Ileoileocolic intussusception in children: diagnosis and significance.

The ileoileocolic type of childhood intussusception is difficult to diagnose pre-operatively and is associated with increased morbidity. This study describes the clinical and imaging features of 10 consecutive ileoileocolic intussusceptions diagnosed ultrasonically in 10 patients over a 36 month period. Ultrasound-guided hydrostatic reduction using Hartmann's solution was attempted in all 10 patients.

Penicillium marneffei infection in a non-HIV infected child.

We report a case of Penicillium marneffei infection in a previously healthy 3.5 years-old Chinese boy and review the literature. The details of the case are described with emphasis on his immune function and treatment outcome.

Growth, puberty and endocrine function in beta-thalassaemia major.

Although delay in onset of puberty is a common cause of growth failure in adolescent thalassaemic patients, growth retardation could also be due to iron overload, the toxic effects of desferrioxamine, or the development of other endocrinopathies such as GH insufficiency or primary hypothyroidism. Abnormal body proportions with truncal shortening are commonly seen and could be due to the disease itself, iron toxicity, delay in puberty or the toxic effects of desferrioxamine. The absence of a pubertal growth spurt during spontaneous or induced puberty is detrimental to the achievement of a normal final adult height.

Iodine insufficiency and neonatal hyperthyrotropinaemia in Hong Kong.

Objectives: 23% of the neonatal hypothyroidism in Hong Kong is transient. The present study aims to evaluate iodine excretion in healthy pregnant women in Hong Kong and to determine whether iodine insufficiency may occur in the local population to account for the type of neonatal thyroid dysfunction seen in our screening programme.

Subjects: Pilot screening of urinary iodine excretion was determined in 253 healthy pregnant women between 32 and 36 weeks gestation.

Growth hormone therapy transiently increases apolipoprotein(a) in short beta-thalassaemia major children with normal growth hormone reserve.

Recombinant human growth hormone (rhGH) is now available for treatment of short stature due to growth hormone (GH) deficiency. It's potential use in other causes of short stature raises concerns about adverse effects of long term treatment on carbohydrate and lipoprotein metabolism. We describe the serial changes in lipids, lipoproteins and apolipoproteins, including apo(a) in 12 children with beta-thalassaemia major undergoing rhGH treatment for 24-36 months.

The timing of early postnatal catch-up growth in normal, full-term infants born short for gestational age.

Postnatal catch-up growth in infants born small for gestational age has been reported to occur mainly during the initial 3-9 months of life. The study presented here characterized early postnatal growth in healthy, full-term infants born short for gestational age (GA) (< -2 standard deviation scores [SDS] in birth length) in two populations. Results from a longitudinal growth study from birth to final height of 139 infants born short for GA between 1973 and 1975 in Göteborg, Sweden, were compared with results from an ongoing detailed prospective 6-month follow-up of 41 Hong Kong Chinese infants born short for GA in 1995 and 1996.

Spontaneous growth in Chinese patients with Turner's syndrome and influence of karyotype.

The pretreatment mixed cross-sectional and longitudinal height measurements of 203 patients with Turner's syndrome (TS) were analysed. Only one observation was included per year per child and a total of 858 observations formed the basis of the growth study. The mean and SD values were fitted separately by a second-degree polynomial function, giving smoothed growth curves.

Childhood intussusception: ultrasound-guided Hartmann's solution hydrostatic reduction or barium enema reduction?

A comparison was made of the efficacy of ultrasound guided Hartmann's solution hydrostatic reduction on 23 patients (US group) with the same number of consecutive patients in whom hydrostatic reduction was done by barium enema (BE group) under fluoroscopy for childhood intussusception. The US group was diagnosed by ultrasound scan and reduction was attempted under the guidance of ultrasonography with Hartmann's solution at 100 mm Hg pressure. Excluded were patients older than 12 years, patients in shock, patients with peritonitis, bowel perforation, and gross abdominal distension as well as recurrent intussusception of more than three episodes.

Sonographically guided hydrostatic reduction of childhood intussusception using Hartmann's solution.

Objective: Currently, the standard methods for therapeutic reduction of intussusception in children involve considerable ionizing radiation. This study tested the effectiveness of sonographically guided hydrostatic reduction of intussusception using Hartmann's solution, a fluid with near-physiologic composition.

Subjects And Methods: Between March 1, 1994, and January 31, 1996, all children clinically suspected of having intussusception were evaluated by sonography.

Born small for gestational age: consequences for growth.

A large number of studies have documented a strong correlation between size at birth and subsequent height, although the reported incidence of catch-up growth and consequently the impact on final height has varied with time and between countries. These variations may be real, but could also be related to a number of methodological problems. The aim of this study was to explore two important aspects related to postnatal growth after disturbed fetal growth: first, the definition of small for gestational age (SGA), including the selection of cut-off points in defining shortness; and, secondly, the importance of the general socio-economic status of the population with regard to the incidence of growth faltering in early life.

An episode of syncope attacks in adolescent schoolgirls: investigations, intervention and outcome.

An increasing number of students in a secondary convent girls school developed syncope attacks over a time course of about two months. Fourteen students who suffered from syncope and 12 other students from the same class with no symptoms were assessed by a team of psychologists and paediatricians with the aim of identifying the cause of the problem and to formulate possible remedial action. Psychological assessments included a mental state examination, developmental, personal and psychological history, state-trait anxiety, self-esteem, hypnotic suggestibility, and students' beliefs about the cause and nature of the syncope attacks.

Existence of iodine deficiency in Hong Kong--a coastal city in southern China.

Objective: Iodine deficiency is a serious public health problem worldwide which is associated with mental retardation and cretinism. In view of a high incidence of transient neonatal hypothyroidism and a relatively high mean cord blood thyrotropin (TSH) concentration, a pilot study was carried out to analyse the urine iodine excretion in Hong Kong, a coastal city in the southern part of China.

Design: Early morning urine was collected from healthy volunteers including children (n = 104), adults (n = 112) and elderly subjects (n = 349).

Population movement in the Asia Pacific region: Singapore perspective.

"This article [is] structured to give some brief overview of the trends and characteristics of population movement in the Asia Pacific region. Wherever relevant, the implications of these regional and global trends for Singapore will be highlighted to offer a better appreciation of its case study. This will touch on Singapore's own experiences of outflow and inflow of people and its policies and philosophy on such movement.

Incomplete catch-up growth in low birthweight Chinese infants in Hong Kong.

Objective: To describe the early catch-up growth in length in Chinese low birthweight (< 2500 g) infants.

Methodology: The infants (n = 181) were delivered between 1988 and 1993 and followed up at Queen Mary and Tsan Yuk Hospitals, Hong Kong. One third had a birthweight below -2SDS, most of whom were term or close-to-term babies small-for-gestational-age (SGA).

A partial transient effect of short-term growth hormone (GH) treatment in short non-GH deficient prepubertal children.

This study reports the growth of 11 short non-GH deficient children before, during short-term GH therapy for 1 year and for 2 years after the cessation of treatment. The mean growth velocity increased significantly (p < 0.0001) from the pretreatment mean of 4.

The effect of arterial lines on blood-drawing practices and costs in intensive care units.

Study Objective: To determine whether the presence of an indwelling arterial access line leads to differences in blood-drawing practices and costs, in patients with similar APACHE II scores, in the ICU.

Design: Prospective, observational.

Setting: Adult surgical and medical ICUs at a large military tertiary care hospital.

A cross-sectional study of growth, puberty and endocrine function in patients with thalassaemia major in Hong Kong.

Methodology: A cross-sectional study of growth, puberty and endocrine function was performed on 35 girls and 33 boys with thalassaemia major.

Results: Despite regular transfusion and chelation therapy, 75% of the girls and 62% of the boys over the age of 12 years were below the third percentile for height. Hypogonadotropic hypogonadism was found in a similar percentage of patients.

Growth hormone treatment of short Chinese children with beta-thalassaemia major without GH deficiency.

Objective: Despite regular transfusion and desferrioxamine treatment, growth failure is commonly seen in adolescent children with beta-thalassaemia major. The growth failure has been thought to be due to GH resistance rather than GH deficiency. We investigated the effect of GH on short non-GH deficient children with beta-thalassaemia.

Invasive Haemophilus influenzae type b infections in children hospitalized in Hong Kong, 1986-1990. Hong Kong Hib Study Group.

A 5-year territory-wide retrospective survey of invasive Haemophilus influenzae type b diseases was conducted in Hong Kong. Between 1986 and 1990, 57 cases (28 male) were recorded in children less than 12 years old (37 cases of meningitis, 9 of septicaemia and 11 of bacteraemic pneumonia). The annual incidence for children less than 5 years old was 2.

Sulfated polyanions prevent HIV infection of lymphocytes by disruption of the CD4-gp120 interaction, but do not inhibit monocyte infection.

Sulfated polyanions (SPs) bind variably to lymphocyte-expressed CD4 and inhibit binding of monoclonal antibodies to the first two domains of CD4. To further define this interaction, soluble recombinant CD4 (sCD4; four extracellular domains), its truncated amino-terminal two-domain derivative, and three linear peptide analogues spanning residues 6-60 (6-24, 20-40, 41-60) in the first domain were investigated for SP binding. Dextran sulfate (DXS) (500 kDa), polyvinyl sulfate, fucoidan, and carrageenan-kappa, each immobilized on carboxymethyl cellulose fibers, bound strongly to both the two-domain and four-domain recombinant CD4 molecules (similar to that observed with native CD4), whereas dextran sulfate (5 kDa), chondroitin 6-sulfate, and pentosan sulfate bound relatively poorly.

Screening test for growth hormone deficiency: usefulness of L-dopa-propranolol provocative test.

This is a retrospective review of 185 short children who were tested for growth hormone (GH) secretion using the L-dopa-propranolol provocative test. One hundred and thirty-three children were deemed to have passed the screening test when a GH concentration of greater than 15 miu/L was elicited after stimulation. Fifty-two failed the screening test, of which 33 were diagnosed as having growth hormone deficiency (GHD) when they had inadequate growth hormone response to insulin-induced hypoglycaemia.

Variant of the Triple A syndrome.

The Triple A syndrome is a rare condition comprising achalasia, alacrima and adrenocorticotrophic hormone (ACTH) insensitivity. A 12 year old Chinese girl with a variant of this syndrome (achalasia and alacrima), presenting with failure to thrive, is reported. Typical appearances of achalasia on barium swallow subsequently led to the correct diagnosis.

On the dynamics of the growth process.

Recent publications have provided evidence that the short-term growth process may be regarded as pulsatile rather than constant over time. The possible influence of changes in soft tissue thickness is one reason why it is not possible to draw any final conclusion about the existence or not of such a pulsatile short-term growth pattern. An answer can probably not be reached until a method has been developed that measures longitudinal bone growth without any soft tissue involvement, especially since such a method has recently been used in the rabbit showing that the day-to-day growth rate was linear or continuous.

Non-operative management of gastric perforation secondary to cardiopulmonary resuscitation.

We report the case of a 72-year-old male who suffered a cardiac arrest during an early positive treadmill stress test. After successful resuscitation the patient had evidence of a gastric perforation. Because of his hemodynamic stability, lack of peritoneal signs, and prohibitively high surgical risk, a non-operative management approach was successfully administered.

Undetectable levels of serum FSH immunoactivity and bioactivity in girls with sexual precocity due to ovarian cysts.

Clinical presentation and endocrine investigations in five girls with precocious sexual development due to ovarian cysts are presented. These girls had pubertal oestradiol and suppressed gonadotrophin responsiveness to LHRH stimulation. FSH bioactivity as measured by the rat aromatase assay was undetectable in basal and LHRH-stimulated serum samples but our results cannot exclude the possibility of the presence of a species-specific follicle stimulating factor in these patients.