[Management of intussusception in infancy and childhood].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to S Nissan.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A case of isolated emphysematous gastritis in a full-term infant, which is the fifth so far in the medical literature, is described. Predisposing factors, mode of treatment, and sequelae differ from the rare adult form of this disease. Of special interest are malnutrition as a predisposing factor in the development of this disease in infants and the very important role of intravenous hyperalimentation in its successful treatment.
A girl with a rare congenital malformation consisting of duplication of the urinary and genital tracts as well as of the entire colon, terminating in double rectogenital fistulas, is presented. Because of a small-capacity urinary bladder on one side and an atonic neurogenic bladder on the other side, urinary diversion was necessary. A preliminary diverting colostomy of the duplicated transverse colon was followed by anoplasty of one anus. Later on, the duplicated proximal colostomy was anastomosed to the one distal colon leading to the rectum with anoplasty. The treatment of this complex anomaly is described.
The rectoanal reflex in the rat consists of relaxation followed by contraction of the internal anal sphincter (IAS). Beta-adrenergic drugs produce prolonged relaxation of the IAS, where alpha-agonists cause brief relaxation followed by contraction. Muscarinic cholinergic drugs contract the IAS. ATP and related purines produce relaxation which is blocked by theophylline. The reflex persists during adregeneric, cholinergic, and purinergic block. The potassium-blocker apamin prevents the relaxation induced by rectal distension. This suggests that the reflex is not mediated by adrenergic, cholinergic, or purinergic transmitters. Blocking potassium conductance was apparently the only way to eliminate this reflex.
An enteric valve to prevent colonic content reflux and to prolong small bowel transit time was created by passing small bowel through a submucosal tunnel in the colon. Barium enema, Gl tract series, and iso- and antiperistaltic pressure measurements showed the valve to be of competence equal to the ileo-cecal valve. Late pathological examination revealed a patent valve with minimal scar formation. The optimal submucosal tunnel length was between 4 and 6 cm. This valve can, theoretically, increase the absorptive capacity in short bowel syndrome and may serve as a substitute for the critically important ileo-cecal valve.
An infant with cricopharyngeal achalasia, recurrent aspiration pneumonia, and severe failure to thrive was fed for 5 months through a nasogastric tube. She responded promptly to dilatations of the spastic cricopharyngeal muscle. Normal oral feedings followed the treatment with progressive weight gain and no further pulmonary complications over a follow-up period of 1 1/2 years. Dilatations were used in the infant described here, in analogy to the well-known success of treatment by dilatations in infants with achalasia of the lower esophagus.
A 13-year-old boy with Sandifer's syndrome whose only symptoms were abnormal posture and movements of the head and neck, underwent a repair of a hiatus hernia. The disappearance of all symptoms following the operation could be explained by the common innervation of the diaphragm and the neck.
A patient with coexistent Hirschsprung's disease and cytomegalovirus infection is presented. The question is raised whether the virus is partially or completely responsible for the disease.
Two neonates with megacystis-microcolon-intestinal hypoperistalsis syndrome are described. Both were boys. The main manifestation was functional obstruction of the urinary and gastrointestinal tracts. While there is no explanation as yet for the aetiology and pathogenesis, the diagnosis is simple, the treatment symptomatic, and the outcome fatal.
Explore the source record for details and available documents.
Volvulus of the splenic flexure is rare. Only 20 cases have been reported. Two additional patients are presented. Both had previous abdominal operations and were correctly diagnosed by barium enema. Resection and anastomosis in the two stages was performed in one patient and unwinding with fixation of the bowel in the other. The literature is reviewed and the pathogenesis discussed.
A patient with nonfunctional paraganglioma situated adjacent to the pancreas is presented. The clinical picture, the laboratory studies, as well as the gross appearance of the tumor and a frozen section at operation were not diagnostic. Internal drainage of the cystic tumor, assumed to be a pseudocyst of the pancreas, was done. Excision was performed when the diagnosis was histologically and ultrastructurally established. The microscopic and the electron microscopic features of this rare neoplasm are discussed. Excision of the tumor is recommended as the treatment of choice because of the malignant potential that does not correlate well with the histological appearance.
Seventy-five percutaneous splenoportographies and splenic pulp pressure measurements were performed in 70 patients. This procedure was done routinely during the preoperative investigation of patients with bleeding esophageal varices. Splenoportagraphy was also performed for evaluation of patients with portal hypertension of an obscure etiology, and for follow-up study after portosystemic shunt procedures, where the spleen had been preserved. There were no complications related to the procedure. Splenoportography is a simple and safe diagnostic tool. The information obtained is important for planning an operation to relieve portal hypertension. It may also help in the postoperative evaluation of the patency of certain types of shunt procedures.
Explore the source record for details and available documents.
The effect of exposure to dexamethasone and serum-deprivation on myofibrillar protease activity was determined by following cleavage of [14C]globin by isolated myofibrils obtained from rat skeletal muscle in culture. Dexamethasone [10(-7) M] produced a 46% increase in protease activity, and serum-deprivation caused a 50% increase in activity over that of the enzyme in control cultures. The increases in proteolysis occurred concurrently with increased rate of overall protein degradation in these cells and were not associated with changes in cell viability. In cultured rat cardiac muscle cells dexamethasone failed to enhance myofibrillar protease activity, while serum-deprivation produced a 52% increase in the enzyme activity. Addition of insulin (50 mU/ml) to the cultures did not affect proteolysis or myofibrillar protease activity, but completely prevented the dexamethasone-induced increase of these activities. This effect of insulin suggests that the increase of muscle proteolysis in insulin-deficient diabetic animals reflects an enhanced response of the muscle to circulating glucocorticoids rather than a direct effect of insulin-deprivation on muscle proteolysis. Taken together, the present observations indicate that muscle cells in culture retain the ability to respond to catabolic stimuli by adaptive changes in the myofibrillar protease activity in a manner analogous to that of their parent tissue in the intact animal.