Ranulas are cystic lesions in the floor of the mouth. They are either retention cysts of the excretory duct of the sublingual gland or pseudocysts formed by excretory duct rupture followed by extravasation and accumulation of mucus in the surrounding tissue. We report the case of a premature newborn with a congenital ranula in the floor of mouth. The ranula caused no discomfort or complications, so that immediate intervention was not necessary. The cyst resolved completely by the age of 4 months. Complications in newborns especially include airway obstruction and feeding difficulties. Surgical treatment options are needle aspiration, excision of the ranula, marsupialization, cryosurgery, and--in addition to excision of the cyst--removal of the ipsilateral sublingual gland. Sclerotherapy has shown good results as well. As many congenital cysts resolve or rupture spontaneously, they should be observed for potential resolution for several months in uncomplicated cases.

The surveyed data support the assumption, that early childhood intervention provides help briefly and economically. For the relatively large group of "multi-problem families" in the sample we can not yet offer intervention strategies, which could help these children to reduce their high developmental risk.

Schl ü sselw ö rter Modulation of Arousal Reaction in Children with Nocturnal Enuresis Modulation der Arousalreaktionen bei Kindern mit Enuresis nocturnaPsychological reasons will often discussed in this patients. Primary nocturnal enuresis is a condition which affects around 15 -20 % of 5 years old, 7 % of 8 years old, 5 % of 10 years old children and 1 -3 % of young adults often with a familary background [14] . The following possible aetiologic mechanisms for primary nocturnal enuresis are discussed: dysfunction of mesopontine reticular Abstract &Background: Disturbances of central regulatory processes of sleep and arousal are potential causes of nocturnal enuresis. The intranasal application of an ADH analogue is an established therapeutic option to infl uence nocturnal enuresis. The aim of the study was to evaluate effects of an ADH analogue on sleep and arousal in patients suffering from primary nocturnal enuresis. Patients and Methods: In our study the infl uence of ADH analogue on sleep architecture was investigated by polysomnographic studies before and during therapy in 24 patients. Results: In polysomnography arousal index and movement time were signifi cantly improved after 6 weeks, sleep stages 1 to 4 did not change signifi cantly. Treatment reduced the frequency of nocturnal wetting signifi cantly and this effect lasted for another 6 weeks. Conclusion: The long lasting effect of ADH to reduce enuresis could possibly be caused by changes in arousal reaction and a normal wake up facilitation.

No abstract

The prognostic accuracy of ultrasound scans performed in the first week of life is important for preterm neonates with gestational age less than 33 weeks. In neonates with gestational age above 32 weeks we revealed no significant predictive value of the method. This limits the value of this technique in this patients as a reliable method for recognising of the infants with the need of early rehabilitation.