Longterm outcome after injection sclerotherapy for oesophageal varices in children with extrahepatic portal hypertension.

A consecutive series of 36 children with bleeding from oesophageal varices secondary to extrahepatic portal hypertension was successfully treated by endoscopic injection sclerotherapy and followed up over a mean period of 8.7 years after variceal obliteration. There were no deaths from portal hypertension or its treatment and morbidity related to oesophageal sclerotherapy was minimal.

Follow-up after inguinal herniotomy or surgery for hydrocele in boys.

A retrospective review of 556 boys who had undergone inguinal herniotomy or surgery for hydrocele was carried out to assess the value of early routine postoperative follow-up. Of 386 children given an appointment, 319 (82.6 per cent) attended.

Social explanations and self-esteem in Northern Ireland.

The relationship between group-serving attributional biases and self-esteem among Catholics and Protestants in Northern Ireland was examined. There was little evidence of any consistently positive association between these variables. Differential patterns of group-serving biases were clearly evident.

Recurrent necrotizing enterocolitis.

In the decade 1981 to 1991, 16 infants developed recurrent necrotizing enterocolitis (NEC). They comprised 12 (6%) of 196 neonates referred for further management of NEC and four others referred with major congenital anomalies. Their median gestational age was 32 weeks (range, 27 to 40), median birth weight was 1,260 g (range, 790 to 3,230), and the sex distribution was equal.

Current results of surgery for achalasia of the cardia.

Several treatment options are available in the management of achalasia of the cardia. Of a recent series of 14 children, 12 were treated by a modified Heller's myotomy combined with a floppy Nissen fundoplication. Symptoms were dramatically improved in nine during a mean follow up period of 3.

Abdominal inflammatory myofibroblastic tumours in children.

Inflammatory myofibroblastic tumours (inflammatory pseudotumours) occurring at intra-abdominal sites in children have rarely been described. This paper reports three patients with this tumour, two of whom presented with fever, anaemia and an abdominal mass, the third with chronic duodenal obstruction. All had experienced significant weight loss.

Familial intussusception.

We report a father and two sons who each suffered from recurrent acute ileocolic intussusception in childhood, suggesting that there may in some cases be a genetic predisposition to the condition. This might have an anatomical basis.

Paediatric intussusception.

Intussusception is one of the commonest causes of intestinal obstruction in infants and accounts for about 700 hospital admissions each year in England and Wales. Improved results of treatment have followed recent technological developments, which include ultrasonographic imaging and pneumatic reduction techniques. Most intussusceptions can be reduced successfully without the need for operation but close cooperation between surgeon and radiologist is essential.

Double duodenal atresia/stenosis: a report of four cases.

Four neonates with double duodenal atresia/stenosis are described. Preoperative plain radiographs in two patients demonstrated atypical appearances suggestive of complex pathology. Cystic dilatation of the second part of the duodenum was observed at laparotomy in two patients and in one of these the "cyst" was palpable preoperatively, causing diagnostic confusion.

Sonographic detection of the lead point in intussusception.

Using ultrasonography, a caecal duplication cyst was identified as the pathological lead point in a 6 year old boy with acute intussusception. The patient underwent definitive surgery rather than inappropriate treatment by attempted radiological reduction. Various pathological lead points in intussusception can now be defined by ultrasound.

Childhood deaths from intussusception in England and Wales, 1984-9.

Objective: To assess the incidence of potentially avoidable factors contributing to death of children with intussusception.

Design: Review of children who died with intussusception in England and Wales between 1984 and 1989 from data of the Office of Population Censuses and Surveys, case notes, coroners' records, and necropsy reports.

Main Outcome Measures: Unambiguous objective criteria such as failure to diagnose intussusception within 24 hours of admission.

Paediatric emergencies.

During the last decade neonatal surgical results have improved considerably. Except for infants born with serious congenital heart disease, diaphragmatic hernia or exomphalos, postoperative mortality rates for infants with single anomalies have fallen to the region of 10%. This dramatic success story has been marred by a corresponding increase in the number of individuals with several anomalies entering late childhood with severe chronic handicaps.

Intergroup violence and intergroup attributions.

Pettigrew's (1979) prediction that relative to in-group behaviour, negative out-group behaviour would be attributed to internal characteristics, was tested in the context of Northern Ireland's continued conflict. Catholic and Protestant respondents were presented with newsreel footage depicting scenes of in- and out-group violence. One showed a Protestant attack on mourners at a Catholic funeral.

Rodletless, a new Aspergillus developmental mutant induced by directed gene inactivation.

The Aspergillus nidulans CAN41 transcription unit is activated by the brlA regulatory gene early during development of the asexual reproductive apparatus, the conidiophore. Disruption of CAN41 results in a novel mutant phenotype in which conidiophore cells and spores lack an external wall layer, the rodlet layer, making them less hydrophobic than in the wild type and leading to inefficient spore dispersal. The rodletless mutation defines a new locus on chromosome III, rodA.

Rationalising the management of swallowed coins in children.

Objective: To assess the management of swallowed coins in children and identify aspects that could be improved.

Design: Study of records of three hospital departments for 1986-90.

Setting: Accident and emergency, radiology, and operating theatre departments in a children's hospital.