摘要:

We studied mononuclear cell (MNC)—mediated natural killing (NK) of varicella‐zoster virus (VZV)—infected fibroblasts in normal children, children with VZV infections, and children with Hodgkin's disease. NK activity was tested in 18hr51Cr release assays. NK activity for adults was significantly higher than that for children 1–3 years old or 4–6 years old (p<0.05). Serological status did not affect NK activity. NK activity in normal children was not increased 4–6 weeks after immunization with varicella vaccine. Seven normal children with natural varicella showed significantly higher NK activity against VZV‐infected and unin‐fected targets. Eight immunosuppressed children with herpes zoster showed significantly reduced NK activity within 72 hours of the onset of herpes zoster. However, their NK activity rose to the normal level one to two weeks later. Children with Hodgkin's disease had low NK activity. These results suggested that NK cells might play an initial defensive role in VZV infections, and that low NK activity in immunocompromised hosts might contribute to their high incidence o

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01349.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

In the present paper we describe the use of an enzyme‐linked immunosorbent assay reinforced with an introduction of monoclonal antibody, for the detection and quantitation of streptococcal pyrogenic exotoxin (SPE) in the serum of patients with mucocutaneous lymph node syndrome (MCLS). The amount of SPE was usually at a high level, and its 100% incidence in patients' sera was proved whenever the assay was made on the day of admission, thereby showing a marked contrast to carefully matched control sera which failed to mediate any positive result. As for the change in detected amount of the toxin, a clear dichotomy was observed between the serum of gammaglobulin‐treated patients and that of infants given aspirin; in the former the positive result turned to negative rapidly following the initiation of treatment coupled with a defervescence, while in the latter the reduction of SPE levels was scarcely monitored for as long as 17 days after the onset of illness. Quantitation of SPE might be an auxiliary test for the diagnosis of MCLS, because a considerable amount of SPE was assessed in a patient who developed characteristic huge coronary artery aneurysms following an illness which did not fulfill the diagnostic criteria. These findings support our speculation in relation to the certain role ofS. pyogenesas an etiological agent for MCLS. The possible mechanisms of gammaglobulin treatment in reducing the prevalence of cardiovascular lesions and the duration of systemic inflammation are discus

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01350.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

We studiedin vinoB‐cell function in Kawasaki disease (KD). By plaque‐forming assay, IgG‐, IgA‐ and IgM‐secreting cells in the first week of KD were markedly increased, and recovered to a normal level in the second week in many cases. Lymphocyte blast formation withStaphylococcus aureusCowan I (SAC), a B‐cell‐specific mitogen, was suppressed in the acute phase, and recovered to a nod level in the convalescent phase. By flow cytometry, HLA‐DR‐ and HLA‐DQ‐positive cells were increased in the acute phase of KD. CD3‐and CD4‐positive cells were also decreased. CD8‐positive cells showed no significant change. In five patients, CD4‐positive cells with HLA‐DR positivity neither increased in the acute phase nor changed during the course of illness. From our results, it can be considered that pathogenic microorganisms or toxins activate B cells directly in KD without the association of T cells. We also studied the effect of high‐dose gamma‐globulin therapy on B‐cell function in KD. However, the results indicated that this form of therapy had no s

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01351.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A four‐year‐old girl with the ocular type of myasthenia gravis was effectively treated with intravenous high dose human immunoglobulin. Since conventional anticholine‐esterase drugs failed to induce a satisfactory outcome and the patient continued to suffer from am‐blyopia, highdose immunoglobulin was tried according to the method of Gados. Sub* quently, she became asymptomatic and her anti‐acetylcholine‐receptor antibody titer decreased gradually to normal. Currently, she is six years old and continues to be free from complaints and on no

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01352.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

In 132 severely obese children (72 boys and 60 girls) who underwent institutional therapy, oral glucose tolerance tests were carried out on admission, and these children were divided into groups with normal and high insulin levels, in terms of the I̊I values obtained, on the basis of the reference value + 2SD calculated by Maruhama et al [8]. From these children, those who had diabetes mellitus (DM) and those in whom DM was suspected were distinguished according to the diagnostic criteria of USPHS (Drash et al [1]). The insulin levels were normal in 58 children and high in 64. Ten children were found to have DM, and 19 were suspected to have DM. Metabolism of the glucose load occurred at both normal and high insulin levels in some children. There was also a group of children in whom glucose metabolism was incomplete at high insulin levels and a group of children in whom glucose metabolism was not possible even at high insulin levels, showing an obvious DM reaction. These findings suggest that there is a difference in the sensitivity of the insulin receptors in these children. Age, severe obesity and a family history of DM were considered to be risk factors for DM. Although there was a moderate, positive correlation between I̊I and the obesity index and between I̊I and age, it seems that the level of insulin secretion varies considerably in obese children.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01353.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Of 287 patients under long‐term therapy with anticonvulsants, 24 with low serum thyroxine and free thyroxine concentrations were prescribed supplementary thyroxine in the present study. In addition, the basal metabolic rate (BMR) was measured in 13 out of 24 patients and in eight of them it was low (under ‐15%). Serum thyroid hormone concentrations improved after administration of thyroxine. However, improvement of the BMR was not obtained after one month of supplementary therapy. EEG after administration showed an increase in the power spectra of the occipital alpha 2 band (10.0–12.8 Hz) and beta 1 band (13.0–19.8 Hz), and a decrease in that of the theta band (4.0–7.8 Hz). The inter‐peak latency from wave I to wave V in the ABR was normalized after administration, These results suggest that supplementary therapy with thyroxine may be necessary in patients with hypothyroidism induced by anti

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01354.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Flunitrazepam (FZP) was administered intravenously, with success, to two patients with status epilepticus. Case 1 was a patient with a tonicclonic status epilepticus. Intravenous phenytoin had no effect. Case 2 had minor status epilepticus. With the intravenous administration of FZP, diluted 1:10 with distilled water at a dose of 0.03 mg/kg at a slow rate, both patients were relieved of the status epilepticus. Unlike diazepam, FZP neither looks cloudy when diluted with distilled water nor causes angialgia. No disturbances in circulation or respiration occurred. Considering that FZP has a strong anticonvulsant action on status epilepticus, it can be expected to be a useful therapeutic agent for status epilepticus in infants and children.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01355.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The usefulness of serum C‐reactive protein (CRP) in the early detection of neonatal infection was studied using a special laser nephelometric apparatus (CRP‐1), by which CRP concentrations could be quickly determined in the nursery, with only a small amount of serum (20 μL). Initial serum CRP concentrations of samples obtained from 90 infants suspected to have sepsis and/or meningitis were evaluated. Of the 90 infants, 25 showed culture‐proven septicemia and/or bacterial miningitis, while 18 were considered to be infectious based on clinical signs and positive sepsis work‐up even though cultures were negative. 47 infants had negative cultures and sepsis work‐up and showed a favorable clinical courses. Statistical analysis for the evaluation of serum CRP at the level of one mg/dL was performed. False negative CRP was demonstrated in seven of 25 infants with culture‐proven sepsis and/or meningitis (28%) and in 4 of 18 infants with other infections (22%). On the other hand, seven of 47 (15%) non‐infected infants showed false positive results. The specificity and sensitivity of serum CRP determination were 85% and 74%, respectively, for all patients, and 85% and 72%, respectively, for patients with sepsis and/or meningitis. The sensitivity varied with the pathogens. We conclude that, while the initial CRP values alone are unsatisfactory for deciding the need for antibiotic therapy, CRP is useful in the early detection of neonatal infections, and its measurement by this new equipment should available

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01356.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

An automated blood exchange transfusion (BET) with a two‐site technique has been devised by Goldmann et al and by us, using an infusion pump. With this method, we successfully performed exchange transfusions 189 times in the past four years on 110 infants with birth weights ranging from 530 g to 4,000 g. The exchange rate by the automated method was compared with the rate by Diamond's method. Serum bilirubin (SB) levels before and after BET and the maximal SB rebound within 24 hours after BET were: 21.6 ± 2.4, 11.5 ± 2.2, and 15.0 ± 1.5 mg/dl in the automated method, and 22.0 ± 2.9, 11.2 ± 2.5, and 17.7 ± 3.2 mg/dl in Diamond's method, respectively. The result showed that the maximal rebound of the SB level within 24 hours after BET was significantly lower in the automated method than in Diamond's method (p<0.01), though SB levels before and after BET were not significantly different between the two methods. The exchange rate was also measured by means of staining the fetal red cells (F cells) both in the automated method and in Diamond's method, and comparing them. The exchange rate of F cells in Diamond's method went down along the theoretical exchange curve proposed by Diamond, while the rate in the automated method was significantly better than in Diamond's, especially in the early stage of BET (p<0.01). We believe that the use of this automated method may give better results than Diamond's method in the rate of exchange, because this method is performed with a two‐site technique using a peripheral artery

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01357.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

To investigate the usefulness of a simplified Master's two step test (s‐MTT) for preschool children aged 4–6, s‐MTT was carried out in our pediatric cardiology clinic using a new stair and connector for joining the leads from each child to the ECG machine. The subjects were 21 children with Kawasaki disease without coronary involvement and four children with arrhythmias. The treadmill exercise test (TET) was done on the same day to compare the exercise load of s‐MTT with that of TET. Oxygen uptake during s‐MTT was also examined using another group consisting of eight outpatients. There were no differences in indices such as peak heart rate (HR), HR immediately after exercise, and performance ratio between the outpatients in this study and kindergarteners in the preliminary report, The proportions of peak HR and HR immediately after exercise in s‐MTT to those in TET were 91.1 ± 7.9 (mean ± SD)% and 91.1 ± 8.6%, respectively. The average oxygen uptake of the eight outpatients in s‐M'IT was 23.2 ± 4.1 ml/min/kg. These studies suggest that the simplified MTT is useful as a screening test, because it can be done for all children aged 4–

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1989.tb01358.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY