Okayama Igakkai Zasshi (Journal of Okayama Medical Association)

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　To elucidate the development of reading and writing abilities among Japanese children, we investigated the scores on 13 reading/writing tasks over a 3-year period among children from preschool age (5 to 6 years old) to the second grade of elementary school (7 to 8 years old). Most of 92 subjects (42 girl, 50 boys) completed all 13 tasks. Preschool-age children were given a hiragana naming task (HNT). The five tasks in the first grade were related to reading and writing hiragana, and the seven tasks in the second grade were related to reading and writing both hiragana and kanji. The preschoolers’ median score on the HNT was 38.0 points (max 40.0), and six children had extremely low scores (5-14 points). Twenty-three children (9 girls, 14 boys) had HNT scores below 32.0 points, and these children also tended to have poor scores on the reading/writing tasks in the first and second grade. The children’s HNT scores showed significantly positive correlations with their scores on the hiragana writing task and the kanji reading/writing tasks. The HNT scores also showed significantly negative correlations with the duration of reading in four reading tasks. These results suggest that evaluations of the HNT score in preschool-age children may be useful to predict the reading/writing abilities of school-age children.

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　Chylothorax is a condition in which chyle leaks into the thoracic cavity. The causes of chylothorax can be nontraumatic, traumatic or idiopathic. The most common cause of nontraumatic chylothorax is obstruction of the thoracic duct by tumor. Traumatic chylothorax is caused by disruption of the thoracic duct, most often due to cardiac surgery or a thoracic surgical procedure, although in rare cases by cough or vomiting. We report the case of a 3-month-old boy with respiratory syncytial (RS) virus infection who presented with right chylothorax. No obstructive tumor mass was identified in the thoracic duct. Clinical symptoms of Noonan syndrome and Down syndrome, which often accompany lymphatic anomaly, were not found. Therefore, we speculate that his severe cough caused a high thoracic pressure and a disruption of the thoracic duct. He was treated by thoracocentesis and MCT milk. One month later, pleural effusion disappeared and did not recur. RS virus infection might be a rare cause of chylothorax in infants.

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　An 86-year-old man was admitted to another hospital with ataxia and general fatigue. Brain MRI scan revealed a high-intensity area in the bilateral thalamus, and he was referred to Okayama University Hospital for detailed examination. Cerebrospinal fluid (CSF) and blood tests showed no evidence of infection or autoimmune encephalitis. An FDG-PET/CT scan revealed systemic lymphadenopathy, and cervical lymph node biopsy showed classical Hodgkin lymphoma. Neurological symptoms were suspicious of paraneoplastic neurological syndrome (PNS), but onco-neural antibodies were not detected in either serum or CSF. He was referred to our hospital, Okayama Red Cross Hospital, for treatment and administered 6 cycles of an ABVD regimen, and an FDG-PET/CT scan showed a complete remission. The brain lesion disappeared and neurological symptoms were improved, so he was diagnosed with PNS. PNS is rare complication associated with malignant lymphoma and early diagnosis is important because neurological symptoms can be improved with anti-cancer treatment.

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