Ultrasonography has been shown to be valuable in diagnosis of appendicitis in children. For the management of cases where clinical and ultrasonography findings lead to different results, we evaluated standard therapeutical concepts which have been proved to be reliable in our clinic.
Three noninvasive Maximum Performance Tasks (MPT)—Maximum Sound Prolongation (MSP), Fundamental Frequency Range (FFR), and Maximum Repetition Rate (MRR)—were administered to 11 children with spastic dysarthria due to cerebral palsy and to 11 control children with normal speech in order to determine the value of the tasks for differentiating between these groups of children. From the acoustic measurements, nine parameters were calculated, and in seven of them highly significant group differences were found. By adding the unweighted z-scores of four parameters (maximum sound prolongation, syllable duration, fundamental frequency range, inter-utterance variability of syllable duration), a composite z-score was constructed with nonoverlapping distributions for both groups. The authors conclude that maximum performance tasks, despite the large intrasubject and intersubject variability in both normal and pathological speakers, are powerful tools for detecting spastic dysarthria.
Maximum performance tasks (MPT) were employed to quantify the speech motor capacities of children with dysarthria and developmental apraxia of speech. Specifically, several MPT (i.e. vowel prolongation, fricative prolongation, maximum syllable repetition rate) were conducted among nine carefully selected children with spastic dysarthria, 11 children with developmental apraxia of speech (DAS), and 11 age–matched normal-speaking children. The results indicated that children with spastic dysarthria can be differentiated from both DAS and normal-speaking subjects on only two of the MPT (i.e. monosyllabic repetition rate and vowel prolongation). Children with developmental apraxia of speech, furthermore, differed from the normal-speaking children on fricative prolongation and trisyllabic repetition rate, as well as on measures of trisyllabic repetitive performances (i.e. number of sequencing errors and number of attempts). The findings underscored the clinical importance of MPT for differential diagnosis, and for the quantification of degree of involvement in speech pathology.
The paper deals with a pulmonary blastoma with CNS involvement in a young child 2 years after resection of congenital cysts from the other lung. Further 25 pulmonary blastomas in infants are compiled from the literature serving as the basis for a discussion of epidemiology, pathogenesis, classification, definition and prognosis as well as diagnostic and therapeutic problems involved in these rare malignant lung tumours.
The interstitial cells of Cajal (ICC) have not yet been investigated in the vermiform appendix. They are important for the peristalsis of the gastrointestinal tract and have been found to be altered in various motility disorders. Motor disturbance has been suggested as a possible contributor in the unclear etiology of appendicitis. We wanted to examine the distribution of the ICC in the vermiform appendix. Furthermore we investigated whether ICC are altered in persons with appendicitis.We investigated the ICC distribution in 28 appendices of children using immunohistochemistry and anti-c-kit antibodies. Cells and processes were quantified in normal, acute and chronic inflamed appendices.IC(C)-CM and IC(C)-LM were found in the circular and longitudinal muscle layers, respectively. IC(C)-LM, however, were scarce and inhomogeneous in contrast to the IC(C)-CM. The functionally important subgroups of the colon, the IC(C)-SM and IC(C)-MP, however, could not be detected in the appendix with the used antibody. There was no difference in the distribution of detected ICC between normal and inflamed appendices.IC(C)-LM are altered and IC(C)-SM and IC(C)-MP are lost in the vermiform appendix with no differences between healthy and inflamed tissue and without a correlation to appendicitis. Thus, other factors must be considered in the etiology of appendicitis.
SUMMARY The performance of two children with traumatic spastic dysarthria, aged 10 and 14 years, on maximum performance tasks was compared with that of two closely matched children with perinatal spastic dysarthria, and reference groups of five children with perinatal spastic dysarthria and five control children with normal speech. Results showed that performance of the perinatal spastic children on all three tasks was poorer than that of their peers with normal speech. In contrast, the traumatic spastic children performed within the normal limits on maximum sound prolongation and fundamental frequency range, but their maximum repetition rate was extremely slow. The overall low performance of the perinatal spastic children could be the result of inadequate motor development in addition to the neurological impairment. The traumatic spastic children–with a normal developmental history–compensated for their impairment by slowing down their speech rate. Therapeutic implications are suggested. RÉSUMÉ Dysarthrie spastique ácquise par traumatisme ou par souffrance périnatale: évaluation au moyen de tests de performance maximale de langage Les performances de deux enfants présentant une dysarthrie spastique traumatique, âgés de 10 et 14 ans, ont été compareés sur des tests de performance maximale avec ceux de deux enfants exactement appariés présentant une dysarthrie spastique ďorigine périnatale, cinq enfants avec dysarthrie spastique périnatale et cinq contrôles à langage normal. Les résultats ont montré que les performances des enfants présentant une dysarthrie spastique périnatale étaient moins bonnes que celles de leurs pairs à langage normal. En revanche, les enfants spastiques traumatiques avaient un réussite dans les limites du normal la prolongation maximale du son el ľétendue des fréquences fondamentales, mais leur taux de répétition maximale était extrêmement bas. La médiocre performance globale des enfants spastiques périnataux pourrait être le résultat ďun développement moteur anormal en plus des lésions neurologiques. Les enfants spastiques traumatiques, avec une histoire de développement normal, pourraient compenser leur trouble en ralentissant la vitesse de leur langage. Des implications thérapeutiques sont suggérées. ZUSAMMENFASSUNG Traumatische versus perinatal erworbene spastische Dysarthrie: Beurteilung anhand von Speech‐like Maximum Performance Tests Die Ergebnisse bei Maximum Performance Tasks‐ von zwei Kindern mit traumatisch spastischer Dysarthrie wurden verglichen mit denen von zwei entsprechenden Kindern mit perinataler spastischer Dysarthrie, fünf Kindern mit perinataler spastischer Dysarthrie und fünf Kontrollkindern mit normaler Sprache. Die Ergebnisse zeigten, daβ die Kinder mit perinataler spastischer Dysarthrie bei alien drei Aufgaben schlechter abschnitten als ihre Kontrollen mit normaler Sprache. Im Gegensatz dazu reagierten die traumatisch spastischen Kinder bei maximaler Geräuschverlängcrung und im Grundfrequenzbereich normal, ihre maximale Wiederholungsrate dagegen war extrem niedrig. Die insgesamt schlechten Leistungen bei den perinatal spastischen Kindern könnten zusätzlich zu der neurologischen Störung das Ergebnis einer inadäquaten motorischen Entwicklung sein. Die traumatisch spastischen Kinder–mit einer normalen Entwicklungsanamnese–kompensierten ihre Störung, indem sie langsamer sprachen. Es werden therpeutische Vorschläge gemacht. RESUMEN Disartria espástica adquirida perinatal frente a traumática; valoración por medio de pruebas de realización de habla máxima Se comparó las tareas de realización máxima de dos niños con disartria espástica traumática de 10 a 14 años, con la realización de dos niños control con disartria espástica perinatal i cinco más con lenguaje normal. Los resultados mostraron que la realización de los niños espásticos perinatales en las tres tareas era más pobre que la de los niños normales. En cambio, los niños espásticos traumáticos tenian una realización dentro de los limites normales en la prolongatión del sonido máximo y margen de frecuencia fundamental, pero la cadencia de repetitión era extremadamente lenta. La realización baja en conjunto de los niños espasticos neonatales, podría ser el resultado de un desarrollo motor inadecuado, además de la alteratión neurológica. Los niños espásticos traumáticos, con un desarrollo normal, compensaban su dificultad a base de enlentecer el habla. Se sugieren implicaciones terapeuticas.
