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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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Article type: Appendix
2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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Article type: Index
2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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Yoshihiro Kitano, Chikashi Goto, Hiroo Uchida, Hiroshi Kawashima, Kaor ...
Article type: Article
2010 Volume 46 Issue 1 Pages
23-27
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Purpose: To obtain information on the age distribution of trainee supervisors of the Japanese Society of Pediatric Surgeons. Methods: The age of each trainee supervisor was estimated from the membership directory and data available on the website of the Japanese Ministry of Health, Labour and Welfare. Age distribution was compared between 2008 and 1990. Results: A total of 251 trainee supervisors were identified. The average age was 56.4 years (range 40-89), which was significantly higher than the 50.1 years (range 40-70) in 1990. Both the number and the ratio of supervisors younger than 50 years decreased from 66 (62.9%) in 1990 to 62 (24.9%) in 2008. Conclusions: Efficient measures are necessary to prevent the further aging of trainee supervisors. Requirement of 15 years of surgical experience may be excluded to shorten the training period.
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Kaori Sato, Hiroo Uchida, Hiroshi Kawashima, Chikashi Goto, Mariko Yos ...
Article type: Article
2010 Volume 46 Issue 1 Pages
28-31
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Purpose: The fixation of the pyloric tumor by grasping the duodenum during conventional laparoscopic pyloromyotomy is not easy; therefore surgeons need to be adept at this surgical procedure. For better visualization and stabilization of the pyloric tumor, we applied a new technique of grasping the pylorus using a vascular clamp. The aim of this study was to assess the safety and benefits of the usage of the vascular clamp during laparoscopic pyloromyotomy. Methods: Seven infants underwent laparoscopic pyloromyotomy using the vascular clamp between April 2008 and July 2009. The operative data were collected retrospectively. Results: There were no intra- or post-operative complications in any of the 7 cases. No patients underwent conversion to open surgery. The vascular clamp could be inserted from a small stab wound incision. The mean operating time was 33.4 minutes for the laparoscopic pyloromyotomy using the vascular clamp. The use of the vascular clamp results in easier and safer manipulation of the pylorus tumor for beginners to laparoscopic pyloromyotomy. No long-term complications were reported and no redo pyloromyotomies were needed. Conclusion: Laparoscopic pyloromyotomy using the vascular clamp offered a better visualization and stabilization of the pyloric mass. It seems to be a good technique for the surgical management of hypertrophic pyloric stenosis and will become an alternative to conventional laparoscopic pyloromyotomy.
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Masayuki Obatake, Yusuke Yamane, Takayuki Tokunaga, Yukio Inamura, Tak ...
Article type: Article
2010 Volume 46 Issue 1 Pages
32-36
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We describe a case of traumatic pancreatic pseudocyst successfully treated by endoscopic transgastric drainage. A 10-year-old girl was admitted with abdominal pain caused by blunt epigastric injury. Abdominal computed tomography (CT) showed a hematoma anterior to the pancreas with peripancreatic effusion leading to a diagnosis of traumatic pancreatitis. She subsequently complained of abdominal pain with an elevation of serum amylase, and the abdominal CT on the 20th hospital day revealed multiple pancreatic pseudocysts, one of which communicated with the main pancreatic duct. The multiple pseudocysts enlarged up to 14 cm in diameter and bulged into the posterior gastric wall. On the 59th day, endoscopic transgastric drainage of the pseudocyst was performed without any complications. Abdominal pain promptly resolved in parallel with decreases of serum amylase level and the pseudocyst size. An endoscopic transgastric drainage can be accomplished safely and effectively, which is less invasive than laparotomy or percutaneous drainage.
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Takashi Hosokawa, Kiminobu Sugito, Manabu Hanada, Shota Uekusa, Kensuk ...
Article type: Article
2010 Volume 46 Issue 1 Pages
37-40
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There is no consensus in the literature as to whether surgical repair improves pulmonary function in pectus excavatum (PE). Surgical repair is usually performed for cosmetic improvement in most cases with PE. PE after a right lower lobectomy for congenital cystic adenomatoid malformation (CCAM) is a rare late complication. Here, we report on a 5-year-old girl presenting with PE, who had received a right lower lobectomy for CCAM 6 days after birth and developed PE. The depression of the chest progressively worsened with asthma and decreased compliance of the thorax. We performed a Ravitch procedure for PE at 5 years of age, and her pulmonary function and asthmatoid symptoms improved after surgery. Based on this experience, we conclude that the Ravitch procedure is useful in terms of pulmonary function for patients with PE who have undergone lobectomy in the neonatal period.
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Takuya Kosumi, Takeo Yonekura, Seika Kuroda, Katsuji Yamauchi, Masafum ...
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2010 Volume 46 Issue 1 Pages
41-47
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The patient is a 13-year-old girl. She complained of a bulge in the left upper quadrant of the abdomen and abdominal pain. She was diagnosed with an intraperitoneal cystic tumor 5 cm in size by abdominal ultrasonography and admitted to our hospital. Abdominal ultrasonography and computed tomography showed a monocular cystic tumor 7 cm in size at the bottom of the spleen. It was diagnosed as a splenic cyst. Laparoscopic dome resection was performed because of the complaint of left abdominal pain and the risk of rupture. We dissected the adhesion between the splenic cyst and the omentum as well as the abdominal wall. A SAND balloon^[○!R] was used for suction of 180 ml of dark red cystic fluid. Thus, we excised the cyst wall with an ultrasonic coagulating device. It was diagnosed as an epithelial cyst by postoperative pathological examination. There has been no relapse for two years after the operation.
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Fumiko Horigome, Toshio Fujiwara, Takashi Tsuchioka, Kentaro Okamoto, ...
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2010 Volume 46 Issue 1 Pages
48-52
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We report a case of cellular-type mesoblastic nephroma (MN). A 3-month-old boy was admitted to our hospital because of sucking loss and a huge abdominal mass 12 centimeters in diameter. The cut surface was milk-white and solid; we had difficulty in a differential diagnosis between a Wilms tumor and clear cell sarcoma of the kidney. In pathologic findings, the tumor was composed of elongated spindle cells forming dense fascicles, and a specific ETV6-NTRK3 fusion-gene product was detected by RT-PCR; therefore we diagnosed cellular-type mesoblastic nephroma. The tumor was completely excised, and the patient has been well and free of tumor for a year after surgery.
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Tatsuo Nakaoka, Sadashige Uemura, Tatsuyuki Yoshida, Terutaka Tanimoto ...
Article type: Article
2010 Volume 46 Issue 1 Pages
53-56
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A female extremely low birth weight (ELBW) infant presented with meconium related ileus (MRI) on her first day of life. We attempted a hydrostatic enema under ultrasonic guidance. The procedure was performed while the infant remained in an incubator. Four-fold attenuation of iopamidol was injected into her colon with 50 cmH_2O static pressure, and an ultrasonic imaging was performed concurrently. The imaging showed that the contrast media reached the ileum and advanced beyond the meconium plug. A roentgenogram showed the same appearance. The intestinal obstruction was reduced about 6 hours after the procedure. Ultrasonic imaging is useful for hydrostatic enema treatment for MRI in ELBW infants.
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Michio Kaneko, Haruo Ohkawa
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2010 Volume 46 Issue 1 Pages
57-62
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A right back tumor and a huge abdominal mass were pointed out in a 3-year-and-7-month-old girl. Imaging studies revealed a huge mediastino-retroperitoneal tumor with intrapleural tumor rupture and intraspinal extension. Though histological diagnosis of a biopsied back tumor was benign ganglioneuroma, intrapleural tumor rupture and strongly suspected multiple lymph node metastases in the imaging studies prompted us to give preoperative chemotherapy. After 3 cycles of 91A1 induction chemotherapy neither the size of the tumor nor the elevated urinary VMA and HVA excretion diminished. The main tumor, multiple lymph node metastases and pleural dissemination were subtotally extirpated followed by intraoperative radiation. Histologic diagnosis of the main tumor and all of the lymph node matastases were uniformly ganglioneuroma. The tumor markers normalized postoperatively and tumor recurrence has never been observed. Scoliosis developed 8 years later, necessitating corrective surgery at 10 years. The tumor was considered to have originated as metastatic neuroblastoma in early infancy then gradually maturated to ganglioneuroma. Restricted surgery without intensive chemotherapy and radiation might have been the best treatment of choice.
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2010 Volume 46 Issue 1 Pages
63-100
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2010 Volume 46 Issue 1 Pages
101-114
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
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2010 Volume 46 Issue 1 Pages
116-117
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