Specific medical and surgical treatment for chronic inflammatory diseases in children.

Treatment for chronic inflammatory conditions in children should take into account the specific pathophysiological and clinical processes underlying these disorders. These guidelines provide a framework for both the medical and surgical treatment of chronic inflammatory diseases such as otitis media, allergic rhinitis and chronic rhinosinusitis, chronic inflammation of tonsils and adenoids, and laryngitis. In addition, the role of vaccinations and immunomodulatory therapies is discussed.

Biological conditions affecting chronic inflammation in upper airways in children.

Problems/objectives: A child's immune system cannot depend on a memory-type immune response and it also induces cytokine responses less efficiently. Biological conditions like allergy or cystic fibrosis, immune deficiency or gastrooesophageal reflux can induce and maintain background inflammation in children's upper airways, making newborns and children more susceptible to upper airway infections and inflammations. This paper will describe in brief how allergy, cystic fibrosis, immune deficiency, nasal and paranasal anatomical variants, and gastro-oesophageal reflux (GOR) can affect the immune and inflammatory responses in upper airways and how they could interfere with immunity development and maturation in children.

Embryology and epidemiology of cleft lip and palate.

Craniofacial anomalies, in particular cleft lip and palate, are major human birth defects with a worldwide frequency of 1 in 700 and substantial clinical impact. This article reviews the embryology of the face, lip, and palate to enhance the understanding of the pathogenesis of these lesions, with particular attention to the period of susceptibility during gestation, complexity, and the factors that may influence their development. It includes an overview of the prevalence and environmental and genetic causes of cleft lip-with or without cleft palate- and cleft palate.

Apertura pyriformis stenosis in the newborn.

Apertura pyriformis stenosis in the newborn. Respiratory distress in the newborn can have a variety of aetiologies, the best known of which are cardiac and pulmonary diseases. Major nasal airway obstruction is probably often overlooked when acute desaturation of the neonate requires reanimation procedures, although it is well established that the baby is an obligate nose breather at birth.

The utility of the guppy (Poecilia reticulata) and medaka (Oryzias latipes) in evaluation of chemicals for carcinogenicity.

There has been considerable interest in the use of small fish models for detecting potential environmental carcinogens. In this study, both guppies (Poecilia reticulata) and medaka (Oryzias latipes) were exposed in the aquaria water to three known rodent carcinogens for up to 16 months. Nitromethane, which caused mammary gland tumors by inhalation exposure in female rats, harderian gland and lung tumors in male and female mice, and liver tumors in female mice by inhalation, failed to increase tumors in either guppies or medaka.

Initial assessment of a neck mass in children.

Objective: To propose national recommendations for the initial assessment of a mass in the neck in children.

Methods: Comprehensive review of the available literature and consensus discussion with national experts in the field.

Results: Consensus guidelines are proposed concerning the work up of children presenting with a mass in the neck.

Thyroid alar cartilage graft in paediatric laryngotracheal reconstruction.

Objective: To evaluate the potential indications of thyroid alar cartilage (TAC) graft in the paediatric laryngotracheal reconstruction (LTR) population based on observations obtained in a case series of 27 consecutive infants referred to our tertiary care center.

Methods: Thyroid alar cartilage grafting was performed for limited Myer grade II and grade III subglottic stenosis requiring a single-stage laryngoplasty and for laryngeal enlargement after translaryngotracheal resection of endolaryngeal tumors. The evolution of the grafted area was evaluated prospectively during endoscopic follow-up.

Iodine-123 alpha-methyl-l-tyrosine single-photon emission tomography for the visualization of head and neck squamous cell carcinomas.

The uptake of iodine-123 alpha-methyl-l-tyrosine (IMT) in the primary tumours and metastatic lymph nodes of squamous cell carcinoma of the head and neck was examined with single-photon emission tomography (SPET). Eleven patients with biopsy-proven carcinomas were studied prior to any therapeutic action. The evaluation of cervical lymph node involvement was based on the findings of physical examination, computed tomography and magnetic resonance imaging, and in six patients on the histological data relating to tissue samples obtained by fine-needle lymph node aspiration or surgical intervention.

Assessment of adenoid size in children by fibreoptic examination.

In order to investigate the relationship between the size of the adenoid and upper respiratory symptoms in children, fibreoptic examination of the nasal cavity and nasopharynx was performed in 817 children. The size of the adenoid was classified into three categories according to the distance between the vomer and the adenoid tissue. There was a significant relation between the size of the adenoid and the complaints of nasal obstruction (P < 0.

The kinetics of the cytologic and rhinomanometric changes in the nose after challenge with allergen.

The objective of these experiments was to study the dynamics of the cytologic and rhinomanometric nasal reaction after allergen challenge. For this purpose a micro-suction system was developed to repetitively and atraumatically collect nasal secretions. Outside of the pollen season, four patients allergic to grass pollen were challenged with phosphate buffered saline (PBS) and, two weeks later, with grass pollen.

Toxicity of polybrominated biphenyls (PBBs) in Domestic and laboratory animals.

The composition, environmental fate, and effects of the polybrominated biphenyls (Firemaster BP-6 or FF-1) involved in the accidental contamination of cattle feed in Michigan in 1973 are reviewed. Toxic effects referred to in this report are limited to those occurring in domestic and laboratory animals and include general toxicity, neurobehavioral toxicity, immunotoxicity, reproductive toxicity, mutagenicity and carcinogenicity. The absorption, distribution, biotransformation and elimination of these polybrominated biphenyls are discussed along with the interactions with other chemicals and drugs.

Amino sugar sensitivity in Escherichia coli mutants unable to grow on N-acetylglucosamine.

Studies were conducted on two mutants of Escherichia coli that lack either glucosamine-6-phosphate deaminase or N-acetylglucosamine-6-phosphate deacetylase and which accumulate glucosamine-6-phosphate or N-acetylglucosamine-6-phosphate, respectively, when grown in the presence of N-acetylglucosamine. The addition of 10(-4) to 10(-5)mN-acetylglucosamine to these mutant strains caused a rapid and complete inhibition of growth on substrates that enter the catabolic pathways at or below the level of fructose-6-phosphate. Growth on glucose was inhibited to a lesser degree, whereas only minor inhibition occurred when the pentoses were used as substrates.