摘要:

Over the past 20 years there have been many important advances in knowledge about diarrhoeal diseases of children. Of these, the development of oral rehydration therapy (ORT), has been outstanding. This is based on the observation that intestinal sodium transport is enhanced by glucose transport in the small intestine and that this sodium‐coupled mechanism for glucose and water transport remains intact in the enterotoxigenic diarrhoeas despite the net secretory effects of bacterial enterotoxins on the small intestinal epithelium. The World Health Organisation has adopted ORT and strongly promoted its application for treatment of diarrhoeal diseases, particularly in developing countries. This has resulted in a drop in diarrhoeal disease mortality and the application of this treatment has been described in an Editorial in theLancet us“potentially the most important medical advance this century

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01555.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01556.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Protoplast‐like “spherical bodies” averaging 0.5‐1.5mUm in diameter and devoid of cell walls were first detected by Ueno et al, in the buffy coat of heparinized venous blood from patients with mucocutaneous lymph node syndrome (MCLS). But the nature of the “bodies” has yet to be clarified because of the absence of convincing evidence pointing to their antigenic characteristics. The present investigations were designed solely to provide a serological identification of the “bodies” by the use of immunoelectron microscopy, with the following results. First, “spherical bodies” bearing a striking resemblance to those observed by the above‐mentioned authors were detected in biopsy specimens from challenge sites in mice infected withStreptococcus pyogenesas well as in the buffy coat of peripheral blood from MCLS patients. Second, the “bodies” detected were stained distinctly in both cases by an immunohistochemical technique using, as the primary antibody, a rabbit antiserum raised towardS. pyogenes‐derhedprotoplasts, which was then absorbed with protoplasts fromStaphylococcus aureusandEscherichia coti.Third, the absorbed sera were proved to be not faultless, because complete specificity toward protoplasts fromS. pyogeneswas not attained due to the presence of a large amount of cross‐reactive antigens between protoplasts from the immunizing and absorbing strains of bacteria. The implications of these findings are discussed, particularly in relation to the evaluation of the present serological te

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01557.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

In mucocutaneous lymphnode syndrome (MCLS) IgG and IgM class immune complex (IC) showed peak levels on day 10 to 20 after the onset of the disease respectively, and a transient decrease in IgM class IC was detected at the beginning of intravenous high dose γ‐globulin therapy (IHDGT). In in vitro examination, when γ‐globulin was added to the serum samples of MCLS patients, IgG class IC increased while IgM class IC decreased. Consumption of complements was also observed in these samples. Disposition of IC in the reticuloendothelial system seemed easier by both binding of γ‐globulin to IC and increasing complement bound to IC resulting in increasing complement‐binding site. These results suggest that IHDGT is effective for the treatment of IC in MCLS. Sodium dodecyl sulfate‐polyacrylamide gel electrophoresis (SDS‐PAGE) revealed 14 bands from 300 K.D. to 42 K.D. in IC of MCLS patients in the acute phase of the disease and prior to treatment. The immunoblotting method revealed that IC contains IgG, IgM, IgE, IgA, C

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01558.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

It is important to prevent corticosteroid(CS)‐induced osteoporosis, particularly in children. One of the mechanisms is a direct inhibitory effect of C S on osteoblasts. Bone Gla protein (BGP) is produced in osteoblasts, and the serum level of BGP reflects the bone formation rate. The aim of this study is to examine the usefulness of BGP as a marker of CS‐induced osteoporosis. In the present study, serum levels of 24 pediatric patients who were given prednisolone (PSL) for long periods were studied in relation to their growth rate. Serum BGP was also determined in 167 healthy children and 16 adults. In healthy children, BGP levels reached a peak at the age of 15 years in boys and 11 years in girls. In patients who were given more than 0.25 mg/kg/day PSL, serum BGP levels were significantly decreased and height growth was remarkably suppressed. In conclusion, the measurement of serum BGP is useful for early detection of CS‐induced osteopo

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01559.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

To elucidate the clinical courses of children chronically infected with HB virus (HBV), RIA values of anti‐HBc were surveyed in 88 cases with positive HBs antigen. Among 56 children with positive HBe antigen, 20 had negative, indefinite or low titers of anti‐HBc, and 18 (90%) of them had no liver malfunction. Out of 30 cases with abnormal liver function tests, 28 (93%) had high titers of anti‐HBc. Follow‐up study for a period of over 12 months reveals that serum HBe antigen disappeared in 10 out of the 40 cases who were positive for this antigen. All of the 10 cases had liver malfunction and high levels of anti‐HBc. Among 12 children with initially positive anti‐HBe, five had high titers of anti‐HBc. Out of 13 children who once had high levels of anti‐HBc, 3 showed reduction in titers of anti‐HBc during the follow‐up period in accordance with decrease in activity of hepatitis. Four out of 16 who initially had HBe antigen and low titers of anti‐HBc showed high titers of anti‐HBc during the observation period, while only one of 33 who had HBeAg and a high titer of anti‐HBc went to the low titer group of anti‐HBc, though continuously positive for HBe antigen. We presume that high levels of anti‐HBc indicate previous or current liver damage due to HBV infection, while low titers of anti‐HBc indicate that HBV‐derived liver damage has not yet occurred or that a long time has passed since the last

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01560.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We assessed the efficacy of a government‐sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow‐up procedures in such infants, including an evaluation of anti‐HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti‐HBs was higher in the standard group than in the follow‐up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti‐HBs response. In conclusion, we recommend that a follow‐up blood test to confirm a response of anti‐HBs to HBV vaccine should be performed at 4–8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infectio

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01561.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01562.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

The aim of this study was to assess the significance of C3 deposition in IgA nephropathy in children and adolescents. One hundred and two patients aged 5–21 years (57 male and 45 female) were studied. The findings of C3 deposition were classified into 8 groups by immunofluorescent (IF) pattern and intensity as follows: group MC3+ (N = 12): mesangiocapillary pattern and 3+ in intensity; group MC2+ (N = 13): mesangiocapillary and 2+; group MC1 + (N = 4): mesangiocapillary and 1 +; group M3+ (N = 11): mesangial and 3+; group M2+ (N = 24): mesangial and 2+; group M1 + (N=18): mesangial 1 +; group S (N = 12): only segmentally positive; and group N (N = 8): negative. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration, and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, fibrous crescents, adhesion and tubulo‐interstitial change). IF findings were scored semiquantitatively and laboratory findings were also studied. The following results were obtained: 1) The scores of total activity index in MC groups were higher than in the M, S or N groups, and the greater the degree of C3 deposition, the higher the score; 2) Such result was not evident in the chronicity index; 3) High IF scores of IgG and IgM were found in the MC3+ and MC2+ groups; 4) Hematuria was more severe in MC3+ and MC2+ than in other groups, and proteinuria was more prominent in the MC than other groups. Thus the degree of C3 deposition was parallel with histological activity and urinary findi

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01563.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Twenty‐five children with IgA nephropathy were studied by serial renal biopsy to investigate C3 deposition. The children were classified into three groups according to the immunofluorescent (IF) course of C3 deposition: group I (N = 9): unchanged or slightly decreased; group II (N = 4): changed to segmental deposition; and group III (N = 12): changed to negative deposition. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, adhesion, fibrous crescents and tubulo‐interstitial change). The IF findings were scored semiquantitatively and laboratory data were also studied. The following results were obtained: 1. Normal urinalysis was often observed in group III; 2. The IF scores of IgA and IgG were decreased at the second biopsy in all groups, most notably in group III; 3. The activity indices at second biopsies were decreased in all groups, most notably in groups II and III, consistently with our previous study which showed that C3 deposition increases in accordance with histological activity; 4. The chronicity index was unchanged in all groups and C3 deposition did not reflect histological chronicity. Thus, this study indicates that C3 deposition occurs as the disease progresses and reflects histological activ

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1991.tb01564.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY