[Tracheal agenesis. A rare cause of respiratory insufficiency in neonates]. / Trachealagenesie. Eine seltene Ursache der respiratorischen Insuffizienz des Neugeborenen.

Tracheal agenesis is a very rare congenital anomaly that occurs isolated or in combination with other anomalies. It presents immediately after birth with an absolute respiratory insufficiency and lack of crying. The immediate precise anatomical classification of the anomaly is crucial in order to decide if surgical therapy is possible. This report describes a newborn boy with tracheal agenesis type II. The diagnosis was confirmed by spiral computed tomography and a selection of the pictures is presented. The treatment was discontinued due to a lack of therapeutical options. Based on this case report we discuss the special situation of this rare anomaly. Interesting information on tracheal agenesis was gathered, the differential diagnosis of respiratory insufficiency of the newborn is summarised and a modified algorithm of the current newborn resuscitation guidelines of the American Heart Association is presented.

Pansclerotic morphea in childhood: a case report.

Scleroderma can be differentiated into progressive systemic and circumscript forms. The extensive form with lethal outcome is known from case reports of children and adolescents. The present case report concerns a boy who died at 16 years of age. In the 5th year of life, he experienced weight loss and developed multiple, firm, partially atrophic plaques in the skin of the extremities. These plaques gradually became confluent and extended over the whole torso and head. Plaque ulceration resulted in massive mutilations to the body. Later the patient's cachexia worsened and he developed keratose, moderately differentiated squamous cell carcinoma of the right leg. The prognosis of pansclerotic morphea for children is worse than for adults. No successful therapy is known.

Incidence of contralateral patent processus vaginalis in children with inguinal hernia.

PURPOSE: The aim of this study was to investigate the incidence of contralateral patent processus vaginalis (PPV) in children with inguinal hernia using direct laparoscopic inspection. METHODS: This study evaluates the incidence and size of contralateral PPVs in 143 children (96 boys, 47 girls) with clinically unilateral indirect inguinal hernia who underwent laparoscopic hernia repair. During repair, the contralateral internal inguinal ring was evaluated for PPV. RESULTS: Boys with hernias on the right side had wide-open contralateral PPVs in 26% of cases compared with 11% in girls. Boys with hernias on the left side had wide-open contralateral PPVs in 30% of cases compared with 38% in girls. In all 4 groups, there were small contralateral openings in 15% to 20% of cases. CONCLUSION: Contralateral PPV seems to occur less commonly than previously assumed.

Tetrachlorodecaoxide does not jeopardize anastomotic healing: an experimental study in animals.

Tetrachlorodecaoxide (TCDO) is a negatively-charged complex of chlorine and oxygen commonly used for the treatment of infected external wounds. However, it displays antiadhesive properties when applied intra-abdominally. In rats, small-bowel and a large-bowel anastomoses were performed and one-half of the animals received TCDO. It was found that TCDO did not alter the bursting pressures of small and large-bowel anastomoses at 1, 3 and 9 days postoperatively.

Smith-Lemli-Opitz syndrome: case report and literature review.

The authors report the case of a 6-week-old boy with the Smith-Lemli-Opitz-syndrome (SLOS) and review the literature on the subject. Intersexuality was suspected and a laparoscopy performed. Abnormalities of the gastrointestinal tract, the lower extremities, and the face prompted DNA analysis, which found a defect of cholesterol biosynthesis in the form of the Smith-Lemli-Opitz-syndrome, a rare congenital defect. The clinical course of this case is compared with similar cases in the literature.

Hyaluronate, tetrachlorodecaoxide, and galactolipid prevent adhesions after implantation of Gore-Tex and dura mater into the abdominal wall in rats.

Gore-Tex (GT) and dura mater (DM) are used as prosthetic materials for the closure of the abdominal wall defects, however, they create intra-abdominal adhesions. This study addresses the question of which substances can reduce these adhesions. In rats, Gore-Tex and DM were placed on the inner abdominal wall. Two weeks later the animals were killed; the anterior abdominal wall was excised and photographed. The photographs were digitized and the surface area covered by adhesion was measured by computer analysis. In animals where DM or GT was implanted without the addition of an anti-adhesive substance, 45% of the DM and 34% of the GT surface was covered by adhesions. When hyaluronate (HA), tetrachlorodecaoxide, or galactolipid was applied to the bowel intra-operatively, adhesions were found on only 14%, 11% or 8% of the GT surface. For DM, only HA was effective, and reduced adhesions to 9% and 10%, respectively. Plasmin, taurolidine, and streptokinase-streptodomase were ineffective in preventing adhesions in both DM and GT.