摘要:

AbstractSeveral bacteria, such as staphylococci and streptococci, can produce superantigens (SA) that induce the activation of T cells in humans. Although these organisms are the major causes of infection in children, the evidence that T cells are vigorously activated by SA produced by such organisms has not been reported except for toxic shock syndrome. In a previous paper, we demonstrated that inhibitory IgG antibodies (Ab) to SA in humans may protect against SA stimulation. In the present study, we investigated the occurrence of these inhibitory Ab to SA in 94 healthy children by the enzyme linked immunosorbent assay technique and the suppressive effect on T cell stimulation by SA.The positivity of Ab to streptococcal pyrogenic exotoxin (SPE)‐A, SPE‐C and staphylococcal enterotoxin B (SEB) increased with age. The age at which more than 50% of children exhibited Ab to SA was 1 year for SEB, 6 years for SPE‐C and 11 years for SPE‐A. Sera from these children were inhibitory to T cell proliferation elicited by SA in proportion to the concentration of IgG Ab to each SA. Sera supplemented with IgG Ab to SA by gamma‐globulin therapy became inhibitory to T cell proliferation by SA. We conclude that, as children grow, they can develop Ab to SA that may play a role in protecting them against vigorous T cell activat

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03425.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA total of 953 children (511 boys and 442 girls) with streptococcal pharyngitis diagnosed with AbbottTest Pack® Strep A (ATPSA) or throat cultures were analyzed. ATPSA specimens were repeatedly obtained until ATPSA turned negative during or after the treatment. The percentage of positive ATPSA specimens reached the lowest value (9.2%) on the fourth day of the course of the treatment, which indicates the acquisition from an infected individual is probably uncommon after the initial treatment. Bacteriological treatment failure (positive ATPSA after 14 days of treatment) occurred in 4.1% of the children. Out of 953 subjects studied, 216 (22.7%) had recurrent infections. More than 30% of the recurrent infections occurred within 2 months after initial infection. ATPSA is useful for establishing a rapid diagnosis and confirming the bacteriological success of the treatment

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03426.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractOrganisms routinely cultured from throat swabs and infectious agents of sepsis and/or meningitis were reviewed. During the last 12 years,Klebsiella pneumoniaeandEscherichia colihave been replaced byStaphylococcus aureusandPseudomonas aeruginosaas the predominant isolates from throat swabs after admission. These change in the etiologic pattern of infectious agents of sepsis and/or meningitis, i.e.,K. pneumoniae, E. coli, S. aureus, P. aeruginosaandstaphylococcus epidermidis, were in agreement with the organisms isolated from the throat swabs after admission. TheS. aureusisolated from throat swabs after admission showed a decrease in the bacterial activity of cloxacillin, cephazolin and cefotaxime since 1978.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03427.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractChanges in auditory brainstem responses (ABR) were studied and followed in hyperbilirubinemic newborns before and after exchange transfusion (ET), in order to check their usefulness in the early detection of acute and chronic bilirubin encephalopathy.ABR were measured in 10 newborns with marked hyperbilirubinemia (total bilirubin concentration [TBC] ≧ 20 mg/dL, direct bilirubin concentration<2 mg/dL) before and after ET. The means of birthweight, gestational age, and day of life on admission were 3267 g, 38.2 weeks and 3.4 days, respectively. The ABR measurements were performed before ET and 6.0 days (the mean) after the ET. The follow‐up of ABR was performed at 3 months of life.In comparison with the control values, the mean latencies of ABR were significantly prolonged (I, I‐III, and I‐V:P<0.05) and the mean amplitudes were significantly decreased (I, III and V:P<0.001) before ET. Significant improvement of ABR was noticed after the ET, especially in the shortening of the latency of wave I (P<0.02) and in increasing the amplitudes of wave III and V (P<0.02 and (P<0.01, respectively), though the recovery of the latency of I‐V (P<0.02) and the amplitudes of I, III and V wave (P<0.001,P<0.001 andP<0.01, respectively) were delayed in comparison to the control. The follow‐up data of ABR showed that, in two of nine infants (one was lost from the follow‐up), there were still abnormal findings at 3 months of age. Only one of these, who prolonged the recovery of ABR until 5 years of age, developed a border intelligence.Though ET is effective for improvement of acute bilirubin encephalopathy with impaired ABR, a complete recovery of the ABR might be delayed in marked hyperbilirubinemia. The delay in improvement of ABR abnormalities might be possibly used as an early predictor for following chronic bilirubin e

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03428.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractHypercholesterolemia has been known to be an important factor in the development of atherosclelosis. Blood cholesterol screening and related health education in children, however, have not yet been widely practiced in Japan.From 1985 to 1990, blood samples were obtained from 5825 school children aged 6 to 14 years residing in Hisayama, Japan. The mean total cholesterol (TC), triglyceride (TG), high‐density lipoprotein cholesterol (HDL‐C) and low‐density lipoprotein cholesterol (LDL‐C) levels were determined.The mean TC levels ranged from 155 to 172 mg/dL for boys and from 156 to 170 mg/dL for girls, peaking at 9 years for both sexes. The TG levels also tended to increase gradually and to peak at 11 years for both sexes. The tendency for TG levels to be higher was much clearer than in US children and adolescents. The HDL‐C levels were highest at 9 years of age for both sexes and the LDL‐C levels also tended to peak at 9 years of age for boys and at 8 years of age for girls. Atherogenic Indices [(TC‐HDL‐C)/HDL‐C] ranged from 1.7 to 1.9 for boys and 1.8 to 2.0 for girls.As the cholesterol level of Japanese children would be expected to rise steadily reflecting their westernized lifestyle, preventive programes on a nationwide base including health education at school environments sho

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03429.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractIn order to measure the effects of high‐dose intravenous methylprednisolone (HIVMP) and compare its efficiency with that of oral prednisolone (OP), 18 patients with active rheumatic carditis were studied. Ten patients received OP, while eight patients were treated with HIVMP. Clinical and laboratory responses to treatment were followed by sleeping pulse rate, systolic blood pressure, erythrocyte sedimentation rate (ESR), cardiothoracic ratio (CTR), PR interval on electrocardiogram, spectral and color flow imaging and Doppler echocardiographic findings; mitral and aortic regurgitant jet flow area, left atrial area, proximal width of mitral regurgitant jet area and regurgitation fractions.The results of patients in the HIVMP group showed statistically significant changes in ESR and CTR when compared with the patients receiving OP, and the recovery was more rapid.HIVMP therapy can be considered as a new method of treatment for acute rheumatic cardit

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03430.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractA preliminary experimental study in dogs was conducted to evaluate the feasibility of transvenous cardiac pacing in the fetus with complete heart block associated with hydrops. Four young mongrel dogs were anesthetized with intravenous administration of sodium pentobarbital and mechanically ventilated, and a pacing lead was inserted via the tricuspid valve. The right ventricular cardiac output, aortic pressure and central venous pressure were measured, and the tricuspid valve regurgitation was measured semi‐quantitatively using echo‐Doppler color flow imaging. The relationship between the location of the pacing lead and the tricuspid valve regurgitation and cardiac function was examined.The mean right ventricular cardiac output when the pacing lead was inserted into the superior vena cava (126 ± 54 mL/min per kg) was not significantly different from that when it was inserted into the right ventricle (110 ± 43 mL/min per kg). The aortic pressure was 66 ± 7.7 mmHg and 67 ± 6.6 mmHg, respectively, and the central venous pressure 5.9 ± 1.7 mmHg and 5.7 ± 1.6 mmHg, respectively, under the two conditions (not significantly different). The ratio of demonstrating significant tricuspid valve regurgitation was 4/13 into the superior vena cava and 5/13 into the right ventricle, respectively (not significantly different).The location of the pacing lead did not change the cardiac function or the amount of the tricuspid valve regurgitation in our experimental study. It was therefore concluded that the transvenous cardiac pacing technique has potential application in intrauterine transvenous cardiac pacing in the fetus with complete he

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03431.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe Lesch‐Nyhan syndrome results as a consequence of a severe deficiency of functional activity of purine salvage enzyme, hypoxanthine phosphoribosyltransferase (HPRT). We performed Southern blot analysis for five patients and their families using full length cDNA of the HPRT gene as a probe.PstI digested Southern blot analysis revealed a large deletion that included exon 2 in patient 3. The size of this deletion was about 4.4 Kb. The mother of this patient had the same mutated allele and a normal one (heterozygote). This type of mutation from a Lesch‐Nyhan syndrome patient has not been previously reported. The restriction fragment length polymorphism (RFLP) pattern was analyzed byBamHI digested Southern blot analysis for one family who had no major gene abnormality. We determined from this analysis that the sister of the patient was a Lesch‐Nyhan syndrome carrier and the fetus (brother) was normal for HPRT activity. This study shows RFLP analysis is still useful for carrier detection and prenatal diagnosis of Lesch‐Nyhan s

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03432.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractThe purpose of this pilot study was to identify the coping strategies used by children, adolescents and youths with insulin dependent diabetes mellitus (IDDM) attending a camp for IDDM patients near Ryosen town, Fukushima Prefecture, Japan.Forty‐three IDDM patients (24 females and 19 males) were studied, divided into two age groups. The first group included children (seven males and 10 females). The second group included adolescents and youths (12 males and 14 females). For the child group a projective drawing method was used for study and for the older group, an open questionnaire was used.Ryan‐Wenger's taxonomy of children's coping strategies and Band's coding systems and classification were used for the content analysis.‘Instrumental action’, ‘Emotional expression’ and ‘Catastrophizing thinking’ were the coping strategies, represented in the child group.Gender differences in coping strategies were found in the group of adolescents and youths. The most often represented and most important coping category for the male subgroup was ‘Behavioral avoidance’. Next in frequency of representation for the male subgroup were ‘Cognitive distraction’ and ‘Behavioral distraction’. The coping categories ‘Seeking social support’ and ‘Behavioral distraction’ were represented with equal frequency in the female subgroup and the next was ‘Aggressive activities’. The most important coping strategy for the female group was ‘Talking to peers’ from the seeking social support category.The study also helped to identify several children and adolescents w

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03433.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

AbstractAn 8 year old girl with acute disseminated encephalomyelitis (ADEM) is described. Elevated serum antibody titers suggested recentMycoplasma pneumoniaeinfection. T2‐weighted image of magnetic resonance imaging (MRI) disclosed multiple lesions of high signal intensity in bilateral basal ganglia and thalami as well as in the white matter. Postcontrast T1‐weighted image revealed an enhanced lesion in the deep white matter. She showed rapid clinical improvement in response to corticosteroid therapy. The lesions had disappeared completely on MRI performed 10 weeks after the onset. ADEM is believed to be a demyelinating disorder of probable autoimmune etiology. MRI findings in this case may support the hypothesis that the primary pathological event is vascular injury and demyelination occurs only as a secondary phenome

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1996.tb03434.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY