Parental smoking and passive smoking in infants: fathers matter too.

This study examines mothers' and fathers' smoking patterns in different kinds of smoking households, and assesses their relative contribution to infants' exposure to environmental tobacco smoke. It uses data from a cross-sectional survey of 314 smoking households (infants: mean age 10 weeks) in Coventry and Birmingham, England, examining reported tobacco consumption and objective measures of exposure: the study infant's urinary cotinine:creatinine ratios and their mother's salivary cotinine. The study shows that both mothers' and fathers' tobacco smoke make substantial contributions to infant exposure to tobacco smoke. Households were more likely to contain a smoking father than mother, with over two-thirds of households including a smoking father. In households where both parents smoke, fathers' tobacco consumption was found to be significantly higher than in households where only the father smokes. This suggests that the interaction between parents needs to be considered rather than focusing on mothers' or fathers' smoking behaviour in isolation. The implications for health promotion programmes are discussed, particularly the need to place more emphasis on tackling fathers' smoking. Currently, fathers' smoking receives far less research or health promotion attention than mothers' smoking. Protecting infants from fathers' as well as mothers' smoking is key to reducing environmental tobacco exposure in early infancy, when the risk of Sudden Infant Death is highest.

Application of magnetization transfer imaging for intracranial lesions of tuberous sclerosis.

PURPOSE: Our goal was to assess the effectiveness of magnetization transfer imaging (MTI) and the usefulness of the magnetization transfer ratio (MTR) in tuberous sclerosis (TS). METHOD: T2- and T1-weighted SE images with saturation pulse on/off before and after gadolinium enhancement in 10 patients with TS were obtained. The numbers of subependymal nodule (SEN), cortical tuber, and white matter (WM) abnormality detected on T1-, proton density, T2-, and MT T1-weighted SE images were compared. The contrast-to-noise ratio (C/N) on T1-, MT T1-, Gd T1-, and Gd MT T1-weighted SE images and MTR (1-Msat/MO) on each set of saturation/nonsaturation images for each lesions were calculated. Mean MTRs (mMTRs) of WM and gray matter (GM) from seven normal volunteers were also obtained. RESULTS: MT T1-weighted SE images always depicted all lesions seen on conventional MRI and allowed depiction of more SENs (n = 80), cortical tubers (n = 197), and WM abnormalities (n = 82) than did T1-weighted (n = 58/85/33), proton density (n = 41/108/36), or T2-weighted (n = 48/121/46) SE images. The best C/N was obtained from Gd MT T1-weighted SE images in SENs and from MT T1-weighted SE images in other lesions. mMTRs of normal WM and GM were 36.43 and 29.42%, respectively. Cortical tubers and WM abnormalities had measured MTRs that were statistically equal to MTRs of GM in normal subjects (p < 0.005). MTRs of SENs showed lower mean (25.55%) and greater diversity (SD +/- 5.30), compared with MTRs of other lesions and normal GM and WM. One SEN with MTR of 20.72% was pathologically confirmed to be subependymal giant cell astrocytoma (SGCA). Nine SENs had measured MTR below 20.72% and six nodules among these were located in the region of the foramen of Monro, which is the characteristic location of SGCA. CONCLUSION: MTI may be effective in detecting all cranial lesions of TS. MTR may increase the specificity of MRI because it can differentiate the histopathologic subtypes and track and evolution of SEN into SGCA.

Interaction of sub-inhibitory concentrations of ciprofloxacin and rifampicin against Staphylococcus aureus.

The frequency of the emergence of ciprofloxacin-resistant mutants to sub-inhibitory concentrations of ciprofloxacin, rifampicin, and ciprofloxacin plus rifampicin were compared in a subcutaneous abscess model of experimental Staphylococcus aureus infection in mice. The in vitro findings showed that the combination of ciprofloxacin and rifampicin was bacteriostatically additive for all strains tested when the combination was examined by the chequer-board technique and fractional inhibitory concentration indices determined. Animals were infected with ciprofloxacin-sensitive and ciprofloxacin-resistant test strains (6989S and 6989R) and left untreated for nine days, which showed that ciprofloxacin resistance had no effect on the pathogenicity of the organisms. In treated animals, ciprofloxacin plus rifampicin was found to be at least as effective as ciprofloxacin alone. However, in the murine model, the combination therapy produced significantly fewer high-level ciprofloxacin-resistant mutants than ciprofloxacin alone (p<0.0005). We conclude that a combination of ciprofloxacin and rifampicin was at least as efficient as either drug alone, and the additional presence of rifampicin reduced the emergence of high level ciprofloxacin-resistant sub-populations in the case of S. aureus subcutaneous abscesses in mice and so the combination may prove to be more efficient than ciprofloxacin alone.

Minocycline versus vancomycin for treatment of experimental endocarditis caused by oxacillin-resistant Staphylococcus aureus.

The purpose of this study was to determine the penetration of minocycline and vancomycin into cardiac vegetations and to determine their efficacy in a rabbit model of endocarditis caused by oxacillin-resistant Staphylococcus aureus. Animals were randomized into three groups: control (no antibiotic), minocycline (6 mg/kg given intravenously every 8 h), and vancomycin (50 mg/kg given intravenously every 8 h). Penetration of the antibiotics into aortic valve vegetations was determined by using the tissue/serum area under the concentration-time curve ratio. The reductions in the bacterial density of the vegetations caused by both vancomycin (4.8 +/- 1.2 CFU/g) and minocycline (5.3 +/- 1.6 CFU/g) were significantly different from that of controls (8.7 +/- 1.8 CFU/g). Although the penetration of minocycline was twice that of vancomycin, they were equally effective in reducing the bacterial density of the vegetations, since the concentrations of both agents in tissue remained above their MICs for oxacillin-resistant S. aureus. For organisms for which the MICs are higher, however, these penetration differences may result in treatment differences.

Reduction of bacterial titers by low-dose aspirin in experimental aortic valve endocarditis.

Using a rabbit model of Staphylococcus aureus endocarditis, we studied the effects of aspirin on the natural progression of this infection. Compared with untreated animals, the aspirin-treated animals showed a 30% (P = 0.11) reduction in the weight of the vegetations and an 84% (P = 0.03) reduction in the bacterial titer of the vegetations.

Moyamoya disease in Korea.

Thirty eight cases of moyamoa disease, 21 children, 17 adults were encountered during a 16-year period at Yonsei University Medical Center. Clinical manifestations, together with computed tomography (CT) and angiographic findings were analyzed with a review of the literature. The mean age was 6.3 +/- 3.5 years in children and 36.8 +/- 9.9 years in adults. The majority of attacks occurred in spring in both adults and children. The most common chief complaint on admission was hemiparesis followed by convulsion in children, while in adults, loss of consciousness was most common followed by headache. Of transient neurologic deficits, hemiplegia was most common in children, while cranial nerve involvement was common in adults. Hemiplegia, also was the most common permanent neurologic manifestation in children, while hemiparesis and intellectual deterioration were the most common in adults. Of the children, 90.6% showed infarction on CT, while 88.2% of adults had hemorrhage. Bilateral occlusion of the carotid arteries was the most common site of lesions in both adults and children on cerebral angiogaphy.

Organic disorders in children with epileptic seizures.

1) Brain C-T scan was done in 1,005 epileptic children as one of the diagnostic methods, and 32% showed abnormal findings. 2) Infantile spasm showed abnormal scan most frequently at 52.9%, persistent subtle seizure 46.7%, simple partial epilepsy 37.7%, and myoclonic epilepsy 37.5%, in order of frequency. 3) In partial epilepsy the positive scan detection rate was 35.2% of the total, with simple partial epilepsy 37.7%, complex partial epilepsy 36.1% and secondary generalized epilepsy 33.5%. These rates are higher than those of generalized epilepsy (27.1%). 4) In generalized epilepsy, generalized tonic clonic showed abnormal scan in 26.1%, generalized tonic in 23.6%, generalized clonic in 20.5%, atypical absence in 15% and typical absence in none. 5) Brain tumor was detected in 2.18%. 6) Positive scan is commonly detected in seizures starting in young age group, and in epileptic patients with focal neurologic signs as well as focal EEG abnormality. 7) The curable lesions were brain tumor, some granulomas, and arachnoid cyst. 8) Brain C-T scan is an effective diagnostic method in epileptic children to identify structural abnormalities of the brain and to make sure that the abnormality does not progress, but it would be better to perform C-T scan case by case rather than as a routine diagnostic procedure.

Guillain-Barre syndrome in Korean children.

Guillain-Barre syndrome is known as one of the autoimmune disease, but the etiology, pathophysiology relating immune reaction, as well as the treatment are not established. It still causes physical handicap although its rate is low. The causes, clinical symptoms and outcome of 132 cases of Guillain-Barre syndrome have been analyzed. The patients' ages ranged from 4 months to 15 years. The antecedent events for 56.1% of the patients were known. These were upper respiratory tract infection, unexplained fever, vomiting, diarrhea, vaccination, measles, german measles, shigellosis, mumps, hepatitis, pertussis and surgery in order of frequency. The CSF protein level reached a maximum at 12.3 +/- 9.5 days. Steroids did not influence the outcome of this disease. More studies are necessary to conquer the disease.