Kawasaki disease,or mucocutaneous lymph node syndrome: report of seven cases in North America.

The clinical and laboratory findings in seven children with Kawasaki disease are reviewed. Four of the patients had the more complicated course that has characterized the cases diagnosed in North America. This suggests that the benign forms are often mistaken for other febrile illnesses. The patients were two girls and five boys ranging in age from 4 months to 7 years; six were Caucasian and one was a North American Indian. Fever, redness of the oral mucosa, an erythematous or scarlatiniform rash and cervical adenopathy were seen in all; six patients had the characteristic fingertip desquamation and nonexudative conjunctivitis. Cardiac involvement occurred in four patients, two of whom had coronary artery aneurysm or thrombosis. Arthritis or arthralgia was seen in six patients, and aseptic meningitis occurred in four. Of the three patients with jaundice two underwent laparotomy and excision of a hydropic gallbladder; one of them died from Klebsiella pneumoniae sepsis and disseminated intravascular coagulopathy.     

Attitudes Toward Weight Gain in Pregnancy

Recently, there has been increased interest in the influence of maternal prenatal nutrition on the course and outcome of pregnancy. Evidence has accumulated that a woman''s weight before pregnancy and the weight gained during pregnancy directly affect infant birth weight, incidence of neonatal mortality, and growth and development of the infant during the first year of life. Although recent recommendations for weight gain in pregnancy have been liberalized, a survey of 195 pregnant women who had prenatal visits in both clinic and private offices showed deficiencies in their understanding of the subject. Some 37 percent of women believed they should gain 20 pounds (9 kg) or less during pregnancy. Eight percent admitted to dieting before at least one antenatal visit and 54 percent thought their doctor would not be concerned about too little weight gained during pregnancy. This suggests that many women and some doctors are still ignorant of current concepts of proper nutrition during pregnancy. Apparently, increased lay and professional educational efforts are needed.     

Reversible steps in the reaction of aldehydes with bacterial luciferase intermediates.

Aliphatic aldehydes of different chain lengths were found to differ in their reaction at 22 °C with the B. harveyi luciferase peroxyflavin intermediate. Although similar quantum yields were obtained in the luciferase reaction with the different chain-length aldehydes, the catalytic turnover rates differed. The kinetics of a reaction utilizing two aldehydes of different chain lengths can thus indicate the degree to which the aldehyde reaction is reversible. By such criteria the reactions of octanal and decanal were found to be readily reversible, while that of dodecanal was not. This conclusion was supported both by the effects of long-chain alcohols, which are competitive inhibitors, and by the secondary addition of hydroxylamine, an aldehyde trapping agent. The results are consistent with a model in which there are many intermediates along the reaction path. Since the reactions are monitored by decay of luminescence intensity, it is difficult to determine the position of the rate-determining step. For octanal and decanal the rate-limiting step could be at an early reversible stage of the reaction, but later for dodecanal, subsequent to a less reversible step, but still prior to the final irreversible step which populates the excited state.     

An ELISA for detection of apoptosis.

We describe a simple and convenient enzyme-linked immunosorbent assay (ELISA) for the detection of apoptosis in tissue culture. An early event in apoptosis is DNA fragmentation followed by release of nucleosomes into the cytoplasm. Our sandwich assay uses a pair of monoclonal antibodies specific for two nucleosomal epitopes to capture and detect cytoplasmic nucleosomes onto the ELISA plate. Our assay is about 500 times more sensitive than the detection of apoptotic DNA ladder by agarose electrophoresis and is especially suited for the testing of large numbers of samples.