Renal parenchymal malakoplakia: An unusual cause of unilateral,diffuse renal enlargement

Renal parenchymal malakoplakia is usually described as a multi‐ or unifocal process. We report an unusual case presenting with unilateral diffuse renal enlargement consistent with an early stage in the evolution of this disease.     

Definition of neonatal hypoglycaemia: Is there a change?

Objective : To compare the definitions of neonatal hypoglycaemia in textbooks and among paediatricians in 1992 with those used in 1986. Methodology : A questionnaire was sent to 420 neonatal paediatricians in the UK and to 88 Australian neonatal paediatricians in 1992 asking for their definition of hypoglycaemia in term babies and preterm/small-for-gestational-age (SGA) babies. Fourteen textbooks on neonatal paediatrics (published since 1990) were also surveyed for the definition of hypoglycaemia used in the text. The UK paediatricians were also asked, ‘Do you believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs?’ The 1992 results were compared with the published results of a similar survey in 1986. Results : There was a 68% response from neonatal paediatricians both in the UK and Australia. Similar to the 1986 results there continued in 1992 to be a wide range in the definition for hypoglycaemia (<1-4mmol/L) among neonatal paediatricians and in textbooks. The median of the definition of hypoglycaemia for both term and preterm/SGA babies among paediatricians and in textbooks in 1992 was significantly different from the results in 1986. Compared with 1986 there was a significant increase in 1992 in the number of paediatricians and textbooks defining a safe blood glucose concentration as being at least 2mmol/L. Sixty per cent of UK neonatal paediatricians believe that a baby who is hypoglycaemic but has no abnormal clinical signs is at less risk of neurological damage than a baby who is hypoglycaemic with abnormal signs. Conclusions : From 1986 to 1992 there was a significant change in the definition of hypoglycaemia both among paediatricians and in neonatal textbooks compared with the definition in use during 1965-86. The findings suggest that neonatal paediatricians do change in their practice. The changes in the definition of hypoglycaemia may be due to the data available and discussion on hypoglycaemia since 1988. Neonatal paediatricians still attach significance to clinical signs associated with hypoglycaemia.     

Wildervanck syndrome

We report a case of the Wildervanck (cervico-oculo-acoustic) syndrome exhibiting Klippel–Feil anomaly, congenital sensorineural deafness and bilateral sixth nerve palsy. Associated anomalies included short stature, microcephaly, mental retardation, and cleft palate.     

Rehabilitating role of glutathione ester on cisplatin induced nephrotoxicity

Cisplatin caused differential toxic effects on blood glucose and plasma urea, uric acid and creatinine levels. Cisplatin also showed an inhibitory effect on kidney marker enzymes like alkaline phosphatase, acid phosphatase, aspartate aminotransferase and alanine aminotransferase. However, administration of glutathione ester modulates the toxic side effect of cisplatin observed in kidney enzymes, and in blood parameters. It seems that glutathione ester plays an important role in protecting against the cisplatin induced nephrotoxicity by inhibiting the accumulation of platinum in kidneys.     

Low concentrations of ethanol deplete type-2 astrocytes of intracellular free magnesium

The acute effects of low concentrations of ethanol on intracellular free magnesium ions ([Mg2+]i) in cultured type-2 astrocytes were studied by digital imaging microscopy using the Mg2+ fluorescent probe, mag-fura-2. In 0-mM ethanol, the basal level of [Mg+]i was 124.7+/-2.56 microM with a heterogeneous distribution within the cells. Treatment of the cells with 10 and 25 mM ethanol (10 min) resulted in rapid concentration-dependent reduction in [Mg2+]i; the greater the concentration of alcohol, the greater the depletion of [Mg2+]i. Exposure of cells to 10 and 25 mM resulted in approximately 27 and 50% reductions in [Mg2+]i, respectively. Reincubation in normal Mg2+-physiological buffer solution restored [Mg2+]i levels. These observations may suggest that acute "binge drinking" of ethanol, which often results in cerebral ischemia and stroke, may do so as a result of depletion of astrocytic [Mg2+]i, possibly producing disruption of the blood-brain barrier.