Subarachnoidal abscess associated with bacterial meningitis in infants--two case reports

Two infants, an 11-month-old boy and a 7-month-old girl, presented with subarachnoidal abscess associated with severe bacterial meningitis refractory to intensive managements with antibiotics. Computed tomography (CT) revealed bifrontal extracerebral low-density areas and remarkably enhanced surfaces of the bilateral frontal lobes postcontrast. Surgical exploration disclosed thick pus accumulation in the subarachnoid space which required curettage. The boy developed appropriately for his age, but the girl showed severe psychomotor retardation because of additional complications such as subdural fluid collection and hydrocephalus associated with the subarachnoidal abscess. Appropriate early neurosurgical management of subarachnoidal abscess is essential for satisfactory psychomotor development. Postcontrast CT should be performed to detect the subarachnoidal abscess as early as possible, and extensive craniotomy to remove the subarachnoidal pus accumulation performed to preserve psychomotor development.     

Familial cystic nephroma and pleuropulmonary blastoma

BACKGROUND: Cystic nephroma (CN) and pleuropulmonary blastoma (PPB) are rare tumors without any previously recognized familial association. METHODS: Two cases of CN and one case of PPB in three siblings are reported. RESULTS: A 27-month-old girl and a 31-month-old boy underwent nephrectomy for CN and are free of disease in the contralateral kidney 16 and 14 years later, respectively. Their 28-month-old sister underwent pleuropneumonectomy with postoperative chemotherapy for PPB and died of recurrent disease 9 months later. CONCLUSION: To the knowledge of the authors, these cases represent the first reported familial occurrence of CN and the second of CN and PPB among siblings. The inheritance of a germline mutation predisposing to the development of these tumors is postulated.     

Collision with spring-loaded football tackling and blocking dummies. Report of near-fetal and fatal injuries

Two infants had congenital atlantoaxial dislocation associated with myelopathy. One of them, a 3-month-old girl, showed anterior dislocation of the atlas on the axis, and had extreme weakness of the extremities. Another patient, an 8-month-old boy, showed tetraplegia, and posterior dislocation with absent odontoid process was demonstrated radiologically. These cases add another cause to the varied etiologies of floppiness in early infancy.     

Utility and safety of parotid gland biopsy in Sj?gren''s syndrome

OBJECTIVE: To review the results of bladder-neck reconstruction in patients with repaired bladder exstrophy and pubic diastasis. PATIENTS AND METHODS: Nine girls (mean age 7 years, range 4-17) and four boys (mean age 9 years, range 5-15) underwent a modified Young-Dees-Leadbetter bladder-neck reconstruction with augmentation cystoplasty (YDL-C). The patients were reviewed retrospectively (follow-up, 1-6 years) to assess continence, particularly in relation to the degree of pubic diastasis measured on an appropriate abdominal radiograph. RESULTS: Ten patients were continent; seven girls and one boy are managed by clean intermittent catheterization (CIC) and one girl and one boy void normally. One girl who would not allow CIC and one boy in whom CIC was not possible are incontinent and are scheduled for construction of a continent diversion. One incontinent boy who also would not allow CIC was lost to follow-up. Public diastasis had no bearing on the surgical results, the 10 continent patients having diastasis ranging from 4 to 9 cm (mean 5.5 cm) and the incontinent patients a diastasis of 3.4 and 6.5 cm (mean 4.5 cm). CONCLUSION: Young-Dees-Leadbetter bladder-neck reconstruction with augmentation cystoplasty is a satisfactory operation in patients with bladder exstrophy. We believe that the rate of continence reflected a competent tubularization with an adequate bladder capacity and assured bladder emptying. A closed pelvis with approximated public bones is not necessary to achieve this objective.     

Sacral chordoma in early childhood: clinicopathological and immunohistochemical study

Two cases of sacral chordoma in a 7-year, 9-month-old boy and a 3-year, 4-month-old boy are presented. In addition to the typical histology of conventional chordoma, both tumors showed the less differentiated sarcomatoid appearance of atypical chordoma in the major portion. Immunohistochemically, in both cases neoplastic cells in areas of conventional as well as atypical chordoma were positive for keratins (CAM 5.2, AE1 and AE3), epithelial membrane antigen, vimentin, S-100 protein, carcinoembryonic antigen, and glial fibrillary acidic protein. Both patients underwent resection of the tumor and chemotherapy. In comparison with conventional chordomas in adults, however, these two tumors showed more aggressive clinical course and were less amenable to therapeutic control. The older boy died of multiple metastasis 1 year after initial diagnosis. At the last follow-up, 15 months after initial diagnosis, the younger boy was alive, but with recurrent and metastatic disease of the left parasacral area and chest wall. Our studies of these two cases and the reported cases suggest that sacral chordoma in children has distinctive clinicopathologic features denoting a highly aggressive tumor and that it should be treated as such.     

Delayed hemopericardium and cardiac tamponade after unrecognized chest trauma

Delayed hemopericardium after blunt chest wall trauma in children is rare and difficult to recognize before overt signs of cardiac tamponade. We present a 21-month-old girl who developed a late hemopericardium with cardiac tamponade after initially unrecognized blunt chest wall injury.     

Chondronecrosis of the cricoid cartilage after intubation. Two case reports

Chondronecrosis of the cricoid cartilage is a rare complication of intubation. The records of two children were reviewed. An 8-month-old girl with myelomonocytic leukaemia developed chondronecrosis 10 days after a 2-day period of ventilation. A 4-year-old girl comatose after poisoning by the histamine antagonist, alimemazine, developed chondronecrosis after a 2-day period of intubation. The complication was suspected when extubation led to dyspnoea owing to laryngeal stridor and was confirmed by direct laryngoscopy. We review the development of the condition, the causative factors, treatment and prevention.     

Familial hemophagocytic lymphohistiocytosis. Differential diagnosis with secondary hemophagocytic syndromes

Three unusual cases of hydatid disease with central nervous system involvement are reported in the pediatric age group: a 9-year-old boy with a total number of 12 intracranial secondary hydatid cysts; a 13-year-old girl admitted in areflexia who survived after cyst puncture and successive mass removal, and a 14-year-old boy with a huge intracranial hydatid cyst weighing 770 g which was extracted without rupture. The article discusses the surgical problems, and the related literature is reviewed.     

The statistical analysis of dyadic social behavior: A multivariate approach.

Extends the logic of the univariate model for studying dyadic social interaction and presents a multivariate model. The more general multivariate model is illustrated using hypothetical data and real data from a study by M. Jacklin et al (see record 1979-25785-001) on girl–girl, boy–boy, and girl–boy interactions among 45 preschoolers. The 8 variables used included passive behavior, frequency of aggression, and frequency of social withdrawal. Some advantages of this model include detection of Type I error rates and generality. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Children's responses to adult–adult and mother–child arguments: The role of parental marital conflict and distress.

Children's responses to verbal and physical conflict between adult–adult, mother–girl, and mother–boy participants were examined as a function of parental marital conflict. Seven- to 9-year-olds viewed videotaped arguments and were then interviewed. In comparison with children from low-conflict homes, children from high-conflict homes perceived the actors engaged in both the interadult and mother–child disputes as more angry and reported feeling more fearful during these arguments. The results extend support for the sensitization hypothesis and indicate that parental marital conflict exacerbates children's perceptions of conflict and fear responding to not only interadult disputes but also to mother–girl and mother–boy conflict. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

In utero varicella-zoster infections

In utero varicella-zoster infections, though infrequent, may have significant consequences for the affected infant depending on the gestational timing of the infection. We present a case of infantile zoster in a 5-month-old boy after maternal varicella infection. Also, we review the three major disorders resulting from in utero infection with respect to severity and management.     

Two siblings with recurrent cardiorespiratory arrest: Munchausen syndrome by proxy or child abuse?

The terms "Munchausen syndrome by proxy" or "Polle syndrome" have been used to describe children who are victims of parentally induced or fabricated illness. This report gives case histories of two siblings (a 7-month-old girl and a 4-year-old boy) with recurrent episodes of cardiorespiratory arrest that were induced by a mother who skillfully resuscitated the children and who demonstrated model parental behavior. Polygraphic monitoring with hidden camera was used to determine that the episodes of cardiorespiratory arrest were parentally induced in the infant. The 4-year-old sibling had previously undergone multiple diagnostic and surgical procedures. After the diagnosis was made in the infant, and the mother was no longer permitted to be alone with the children, neither child had further episodes. A psychologic profile of the mother is presented, and special features of these two and other cases in the literature are reviewed. These cases represent a form of child abuse. A parentally induced illness should be considered in the differential diagnosis of unusual illnesses with bizarre features, even when the parent's behavior appears exemplary.     

Conjunctival malignant melanoma in children

The first case concerns a 14-year-old girl with a brown conjunctival mass temporally in her right eye which was excised and diagnosed as active conjunctival melanotic lesion. Five years later, a malignant melanoma of the right lacrimal sac and orbit led to general metastatic spread. The second case demonstrates a conjunctival brown mass temporally in the left eye of a 3-year-old boy which enlarged over 4 years. The excision revealed a melanotic lesion which was of uncertain histological dignity. The third case occurred in a 4-year-old boy with a conjunctival glassy tumor temporally in his right eye which after excision led to controversial discussions concerning benign nevus or malignant melanoma.     

Extrafollicular variant of centrally located adenomatoid odontogenic tumor]

Primary intramedullary anaplastic oligodendroglioma is a rare tumor, only four cases of which have been reported. The authors present the case of a 38-month-old boy with primary intramedullary anaplastic oligodendroglioma. He underwent partial removal of the tumor and spinal radiation therapy. The residual tumor disappeared 12 months after radiation, and 48 months after treatment there was no evidence of recurrence. This case shows that in primary intramedullary anaplastic oligodendroglioma, postoperative radiation therapy confined to the spinal cord can yield an optimal result.     

Statistical analysis of dyadic social behavior.

Describes a method for determining the effects of sex (or any other dichotomous characteristic) from the individual correlated behavioral responses observed in dyadic interactional situations. In the illustration used, the dyads are of 3 types: girl–girl, girl–boy, and boy–boy. Main effects of sex of S and of sex of partner and interaction effects are estimated and tested, using a generalization of the matched-pair t-test approach. Intragroup correlations between paired responses are examined separately. Alternative procedures of analysis are discussed and compared. The present method is extended to interacting groups larger than dyads when the S characteristic remains dichotomous (e.g., boys and girls in groups of 3, 4, etc). In these cases there are 3 intragroup correlations of interest for responses within the same interacting groups: boys vs boys, boys vs girls, and girls vs girls. (12 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influences of student background and teacher authoritarianism on teacher expectations.

Asked 25 White elementary school teachers to predict the academic grades and occupational attainment of 6 students: a middle-class White boy; a middle-class White girl; a lower-class White boy; a lower-class White girl; a middle-class Asian boy; and a middle-class Asian girl. In addition, teachers were classified as high or low in authoritarianism based on their tolerance of ambiguity and cognitive complexity. It was found that higher grade and occupational expectations were held for middle-class than for lower-class students. Grade expectations were higher for girls than boys and tended to be higher for Asians than Whites. White females were expected to attain higher occupational status than Asian females, but Asian males were expected to surpass White males on this measure. Finally, teachers who were high authoritarians were more likely than low-authoritarian teachers to utilize stereotypes that favored ingroups and tended to be less likely to use stereotypes that favored outgroups. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Surgically resected brain stem cavernous angioma in an infant

An infantile case of surgically resected brain stem cavernous angioma is presented. This 21-month-old boy was admitted to our department after repeated severe pontine hemorrhage. A deeplying lesion with hematoma was successfully removed via the IV ventricle approach. Few infantile cases of this lesion have been presented previously, and the approaches to brain stem cavernous angiomas in infants are discussed.     

Triplet pregnancy and delivery after intracytoplasmic injection of round-headed spermatozoa

Intracytoplasmic sperm injection (ICSI) of round-headed spermatozoa into mature oocyte resulted in normal fertilization, embryo development and pregnancy in a 28 year old female. The husband had a long history of primary infertility. Three ICSI attempts were carried out and fertilization and embryo development occurred in all trials. However, only the third trial led to a pregnancy, which proved to be quadruplet after the transfer of four embryos. One embryo vanished and the remaining triplets were delivered at 35 weeks of gestation by Caesarean section. Two of the babies, a boy weighing 2000 g and a girl weighing 2250 g at birth were discharged in a good condition 1 week after delivery and the third baby, a boy weighing 1550 g, was discharged 3 weeks after delivery.     

Effects of HMG-CoA reductase inhibitors on excitation-contraction coupling of rat skeletal muscle

We report on two unrelated children, a girl and a boy, with regressive metaphyseal dysplasia. Both children had bow legs and a transient growth decline in early childhood. Metaphyseal modifications of the long bones in the children were most conspicuous at an early age and then subsided by age 2 to 3 years. The father of the boy may have had the same disorder, because he was shorter than his sibs and showed mild modifications of the vertebral end plates with mild narrowing of the interpediculate distance of the lumbar spine. The evolution of the metaphyseal dysplasia in the children closely resembled that of metaphyseal anadysplasia (MAD), which is X-linked recessive in inheritance. By contrast, the occurrence of an isolated, affected girl and possible father-to-son transmission reported here were consistent with autosomal dominant transmission, suggesting heterogeneity of MAD. Molecular studies of the type X collagen gene in the boy did not demonstrate any disease-causing mutation.