The development of stool bacterial flora was studied in breast-fed and bottle-fed infants. In both groups of infants, the intestine was first colonized with enterobacteria and their number attained 109 per gram of feces. On day 6, bifidobacteria were the predominant organisms in the stool of breast-fed infants, exceeding enterobacteria by a ratio of 1,000:1, whereas enterobacteria were the predominant organisms in formula-fed infants, exceeding bifidobacteria by approximately 10:1. At 1 month of age, bifidobacteria were the most prevalent organisms in both groups but the number of these organisms in the stool of bottle-fed infants was approximately one tenth that of breast-fed infants. The properties of breast milk that promote the growth of bifidobacteria and suppress the growth of coliform and other potentially pathogenic organisms, theoretically, would help to minimize the incidence of neonatal diseases caused by these organisms. The results would support the advantages of breast-feeding for optimal care of newborn infants.

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ObjectiveTo evaluate the parameters associated with significant gastrointestinal (GI) involvement in Henoch-Schönlein Purpura (HSP), and construct a scoring system for the identification of patients at high risk of gross blood in stools.Study designData for HSP patients hospitalized at each of seven institutes were retrospectively analyzed. Patients were divided into four groups according to the consequent severity of GI involvement. Identification of laboratory parameters at the time of admission were then used to differentiate the groups, and a scoring system to predict gross intestinal bleeding was constructed. Prognostic efficiency, correlation with the subsequent duration of abdominal pain, and association with manifestations excluding abdominal pain were also analyzed.ResultsAn analysis of variance (ANOVA) test showed significant intergroup differences in white blood cell (WBC) count, neutrophil count, serum albumin, potassium, plasma D-dimer and coagulation factor XIII activity. A scoring system consisting of these parameters showed a good prognostic value for gross intestinal bleeding in a receiver operating characteristic (ROC) analysis, and a cut-off value of 4 points showed a sensitivity of 90.0% and specificity of 80.6%. The score was also correlated with the duration of abdominal pain after admission. A significantly higher score (s) was observed in patients presenting with nephritis, although the predictive value was poor.ConclusionA scoring system consisting of generally available parameters was of use in predicting severe GI involvement in HSP patients. Although further study is needed, initial therapy in accordance with disease activity may be taken into consideration using this scoring system.

Protein-losing enteropathy (PLE) is a rare and life-threatening complication that occurs after the Fontan procedure. We herein report the case of an 11-year-old Japanese boy who developed PLE six times after undergoing the Fontan procedure. High-dose spironolactone therapy has been effective for 2 years. His high level of serum aldosterone decreased to a nearly normal range and spironolactone may have a diuretic and anti-inflammatory potential.

1 Background. Disseminated neonatal herpes simplex virus (HSV) infection causes a typical2