Occult neurovesical dysfunction in children with imperforate anus and its variants.

Neurovesical dysfunction (NVD) is frequently encountered in children with imperforate anus and its variants. Such functional urologic problems are often compounded by associated anatomic urologic abnormalities that in combination may profoundly alter the course and prognosis of children with imperforate anus. Herein, we report 16 such cases.

The use of prostaglandin F2 alpha for the prophylaxis of cyclophosphamide induced cystitis in rats.

It is well-established that cystitis is a significant cause of morbidity after cyclophosphamide administration in clinical populations. We induced hemorrhagic cystitis in rats using cyclophosphamide and compared controls to those pretreated with prostaglandin F2 alpha. Rats were then evaluated for differences in bladder weights, gross edema, gross bleeding, and histologic changes.

Duplicate bladder exstrophy: a new variant of clinical and embryological significance.

A case of duplicate exstrophy of a nature not previously encountered is reported, which we believe has important clinical and embryological implications. The patient presented with what appeared to be classical exstrophy. The inability to identify the ureteral orifices at operation led to the discovery of a previously unrecognized subjacent bladder of normal size and configuration except for a patulous bladder neck and associated epispadias.

Advantages of automating vital signs measurement.

A comparison of automated versus conventional vital signs measurement methods revealed that the automated method required significantly less time and was perceived by nursing staff to be easy to use, accurate, and superior to the conventional method.

Unusual causes of renal failure in diabetics: two case studies.

An atypical course of diabetic nephropathy may signal an associated glomerulonephritis or other complicating illness. Two cases illustrate the importance of seeking reversible causes of renal dysfunction in diabetics.

Percutaneous transperineal pouch localization in low imperforate anus: a new approach.

Patients who have an imperforate anus with associated infralevator, or low rectal pouch, are candidates for a perineal anoplasty. However, in the absence of a perineal fistula, intraoperative localization and isolation of the rectal pouch can be difficult. We have developed a technique to facilitate isolation and dissection of the rectal pouch for perineal anoplasty in patients with a low imperforate anus who do not have a perineal fistula present.

The influence of donor age on graft survival in renal transplantation.

The current supply of kidneys from cadaver and living related donor sources is not sufficient to meet the demand. As a result, alternative sources of renal allografts are being explored, including very young donors and anencephalic newborns. However, data on the success of transplanting kidneys from very young donors are limited and conflicting.

Mutagenesis analysis of a self-cleaving RNA.

The hammerhead structural model proposed for sequences that mediate self-cleavage of certain RNAs contains base-paired three stems and 13 conserved bases. Insertion, deletion and base substitution mutations were carried out on a 58 base RNA containing the sequence of the single-hammerhead structure of the plus RNA of the virusoid of lucerne transient streak virus, and the effects on self-cleavage assessed. Results showed that there is flexibility in the sequence requirements for self-cleavage in vitro, but alterations of the conserved sequence or predicted secondary structure generally reduced the efficiency of self-cleavage.

RNA stem stability in the formation of a self-cleaving hammerhead structure.

The proposed single-hammerhead structure of the self-cleaving newt RNA is unstable due to a weak stem III and therefore is unable to mediate self-cleavage. A double-hammerhead structure with greater theoretical stability has been shown to mediate the self-cleavage of this RNA (Forster et al., 1988, Nature 334, 265).

Umbilical artery flow velocity waveforms in labour.

Doppler signals were recorded from the umbilical arteries in 103 women during labour. The pulsatility index (PI) did not alter with progress in labour. During uterine contractions the PI showed a change only if there was a deceleration in the fetal heart rate.

Factors influencing patient and graft survival in 300 cadaveric pediatric renal transplants.

We reviewed the results of 300 cadaveric pediatric renal transplantations performed at our institution. The procedures provided significant survival and improvement of the quality of life in the majority of children. Recipient and graft survival was better in patients more than 5 years old than in younger children.

Trial of ganglioside GM1 in acute stroke.

Ganglioside GM1 (100 mg) was given daily by intramuscular injection for 28 days in a double-blind placebo controlled trial of acute stroke. No significant difference was detected in a 6 month follow-up period between well matched control and active groups. Although the number of patients studied was small the findings are believed to indicate that GM1 is unlikely to be of value in the treatment of acute stroke in the dose and route of administration used.

Self-cleaving viroid and newt RNAs may only be active as dimers.

Avocado sunblotch viroid (ASBV) is a 247-nucleotide, single-stranded, circular RNA. It is considered to replicate via a rolling-circle mechanism in which circular, monomeric plus and minus RNAs act as templates for the synthesis of longer-than-unit-length precursor RNAs. Processing of these RNAs in vivo may occur by a self-cleavage reaction, as indicated by ability of dimeric, linear plus and minus ASBV RNAs to specifically self-cleave in vitro with the excision of a monomeric RNA with 5'-hydroxyl and 2',3'-cyclic phosphodiester termini.

Thoracoscopy: assessment of a physician service and comparison of a flexible bronchoscope used as a thoracoscope with a rigid thoracoscope.

The practicality of physicians performing thoracoscopy for diagnostic purposes was assessed in 30 patients with pleural effusions of unknown cause. A rigid thoracoscope was compared with a fibreoptic bronchoscope used as a flexible thoracoscope and the diagnostic adequacy of biopsy specimens obtained with the two instruments assessed. The two instruments were inserted by a physician in the bronchoscopy suite using local anaesthesia.

The genitourinary system in patients with imperforate anus.

The incidence and significance of associated genitourinary abnormalities was reviewed in a series of 484 infants with imperforate anus encountered over a 17-year period. Fourteen percent of the entire series had significant bilateral upper tract urinary abnormalities (either asymmetric or symmetric). Of 67 such patients only 14 had combinations of renal agenesis and hypoplasia-dysplasia representing uncorrectable renal pathology.

Hypospadias.

This article outlines the basic etiologic, anatomic, and reconstructive considerations needed for screening, evaluating, counseling, and following patients with hypospadias.

Surgical considerations in childhood end-stage renal disease.

This article provides a conceptual framework that is useful to the pediatrician who provides children with renal failure with care. Operative and perioperative consideration are emphasized.

Renal transplantation in children.

The application of the principles underlying successful renal transplantation in children has led us to increasing success in achieving our goals, which involve more than simple renal function replacement and include effective growth in stature, skeletal and central nervous system development, as well as social development. To succeed in these diverse areas, all modalities of therapy for ESRD may be needed at various times in some patients. Pretransplant therapy must be judiciously selected, and post-transplant protocols often modified to reflect individualized needs.