Quiste de colédoco como causa de dolor epigástrico / Choledochal cyst as a cause of epigastric pain

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Giant urethral calculus in a 6-year-old girl.

Urinary stones are rarely seen in the urethra and are usually encountered in men with urethral stricture or diverticulum. Primary urethral calculi are extremely infrequent in females. We describe a case of a giant urethral stone impacted in a 6-year-old girl.

Neumopatía en pacientes intervenidos de atresia de esófago tipo III / Pulmonary dysfunction in esophageal atresia witii tracheoesophageal fistula

Los pacientes intervenidos de atresia de esófago (AE) y fístula traqueoesofágica presentan una difícil infancia debido a las complicaciones respiratorias que se han asociado a la dislnotilidad esofágica, al reflujo gastroesofágico (RGE) y a la disfunción pulmonar. Material y Inétodos. Diez pacientes intervenidos de AE tipo 111 fueron evaluados según un protocolo consistente en: I. Revisión de la historia clínica. 2. Entrevista que valoró la evolución digestiva y respiratoria anual durante los tres primeros años. 3. Actualización del estudio digestivo. 4. Pruebas de función pulmonar (PFP) (espirometría basal). 5. Situación clínica actual. Resultados. El tiempo medio de seguimiento ha sido (le 7,3 ñ 4,45 años con un rango de 8 meses a 15 años. Durante el primer año, 7 de los 10 pacientes (70 por ciento) presentaron episodios de dificultad respiratoria con fatiga y/o sibilancias. Se evidenció RGE en tres pacientes precisando fundoplicatura de Nissen uno de ellos por esofagitis severa. La espirometría realizada a los pacientes por encima de los 4 años de vida (6 pacientes) mostró en la mitad de ellos una disminución de la capacidad vital forzada (FVC) (< 80 por ciento) en relación al volumen espiratorio forzado en el primer minuto (FEV 1), correspondiéndose con la existencia de un patrón pulmonar restrictivo. Conclusión. Los episodios de dificultad respiratoria en estos niños son muy frecuentes durante el primer año (70 por ciento en nuestra serie); sin embargo, sólo en un 25 por ciento tienen una clara relación con la existencia de RGE. La evaluación neumológica nos ayuda a conocer mejor el pronóstico de esta malformación, ya que estas neumopatías pueden ser tratadas precozmente y con otro fundamento fisiopatológico (AU)

[Pneumopathy in patients surgically treated for type III esophageal atresia]. / Neumopatía en pacientes intervenidos de atresia de esófago tipo III.

UNLABELLED: Patients following esophageal atresia with tracheoesophageal fistula (EA-TEF) treatment have several long-term respiratory complications during infancy. They are associated with esophageal dismotility and gastroesophageal reflux (GER) as well as lung dysplasia. MATERIAL AND METHODS: Ten patients were evaluated as follow: 1. Review of medical record. 2. An annual interview was performed concerning respiratory and digestive symptoms. 3. Phmetric score and radiologic studies of the digestive tract. 4. Functional respiratory test. 5. Update symptoms. RESULTS: Mean follow-up was 7.3 +/- 4.45 years (8 months-15 years). Seven cases (70%) had respiratory distress during the first postoperative year. Two of them had middle GER, performing a Nissen procedure in another patient with severe GER. Spirometry was underwent in 6 cases, showing a restrictive pattern in three. CONCLUSION: Respiratory distress were common during the first postoperative year (70% of cases in our serie) but only 25% were GER related. Pulmonary function test can be performed in long-term evolution of patients following operation for EA-TEF in order to have early treatment for respiratory complications.

Testicular size following embolization therapy for paediatric left varicocele.

Optimal management of varicocele testis in children and adolescents is controversial, but testicular hypotrophy has been suggested as an indication for treatment in adolescents. This report concerns the diagnosis and management of left varicocele in 30 patients aged 6-15 years and the influence of treatment on testicular size. The left testicle was significantly smaller than the right in 14 patients at enrollment in the study. All patients were treated in local anaesthesia with percutaneous transfemoral spermatic venography and embolization of that vein with spring coil, followed by 24-hour observation. There were no major complications. At follow-up 9 to 12 months after the treatment, the size of the left testis had increased in 12 patients. Spring-coil embolization of the spermatic vein proved to be a safe and effective technique for treatment of varicocele.

Percutaneous venography and embolization of the internal spermatic vein by spring coil for treatment of the left varicocele in children.

The treatment of varicocele is controversial in boys and it is a contributing factor to male infertility. Recently it has been proposed that early therapy of a varicocele during childhood or adolescence may improve the prognosis of fertility. The authors review their experience with the diagnosis and management of left varicocele in 20 pediatric patients 6 to 15 years old. All were managed under local anesthesia by spermatic venography and percutaneous transcatheter embolization of the internal spermatic vein with spring coils. All achieved satisfactory occlusion, and during the follow-up, from 13 years to 9 months, there was only one recurrence, noted in a patient 6 months after the procedure. Complications were phlebitis of the pampiniform plexus, leading to swelling and erythema of the left scrotum, and mild flank pain; these symptoms resolved without sequelae. This is a safe and effective nonsurgical method of obliterating varicoceles in children, with a low morbidity rate and a short hospital stay.

Cystadenoma of the epididymis, another cause of scrotal mass in infancy.

We describe a case of cystadenoma of epididymis in a boy, 12-year-old. This condition should be emphasized in the differential diagnosis of a scrotal mass in the infancy.

Meconium ileus equivalent and Kawasaki syndrome. Case report.

Kawasaki syndrome appeared after operation for meconium ileus equivalent in a 4-year-old child with cystic fibrosis. The course and management are described.

Role of presynaptic purinoceptors and cyclic AMP on the noradrenaline release in cat cerebral arteries.

Field electrical stimulation (ES), K+ (50 mM) or ionophore X-537A (0.01 mM) induced tritium release from cat cerebral arteries preincubated with [3H]noradrenaline (NA). Adenosine and AMP (0.5 mM) did not modify tritium release caused by ionophore X-537A, but these agents and ATP (0.5 mM) significantly reduced that elicited by ES and K+; this reduction was antagonized by 1-methyl-3-isobutylxanthine (MIX; 0.05 mM). Inosine (0.5 mM) and the agonist of purinergic A2-receptors, 5'N-ethyl-carboxamide adenosine (NECA; 0.5 mM) had no effect, but the agonist of purinergic A2-receptors L-N6-phenylisopropyl adenosine (L-PIA; 0.1 mM) diminished tritium efflux caused by ES and K+. The adenosine inhibition of ES-induced radioactivity release was not affected by indomethacin (0.05 mM). MIX (0.05 mM) increased tritium release evoked by ES and K+. Agents that increase intracellular cyclic (c)AMP levels, such as dibutyryl cAMP (0.5 mM), the phosphodiesterase inhibitor Ro 20-1724 (0.1 mM), and the activators of adenylate cyclase, forskolin (0.005 mM) and NaF (2 mM) reduced tritium secretion elicited by ES and K+. However, the intracellular increase of cyclic GMP (cGMP) caused by 8-Br-cGMP did not affect this secretion. Dipyridamole (0.05 mM) and the adenosine deaminase inhibitor erythro-9-2-hydroxy-3 nonyl adenosine (EHNA; 0.1 mM) also produced inhibition of tritium secretion elicited by ES and K+. Dipyridamole reduced both the uptake of [3H]NA and [3H]adenosine.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pneumothorax in neonates and infants]. / Der Pneumothorax bei Neugeborenen und Säuglingen.

Pneumothorax in newborns and infants can have different etiologies: alveolar disruption following mechanic ventilation or reanimation, surgery for congenital diaphragmatic hernia or esophagus atresia, staphylococcal pneumonia, or thoracic traumas. We studied 105 cases of pneumothorax (96 newborns) treated in our hospital during the last 15 years. Pleural puncture with drainage and antimicrobial therapy were the treatments of choice. Due to early diagnosis and treatment of the pneumothorax and concomitant anomalies mortality was reduced to 17.4%.

Purinergic and cyclic AMP modulation of noradrenaline release in cat femoral arteries.

1. Adenosine, AMP, ATP (5 x 10(-4) M), 5'-N-ethylcarboxamide adenosine (NECA) and N6-L-phenylisopropyl adenosine (L-PIA) (10(-4) M) decreased tritium release elicited by electrical stimulation (ES) or 50 mM K+ in cat femoral arteries preincubated with [3H]noradrenaline (NA). 2. This effect was antagonized by 1-methyl-3-isobutylxanthine (MIX, 5 x 10(-5) M). 3. The release induced by ionophore X-537A (10(-5) M) was unaffected by adenosine and AMP. 4. The increase of intracellular cAMP levels caused by dibutyryl cAMP (5 x 10(-4) M), Ro-20 1724 (10(-4) M), forskolin (5 x 10(-6) M), NaF (2 x 10(-3) M) reduced, but MIX (5 x 10(-5) M) increased tritium release elicited by ES and K+. 5. Dipyridamole (5 x 10(-5) M) and erythro-9-2-hydroxy-3 nonyl adenosine (EHNA) (10(-4) M) also reduced tritium release. 6. Dipyridamole decreased both the uptake of [3H]NA and [3H]adenosine. 7. These data indicate: (a) the existence of A1 and A2 subtypes of purinoceptors situated presynaptically, which modulates NA release, (b) the intracellular increase of cAMP negatively modulates this secretion, and (c) these arteries possess an active system for incorporating and degrading adenosine.

Papillary cystic tumor of the pancreas.

A 10-year-old girl had fever, abdominal pain and a palpable mass at the left hypochondrium. She was found to have a pancreatic cystic tumour that was biopsied and removed by coeliotomy. The pathologic diagnosis was papillary cystic tumour of the pancreas with chronic pancreatitis. No pathological lesion was found elsewhere. 2 years later she is asymptomatic and without recurrence.