ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00796.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00797.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Antibiotic susceptibilities of 38 type bHaemophilus influenzaeand 28Streptococcus pneumoniaestrains 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 negativeH. influenzaeisolates were 32–64 and 0.25 μg/ml, respectively. The MIC of chloramphenicol against one of the β‐lactamase positiveH. influenzaestrains was 8 but MICs against the rest of the organisms were 0.5–1 μg/ml. MICs of cefotaxime, ceftriaxone and cefuroxime against allH. influenzaestrains were 0.016, 0.008 and 0.5 μg/ml, respectively. NoS. pneumoniaeisolates were resistant to penicillin G and MICs of this drug were 0.016–0.032 μg/ml. MICs of cefotaxime, ceftriaxone and cefuroxime against allS. pneumoniaestrains 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 ofS. pneumoniaeisolates 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‐resistantH. influenzae, S. pneumoniae, andListeria monocytogenesin Japan. These antibiotics should be changed according to the causative organisms and

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00798.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

We examined serum‐free carnitine (SFC) concentrations and serum acylcarnitine (SAC)/SFC ratios in 40 severely handicapped patients, aged 2 to 36 years, and 69 age‐matched control subjects. SFC levels in the patients treated with valproic acid (VPA) and/or receiving carnitine‐deficient elemental diets (ED) were significantly lower, and their SAC/SFC ratios were significantly higher than in the other patients or in control subjects. There were 6 patients whose SFC levels were less than the ‐2SD level (15.8 ± 6.7 μM, range 6.3±25.5) of those in control subjects (52.1±11.5 μM). They had no clinical symptoms of carnitine deficiency such as non‐ketotic hypoglycemia, hepatomegaly, muscle weakness or cardiac function impairment, and showed normal transaminase, lipid and ammonia levels. In two cases (SFC=11.0, 13.4 μM), the ketogenic responses to intravenous administration of fat‐emulsion were impaired, but they were restored after D‐,L‐carnitine supplementation (30mg/kg/day, po) for 1 month. However, in one case with the lowest SFC level (6.3 μM), the ketogenic responses to fat‐emulsion infusion or fasting were normal, and dicarboxylic aciduria was not detected. These results indicate that 1) SFC levels are reduced in handicapped patients receiving VPA and/or ED, although clinical symptoms of carnitine deficiency do not easily develop, 2) some of these hypocarnitinemic cases show a subclinical impairment of hepatic fatty acid metabolism, not always correlated with the degree of SFC reduction, which can be restored by exogenous carnitine supplements, and therefore 3) in patients with acquired hypocarnitinemia, carnitine therapy should be considered, although a low SFC level alone may not imply

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00799.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A new system for selective low density lipoprotein apheresis with an automated regenerating column using dextran‐sulfate (DS) as ligand was evaluated for six months in a 13‐year‐old boy homozygous for familial hypercholesterolemia. Two columns each containing 150 ml of DS cellulose were alternately used after rinsing with a regenerating solution. The patient could well tolerate the volume in the system. The values of plasma total cholesterol decreased by 79.4 ± 4.9% of the pretreatment levels after a total of 5ℓ plasma apheresis, while those of high density lipoprotein cholesterol did not change. Although the values of CH50decreased, no adverse reaction was seen during the period of treatment. It was concluded that the present apheresis system was highly efficacious and safe for children homozygous for the mutant LDL recep

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00800.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Two patients with disseminated histiocytosis X were treated with intramuscular injections of recombinant interferon αLA. The bone, skin and visceral lesions of these patients diminished rapidly. Significant sclerosis and recalcification of bone were observed. From our limited but positive experience, it would be justified to consider the use of interferon in patients with disseminated histiocytosis X

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00801.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

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 t

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00802.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Many Sri Lankan children with cough and wheeze and peripheral blood eosinophilia are treated with diethyl carbamazine (D.E.C.) on the assumption that filaria is the cause. We tried to establish whether filaria can trigger asthma and whether D.E.C. improves bronchial reactivity. In 35 symptomatic and 22 asymptomatic children peripheral blood eosinophil counts, filarial antibody test, stool examination, chest radiography, allergy skin tests and histamine inhalation tests were performed before and after treatment with D.E.C. Most of the symptomatic children were atopic; 1/3 of all children had helminthiasis, positive filarial antibodies and total eosinophil counts of>2,000. Ten children had chest radiographs suggestive to tropical pulmonary eosinophilia. Only in those with intermittent symptoms was there a marked improvement in bronchial reactivity after D.E.C., but baseline peak expiratory flow (P.E.F.) improved in all symptomatic groups. We conclude that 1/3 of the children had filariasis which in an atopic individual may trigger asthma. Both the anti‐inflammatory and the anti‐filarial action of D.E.C. probably contribute to improvement of bronchial reactiv

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00803.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Asthma is common in Thai children with a prevalence of about 4%. A prospective study of 2,000 Thai asthmatic children showed boys to be more frequently affected than girls, and fifty percent of patients experienced their first attack within the first 2 years of life. Attacks usually occurred in winter and the rainy season. 63.15% of patients had asthma associated with other allergic diseases and 79.25% had a family history of allergic diseases. Positive skin tests to important antigens were noted in 93.7% of cases, and house dust was the most common. Pharmacokinetic studies of theophylline were made in Thai asthmatic children after oral administration revealed that the elimination half‐life of theophylline was longer than that observed in subjects in Western countries. Long‐term follow up of 247 Thai asthmatic children revealed that in 37.2% of patients, symptoms ceased at the age of 15 years. The factors which indicated a favorable prognosis included male sex, mild or moderate illness, negative skin tests or positive skin tests to only a few allerg

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00804.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Exercise induced bronchospasm limits physical activity in most asthmatic children. Twelve children with stable chronic asthma were enrolled in a physical conditioning program to improve ventilation mechanics and to promote physical activity. The program consisted of eight weekly sessions of one‐and‐a‐half hours each, followed by three months of weekly swimming lessons. The activities were preceded by a warm‐up period and interspersed with rest. Premedication with an aerosol bronchodilator or sodium cromoglycate was allowed before training. Cardiorespiratory status was studied before and after the program. The program was well received by the children with no bronchospasm. Five showed improvement in lung volumes and/or flow rates. Bronchial lability remained the same. The basal heart rate slowed in four children. No significant arrhythmia was detected. With continued practice, cardiorespiratory function might improve further. The program should be incorporated as part of the overall management of bronchial

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1990.tb00805.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY