Respiratory syncytial virus infection in children with severe motor and intellectual disabilities.

Children with severe motor intellectual disabilities (SMID) are at high risk of death from acute viral lower respiratory tract infections (LRTI). Although respiratory syncytial virus (RSV) is the most common cause of viral LRTI in children, there have been a few reports on the relationship between SMID and the severity of RSV-LRTI. The aim of the present study is to assess the influence of RSV-LRTI in children with SMID. A case-control study composed of children with SMID (n = 18) and previously healthy children (n = 43) less than 16 years old hospitalized for RSV-LRTI was performed during five consecutive RSV seasons. The clinical presentation and the laboratory data in the SMID group were compared with those in the non-SMID group. In the bivariate analysis, the median age of the SMID group was higher than that of the non-SMID group (p = 0.002). Children with SMID had an increased risk for ventilation support (p = 0.057). The count of neutrophils in the SMID group was significantly increased (p = 0.012), whereas the proportion of bacterial co-infection was lower than that in the non-SMID group (p = 0.005). Multivariate logistic analysis showed that SMID was associated with longer oxygen usage [>7 days: odds ratio (OR) 5.309, p = 0.033]. The present study revealed that children with SMID were prone to developing hypoxia by RSV-LRTI. The strategies for the treatment and prevention of RSV infection need to be improved in SMID children.

Examination of exchange assay for glucocorticoid receptor.

We examined a method for the measurement of total, activated and non-activated glucocorticoid receptors using sodium-p-hydroxymercuribenzoate (PHMB) and dithiothereitol (DTT) developed by Banerji and Kalimi (1981). Since the concentration of PHMB required for dissociation of the ligand from the receptors varied with the concentration of protein in the reaction mixture and the rate of reassociation of the ligand to the ligand-liberated receptors was sensitive to the concentration of PHMB used, it was necessary to find the minimum concentration of PHMB which was required for complete dissociation of the ligand. When the optimum concentration of PHMB was selected based on the concentration of protein in the cytosol, almost 100% exchange was attained in the non-heated dexamethasone (Dex)-receptor complexes by this method. However when Dex-receptor complexes were heated at 25 degrees C for 30 min, the amount of 3H-Dex reassociated with the glucocorticoid receptors dropped to 60% of that of the non-heated ones. DEAE-cellulose chromatography of the heated sample revealed that approx. 40% of the bound receptors were activated (eluted with 0.05 M KCl) during the heating period. After DEAE cellulose column chromatography of the exchanged 3H-Dex receptor, complexes reassociated with 3H-Dex were observed only in the fraction of unactivated receptor complexes (eluted with 0.2 M KCl). Furthermore, the fraction eluted with 0.05 M KCl in the DEAE cellulose chromatography of liver cytosol bound to unlabelled Dex did not exchange significantly with 3H-Dex with the method used in the present study.(ABSTRACT TRUNCATED AT 250 WORDS)

Echographic findings and histological feature of the thyroid: a reverse relationship between the level of echo-amplitude and lymphocytic infiltration.

In 43 patients with Graves' disease, 5 patients with painless thyroiditis and 30 patients with Hashimoto-thyroiditis ultrasonographical observations and histological examinations by needle biopsy of the thyroid were carried out simultaneously. In all cases the level of echo-amplitude was well correlated with the rate of lymphocytic infiltrations and fibrosis. In cases which exhibited marked lymphocytic infiltrations in the thyroidal biopsy specimen, no apparent echoes or very low amplitude echoes were observed in the whole thyroid and in cases in which replacement with lymphocytic infiltration was observed in almost a half part of the thyroid, several sonolucent regions were observed in the thyroid and in cases in which lymphocytic infiltration or fibrosis was observed sporadically, low-amplitude and uniform echoes were observed in the whole or several regions of the thyroid. In cases with no lymphocytic infiltration in the histological specimen, diffuse high-amplitude and uniform echoes were observed throughout the whole lobe of the thyroid. In patients with painless thyroiditis, the amplitude of echo was low when the level of lymphocytic infiltration was high and the echo-amplitude showed a tendency to increase along with the decrease in the rate of lymphocytic infiltration. From these observations it is concluded that echo-amplitude is well correlated with lymphocytic infiltration and fibrosis in patients with Hashimoto-thyroiditis, Hashitoxicosis and painless thyroiditis.

[Side effects of antithyroid drugs].

In order to investigate the incidence of side effects of antithyroid drugs and to study if there were any factors related to the onset of the side effects, clinical and laboratory findings were examined in 71 untreated Graves' patients. The overall incidence was 28.2% among 71 cases who were initially administered methimazole or propylthiouracil. The incidences were 23.2% (13 of 56 cases) for methimazole and 46.7% (7 of 15 cases) for propylthiouracil, respectively, which were significantly higher than those previously reported. Seventeen of 20 cases with side effects under the drug of first choice were administered the another antithyroid drug. Four of 17 (23.5%) cases successively had side effects. The side effects were observed within 1.5 months of administration of less than 150 tablets in total in most of the cases. The serum concentration of Ig-E and peripheral eosinophils(/mm3) at the onset of the side effects were significantly higher than those before treatment. These results suggest that allergic mechanism rather than accumulating may concern the onset of side effects. Since in cases without the side effects the peripheral eosinophils at 3 to 4 weeks after administration were significantly higher than those before treatment and 19 of 51 (38.0%) cases without side effects had a high concentration of Ig-E of more than 500 u/ml, it is suggested that allergic mechanism may be triggered in most of Graves' patients who were administered methimazole or propylthiouracil. Thus, immunological disturbances in Graves' disease seems to be the cause of the side effects of antithyroid drugs, although there was no correlation between antithyroid autoantibodies and development of the side effects.

Nuclear binding sites in the liver for dexamethasone and in the ventral prostate for R1881.

Nuclear binding sites which exhibit affinity similar to previously reported "Type II" sites (Clark et al., 1978) for estradiol in rat uterus were found in the liver and ventral prostate of rats and showed a binding specificity for glucocorticoid and androgen, respectively. However, both binding sites were qualitatively different from those of the rat uterus; a reducing agent, dithiothreitol, did not block the binding of steroids in the liver and ventral prostate. Extraction of the bound ligands discriminated the binding of the liver from that of the ventral prostate, Triton X-100 solubilized a majority of the bound Dex in liver nuclei, while the effect of KCl treatment was more remarkable on the bound R1881 in nuclei of the ventral prostate. Castration caused a drastic decrease in the binding of ventral prostate, only trace binding was observed at 48 h after hormone deprivation and replacement therapy restored the binding rapidly, at 3 h after testosterone injection almost 70% of the binding was detected. Although adrenalectomy did not result in a profound change in the binding sites of liver, the injection of Dex increased the number of binding sites significantly. The physiological significance of these binding sites is not clear at the present time.