Nagahide Goya

High doses of gamma globulin and methylprednisolone therapy for idiopathic thrombocytopenic purpura in children

In four children with chronic idiopathic thrombocytopenic purpura (ITP), high doses of gamma globulin or methylprednisolone were effective in increasing platelet counts transiently, yet there was no quantitative relationship between the platelet responses to these two therapies. This finding suggests a qualitative difference in the mechanisms of increasing platelets by the two drugs. High doses of gamma globulin and methylprednisolone showed a synergistic effect on the initial and maximal platelet responses, suggesting an intensification of the effect of gamma globulin by methylprednisolone. This combination therapy should be clinically useful, particularly in the control of acute haemorrhage or in preparations for emergency surgery.

Facial hemangioma with cerebrovascular anomalies and cerebellar hypoplasia

A 5-year-old female patient with a left facial strawberry nevus, ipsilateral optic atrophy and cerebellar signs was observed. Computed tomography and cerebral angiography confirmed left cerebellar hypoplasia and cerebrovascular abnormalities such as internal carotid arterial stenosis, basilar artery occlusion, and a saccular aneurysm of left carotid siphon, all of which are presumed to develop congenitally. This case may represent a new variety of neurocutaneous syndrome which is different from other syndromes associated with facial hemangioma, such as the Sturge-Weber syndrome and the Wyburn-Mason syndrome.

A Sensitive Solid Phase Radioimmunoassay for Secretory IgA

A sensitive solid phase radioimmunoassay method was established for the specific quantitative determination of secretory IgA (sIgA) by taking advantage of the dual antigenicities of sIgA, one specific for α‐chain and the other for secretory component (SC). The sIgA and IgA in the sample were first bound by anti‐IgA antibodies coated on the polystyrene tube, then the amount of bound sIgA was quantified by the use of 125I‐labeled anti‐SC antibodies. This method is quite sensitive and allows us to distinguish sIgA from IgA and free SC which usually coexist in exocrine secretions. Linear relationship was observed between the bound radioactivity of radioiodinated anti‐SC and the amount of sIgA in the range of 5 to 60 ng of sIgA.

High-Dose 1-(4-Amino-2-methyl-5-pyrimidinyl)-methyl-3-(2-chloroethyl)-3-nitrosourea Hydrochloride (ACNU) with Autologous Bone Marrow Rescue for Patients with Brain Stem Tumors

4 patients with brain stem tumors were treated with high-dose ACNU with autologous bone marrow rescue. Hematologic and nonhematologic toxicities were not profound. There was objective evidence of response in 2 out of the 4. All were alive for 11-21 months from onset. Safe administration of high-dose ACNU with marrow rescue will warrant further control studies to determine its superiority over conventional doses.

Graft-versus-host reactions against H-Y antigen.

Spleen cells of female C57BL/6 mice, preimmunized to male histocompatibility antigen, elicited splenomegaly in adult male recipients and caused mortality of the newborn recipients. These cells, upon stimulation in vitro with the male antigen, were cytotoxic to male target cells.

Suppression of Tuberculin Reactivity During Natural Rubella Observations with 54 Patients

Fifty-four patients with previously positive tuberculin reactions were fol lowed for tuberculin sensitivity, between the incubation period of natural rubella and the 40th day after the onset of rash. In many instances, tuberculin sensitivity was partially or completely depressed beginning in the incubation period and extending for up to 4 weeks after rash onset. Two of 3 cases of subclinical rubella infection also showed this phenomenon. The highest inci dence of negative reactions was 83 per cent in the first 3 days after rash onset. A few subjects had a larger skin reaction to tuberculin than the baseline reading during the 2 to 5 weeks after rash onset.

Behavioral disorders in Japanese epileptic children.

Abstract: Psychiatric problems have been discussed concerning epileptic children and they are still controversial as to whether it is characteristic to epilepsy or not. We analyzed the behavioral problems both in the normally developed children with epilepsy and the normal control group with the same behavioral score and then investigated the differences between epileptic children with normal development and those with retardation. The study disclosed that the epileptic children had problems in almost all fields such as emotional disturbances, daily life activity and human relationship and these were associated with the development and control of seizures. The retarded children had the disorders more frequently than the normally developed epileptic children.

Experimental Models for Prevention of Graft-versus-Host Reaction in Bone Marrow Transfusion

Splenomegaly was strong in the degree and continued for a long period of time in adult F1 hybrids between AKR (H-2k) and C3H/He (H-2k) mice after transfer of spleen cells from normal C3H/He mice. In spleen cells of such F1 recipients, cytotoxicity was detected by an in vivo neutralization test using methylcholanthrene-induced sarcoma or AKR origin as target cells. All of newborn F1 recipients died within 17 days after cell transfer. Induction of splenomegaly and cytotoxicity was not prevented by repeated pretreatments of donors with sonicated AKR spleen cells in saline, which suppressed completely such phenomena of graft-versus-host reaction in an H-2 nonidentical combination. Induction of cytotoxicity in the spleen of F1 recipients was not prevented by a pretreatment of donors with AKR spleen cells in complete Freunds adjuvant, which suppressed the induction of cytotoxicity in an H-2 nonidentical combination. Graft-versus-host reaction appears to be stronger in a combination between parental strains of which major histocompatibility antigens were identical.When lymphoid cells were obtained from AKR donors 12 h after a treatment with C57BL/L cells in complete Freunds adjuvant and transferred to (AKR X C57BL/6) F1 mice, splenomegaly in F1 recipients was augmented but cytotoxicity was suppressed. The suppression of cytotoxicity was antigen-specific. When cell transfer was carried out at stages as early as 3 or 6 h after the treatment of donors, cytotoxicity was enhanced but splenomegaly was suppressed. Irreversible deviation of immune response from the generation of cytotoxicity to the development of splenomegaly appears to occur within 12 h after such a treatment of donors.

Epilepsy of Children with Midtemporal‐Central Paroxysmal Foci

Introduction Focal spike or sharp wave discharges in the Rolandic (central-temporal) region in children have been discussed for more than twenty years since Gastaut’) described prerolandic spike foci in 1952. Gibbs and Gibbs2) (1960) reported that patients with midtemporal spike foci have a good prognosis. Lombrosos) (1967) proposed a term “Sylvian seizures” for a benign epilepsy which showed midtemporal spike foci and simple partial seizures in children. Recently, there have been many authors (Bancaud et al4) 1958, Nayac and Beaussart5) 1958, Faure and Loisseau6) 1960, Blom and Brorson7) 1966, Blom et a]*) 1972, Beaussartg) 1972, Loiseau and Beaussartlo) 1973) stressing the disparity between partial seizures and psychomotor epilepsy. The purpose of this study is to clarify clinical features and prognosis in epileptic children with midtemporal-central spike foci.

Growth Hormone and Adrenocorticotropic Hormone Levels Increased in a Child with Diencephalic Syndrome

A Japanese male child with diencephalic syndrome due to suprasellar tumor was treated in our department. There were no symptoms suggestive of hyper‐adrenalism despite an increased adrenocorticotropic hormone (ACTH), nor was there an excessive growth even in the presence of high fasting levels of growth hormone (GH). After radiation therapy, both ACTH and GH levels reverted to normal. Thus, the abnormal hypothalamic control following destruction of a certain area of the diencephalon may have led to increases in the levels of ACTH and GH. This may be the first documentation of increased ACTH levels in a patient with diencephalic syndrome.