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When using testosterone ointment as a treatment for microphallus, it should be borne in mind that this application has systemic effects.

International and Japanese guidelines classify childhood asthma as mild, moderate, or severe, and recommend treatment with "as needed" bronchodilators, inhaled sodium cromoglycate, and inhaled corticosteroids, respectively. Alternatively, some investigators proposed inhaled corticosteroids as first-line therapy to prevent airway inflammatory obstruction. This article describes a clinical study assessing the effect of early intervention with inhaled sodium cromoglycate in childhood asthma. This was a retrospective study of 189 asthmatic children treated with inhaled sodium cromoglycate for five years and whose age of onset of asthma was six year of age or younger. An end-of-study questionnaire completed the examination. Children administered oral or inhaled corticosteroids simultaneously with sodium cromoglycate, were excluded. Asthma scores as defined by the Japanese Pediatric Allergic Committee, were reduced continuously during the five years after the start of sodium cromoglycate treatment. The frequency of emergency department visits and hospitalizations also decreased. Significant between-period intervention differences showed improvement of clinical outcomes for children with severe asthma during the five years of sodium cromoglycate inhalation. The early intervention regime of starting sodium cromoglycate inhalation within two years of the onset of asthma shows a large improvement in the long-term prognosis of childhood asthma, especially for children with severe asthma. It is possible that starting inhaled sodium cromoglycate earlier than the present recommendation of corticosteroids could further improve clinical outcomes, but a prospective study should be performed to verify our results.

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Atherosclerosis begins in childhood. Protection from atherosclerosis is provided by high-density lipoprotein (HDL), a heterogeneous particle, which includes several subclasses differing in size, density and apolipoprotein content. The objective of this study was to document the relevance of assessing HDL particle size as another feature of dyslipidemia related to the develpment of atheosclerosis during childhood. For that purpose, HDL particle size in 268 community-based children (137 boys and 131 girls), 7–13 years old, was measured by gradient gel electrophoresis, and relationships of HDL particle size to plasma lipids parameters and the anthropometric indices were analyzed. There was no gender difference in HDL particle diameter. The results of analysis revealed significant positive correlations between HDL particle diameter and HDL-cholesterol level (r=0.363, p<0.01), apolipoprotein AI level (r=0.310, r<0.05) and low-density lipoprotein particle (LDL) size (r=0.290, p<0.05), while there was an inverse correlation with atherogenic index (r=–0.316, p<0.05). There was no significant correlation between HDL particle size and triglyceride levels in the overall analysis (n=268), however, when this relation was analyzed in the limited HDL size range below 11 nm, a significant inverse relation appeared between particle size and TG levels (r =–0.546, P<0.01, n=75). These findings indicate that the general shift toward smaller HDL particle size was associated with dyslipidemia characterized by higher atherogenic index and triglyceride level, lower HDL-C level and smaller LDL particle size. Therefore, HDL size may represent another relevant marker of atherogenic lipid metabolism.

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Abstract:We reported a case of an infant, who developed acquired subglottic stenosis after endotracheal intubation for relatively short period of 11 days. Tracheotomy and operation to enlarge glottis were performed, and she required long-term hospitalization as long as about 6 months. Despite of intubation for relatively shortperiod, she developed subglottic stenosis, and this may be attributed to the use of an excessively large tube or to tracheal infection.These results suggest that full consideration and care must be given on the possibility of complications even when intubation period may be relatively short and perfom positively laryngeal fiberscopy.