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Isolated posterior cruciate ligament injury in a child: Literature review and a case report
INTERNATIONAL ABSTRACTS
The spica group with the short hospital stay had obvious economic, medical (less radiography), and emotional (minimal parent child separation) advantages. The conclusion is that early reduction and application of a well-padded, well-moulded single spica is a safe, satisfactory, and economical method of treating femoral shaft fractures in children.--A.J.W. Millar Isolated Posterior Cruciate Ligament Injury in a Child: Literature Review and a Case Report. C. Frank and R. Strother. Can J Surg
32:373-374, (September), 1989. The authors report a rare (sixth reported) case of a 7-year-old boy with a truly isolated posterior cruciate ligament injury. The boy suffered a skiing injury to his right knee that wasn't diagnosed until his knee locked I year later. An arthroscopic procedure and quadriceps therapy cured him. Review of this case emphasizes several points: (1) the need for awareness of posterior cruciate ligament injuries in children; (2) the inability of x-rays to detect such cartilaginous avulsions; and (3) the fact that such missed avulsions can cause locking and may also result in abnormal ligament length preventing reattachment in the growing child. Functional results support at least short-term conservative management of such injuries in children.--Sigmund H. Ein Infant Hip Ultrasound. S. T. Scott. Clin Radiol 40:551-553, (Novem-
ber), 1989. The author describes the use of ultrasound to image the infant hip, a method that clearly displays the cartilageous acetabulum and femoral head not visible on a radiograph. Clinical screening only detects half the cases of congenital dislocation of the hip, many remaining undetected until 12 to 18 months of age. Ultrasound can identify hips that need treatment and can detect abnormal hips that are clinically normal. The author discusses Grat~s method and stresses the interpretation of the ultrasound examination and its implication for management of these infants.--Amir Azmy
NEOPLASMS Elevated Serum Croatina Kinase B Levels in Patients With Neuroblsstoma. Y. Ishiguro, H. Akatsuka, T. /to, et al. J Jpn Soc Pediatr
Surg 25:761-767, (May), 1989. The association between neuroblastoma and the subunit B of creatine kinase (CK-B) was investigated to assess the possibility of the role CK-B as a tumor marker for neuroblastoma. With the use of a sensitive solid-phase sandwich enzyme immunoassay system, the concentration of serum CK-B was measured in 47 patients with inguinal hernia under 10 years of age for normal controls, and in 29 patients with neuroblastoma. The CK-B concentration was elevated on 66% of the neuroblastoma patients. The relationship between the prognosis of neuroblastoma patients and the serum CK-B level was found to be statistically significant. These data suggest that CK-B is a useful serum marker for prediction of prognosis, diagnosis, and monitoring the effectiveness of therapy.--Takeshi Miyano Report of a Committee Convened to Discuss the Evaluation and Staging of Patients With Hodgkin's Disease: Cotswolds Meeting.
T.A. Lister, D. Crowther, S.B. Sutcliffe, et al. J Clin Oncol 7:16301636, (November), 1989. This paper defines the consensus of care of the Hodgkin's disease reached by a number of pediatric oncologic institutions in Great Britain and the United States. It provides excellent review of the
831
current recommendations of staging both clinical and anatomic. The major new accepted practice is to legitimize the use of computed tomography scanning for detection of abdominal disease and to reserve staging laparotomy only for cases in which stage would be altered in such a way that treatment would be changed. We would recommend review of this paper to all those caring for children with Hodgkin's disease.--Michael P. Hirsh Immunophenotyping to Detect and Characterize Acute Lymphocytic Leukemia in Testicular Biopsies. C.J. Verdi, dr. Hutler, and
T.M. Grogan. Pediatr Pathol 9:117-130, 1989. The authors evaluate immunophenotyping to detect and characterize acute lymphocytic leukemia in testicular biopsies in six patients. The utility of routine testicular biopsy to detect subclinical disease prior to cessation of chemotherapy remains controversial. Histological confirmation of testicular involvement by routine light microscopic histology is sometimes difficult, especially in discerning scant lymphocytic infiltrates. Monoclonal antibodies that have been used to characterize leukemia (ie, Tdt, CALLA) were used in these patients. There was complete concordance between histological and immunologic evaluation. However, the authors felt that the specificity of the leukemic markers and their absence in normal testes while of adjunctive benefit now, will be the procedure of choice in evaluating testicular involvement in the future. These markers may be of clinical value in (1) confirming leukemic relapse; (2) certifying the absence of testicular disease prior to discontinuation of maintenance therapy; (3) excluding clinically suspected disease; and (4) evaluating drug resistance.--Eugene S. Wiener Yolk Sac Tumor of the Testis in Children. E. Okamoto, S. Tani-
kaze, K. Yoshino, et al. J Jpn Soc Pediatr Surg 25:670-673, (June), 1989. Seventeen cases of testicular yolk sac tumor, which the authors have experienced in the past 17 years, are reviewed. Orchiectomy combined with retroperitoneal lymphadenectomy had been performed in the early years. However, in 1976, chemotherapy was introduced with vincristine, actinomycin D, and cyclophosphamide being the drugs of choice. Three children who had lung metastasis at the time of the initial operation died. Since 1983, with the introduction of cisplatinum, all patients, including one case with obvious lung metastasis, have survived.-Takeshi Miyano Bilateral Prapubertal Carcinoma in Situ of the Testis and Ambiguous External Genitalia. D. Cortes, J. Thorup, and N. Graem. J Urol
142:1065-1069, (October), 1989. The case of a 10-year-old boy with bilateral carcinoma in situ in maldescended testes and concomitant ambiguous genitalia is presented. The authors advise biopsy of the testes at orchidopexy in all boys with concomitant abnormalities of the external genitalia. Currently there is no established treatment of children who present with carcinoma in situ of the testes. Previously, orchiectomy or a wait-andsee regimen with repeated biopsies has been chosen.--G. W. Holcomb, Jr Mesenchymal Hamartoma of the Liver: A Report of 5 Cases, K.
Cooper, G. Hadley, and P. Moodley. So Afr Med J 75:295-298, (March), 1989. This paper describes the clinical and pathological features of five infants and children with mesenchymal hamartoma of the liver. All were boys with ages ranging from 1 month to 3 years. The chief presenting feature was abdominal distension (4). Examination con-
The spica group with the short hospital stay had obvious economic, medical (less radiography), and emotional (minimal parent child separation) advantages. The conclusion is that early reduction and application of a well-padded, well-moulded single spica is a safe, satisfactory, and economical method of treating femoral shaft fractures in children.--A.J.W. Millar Isolated Posterior Cruciate Ligament Injury in a Child: Literature Review and a Case Report. C. Frank and R. Strother. Can J Surg
32:373-374, (September), 1989. The authors report a rare (sixth reported) case of a 7-year-old boy with a truly isolated posterior cruciate ligament injury. The boy suffered a skiing injury to his right knee that wasn't diagnosed until his knee locked I year later. An arthroscopic procedure and quadriceps therapy cured him. Review of this case emphasizes several points: (1) the need for awareness of posterior cruciate ligament injuries in children; (2) the inability of x-rays to detect such cartilaginous avulsions; and (3) the fact that such missed avulsions can cause locking and may also result in abnormal ligament length preventing reattachment in the growing child. Functional results support at least short-term conservative management of such injuries in children.--Sigmund H. Ein Infant Hip Ultrasound. S. T. Scott. Clin Radiol 40:551-553, (Novem-
ber), 1989. The author describes the use of ultrasound to image the infant hip, a method that clearly displays the cartilageous acetabulum and femoral head not visible on a radiograph. Clinical screening only detects half the cases of congenital dislocation of the hip, many remaining undetected until 12 to 18 months of age. Ultrasound can identify hips that need treatment and can detect abnormal hips that are clinically normal. The author discusses Grat~s method and stresses the interpretation of the ultrasound examination and its implication for management of these infants.--Amir Azmy
NEOPLASMS Elevated Serum Croatina Kinase B Levels in Patients With Neuroblsstoma. Y. Ishiguro, H. Akatsuka, T. /to, et al. J Jpn Soc Pediatr
Surg 25:761-767, (May), 1989. The association between neuroblastoma and the subunit B of creatine kinase (CK-B) was investigated to assess the possibility of the role CK-B as a tumor marker for neuroblastoma. With the use of a sensitive solid-phase sandwich enzyme immunoassay system, the concentration of serum CK-B was measured in 47 patients with inguinal hernia under 10 years of age for normal controls, and in 29 patients with neuroblastoma. The CK-B concentration was elevated on 66% of the neuroblastoma patients. The relationship between the prognosis of neuroblastoma patients and the serum CK-B level was found to be statistically significant. These data suggest that CK-B is a useful serum marker for prediction of prognosis, diagnosis, and monitoring the effectiveness of therapy.--Takeshi Miyano Report of a Committee Convened to Discuss the Evaluation and Staging of Patients With Hodgkin's Disease: Cotswolds Meeting.
T.A. Lister, D. Crowther, S.B. Sutcliffe, et al. J Clin Oncol 7:16301636, (November), 1989. This paper defines the consensus of care of the Hodgkin's disease reached by a number of pediatric oncologic institutions in Great Britain and the United States. It provides excellent review of the
831
current recommendations of staging both clinical and anatomic. The major new accepted practice is to legitimize the use of computed tomography scanning for detection of abdominal disease and to reserve staging laparotomy only for cases in which stage would be altered in such a way that treatment would be changed. We would recommend review of this paper to all those caring for children with Hodgkin's disease.--Michael P. Hirsh Immunophenotyping to Detect and Characterize Acute Lymphocytic Leukemia in Testicular Biopsies. C.J. Verdi, dr. Hutler, and
T.M. Grogan. Pediatr Pathol 9:117-130, 1989. The authors evaluate immunophenotyping to detect and characterize acute lymphocytic leukemia in testicular biopsies in six patients. The utility of routine testicular biopsy to detect subclinical disease prior to cessation of chemotherapy remains controversial. Histological confirmation of testicular involvement by routine light microscopic histology is sometimes difficult, especially in discerning scant lymphocytic infiltrates. Monoclonal antibodies that have been used to characterize leukemia (ie, Tdt, CALLA) were used in these patients. There was complete concordance between histological and immunologic evaluation. However, the authors felt that the specificity of the leukemic markers and their absence in normal testes while of adjunctive benefit now, will be the procedure of choice in evaluating testicular involvement in the future. These markers may be of clinical value in (1) confirming leukemic relapse; (2) certifying the absence of testicular disease prior to discontinuation of maintenance therapy; (3) excluding clinically suspected disease; and (4) evaluating drug resistance.--Eugene S. Wiener Yolk Sac Tumor of the Testis in Children. E. Okamoto, S. Tani-
kaze, K. Yoshino, et al. J Jpn Soc Pediatr Surg 25:670-673, (June), 1989. Seventeen cases of testicular yolk sac tumor, which the authors have experienced in the past 17 years, are reviewed. Orchiectomy combined with retroperitoneal lymphadenectomy had been performed in the early years. However, in 1976, chemotherapy was introduced with vincristine, actinomycin D, and cyclophosphamide being the drugs of choice. Three children who had lung metastasis at the time of the initial operation died. Since 1983, with the introduction of cisplatinum, all patients, including one case with obvious lung metastasis, have survived.-Takeshi Miyano Bilateral Prapubertal Carcinoma in Situ of the Testis and Ambiguous External Genitalia. D. Cortes, J. Thorup, and N. Graem. J Urol
142:1065-1069, (October), 1989. The case of a 10-year-old boy with bilateral carcinoma in situ in maldescended testes and concomitant ambiguous genitalia is presented. The authors advise biopsy of the testes at orchidopexy in all boys with concomitant abnormalities of the external genitalia. Currently there is no established treatment of children who present with carcinoma in situ of the testes. Previously, orchiectomy or a wait-andsee regimen with repeated biopsies has been chosen.--G. W. Holcomb, Jr Mesenchymal Hamartoma of the Liver: A Report of 5 Cases, K.
Cooper, G. Hadley, and P. Moodley. So Afr Med J 75:295-298, (March), 1989. This paper describes the clinical and pathological features of five infants and children with mesenchymal hamartoma of the liver. All were boys with ages ranging from 1 month to 3 years. The chief presenting feature was abdominal distension (4). Examination con-