Human milk reduces the risk of retinal detachment in extremely low-birthweight infants

BACKGROUND: Retinopathy of prematurity (ROP) is a major cause of blindness in children. Because the use of oxygen is a known risk factor for development of ROP, supplemental oxygen is used carefully. However, it does not necessarily reduce the morbidity of ROP-induced blindness. The aim of the present study was to identify the possible risk factors for progression to retinal detachment, a most relevant cause of visual impairment, in extremely low-birthweight infants (ELBWI). METHODS: The medical records of the 42 ELBWI who were admitted to the neonatal intensive care unit in Asahikawa Kosei Hospital from April 1999 to March 2004 were retrospectively reviewed. Seven infants (16.7% of the ELBWI) developed retinal detachment and two of them became blind. Perinatal and postnatal variables in these infants with retinal detachment were compared with those in infants without retinal detachment. RESULTS: A striking difference in the daily intake of human milk was found between the infants with or without retinal detachment when their gestational ages at birth were matched. The infants without retinal detachment were fed more human milk (67-83% volume of total nutritional intake) as compared to those with retinal detachment (24-38% volume of total nutritional intake) at a specific postnatal period, 5-7 weeks postnatal age. CONCLUSIONS: Human milk may contain some beneficial factors to reduce the severity of ROP. Identifying these factors in human milk may contribute to development of a strategy to rescue premature infants from blindness.     

Histomorphometric analysis and immunolocalization of RANKL and OPG during the alveolar healing process in female ovariectomized rats treated with oestrogen or raloxifene

Objective

To investigate the effects of bone-resorption inhibitors (oestrogen and raloxifene) on the RANKL/OPG balance during the chronology of the alveolar healing process in ovariectomized (OVX) rats by means of immunocolocalization and histomorphometric analysis.

Materials and methods

One hundred sixty female Wistar rats at 70 days of age were either OVX or sham-operated and divided into four groups: sham, OVX/Oil, OVX with E₂ replacement (17β-estradiol, 400 μg/month), OVX with RLX treatment (1 mg/kg bw/day). The 60-day treatment started 8 days after ovariectomy. The incisors were extracted to allow analysis of 7, 14, 21, 28 and 42 days of wound healing. After obtaining the histological samples, slides were stained with hematoxylin and eosin or subjected to immunocolocalization reaction for RANKL and OPG. Results were quantitatively evaluated.

Results

Histomorphometric analysis showed that the sham group presented the highest and OVX/Oil group the lowest mean bone formation value in the post-extraction period. The immunocolocalization analysis showed a larger increase in bone turnover at 7 postoperative days in OVX/Oil and sham groups and decreasing bone turnover in the other periods. The OVX/Oil group showed a large decrease in bone turnover at 14 postoperative days, a period demonstrated by mild cellular activity. OVX/E₂ and sham groups showed a decreased bone turnover at 28 postoperative days while OVX/RLX group showed a decreased bone turnover at 21 postoperative days. On the 42nd postoperative day, sham and OVX/RLX groups showed an established alveolar bone healing process.

Conclusions

Ovariectomy delays the alveolar healing process and interferes with bone turnover through the balance between RANKL and OPG. Oestrogen replacement or raloxifene treatment did not totally recover the oestrogen-deficient state. However raloxifene treatment showed more satisfactory results than oestrogen replacement.     

Studies of peptide antibiotics. XLIV. Syntheses and biological activities of gramicidin S analogs containing δ-hydroxy-l-norvaline or glycine

The antibiotic gramicidin S (GS) has the structure of cyclo (-l -Val¹-L-Orn²-l -Leu³-d -Phe⁴-l -Pro⁵-L-Val¹′-l -Orn²′-l -Leu³′-d -Phe⁴′-l -Pro⁵′-) and is basic in character. Five GS analogs including [Gly^1,1′]-GS and the neutral [l -Hnv^2,2′]-GS (Hnv represents δ-hydroxynorvaline) were synthesized by the solid-phase method to evaluate the role of l -Val^1,1′ and l -Orn^2,2′ residues in GS. The hybrid analogs ([Gly¹]-GS and [l -Hnv²]-GS) and [d -Tyr^4,4′]-GS showed high antibacterial activities, whereas [Gly^1,1′]-GS and [l -Hnv^2,2′]-GS possessed no activity. Inhibitory effects by these analogs for the adsorption of ¹⁴C-labeled GS on cells of bacteria sensitive to GS were determined. The structure-activity relationship of GS is discussed on the basis of the results on these GS analogs.     

Sarcomatous Renal Tumor in A Child: A Case Report

A patient, a 7-yr 4-mo-old boy, with sarcomatous renal tumorwas presented. At the age of 3 yr and 1 mo, he had a right nephrectomyfor a renal tumor, group I, which was histologically evaluatedas an abortive subtype of the nephroblastic type of nephroblastoma.For 24 mo after surgery, the outlook for the patient seemedto be favorable. When he was 5 yr and 2 mo old, he complainedof pain and swelling of the left shoulder. By X-ray examination,an osteolytic mass in the left scapula was discovered. Afterbiopsy, it was histologically diagnosed as a metastasis of thesarcomatous renal tumor. During the next 29 mo, multiple bonemetastases appeared in the ribs, vertebrae, skull and long bonesand slowly increased in size. ⁶⁰Co irradiation of a total of 12,015 rads to four differentregions and various chemotherapy regimens consisting of actinomycinD (AMD), AMD+vincristine (VCR), VCR+adriamycin (ADR)+cyclophosphamide(CYD), vinblastine+6-mercaptopurine and VCR+AMD+CYD, were givenfor the 53 mo from surgery to death, but they were not effectiveagainst this tumor. The clinical course of this case may show the natural historyof sarcomatous renal tumor.     

Prune Belly Syndrome: Report of Twelve Autopsy Cases and Possible Pathogenesis

Abstract Twelve autopsy cases (9 males, 3 females) of the prune belly syndrome are presented. Principal anomalies of this syndrome are a prune-like abdominal feature and a giant bladder. Urethral atresia was observed in most but two cases. Imperforate anus and rectovesical fistula were observed in 8 and 7 cases respectively. Associated anomalies were those which may or may not be embryologically related to the principal anomalies.
As regards the pathogenesis, the authors propose that a primary defect may occur during any developmental stage of the somitic mesoderm, genital tubercle and urethra. In conclusion, the prune belly syndrome may be of spectrum anomalies depending on the stage specificity mainly in the abdominal wall and genito-urinary organs.     

EXPERIMENTAL STUDY ON HEMORRHAGE IN THE BRAIN STEM INDUCED BY AN INTRACRANIAL SPACE OCCUPYING LESION

Increased intracranial pressure was experimentally produced in dogs by inserting a rubber balloon epidurally in the left temporal region and then inflating the balloon with water. The animals were killed after a set interval and the hemorrhagic lesion in the brain stem examined in detail. 1. The hemorrhagic lesions in the brain stem could be microscopically classified into three types; arterial, venous and capillary. Massive hemorrhagic lesion was also observed in some animals. 2. Arterial hemorrhage was distributed mostly in the area supplied by the thalamo-perforating artery in the diencephalon and in the area supplied by the paramedian branches of the basilar artery in the lower brain stem. Venous hemorrhage was found mostly in the region of the terminal vein and basal vein in the diencephalon and in the region of the basilar vein in the lower brain stem. Capillary hemorrhage was extensive and the distribution corresponded approximately with that of venous hemorrhage but also in part with that of arterial lesions. 3. A relation was apparent between the hemorrhagic lesion in the brain stem and the amount of water instilled into the rubber balloon, which could be correlated to intracranial pressure. Capillary hemorrhage was observed in most cases in which over 3.5 ml of water was instilled. With instillation of 4.0 ml of water, all types of hemorrhage were observed profusely but venos hemorrhage predominated. With instillation of more than 4.5 ml of water, arterial hemorrhage was dominant. 4. The relation between the hemorrhagic lesions and the survival time after procedure was studied in the animals which had died naturally. Capillary hemorrhage was observed in almost all the animals irregardless of the survival time. Both arterial and venous hemorrhage were observed abundantly in animals which survived for over 10 hours. Arterial hemorrhage, in particular, was dominant in the cases which died within 12 hours and the venous type was dominant in the case surviving over 12 hours.     

Neurofibromatosis complicated with XXX syndrome and renovascular hypertension

A 25-year-old woman with neurofibromatosis was admitted to our hospital for evaluation of hypertension. When she was 6 years old, she was diagnosed as having neurofibromatosis and XXX syndrome because of multiple café-au-lait spots, neurofibromas of the skin and mental retardation. Chromosome analysis revealed that her karyotype was 46, XX/47, XXX. Renal arteriography disclosed aneurysmal change and stenosis of the right renal artery. After right-side nephrectomy and aneurysmectomy, the kidney was autotransplanted in the left iliac fossa. Surgical procedure resulted in marked amelioration of the hypertension without medical treatment. Thus, aortorenal bypass and renal autotransplantation have emerged as the preferred revascularization operations. This is the first report of a chromosomal linkage between neurofibromatosis which is thought to be an autosomal dominant disease and the XXX syndrome.     

Incidence of hypocomplementemia in elementary and junior high school children with urinary abnormalities

Abnormalities were detected in 2669 of 326 257 elementary and junior high school children (169 856 males and 156 401 females) who were screened at school for urinary abnormalities. Serum complement (C3) level was measured in all 2669 children having urinary abnormalities (811 males, 1856 females). Three had a serum C3 level that was more than three standard deviations below the mean value. Type I membranoproliferative glomerulonephritis (MPGN) was diagnosed on histological examination in one of these three children, while the other two did not undergo renal biopsy because they had serum C3 levels of 40 and 44 mg/dL, respectively, and because their urinary abnormalities were transient. It was considered that there is not much significance in testing the serum complement in the urine screening done at school and the cost/benefit ratio is low. The results appeared to reflect the frequency of persistent hypocomplementemic MPGN in Japan in recent years.