Atsuto Hosaka

Effects of bifidobacterium breve supplementation on intestinal flora of low birth weight infants

Abstract Background : It is known that the bifidobacteria flora play important roles in mucosal host defense and can prevent infectious diseases. Because bacterial populations develop during the first day of life, the authors examined whether the early administration of bifidobacteria has a positive effect on the health of low birth weight infants.

Effect of Testosterone on Radial Bone Mineral Density in Adolescent Male Hypogonadism

Gonadal function is considered to be important in both men and women for the maintenance of normal bone mineral content; failure of gonadal function causes osteopenia in adults (1). Furthermore, it is known that bone mineral density increases during puberty (2, 3 ) . In order to assess the effect of gonadal steroid on bone mineral density in adolescent males with osteopenia due to hypogonadism, we compared the changes in bone density in patients given testosterone replacement with those in patients without this replacement therapy. This study was approved by the ethics committee of our hospital.

Kawasaki disease in a father and daughter.

recognizefutile treatmentand apply care restrictions widely. We haveshownpreviouslythat thesedecisions were influencedby family ethnicity, religious beliefs and paediatricianbias (3). This currentstudy concurs with Martinot’s findingsthatseverityof illness,suchas the PRISM score and the extent of multiple organ dysfunction, was poorly predictive of the modesof death.Despiterecognizingthat quality of life assessments were important in end-of-life decisions, it appearsthat pre-existinghandicapwas not associated with the useof care limitation. Factorsthat influence end-of-life decision-makingare increasingly recognized. However, severity of illness and pre-existing functional status could not be used to predict the different end-of-life events in critically ill children. We agreewith theauthorsthat thenextstepis to study the ethical processesleading to care restrictionsand investigateinternationaldifferencesin the application of suchorders. References

Central diabetes insipidus in hypoxic brain damage

We describe two children who after cardiopulmonary arrest developed hypernatremia at the terminal stage. Urinary antidiuretic hormone concentration was very low, indicating central diabetes insipidus. These cases illustrate the necessity of alertness to the development of central diabetes insipidus in patients with severe hypoxic brain damage.

Water intoxication in asthma assessed by urinary arginine vasopressin.

A 3-year-old girl with status asthmaticus developed a grand mal seizure in association with hyponatraemia after 16 h of fluid therapy. Urinary arginine vasopressin (AVP) was elevated during the attack and rose strikingly before the onset of the convulsion. In 13 of 17 other patients with moderately severe asthmatic attacks, increases in urinary AVP levels occurred before the initiation of treatment. Dilutional hyponatraemia (water intoxication) must be prevented in patients with severe asthmatic attacks in whom diuretic capacity is impaired.

Cystic adult granulosa cell tumor causing precocious pseudopuberty in a six‐year‐old girl

A very rare occurrence of adult granulosa cell tumor of the ovary (not of the juvenile type) causing precocious pseudopuberty in a six‐year‐old girl is described. An additional feature of interest was that the tumor appeared entirely cystic. To our knowledge, this condition in such a young premenarchal patient has not been reported previously.

Serum free T4 and thyroid stimulating hormone levels in preterm infants and relationship between these levels and respiratory distress syndrome.

Background: There have been few studies of the thyroid stimulating hormone (TSH) surge in extremely low‐birthweight (ELBW) infants, and the relationship between thyroid hormones and respiratory distress syndrome (RDS) has yet to be clarified. The present study sought to determine the serum levels of free T4 (fT4) and TSH in ELBW infants and to examine the relationship between these levels and the development of RDS.

Postnatal and postprandial changes in plasma concentrations of glicentin in term and preterm infants

Aim: To examined the changes in basal plasma concentrations of glicentin in developing children and the postnatal and postprandial changes in plasma glicentin levels in infants. Methods: Glicentin, an active component of enteroglucagon, is considered to have a significant trophic action on the intestinal mucosa. Fasting plasma concentrations of glicentin in healthy children and in term and preterm infants were measured before and 30 min after feeding during the first 14 d of life. Results: Plasma basal concentrations of glicentin in children under 1 y of age were significantly higher than those in children aged 1 to 15 y. Plasma basal concentrations of glicentin at 5 or 6 d (2496 and 2190 pg/ml) and at 14 d (2987 and 2817 pg/ml) after birth were significantly higher than those at 1 or 2 d (1098 and 1240 pg/ml) after birth in normal birthweight (NBW) and low‐birthweight (LBW) infants. There was no significant difference in the glicentin level between infants at 1 or 2 d (1864 pg/ml) and at 5 or 6 d (1910 pg/ml) after birth in very‐low birthweight (VLBW) infants, but the levels at 14 d (3310 pg/ml) after birth were significantly higher than either of those levels. Plasma glicentin concentrations after feeding were significantly higher than those before feeding at 1 or 2 d and at 5 or 6 d after birth in NBW and LBW infants, but a significant increase in the plasma glicentin level after feeding was first observed at 14 d after birth in VLBW infants. There were no significant differences in the basal plasma (2401 and 2718 pg/ml) and postprandial (3007 and 3912 pg/ml) glicentin levels between breastfed and formula‐fed infants.

Graves’ disease associated with exophthalmos, cerebral ventricular dilatation and accelerated growth

A report is presented of a girl with Graves’ disease, which was diagnosed at the age of 1.7 years. The mother had no thyroid disease. The patient developed signs of hyperthyroidism shortly before her first birthday, and the most prominent manifestations were accelerated skeletal maturation and linear growth, and dilatation of the brain ventricles. The latter manifestation, which has not been reported previously, was reversible upon normalisation of thyroid function with antithyroid treatment for three years.

Osteoporosis in a boy with hypogonadotropic hypogonadism

SummaryWe describe a 16-year-old boy with idiopathic hypogonadotropic hypogonadism associated with osteoporosis. Osteoporotic lesions of the hands, skull and spine were shown by routine radiography. Single-photon absorptiometry at the distal radius confirmed a significant reduction of bone mineral density. The parathyroid hormone-vitamin D axis and calcitonin secretion showed no derangement. Reduced bone mineral density in association with relatively elevated levels of serum osteocalcin and alkaline phosphatase suggested an increased bone turnover (so-called high-turnover osteoporosis). Tetosterone therapy for 3 months significantly increased the radial bone mineral density.This case illustrates that testosterone deficiency during puberty seems to alter the bone mineral status, impairing bone mineralization and bone remodeling.