Extra-hepatic portal hypertension: the significance of variceal haemorrhage

ABSTRACT. Sixty-two children with extra-hepatic portal hypertension (EHPH) were seen at the Royal Children's Hospital, Melbourne, during a 30-year period. A partly retrospective and partly prospective study of these patients has been undertaken with particular reference to methods of establishing the diagnosis, evaluating the results of treatment, and attempting to predict the probability of recurrent bleeding.     

Automatic switching and guidance system to facilitate unassisted uroflowmetry using commercial electronic devices

To enable male patients to undergo uroflowmetry in a private condition without medical supervision, we devised an automatic switching and patient guidance system for the spinning disk uroflowmeter Urodyn 1000, using two commercial electronic devices (an infrared motion sensor tap and a memorizable vacuum fluorescent display). Instead of running the uroflowmeter continuously, which shortens the life of the spinning disk due to mechanical wear, an infrared motion sensor turns on the devices each time a patient enters the room. The patient urinates according to the timely instructions on the visible display and voided urine directly flows into a urinal. The devices are automatically turned off 5 min after the patient leaves the room. With the use of our system, men already acquainted with uroflowmetry could perform self-administered uroflowmetry any time in private. The system was considered useful for improving the quality of patient service.     

ANTI-GLUCOCORTICOID EFFECTS OF MELATONIN IN YOUNG RATS

Administration of the pineal hormone melatonin to young female rats provided significant prevention of the injurious effects (decrease of body weight gain, atrophy of the thymus and adrenals, glucosuria, elevation of the blood level of glucose, free fatty acid, triglyceride, and total cholesterol) caused by three different glucocorticoids, i.e. dexamethasone, prednisolone, and hydrocortisone. Although these protective effects of melatonin were slightly more remarkable in dexamethasone-treated rats than in prednisolone- or hydrocortisone-treated rats, our hypothesis of melatonin's anti-glucocorticoid effects is said to have been confirmed rather universally and with a considerably wide range through this experiment.     

Outbreak of pertussis in highly immunized adolescents and its secondary spread to their families

An outbreak of pertussis was recognized in a highly immunized sixth-grade class of schoolchildren. Among 43 children aged 11–12 years in the class, 38 had been immunized with three doses or more of DTP containing whole-cell pertussis vaccine, two with two doses of DTP and three children were unimmunized. The last DTP vaccines had been given 6–10 years before the outbreak. A total of eight children with pertussis suffering paroxysmal coughing attacks for 3 weeks or more were identified, seven being fully immunized and one unimmunized. Among the eight cases, two were confirmed by both culture and serology and one by serology alone. The attack rate in fully immunized children was 18.4% (7/38). Secondary spread of pertussis was identified in five of the households from which the eight patients originated. A total of six cases of pertussis from these five households were identified, and two of these were culture-confirmed. These observations suggest that vaccine-induced immunity weakens considerably 6–10 years after vaccination, and that booster immunization with DTP instead of DT is therefore recommended for the control of pertussis.     

Multicentre population‐based dementia prevalence survey in Japan: a preliminary report

Community‐based surveys were performed in seven rural areas in Japan to investigate the prevalence of dementia and illnesses causing dementia. A total of 5431 elderly subjects were selected based on census data from 1 October 2009. In total, 3394 participants were examined (participation rate: 62.5%), and 768 dementia cases and 529 mild cognitive impairment cases were identified. Of the illnesses causing dementia, Alzheimer's disease was the most frequent (67.4%), followed by vascular dementia (18.9%), dementia with Lewy body disease (4.6%), mixed dementia (4.2%) and other illnesses. The prevalence of dementia according to 5‐year age strata between 65 and 99 years was 5.8–77.7% among the participants. The prevalence of dementia in this study was higher than in previous reports in Japan and other countries. To verify the upward trend of dementia prevalence and its background factors, we have scheduled surveys for three other urban areas in 2011–2012.