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Objectives:Supraglottoplasty for the treatment of laryngomalacia has little current evidence regarding post-operative care. Our study aimed to: (1) retrospectively assess what proportion of patients required paediatric intensive care unit level of care; (2) identify pre-operative predictive factors common to these cases; and (3) report patient outcomes at six weeks’ follow up.Methods:A 10-year retrospective case series analysis was conducted of all patients diagnosed with laryngomalacia and subsequently treated with supraglottoplasty. Paediatric intensive care unit level of care was defined as the need for intubation or tracheostomy, positive pressure ventilation, multiple doses of nebulised adrenaline, and oxygen dependency beyond 12 hours.Results:Forty-two patients (19 males, 23 females) were identified; 28.5 per cent of cases met our criteria for paediatric intensive care unit level of care. A low pre-operative oxygen saturation was the only significant risk factor that predicted a future need for paediatric intensive care unit level of care (p = 0.0008).Conclusion:This is the first study published in the UK to suggest the importance of pre-operative oxygen saturation as a predictor of a future need for paediatric intensive care unit level of care.

This study explored some toxicological aspects of vanadyl sulphate (VOSO4) treatment of rats made diabetic with a single intravenous injection of streptozotocin (60 mg/kg). Administered in drinking water (0.25, 0.5, 0.75 or 1 mg of VOSO4, 5H2O ml) VOSO4 treatment partially or totally corrected some of the alterations associated with the diabetic state (hyperglycaemia, polydipsia, polyphagia, high cholesterol and triglycerides levels) and did not produce any changes in various plasma or blood cell parameters which were not previously altered by diabetes. Measurement of vanadium levels indicated that tissues accumulated vanadium in the following order of concentrations: bone greater than kidney greater than spleen greater than liver greater than lung greater than or equal to muscle greater than blood. Histopathological studies did not reveal any difference in liver, stomach, ileum, spleen, heart and lung from control, non-treated diabetic or VOSO4-treated diabetic animals. Kidney of all non-treated diabetic animals showed an epithelial cellular swelling of distal tubules while only 2 of 6 VOSO4-treated diabetic animals showed this alteration. Cellular degeneration of pancreas B-cells was less marked in VOSO4-treated that in non-treated diabetic animals. The study indicates that VOSO4 may be a potential antidiabetic agent.

An 18-month-old boy presented to the accident and emergency department following trauma to the oropharynx by a doll’s umbrella. Although no significant injury could be identified at first, it later transpired that he had developed retropharyngeal surgical emphysema with abscess. This case report aims to review the nature of retropharyngeal abscesses and to highlight and re-emphasize the fact that apparently non-serious pharyngeal injuries in children should be treated with suspicion.

In previous studies, we found, using the micronucleus test, that the adult male mouse is about twice as sensitive as the female to the clastogenic action of orally administered benzene (Siou and Conan, 1978). For new-born mice suckling mothers who are receiving benzene orally (Siou and Conan, 1979), or for three-week-old mice receiving benzene orally (Siou and Conan, 1980), there was no significant difference in sensitivity between males and females. The difference in sensitivity was shown to be due to the influence of hormonal factors. No differences in sensitivity were observed between females and castrated males; castrated males treated with testosterone regained their original sensitivity. The objectives of the experiments described here were to confirm these findings by metaphase chromosome analysis of bone-marrow cells from mice and Chinese hamsters. Metaphase chromosome studies and micronucleus counts were performed on each animal to investigate the relationship between the 2 techniques.

The lipopolysaccharide of Haemophilus influenzae is presumed to have a toxic effect on the tracheal epithelium, and then induce a bronchial obstruction. This activity of LPS was studied in vitro on the ciliary beat using a photo-oscillographic apparatus, and in vivo on the rabbit trachea. Neither modification of ciliary beat frequency, nor epithelial damage in the rabbit trachea was observed after a single administration of LPS. In contrast, histopathologic changes were observed in vivo when the intratracheal administration of H. influenzae LPS was followed 24 h later by an intravenous injection of the same LPS. These experimental models seem thus to implicate a Shwartzman type cellular necrosis in the trachea in vivo in the absence of a direct toxic effect of endotoxin itself on trachea in vivo or in vitro.