Right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis.

A case of right-sided diaphragmatic hernia following group B streptococcal pneumonia and sepsis is reported herein. The clinical course was characteristic. The position of the right hemidiaphragm was initially normal.

Fate of infants with neonatal hepatitis: pediatric surgeons' dilemma.

Thirty-five cases of neonatal hepatitis (20 males and 15 females) were reviewed, 3 of whom were lost during the follow-up, leaving 32 patients for review. There were 10 late deaths and 22 patients survived, 18 of whom with a normal bilirubin level and 4 with a bilirubin level of greater than 1.0 mg/dL.

Antenatally detected ovarian cysts--a therapeutic dilemma.

Twenty-four instances of ovarian cysts detected antenatally are reported. Most cysts were functional in origin, histologically benign simple cysts. Pregnancy was clinically uncomplicated in all, followed by a spontaneous vaginal delivery in 20 cases between the 33rd and 41st week, four neonates were delivered by a cesarean section for obstetrical reasons.

Manometric evaluation of gastrointestinal motility in a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS).

We report on a manometric study of the esophagus, stomach, duodenum, jejunum and anorectum in a case of megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS). An esophageal examination showed normal esophageal contractions and a positive rectoanal reflex was obtained in an anorectal manometry. However, the continuous fasting manometric recording of the antrum, duodenum and jejunum lasting a total of 12 hours revealed a severe motility disturbance of the gastrointestinal tract.

Undifferentiated (embryonal) sarcoma of the liver: report of three cases.

Undifferentiated (embryonal) sarcoma is a rare malignant tumor of the liver. It typically presents in late childhood and its prognosis is poor. We experienced three cases of such a tumor during the period of 1976-1989; two of these patients are still alive without disease.

Establishment and characterization of a cell line of congenital primitive neuroectodermal tumor of soft tissue.

A new human cell line, termed Muraoka, has been established from the recurrent tumor of a case of congenital primitive neuroectodermal tumor (PNET) arising at the temporofacial region of a male infant. The microscopic findings of this cell line were epithelioid, and the xenografted tumor in a nude mouse consisted of the malignant epithelioid cells. Immunohistochemically, the cells were positive for neuron-specific enolase, S-100 protein, carcinoembryonic antigen, cytokeratin, epithelial membrane antigen, and glial fibrillary acidic protein.

Verapamil attenuates postischemic oxidative injury in the rat liver.

We assessed the effects of the calcium channel blocker verapamil on postischemic oxidative injury in the rat liver. In the untreated rats, the values of tissue lipid peroxidation products (thiobarbituric acid-reactive substances) remained unchanged during 90 min of warm ischemia. However, the values increased significantly after the next 60 min of reperfusion compared with those in the sham-operated rats (P less than 0.

Different genomic and metabolic patterns between mass screening-positive and mass screening-negative later-presenting neuroblastomas.

The mass screening of neuroblastoma has been undertaken in Japan by measuring urinary vanillylmandelic acid (VMA) and homovanillic acid (HVA) in all infants at the age of 6 months. This program may not only improve the prognosis but also provide important insights into the biology and evolution of human neuroblastoma. The authors studied and discuss the clinical significance of the N-myc oncogene, catecholamine metabolism, and other tumor markers in 43 patients with neuroblastoma who underwent the urinary screening test at 6 months of age.

Histological classification of nesidioblastosis: efficacy of immunohistochemical study of neuron-specific enolase.

Pancreatic specimens of six patients with nesidioblastosis were studied by light microscopy and immunohistochemistry in order to classify the changes of the endocrine pancreas and relate them to the clinical outcome. Neuron-specific enolase immunostaining was useful in demonstrating the distribution of whole pancreatic endocrine cells. The six cases with nesidioblastosis were classified into two types; four cases of focal type (head 1, body 1, tail 2), and two cases of diffuse type.

Carcinoma of the colon in children: a case report and review of 41 Japanese cases.

We report a case of sigmoid colon carcinoma in a 14-year-old girl. She had been suffering from several nonspecific abdominal symptoms for about 1 year before a definite diagnosis was made. While undergoing an operation, the main tumor was found to be unresectable.

Remnants of urachus in infants and children--the problems of diagnosis and treatment.

A total of 17 cases of remnants of urachus were examined between 1981 and 1989, including 2 cases of patent urachus, 5 of urachal cyst, 9 of urachal sinus, and 1 of urachal diverticulum. A long urachal sinus was considered to be caused by the self-destruction of a cyst. While patent urachus was diagnosed in neonates with urine discharge from the umbilicus, cysts or sinuses accompanied by infection were more often found in older children.

Significance of prenatal diagnosis in a patient with a huge neck tumor.

Due to the great advancements in fetal ultrasonography, the number of prenatal diagnoses are increasing, greatly contributing to improved neonatal surgery. It is now relatively easy to detect huge fetal cystic masses, and we have experienced three cases with a huge neck tumor detected in utero, one case with teratoma and two cases with cystic hygroma. Each case was complicated by neonatal asphyxia, and the neonate needed resuscitation by means of endotracheal intubation.

Therapeutic dilemmas associated with antenatally detected ovarian cysts.

Fifteen instances of ovarian cysts detected antenatally are reported. Seven cysts more than 5 centimeters in diameter were treated surgically because of clinical signs, such as palpable abdominal mass, vomiting and abdominal distension. Seven cysts less than 5 centimeters in diameter, and one cyst more than 5 centimeters in diameter began to regress spontaneously within six months after birth.

The fate of swallowed button batteries in children.

The method of treatment and fate of 41 button batteries ingested by 34 children were analysed; 31 batteries were in the stomach and 10 beyond the pylorus. In 31 batteries situated in the stomach, removal by magnet tube technique was attempted in 30 batteries, 25 being successfully taken out, while 5 failed passing through the pylorus at the duodenum. One was removed endoscopically, since a magnet tube was not available.

Xanthogranulomatous cholecystitis in an infant with obstructive jaundice.

We describe a female infant with obstructive jaundice due to inflammatory stenosis of the choledochus. It was surrounded and narrowed by a xanthogranulomatous lesion, extending from xanthogranulomatous cholecystitis (XGC). The obstructive jaundice was released by a cholecystectomy, resection of the choledochus, and hepaticojejunostomy.

Distribution of neuropeptide Y-like immunoreactivity in the normoganglionic and aganglionic segments of human colon.

The localisation and distribution of neuropeptide Y (NPY)-like immunoreactivity were studied by use of immunohistochemical methods in gut tissues from 19 patients with Hirschsprung's disease, including 4 cases of long segment aganglionosis. In the normoganglionic segment, immunoreactive cell bodies and nonvaricose processes were seen within both myenteric and submucous plexuses. A scarce supply of varicose fibres was found in the lamina propria mucosae, muscularis mucosae and longitudinal muscle layer.

Effect of verapamil on conversion of xanthine dehydrogenase to oxidase in ischemic rat liver.

The effect of organ flushing with the calcium entry blocker verapamil on the conversion of innocent enzyme xanthine dehydrogenase (XDH) to superoxide generating enzyme xanthine oxidase (XOD) in ischemic rat livers was studied. This enzyme conversion progressed over time in warm or cold ischemia. In non-flushed livers, the activities of XOD as percentages of XDH plus XOD after 6 h at 37 degrees C and 6 days at 4 degrees C were 80.

Management of pediatric patients who have swallowed foreign objects.

The clinical management of children who have swallowed foreign bodies presents a great challenge for both pediatricians and pediatric surgeons. Our 7-year experience of treating 141 patients with a history of foreign body ingestion is reported. In 114 patients, there were 122 foreign bodies present in areas from the esophagus to the rectum, as located by plain chest and abdominal x-ray examination.

Heterogenous expression of endothelial cell markers in infantile hemangioendothelioma. Immunohistochemical study of two solitary cases and one multiple one.

Three cases of infantile hemangioendothelioma were immunohistochemically studied with the use of antibodies against von Willebrand factor (vWF), Ulex europaeus I lectin (UEA I), vimentin, thrombomodulin (TM), and actin, as endothelial cell (EC) markers. Because of a broad variety of histologic features, the growth pattern of the tumor cells was subclassified into the following four subtypes: capillary, sinusoidal, cavernous, and myxomatous parts. The solitary tumor from patients 1 and 2 was composed of these four components, but the multiple tumor in the patient 3 consisted of capillary and sinusoidal parts.

Prolonged retention of a swallowed foreign body in the stomach following pyloromyotomy.

An unusual case of prolonged retention of a swallowed, round-shaped, magnet tack in the stomach of a patient is reported. The patient had had a previous pyloromyotomy for pyloric stenosis. Patients with a history of pyloromyotomy for pyloric stenosis may present special problems for the passage of foreign bodies reaching the stomach and may be more likely to require surgical intervention.