Effects of tonsillectomy in children with IgA nephropathy, purpura nephritis, or other chronic glomerulonephritides.

This report focuses on the effects of tonsillectomy on the improvement of renal function in children with IgA nephropathy, purpura nephritis, or other chronic glomerulonephritis. Tonsillectomies were done on 21 patients, 3 to 13 years of age, who had been diagnosed as one of these nephritides by renal biopsy findings (operation group). Eighteen age-matched controls who also underwent renal biopsy received medication only (non-operation group). For the evaluation of renal function we performed urinalysis for red blood cell count and protein content before and 1 year after surgery in the operation group, and at the first visit to our clinic and 1 year after the medical treatment in the non-operation group. In the operation group, 5 of the 8 cases with IgA nephropathy showed a decrease in both hematuria and the level of proteinuria. Three of 5 with purpura nephritis and 5 of 8 with other glomerulonephritis showed the same results. In the non-operation group, those showing improvement in both hematuria and proteinuria were 1 of 7 patients with IgA nephropathy, 3 of 6 with purpura nephritis, and 1 of 5 with other glomerulonephritis. The results suggest that tonsillectomy may deserve more attention as a treatment modality for nephritis; new indications for the procedure need to be established.

Effect of tonsillectomy and adenoidectomy on obese children with sleep-associated breathing disorders.

In children and adolescents there have been only few reports dealing with Obstructive Sleep Apnea (OSA) associated with morbid obesity. We report here on sleep-associated breathing disorders in morbidly obese children and the effect of adenoidectomy and tonsillectomy on sleep-associated breathing disorders. The subjects were 31 children with morbid obesity. The mean patient age was 7.9 years ranging from 2 to 14 years. The percentage of expected body weight ranged from 130% to 260%. All of them had adeno-tonsillar hypertrophy. We undertook the study during the period of natural sleep. Percentage of sleeping period with irregular breathing was determined by means of respisomnogram and the percentage of sleeping period with SpO(2) > or = 90% with a pulse oximeter. The percentage of sleeping period with irregular breathing ranged from 10% to 85% before the operation. In all cases, the irregular breathing period decreased almost to zero after the adenoidectomy and tonsillectomy. The percentage of sleeping period with SpO(2) > or = 90% ranged from 1.7% to 95%. The percentage was related to reduction of body weight and it increased gradually as a result of a diet given as therapy. Our studies reveal that weight control may result in partial cure of sleep-associated breathing disorders. Operations, such as adenoidectomy and tonsillectomy, were remarkably effective in treating sleep-associated breathing disorders of severely obese children with large adenoids and tonsils, even if the severe obesity remained.

Treatment for B-cell-type lymphoma in a girl associated with Bloom's syndrome.

A 12-year-old girl suffering from Bloom's syndrome developed B-cell-type lymphoma in the epipharynx. She was identified as having Bloom's syndrome at the age of 3. While the tumor was eradicated completely by induction chemotherapy, the bone marrow suppression was severe and persistent. For this reason, we modified subsequent chemotherapy to a milder form. Thus the remaining therapy could be safely completed. This is the first case clearly diagnosed as having epipharyngeal B-cell-type lymphoma in the Bloom's Syndrome Registry.

Binding of ouabain to Na+, K+-dependent ATPase during the ATPase reaction. Evidence for a dimer structure of the ATPase.

Na+, K+-dependent ATPase [EC 3.6.1.3] was purified from porcine kidney by the method of Lane et al. [(1973) J. Biol. Chem. 248, 7197-7200] with slight modifications [Yamaguchi, M. & Tonomura, Y., (1979) J. Biochem. 86, 509-523]. The amounts of a phosphorylated intermediate (EP) and ouabain bound to the enzyme during the ATPase reaction were measured in 2.1 mM MgCl2 and various concentrations of NaCl and KCl at pH 7.5 and 20 degrees C. In presence of NaCl and the absence of KCl, the molar ratio of the amounts of EP and bound ouabain was 1 : 2. In the presence of both NaCl and KCl, it was 1 : 1. In both cases, the amount of bound ouabain was equal to that of EP in the absence of ouabain. These findings suggest that the functional unit of the transport ATPase is a dimer.