From 1976 to 1998 we have treated 17 neonates with short-bowel syndrome. Those 8 patients who had an intact ileocecal valve as well as the total colon preserved did significantly better than the 9 children without ileocecal valve and > 50% missing colon. In addition to the length of the intestinal remnants, motility had a major impact on the incidence of complications and final outcome. Four patients died (23.5%). All of them had an intestinal length of less than 30 cm, severe dysmotility, no ileocecal valve and an incomplete colon. The average duration of hospitalization of the children weaned from parenteral nutrition (n = 11) was 8.5 months. The majority of them still need supplementation of vitamins and/or trace elements. Two children suffer from recurrent d-lactic acidemia. Six children have a significant psychomotor developmental delay with three suffering from congenital cerebral abnormalities.
Chronic ulnar nerve subluxation out of its sulcus in the elbow region may be a rare reason for undefined chronic disorders in the medial elbow aspect. We present two cases, a 38-year-old male patient complaining of a recurrent painful disorder including paresthesia of the 4th and 5th fingers and a 12-year-old boy presenting with a palpable band in the medial elbow region without pain. Ultrasonography was performed using a high frequency linear probe in the longitudinal and horizontal planes including dynamic examination. In both patients, the ulnar nerve was completely identified, both in the transverse and longitudinal planes. The sonomorphology and echogeneity of the nerve were the same as in the contralateral limb. Ulnar nerve subluxation was diagnosed in elbow joint flexion, in both cases. It is possible through dynamic ultrasonographic examination to diagnose and document ulnar nerve subluxation for further (surgical) treatment.
In a retrospective study the records of 447 boys (median age 5 y, age range 2 wk to 12 y) undergoing orchidopexy in a university hospital paediatric surgical department over a 2-y period were analysed for epidemiological factors related to disturbed testicular descent by comparison with the notes of an equal number of otherwise healthy male trauma patients matched for age. There were higher rates of peripartal asphyxia and intrauterine growth retardation (reflected by lower birthweights in combination with equal gestational age distribution), more complicated deliveries, an increased incidence of congenital malformations and more frequent occurrence of a number of chronic diseases in the families of affected boys. First- and second-born boys were over-represented in the study group. A cyclical pattern for the month of birth is suggested by the data, but this did not reach statistical significance. Neither was any statistical difference found for premature delivery, the incidence of extra-uterine fertilization, hormonal treatment of the mother while pregnant, twin pregnancies, threatened or imminent abortions or parental age. The literature dealing with this topic was reviewed. Discrepancies between different studies can be explained, at least in part, by considering different forms of undescended testicles as different nosological entities that should be assessed separately in forthcoming research.
Mobilization of the anterior urethra for correction of distal hypospadias with or without chordee is highly successful, less extensive, and provides an excellent cosmetic and functional result with a minimal risk of complication. Uroflowmetry is a noninvasive, objective diagnostic tool for evaluating the functional results of hypospadias repair.
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