LOWE'S SYNDROME: Absence of Amino Acid Transport Defect in Cultured Fibroblasts

Transport of lysine and glycine was studied in cultured fibroblasts of a patient with Lowe's oculocerebrorenal syndrome. Although patients with this syndrome demonstrate renal and intestinal amino acid transport defects, no abnormality was found in our study.     

Implantation Techniques of Antitachycardia Devices

Implantation of a defibrillator may be by a mixed technique of transvenous leads and subcostal thoracotomy. An alternative approach is placement of all defibrillator leads and possible pacemaker leads via median sternotomy. All sensing leads, either for a defibrillator or a pacemaker, should be bipolar to provide maximal rejection of interference signals. Interpretation of the electrogram requires analysis of the pathologic electrogram to distinguish it from the "normal" electrogram for that patient and may require several leads to determine the activation sequence; which will allow diagnosis of a tachycardia in a fashion similar to that performed by a human observer.     

Preventing diarrhoea: what are the policy options?

Oral rehydration therapy (ORT) has become the cornerstone ofmost programmes of diarrhoea control, and is highly effectivein preventing death from dehydration caused by acute wateryepisodes of diarrhoea. The effectiveness of ORT in reducingmortality from chronic or dysenteric diarrhoeas is believedto be low and, in addition, ORT can be expected to have littleor no impact on diarrhoea morbidity rates. In view of this,ORT should be complemented by other interventions designed toavert mortality not averted by ORT, and to reduce morbidityrates. The Diarrhoeal Diseases Control Programme of WHO hasinitiated a systematic study of the effectiveness and cost ofinterventions that are potentially useful in diarrhoea control.This paper summarizes the findings of this study, concentratingon those interventions for which the evidence for high effectivenessand feasibility is strong. These are: promotion of breast feeding,weaning education, measles immunization, improving water supplyand sanitation, promotion of hygiene, and, when the new vaccinesare available, rotavirus, and possibly cholera, immunization.Estimates are presented of the cost-effectiveness of these interventionsin reducing diarrhoea morbidity and mortality rates among childrenunder 5 years of age.