Miscellaneous conditions of the peritoneal cavity—Peritoneal tumors,pseudomyxoma, mesothelioma,fibroblastic reaction,cocoon, cystic lymphatic malformations,blue-bleb,and chylous ascites

The peritoneum is subject to both primary neoplasia and secondary malignancy from direct, trans-coelomic, or hematogenous spread from any cancer. The knowledge base in the pediatric age group is very limited due to the rarity of peritoneal conditions in children, and much of the information is extrapolated from adult literature. There have been few reports in the pediatric population on the diagnosis and management of peritoneal conditions including peritoneal malignancy. In this article, we aim to highlight some of these conditions and the treatments available with a special emphasis on the evolving role of cytoreduction surgery and hyperthermic intraperitoneal chemotherapy in the treatment of certain peritoneal malignancies in children.     

Food-induced anaphylaxis: who, what, why, and where?

Food-induced anaphylaxis is a leading cause of anaphylaxis treated in emergency departments and hospitals around the world. Peanuts, tree nuts, fish, and shellfish are the most commonly implicated foods. Food-induced anaphylaxis may occur in any age group and with any food. However, food-induced anaphylaxis fatalities disproportionately affect adolescents and young adults with peanut and tree nut allergy. Individuals who have both IgE-mediated food allergy and asthma are at a higher risk for food-induced anaphylaxis fatality. Delayed administration of epinephrine is also associated with fatal outcome. Often, in fatal reactions, the food allergen is unknowingly ingested away from home, in settings such as restaurants and schools. Although avoidance of food allergens is critical, timely administration of epinephrine is also of great importance in the treatment of food-induced anaphylaxis. Patients, families, and caregivers must be well educated regarding the signs, symptoms and risk factors for anaphylaxis. They must also be counseled on the importance of strict food avoidance of the implicated food allergens, compliance with having self-injectable epinephrine available at all times, and the importance of timely administration of epinephrine, even when cutaneous symptoms are lacking.     

肉眼血尿,心脏杂音,赘生物

患儿为学龄期女性,因发现肉眼血尿1d入院.入院后迅速完善检查,明确了系统性红斑狼疮诊断.治疗后病情好转,但病程中出现心脏杂音,行心脏彩超提示赘生物.为儿童罕见病例,经过会诊,诊断Libman-Sacks心内膜炎.总结:重视临床体检,注意病情的变化;重视多学科的合作.     

Zellen, Feten, Menschenwürde

The goal of prenatal diagnosis includes the identification of severe fetal abnormalities. It inherently involves the option of abortion and as such is generally accepted by society as a means of primary prevention. In contrast, discarding of in vitro fertilized oocytes and cultured embryonic stem cells is controversial because the principle of human dignity is said to extend to human life at its very beginning. Considerable conceptual and ethical difficulties result from this definition of human life. These difficulties can be overcome by separating human life from the concept of a“person,” i.e., from traits such as self-consciousness, language, reasoning, self-determination, and so on. Human life can be biologically defined by its genotypic uniqueness. In this way, it can be awarded human dignity requiring basic respect in the context of respect for life as such. In contrast, a person is a developing being and can be protected by graded declaratory acts. The principle of restraining the basic right to life, such as in self-defense or war, is well entrenched in basic constitutional law.     

体外循环肺损伤与粒细胞,血小板,红细胞,血红蛋白的关系

体外循环(CPB)下心内直视手术对外周血细胞可产生明显的损害。由于血液的媒介引起肺损伤、骨髓损伤、脑损伤等已有报道。曾有学者研究,CPB下犬的肺损伤与血液有形成份的关系,以及山莨菪碱对肺损伤的保护作用。国内文献还未见有关辅酶Q_(10)应用在CPB中的临床研究。本文报道辅酶Q_(10)应用于CPB对血液有形成份和肺损伤的保护作用。 资料与结果 一、临床资料 本组40例,男26例,女14例;     

临床病例讨论—长期咳嗽,气促,肺不张,胸腔积液

病史摘要 女,56天。因咳嗽、气促35天入院。系足月平产,出生体重3000g,无窒息及黄疸史,生后3天接种卡介苗。生后21天出现阵发性咳嗽,伴有气促、呼吸困难及发绀,当时不发热,在当地市医院就诊,胸片示“新生儿肺炎”,血WBC35.2×10~9/L,N0.6,L0.4,先后用过青霉素、氨苄西林、头孢唑啉、红霉素、头孢哌酮、氯霉素和头孢曲松等抗感染,病情渐重,咳嗽气促加剧。入院前5天出现发热、痰液增加,复查胸片示右侧胸腔积液。血象多次复查WBC25.6～70.0×10~9/L,N0.3～     

微量元素锌,铜,铁与免疫

营养紊乱性疾病是小儿时期最常见的临床疾病,由营养紊乱所致的免疫功能低下,是小儿易患感染性疾病的主要原因之一。营养素分为产热营养素(糖、蛋白、脂肪)和非产热营养素(微量元素、宏量元素和维生素),其中任何一种营养素的缺乏,均可同时累及多种免疫功能的损害。一旦所缺营养素得到补充,低下的免疫功能便能恢复正常。因此,在处理小儿时期的免疫性疾病时,应考虑到营养因素的影响,本文就微量元素锌、铜、铁与免疫的关系作一概述。     

心,肺,脑复苏的进展

围绕着如何提高复苏质量、提高抢救成功率,许多专家进行了心、肺、脑复苏机制和效果方面的研究。一直盛行的胸外按摩复苏法的实际效果受到了怀疑,并认为其促进血流的作用主要是通过胸内压变化而产生的,对搁置已久的开胸心脏按摩术,目前有了新的评价。早期和有效的复苏越来越受到重视。心停搏后的脑缺血损害机制极为复杂,与缺血程度和复苏后再灌注有关。代谢中所产生的乳酸、自由基,钙离子和铁离子的转移,以及某些兴奋性递质均参与了脑损害过程。巴比妥和钙通道阻滞剂的治疗效果尚不肯定。     

Über das Verhalten der Fermente LDH,MDH, GOT,GPT, ALD,LAP in den Gewebsfraktionen der Nierenrinde bei experimenteller Nephritis

Ohne ZusammenfassungLDH=Lactatdehydrogenase, MDH=Malatdehydrogenase, GOT=Glutamat-Oxalacetat-Transaminase, GPT=Glutamat-Pyruvat-Transaminase, ALD=Aldolase, LAP=Leuzinaminopeptidase.Für die wertvolle und umsichtige Mitarbeit sei den Mitarbeiterinnen König, Güntzel, Meinel und Staak an dieser Stelle gedankt.