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Biomedical subjects

N M Bax

Publications and source records attributed to N M Bax.

At least 55 records · Page 3Linked to original sources
PubMed1995

Laparoscopic Thal fundoplication in severely scoliotic children.

Surgical treatment of gastroesophageal reflux in severely scoliotic children can be quite bothersome because sometimes the working space between the subcostal margins, iliac crest, and spinal column is very limited; the hiatus lies extremely deep away and is frequently rotated, making exposure more difficult. The laparoscopic approach could lend the necessary extension to the surgeons' hands to reach the deep hiatus. Moreover the entrance of the ports can be adjusted to the special requirements dictated by the scoliosis. Between February and December 1994 laparoscopic Thal fundoplication was performed in five severely scoliotic children; four also had a feeding gastrostomy. There were no intraoperative complications. The laparoscopic approach allowed improved operative visibility. Mean hospital stay was 3 days. The children displayed no symptomatic postoperative gastroesophageal reflux, which was confirmed by 3 months postoperative pH study. The laparoscopic approach of fundoplication allows improved visibility and easier access to the hiatus in severely scoliotic patients in comparison to the open approach. Results so far are good.

Child↗
PubMed1995

Are infantile myofibromatosis, congenital fibrosarcoma and congenital haemangiopericytoma histogenetically related?

Infantile myofibromatosis, congenital fibrosarcoma and congenital/infantile haemangiopericytoma are generally considered distinct entities. Overlapping microscopic features between infantile myofibromatosis and congenital fibrosarcoma, and between infantile myofibromatosis and congenital/infantile haemangiopericytoma, however, have been noted, but not formally reported. This report concerns six neonatal tumours, each exhibiting more than one of the above patterns, supporting a histogenetic relationship among these entities. Immunohistochemistry for smooth muscle actin was found to be useful in the diagnosis of congenital/infantile haemangiopericytoma, and also served to support a histogenetic relationship with the other two entities under consideration.

Actins↗
PubMed1995

Spine evaluation in children with anorectal malformations.

The value of radiography, ultrasound and magnetic resonance imaging (MRI) in detecting skeletal and intraspinal pathology was assessed in infants with anorectal malformations, and the need for spinal MRI examination in this group of patients was evaluated. Twenty-one infants were examined with radiography, ultrasound and MRI of the lower spine. The detection of skeletal and intraspinal abnormalities was compared for the three imaging modalities. Fifteen patients were normal in all three examinations. Radiography showed bony skeletal abnormalities in six children, although sometimes very subtle. By ultrasound both bony and cartilaginous malformations were detected in all six patients and by MRI in five patients. Five of the six children with skeletal abnormalities had intraspinal pathology, detected in all cases by ultrasound and MRI. However, the abnormalities were more clearly demonstrated by MRI than by ultrasound. Spinal radiographs must be examined carefully for abnormalities, because they can indicate the presence or absence of intraspinal pathology. Normal radiographic and sonographic appearance of spinal anatomy in children with anorectal malformation makes MRI superfluous, but if radiographs or ultrasound are abnormal, MRI should be used to accurately depict possible intraspinal pathology.

Abnormalities, Multiple↗
PubMed1994

A method for sonographic counting of the lower vertebral bodies in newborns and infants.

PURPOSE: To determine whether the lumbosacral junction of the vertebral column can be identified with sonography in newborns and infants and thus serve as a method for counting the lumbar and sacral vertebral bodies. METHODS: In 32 newborns and infants, the number of ossified vertebral bodies distal to the lumbosacral junction was counted with sonography and radiography. RESULTS: Sonographic and radiographic findings agreed in 29 of 32 examinations (91%). CONCLUSIONS: The lordotic transition at the lumbosacral junction can be identified with sonography in the majority of newborns and infants, allowing intraspinal structures to be related to a specific vertebral level.

Female↗
PubMed1993

Treatment of giant omphalocele by enlargement of the abdominal cavity with a tissue expander.

Even in the absence of major associated anomalies, treatment of giant omphaloceles is difficult primarily because of the disproportion between the large volume of the omphalocele and the small volume of the intraabdominal cavity. The case of a child is presented in whom conservative treatment had to be abandoned. Reduction of the omphalocele contents and closure of the defect was successfully accomplished after a 19-day period of enlargement of the abdominal cavity by means of an intra-abdominally placed tissue expander.

Abdomen↗
PubMed1993

[Anatomic anomalies in neonatal cholestatic jaundice].

Disorders of the biliary tree are an important cause of cholestatic jaundice in infancy. For the most frequent diseases in this group, biliary atresia and choledochal cyst, prognosis is strongly dependent on timely diagnosis and treatment. In biliary atresia the bile flow is obstructed due to obliteration of the extrahepatic bile ducts. Construction of an hepatic portoenterostomy before 60 days of age will result in restoration of bile flow in the vast majority of patients. When failed, the disease is progressive and ultimately fatal, unless a liver transplantation is performed. For those patients in which restoration of the bile flow succeeds, the subsequent course is strongly dependent on the occurrence of cholangitis. For all patients fat-soluble vitamins should be supplemented and caloric intake should be carefully monitored. Presentation of a choledochal cyst can be either before or after the first year of life. It is mostly characterized by jaundice, with or without abdominal pain. Therapy consists of resection of the cyst, followed by a hepatico-jejunostomy. Paucity of bile ducts is an intrahepatic disorder, in which--almost--no bile ducts can be found in the portal tracts. This anomaly is frequently found in combination with a typical facies, a pulmonary stenosis and vertebral anomalies, a combination which is called Alagille syndrome. Prognosis is generally good.

Alagille Syndrome↗
PubMed1992

Sonographic findings in spontaneous renal transplant rupture.

A post-transplant kidney became acutely swollen during a rejection episode. The hemoglobin level and pulsitility index fell. Sonographic examination demonstrated extrarenal and subcapsular collections due to spontaneous renal transplant rupture.

Adolescent↗
PubMed1991

Aortic aneurysm in a 5-year-old boy with tuberous sclerosis.

A 5-year-old boy known to have tuberous sclerosis was admitted with an abdominal aortic aneurysm. The aneurysm was resected and replaced by a bifurcation prosthesis. Follow-up, which amounts up to 4 years, has been uneventful. Prompt recognition and surgical treatment are essential in the management of this rare but potentially lethal condition.

Aorta, Abdominal↗
PubMed1991

Scrotal pneumatocele: a rare phenomenon.

In contrast to what would be expected in newborns with pneumoperitoneum, pneumoscrotum is a rare phenomenon. A newborn who presented with a pneumoscrotum as first, overt, sign of pneumoperitoneum is described. A perforated Meckel's diverticulum was responsible for the airleak.

Air↗
PubMed1990

[Non-tuberculous mycobacterial lymphadenitis].

Twenty-two children (1-12 years old) with cervical lymphadenitis caused by non-tuberculous mycobacteria (NTM) are described. Skin tests revealed the causative agent in 20 out of 22 cases. Mycobacterium avium was cultured in 12 cases, 7 cultures remained negative. Treatment should consist of primary excision of the infected lymph node. If this is impossible puncture, incision, drainage and curettage should be applied. Antituberculous drugs should only be prescribed in case of systemic NTM infection or prolonged ulceration.

Antitubercular Agents↗
PubMed1990

Premature thelarche: a possible adverse effect of cimetidine treatment.

An 18-month-old girl is reported in whom marked unilateral breast enlargement occurred after 4 weeks of cimetidine therapy. After withdrawal of the drug the enlargement rapidly disappeared. This observation points to cimetidine as a possible cause of premature thelarche. Cimetidine, a selective H2 receptor blocking agent, is known to cause gynaecomastia in males. This effect seems related to elevated plasma oestrogens, gonadotropins, or to binding of the drug to androgen receptors. Ranitidine, a much more potent selective H2 receptor blocker, does not cause gynaecomastia and seems therefore preferable to cimetidine.

Breast↗
PubMed1989

Prognosis of extrahepatic biliary atresia.

We carried out a retrospective investigation of the 89 patients with extrahepatic biliary atresia born in The Netherlands during a 10 year period. Of these 89 patients 10 had a diagnostic laparotomy only. Eight patients had an anastomosis between the proximal bile duct and the intestine, and the remaining 71 had hepatic portoenterostomies. Bile drainage was re-established in 46 (65%). After successful hepatic portoenterostomy the development of cholangitis was the most important determinant of long term survival; five year survival was 54% in the 19 patients who had cholangitis and 91% in the 27 who did not. In the whole group of 71 patients the five year survival was 47%. Seventeen patients were at least 5 years of age at the time of writing, three of whom had had liver transplantation. Three patients have cirrhosis and hyperbilirubinaemia, and the other 11 have normal bilirubin concentrations and normal or slightly raised transaminase activities. To improve these results early surgical intervention in all children with extrahepatic biliary atresia is necessary, as are better methods of prophylaxis and treatment of cholangitis.

Anastomosis, Surgical↗