Posttraumatic priapism in a 6-year-old boy: a case report

A 6-year-old boy showed priapism after blunt perineal trauma. We diagnosed him with venous priapism mainly based on clinical symptoms, although we could not deny an arterial type. In fear of possible erectile dysfunction as a late complication of the venous type, we performed a shunt operation. The shunt was created between glans penis and corporacavernosa, resulting in disappearance of priapism and preservation of erectile function. We also reviewed 14 cases reported previously.     

A fatal influenza infection in a 10-year-old boy

A previously healthy 10-year-old boy died a few days after onset of septicaemia with non-specific clinical symptoms. Influenza B virus was isolated post mortem from pulmonary tissue. The histopathological findings did not indicate a virus disease. Specimens were taken for virus culture from other people in contact with the patient and affected with influenza-like illnesses. One other strain of influenza B virus was isolated. The strains could not be distinguished either serologically or genetically from other influenza B isolates of the season 1992/'93.     

Giant ureteral stone in a 4-year-old boy

A 4-year-old boy presented with sudden onset of fever, pyuria, and bacteriuria. Ultrasound revealed left hydronephrosis and hydroureter. A plain abdominal radiography and excretory urogram showed a giant ureteral stone measuring 9 cm causing ureteral obstruction. Underlying anatomic or metabolic abnormalities were not detected. Extraction of the stone resulted in complete disappearance of the hydronephrosis and hydroureter.     

Isolated magnesium malabsorption in a 10-year-old boy

Isolated magnesium malabsorption (congenital hypomagnesemia) has been reported in approximately 30 patients worldwide. Patients typically present by 6 months of age with convulsions and diarrhea. We report an unusual case of isolated magnesium malabsorption in an older boy with no diarrhea.     

Diagnosis and pathophysiology of paradoxical embolism

A review of the experience with 134 consecutive patients with germinal cell testicular neoplasia indicates that definitively accurate staging of the malignancy at presentation is the single most important prognostic factor. Nearly two-thirds of the patients with all types of germinal malignancies survived or died of other causes and the highest survival rates were seen among patients with earlier stages of seminoma. In recent years patients with all types of germinal malignancies of the testis have been treated by radical retroperitoneal lymphadenectomy with enhancement of survivals. Patients with seminoma and non-seminomatous tumors exhibited increased survival rates with node dissection. In 66 consecutive lymphadenectomies the complication rate was less than 14 per cent, with only 1 death related to the operation. Retroperitoneal lymphadenectomy not only affords therapeutic advantage but also provides an opportunity for accurate surgical staging of disease and allows for rational decision relative to additional treatment, radiation therapy or chemotherapy.     

Pulmonary embolism and impending paradoxical embolism: a role for transesophageal echocardiography?

Thrombolysis is advocated as the treatment of choice for hemodynamically important pulmonary embolism. This paper reports the case of a patient with subacute massive pulmonary embolism in which thrombolysis was not considered appropriate because transesophageal echocardiography demonstrated a patent foramen ovale and impending paradoxical embolism.     

A complication of pacemaker lead extraction: paradoxical embolism of a lead fragment in a leg artery

Extraction of three chronically implanted pacemaker leads was performed via the implant vein in a 71-year-old man. One of the leads broke in the subclavian scar tissue. The lead fragment migrated into the left peroneotibial trunk artery. Transesophageal echocardiography showed patent foramen ovale associated with right-to-left atrial shunt. This complication of lead extraction is discussed along with the role of echocardiography prior to lead removal.     

Thoughts on a case of perforating flying-stone injury on a 10-year-old boy (author's transl)

After a left-sided perforating corneal injury caused by a stone, with iris prolaps and wound cataract suffered by a 10-year-old boy, retinal detachment or shrinking of the eye (phthisis bulbi) can occur. On the other hand vision with contact lenses excludes only a few occupations, e.g. in the armed forces, railways, ships etc. The possibility of retirement neurosis (money for suffering!) must also be considered.     

Crohn's disease of the prepuce in a 12-year-old boy: a case report and review of the literature

We report a case of Crohn's disease with involvement of the foreskin in a 12-year-old boy. One year previously, on the basis of clinical features (diarrhea with blood, perianal fissures) and histologic examination, a diagnosis of Crohn's disease was made. Subsequently, he developed phimosis and balanitis and underwent circumcision. Sections submitted from the foreskin revealed noncaseating granulomatous inflammation consistent with Crohn's disease. Crohn's disease with involvement of the genitalia is unusual. Only 26 cases including our case have been reported in the scientific literature. We have analyzed these cases with emphasis on gender, age, clinical features, duration of Crohn's disease, and probable mode of spread to the genitalia. Careful examination of sections from genital lesions, including those submitted from the foreskin, is essential to detect small isolated granulomas that may then lead to the diagnosis of inflammatory bowel disease.     

Reiter''s disease in an 11-year-old boy

The breast basic conserved gene (D16S444E) is a candidate tumor suppressor gene previously mapped to human chromosome 16. We determined the map position of D16S444E more precisely using a somatic mouse x human hybrid panel and fluorescence in situ hybridization on metaphase spreads and interphase nuclei. We show that the D16S444E gene is localized on band 16q24.3 and is located between APRT and D16S44.