typical findings of this syndrome, slight dyspnea and persistent wheezing. Doppler echocardiography revealed asymmetric septal hypertrophy and systolic anterior movement of the anterior mitral leaflet. There was grade 1 mitral regurgitation. Although once her heart failure had been controlled medically, she died suddenly following deterioration of her heart condition. Costelio syndrome can complicate fatal hypertrophic obstructive cardiomyopathy.
A 3-year-old boy presented with persistent abdominal pain, hematuria and facial pallor with progressive anemia. A computed tomography scan showed a massive intraperitoneal hemorrhage and tumor mass in the bladder. Histological examinations of the resected tumor revealed findings of pseudosarcomatous myofibroblastic tumor (PMT). The clinico-pathological features of this case warn us that PMT can cause acute abdomen syndrome with massive intraperitoneal hemorrhage.
Abstract The case of a 7‐year‐old girl with a 2 year history of easy bruising associated with thrombocytopenia is reported. On admission she presented with ecchymoses, abdominal distention and splenomegaly. Hemostasis investigation revealed a consumption coagulopathy. Several radiological studies failed to confirm the diagnosis of diffuse splenic and visceral hemangiomatosis, which was eventually estasblished by an explorative laparotomy. Platelet count and the other coagulation abnormalities progressively returned to normal after splenectomy, although the remaining hemangiomas were extensive.
Background: We characterized developmental changes in the EEG-gamma band during childhood using the autoregressive (AR) model, which was previously developed and described in our laboratory.Methods. The subjects comprised 707 healthy children ranging in age from 3 to 12 years. Electroencephalographs (EEG) were recorded from Fp1, Fp2, C3, C4, O1 and O2 monopolar leads referenced to the ear during quiet wakefulness (eyes closed). One 10 s artifact-free segment was selected from each record, digitized, then analyzed by AR and component analysis, which estimated the component wave and power spectrum.Results: Component waves obtained from all EEG leads were divided into eight groups, which comprised approximately 2, 5, 10, 17, 25, 30, 40 and 47 Hz peaks. The gamma band (peak wave 40 Hz; range 35-45 Hz) was a major EEG component throughout childhood. Different developmental characteristics of the gamma band power were exhibited in each lead. The power increased significantly (P < 0.01) between 3 and 4 years of age in all leads reaching a peak at 4-5 years of age, especially in the frontal region.Conclusions: These developmental characteristics might be related to the information processing and cognitive function, which is enhanced at 4-5 years of age, especially in the frontal region.
Abstract We experienced three patients with CD30+ diffuse large cell lymphoma having chromosomal abnormalities. The first patient was an 8‐year‐old girl with bilateral cervical lymphadenopathy. A biopsy of a cervical lymph node revealed diffuse large cell lymphoma (stage III), positive for CD30 and a chromosomal abnormality. t(2;5). She attained a remission and is now in complete remission 108 months after diagnosis, despite frequent relapses. The second patient was a 13‐year‐old boy with right axillar and supraclavicular lymph‐node adenopathy. A biopsy of a cervical lymph node revealed diffuse large cell lymphoma (stage III), positive for CD30 and a chromosomal abnormality, t(2;5). He attained remission and was in continuous first remission 112 months after diagnosis. The third patient was an 11‐year‐old boy with fever and bilateral cervical lymph node revealed diffuse large cell lymphoma (stage III), positive for CD30 and chromosomal abnormality without t(2;5). He showed a very aggressive clinical course. Only the patients with Ki‐1 lymphoma having t(2;5) survived over 100 months from the diagnosis, despite the advanced stage of the disease. These findings and a review of the literature showed that the presence or absence of t(2;5) may influence the outcome of Ki‐1 lymphoma.
We describe a 27-month-old boy who was first admitted to our hospital on 7 January 1995 with nasal bleeding. From 6 months of age he has had lymphadenopathy, low levels of serum uric acid, increased levels of serum lactate dehydrogenase and hyper gamma-globulinemia. From the age of 18 months he has had persistent Epstein-Barr virus (EBV) infection (target cells; B cells), recurrent episodes of thrombocytopenia, anemia and hepatosplenomegaly. Dysmobility of the left leg and arm from a central nervous system complication during a relapse with pancytopenia on March 1995, was also observed. Relapses of thrombocytopenia with increases of platelet-associated immunoglobulin G and hepatosplenomegaly have been observed approximately every 2 months, and two relapses of pancytopenia were accompanied with weak positivity of Coombs test and low level of haptoglobin. These recurrent episodes were improved with prednisolone. However, now in June 1997 we have not been able to diagnose what underlies the above clinical symptoms, except that the patient has a persistent EBV infection.
Background: influenza-related encephalopathy or encephalitis is not rare in children. However, it is not well understood why the brain lesion develops from influenza infection. The purpose of this study was to clarify its pathogenesis by analyzing the clinical and neuroradiological findings in patients having influenza-related brain lesions.Methods: The clinical findings in 10 children with influenza-related brain lesions were analyzed. Eight patients had findings consistent with the diagnosis of acute encephalopathy and two had postinfectious focal encephalitis.Results: The results from magnetic resonance imaging (MRI) or computed tomography were divided into Ave categories: normal (category 1), diffuse involvement of the cerebral cortex (category 2); diffuse brain edema (category 3); symmetrical involvement of the thalamus (category 4); and postinfectious focal encephalitis (category 5). Patients in categories 2-4 had symmetrical or diffuse brain lesions without leukocytosis in their cerebrospinal fluid, and there were no inflammatory reactions in the brains of two autopsied patients. Furthermore, serum concentrations of GOT were high in all, and disseminated intervascular coagulation was present in 4 of 5,Conclusions: These findings suggested that the pathogenesis of the brain lesions in these cases was toxic or metabolic damage due to multisystemic organ diseases induced by the influenza virus. The MRI findings in patients in category 2 suggested diffuse cortical cell necrosis. On the other hand, the thalamic lesions in category 4 patients reflected hyperpermeability of the blood vessels followed by severe edema with or without microhemorrhages. The pathogenesis of lesions of category 5 included allergic angitis of a self-limiting nature. These findings indicated that the pathogenesis of brain damage induced by influenza infection was very variable.
Background: Chronic granulomatous disease (CGD) is an inherited disease characterized clinically by severs. recurrent bacterial infections from infancy. This disease is a disorder of the formation of superoxide (O-2(-)) by the neutrophil NADPH oxidase system, mostly due to defects in cytochrome b(558) (cyt b(558)), which is one of the oxidase components. Diagnosis of CGD has been performed by the assay of the O-2(-) forming activity, immunological determination of defects in the oxidase components, and or spectrophotometry of cyt b(558). However, spectrophotometric analysis of the b-type heme is difficult with small amounts of blood from infant CGD patients, as the limited amounts of neutrophils are contaminated with a relatively high ratio of hemoglobin (Hb) that interferes with the heme spectrum of cyt b(558). This report presents an accurate method for the spectrophotometric analysis of cyt b(558) in a small amount of CGD neutrophils that were treated with CO gas in a safe procedure instead of the previously reported CO-bubbling method.Methods and Results: The difference of the reduced minus oxidized cyt b(558) spectrum was measured under no interference from oxy Hb at the alpha and beta bands and differentiated as d[Delta A]/d lambda (lambda = wavelength) to obtain further evidence for the defects of the cyt b(558) heme spectrum. The interference from GO-insensitive met Hb was eliminated by subtracting the absorption peak at the Soret (gamma) band of the contaminating met Hb, which was estimated from the GO-treated and untreated spectra of the same, hemolyzed sample.Conclusions: This spectrophotometric method is feasible for the determination of abnormality and heme content of cyt b(558) with a small amount of CGD neutrophils in 10-20 mt of blood even in the presence of contaminating Hb.
BACKGROUND AND METHODS:In Japan, 26 children who vertically acquired human immunodeficiency virus (HIV) infection had been reported as at February 1997. Little information was published about their epidemiological backgrounds and the rate of perinatal HIV transmission in Japan remains unknown. To learn the epidemiological features of perinatal HIV infection in Japan, we examined the medical records of five perinatally infected children.RESULTS:Three of five mothers were Japanese and two others were South East Asian. Four of them acquired HIV infection abroad and one became infected through her spouse who had acquired infection abroad. Therefore, HIV infection in these five cases can be regarded as an imported infectious disease. None of the five mothers noticed their HIV infection before their pregnancy. One mother was found to be HIV seropositive during her pregnancy, but the others did not notice their HIV infection until their delivery.CONCLUSIONS:To reduce the incidence of perinatally HIV-infected children it is necessary to lower the incidence of mother-to-infant HIV transmission. In Western countries they have succeeded in reducing the risk for perinatal HIV transmission with perinatal zidovudine therapy. To prescribe the preventive therapy against perinatal HIV transmission, it is essential to know if pregnant women are infected with HIV or not. Therefore, women of childbearing age should accept voluntary prenatal HIV testing. At the same time, they should be offered such programs that can enable them to receive timely counseling, besides medical treatment, if they are found to be HIV infected.
Abstract Loyalty to one's extended family, a well‐known Japanese tradition, has broken down following World War II. Child rearing in Japan, therefore, has been changing gradually and clearly. Traditionally, child rearing was taught to young mothers by the grandmothers. However, recently young couples are no longer living with their parents. Therefore, there are no advisers nor consultants available at home for their child rearing. Commercialism has certainly invaded the field of child rearing, including too many guidebooks and even baby‐sitting companies. Children's lives have become much more competitive, busy and unnatural in comparison with those of20–30 years ago. This might be one cause of the increased incidence of bullying, school phobia and psychological disorders in children.
Many children in Japan developed various neuropsychological problems, including seizures, while watching the program Pocket Monster, televised on 16 December 1997. To examine the basis for this incident, we have performed a survey of volunteering children and their parents who visited our pediatric clinics for other reasons from 8 January to 28 February 1998. Children and their parents filled out questionnaires. Among the total of 662 children surveyed, the great majority (603, 91.1%) was found to have watched the Pocket Monster program and 30 individuals (5.0% of viewers) complained of variable degrees of neuropsychological abnormalities. These included seizures (two cases), headache (nine cases), nausea (eight cases), blurred vision (four cases), vertigo (two cases), dysthymia (two cases) and vomiting (one case). Nearly half (14) of these children developed symptoms during or immediately after watching the program, while the remainder did so later. Representative cases are reported and other statistical aspects are discussed.
Japan and the UK are compared in relation to various child health outcomes. It is noted that in the rates of child abuse and criminal activity, Japan is in a more favorable position. Rates of behavior problems and suicide rates are very similar in the two countries. Consideration is given to the reasons for the differences. The rates of single parents and divorce are much lower in Japan. The rates of working mothers are about the same, but Japanese women work longer hours. However, it is suggested that more important differences may lie in the greater respect for authority and emphasis on discipline and conformity in Japan. The effects of industrialization on family life and on child development are summarized. It is suggested that the separation of the adolescent age group from the rest of the population has had especially negative results in Western industrialized countries. Various suggestions are made concerning the positive role that pediatricians can play in promoting child development. In particular, pediatricians are encouraged to support and not undermine parents, to involve fathers in management of illness and disability, to press for full implementation of the United Nations Convention on the Rights of the Child, and for ready availability of good substitute child care facilities.
Background: Measuring urinary beta(2) microglobin (B2M) and N-acetyl-beta-D-glucosaminidase (NAG) excretion is widely used as a valuable clinical tool in assessing renal tubular lesions. However, few data are available on normal values for urinary excretion of B2M and NAG in infancy.Methods: Urinary B2M and NAG were measured in healthy infants. The logarithmic values of urinary B2M, NAG, B2M/creatinine ratio and NAG/creatinine ratio were distributed almost normally and reference ranges were calculated from the logarithms of the observed values.Results: The levels of urinary B2M and B2M/creatinine ratio were highest in the 1-month-old group, followed by a decrease during the first 3 months. Urinary B2M excretions in the 3-month-old group showed rather lower levels than those of the 12-month-old and 36-month-old groups. Although urinary NAG excretions were almost constant throughout all groups, urinary NAG/creatinine ratio decreased gradually until 3 years of age.Conclusions: We suggest that these reference ranges are of importance in evaluating tubular damage due to a variety of renal diseases in infancy.
BACKGROUND:To determine the usefulness of the IgG z-score (age and sex-standardized serum IgG level) before intravenous gamma globulin therapy (IVGG) in predicting the occurrence or severity of coronary complications in Kawasaki disease (KD). METHODS:A case-control study of clinical and laboratory findings with 88 children in the early stage of acute KD who received IVGG (100 or 200 mg/kg for 2-5 days) therapy. Of these, 20 cases had persistent coronary arterial lesions (small aneurysm, moderate aneurysm or large aneurysm persisting more than 1 month). The controls comprised 68 children with no coronary aneurysms or transient small aneurysm only observed within 1 month after the onset of KD. The association between serum levels of immunoglobulin G (IgG). IgM, IgA as well as other coronary risk factors previously reported and the occurrence of the coronary arterial lesions was evaluated using logistic regression analysis. RESULTS:After adjustment for age, gender, total IVGG dose before the 9th illness day and other traditional coronary risk factors, the odds ratio for the persistent coronary aneurysm associated with lower serum IgG z-score (< -0.7485 vs > or = -0.7485), was 30.3 (95% confidence interval, 3.8-243.2). Furthermore, the serum IgG z-score was inversely correlated with the severity of the coronary arterial lesion. CONCLUSIONS:The IgG z-score before IVGG therapy in the early stage of KD provides useful information on the risk factors for persistent coronary aneurysm and is a novel, additional indicator for therapy to prevent the coronary complications in acute KD.
Magnesium (Mg) catalyzes or activates more than 300 enzymes in the body, and it plays a pivotal role in the metabolism of carbohydrates, fats and proteins. Until recently Mg has only been measured as a total substance concentration; however, it is the free ionized form of magnesium (iMg2+) that is physiologically active. In 1992, a novel ion selective electrode (ISE) utilizing a neutral carrier-based membrane for assessment of iMg2+ in whole blood, plasma or serum was designed and it was used to measure the iMg2+ level in whole blood of 160 healthy Japanese children. There was a significant positive correlation between serum total magnesium (SMg) and iMg2+. Percent ionized magnesium (iMg2+/SMg) was 58.3 +/- 4.1% and increased with growth (age and bodyweight). The level of iMg2+ was 1.29 +/- 0.08 mg/dL (range, 1.09-1.51) ¿0.535 +/- 0.033 mmol/L (range, 0.452-0.627)¿ and was constant irrespective of growth. On the other hand, SMg, serum total calcium (SCa) and ionized calcium (iCa2+) decreased with growth. Thus only iMg2+ level was constant irrespective of growth. It is suspected that the buffer action of protein binding Mg may keep the iMg2+ level constant, because iMg2+ plays an important part in the activation of many enzymes.
