Transcatheter Arterial Sclerosing Embolization for the Treatment of Giant Propranolol-Resistant Infantile Hemangiomas in the Parotid Region

PurposeTo report the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of parotid infantile hemangiomas that did not respond appreciably to propranolol.Materials and MethodsA total of 21 infants (12 male and 9 female) with large propranolol-resistant infantile hemangiomas in the parotid region were enrolled in this study. During TASE, the feeding arteries of the lesions were embolized using pingyangmycin-lipiodol emulsion and polyvinyl alcohol particles (300–500 μm) to reduce the blood flow rate. All children were followed up as outpatients at 2 weeks and monthly thereafter. The curative effect was evaluated at the 1- and 3-month follow-up visits.ResultsNine lesions were located on the right side of the parotid gland, whereas 12 were located on the left side. The feeding arteries in all patients originated from branches of the external carotid artery. TASE was technically successful in all patients. The mean (± SD) maximal diameter of the hemangiomas significantly decreased from 6.50 cm ± 2.28 before treatment to 3.56 cm ± 1.84 at 1 month after TASE (P <. 05). Three months after TASE, the mean maximal diameter further significantly decreased to 1.94 cm ± 1.58 (P <. 05). During the follow-up period, 16 cases were rated as excellent and 5 as good; no recurrence or serious complications were noted. Minor side effects, such as slight pain, mild fever, and tissue swelling, were observed.ConclusionsTASE significantly decreased the size of the parotid hemangiomas with minor side effects during a short follow-up period.     

Panayiotopoulos syndrome with convulsive status epilepticus at the onset: A long-term study

PurposeTo better define the convulsive status epilepticus (CSE) as a possible manifestation at the onset of Panayiotopoulos syndrome (PS) and to assess its prognostic value in these children.MethodsChildren with CSE and diagnostic criteria of PS were identified, followed clinically and compared with a group of patients with PS without CSE from 1993 to 2012.ResultsWe identified 37 patients with CSE at the onset of PS. During the same period we identified 72 children with autonomic symptoms of PS without CSE. The first episode of CSE occurred at a mean age of 6.5 years. Generalized clonic seizures were the most common ictal event and one-third of the patients required admission to Intensive Care Units. Interictal EEGs showed occipital spike activity in 31 (83.7%) subjects. Only 14 (37.8%) patients were treated with valproic acid and for two of them (5.40%) it was necessary to administer other drugs. There were no intractable cases. The overall prognosis was excellent. After the first event, 15 subjects (40.54%) experienced at least another typical PS seizure, but all patients were seizure free at the last follow-up.ConclusionCSE is not uncommon in PS and it may occur at the onset of benign childhood epilepsy, without leading to a poor prognosis.     

Participation of bone marrow-derived cells in hippocampal vascularization after status epilepticus

PurposeDiseases such as temporal lobe epilepsy, brain trauma and stroke can induce endothelial cell proliferation and angiogenesis in specific brain areas. During status epilepticus (SE), bone marrow-derived cells are able to infiltrate and proliferate, dramatically increasing at the site of injury. However, it is still unclear whether these cells directly participate in vascular changes induced by SE.MethodTo investigate the possible role of bone marrow-derived cells in angiogenesis after seizures, we induced SE by pilocarpine injection in previously prepared chimeric mice. Mice were euthanized at 8 h, 7 d or 15 d after SE onset.ResultsOur results indicated that SE modified hippocampal vascularization and induced angiogenesis. Further, bone marrow-derived GFP⁺ cells penetrated through the parenchyma and participated in the formation of new vessels after SE. We detected bone marrow-derived cells closely associated with vessels in the hippocampus, increasing the density of blood vessels that had decreased immediately after pilocarpine-induced SE.ConclusionWe conclude that epileptic seizures directly affect vascularization in the hippocampus mediated by bone marrow-derived cells in a time-dependent manner.     

短期去乳糖奶粉喂养方法对新生儿腹泻的效果

目的：探讨短期去乳糖奶粉喂养方法对新生儿腹泻的效果。方法选取2013年3月—2014年2月腹泻患儿140例，按随机数字表法随机分为观察组和对照组各70例，观察组采用短期去乳糖奶粉喂养，对照组采用长期去乳糖奶粉喂养。比较两组患儿治疗效果、胃肠道症状、体质量增长与喂养耐受情况。结果观察组患儿痊愈51例，有效17例，无效2例；对照组痊愈47例，有效20例，无效3例，差异无统计学意义（Z＝0．758，P＝0．366）。观察组患儿平均体质量增长（34．30±7．35）g／（kg· d），平均摄入奶量（105．37±24．02）ml／（kg· d），优于对照组的（24．29±8．06）g／（kg· d），（97．21±21．66）ml／（kg· d），差异有统计学意义（t值分别为2．809，3．161；P＜0．05）。观察组排便次数、呕吐、腹胀、胃潴留发生例数均少于对照组，差异有统计学意义（P＜0．05）。结论腹泻新生儿采取短期去乳糖奶粉喂养方式既符合婴幼儿的生长发育特点，又可以维持其免疫功能的平衡，且经济实惠，值得在临床推广。     

Transmettre à et pour des enfants en détresse. Observations à partir de films institutionnels autour de la Seconde Guerre mondiale

Questions of transmission have been addressed by psychiatrists through clinical film recordings since the pioneering work by René A. Spitz (1887–1974). These films screen child behavior in clinical situations exploring forms and structures of parent-child transmission. Departing from clinical teaching film addressed to professional audiences, the present contribution turns to films of universal distribution and in particular the film A child went forth by the American film director Joseph Losey (USA, 1940, 26 min), investigating transmission to and for children around WWII. An early expression of Losey's fascination with alternate perspectives of childhood and education, his documentary is sold to the US government and adapted to include security statements for families threatened by war. The film becomes a document of state information in a time where family structures could potentially be disrupted by mobilization or through non-return from war. The inquiry about the film invites a threefold level of analysis: first transmission to the children; second transmission between professionals; and third transmission to the general public referring to information and propaganda. In contrast to clinical teaching films recording children as patients, documentary film, as an object and as a vector addressed to a general public, opens another venue for observation and analysis of adult-child transmission from the widest possible perspective.