Unusual Laryngeal Problems in Children

1973 ◽  
Vol 82 (5) ◽  
pp. 637-642 ◽  
Author(s):  
Burton F. Jaffe
Keyword(s):  
Vocal Cord ◽  
Microscopic Examination ◽  
Functional Result ◽  
Clinical Course ◽  
Medical Center ◽  
Cystic Hygroma ◽  
Abductor Paralysis ◽  
Excellent Functional Result ◽  
One Year ◽  
Suspension Laryngoscopy

Three rare laryngeal lesions were seen in one year at Children's Hospital Medical Center in Boston. Case 1 is a subglottic mass that is a diagnostic problem since various pathologists have differing opinions ranging from a benign to a malignant tumor. The tumor mass was totally removed as a biopsy and to avoid a tracheotomy. Clinical management is now conservative and awaits both a definite pathologic diagnosis as well as a definite clinical course. Case 2 is an isolated lymphangioma of the larynx unrelated to a cervical cystic hygroma. The edematous arytenoid prominences and aryepiglottic folds were removed with an excellent functional result. Case 3 is a bilateral vocal cord adhesion following four days of endotracheal intubation. An inappropriate diagnosis of bilateral vocal cord abductor paralysis was made earlier and corrected on a later microscopic examination of the larynx. Simple division of the posterior adhesion gave an excellent functional result. Suspension laryngoscopy with microscopic examination of the larynx was important in all three cases both from a diagnostic and a therapeutic viewpoint.

A Case of Successful Enlargement of the Glottic Space Resulting from Modified Thyroarytenoid Myotomy for Bilateral Vocal Cord Abductor Paralysis

2006 ◽  
Vol 57 (4) ◽  
pp. 371-377 ◽  
Author(s):  
Makoto Ogawa ◽  
Yoshifumi Yamamoto ◽  
Takeshi Kamakura ◽  
Hidenori Inohara ◽  
Yusuke Watanabe ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Abductor Paralysis

scholarly journals Acute Disseminated Encephalomyelitis Associated with Pasteurella multocida Meningitis

2003 ◽  
Vol 30 (2) ◽  
pp. 155-158 ◽  
Author(s):  
Normand L. Proulx ◽  
Mark S. Freedman ◽  
James W. Chan ◽  
Baldwin Toye ◽  
Cathy C. Code
Keyword(s):  
Case Report ◽  
Antibiotic Treatment ◽  
Pasteurella Multocida ◽  
Clinical Course ◽  
Acute Disseminated Encephalomyelitis ◽  
Persistent Fever ◽  
Mri Scans ◽  
One Year ◽  
Culture Positive ◽  
Serial Mri

ABSTRACT:Objective:To describe a case of Pasteurella multocida meningitis associated with acute disseminated encephalomyelitis (ADEM).Case report:A 33-year-old woman employed in a dog pound presented herself to hospital with fever and meningismus and was found to have culture positive Pasteurella multocida meningitis. Despite appropriate antibiotic treatment her clinical course was characterized by a persistent fever and worsening encephalopathy, which prompted further neurological investigation. Spinal fluid exam and serial MRI scans as well as her one-year clinical course were found to be compatible with ADEM.Conclusion:Persistent fever and worsening encephalopathy in meningitis may indicate a para-infectious immune process such as ADEM, and may serve as indications for further neurological investigation.

Varicella and Cortisone

PEDIATRICS ◽  
1956 ◽  
Vol 18 (1) ◽  
pp. 160-162 ◽  
Author(s):  
ROBERT J. HAGGERTY ◽  
R. CANNON ELEY
Keyword(s):  
Infectious Diseases ◽  
Clinical Course ◽  
Medical Center ◽  
Post Mortem ◽  
The Past ◽  
Vesicle Fluid ◽  
Heart Blood ◽  
Cortisone Therapy ◽  
Relationship Of

In the past 2 years we have seen 2 patients at the Children's Medical Center, who, while receiving cortisone therapy, developed varicella and died following a state of shock within a few days after the appearance of the vesicles. Post-mortem examinations of these patients revealed hemorrhagic vesicles throughout all viscera. In 1 case the virus of varicella was grown from vesicle fluid, heart blood, and lung. Since fatalities from varicella in childhood are so rarely encountered, even by physicians with vast experience in the field of infectious diseases, and since the clinical course of the infection in these two patients was so fulminating, the possible relationship of cortisone administration was raised.

Detection of Novel mutation in VANGL1 gene indicating genetic association of Myelomeningocele

2021 ◽  
Vol 15 (8) ◽  
pp. 1938-1941
Author(s):  
Urooj Fatima ◽  
Syed Meesam Iftikhar ◽  
Sabahat Gul ◽  
Farrukh Mustafa Memon
Keyword(s):  
Folic Acid ◽  
Genetic Association ◽  
Novel Mutation ◽  
Medical Center ◽  
Folic Acid Deficiency ◽  
Lumbar Region ◽  
Cross Sectional ◽  
Rare Mutation ◽  
Congenital Birth Defect ◽  
One Year

Aim: To detect the novel mutation in VANGL1 gene indicating genetic association of Myelomeningocele. Methodology: The study design was cross sectional. It comprises of sixty individuals, of them fifty were diagnosed cases of myelomeningocele and ten were healthy individuals taken as controls. The cases were collected from Jinnah Postgraduate Medical Center. The study was carried out in Dow Diagnostic and Research Laboratory (D.D.R.L.). Most of the patients were less than one year of age. The cases were evaluated for various other parameters like site and size of cyst and associated features like presence of hydrocephalus in the individuals. Since folic acid deficiency is the key component in the causation of the disease so mothers were also asked about the consumption of folic acid. Blood was drawn from patients after a written permission from the parents of the concerned patient. It was followed by the conduction of PCR to seek for any mutation in VANGL1 gene. Results: We found a rare mutation in VANGL1 gene revealing substitution of valine to serine at position 239 i.e. V239S. Hydrocephalus being the associated anomaly was present in 32% of the patients. Most of the affected individuals were males. 98% mothers of the sufferers did not take folic acid during pregnancy. In most of the patients, lump was present on the lumbar region. Conclusion: Myelomeningocele is a congenital birth defect with lifelong complications. Its prevalence can be decreased by taking certain measures. Periconceptional intake of folic acid has been established to lessen the risk of the disease. We identified a rare mutation in VANGL1 gene that may result in the causation of myelomeningocele. Keywords: Neural tube defects, mutation, myelomeningocele.

A Therapeutic Trial of Fatty Acid Supplementation in Cystic Fibrosis

PEDIATRICS ◽  
1976 ◽  
Vol 57 (4) ◽  
pp. 474-479
Author(s):  
Robert B. Elliott
Keyword(s):  
Cystic Fibrosis ◽  
Fatty Acid ◽  
Clinical Course ◽  
Therapeutic Trial ◽  
Biochemical Abnormality ◽  
Fatty Acid Supplementation ◽  
Oil Emulsion ◽  
Soya Oil ◽  
One Year ◽  
Better Than

Seven children with cystic fibrosis (CF) have been treated for at least one year with intravenously administered soya oil emulsion. In all, an improvement of at least one biochemical abnormality in character with the disease appeared. The children's clinical course remains benign. This course is remarkably better than that of other children with CF treated without Intralipid in Auckland in the same period, though a placebo effect cannot be discounted. It is postulated that intravenous supplementation with essential fatty acid in CF may in turn partially correct an error of metabolism of prostaglandins present in the disease.

Children With Encopresis: A Study of Treatment Outcome

PEDIATRICS ◽  
1976 ◽  
Vol 58 (6) ◽  
pp. 845-852 ◽  
Author(s):  
Melvin D. Levine ◽  
Harry Bakow
Keyword(s):  
Treatment Outcome ◽  
Treatment Program ◽  
Marked Improvement ◽  
Medical Center ◽  
Outcome Data ◽  
Careful Monitoring ◽  
Maintenance Program ◽  
Pediatric Treatment ◽  
One Year

A pediatric treatment program for encopresis was established in a large medical center. This consisted of counseling and education, initial bowel catharsis, a supportive maintenance program to potentiate optimum evacuation, retraining, and careful monitoring and follow-up. A group of 127 children received care for this problem. At the end of one year, outcome data were obtained on 110 patients. Of these, 51% had not had "accidents" for more than six months. Another 27% showed marked improvement and were having only rare episodes of incontinence. 14% of these children showed some improvement, but continued to have incontinence, while 8% showed no improvement whatsoever during the treatment year. These four outcome groups were compared with respect to a large number of demographic, developmental, psychosocial, and clinical variables.

scholarly journals Does CSF pleocytosis have a predictive value for disease course in MS?

2019 ◽  
Vol 6 (5) ◽  
pp. e584 ◽  
Author(s):  
Itay Lotan ◽  
Felix Benninger ◽  
Rom Mendel ◽  
Mark A. Hellmann ◽  
Israel Steiner
Keyword(s):  
Clinical Course ◽  
Medical Center ◽  
Oligoclonal Bands ◽  
Disease Course ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Csf Pleocytosis ◽  
Csf Oligoclonal Bands ◽  
Rabin Medical

ObjectiveMS is a demyelinating CNS disorder with a spectrum of clinical patterns regarding course and prognosis. Although several prognostic factors are considered in the initial evaluation of patients, biological markers defining the disease course and guiding treatments are currently lacking. It is unknown whether patients with CSF pleocytosis differ in regard to symptoms, disease course, and prognosis from those without. The aim of this study was to evaluate whether CSF pleocytosis during the initial presentation has an impact on the clinical course and progression of MS.MethodsWe retrospectively evaluated patients attending the MS Clinic at Rabin Medical Center between January 1999 and January 2016 who underwent lumbar puncture (LP) at disease presentation, considering CSF cell count, clinical diagnosis (clinically isolated syndrome [CIS] and relapsing-remitting MS [RRMS]), annualized relapse rate (ARR), paraclinical findings (imaging, CSF oligoclonal bands, and evoked potentials), and disease progression, expressed by the Expanded Disability Status Scale (EDSS).ResultsOne hundred fourteen patients (72 females) underwent LP at disease presentation (RRMS: n = 100, CIS: n = 14). Age at diagnosis was 32.4 ± 12.2 years, and the follow-up time was 9.4 ± 3.8 years. Forty-six patients showed a pleocytic CSF (≥5 cells per μL). Compared with patients with <4 cells per μL, patients with pleocytosis had a higher ARR (0.60 ± 0.09 vs 0.48 ± 0.04; p = 0.0267) and a steeper increase (slope) in the EDSS score throughout the follow-up period (correlation coefficient: r2 = 0.04; p = 0.0251).ConclusionsCSF pleocytosis may be considered a biological unfavorable predictive factor regarding disease course and progression in MS.

Reproduction, Growth and Mortality of Venus Striatula (Da Costa) in Kames Bay, Millport

1961 ◽  
Vol 41 (1) ◽  
pp. 191-215 ◽  
Author(s):  
Alan D. Ansell
Keyword(s):  
Sex Ratio ◽  
Microscopic Examination ◽  
Seasonal Changes ◽  
One Year

Seasonal changes in the gonads of both sexes of Venus striatula were followed by macroscopic and microscopic examination, in over 700 animals from a population consisting mainly of one year-group. The sex ratio was approximately equal, and no hermaphrodite adults were found.

Laryngeal Dysfunction following Prolonged Intubation

1979 ◽  
Vol 88 (4) ◽  
pp. 474-478 ◽  
Author(s):  
Robert E. Whited
Keyword(s):  
Vocal Cord ◽  
Medical Center ◽  
Recovery Phase ◽  
Clinical Findings ◽  
Posterior Commissure ◽  
Prolonged Intubation ◽  
Vocal Cord Paresis ◽  
The Many ◽  
The University

Prolonged endotracheal intubation in the adult is becoming more popular with the advent of “soft” tubes and cuffs. The many deleterious effects of such long-term intubation on the laryngotrachea have been extensively discussed in the literature. However, only sporatic attention has been given to vocal cord paresis or paralysis. The University of Cincinnati Medical Center experience with postintubation patients has shown that cord mobility disturbances are relatively common. Sixteen patients are presented who have had similar clinical findings and course following extubation. The clinical picture is that of a symmetrical vocal cord paresis or paralysis associated with arytenoid and posterior commissure edema and erythema. Vocal cord position is most often median or paramedian. A spontaneous recovery over days to weeks is the usual course. During the recovery phase cord movement most often remains symmetrical; however, full motion may occur in one cord before the other. In all patients abduction was most limited and slowest to return. In this series the most significant effect has been aspiration. Two patients developed a posterior commissure stenosis. This entity is believed to be due to inflammation initiated by the tube and its movement against the posterior half of the endolarynx. In particular, inflammatory involvement of the cricoarytenoid joints and interarytenoid region best explain the clinical course. When mucosal ulcerations and granulation tissue are superimposed on the immobilized cords interarytenoid scarring may lead to chronic stenosis.

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