Solid pseudopapillary tumor (SPT) of the pancreas occurs most frequently in the second or third decades of life, and is prevalent in females. Unlike other pancreatic malignancy, SPT usually has a low malignancy potential. This study reviews our clinical experience and surgical treatment of pancreatic SPT. Admission records and follow-up data were analyzed retrospectively for the period between January 1996 and January 2003. Five patients with a pancreatic mass were operated upon and SPT was confirmed by pathology in each case. The male to female ratio was 1: 4. The median age was 13.8 years. Findings were vague upper abdominal pain (n=5, 100 %) and an abdominal palpable mass (n=3, 60 %). The median tumor diameter was 6.8cm and the locations were 2 in the pancreatic head (40 %) and 3 in the pancreatic tail (60 %). Extra-pancreatic invasion or distant metastasis was not found at the initial operation in all five cases. A pyloruspreserving pancreaticoduodenectomy (n=1) and a mass enucleation (n=1) were performed in two patients of pancreatic head tumors. For three cases of tumors in pancreatic tail, distal pancreatectomy (n=2) and combined distal pancreatectomy and splenectomy (n=1) were performed. The median follow-up period was 60 months(12-117month). During the follow-up period, there was no local recurrence, nor distant metastasis. Postoperative adjuvant chemotherapy or radiotherapy was not carried out. All five children were alive during the follow up period without any evidence of disease relapse. SPT of the pancreas in childhood has good prognosis and surgical resection of the tumor is usually curative.
Purpose: Chloramphenicol and tetracycline are not recommended for treating scrub typhus in pediatric patients because of potential side effects, such as aplastic anemia or tooth discoloration. While clarithromycin has recently been used in adults, few reports have been published on its effects in pediatric patients. We report the clinical profiles of pediatric scrub typhus and the effects of clarithromycin on scrub typhus in children. Methods: We retrospectively analyzed medical records of 56 children with scrub typhus who were admitted between 2004 and 2013 to Chonbuk National University Hospital, Jeonju, Korea. Cases were divided into 3 groups based on the treatment drug (chloramphenicol, azithromycin, and clarithromycin). We compared their clinical manifestations and laboratory findings. Results: All patients exhibited fever and rash. Other common clinical manifestations were eschars (66%), lymphadenopathy (48%), upper respiratory symptoms (42%), abdominal pain (32%), and hepatosplenomegaly (14%). Elevated levels of C-reactive protein, erythrocyte sedimentation rates, aspartate transaminase, and alanine transaminase were detected in 95%, 96%, 84%, and 77% of patients, respectively. Additionally, decreased platelet and white blood cell levels were observed in 43% and 36% of patients, respectively. There were no statistical differences between the treatment groups in mean age (P=0.114) or sex (P=0.507). However, time to defervescence after the treatments differed significantly, being the shortest in the clarithromycin group (P=0.019). All patients recovered without complications related to the disease or drugs. Conclusion: Clarithromycin was as effective as chloramphenicol and azithromycin in pediatric scrub typhus patients and may be used as a first-line treatment drug.
Background and Objectives : Vocal nodules occur with a 12-22% prevalence in pediatric populations. Most otolaryngologists recommend voice therapy as the primary treatment. The aim of this study is to evaluate patient compliance with voice therapy and its effect on vocal nodules in children. Materials and Methods : We retrospectively reviewed 44 pediatric patients between 3 and 11 years old diagnosed with vocal nodules between March 2015 and December 2017. We evaluated the treatment adoption rate, dropout rate during voice therapy, and reasons for dropout. For patients who completed voice therapy, we measured the changes in nodule size, perceptual parameters, and acoustic parameters. We evaluated patient satisfaction using the pediatric voice handicap index (P-VHI). Results : Of the 44 pediatric patients diagnosed with vocal nodules, 22 (50%) agreed to voice therapy. Of the 22 patients who started voice therapy, 5 (22.7%) dropped out during therapy because they were unsatisfied with their treatment. Another 4 patients discontinued therapy for reasons unrelated to treatment effectiveness. Vocal nodule disappeared or decreased in all 13 patients who completed voice therapy. All voice parameters were improved and statistically significant changes were observed in perceptual, acoustic, and P-VHI parameters. Conclusions : Although compliance to voice therapy among the pediatric patients with vocal nodules was low, there were significant improvements in voice parameters for those who completed voice therapy. A change toward a positive perception of voice therapy is necessary and a multidisciplinary approach is needed to improve the effect of voice therapy on pediatric patients with vocal nodules.
This study aimed to analyze the prevalence and severity of infraoccluded primary molars (IPM) and their correlation with the agenesis of permanent successors (APS). A total of 4,011 panoramic radiographs from children aged 4 to 11 years who had all 8 primary molars were examined. The prevalence of APS was analyzed based on the severity and tooth type of IPM. The prevalence of IPM was 13.0%, and there was no difference between genders. The majority of the children had two IPMs each. In all tooth types, mild infraocclusion was the most prevalent, whereas severe infraocclusion was the least frequent. Among the types of primary molars, the lower primary first molar (62.3%) was the most affected, followed by the lower primary second molar (27.7%), the upper primary second molar (5.8%), and the upper primary first molar (4.2%). Infraocclusion was 11.2 times more prevalent in the mandible than in the maxilla, with no significant difference between the left and right sides. The correlation between IPM and APS was also investigated. Among the subjects, 177 had one or more agenesis of premolars, of whom 54 (30.5%) had IPM. Additionally, among the 521 individuals with IPM, 54 individuals exhibited APS (10.4%). This study identified a noteworthy prevalence of infraocclusion, with notable variations among molar types. The LPFM was particularly affected. The majority of cases were classified as mild in severity. Furthermore, a compelling association between IPM and APS was established. Understanding this connection may enhance treatment strategies for infraoccluded teeth and tooth agenesis.
Vascular tumors of the liver are mesenchymal lesions from endothelial cells. They range from common benign lesions such as haemangioma, intermediate tumors like Kaposi sarcoma, and perivascular epithelioid cell tumor to malignant tumors such as hepatic epithelioid hemangioendothelioma and hepatic angiosarcoma in adults. Pediatric vascular tumors of the liver also include benign, locally aggressive, borderline, and malignant masses with haemangiomas being the most common benign tumors and epithelioid hemangioendothelioma being an uncommon pediatric malignancy. The list of these lesions is completed by nodular regenerative hyperplasia, solitary fibrous tumour, and hepatic small vessel neoplasms (HSVN). Some of these tumors are uncommon and rare. This review article aimed to enumerate hepatic vascular tumors along with their imaging, histopathology, molecular findings for accurate diagnosis that can result in better management.
Motawi, Tarek M.K.;Zakhary, Nadia I.;Salman, Tarek M.;Tadros, Samer A.
Asian Pacific Journal of Cancer Prevention
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제13권11호
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pp.5399-5403
/
2012
Aims and Background: Human leukocyte antigen-G and interleukin-2 receptor play pivotal roles in the proliferation of lymphocytes, and thus generation of immune responses. Their overexpression has been evidenced in different malignant hematopoietic diseases. This study aimed to validate serum soluble human leukocyte antigen-G (sHLA-G) and serum soluble interleukin-2 receptor (sIL-2R) as an additional tool for the diagnosis and follow up of acute lymphoblastic leukemia (ALL). Subjects and Methods: Both markers were determined by ELISA in the serum of 33 ALL pediatric patients before treatment and after intensification phase of chemotherapy as well as in the serum of 14 healthy donors that were selected as a control group. Results: ALL patients showed abnormal CBC and high serum lactate dehydrogenase, which were improved after chemotherapy. Also, there was a non-significant increase in serum sHLA-G in ALL patients compared with the control group. However, after chemotherapy, sHLA-G was increased significantly compared with before treatment. On the other hand, serum sIL-2R in ALL patients was increased significantly compared with the control group. After chemotherapy, sIL-2R decreased significantly compared with before treatment. Conclusions: From these results it could be suggested that measurement of serum sHLA-G might be helpful in diagnosis of ALL, while sIL-2R might be useful in diagnosis and follow-up of ALL in pediatric patients.
This study was conducted to provide the baseline data for preparing an educational program for mothers of pediatric asthma patients by identifying the knowledge about asthma, mother's educational demand and the perceived educational performance. This study used survey design. The subjects were chosen from the mothers whose children have received pediatric asthma treatment or who have admitted in the pediatric unit of major hospitals using selection criteria. The total number of subjects were 63 mothers. The data collection period was from May 1st, 2001 to April 17th, 2001. Instruments used for this study were knowledge examination, educational demand evaluation, and educational performance. The data were analysed using t-test, ANOVA with SPSS PC(Version 10.0). The results of this study were as follows. 1. Mean score of knowledge about pediatric asthma was 17.95, which suggests the mothers of children with asthma have a medium knowledge level. The highest grade was knowledge about treatment and follow management and the lowest grade was knowledge about diet. 2. Demand for education showed 4.23, which suggests the mothers of children with asthma have high educational demand. The highest score was about exercise and activity in daily life and the lowest score was medication. 3. Perceived educational performance score of themselves showed 2.40, which suggests the mothers of children with asthma thought that health team do not give enough education to them. The highest score was knowledge about pediatric asthma itself and the lowest score was exercise and activity in daily life. 4. Demand for education and perceived educational performance about pediatric asthma showed significant difference in all areas. 5. There were no statistically significant difference noted between general characteristics and degree of knowledge, educational demand and perceived educational performance about pediatric asthma. In conclusion, there needed a systematic educational program development for the mothers of children with asthma. Especially, an education program for mothers in the beginning period of pediatric asthma should be emphasized.
Background: Many critically ill patients require transfer to a higher-level hospital for complex medical care. Despite the publication of the American Academy of Pediatrics guidelines for pediatric interhospital transportation services and the establishment of many pediatric transport programs, adverse events during pediatric transport still occur. Purpose: To determine the incidence of adverse events occurring during pediatric transport and explore their complications and risk factors. Methods: This prospective observational study explored the adverse events that occurred during the interhospital transport of all pediatric patients referred to the pediatric intensive care unit of Ramathibodi Hospital between March 2016 and June 2017. Results: There were 122 pediatric transports to the unit. Adverse events occurred in 25 cases (22%). Physiologic deterioration occurred in 15 patients (60%). Most issues (11 events) involved circulatory problems causing patient hypotension and poor tissue perfusion requiring fluid resuscitation or inotropic administration on arrival at the unit. Respiratory complications were the second most common cause (4 events). Equipment-related adverse events occurred in 5 patients (20%). The common causes were accidental extubation and endotracheal tube displacement. Five patients had both physiologic deterioration and equipment-related adverse events. Regarding transport personnel, the group without complications more often had a physician escort than the group with complications (92% vs. 76%; relative risk, 2.4; P=0.028). Conclusion: The incidence of adverse events occurring during the transport of critically ill pediatric patients was 22%. Most events involved physiological deterioration. Escort personnel maybe the key to preventing and appropriately monitoring complications occurring during transport.
The purpose of this study was to evaluate whether the newly introduced calcium silicate-based materials with fast-setting properties could be appropriately used as basement materials in indirect pulp treatment (IPT). This was performed by quantifying the durability of adhesion between the material and composite resin, measured by the shear bond strength (SBS). Five calcium silicate-based materials, TheraCal LC® (TLC), TheraCal PT® (TPT), TheraBase® (TB), Well-RootTM PT (WPT), and Endocem® MTA (EMTA), as well as two glass ionomer-based materials, Fuji II and Fuji II LC, were included. Specimens containing these materials were manufactured and bonded to composite resin with a universal adhesive applied in self-etch mode. The SBS values and failure modes were recorded, and the mean SBSs of the materials were compared. Both TPT and TB exhibited SBS values that were similar to TLC, while both WPT and EMTA appeared to have statistically lower SBS values. Mixed failure was commonly observed in TLC and TPT, while all WPT and EMTA samples showed cohesive failure. In comparison with TLC and TPT, more samples with cohesive failure were observed in TB, implying that this material forms a stronger bond with composite resin. Together with the ability of TB to chemically bind to dentin due to its 10-methacryloyloxydecyl dihydrogen phosphate component, TB seems to be a promising material for IPT within the limitations of this in vitro study.
Sejin Chun;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
대한소아치과학회지
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제51권3호
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pp.279-289
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2024
This study aimed to identify the clinical characteristics of molar root-incisor malformation (MRIM) and provide clinical considerations for treatments. Panoramic radiographs and electronic medical records of 64 patients with MRIM were retrospectively reviewed. Age, gender, follow-up period, medical history, complications, distribution of MRIM teeth, treatment, and prognosis were analyzed. Females were affected 1.56 times more than males, and the average age was 8.2 years. Dental complications, including periapical lesions, abscesses, and alveolar bone loss, were observed in 71.9%, and eruption disturbance of adjacent teeth was noticed in 37.5%. Most patients had medical histories in the first year of life. The most prevalent history was prematurity or low birthweight, followed by neurological conditions, surgeries, medications, and infections. All patients had MRIM on permanent first molars. The primary second molars were the second most frequently involved, followed by maxillary permanent central incisors and primary first molars. The prevalence was low on permanent lateral incisors and canines. Extraction was the most prevalent treatment done on MRIM-affected teeth, and most extraction sockets were managed by the eruption of permanent second molars. Few cases received endodontic treatment but with low success rates. Early detection of MRIM and prompt, appropriate treatment are important to avoid unnecessary discomfort from complications.
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