Occult intraspinal anomalies and congenital scoliosis.
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Biomedical subjects
Publications and source records attributed to D G Young.
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The Executive Committee of the B.A.P.S. instituted a collaborative study of patients with thoracic neuroblastoma treated by members in the British Isles. The study covers patients diagnosed in the decade 1970-1979. There is clear evidence of thoracic disease in all patients reported but there is a problem in defining whether the thoracic disease is primary or part of disseminated disease. In 9 of the deaths the thoracic component at presentations seems likely to be part of a generalised disease without definition of a primary site. Overall mortality in this series is 35% indicating the better prognosis of the patients presenting with thoracic neuroblastoma compared to other primary sites. If the 9 patients considered to have generalised disease are excluded then the mortality in this collected series is 22% (10 of 45). The investigations and management are outlined and the complications of therapy are considered.
Of 114 children with oesophageal atresia, 6 had cleft palate and other craniofacial anomalies present included cleft lip, micrognathia, hypertelorism, microcephaly, and hydrocephalus. The difficulties encountered in the management of patients in whom these conditions present together are emphasised with special reference to swallowing problems and recurrent chest aspiration.
The growth of Rio Grande (RG) virus, the only phlebovirus known to occur in the United States, was studied in Lutzomyia anthophora, its suspected sand fly vector. RG viral titers in infected flies increased more than 10,000-fold within 7 days after intrathoracic inoculation. Experimentally infected female L. anthophora transmitted virus transovarially (vertically) to 54.8% of their F1 progeny. This is the first virologically confirmed demonstration of transovarial transmission of a phlebovirus by sand flies. It indicates one mechanism by which RG and possibly other phleboviruses may be maintained in nature.
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A review of 53 patients with 60 duplications of the alimentary tract treated at the Royal Hospital for Sick Children, Glasgow, from 1947 to 1978 has been made. This consisted of 19 foregut, 32 midgut and 9 hindgut duplications. The experience with these patients has been recorded and discussed with reference to the literature.
Hydronephrosis secondary to pelvi-ureteric obstruction affecting one hundred children and derived from a 13 year period were reviewed. Particular attention was paid to symptomatology in infancy and childhood, pre-operative investigations and postoperative assessment. Following pyeloplasty the late results assessed clinically, radiologically and renographically were entirely satisfactory. The operative technique varied satisfactory. The operative technique varied according to the nature and severity of the abnormality but dismembered pyeloplasty and nephrostomy and splintage was favoured. Twelve patients with aberrant lower pole vessels had simple hitching of vessels alone with good results. Our experience suggests that the recuperative power of the kidney in the infant is unpredictable and surprising. For this reason a plea is made for extreme conservatism.
110 patients presenting to the Royal Hospital for Sick Children, Glasgow and the Paediatric Unit at Stobhill Hospital, Glasgow in the decade 1971 to 1980 were studied retrospectively. All patients had progressive hydrocephalus but excluded from consideration were patients with neural tube defects such as myelomeningocele and encephalocele. The aetiology, clinical course and outcome have been studied. The mortality was 17.2% in the first year of life and the overall mortality was 28.2%.
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A total of 209 cases of intussusception treated at the Royal Hospital for Sick Children, Glasgow, in the past decade has been reviewed. The results are compared with similar reports for the two preceding decades from the same hospital. The mortality rate has fallen; there were 5 deaths in this series, 2 of these deaths occurring some months after the presentation with intussusception and death being caused by dissemination of lymphosarcoma. The continuing delay in diagnosis is apparent.
In a retrospective study carried out at the Royal Hospital for Sick Children, Glasgow, for the period 1952-79, 7 cases of primary thoracic neuroblastoma were identified. The average age at presentation was 2 years. Respiratory symptoms were the modes of presentation in 2 patients, neurological symptoms in 4, and urinary tract symptoms in 1 patient. Dilatation of the urinary tract was present in 2 cases, and a third had a normal urinary tract but previous infections. After a maximum of 27 years and a minimum of 20 months, 5 of the patients remain well. One child died as a direct result of her tumour, the other from an unrelated tumour 25 years after partial excision of his neuroblastoma. The better prognosis of primary thoracic neuroblastoma and the variability of presentation compared with neuroblastoma in other sites are stressed.
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