Masato Hirabayashi

B-type natriuretic peptide for assessment of haemodynamically significant patent ductus arteriosus in premature infants.

Haemodynamically significant patent ductus arteriosus (hsPDA) is frequently observed in premature infants. This study was conducted to explore whether the blood BNP can be a valuable biomarker to assess the necessity of treatment for hsPDA in premature infants.

Cause of uric acid stones in rotavirus-associated gastroenteritis

gastroenteritis. Fujita et al. suspected that there may be an association between renal hypouricemia and uric acid stone formation in patients with HRV-associated gastroenteritis due to the number of cases, including our own, that have been reported, primarily in Japan (2-6). Urate urolithiasis is rarely seen in children. It is generally associated with an increased urinary concentration of urate and its subsequent deposition. Hyperuricuria and uric acid nephrolithiasis are mainly caused by the increased excretion or disturbed reabsorption of uric acid by the renal proximal tubular cells: the former is accompanied with hyperurice- mia, while the latter may be associated with hypouricemia. Hyperuricemia is observed in children with tumor lysis syndrome, Lesch-Nyhan syndrome and hypoxanthine-

Characteristic Bands Manifesting as Zebra Lines on Radiographs in Osteogenesis Imperfecta

Osteogenesis imperfecta (OI) is an inheritable bone disorder, and its estimated incidence is approximately 1 per 15–20,000 births [1]. It is typically characterized by recurrent fractures and bone deformations because of bone weakness. The bone healing ability is normal, but bone remodeling tends to be delayed. The treatment of choice for OI is the administration of bisphosphonates (BP) to increase bone density [2]. A girl currently 3 y and 1 mo old was diagnosed with OI, most likely type III. At 3 mo of age, she was administered BP to prevent bone fractures. She received a total of 7 treatments, which took place every 2 to 3 mo. At present, she can sit and pull herself up, but cannot walk yet. Her current radiographs show seven parallel metaphyseal bands of increased bone density in the proximal and distal femur (Fig. 1). These bands are called Zebra lines [3]. The number of bands observed on radiographs correlated with the number of treatment cycles of BP. Thus, it is conceivable that BP therapy facilitates bone mineralization and increases the bone density, which then manifests as Zebra lines. Compliance with Ethical Standards

The Diagnostic Significance of Comorbidities of Congenital Heart Diseases, Low-Set Ears, and Intrauterine Growth Restriction in Neonates With Trisomies 13 and 18

Background Trisomies 13 and 18 (T13/18) are autosomal trisomy syndromes with dismal prognoses. Deciding whether to perform a chromosomal analysis for the definitive diagnosis is often difficult (even for experienced pediatricians) because representative clinical signs may not be found in all T13/18 neonates. Objectives This study aimed to investigate any clinical signs that could be useful for screening for T13/18 in participants without the representative clinical signs traditionally found in odd-looking neonates with malformation syndromes. Patients and Methods We retrospectively analyzed 15 T13/18 patients, 33 trisomy 21 patients, and 48 controls with other malformation syndromes, for apparent clinical signs during the neonatal period. All participants had been admitted to the neonatal intensive care unit of Kansai Medical University over a nine-year period. Results The three leading clinical signs in patients with T13/18 were congenital heart diseases (CHD; 100%), low-set ears (LSE; 80%), and intrauterine growth restriction (IUGR; 73.3%). A comorbidity of these two leading non-specific clinical signs was CHD with LSE, which showed the highest diagnostic accuracy between T13/18 and controls with a sensitivity of 80.0% and a negative predictive value of 92.5%. The chi-square test among these three groups (P < 0.01) and multiple comparison tests of proportional differences showed that the comorbidity of CHD with LSE was specific for autosomal trisomy syndromes. A comorbidity of CHD with IUGR also revealed a similar diagnostic accuracy with a sensitivity of 73.3% and a negative predictive value of 90.9% as well as a specificity for T13/18. Conclusions The comorbidities of either CHD with LSE or CHD with IUGR should be suspected in neonates with autosomal trisomy syndromes, particularly T13/18 without the expected representative clinical signs.