The role of parenting sensitivity, infant temperament, and dyadic interaction in attachment theory and assessment.
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Female↗
Biomedical subjects
M Schiller
Publications and source records attributed to M Schiller.
[Surgical treatment of choledochal cyst].
Our experience with 11 cases of cystic dilation of the biliary tract is reported. 10 children with choledochal cyst were treated by cystduodenostomy (5 cases) and excision of the cyst with hepaticojejunostomy (5 cases). 1 patient who presented with Caroli's disease was not operated. At long term follow-up, all patients except 1 are asymptomatic. A 16-year-old girl who presented with acute pancreatitis 13 years following cystduodenostomy, early in our experience, underwent excision of the choledochal cyst and hepaticojejunostomy, with uneventful postoperative course. We conclude that in the era of modern imaging, accurate preoperative diagnosis may contribute to better planning and outcome of the surgical treatment of these relatively rare congenital biliary anomalies.
Adolescent↗
Hemophilia growth and development study: baseline neurodevelopmental findings.
Reported baseline findings from the neurological assessment component of the Hemophilia Growth and Development Study (HGDS). HIV-positive (HIV+; n = 207) and HIV-negative (HIV-; n = 126) young males with hemophilia ages 6 to 18 years, were enrolled in a prospective study of their growth and development. At baseline, HIV+ and HIV- subjects were not significantly different in test performance. The number of subjects exhibiting below-average performance in three or more areas assessed was about 25% overall. For both groups, mean test scores were within the average range. Academic and adaptive skills were lower than expected based on mean IQ scores, and more behavioral/emotional problems than expected were reported by parents. Absolute CD4 cell counts per mm3 were not related to neuropsychological performance at baseline. Results suggest that the subjects with HIV were relatively free of HIV-related neuropsychological impairment at baseline and that observed differences from a general population reflect effects of hemophilia as a chronic illness.
Adolescent↗
[Retinal photocoagulation with a pulsed, frequency-doubled Nd:YAG laser (532 nm)].
The small difference in wavelength between an argon laser (514 nm) and a frequency-doubled Nd:YAG laser (532 nm), together with the advantage of the solid-state technology, makes the Nd:YAG laser likely to play a major role in retinal photocoagulation in the near future. For technical reasons all frequency-doubled Nd:YAG lasers work in a quasi-continuous mode, emitting a burst of highly repetitive short laser pulses during the exposure time desired. We investigated the side effects due to high peak irradiances of those short laser pulse trains (Crystal Focus Nd:YAG laser, Emerald; pulse duration 1-10 microseconds, repetition rate 13 KHz) in rabbits in comparison with a standard argon laser system (Zeiss, Visulas, Argon II). The energy necessary for blanching the retina was similar in both cases. As opposed to the argon laser system, subretinal bubbles were regularly visible ophthalmoscopically with the Nd:YAG system, when average powers as high as 200 mW were used. The ED50 power for bubble formation is about 2-3 times above the ED50 power for blanching. Thermal calculations show that this bubble formation effect is likely to be related to the peak power of the short pulses. The hemorrhage threshold is similar in both systems. However, light microscopically there is no difference between the two laser systems. Panretinal photocoagulation (300-500 microns, 100-200 ms) in patients with proliferative diabetic retinopathy produced such bubbles about once per 1000 lesions.
Animals↗
[Nonoperative treatment of pancreatic pseudocyst in children].
3 children with pseudocyst of the pancreas resulting from blunt abdominal trauma are described (boys 6 and 8.5 years old, and a 6.5-year-old girl). Based on abdominal ultrasound and CT findings, nonoperative treatment was elected. There was spontaneous resolution in 1 and in the other 2 the pseudocyst was successfully drained. Previous reports and our own results indicate that it is safe to treat pancreatic pseudocysts in children after blunt abdominal trauma.
Abdominal Injuries↗
Renal trauma with posttraumatic hypertension in a neonate.
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Female↗
Giant cystic hygroma associated with venous aneurysm.
Complete excision of giant cystic hygroma requires meticulous dissection of the multilocular lymphatic cysts from the adjacent vascular and neural structures. The association of venous aneurysms with cystic hygroma is extremely rare. We report two infants with cystic hygroma in whom preoperative diagnosis of venous aneurysm was helpful in planning complete excision of the lymphatic lesions.
Aneurysm↗
Sarcoma botryoides of the common bile duct: preoperative diagnosis by coronal CT and PTC.
Sarcoma botryoides of the extrahepatic bile ducts is a rare cause of obstructive jaundice in the pediatric population. It is rarely diagnosed preoperatively. We present a case of this tumor which was diagnosed by ultrasound, computerised tomography and PTC. Coronal CT sections were particularly useful in demonstrating the relationship of the tumor to the porta hepatis, pancreas and duodenum.
Child, Preschool↗
Familial Hirschsprung's disease--a report of 22 affected siblings in four families.
Twenty-two infants, belonging to four families from Gaza, presenting with typical features of Hirschsprung's disease are reported. Eight patients died at home shortly after birth, prior to 1974, due to low intestinal obstruction. Fourteen patients were referred to Hadassah University Hospital after 1974 and diagnosed, by rectal biopsy, as having Hirschsprung's disease. Thirteen underwent laparotomy and multiple intestinal biopsies. Ten had total intestinal aganglionosis, two had total or near total aganglionosis, and in only one patient was the common rectosigmoid aganglionosis found. One patient died prior to surgery. This unusual familial disease, involving very long aganglionic segments, raises the possibility that these infants suffered from a unique variant of Hirschsprung's disease.
Family↗
Primary Burkitt's lymphoma of the appendix.
Appendicitis is a very rare presenting symptom of abdominal Burkitt's lymphoma. Only four cases have previously been identified in the literature, all of them males. This is the first reported case of a female as well as the youngest and is representative of the therapeutic considerations in this unusual manifestation of the disease.
Abdomen, Acute↗
Dysphagia in a child with aggressive fibromatosis of the esophagus.
A case of a girl who developed severe dysphagia from an aggressive fibromatosis involving the cervical esophagus is reported. A 3 x 4 cm unencapsulated fibrous tumor was completely excised with the involved esophageal wall. The esophageal defect was bridged by an inverted skin tube with good functional and cosmetic results. Eight years later the patient is disease-free. Primary radical excision is the treatment of choice of aggressive fibromatosis.
Child, Preschool↗
Elevation by atrial natriuretic factors of cyclic GMP levels in astroglia-rich cultures from murine brain.
Atrial natriuretic factors, peptide hormones originally found in the heart, slowly but strongly elevate the level of cyclic GMP in primary astrocyte-rich cultures derived from brains of newborn rats or mice but not in neuron-rich cultures prepared from embryonic rat brain. In the absence of a phosphodiesterase inhibitor, a plateau level of cyclic GMP is obtained within 10 min. In the presence of the inhibitor 3-isobutyl-1-methylxanthine, the concentration of cyclic GMP continues to rise, even after 30 min. The elevation of the level of cyclic GMP in response to atrial natriuretic factor is much more pronounced in the rat cultures than the mouse cultures. Even at peptide concentrations of 1 microM, plateaus of the concentration-response curves are not yet reached. The potencies of the active peptides vary over a range of approximately 1.5 orders of magnitude, with atriopeptins II and III and auriculin A being the most potent ones. These results suggest (a) that atrial natriuretic factors may regulate functions of glial cells, most likely of astrocytes, in brain and (b) that such cultures may be useful tools in defining such astroglial functions.
1-Methyl-3-isobutylxanthine↗
Congenital angiodysplasia of the superficial venous system of the lower extremities in children.
Congenital angiodysplasia of the superficial venous system (SVS) of the lower extremities was diagnosed in 24 children 3-15 years of age. Nine patients presented with painful swelling in the affected limb. Venectasia and spongy venous masses were the main morphologic changes in the current series. Selective ascending functional phlebography and superficial phlebography were used to assess the anatomic extension of the lesions and to evaluate the functional status of the involved extremity: 14 patients had only SVS angiodysplasia, in 10 patients additional pathologic features of the deep veins (DV) were found. Venous reflux was demonstrated in 16 patients and significant venous insufficiency was detected in five patients. The patients were classified into three groups according to the severity of the disease: mild (11 patients), moderate (8 patients), and severe (5 patients). The prognostic and the long-term outcome of surgical treatment can be predicted by the depth and the extension of the angiodysplastic lesions.
Adolescent↗
Neonatal gastric volvulus secondary to rectal atresia.
The "upside-down stomach" is a rare form of organo-axial neonatal volvulus, which occurs because of absent or attenuated anatomical anchors and abnormal motility of the stomach. It is considered a surgical emergency that requires immediate correction. We report a previously undescribed etiology of gastric neonatal volvulus caused by an extremely distended transverse colon, secondary to rectal atresia. The etiologic and diagnostic considerations are discussed. Gastropexy in the form of gastrostomy proved to be an effective treatment.
Humans↗
Surgical treatment of varicocele in children.
Fifty boys aged 6 to 14 years underwent surgery for left varicocele. Thirty-four patients underwent preoperative retrograde left renal venography and pressure measurements of both renal veins and inferior vena cava. In all patients an intraoperative antegrade renal venography was performed via the internal spermatic vein. The preoperative venographic studies revealed renospermatic reflux in all patients examined. The intraoperative studies demonstrated impaired renal venous drainage in 38 patients (Group A) and normal venous return in 12 patients (Group B). Manometric studies revealed increased left renal venous pressure in Group A. In view of these anatomical and functional disorders, our preferred procedure is a retroperitoneal ligation and excision of the left internal spermatic vein. The retroperitoneum was thoroughly explored and all the visible collaterals of the internal spermatic vein ligated. Forty boys were followed for 1 to 5 years; the varicocele was completely resolved in 35 of them. Five patients had recurrent varicocele; recurrence was observed only in patients with increased left renal vein pressure (Group A).
Adolescent↗
[Assessing severity of disease in a pediatric intensive care unit].
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Child↗
Immunoresponses to Neisseria meningitidis epitopes: in vivo analysis of immunocompetent cells involved in suppression of secondary response to phosphorylcholine.
The immune response to phosphorylcholine (PC) antigens has been extensively studied in recent years. Neisseria meningitidis serogroup B M986 (NMB) was recently reported to induce a PC-specific plaque-forming cell (PFC) immuno-response in mice, a characteristic useful for the study of immunomodulating properties of N. meningitidis. With this technique, priming mice with low doses of NMB has been shown greatly to impair their ability, one month after priming, to mount an anti-PC response induced by NMB; this suppression is permanent, does not involve switching from IgM to another immunoglobulin class, transiently affects the T15 idiotype expression and is carrier specific. We report, based on an analysis of spleen cells from NMB-primed mice in an adoptive transfer model, that this suppression does not appear to be mediated by B lymphocytes nor does it seem to be under the direct control of T lymphocytes; rather, it involves radio-resistant cells. Additionally, our results show that NMB modulates the idiotype composition of the anti-phosphorylcholine response, probably by enhancing the expression of so called hapten-augmentable PFC. These results demonstrate that NMB can interfere effectively with the immune response in a variety of ways.
Animals↗
Non-operative management of traumatized spleen in children: the role of open abdominal tap.
Experience with non-operative management of paediatric splenic trauma in 12 children, and current treatment protocol are presented. Splenic injury was confirmed in all instances by scintiscan. Under close observation no evidence of rebleeding was found. In one patient with persistent fever, peritoneal irritation and leukocytosis open abdominal tap was performed in order to eliminate other intra-abdominal injury and conservative treatment continued. Average stay in hospital was 11 days. Patients recovered fully by six weeks and repeat scintiscan at three months were normal in 9 patients and greatly improved in the other three. Most children sustaining splenic injury may be non-operatively managed. In a special subgroup of moderate bleeders open abdominal tap may increase the safety of this approach and reduce the number of superfluous laparotomies to a minimum.
Adolescent↗