Biomedical subjects
Publications and source records attributed to J J De Nef.
We report four cases of acute idiopathic scrotal oedema, an underreported cause of acute painless or moderately painfull swelling and erythema of the scrotum in young boys. It is a self-limiting disease and to prevent unnecessary surgical exploration or antibiotic therapy, it is very important to distinguish acute idiopathic scrotal oedema from more serious diseases.
A previously healthy 1-year-old infant was admitted with pyrexia and mild gastro-intestinal symptoms. A blood culture, taken on admission, showed growth of Listeria monocytogenes (serotype 4b) on the 3rd day, at which time a lumbar puncture revealed a listeric meningitis. Despite the delay of antibiotic treatment, the infant never showed any neurological symptoms. She recuperated without any residual effects.
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Analysis of lower urinary tract function with an extension of standard renography with 123I-hippurate was carried out in 199 children. Maximum bladder capacity, voiding and residual bladder volumes, average and maximum urine flow rates and urine flow patterns were estimated. The index of urine transport (IUT), representing the relationship between urine flow rate and bladder volume, was introduced as a measure of outflow capability. Of 129 children without evidence of outflow obstruction, 90% had a normal urine flow pattern; in 96% the average IUT was 0.8 or higher and in 87% the maximum IUT was 1.2 or higher. A sawtooth-shaped pattern with both normal and abnormal IUT values was observed in 10% of these children. In 63% of the children with outflow tract obstruction there was a low, flat urine flow pattern together with decreased IUT values. A sawtooth-shaped pattern with varying IUT values was observed in 15%, whereas in 20% the urine flow pattern and IUT values were normal. This extension of standard radionuclide renography as a method of screening lower urinary tract function is recommended. It is at least as good as conventional direct urine flow rate recording, it has the advantage of being non-invasive and it is also part of an established urological investigation.
A noninvasive intravenous assessment of lower urinary tract function with 123I-hippurate was carried out in 129 children without suspicion of lower urinary tract outflow pathology. Without increasing the radiation burden standard renography was extended by lower urinary tract function analysis in the same session. The maximum bladder capacity, voiding and residual bladder volumes, average and maximum urine flow rates were calculated and the relation between the urine flow rate and bladder volume expressed as the index of urine transport (IUT). This index seems to be a much more reliable standard than isolated measurements of urine flow rates and bladder volumes in screening lower urinary tract function. Three different urine flow patterns were recognized: a single sharp peak (in 70%) and a biphasic curve (in 20%) were considered to be normal. A sawtooth-shaped pattern, observed in 10% of the children, may be caused by detrusor malfunction. The prolonged time necessary for this more extensive analysis of the lower urinary tract is well compensated by the additional information gained.
The history of a Moroccan girl is described with splenomegaly, lymphadenopathy and pancytopenia after a holiday in her native country. Bone marrow smears were considered negative for Leishmaniasis in four different laboratories. All other diagnostic options could also not be confirmed. Reexamination of the bone marrow smears in a laboratory for tropical diseases revealed Leishmania donovani organisms. Treatment with sodium antimony gluconate was successful. Epidemiology, symptoms and diagnostic problems are discussed.
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A clinical description is given of a syndrome present in three postnatally and two prenatally detected cases with partial trisomy 16p, caused by a familial translocation t(16;21) (p11;q22). The most consistent features of this syndrome are: low birth weight, small head circumference, low-set ears, palato(gnatho)schisis, micrognathia, thumb-agenesis or hypoplasia, hypertonia, overlapping fingers, single umbilical artery, and psychomotor retardation. The clinical picture was identical to that described by Roberts & Duckett (1978) for a single case.
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