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Biomedical subjects

R Luoma

Publications and source records attributed to R Luoma.

11 recordsLinked to original sources

Duodenal duplication with pancreas bifidum--a case report.

Duodenal duplications constitute less than five percent of gastrointestinal duplications. Rarely, enteric duplication cysts are found in an intra- or juxtapancreatic position with or without connection to the pancreatic duct. Complete pancreaticoduodenal duplication is even less common, although there is a close relationship in the development of the two organs. We report here the case of a child with a paraduodenal cystic lesion, followed up since infancy, which turned out to be duodenal duplication cyst with a connection to Wirsung's duct of the ventral pancreas.

Duodenal Obstruction↗

Definitive treatment of congenital liver cyst with alcohol.

A full-term newborn boy presented with a palpable liver. Ultrasonography showed a solitary liver cyst. In 6 months the cyst grew 15-fold in volume. Intervention was deemed necessary because of large palpable abdominal mass in spite of the fact that the boy remained asymptomatic. Permanent resolution of the cyst was achieved by percutaneous ethanol injection-aspiration. At 7-year follow-up there has been no recurrence. The authors would like to draw attention to this minimally invasive alternative to surgery.

Cysts↗

Neonatal cricopharyngeal achalasia--a case report.

Primary neonatal cricopharyngeal achalasia due to a spastic cricopharyngeus muscle manifests itself with intractable feeding difficulties, nasal reflux, recurrent aspiration pneumonia and failure to thrive. There are very few reports of this condition in the literature. In the absence of anatomically demonstrable cause, these children are likely to be labelled as having an impairment of the central-nervous system. This in turn may result in long-term misery with ng-tube feeding, and eventually, the creation of a feeding gastrostomy. A minor operation-- cricopharyngeal myotomy-- has been shown to be safe and curative. It can be performed even if only limited preoperative diagnostic tools are available.

Cricoid Cartilage↗

Colon-patch oesophagoplasty.

Colon-patch oesophagoplasty has been tried experimentally and used clinically to treat benign strictures of the oesophagus in children. However, reports are few. We advocate this operation and report on two cases where this technique was employed for caustic stricture using a vascularized colon patch avoiding the need for oesophageal substitution. This procedure has its immediate and late complications but after a long follow-up we are satisfied with our results. Patching is a useful alternative to substitution for limited benign strictures of oesophagus in children.

Burns, Chemical↗

Operative reduction and fixation of a difficult supracondylar extension fracture of the humerus.

We evaluated the results of the operative treatment of a difficult supracondylar fracture of the elbow. A series of 45 consecutive children, the majority presenting initially with a complete dislocation of the humerus, was reexamined. Thirty-two of the patients had undergone an early operation applying the anterior cubital approach and 13 patients had been treated by traction. The lengths of the follow-up periods were 3.1 +/- 1.5 and 8.8 +/- 2.6 years, respectively. Normal range of extension-flexion and rotation movements was preserved almost invariably by either modality of therapy, whereas the carrying angle of the elbow was reduced significantly more often in the group treated by traction. None of the patients presented with permanent nerve dysfunction, keloid formation, or myositis ossificans. The two preventable early complications, slipping of the osteosynthesis and entrapment of the ulnar nerve, were related to the fixation of the fracture. There were no early or late infectious complications. When the anterior approach was used, operative reduction and fixation of a difficult supracondylar fracture of the humerus proved to be both safe and timesaving. Anatomical results of operation were superior to those attained by traction therapy in our series.

Child↗

Environmental allergens and morbidity in atopic and non-atopic families.

148 newborns of non-atopic and 329 newborns of atopic parents were included in a five-year follow-up study of atopic diseases. The prevalence of atopic diseases at five years of age is compared to environmental factors, which may be involved in the development of atopic diseases. There was no significant correlation between the development of atopic disease and the following factors: the nature of the immediate environment (industrial, agricultural, rural, urban, arboreal, lake-district); building materials, heating systems and general state of repair of the houses, including its interior decoration; the presence of pets, plants, humidifiers or cigarette smoke. There was, however, one exception: in both family groups the avoidance of woollen garments and bed clothes before the outbreak of atopic symptoms was associated with the increased prevalence of asthma, allergic rhinitis and atopic dermatitis. The cause of this association remained uncertain. Children with atopic diathesis are known to frequently display skin intolerance to wool. Therefore, wool avoidance in a family may only indicate that the child was potentially atopic. Atopic children suffered from ear infections and vomiting more often than control children. The incidence of ear infections was also increased amongst children with a positive family history of atopy, even if no atopic disease was diagnosed in the child himself. Although breast fed infants tended to have less infectious diseases than those weaned early, ear infections were equally common in all feeding groups. This is further evidence, that in part of the cases of recurrent ear infections, atopy should be considered as a possible etiologic factor.

Allergens↗

Antebrachium fractures: rush pin fixation today in the light of late results.

A study was undertaken to clarify the usefulness of the Rush pin intramedullary semirigid nailing technique in the treatment of 88 antebrachium fractures in 48 consecutive adult patients during the years 1966 through 1977. Of the patients 45 were followed for an average of 7.6 years (range, 2-14 years). The clinical results (antebrachium and wrist movements) were good in 78% of the cases with few complications. Union was delayed in five cases. There were no cases of wound infection, nonunion, or bone atrophy. The method was suitable for almost all types of fracture, even in elderly patients. Severe comminuted fractures with a shortening tendency on the radius require a special technique to prevent ulnar variance. The low degree of operative trauma may contribute to the excellent results obtained with the Rush technique.

Adolescent↗

Development of asthma, allergic rhinitis and atopic dermatitis by the age of five years. A prospective study of 543 newborns.

543 children were followed up from birth to 5 years of age. Children with a positive history of parents' atopy had a 51% occurrence of respiratory or dermal symptoms of atopy vs. a 19% occurrence among children with no family history of atopy. There was an association between asthma and allergic rhinitis while atopic dermatitis occurred equally in children with or without respiratory symptoms. The clinical course of atopic symptoms could not be correlated to the family history of atopy. The significance of date of birth, nasal eosinophilia and serum IgE levels seemed to be relatively low in atopic dermatitis while these parameters had a correlation to the development of respiratory atopies.

Aging↗

Occurrence of atopic diseases in three generations.

The incidence of asthma, hay fever and atopic dermatitis was assessed in three generations in 2820 families by a questionnaire. 35% of the families were atopic when the histories of parents and grandparents were included. 64% of atopic children had atopy in probands and the corresponding figure for non-atopic individuals was 31%. The highest prevalence of atopy was found in the parents' generation (13.5%) but it did not differ significantly from that of children (10.8%) when compared with grandparents (7.6%). The results suggested an increasing prevalence of children's atopic dermatitis in Finland since the 1950s. The influence of heredity was apparent. Few geographical differences were observed.

Adolescent↗