Since 1974, 56 children with a neuropathic bladder were selected for intermittent or indwelling catheterisation. Indications for catheterisation included incontinence, hydronephrosis, and/or difficulty with bladder expression. Good results were obtained in 70% of girls and 50% of boys. The catheter was abandoned in 7 children, mainly because of lack of cooperation from the parents. Deterioration occurred only in those children with both hydronephrosis and vesico-ureteric reflux prior to catheterisation. Of the latter group of children, 33% suffered upper tract deterioration, and we now consider vesico-ureteric reflux to be a relative contra-indication to catheterisation, except in those children with severe disabilities and deformities, in whom antireflux surgery or urinary diversion would be unacceptable or technically difficult. Indwelling penile catheters should not be recommended for boys, but catheterisation via a perineal urethrostomy may prove helpful in those unable either to catheterise themselves intermittently or to wear a penile appliance.

Adolescent↗

PubMed1982

The employment of diabetics.

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Attitude to Health↗

PubMed1982

Can future type I diabetes be predicted? A study in families of affected children.

This article examines the risk of type I (insulin-dependent) diabetes in siblings of affected children, in relation to HLA genotypes. The 288 available siblings of 160 diabetic probands were grouped according to the number of HLA haplotypes in common with their probands. HLA-identical siblings (both haplotypes in common) have an approximately 100 times greater risk of developing the disease than that in the general population, and this risk is significantly higher than that in haplo-identical siblings (one haplotype in common) P = 0.008). Thus, in Northern European populations, some 30% of HLA-identical siblings are expected to be diabetic by the age of 30 yr. The risk in nonidentical siblings (neither haplotype in common) is not significantly increased. These findings carry implications for genetic counseling and research.

Adolescent↗

PubMed1981

Biliary atresia: lessons from Japan.

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Age Factors↗

PubMed1981

HLA-Bw35 and prognosis in adult Still's disease.

Twenty-five patients with adult Still's disease were studied to determine clinical course and possible HLA associations. Two types of disease evolution were distinguishable clinically: a self-limited remitting disease with or without recurrent cyclic exacerbations was found in 11 patients, and a persistent disease with continuous activity for more than 1 year, generally accompanied by progressive joint disease, was determined in 8. Disease course could not be classified in 6 patients. The antigen frequencies of HLA-Bw35 (40%, P less than 0.05) and Cw4 (44%, P less than 0.05) were increased in adult Still's disease as compared to controls (18% and 20%, respectively). Because HLA-Bw35 was associated with self-limited remitting type disease (P less than 0.02), this antigen may be a favorable prognostic marker in adult Still's disease.

Adolescent↗

PubMed1981

Congenital neuroblastoma, neuroblastoma in situ, and the normal fetal development of the adrenal.

In normal fetal development nodular collections of neuroblast cells were found in the adrenal glands from 7 wk gestation; there nodules increased in size and number, and in all specimens from fetuses of 14-18 wk gestation, aggregates of nodules closely resembling neuroblastoma in situ could be found. From about 12 wk gestation the large neuroblast nodules appear to split into smaller nodules and differentiation into chromaffin cells takes place. The mean nuclear size of neuroblasts at all stages of development studied was 4.25 +/- 0.84 mu, statistically significantly less than the mean nuclear size of the cells measured in 7 neonatal neuroblastomas. Measurement of nuclear size may be a way of distinguishing a true potentially malignant neuroblastoma in situ from a normal benign residual neuroblast nodule.

Adrenal Gland Neoplasms↗

PubMed1981

Human fetal development of the hepato-pancreatic duct junction--a possible explanation of congenital dilatation of the biliary tract.

Review of 20 cases of congenital dilatation of the common bile duct in childhood showed an association with anomalous choledocho-pancreatic junction in 8. Study of human fetuses showed that the choledocho-pancreatic junction was outside the wall of the duodenum before 8 wk gestation and moved inward and towards the duodenal lumen as age advanced. Arrest of this migration can explain the formation of the anomalous junction. Normal formation of the sphincter of Oddi may also be affected by this process, and lead to functional obstruction and dilatation of the common bile duct.

Adolescent↗

PubMed1981