Radiation protection in pediatric radiology.

Background: The German Federal Law on Radiation Control contains no special provisions for X-ray studies in children and adolescents, even though exposure to ionizing radiation must be kept especially low in young persons, because their tissues are highly radiosensitive. Children, who have many years left to live, are more likely than adults to develop radiation-induced cancer; also, as future parents, they are at risk for passing on radiation-induced genetic defects to the next generation. Whenever possible, radiological studies on children and adolescents should be of a type that does not involve ionizing radiation, such as ultrasonography or magnetic resonance imaging.

Class test stress as an unusual cause of spontaneous pneumomediastinum in a 14-year-old girl.

Pneumomediastinum can occur spontaneously in several medical conditions such as asthma or secondarily because of injuries of the trachea or esophagus. Both types of pneumomediastinum may be life threatening, depending on possible complications and, additionally, in the secondary pneumomediastinum, because of an underlying condition. This is the case of a 14-year-old girl who experienced a pneumomediastinum after snorting during a class test owing to psychologic stress.

Focal nodular hyperplasia of the liver in longterm survivors of neuroblastoma: how much diagnostic imaging is necessary?

Objectives: Focal nodular hyperplasia of the liver is a tumor-like lesion, uncommon in children, but it has recently been more frequently observed in children treated for malignant diseases, especially neuroblastoma. The aetiology is unclear, the pathogenesis remains controversial. Focal nodular hyperplasia of the liver is suspected to be a sequela of tumor therapy.

Localized infant neuroblastomas often show spontaneous regression: results of the prospective trials NB95-S and NB97.

Purpose: The excellent prognosis of localized neuroblastoma in infants, the overdiagnosis observed in neuroblastoma screening studies, and several case reports of regression of localized neuroblastoma prompted us to initiate a prospective cooperative trial on observation of localized neuroblastoma without cytotoxic treatment.

Patients And Methods: For infants with localized neuroblastoma without MYCN amplification, chemotherapy was scheduled only in cases with threatening symptoms; otherwise, the tumor was either resected or observed by ultrasound and magnetic resonance imaging (MRI).

Results: Of 340 eligible participants, 190 underwent resection, 57 were treated with chemotherapy, and 93 were observed with gross residual tumor.

Review of image defined risk factors in localized neuroblastoma patients: Results of the GPOH NB97 trial.

Background: Recently, an international expert group proposed revision of the International Neuroblastoma Staging System (INSS). Localized disease can be classified as L1 without and as L2 with image defined risk factors (IDRF published in JCO 2005; 23:8483-8489). Our aim was to evaluate IDRF for the prediction of resectability, complications, and outcome.

True thymic hyperplasia associated with severe thymic cyst bleeding in a newborn: case report and review of the literature.

We report on a 5-week-old male infant with recurrent respiratory distress since birth and congenital thymic hyperplasia. Acute life-threatening thymic bleeding apparently from ruptured thymic cysts into the pleural spaces complicated the clinical situation. Thoracotomy and complete thymectomy were performed.

Prospective volumetric analysis of gallbladders in critically ill newborns: the impact of nutrition.

Background: Neonatal reference values of gallbladder size have been assessed in healthy newborns with enteral feeding regimen. Their applicability to critically ill patients under total parenteral nutrition (TPN) remains to be questioned.

Objective: Our aim was to evaluate the impact of short-term TPN versus enteral nutrition (EN), gender and birth weight on neonatal gallbladder volume.

Prospective sonographic evaluation of fentanyl side effects on the neonatal gallbladder.

Objective: In an effort to minimise the stress and pain of mechanically ventilated neonates, the application of opioids has increased markedly. Abdominal adverse effects of opioid analgesics are constipation and increased pressure in the biliary system. Our aim was to evaluate the impact of continuous intravenous infusion of fentanyl on the volume of the neonatal gallbladder and to assess potential gastrointestinal side effects.

Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia.

The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature.

Proton spectroscopic metabolite signal relaxation times in preterm infants: a prerequisite for quantitative spectroscopy in infant brain.

Purpose: To determine relaxation times of metabolite signals in proton magnetic resonance (MR) spectra of immature brain, which allow a correction of relaxation that is necessary for a quantitative evaluation of spectra acquired with long TE. Proton MR spectra acquired with long TE allow a better definition of metabolites as N-acetyl aspartate (NAA) and lactate especially in children.

Materials And Methods: Relaxation times were determined in the basal ganglia of 84 prematurely born infants at a postconceptional age of 37.

Nephrocalcinosis in preterm infants: a single center experience.

The risk of nephrocalcinosis in preterm infants is considerable, but conflicting numbers are given for the actual incidence (10-65%). Furosemide induced hypercalciuria is said to be the main risk factor. We examined retrospectively the incidence, causes and outcome of nephrocalcinosis in preterm infants born in our hospital from 1988 to 1998 ( n=2190).