Popliteal venous aneurysm, a cause of pulmonary embolism.

Generally, most aneurysms of the venous system are probably congenital and rarely have clinical significance. Popliteal aneurysms are an exception of this rule and are known to be a source of recurrent pulmonary emboli. We present a previously healthy 42 year old man with multiple pulmonary emboli, diagnosed with a high probability lung scan. Venous duplex imaging and magnet resonance imaging showed a mass with connection to the popliteal vein of the left knee, suggesting a venous aneurysm. Despite therapeutic anticoagulation he suffered further pulmonary emboli. After insertion of a temporary vena cava inferior filter aneurysm resection and patch reconstruction of the popliteal vein was performed. By duplex imaging we proved the patency of the popliteal vein after surgical repair. Popliteal venous aneurysms should be kept in mind as possible thromboembolic source in young patients with pulmonary embolism. Our review of the current literature about popliteal venous aneurysms revealed a high rate of pulmonary embolism.

Nosocomial rotavirus infections in neonates: means of prevention and control.

Fifteen out of 24 risk neonates from the premature baby ward (= 63%) and 36 of 79 healthy neonates from the infant nursery (= 46%) at a Zürich hospital were infected within a period of 29 days during a nosocomial epidemic human rotavirus (HRV) outbreak. Forty-two out of 51 of all HRV-infected babies (=82%) manifested clinical symptoms, but these could not all be attributed to an HRV infection. On average, rotavirus could be detected in infected risk neonates five days after their admission to the premature baby ward. Eleven of the 15 risk neonates were infected within 10 days after the admission of the index case. Immediately after detection of the epidemic process, specific detailed countermeasures were instituted, including hand protection and hand disinfection, individual nursing set and cohorting of already infected babies. Early institution of such measures and information of all persons responsible for treatment and care of the babies concerned are crucial for success.

Dandy-Walker(like) malformation, atrio-ventricular septal defect and a similar pattern of minor anomalies in 2 sisters: a new syndrome?

We report on sisters with similar craniofacial anomalies, a brain malformation in the area of the posterior fossa, and a congenital heart defect. The craniofacial findings include macrocephaly, a prominent forehead and occiput, foramina parietalia, hypertelorism, downslanting palpebral fissures, a depressed nasal bridge, narrow palate, and apparently low-set ears. Patient 1 had a Dandy-Walker malformation with communicating hydrocephalus, aplasia of the posterior portion of the cerebellar vermis, and high insertion of the confluent sinus, while in patient 2, a Dandy-Walker variant was found with aplasia of the cerebellar vermis and hypoplasia of the hemispheres, large cisterna magna, high insertion of the confluent sinus, but no hydrocephalus. Both sibs were moderately mentally retarded. The older sister had a complete atrio-ventricular canal and died after unsuccessful heart operation at 3 1/2 years. The younger had a successful operation on a cleft mitral valve and septum primum defect. Chromosomes were normal. The occurrence of a distinct and similar pattern of congenital anomalies in sisters born to healthy parents points toward a "new" syndrome caused by the homozygous state of an autosomal recessive gene.

Antley-Bixler syndrome in sisters: a term newborn and a prenatally diagnosed fetus.

Sisters with the Antley-Bixler syndrome are reported herein. The first infant died at 14 days of respiratory failure and the following findings characteristic of the syndrome: craniosynostosis of coronal and lambdoid sutures, brachycephaly, frontal bossing, severe midface hypoplasia with proptosis and choanal stenosis/atresia, humero-radial synostosis, medial bowing of ulnae, long slender fingers with camptodactyly, narrow iliac wings, anterior bowing of femora, cardiac and renal malformations. Unlike two previously published cases, she did not have connatal fractures, but she had vaginal atresia. Ultrasound examination in a subsequent pregnancy showed immobility at the elbows of the fetus, humero-radial synostosis, medial bowing of ulnae, and long hands and fingers. The fetus also had mild bowing of femora. The pregnancy was terminated in the 21st week and the findings were confirmed by clinical and radiologic examinations. Additional autopsy findings included cardiac and renal malformations. The Antley-Bixler syndrome is a recognizable malformation syndrome with a probable autosomal recessive mode of inheritance, which can be diagnosed in the fetus by midtrimester ultrasound examination.

[Dysplasia opticoseptalis]. / Dysplasia optico-septalis.

Dysplasia opticoseptalis was diagnosed in a one-year-old girl. At autopsy an agenesis of the olfactory bulb and other developmental anomalies of the brain were found.