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Objectives-To investigate the relation between cranial irradiation received during treatment for childhood leukaemia and obesity at final height. Design-Retrospective cross sectional study. Setting-Paediatric oncology centres at Great Ormond Street Hospital for Children and the Royal Marsden Hospital. Subjects-Survivors of childhood leukaemia who received cranial irradiation, were in continuous first remission, and had reached final height. An unirradiated group of patients from the United Kingdom acute lymphoblastic leukaemia XI trial was also included; these patients were in continuous first remission and had been followed for at least four years from diagnosis. Main outcome measures-Body mass index standard deviation score (BMI z score) at final height for irradiated patients and at most recent follow up for unirradiated patients. Regression analysis was used to examine the eVect on BMI z score of sex, age at diagnosis, and the dose of radiation received. Results-For cranially irradiated patients, an increase in the BMI z score at final height was associated with female sex and lower radiation dose, but not with age at diagnosis. Severe obesity, defined as a BMI z score of > 3 at final height, was only present in girls who received 18-20 Gy irradiation and had a prevalence of 8%. Both male and female unirradiated patients had raised BMI z scores at latest follow up and there was no association with age at diagnosis. Conclusions-These data are further evidence for a sexually dimorphic and dose dependent eVect of radiation on the human brain. (Arch Dis Child 1999;81:500-504)

(DMSA) scans are more sensitive for detecting early renal defects, especially in the under 5 age group,89 and the relative uptake of DMSA can be measured to give an objective measurement of renal function in unilateral damage. The appearance of new defects on subsequent scans is likely to be due to new lesions rather than the contraction of original scars by fibrosis, as shown by excretory urography.We have now carried out second DMSA scans on 45 children who were originally scanned shortly after a first urinary tract infection, and we report the changes. Patients and methodsOver a three year period 115 children under the age of 5 years presented with a symptomatic, microbiologically proved, urinary tract infection. None of the children had a history of previous urinary tract infections or of recurrent fevers of unknown origin. A DMSA scan was performed as part of an investigation protocol that also included intravenous urography and ultrasonography, and micturating cystourethrography in selected patients. The methods and the results have been reported previously.9