摘要:

AbstractIncreasingly, epidemiological studies are showing the benefits of exclusive breast‐feeding to infants in industrialized countries, as they have previously for those in developing countries. In this review we have focused on several recent developments, in particular on the interplay between infant behaviour and maternal physiology in regulating breast milk supply. This will illustrate that many past and current clinical problems concerning breast‐feeding are likely to be of iatrogenic origin, the products of imposing arbitrary rules for breast‐feeding management. In order for the protective benefits to be fully realized it is necessary to ensure that breast‐feeding is free from prescriptive practices. We will illustrate the key role played by the infants' control of appetite in the hope of encouraging clinicians to empower infants to exercise more control over the feeding

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb02996.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractPhenotypic changes in lymphocytes from healthy children with antibody for human T lymphotrophic virus type I (HTLV‐I) were studied using two color flow cytometry. The subjects were high school students within a small district of Kyushu, Japan. In the carrier group, a subset of lymphocytes which expressed CD8+CD57+was significantly lower in percentage (P<0.01) and in number (P<0.05). There was no significant difference between carriers and non‐carriers in the percentage and number of CD4+Leu8+cells or CD4+HLA‐DR+cells. The IgG levels were slightly higher in carriers than in non‐carriers (P<0.05). These findings suggest that HTLV‐I‐infected cells may affect the immune system in healthy carri

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb02997.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractWe reported a case of abscess in whichSerratia marcescenswas isolated as the causative organism. We measured the postantibiotic effect (PAE) of dibekacin (DKB) and gentamicin (GM) againstS. marcescensand studied the relationship between the clinical effect and the PAE. The minimal inhibitory concentration (MIC) of DKB againstS. marcescenswas 6.25 μg/mL and the serum concentration 30 min after infusion of 100 mg DKB was 5.99 μg/mL. The abscess was cured by the administration of DKB every 12 h. The PAEin vivowas 2.5, 2.9 and 3.3 h when DKB was administered at 50 mg/kg, 100 mg/kg and 200 mg/kg, respectively. This PAE is one of the reasons that infection can be effectively treated with intermittent administration, even if the serum concentration is below the MI

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb02998.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractLong‐term sequelae of bone marrow transplantation (BMT) are a major concern among long‐term survivors since the procedure has been considerably developed over the past decade. In this study, linear growth and growth hormone (GH) secretion were evaluated in 25 children (14 males and 11 females) with various neoplastic or non‐neoplastic hematological disorders who had survived for more than 3 years after BMT. Impaired linear growth after BMT, as defined by a change in height standard deviation score (SDS) by more than − 1.0 SD, was observed in 14 patients (56%). Four children showed severe growth suppression with a decrease in SD score by more than 2.0, and 10 exhibited a moderate reduction by between 1.0 and 2.0 SD. A recovery of normal height velocity was observed in those who had received BMT at a younger age. The type of disease, a difference in preconditioning regimen, the presence of chronic graft‐versus‐host disease or a GH secretory capacity 1 year after BMT were not contributing factors for impaired growth. A serial examination of GH secretion with insulin‐induced hypoglycemia demonstrated that poor GH secretion was not necessarily a prerequisite for impaired growth. These results indicate that the secretory status of GH does not predict the future growth pattern of children who

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb02999.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe present study examined chronotropic dysfunction and the role of vagotony in congenital long QT syndrome, sinus node function and the effects of parasympathetic blockade. Six patients with congenital long QT syndrome were studied. The four males and two females, aged 1–15 years, had episodes of syncope and malignant ventricular arrhythmias. Congenital long QT syndrome was defined as a corrected QT interval greater than 0.45 s, T wave alternans and the age at diagnosis.The sinus heart rate measured from a 24 h electrocardiograph was abnormally low (<50 min) in three patients (1, 4 and 5 years old) and did not increase sufficiently with the administration of atropine in five of the six patients with congenital long QT syndrome. From intracardiac electrophysiological studies, the corrected sinus node recovery time was prolonged in three patients and the total sinoatrial conduction time was prolonged in two patients. In most patients who had an abnormally long sinoatrial conduction time and corrected sinus node recovery time, these values returned to normal following atropine administration. In one patient, the corrected sinus node recovery time was prolonged paradoxically by atropine. Sinus node dysfunction in congenital long QT syndrome was affected by vagotony associated with a right sympathetic nerve system abnormalit

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03000.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractForty‐two patients each with a colorectal polyp have been treated in our hospital over the past 10 years. In twenty‐two cases the polyps were noted in the rectum, nine in the sigmoid colon, seven in the descending colon and four in the transverse colon. Each patient had only one polyp. Hematochezia was the main symptom in 29 patients, prolapse of the polyp from the anus in 10, abdominal pain due to intussusception in two and no symptoms were observed in one. Auto‐amputation of the polyp was considered to have occurred in five patients. Twelve rectal polyps were resected from a transanal operation, and another 25 polyps were removed endoscopically with electric cautery. We have had no experience of endoscopic complications such as bleeding or perforation. A histological examination revealed an adenoma in one patient. Other polyps were non‐neoplastic and were classified as juvenile, inflammatory and hyperplastic in 30, two and four patients, respectively. There have been no recurrences of polyps

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03001.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractChronic idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by the antibody‐mediated destruction of platelets. To maintain the platelets above the symptomatic level we administered 100 μg of anti‐D for 5 consecutive days to 19 children with ITP. Four patients did not respond to the treatment. Fifteen responded with an increase in the average platelet number to 76 000/μL 7 days postinjection. However, the platelet count dropped within 45 days to 27 000/μL. Three months after this study, two patients from the study group were then administered monthly anti‐D after reinjecting anti‐D daily for 5 consecutive days, as previously performed. Platelet levels in these two patients were maintained above 30 000/μL for 5 and 6 months respectively.We concluded that anti‐D administration for 5 consecutive days can induce an increase in platelets followed by a decrease below 30 000/μL after 30–45 days. However, monthly administration of anti‐D after daily injections for 5 consecutive days can keep platelets above the symptomatic level and may provide a corticosteroid‐free safe interval

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03002.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractA 6 month old boy was diagnosed as a case of combined immunodeficiency (with predominant T cell defect by previous classification). His T cell count was decreased, his B cell count in peripheral blood was increased, his serum IgG level was decreased, his serum IgM level was normal and the thymus was not evident on CT scans and magnetic resonance imaging. Administration of the thymus hormone, thymosin, led to a partial recovery of T cell function without normalization of the T cell count. At age 26 months the patient received an irradiated thymus transplantation from a 16 week old female fetus. After the transplantation, the T cell count (mainly CD4+cells) increased by 50–70%. A mild graft‐versus‐host reaction (GVHR) occurred and several immunosuppressants were prescribed. Chromosome analysis showed that the T cells have both 46 XY and 46 XX karyotypes while the B cells have the 46 XY karyotype alone. His cellular immunity (skin tests, DNA synthesis, mixed lymphocyte reaction, cytotoxic activity and natural killer cell function) and his serum IgG level remained low. However, being on regular r‐globulin therapy and oral anti‐fungal drugs, he is now living normally with almost no trouble at age 6 years and 3 months. This case showed that irradiated thymus transplantation might be a useful method when an adequate donor for bone marrow transplantation is not available. The unexpected observation that the increased T cells were mainly CD4 may be related to the mild GVHR and the clinical im

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03003.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractA13 year old boy with Crohn's disease had a prominent expansion (over 40%) of ωδT cell receptor‐positive cells (ωδT cells) in the peripheral blood. The ωδT cells were gradually decreased from 48 to 22% in 18 months. Anti‐ωδT cell receptor‐triggered cytotoxicity was evident at onset and after 1 year. The significance of peripheral expansion of ωδT cells in a patient with Crohn's disea

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03004.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractWe have been following a male case of congenital sodium diarrhea (CNaD), who had a distended abdomen, passed watery stools with high sodium concentration, and showed metabolic acidosis in the first week of life. He also showed hyponatremia, low urine sodium, high serum aldosterone and high renin activity. Other possible causes of secretory diarrhea were ruled out. The initial effective treatment was oral supplements of water and electrolytes lost in the fecal fluid: with this he gained weight, and hyponatremia and metabolic acidosis were corrected. Loperamide hydrochloride was administered to increase intestinal absorption of sodium, as the serum prostaglandin was high. Watery diarrhea then improved, but as he passed acholic stools, we stopped and postponed the treatment for a while; the stools then became watery again. Although diarrhea has persisted, he has not shown any abnormalities in growth or psychomotor development for the first two years of life.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03005.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY