ABSTRACT
Monozygotic twin sisters are reported who have discordant pubertal growth and sexual development. Although both sisters were physiologically appropriate for chronological age in their pubertal development, their adolescent development was considerably different from that expected of monozygotic twin sisters. The more pubertally advanced sister by magnetic resonance imaging had an optic pathway glioma while none was present in her twin sister. Precocious puberty is not an unexpected complication of neurofibromatosis type 1 and is always associated with the presence of an optic pathway glioma. These sisters emphasize the striking similarity that is expected of monozygotic twins and the need for investigation when intertwin differences in growth and/or development arise.
Subject(s)
Diseases in Twins/genetics , Neurofibromatosis 1/genetics , Pregnancy Complications , Birth Weight , Body Height , Child , Female , Growth , Humans , Infant, Newborn , Magnetic Resonance Imaging , Neurofibromatosis 1/diagnosis , Parity , Pregnancy , Puberty, Precocious/diagnosis , Puberty, Precocious/genetics , Respiratory Distress Syndrome, Newborn/diagnosis , Respiratory Distress Syndrome, Newborn/genetics , Retinoblastoma/diagnosis , Retinoblastoma/genetics , Twins, MonozygoticABSTRACT
One hundred parents of infants aged 2 weeks to 6 months were surveyed at the time of routine well-child visits to assess parental knowledge about baby powder and to determine whether hospital policy of providing a free powder sample to newly delivered mothers was unwittingly promoting powder usage. Most parents (69%) reported regular baby powder use as part of routine infant skin care. Powder-users were significantly more likely than nonusers to attribute to baby powder the ability to kill bacteria and yeast and to prevent diaper rash (p less than 0.01). Even among nonusers, fewer than half were aware that aspiration/ingestion of baby powder was a potential health hazard. Almost all parents reported receiving a free sample of baby powder while in the hospital as part of a complimentary gift pack provided by the manufacturers. Most powder-users were currently using a brand they had received as a sample, and eight parents cited the receipt of a sample as the major determinant for selecting a particular brand of powder. The short- and long-term effects of distributing sample packs to newly delivered parents deserve further study.
Subject(s)
Infant Care , Parents/psychology , Powders/adverse effects , Adolescent , Adult , Female , Humans , Infant , Infant, Newborn , Male , Skin , Surveys and QuestionnairesABSTRACT
The advantages of this method appear to be (1) minimal dissection in the area of previous surgery or aneurysm; (2) high exposure of the upper portion of the internal carotid artery, avoiding damage to the vagus and hypoglossal nerves, plus good exposure and control in a clean area; (3) easy shunting that facilitates the distal anastomosis as well as protects the brain; (4) proper length of the graft is assured by stretching it down the shunt and slitting it to the level of the upper end of the common carotid arteriotomy, (5) no dissection is necessary to preserve the external carotid, and it is not necessary to clamp this vessel; (6) intraluminal ligation of the external carotid artery after reconstruction in the case of aneurysm prevents unnecessary dissection.
Subject(s)
Aneurysm/surgery , Carotid Artery Diseases/surgery , Carotid Artery, Internal/surgery , Humans , RecurrenceSubject(s)
Arginine/analogs & derivatives , Argininosuccinic Acid/urine , Argininosuccinic Aciduria , Citrulline/blood , Lyases/deficiency , Ornithine Carbamoyltransferase Deficiency Disease , Urea/metabolism , Ammonia/blood , Child, Preschool , Coma/diagnosis , Coma/etiology , Coma/therapy , Female , Humans , Infant , Infant, Newborn , Intellectual Disability/complications , MaleABSTRACT
Severe ischemia and distal gangrene of lower extremities due to obstruction of the popliteal artery and its branches need not require major amputation. Autogenous vein grafts to the distal anterior tibial, posterior tibial, peroneal and dorsalis pedis arteries can avoid tissue loss in many instances.
Subject(s)
Femoral Artery/surgery , Foot/blood supply , Ischemia/surgery , Amputation, Surgical , Humans , Tibia , Transplantation, Autologous , Veins/transplantationSubject(s)
Anemia, Sickle Cell/physiopathology , Deer/blood , Hemoglobin, Sickle , Hemoglobins, Abnormal , Sickle Cell Trait/physiopathology , Amino Acid Sequence , Amino Acids/analysis , Animals , Cyanates , Diphosphoglyceric Acids , Genetic Variation , Goats , Hydrogen-Ion Concentration , Ligands , Microscopy, Electron , Models, Molecular , Oxygen/blood , Oxyhemoglobins , Protein Binding , Protein Conformation , Sheep , Species Specificity , Urea , X-Ray DiffractionSubject(s)
Pituitary Gland/metabolism , Pituitary Neoplasms/metabolism , Polyribosomes/metabolism , Aminoacylation , Animals , Binding Sites , Centrifugation, Density Gradient , Chromatography, Gel , Cytosol/metabolism , Female , Neoplasm Proteins/biosynthesis , Neoplasms, Experimental/metabolism , Neoplasms, Experimental/pathology , Phenylalanine/metabolism , Pituitary Gland/cytology , Pituitary Gland/pathology , Pituitary Hormones/metabolism , Pituitary Neoplasms/pathology , Rats , Ribosomes/metabolism , Spectrophotometry, Ultraviolet , Subcellular Fractions/metabolism , Time Factors , Tritium , UltracentrifugationSubject(s)
Aorta, Abdominal , Aortic Coarctation/surgery , Aortic Coarctation/complications , Blood Vessel Prosthesis , Female , Humans , Iliac Artery/surgery , Intermittent Claudication/etiology , Leg/blood supply , Male , Methods , Middle Aged , Renal Artery/surgery , Renal Artery Obstruction/etiologySubject(s)
Arteries/surgery , Postoperative Complications/surgery , Vascular Surgical Procedures/adverse effects , Adult , Aged , Aortic Aneurysm/surgery , Blood Vessel Prosthesis/adverse effects , Embolism/surgery , Follow-Up Studies , Hemorrhage/surgery , Humans , Intestinal Obstruction/surgery , Intestines/blood supply , Ischemia/surgery , Laparotomy , Middle Aged , Thrombosis/surgerySubject(s)
Sympathectomy , Abdomen , Adult , Aged , Humans , Intestinal Obstruction/etiology , Methods , Middle Aged , Postoperative Complications , Pulmonary Atelectasis/etiology , Time FactorsSubject(s)
Blood Pressure , Catheterization , Subclavian Vein/surgery , Central Nervous System , Humans , MethodsABSTRACT
A method for replacement of an arterial graft when sepsis develops in the groin involves "blind" passing of a prosthetic vessel from the pelvis via the obturator foramen to the popliteal space. This can be carried out with minimal dissection and no incision in the thigh. Adequate initial drainage, the use of antibiotics, locally and systemically, and suturing with monofilament polyester material appears to help toward a successful outcome.
