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Takayoshi Moriuchi, Tetsuro Nakamura, Takashi Azuma, Ken Harumoto, Tat ...
Article type: Article
2005 Volume 41 Issue 4 Pages
631-635
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Purpose: The usefulness and limitations of MRCP in diagnosing pancreaticobiliary maljunction in children was investigated in this study. Methods: Eighteen children with pancreaticobiliary maljunction underwent preoperative MRCP and intraoperative cholangiopancreatography (IOCP). They were divided into 13 children whose common channels were detected with MRCP (Group A) and other 5 whose common channels were not detected (Group B). Results: Age, body height and body weight in Group A (61.3±31.7 months, 105.8±18.2cm, 19.0±7.0kg) were significantly different from those in Group B (21.8±8.3 months, 82.1±10.0cm, 10.2±1.8kg). We regarded 30 months, 90cm and 12kg as cut off figures based on the values of mean-SD for each item in Group A and mean+SD in Group B. In 9 of 10 patients over the cut off figures, the common channels were found in MRCP. There was no significant difference in the form of the common bile duct and the mean length of the common channels. In 7 children, a significant correlation was seen between the length of the common channel in MRCP and that in IOCP (p=0.04, R=0.77, Y=5.743+0.817X). Conclusions: We suggest that MRCP is useful in diagnosing of pancreaticobiliary maljunction in children over 2 years and 6 months of age. The length of the common channel and the form of the common bile duct do not influence the usefulness of MRCP.
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Masahiro Chiba, Yutaka Sanada, Yasuo Yoshizawa, Shinya Kawano, Masayuk ...
Article type: Article
2005 Volume 41 Issue 4 Pages
636-642
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Purpose: Glicentin, the main component of enteroglucagon, has trophic effects on intestinal mucosa. It may also have an inhibitory effect on extraintestinal invasion of enteric bacteria (bacterial translocation). We have established an in vitro bioassay system for determining the effects of recombinant human glicentin on cell-cell junction by using confluent enterocytes. Methods: An INT-407 cell line was serum-deprived for 2 days, then was treated for 24h with a medium containing either glicentin 1μg/ml, 10% fetal calf serum (FCS) or no growth factors. 1) Monolayers were confirmed using immunofluorescence techniques and exposed to E-cadherin, ZO-1 and sIgA. 2) These culture media and extractive solutions were assessed by enzyme-linked immunosorbent assay (ELISA) to determine the concentrations of soluble E-cadherin. Results: Confocal laser scanning microscopy showed that glicentin caused a marked induction of E-cadherin, ZO-1 and sIgA. The E-cadherin level within the glicentin-treated group was approximately 135% of that of the control group. Conclusions: Glicentin seems to function as a barrier-sustaining agent by a mechanism that might be related to the integrity of the enterocyte adhesive junctions, tight junctions and the production of sIgA.
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Akira Nishi, Tadashi Iwanaka, Hiroo Uchida, Hiroshi Kawashima, Katsumi ...
Article type: Article
2005 Volume 41 Issue 4 Pages
643-649
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Purpose: Inguinal hernia is a very common disease among infants and children. However, it is difficult to decide the timing of surgical intervention in girls with asymptomatic ovary-sliding inguinal hernia. The cases of inguinal hernia with ovarian necrosis are reviewed and evaluated. Methods: The clinical charts of all 1,875 girls who underwent inguinal herniorrhaphy between 1983 and 2003 were studied retrospectively. Results: Hemilateral or bilateral ovaries were palpable in 355 patients. Of these, 15 cases needed emergent surgical intervention for the suspected strangulated ovary. Necrotic ovaries were removed due to ovarian torsion in 6 cases, who were less than 1 year old. Conclusions: Even without signs of strangulation, ovary-sliding hernia should be repaired as soon as possible.
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Junko Akiyoshi, Takeshi Yamanouchi, Shigeru Yakabe, Kotaro Yasumori, T ...
Article type: Article
2005 Volume 41 Issue 4 Pages
650-655
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A 15-year-old girl was presented with upper abdominal pain, nausea, and vomiting after overeating. The abdominal roentgenogram showed a dilated stomach and duodenum. Ultrasound examination showed multiple hyper echoic nodules suggesting gas in the blood vessels of the liver. Computed tomography showed portal vein gas in the liver and gastric emphysema. The lumen of the duodenum was completely collapsed between the superior mesenteric artery and the abdominal aorta. She was diagnosed as SMA syndrome associated with gastric emphysema and portal vein gas. She was successfully treated by conservative therapy using a nasogastric tube and intravenous fluids infusion. Findings of gastric emphysema and portal vein gas disappeared in four days after admission and she was discharged in 7 days after admission.
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Minoru Horisawa, Norihisa Uemura, Yukio Ogura, Noriji Niinomi, Shinsuk ...
Article type: Article
2005 Volume 41 Issue 4 Pages
656-660
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We report a case of a three-year-old boy with a foreign body (head of toothbrush) lodged in his retropharyngeal space for which the diagnosis was made one day later. He had fallen with the toothbrush in his mouth and its head disappeared. He said the head of the toothbrush was swollen at that time. He was referred to our clinic. An abdominal X-P was taken which revealed no sign of a foreign body. An emergency endoscopy under general anesthesia was undertaken but failed to find any foreign body from mouth to stomach. Next morning, he complained of cervical pain with mild fever. Then the head and neck X-Ps taken revealed the foreign body in the retropharyngeal space. 3-D CT revealed the exact anatomical locus of the foreign body, and the head of the toothbrush was removed safely by extracervical incision. The pitfalls of recognition of a foreign body in retropharyngeal space were discussed.
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Ken Harumoto, Masashi Nakahira, Tetsuro Nakamura, Takashi Azuma, Tatsu ...
Article type: Article
2005 Volume 41 Issue 4 Pages
661-667
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A 7-year-old boy who was treated with chemotherapy because of tracheobronchial tuberculosis is reported. Severe stenosis of the trachea and the right main bronchus which may be life-threatening occurred during the course of treatment. As an emergent treatment, resection of lesions and tracheoplasty were needed even in the tuberculostatic treatment. Two months after the surgery, stenosis appeared at the anastomotic site, which required dilatation. The remnant lesions in the right main bronchus were treated with 6-month chemotherapy, followed by sleeve lobectomy. Surgical treatment for tracheobronchial tuberculosis is indicated for patients with infection resistant to chemotherapy and those with recurrent atelectasis. Usually, it is recommended that surgical treatment should be performed after 6-month chemotherapy. Since the tracheal diameter is definitely small in children, stenosis may appear in a short period. Careful attention should be paid as to the time of surgery and indications of surgical treatment.
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Kiminobu Sugito, Tsugumichi Koshinaga, Mayumi Hoshino, Mikiya Inoue, H ...
Article type: Article
2005 Volume 41 Issue 4 Pages
668-672
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We report a case of hepatoblastoma with multiple tumoral calcinosis and neonatal hepatitis. We experienced an infant with hepatoblastoma, after multiple tumoral calcinosis spontaneously regressed after an excisional biopsy and neonatal hepatitis returned to normal condition. At the age of 22 months, computed tomography showed a liver tumor and the alpha-fetoprotein level had increased dramatically. At the age of 33 months, liver biopsy was performed. The patient was diagnosed as having hepatoblastoma and had chemotherapy and partial liver resection. In this case, we could not find the factors reported to be associated with hepatoblastoma. It was supposed that medication for hepatitis and frequent X-ray irradiations were one cause of tumorigenicity.
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Keinosuke Ishido, Michihiro Sugai, Yoshihiro Takahashi, Kiminori Terui ...
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2005 Volume 41 Issue 4 Pages
673-678
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A 4-month-old male infant with an abdominal mass and appetite loss was admitted to our hospital. An abdominal CT scan revealed a giant multicystic mass in the left lateral region. On diagnosis as retroperitoneal lymphangioma, the operation was planned. On the operation day, the radical enlargement of the abdominal mass and severe anemia (Hb, 4.0g/dl) were demonstrated. Since intraabdominal hemorrhage due to a rupture of the tumor was suspected, an emergency operation was performed. The operation findings revealed a cystic tumor located on the upper pole of the left kidney was ruptured. The left nephrectomy was performed because the tumor was not separated from the left kidney. The tumor was 13×9×8cm in size and weighted 430g. Histopathologic diagnosis was congenital mesoblastic nephroma of the cellular type. Postoperative chemotherapy was performed because of the intraabdominal dissemination of the tumor cells. No sign of recurrence has been seen for 32 months since the operation. Cystic congenital mesoblastic nephroma is rare, and only 14 cases have been reported in the literature. We describe the findings of our case and also discuss the treatment for this disease.
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Nobuyuki Sano, Masaki Nio, Hideyuki Sasaki, Atsushi Kotera, Ryoji Ohi
Article type: Article
2005 Volume 41 Issue 4 Pages
679-683
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A 3-year-old girl was transferred to our hospital after a 36-hour history of abdominal pain and vomiting. An abdominal X-ray showed a foreign body at the upper abdomen and dilated small intestine. She had slight abdominal tenderness but no sign of peritonitis. Laboratory data were almost within the normal range. A CT scan demonstrated a foreign body with metallic density, which was revealed to be a ring-shaped structure composed of 8 small pieces of metals by means of a volume rendering method. From the information from her parents, the metals were supposed to be magnet particles. Because intestinal damage caused by magnet ingestion was suspected, an emergency operation was performed. The intestinal loop containing magnets was laparoscopically confirmed, and was taken out from the umbilical wound. The jejunojejunal fistula and the intestinal strangulation localized at the anal part of the blind loop which developed following the fistula formation were found and repaired. The postoperative course was uneventful. The establishment of the fistula might have ameliorated the symptoms of the intestinal strangulation. This bypass-effect enabled accomplishment of the less invasive procedure utilizing laparoscopy as well.
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Tsuneo Chiba, Chie Sato
Article type: Article
2005 Volume 41 Issue 4 Pages
684-686
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A 1-day-old female infant was admitted to the Sendai Medical Center with complaint of a red-colored tumor with small omphalocele. No urination has been observed during the first 30h after birth. A cystic mass of 16mm in diameter, was observed at 16 weeks of gestation, and had increased in size with fetal age. Fetal growth was abnormally slow, up until the spontaneous rupture of the cyst. After the rupture, fetal growth had returned to normal. Srugery had been implemented, and it revealed that the patient had vesi-coumbilical fistula which was removed successfully. It was not until after surgery that proper urination was observed.
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
690-691
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
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2005 Volume 41 Issue 4 Pages
691-692
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2005 Volume 41 Issue 4 Pages
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