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Objectives To reduce the incidence of exit-site infection (ESI) a new peritoneal dialysis (PD) catheter, the Swan neck presternal catheter (SNPC), composed of abdominal and presternal parts joined by a titanium connector, with the exit site located on the chest wall, was designed. Design A prospective study was undertaken to estimate the usefulness of the SNPC for continuous ambulatory peritoneal dialysis (CAPD) in children. Setting University Children's Hospital, Medical Academy, Warsaw, Poland. Patients From December 1991 to June 1997, 11 SNPCs were implanted in 10 children for the following reasons: recurrent ESI in 3, the presence of ureterocutaneostomies in 3, obesity in 3, the use of diapers in 2, young age in 1, and fecal incontinence in 1. More than one indication was present in some patients. In 7 patients the SNPC was the first PD catheter inserted. Intervention In all children the presternal catheter was implanted surgically by the modification of the technique described by Twardowski et al. Results The observation period ranged from 1 -60 months. The rate of ESI was 11162 patient-months. The major complication was trauma of the exit site (4 times in 3 of 10 patients). In spite of leaving an extra length of the catheter in the entire subcutaneous tunnel at the time of implantation, the two parts of the SNPC became disconnected in 2 children (after 7 and 33 months respectively). Conclusion Our results achieved with the SNPC in children are very good. The presternal catheter reduces the risk of ESI. However, the chest localization of the exit site does not help to prevent trauma in children. This type of PD catheter should be reserved for patients with specific indications.

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Mn-doped YAlO3 crystals have been characterized by means of optical absorption, photoluminescence, x-ray luminescence and thermoluminescence measurements. The influence of after-growth high-temperature thermal treatments of the crystals in oxidizing and reducing atmosphere as well as the effect of co-doping with Si4+ on the optical properties of the crystals have been studied. The recharging processes of manganese ions involving Mn3+, Mn4+ and Mn5+ ions in octahedral (Al) positions, which take place under ionizing irradiation and thermal treatments, have been studied.

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SummaryBackgroundHepatic portal venous gas (HPVG) is a rare imaging finding in children. It can be an important manifestation of severe diseases such as necrotizing enterocolitis (NEC) in neonates or bowel wall rupture in older children. However, there are many other diseases presenting with HPVG that do not necessarily require a surgical intervention.Case ReportIn the period between 2011–2015, there were 12 cases of HPVG in children aged up to 24 months in our hospital. We did not include children with NEC. We retrospectively analyzed clinical data and US examinations as regards the suspected causes and final diagnoses.Only 1 patient with HPVG required an immediate surgical intervention. This was – a 4-month-old girl 32 days after a repair of a congenital diaphragmatic hernia, with ultrasound signs of acute bowel wall necrosis. During surgery a bowel strangulation was revealed.Other causes included: – 4 patients with bowel inflammation (including complications of neoplastic diseases such as leukemia and Hodgkins’disease); – 3 patients with food allergy; – 1 patient with acute gastroenteritis; – 1 patient with hepatic injury because of a suspected metabolic disease; – 1 incidental finding revealed before closing a ventricular septum defect; – 1 patient during follow-up performed 2 weeks after a reconstruction of bowel continuity.ConclusionsHPVG is not always a sign of a life-threatening condition and it should not be by itself an indication for surgical treatment.HPVG requires a close monitoring of the clinical status, which is crucial for further management. In patients in non-severe clinical condition, we propose to perform a follow-up ultrasound imaging within 1–2 days, and not to extend diagnostic procedures, especially in case of ultrasound picture normalization.An abdominal ultrasound examination appears to be the method of choice for the identification of gas in the hepatic portal system in children.

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