A prenatally detected case of congenital hepatoblastoma.

Hepatoblastoma is a rare tumor of childhood and its incidence in the first year of life is about one in a million. Forty-two congenital hepatoblastoma cases were reported so far. Among 42 congenital hepatoblastoma patients, only seven cases have been detected in the prenatal period. Here we report a rare case diagnosed before birth and confirmed by postmortem autopsy.

Effects of neonatal dexamethasone or methylprednisolone on rat growth and neurodevelopment.

BACKGROUND: Clinical studies have demonstrated that premature infants receiving long-term dexamethasone therapy have reduced linear growth, decreased weight gain, and smaller head circumferences. The purpose of the present study was to investigate the effects of the same equivalent doses for anti-inflammatory potency of neonatal dexamethasone and methylprednisolone on rat growth and neurodevelopment. METHODS: The pups were randomly separated into three treatment groups on postnatal day (PD) 3. At postnatal 3-5 days, tapering doses of corticosteroids or sterile saline were administered subcutaneously. Group 1 was the dexamethasone group (n = 12; PD 3, 0.5 mg/kg; PD 4, 0.25 mg/kg; PD 5, 0.125 mg/kg; PD 6, 0.05 mg/kg s.c.); group 2, methylprednisolone group (n = 12; PD 3, 2.6 mg/kg; PD 4, 1.3 mg/kg; PD 5, 0.650 mg/kg; PD 6, 0.325 mg/kg; group 3, control group (n = 12; normal saline injected). Weight was recorded on PD 3-6, 8, 14, 22, length was recorded on PD 3, 7, 14, 21 for each group. Neurological responses and physical development were tested on PD 7, 14, 21. RESULTS: On PD 4-6, 8, 14, 22 the weight in the dexamethasone and methylprednisolone groups was lower than in the control group, but the weight in the dexamethasone group was the lowest (P < 0.05). The length in the dexamethasone group was significantly shorter than in the methylprednisolone group on PD 14 and 21. Dexamethasone-treated animals had a reduced total neurological score compared with the methylprednisolone and control groups on PD 7, 14, 21. Although methylprednisolone-treated animals had lower total neurological score than that of the control group on PD 7 and PD 14 (P < 0.05), total neurological scores were not different in the methylprednisolone and control groups on PD 21. CONCLUSIONS: Postnatal methylprednisolone treatment might be safer than dexamethasone treatment in newborns.

Childhood asthma and its relationship with tonsillar tissue.

The aim of this study was to evaluate the prevalence of asthma among 4-17 years old school children and to determine the relationship between frequent tonsillitis, tonsillar hypertrophy and asthma-related symptoms. A total of 2,000 school children, aged 4-17 years, in Denizli were surveyed using the ISAAC questionnaire; the size of the tonsils was evaluated by physical examination. A total of 1,784 questionnaires were completed giving an overall response rate of 89.2%. The prevalence of lifetime wheezing, 12-month wheezing and lifetime doctor-diagnosed asthma were 16.4%, 6.2% and 1.7%, respectively. The prevalence of frequent tonsillitis and tonsillar hypertrophy were 19.9% and 3.4%, respectively. Tonsillar hypertrophy was positively correlated with a history of frequent tonsillitis. Frequent tonsillitis and tonsillar hypertrophy could be evaluated as risk factors for asthma due to their significant association with asthma-related symptoms.

Severe thrombocytopenia after hepatitis B vaccine in an infant from Turkey.

Recombinant hepatitis B vaccine has been used widely in the world since 1991. The side effects of hepatitis B vaccine are seen rarely. In this paper, we present clinical and laboratory progress of an infant who gets severe thrombocytopenia after the second dosage hepatitis B vaccine. Our case is different from other cases because our patient is very young, the number of platelet is the lowest in the literature, and intravenous immunoglobulin (IVIG) are immunoglobulin (IVIG) are used in the treatment. Although it is a severe thrombocytopenia, the patient has recovered without any bleeding.

Variation in tonsil size in 4- to 17-year-old schoolchildren.

OBJECTIVE: The purpose of this study was to evaluate the variation in tonsil size and prevalence of asymmetric tonsils in 4- to 17-year-old schoolchildren and the relationships between tonsillar hypertrophy and frequent tonsillitis, frequent fever, and sleep-related symptoms observed by parents. DESIGN: Cross-sectional study. SETTING: Six daycare centres, four primary schools, and four high schools. METHODS: Questionnaire and physical examination. MAIN OUTCOME MEASURES: The size of the tonsils was evaluated and scored on a 4-point scale. The interrelationships between tonsillar hypertrophy and other studied symptoms were examined. RESULTS: In the study, the parents of 1784 children, consisting of 803 (45%) boys and 981 (55%) girls, completed the questionnaires. The prevalence rates of snoring, habitual snoring, observed apnea, and habitual observed apnea were 24.6%, 4.1%, 3.8%, and 0.9%, respectively. The results of tonsil scoring were grade 1, 62.7%; grade 2, 28.4%; grade 3, 3.3%; and grade 4, 0.1%. The prevalence rate of grade 1 tonsils was increasing, whereas the prevalence rates of grade 2 and 3 tonsils were decreasing with increasing age. Tonsil size peaked in 4- to 8-year-old children. The prevalence rates of tonsillar hypertrophy and asymmetric tonsils were 3.4% and 1.7%, respectively. Tonsillar hypertrophy was found to be significantly associated with male gender, a history of frequent tonsillitis, a history of frequent fever, often or always snoring, and often or always observed apnea. CONCLUSIONS: A tonsil size curve was developed in 4- to 17-year-old schoolchildren. Children aged 4- to 8 years with oropharyngeal symptoms and particularly male gender should undergo consultation with otorhinolaryngology and pediatric pulmonology physicians for the evalution of adenotonsillar tissue.