AIM To determine whether vitamin K1, which is routinely administered to neonates, could act as an exogenous oxidising agent and be partly responsible for haemolysis in glucose-6-phosphat-dehydrogenase (G-6-PD). METHODS G-6-PD deficient (n=7) and control (n=10) umbilical cord blood red blood cells were incubated in vitro with a vitamin K1 preparation (Konakion). Two concentrations of Vitamin K1 were used, both higher than that of expected serum concentrations, following routine injection of 1 mg vitamin K1. Concentrations of reduced glutathione (GSH) and methaemoglobin, indicators of oxidative red blood cell damage, were determined before and after incubation, and the mean percentage change from baseline calculated. RESULTS Values (mean (SD)) for GSH, at baseline, and after incubation with vitamin K1 at concentrations of 44 and 444 μM, respectively, and percentage change from baseline (mean (SD)) were 1.97 + 0.31 μmol/g haemoglobin, 1.89 ± 0.44 μmol/g (-4.3 ± 13.1%), and 1.69 ± 0.41 μmol/g (-14.5 ±9.3%) for the G-6-PD deficient red blood cells, and 2.27 ± 0.31 μmol/g haemoglobin, 2.09 ± 0.56 μmol/g (−7.2 ± 23.2%), and 2.12 ± 0.38 μmol/g (−6.0 + 14.1%) for the control cells. For methaemoglobin (percentage of total haemoglobin), the corresponding values were 2.01± 0.53%, 1.93 ± 0.37% (−0.6 ± 17.4%) and 2.06 ± 0.43% (5.7 ± 14.2%) for the G-6-PD deficient red blood cells, and 1.56 ± 0.74%, 1.70 ± 0.78% (12.7 ± 21.9%), and 1.78 ± 0.71% (20.6 ± 26.8%) for the control red blood cells. None of the corresponding percentage changes from baseline was significantly different when G-6-PD deficient and control red blood cells were compared. CONCLUSIONS These findings suggest that G-6-PD deficient red blood cells are not at increased risk of oxidative damage from vitamin K1.

Two nursing neonates deficient in glucose-6-phosphate dehydrogenase developed severe hyperbilirubinemia despite phototherapy. Mothers of both the infants had recently eaten fava beans. The hemolytic triggers found in fava beans may have been absorbed by the mothers and excreted in their breast milk. Carboxyhemoglobin determination performed on one of the infants reflected ongoing hemolysis.

A 5-year-old girl with chronic granulomatous disease (CGD) and esophageal narrowing is described. To date, only two cases of esophageal involvement in CGD have been reported. We present a third, well-documented case and a brief review of the literature.

Primary extranodal lymphoma of the salivary gland is an extremely rare disease. In this report we describe twelve cases of primary lymphoma of the parotid gland seen at a single centre, and review the relevant literature. The 12 cases were treated in different departments and did not receive a uniform therapeutic approach. All three patients with Hodgkin's disease are still alive and two are in complete remission after initial radiotherapy. One of these cases developed stage 4 disease and had to receive combination chemotherapy subsequently. Of the 9 non-Hodgkin's lymphoma (NHL) patients, four had low grade NHL and 5 intermediate or high grade NHL. Of these, 2 died with disseminated disease. However, 6 are still alive and well from 1 to 5 years after therapy. These cases were treated with surgery alone, radiotherapy alone or combination chemotherapy with an anthracycline-bearing regimen. Consequently, we are unable to draw any conclusions relating the success of therapy in these cases, nor can we suggest therapeutic guidelines on the basis of this study alone. The treatment of parotid lymphoma is discussed briefly in the light of the available literature. In most cases, symptoms related to an enlarging mass in the parotid region, were evident. In the light of the above data, we suggest that, despite its rarity, lymphoma of the salivary gland should always be considered in the differential diagnosis of a parotid mass. No correlation between lymphoma and Sjogren's syndrome was noted in the present study.

Exercise tests were carried out on 18 children who had had wheezy bronchitis under the age of 5 years during hospitalization 7 years previously. A control group of 12 children who had been hospitalized with gastroenteritis at the same time were also studied. It was found that there was still a significant increase in bronchial lability among the wheezy bronchitis group compared with the controls, and this was especially obvious in the 7 children who had continued to have mild episodes of wheezing. It is suggested that the same abnormal mechanism operates in at least some cases of wheezy bronchitis as it does in asthma.

In order to identify injury-proneness in female competitive gymnasts, 20 measures of flexibility, hypermobility, spinal posture and anthropometry were performed on 40 competitive gymnasts and injury scores were derived from the severity and extent of previous gymnastic injury and inherent hypermobility traits. Results were compared between contrasting groups of "low" and "high" injury gymnasts respectively (both N = 10). Nine variables demonstrated significant differences between the "low" and "high" injury risk status groups namely, weight (p less than 0.001), height (p less than 0.001), age (p less than 0.001), mesomorphy (p less than 0.01), Quetelet Index (p less than 0.01), shoulder flexion (p less than 0.05) and lumbar extension (p less than 0.05), standing lumbar curvature and total peripheral flexibility score (both p less than or equal to 0.05). Multiple regression analysis was applied to determine the relative contribution of these variables to the estimation of injury-proneness as evidenced by previous history of injury and hypermobility traits. Using 9 independent variables, multiple regression yielded a multiple correlation coefficient (R) = 0.840, accounting for over 70% of the observed variance (R2 = 0.706) in injury scores among the total group of gymnasts. However, a subset of five variables, (weight, mesomorphy, standing lumbar curvature, age and height) yielded a multiple correlation coefficient (R) = 0.834 accounting for almost 70% of the observed variance (R2 = 0.696). This was not significantly different from the larger subset. Using injury classification system of "low", "medium", and "high" risk categories, comparisons were made between predicted and observed injury scores in the respective risk categories. In "high" risk and "low" risk gymnasts, injury scores could be classified correctly with 70% and 79% accuracy respectively, so that relative risk status could be determined from simple physical tests which may be employed by practitioners in the field.