Early retropulsion of titanium threaded cages after posterior lumbar interbody fusion.
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Humans↗
Biomedical subjects
P Jenny
Publications and source records attributed to P Jenny.
Meconium periorchitis: case report and literature review.
Meconium periorchitis (MPO) is an uncommon entity associated with healed meconium peritonitis. The typical presentation is soft hydrocele at birth which becomes harder in weeks as the meconium calcifies. It mimics a scrotal mass, and, without knowledge of this rare disease, this may lead to unnecessary surgery. Both the masses and the calcifications have the tendency to resolve spontaneously without compromising the testicle. Sonographic features together with an abdominal plain film are diagnostic, and visualization of the normal testicle may be helpful in differentiating this tumor-like lesion from scrotal tumors. A case of a meconium periorchitis is reported on and the radiological and histological features are discussed with a literature review on the subject.
Calcinosis↗
Cytogenetic analysis of South Asian berry pickers in British Columbia using the micronucleus assay in peripheral lymphocytes.
Micronuclei in peripheral blood lymphocytes from British Columbia seasonal farmworkers and controls were evaluated using the cytokinesis-block technique. The farmworkers harvested berry crops and were likely occupationally exposed to pesticides. Subjects were 39 female subjects of South Asian descent; 18 farmworkers employed during 1993 and 21 age-matched controls. The mean age was 55.9 years. Micronuceli were also scored for the presence of kinetochores. No significant difference was found between the frequency of micronucleated binucleates in the farmworkers group (19.20/1000 binucleates), and the control group (21.76/1000 binucleates). However, among the farmworkers employed in 1993, there was a positive, but not statistically significant, association between micronucleated cell frequency and weeks worked: 16.44/1000 binucleates in those working less than 20 weeks; 23.78/1000 binucleates in those working 20 to 23 weeks; and 25.43/1000 binucleates in those working more than 23 weeks. In those who had ever been employed as farmworkers, there was an elevated frequency of micronucleated cells in the group with the longest history of employment as a farmworker (25.28/1000 binucleates) compared to those with the shortest employment history (16.48/1000 binucleates). This trend remained evident after adjusting for age, red blood cell folate, meat consumption, coffee consumption and recent vaccination. A positive association between the consumption of meat and micronucleus frequency was also observed. Non-meat eaters were likely life-long vegetarians. Micronuclei in farmworkers had a lower frequency of kinetochore positive micronuclei than controls. This study indicates that South Asian berry pickers in British Columbia may be at risk for genetic damage. More studies in other ethnic groups and in males are needed to generalize the findings of this study. More direct measures of exposure are needed to elucidate the sources of genotoxicity.
Adult↗
GAX 65: new injectable cross-linked collagen for the endoscopic treatment of vesicoureteral reflux--a double-blind study evaluating its efficiency in children.
PURPOSE: In the experimental model glutaraldehyde cross-linked collagen GAX 65 with a collagen concentration of 65 mg./ml. has proved to have more persistent implant volume and, therefore, a better antireflux effect than GAX 35, which is injected more commonly. The aim of this study was to evaluate the potential clinical application of GAX 65. MATERIALS AND METHODS: Ten boys and 8 girls an average of 4.6 years old presented with unilateral or bilateral primary reflux and were randomly divided into 2 groups. All refluxing ureters received 1 endoscopic subureteral injection of an average of approximately 2.9 ml. collagen. In group 1, 16 refluxing ureters were treated with GAX 65 and in group 2, 12 were treated with GAX 35. In all patients voiding cystourethrography was performed immediately after injection and 3 months postoperatively, and ultrasound was done on day 1, and at 1 and 3 months. Implant volume was calculated at the day of injection and at 3 months. The distribution of reflux grades was comparable in the 2 groups. RESULTS: Both materials had excellent injection properties. Immediately after injection all ureters were reflux-free. Of the 16 ureters treated with GAX 65 14 (87.5%) were reflux-free at the 3-month followup. Three months postoperatively ultrasound revealed an average implant volume increase of one-third. However, of the 12 ureters treated with GAX 35 reflux had resolved in 59.3% and the average implant volume had decreased by half 3 months after injection. CONCLUSIONS: Three months after endoscopic subureteral injection of GAX 65 vesicoureteral reflux was absent in 87.5% of patients. Therefore, GAX 65 has greater potential for treating reflux in the short term than GAX 35. To define the final efficacy of GAX 65 for treating vesicoureteral reflux, long-term evaluation of this series is necessary. In addition, further studies are mandatory to prove the long-term advantage of this new injectable substance.
Biocompatible Materials↗
The chance for fertility in adolescent boys after corrective surgery for varicocele.
We estimated the efficacy of a surgical procedure in adolescent patients with varicocele and left testicular atrophy. A total of 25 young men (mean age 23.6 years) had a complete andrological followup for 10 years after successful ligation of the spermatic vein (according to Ivanissevich) to correct left varicocele and testicular atrophy. Levels of follicle-stimulating hormone, luteinizing hormone and testosterone in the plasma were normal in all cases. Patients were characterized into 2 distinct groups: group A--11 patients with asthenoteratospermia and group B--14 with a normal spermiogram. There was a significant difference between groups A and B in the number of sperm per ejaculate (32 x 10(6) in A and 234.9 x 10(6) in B, p < 0.001). Preoperatively there was no difference between these 2 groups regarding testicular atrophy of the left compared to the right testis (87% in A and 86.4% in B) and the comparative testicular histology of biopsies since the number of Ad spermatogonia per tubule was considerably reduced in all patients (right side 0.68 +/- 0.71 and left side 0.38 +/- 0.39 in A, and right side 0.15 +/- 0.17 and left side 0.14 +/- 0.11 in B). In both groups there was no distinguishable difference in the degree of atrophy of seminiferous tubules or Leydig cells in both testes, or patient age at surgery (mean 13.3 years in A and 12.8 years in B). While the left testis of patients in group B caught up in size to the contralateral testis, the left testicular volume in patients in group A was only 80% of the right testicular volume (p < 0.03, the Fisher test). One patient from group B required a second surgical procedure because of a relapse. Persistent atrophy of the left testis in group A indicates that some patients benefit suboptimally from the conventional surgical procedure.
Adolescent↗
Endoscopic subureteral collagen injection for the treatment of vesicoureteral reflux in infants and children.
Between June 1988 and September 1994, 100 girls and 32 boys 2 months to 15.5 years old (average 4.9 years) with 204 refluxing ureteral units were treated by endoscopic subureteral collagen injection. The collagen injected was of bovine origin and cross-linked with glutaraldehyde (Zyplast*). Followup ranged from 3 to 75 months (mean 33). Reflux was absent in 62.7% of cases 3 months after 1 endoscopic subureteral injection. Improvement to reflux grades I and II, generally not requiring further treatment, occurred in a further 15.2% of cases. A total of 66 ureters was injected twice. The overall cure rate after 1 or 2 injections was 79.4% 3 months after injection. There was no correlation between the risk of recurrent reflux and initial degree of reflux. Late recurrence of reflux following a reflux-free period occurred in 11.3% of the 204 units during the observation period, which varied from 3 months to 6 1/4 years. Reflux was absent after 1 or 2 injections, including late recurrence, in 70.6% of cases and in an additional 13.2% recurrent reflux was grade I or II, not necessitating any further treatment. Considering these results, subureteral collagen injection remains an adequate method of treatment for vesicoureteral reflux in children.
Adolescent↗
Subureteral collagen injection for the endoscopic treatment of vesicoureteral reflux in children. Followup study of 97 treated ureters and histological analysis of collagen implants.
Endoscopic subureteral injection has become an established alternative means for treating vesicoureteral reflux in select children. However, which injection material to use remains a controversy. Polytetrafluoroethylene (Teflon) has been injected in more than a thousand patients with few complications, although experimental and clinical studies have demonstrated migration of the injected particles into distant organs, such as the lungs and the brain, as well as local and metastatic granuloma formation. Therefore, we introduced, following experimental studies in the mini-pig model, glutaraldehyde cross-linked, highly purified bovine collagen for injection. Between June 1988 and October 1991, 97 refluxing ureters in 66 children were treated by endoscopic subureteral collagen injection. In 58.8% of the ureters reflux was cured after 1 and in 77.3% after 2 injections. Considering improvement to grades I and II reflux without further treatment as success, the success rate increased to 68.0% after 1 and to 89.7% after 2 injections. Mean followup was 18.5 months (range 3 to 39 months). After 2 failed injections the patients either returned to antibiotic long-term prophylaxis or the reflux was operatively corrected. The operative procedure was never compromised by the preceding injection. A direct correlation between deficient length of the submucosal tunnel of the intravesical ureter and the iatrogenic malposition of the collagen deposits, and the failures could be demonstrated. Granuloma formation at the site of injection was not found. The results of the histological investigation of the collagen deposits removed at open ureteral reimplantation for failures are reported. It could be demonstrated that endogenous fibroblasts invade the bovine collagen implant and that these cells show active production of new human collagen, types I and III, replacing the implant.
Adolescent↗
Contribution of a 28-kilodalton membrane protein to the virulence of Haemophilus influenzae.
A Haemophilus influenzae b (Hib) membrane protein with a molecular mass of 28 kDa bound polyclonal antisera raised against a highly purified Hib fimbrial subunit. We cloned the gene encoding this protein and found that the gene was expressed in Escherichia coli. DNA sequence analysis identified an 843-bp open reading frame which predicted a 26.78-kDa protein with an amino-terminal signal sequence and a mature protein with 70% similarity to the 28-kDa lipoprotein of E. coli (F. Yu, S. Inouye, and M. Inouye, J. Biol. Chem. 261:2284, 1986). Colony blot hybridization analysis with an intergenic probe of the cloned gene demonstrated that 29 of 32 H. influenzae strains hybridize with this gene. Insertion of a chloramphenicol acetyltransferase gene into the open reading frame inactivated expression of the 28-kDa protein in E. coli. Isogenic Hib strains were derived by marker exchange mutagenesis to generate mutants which no longer expressed the 28-kDa protein as recognized with Western immunoblot analysis. There was no difference in the rate of nasopharyngeal colonization of infant rats or monkeys by the isogenic mutants which lacked the 28-kDa protein compared with colonization by the wild-type strain. In contrast, the frequency of invasion and density of bacteremia in infant rats caused by the isogenic mutants were reduced relative to those caused by the wild-type Hib strain. We conclude that this 28-kDa outer membrane protein aids transepithelial invasion of type b strains but is not essential.
Amino Acid Sequence↗
Priapism following testosterone administration for delayed male puberty.
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Adolescent↗
Testicular and vascular changes in children and adults with varicocele.
We analyzed bilateral testicular biopsies of 188 infertile patients with idiopathic left varicocele. The left side had significant pathological tubular testicular changes compared to the right side, whereas in only 7 per cent of the patients tubular damage was more pronounced on the right side. The Leydig cell pathological score was identical in both testes in 95 per cent of the patients. However, the lower the Leydig cell pathological score the better the testicular histology, suggesting an association between Leydig cell score and testicular function. Of the 188 patients 11 boys and 8 adults were randomly selected, and they displayed clear endothelial proliferative lesions of the capillaries at the ultrastructural level. Proliferative endothelial lesions in the patients with varicocele preceded the testicular changes. This, together with the prevalence of tubular damage at the site of the varicocele and the reversibility of these changes postoperatively, emphasizes the deleterious effects of varicocele as a cause of infertility in these patients. Early surgery for boys in whom the first signs of testicular atrophy occur is highly recommended.
Adolescent↗
[A conservative, surgery-delaying attitude in the treatment of concomitant hydrocephalus in patients with meningomyelocele].
Between 1978 and 1987 5 out of 16 hydrocephalic patients with Arnold Chiari malformation and a meningomyelocele underwent a non-operative management. They showed normal mental development. Through meticulous clinical and neurological examinations as well as regular ultrasound and CT controls, it was possible to treat them conservatively.
Cephalometry↗
[Y-ureterocutaneostomy in congenital hydroureter--causal therapy?].
Between 1975 and 1987 30 patients with congenital hydronephrosis and megaureter were treated by Y-cutaneostomy according to Sober. 28 are still under our control. 5 of them showed normalisation of urine drainage. No further operation except the closure of the stoma was necessary.
Female↗
[Heterotopic stomach tissue in the rectum and small intestine].
We report on a case with ectopic gastric tissue in the rectum and on another one with this heterotopia in the small intestine.
Adolescent↗
Release factor competition is equivalent at strong and weakly suppressed nonsense codons.
We have compared the competition between strong or weak suppressor tRNAs and translational release factors (RF) at nonsense codons in the lacI gene of Escherichia coli. Using the F'lacIZ fusions developed by Miller and coworkers, UAG, UAA, and UGA codons at positions 189 and 220 were efficiently suppressed by plasmid-borne tRNA(trp) suppressors cognate to each nonsense triplet. Introduction of a compatible RF 1 plasmid competed at UAG and UAA but not UGA codons. An RF2 expressing plasmid competed at UAA and UGA but had little effect at UAG. Release factor competition against weak suppressors was measured using combinations of noncognate suppressors and nonsense codons. In each case, release factor plasmids behaved identically towards poorly suppressed codons as they did when the same codons were efficiently suppressed. The implications for these studies on the role of release factors in nonsense suppression context effects are discussed.
Codon↗
[The Lich-Grégoir extravesical antireflux-plasty].
Between 1974 and 1986 96 children underwent the Lich-Grégoir antireflux procedure, in 63 patients on both sides in one session. 17 patients had double ureter. In totally 153 controlled operations we found 4 persistent reflux (2.6%) and 1 stenosis (0.7%). The success ratio is, therefore, 96.7%.
Child↗
Absence of the enteric nervous system in the newborn: presentation of three patients and review of the literature.
Three patients suffering from an absence of the enteric nervous system are reported. Two sisters presented with severe vomiting shortly after birth and dilatation of the intestine proximal to a stenosis. There was an absence of the enteric nervous system throughout the entire length of the intestine distal to the duodenum. A boy presenting an ileus was found to suffer from an aganglionosis of the entire colon. There was also an absence of neuronal bodies and nerve fibers in the small intestine. The final diagnosis was made by histochemical and immunocytochemical stains for acetylcholinesterase, lactate hydrogenase, neuron-specific enolase, protein S-100, and substance P. In the literature, 13 other patients have been reported. On the basis of differences of symptoms, incidence, sex ratio, genetics, and, presumably, pathogenesis between absence of the enteric nervous system and aganglionosis, it is assumed that the two diseases are separate entities.
Acetylcholinesterase↗
Experiences with the anti-siphon device (ASD) in shunt therapy of pediatric hydrocephalus.
A follow-up study was performed on 41 hydrocephalic children with primary (10 patients) or secondary (31 patients) placement of an anti-siphon device (ASD) connected to their shunt. The clinical course before and after ASD implantation was compared in these two groups, including studies of the head circumference, the radiological ventricular size, cerebrospinal fluid pressure studies on the supine and upright patient, and the history of shunt-induced complaints and complications leading to hospitalization. The authors discuss the pathophysiological concept of the "chronic overdrainage " or slit-ventricle syndrome based on ventricular collapse due to chronic suction-induced overdrainage by the vertical shunt system in the upright patient. The use of an ASD in connection with the regular shunt system of children with hydrocephalus is proposed. This ASD-shunt combination successfully reduced the number of complaints and shunt dysfunctions over a period of more than 6 years.
Adolescent↗
[Primary peritonitis].
Primary peritonitis accounts for 1 to 2 per cent of all paediatric abdominal emergencies and for about 15 per cent of diffuse peritoneal sepsis. The condition is still mainly seen in infants and in mid-childhood years, Most frequently in children four to eight years of age, with females outnumbering the males except among neonates where the males predominate. The mortality rate is about 50 per cent for infants, but drops to 10 to 15 per cent in older children. The origin of the infecting organism may be a haematogenous spread or ascension through the female genital tract, but transdiaphragmatic lymphatics and transmural migration through the gut wall may also be possible sources. The incidence of primary peritonitis is increased in children with nephrotic syndrome, postnecrotic cirrhosis with ascites and immunologic deficiency. Practically all kinds of pathogenic organisms are found, but a relative increase in staphylococcal and gram-negative infections has been noted.
Child↗