Prevalence of bifid uvula in primary school children.

Background: A bifid uvula is an anatomic variation that can be predictive of sub-mucous cleft palate, which may cause velopharyngeal insufficiency (VPI). Bifid uvula prevalence in the literature ranges from 0.18% to 10.

Skin-Sparing Débridement for Necrotizing Fasciitis in Children.

Background: Necrotizing fasciitis is a serious soft-tissue infection associated with sepsis and tissue destruction. Surgical management usually requires extensive débridement of necrotic fascia and overlying skin, with significant aesthetic and functional consequences. The authors review the outcome of all recent cases of necrotizing fasciitis treated with skin-sparing débridement at their institution.

Microstructural changes in thickened corpus callosum in children: contribution of magnetic resonance diffusion tensor imaging.

Background: Thickened corpus callosum is a rare finding and its pathophysiology is not well known. An anomalous supracallosal bundle has been depicted by fiber tracking in some cases but no diffusion tensor imaging metrics of thickened corpus callosum have been reported.

Objective: To use diffusion tensor imaging (DTI) in cases of thickened corpus callosum to help in understanding its clinical significance.

Chest CT in bronchopulmonary dysplasia: clinical and radiological correlations.

Background: Chest CT is very sensitive in assessing pulmonary damage in bronchopulmonary dysplasia (BPD) and radiological findings in BPD are well described. Validated CT scores are available to assess BPD, as available in other pulmonary diseases such as cystic fibrosis.

Aim: To investigate whether there is a correlation between radiological pulmonary lesions and relevant BPD clinical data (gestational age, type and duration of mechanical ventilation, and severity of BPD) and assess the usefulness of a CT score in evaluating clinical severity.

Recovery of physical activity levels in adolescents after lower limb fractures: a longitudinal, accelerometry-based activity monitor study.

Background: In adolescents, loss of bone mineral mass usually occurs during phases of reduced physical activity (PA), such as when an injured extremity spends several weeks in a cast. We recorded the PA of adolescents with lower limb fractures during the cast immobilization, at 6 and at 18 months after the fracture, and we compared these values with those of healthy controls.

Methods: Fifty adolescents with a first episode of limb fracture and a control group of 50 healthy cases were recruited for the study through an advertisement placed at the University Children's Hospital of Geneva, Switzerland.

Radiation-induced craniofacial bone growth inhibition: acute and long-term effects on bone histopathology with and without cytoprotection.

Background: The authors previously established an animal model of radiation-induced craniofacial bone growth inhibition and demonstrated the effectiveness of cytoprotection in preserving growth using amifostine, but the mechanism is unclear. The objective of this study was to investigate the acute and long-term histopathologic effects of single-dose orthovoltage irradiation on craniofacial bone with and without cytoprotection.

Methods: Sixty infant New Zealand White rabbits (7-week-old) were randomized into three groups (n = 20 per group): group 1, 0-Gy, sham irradiation; group 2, 35-Gy single-dose orthovoltage irradiation; and group 3, cytoprotection with amifostine before irradiation.

Local hemodynamic effects of radiation on the rabbit orbitozygomatic complex with and without cytoprotection.

Background: The authors have previously demonstrated that radiation-induced craniofacial bone growth inhibition may be ameliorated using the known cytoprotectant amifostine in the infant rabbit orbitozygomatic complex. The authors' hypothesis is that reduction in blood supply plays an important role in inhibiting craniofacial bone growth following radiotherapy and that cytoprotective pretreatment exerts its protective effect by maintaining blood supply.

Methods: Seven-week-old New Zealand male infant rabbits underwent single-dose orthovoltage irradiation to the right orbitozygomatic complex using established protocols: 0 Gy (sham), 35 Gy, and 35 Gy following pretreatment with amifostine (300 mg/kg administered intravenously).

Cholestasis as the leading sign of a transmesenteric hernia in a split-liver transplanted child - a case report and review of literature.

Internal hernias are an extremely rare complication after pediatric liver transplantation, and its presentation with cholestasis has not been described to date. We report the case of a 12-yr-old boy who presented with moderate abdominal pain 11 yr after split liver transplantation and biliary-enteric anastomosis. He developed severe jaundice within 24 h of initial presentation.

Paediatric liver transplantation for metabolic disorders. Part 1: Liver-based metabolic disorders without liver lesions.

Liver-based metabolic disorders account for 10 to 15% of the indications for paediatric liver transplantation. In the last three decades, important progress has been made in the understanding of these diseases, and new therapies have emerged. Concomitantly, medical and surgical innovations have lead to improved results of paediatric liver transplantation, patient survival nowadays exceeding 80% 10-year after surgery with close to normal quality of life in most survivors.

Paediatric liver transplantation for metabolic disorders. Part 2: Metabolic disorders with liver lesions.

Liver based metabolic disorders account for 10 to 15% of the indications for paediatric liver transplantation. In the last three decades, important progress has been made in the understanding of these diseases, and new therapies have emerged. Concomitantly, medical and surgical innovations have lead to improved results of paediatric liver transplantation, patient survival nowadays exceeding 80% 10 year after surgery with close to normal quality of life in most survivors.

No improvement of survival with reduced- versus high-intensity conditioning for allogeneic stem cell transplants in Ewing tumor patients.

Background: Outcomes of Ewing tumor (ET) patients treated with allogeneic stem cell transplantation (allo-SCT) were compared regarding the use of reduced-intensity conditioning (RIC) and high-intensity conditioning (HIC) regimens as well as human leukocyte antigen (HLA)-matched and HLA-mismatched grafts.

Patients And Methods: We retrospectively analyzed data of 87 ET patients from the European Group for Blood and Marrow Transplantation, Pediatric Registry for Stem Cell Transplantations, Asia Pacific Blood and Marrow Transplantation and MetaEICESS registries treated with allo-SCT. Fifty patients received RIC (group A) and 37 patients received HIC (group B).

National survey on abdominal trauma practices of pediatric surgeons.

Introduction: Pediatric blunt abdominal trauma is a frequent reason for hospital admission, but there are no established guidelines to assess these patients. Our study aims to evaluate the diagnostic process used by pediatric surgeons in Switzerland to evaluate abdominal trauma.

Material And Methods: A scenario-based survey was carried out among Swiss pediatric surgeons.

Cure of multifocal panhepatic hepatoblastoma: is liver transplantation always necessary?

Purpose: Multifocal panhepatic hepatoblastoma (HB) without extrahepatic disease is generally considered as an indication for total hepatectomy and liver transplantation. However, after initial chemotherapy, downstaging of the tumor sometimes allows complete macroscopic resection by partial hepatectomy. This procedure is no longer recommended because of the risk of persistent viable tumor cells in the hepatic remnant.

Spontaneous thrombosis of hepatic aneurysms in an infant with Wiskott-Aldrich syndrome.

Vasculitides and aneurysm formation are well-known complications in Wiskott-Aldrich syndrome (WAS), most often appearing later in life, usually in second decade. The authors report the case of a 5-month-old boy with a genetically and phenotypically severe Wiskott-Aldrich syndrome and sequential formation and spontaneous thrombosis of hepatic aneurysms. This case demonstrates that aneurysm formation may develop early in the course of severe WAS phenotypes.

Blunt abdominal trauma in children: a score to predict the absence of organ injury.

Objectives: To evaluate the initial workup and design a score that would allow ruling out significant intra-abdominal organ injuries following blunt abdominal traumas (BAT).

Study Design: Data were collected prospectively from 147 consecutive patients admitted for BAT in a tertiary care hospital, over a 30-month period.

Results: Statistical significance of various parameters (trauma mechanism, clinical examination, laboratory tests, and ultrasound findings) were analyzed in relation to intra-abdominal injuries.

Infected urocolpos and generalized peritonitis secondary to labia minora adhesions.

Introduction: Labia minora adhesions (LMA) are a common finding in young girls. Usually, this condition is asymptomatic and spontaneously disappears during adolescence. We report on a case revealed by infected urocolpos and peritonitis and whose treatment finally required surgical reduction labioplasty.

Correlation of lung abnormalities on high-resolution CT with clinical graft-versus-host disease after allogeneic versus autologous bone marrow transplantation in children.

Background: Late-onset noninfectious pulmonary complications (LONIPCs) are life-threatening complications of bone marrow transplantation (BMT). Several pathological patterns are described in the literature with different prognoses, and with different relationships to graft-versus-host disease (GVHD). The role of high-resolution CT (HRCT) is not yet well established.

MRI neurography and diffusion tensor imaging of a sciatic perineuroma in a child.

Perineuroma, rare in children, presents as a painless mononeuropathy of a major nerve trunk. Resection of the lesion with end-to-end sural nerve grafting appears to be the treatment of choice. This technique is not recommended if the unhealthy segment of nerve is too long or if spinal roots are involved.

Radiation-induced craniofacial bone growth inhibition: in vitro cytoprotection in the rabbit orbitozygomatic complex periosteum-derived cell culture.

Background: Radiotherapy for the management of head and neck cancer in pediatric patients results in severe inhibition of craniofacial bone growth. Previously, the infant rabbit orbitozygomatic complex was established as an experimental model. Amifostine, a cytoprotective agent, was found effective in preventing radiation-induced bone growth inhibition.

Liver function tests in children with blunt abdominal traumas.

Background: Previous studies have suggested that there are cut-off values for liver function tests (LFTs) beneath which significant liver injury can be excluded after blunt abdominal trauma in children. Our objective is to test this hypothesis in our patient population.

Methods: The LFTs of all consecutive patients admitted in Geneva from January 1, 2001 to December 31, 2004 following blunt abdominal trauma were analysed and compared to radiological (ultrasound and/or computed tomography scan) findings and final outcome.

Radiation-induced craniofacial bone growth disturbances.

Multimodality treatment, including radiotherapy, chemotherapy, and surgery, is required for the management of head and neck cancer in pediatric patients. Despite the modern advances in radiation dosing and targeting techniques, the radiation damage to the growing craniofacial skeleton in children remains a significant clinical problem. The first part of this review summarizes the clinical effects of radiotherapy on craniofacial bone growth in children.