Haruki Mikawa

Effect Of Body Position On Later Postural And Functional Lateralities Of Preterm Infants

The effects of body position during the neonatal period on subsequent functional and postural behaviours were examined in relatively low‐risk preterm infants. 44 infants were nursed in the supine position and 37 in a prone position throughout their admission period. Persistent head‐turning to the right was observed more often and continued longer in the infants lying in supine. Asymmetrical postures, e.g. of skull and trunk, were more often seen in infants lying in supine than in prone. The prone position was thought to help prevent infantile scoliosis. At nine months, preference for the right hand was more marked in infants lying in supine, whereas infants lying in prone used their hands bilaterally, a tendency that persisted at 18 months. Asymmetrical gait pattern with mild gait disturbance was found more often in infants lying in supine than in prone. The prone position was thought to prevent asymmetrical posture and excessive functional asymmetries.

The Inhibition of Lymphocyte Blastogenesis by Asparaginase: Critical Role of Glutamine in both T and B Lymphocyte Transformation

L‐Asparaginase has long been used in the treatment of acute lymphoblastic leukemia or malignant lymphoma in childhood. To determine cell type specific sensitivity to this drug, the L‐asparaginase‐mediated inhibition of blastogenesis of human peripheral T or B lymphocytes was compared. The rate of incorporation of [3H]‐thymidine into the DNA of either T lymphocytes due to phytohemagglutinin (PHA) or B lymphocytes due to Staphylococcus aureus Cowan I (SAC) was measured by the addition of Escherichia coli L‐asparaginase in the medium. The blastogenic response of either T or B lymphocytes was also determined in medium depleted of exogenous asparagine and/or glutamine, both of which are hydrolyzed by this enzyme. The in vitro blastogenesis of either human T lymphocytes due to PHA or B lymphocytes due to SAC was inhibited by the inclusion of asparaginase in the medium. The deprivation of exogenous asparagine did not have any inhibitory effect on the blastogenic response of both T and B lymphocytes to each mitogen. On the other hand, the glutamine concentration in the culture medium provided a critical influence on the proliferative response of T and B lymphocytes. The rate of incorporation of [3H]‐thymidine into DNA was increased markedly as the concentration of glutamine was increased from 2‐7‐2 mmol/1. It is concluded that the mechanism of inhibition of PHA‐ or SAC‐stimulated lymphocyte blastogenesis by L‐asparaginase is not asparagine deprivation but glutamine deprivation. Glutamine, which is the most abundant amino acid, is thought to have an important role in the immune response of lymphocytes.

Growth Response to Daily Subcutaneous Administration of Growth Hormone

The effect on growth rate of daily subcutaneous (sc) administration of growth hormone (GH) was studied in seven GH‐deficient children. All patients had been receiving conventional GH treatment (intramuscularly, twice or thrice weekly) for three to six years. The growth‐promoting effect of conventional treatment gradually decreased in these seven patients [4.0 ± 0.3 (mean ± SD) cm%sol;year during the last preceding year of conventional treatment]. Following transfer to daily sc GH treatment without increase in weekly dosage, all seven patients showed an increase in growth rate (7.5 ±1.1 cm%sol;year, P>0.001). During the period of daily sc GH treatment, the pubertal stage did not advance in six of the seven patients. An increase in Δheight age%sol;Δbone age ratio was observed in six patients. None of the patients developed antibodies against GH. Local reactions were not observed at the injection site. Daily sc GH injections were tolerated without complaint. In conclusion, daily sc GH treatment is recommended for patients whose growth response to conventional GH treatment is poor.

Immunological aspects of asthma (prophylaxis).

A long follow‐up study revealed that convalescent stage children still have the potency to have an immediate type hypersensitivity reaction on exposure to mite antigen, with a high titer of mite specific IgE in their sera, but they are free from asthmatic attacks because of the reduction in the amount of mite antigen in the body, as shown by the reduction in the amount of mite specific IgG. We also made a prospective study to see whether early elimination of the allergen has any beneficial effect on the cessation of the development of allergic diathesis thereafter. Our study suggested that early elimination of food allergen in infancy not only improved clinical manifestations but also had a protective effect on the progression of the allergic march so far as production of reaginic antibodies was concerned: production of total IgE and mite specific IgE was kept to a minimum.

Juvenile nephronophthisis diagnosed from glucosuria detected by urine screening at school.

We describe the case of an 11‐year‐old girl in whom glucosuria detected by urine screening at school was the first clue to the diagnosis of juvenile nephronophthisis (JN). On admission, she showed renal failure with combined proximal and distal tubular defects and progressive deterioration of renal function. JN should be considered in children with glucosuria.

Hemolytic Uremic Syndrome Associated with Common Bile Duct Obstruction

A four‐year‐old female with hemolytic uremic syndrome (HUS) had reduced plasma prostaglandin I2 regenerating activity (PGI2‐RA). The patient had a cholecystectomy with T‐tube drainage of the common bile duct, because she developed common bile duct obstruction due to cholelithiasis. This is the first report of this syndrome in which there was associated common bile duct obstruction due to cholelithiasis.

Y chromosome specific DNA probe in the diagnosis of a patient with mos 45,X/46,XYnf.

In a patient with mos 45,X/46,XYnf, the diagnosis was confirmed with a Y chromosome‐specific DNA probe, Y‐190. The patient was a phenotypic female without Turner syndrome stigmata other than short stature. She showed some evidence of virilization and high serum testosterone. Her peripheral blood karyotype was mos 45,X/46X, +mar. Although this marker chromosome resembled a Y chromosome, there was no quinacrine bright region on its long arm. Southern blot analysis of her peripheral blood mononuclear cell DNA with Y‐190 as a probe showed strong hybridization with this probe. Gonadectomy was performed, and bilateral gonadoblastomas were found.

On the Mechanism of the Change of Histamine Release or Synthesis by Interferon

Viral respiratory infections have been shown to trigger recurrent episodes of wheezing in the asthmatic child. A variety of immunologic and immunopathologic processes are known to operate during the course of viral infections. Despite a vast literature on mechanisms of humoral and cellular immunity in viral infections and considerable information on replication of viruses in cells of the immune system, there are still few experimental data on allergic reactions in viral diseases. Recently, the function of basophilic leukocytes has been found to be altered after an in vitro incubation with respiratory viruses. Antigen-induced histamine release, migration of basophilic leukocytes to a chemotactic stimulus, and IgEbinding to basophilic leukocytes are enhanced after an incubation with viruses. These changes in basophil function have been associated with interferon production during the incubation period and can be stimulated by incubating leukocytes with interferon alone. Especially, the release of histamine from basophilic leukocytes has provided a reliable model to examine allergy and is

Treatment of Pediatric Malignant Tumors with VP‐16

The West Japan Pediatric Oncology Group studied the treatment of pediatric malignant tumors with VP‐16 from December 1984 to March 1988. Study subjects were divided into two groups. One group received only VP‐16, while the other received VP‐16 combined with other anti‐tumor agents. VP‐16 evaluation was possible in a total of 116 cases. The efficacy rate was calculated by considering both complete and partial remission as effective. The efficacy rate for VP‐16 alone was 87.5% for primary cases of ANLL and 100% for primary cases of histiocytosis. The efficacy rates for combination therapy were as follows: 92.6% for primary cases of ANLL, 66.7% for primary cases of histiocytosis, 45.5% for relapsed cases of ANLL and 66.7% for relapsed cases of ALL. Bone marrow suppression was seen in the form of leukopenia and thrombocytopenia for 2 to 3 weeks after VP‐16 administration. Alopecia, mucositis and gastrointestinal symptoms were also observed, but they presented no significant problem. From our results, we believe that chemotherapy including VP‐16 is effective for remission induction therapy in primary cases of ANLL and for salvage therapy in relapsed leukemia. Additionally, VP‐16 is considered to be effective for the treatment of histiocytosis.

Quantitative Autoradiographic Study of Benzodiazepine Receptors: Comparative Study between Normal ddY Mouse and El Mouse

The mechanism of benzodiazepine central action has been attributed to its binding sites. There are two subtypes of central high affinity benzodiazepine receptors, but it is unclear which subtype is coupled to the GABA receptor complex and is related to anticonvulsant action. In this quantitative autoradiographic study, we examined r H ] flunitrazepam (FNP) binding and CL218,872-displaced [3H] FNP binding, which is sensitive to the benzodiazepine type I receptor, in stimulated El mice, unstimulated El mice and normal ddY mice.