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PURPOSE Pyloric atresia is an uncommon congenital anomaly that may present with emesis and dehydration early in infancy. Definitive therapy consists of pyloroplasty or gastroduodenostomy depending on the subtype of atresia involved. CASE PRESENTATION We report the case of a 2-day-old girl infant who presented with nonbilious emesis with feeds. Abdominal ultrasound and upper gastrointestinal series were performed and demonstrated a dilated, air-filled stomach with no distal air or passage of contrast. The patient was successfully treated by laparoscopic-assisted open pyloroduodenostomy of a type 2 pyloric atresia. CONCLUSION Type 2 pyloric atresia is a rare clinical entity that can present with symptoms of gastric outlet obstruction. The patient described was treated by laparoscopic-assisted open pyloroduodenostomy, which has not been previously described for pyloric atresia. This work demonstrates an example of the safety and efficacy of laparoscopic surgery for infants with this anomaly.

Recombinant adenoviral vectors are effective in transferring foreign genes to a variety of cells and tissue types, both in vitro and in vivo . However, during the gene transfer, they may alter the principal function and local environment of transfected cells. Increasing evidence exists for a selective adrenotropism of adenovirus during infections and gene transfer. Therefore, using bovine adrenocortical cells in primary culture, we analyzed the influence of different adenoviral deletion mutants on cell morphology and physiology. Transfection of cells with an E1/E3-deleted adenoviral vector, engineered to express a modified form of the Aequorea victoria green fluorescent protein, was highly efficient, as documented by fluorescent microscopy. Ultrastructural analysis, however, demonstrated nuclear fragmentation and mitochondrial alterations in addition to intranuclear viral particles. Basal secretion of 17-OH-progesterone, 11-deoxycortisol, and cortisol was significantly increased by E1/E3-deleted vectors; yet, the corticotropin-stimulated release of these steroids was decreased. Interestingly, neither purified viral capsids nor E3/E4-deleted adenoviral mutants altered basal and stimulated steroidogenesis of adrenocortical cells. An intact adrenal response is crucial for adaptation to stress and survival. Therefore, the implications of our findings need to be considered in patients with adenoviral infections and those undergoing clinical studies using adenoviral gene transfer. At the same time, the high level of transfection in adrenocortical cells might make appropriately modified adenoviral vectors suitable for gene therapy of adrenocortical carcinomas with poor prognosis.

There were in all 116 children examined, 58 boys and 58 girls. Von Pirquet reactions were made on all cases with old tuberculin and bovine tuberculin. Whenever a positive reaction was present for one, it was also present for the other. There were no exceptions to this rule. Of the 58 boys, 20 reacted positive and 38 negative. Of the 58 girls, 22 reacted positive and 36 negative—a total of 42 positives and 74 negatives. In 18 out of 20 positive reactions in boys, a clinical diagnosis of tuberculosis of the bone had been made. In the other two positive cases, one suffered from clubfoot and the other from infantile paralysis. In 15 out of the 22 positive von Pirquet reactions in girls, the clinical diagnosis was tuberculosis of the bones or joints. Of the other 7 cases, one had clubfoot, 2 dislocated hips, 2 rickets, and 2 curvature of

The treatment of syphilis with the different mercurial preparations is still a haphazard affair, the rule being to give as much mercury as the patient will tolerate without salivation or diarrhea. Assuming that the amount of mercury eliminated in the urine during a given time would give a fair index of the amount in the circulation, Ramsey and Ziegler made some experiments, the report of which was read before this societyin 1918. 1 From this series of experiments we were able to draw the following conclusions: In infants and children, mercury, when given by the month, by inunction or intramuscularly, is excreted at least partly by the urine. In new-born infants and older children mercurial ointment when placed in contact with the skin, without any friction being used (protected and sealed by wax paper from being volatilized and inhaled), is taken up by the skin and excreted in the urine

M. L., a girl, was first seen two years ago, aged 3 years. She was of normal birth and was breast fed for one year. There were three other children, all of whom were normal. The past history of the patient was unimportant, there were no previous illnesses. The child was brought in because the teeth were badly decayed and the mouth constantly dry. The mother said that when nursing, the milk would collect around the inside of the lips and cheeks and become dry. She would always have to wash it off with wet cotton before the next nursing. The tongue and mouth always seemed dry. The condition of the mouth on examination was then as follows: The teeth were discolored, the gums retracted around the teeth, so that they seemed to be stuck in the jaws at irregular angles. The child ate well, but had to take drinks

In spite of the different forms of arsenic used under various trade names, mercury, in some form, still holds the foremost place in the treatment of syphilis. Even when the arsenic preparations are used, mercury is usually continued for long periods in order to effect a cure. Many of the salts of mercury, including metallic mercury itself, are administered in various ways: by mouth, by insufflation, subcutaneously and by inunction. ABSORPTION AND ELIMINATION OF MERCURY Owing to the difficulty in detecting mercury in the body fluids, little light has been thrown on the question as to what extent the different forms of mercury were absorbed and how eliminated. Meyer and Gottleib 1 state, "the excretion of mercury in the urine offers a means of estimating the amounts of mercury circulating in the body and the duration of its action. After absorption it circulates as a compound of mercury albuminate and

The medical profession is very reluctant to adopt new standards, but having been once convinced as to their correctness, they are just as loath to discard them. The result is that certain standards such as weights and measures, for example, are copied by one writer after another for years without any one, or at least very few, taking the trouble to verify their correctness. Standards which are correct in one country are often quite incorrect in another country, under different conditions. The following observations were made from the charts in the ward for new-born of the University Hospital where, owing to the efforts of Dr. Sedgwick, chief of the Pediatric Department, and the cooperation of Dr. Litzenberg, chief of the Obstetric Clinic, all new-born infants come under the pediatrics service directly after birth. The points to be ascertained from an analysis of the charts were as follows: The average birth

Since Escherich, in 1898, demonstrated infections of the urinary tract with the colon bacillus in infants and children to be extremely common, the subject has been discussed from almost every point of view. The route by which the infection gains entrance to the urinary tract is yet to be decided, as recently pointed out by Helmholz. 1 In looking over the literature for the past twenty years, it is interesting to note that practically nothing new has been added during the past ten years. In 1910, I published an analysis of twenty-five cases, 2 the first dating 1901, which included virtually every clinical phase of the disease. The one characteristic symptom is the sudden onset with high fever, frequently as high as 105 or 106 F. There is often no other symptom and the child does not seem to be "sick" enough to correspond to the degree of fever present