Bladder dysfunction in infants with primary vesicoureteric reflux.

There is growing evidence that bladder dysfunction is a negative prognostic factor for spontaneous resolution of vesicoureteric reflux (VUR). This study evaluated the prevalence of urodynamic abnormalities in infants with primary VUR who were referred over a 4-year period. The urodynamic evaluations and medical records of 54 infants with primary VUR (79 ureters with reflux) were reviewed prospectively. Urodynamic dysfunction was observed in 46.3% (n = 25) of infants with primary VUR; 35.2% (n = 19) had a low bladder capacity and 11.1% (n = 6) had a large bladder capacity. All infants with large bladder capacities also had high grade (IV - V) VUR. In conclusion, there was a close relationship between bladder dysfunction and primary VUR. For that reason, urodynamic testing of infants with primary VUR should be performed as part of routine clinical evaluations.

Thin-section axial multidetector computed tomography and multiplanar reformatted imaging of children with suspected foreign-body aspiration: Is virtual bronchoscopy overemphasized?

PURPOSE: To determine the added value of multidetector computed tomography (MDCT)-assisted virtual bronchoscopy (VB) to axial MDCT and multiplanar reformatted (MPR) imaging with respect to conventional bronchoscopy in the evaluation of children with suspected foreign-body aspiration (FBA). MATERIAL AND METHODS: Twenty-one consecutive children (14 male, seven female, age 8 months-7 years, mean age 3.5 years) presenting with the suspicion of FBA were examined with 16-slice MDCT using 100-120 kV, 30-50 mA, 1-mm section thickness, 1.2 pitch ratio, and 0.6-1.0-mm reconstruction interval. Before CT examinations, chest radiographies were also obtained in all cases. VB and MPR imaging were carried out after MDCT examinations. RESULTS: Nine foreign bodies were identified by gold-standard conventional bronchoscopy. VB, thin-section axial MDCT, and MPR images identified eight of nine foreign bodies. CT scans with MPR images and VB did not reveal a chronic foreign body; and, in one patient, endobronchial mucous was diagnosed as the foreign body. The sensitivity, specificity, and accuracy of thin-section axial MDCT and MPR images alone in the diagnosis of FBA were 88.9%, 91.7%, and 90.5%, respectively. Results were the same as those obtained when VB was also included. CONCLUSION: MDCT with VB and axial/MPR images provide equally valuable information in children with suspected foreign-body aspiration and prevent unnecessary conventional bronchoscopic examinations. However, VB increases total examination time and cost, and it does not provide additional information over MPR images in the evaluation of foreign-body aspiration.

Effects of phototherapy on newborn rat testicles.

Phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. In the routine, phototherapy has some side effects including skin eruption, fluid loss, abdominal distention, mild hemolysis and mild thrombocytopenia. The aim of the study was to investigate the possible mutagenic and gametocidal side effects of 72 h continuous phototherapy on the rat testicle. We observed decreases in spermatogonia numbers per tubule (S/T values), tubular fertilization index (TFI) and sperm sertoli cell index (SSCI), which are the most reliable methods in estimating future fertility potential, due to sensitivity to phototherapy. The differences between study and control groups for S/T, TFI and SSCI values were statistically significant (p = 0.008, p = 0.02 and p = 0.004, respectively). There were significant differences in seminiferous tubule diameters between the control and study groups (p < 0.005), but no significant difference in DNA index values between the control (0.66 +/- 0.12) and study (0.59 +/- 0.05) groups (p > 0.05). As a conclusion, phototherapy seems to have some side effects on the newborn rat testicle. Further studies with larger groups, designed for investigation of the effects of phototherapy on seminiferous tubules, may give more beneficial results.

Effects of testicular fixation on oxidative stress-related parameters in prepubertal rat testis.

The goal of orchiopexy is to provide adequate scrotal fixation to prevent recurrent torsion of the testis and the spermatic cord or ascent of the testis, to be achieved with minimal trauma to the testis. Forty-two prepubertal male Sprague-Dawley rats were equally distributed into 6 groups (1 SHAM + 5 Operation). In operational groups, two lateral sutures were placed near the upper and lower pole of the testis passing through the tunica albuginea with 4-zero polyglactin suture in the transverse axis of the testis. At the 1st-3rd-7th-15th and 30th postoperative days, bilateral orchiectomy was performed, then malondialdehyde (MDA), nitrite, superoxide dismutase (SOD) and glutathion peroxidase (GPx) values were measured in testicular tissue homogenates. MDA and nitrite levels increased, while GPx and SOD levels diminished, statistically significant in both ipsilateral and contralateral testicular tissue homogenates. Prepubertal testicular fixation causes overproduction of the lipid peroxidation end product and free radicals while heavy consuming anti-oxidant reserve systems in both ipsilateral and contralateral testicular tissue. These results clearly reveal the extent of the testicular deterioration due to suture fixation technique.

Long-term results of topical glyceryl trinitrate ointment in children with anal fissure.

BACKGROUND/AIM: Although topical glyceryl trinitrate ointment (GTN) has become a popular treatment for anal fissure in adults, its use in children is still limited. We aimed to determine the effectiveness and safety of topical GTN in the long-term management of anal fissure in children, which has not yet been reported. METHODS: Thirty-one children with anal fissure who received topical 0.2% GTN treatment between 1997 and 1998 were evaluated in 2004. RESULTS: Ten patients had one or more relapses after initial treatment with 0.2% GTN, all within 1 year of first onset of anal fissure. No further recurrences were diagnosed during the 4-year follow-up period. CONCLUSION: Although early recurrence can occur, topical GTN ointment is effective in healing chronic anal fissures in children.

Testicular blood flow alterations and flow cytometric analysis in prepubertal rats with experimentally induced unilateral varicocele.

Unilateral testicular pathologies have been accused of causing contralateral damage through a decrease in testicular blood flow. However, the contralateral testicular blood flow in unilateral varicocele has not been studied in detail. Therefore, the present study has been designed to evaluate the effects of a unilateral varicocele on the ipsilateral and on the contralateral testicular blood flow and the flow cytometric alterations in prepubertal rats. Experimental stenosis of the left renal vein in prepubertal rats causes dilation of the testicular vessels after puberty. Partial stenosis of the ipsilateral renal vein during the prepubertal period has no effect on ipsilateral or contralateral testicular blood flow, but does induce significant testicular damage, as determined by flow cytometry.

A primary vaginal stone in a disabled child.

BACKGROUND: Primary vaginal stones in children are extremely rare but important because they are often mistaken for bladder calculi on plain film. CASE: A 13-year-old girl was admitted to the hospital with abdominal pain. Physical and serial radiologic examinations found a hard mass anterior to the rectum. By vaginoscopy, the stone was found at the posterior fornix of the vagina. CONCLUSION: Primary vaginal stones should be suspected, especially in disabled children.

Adrenal calcification in children: a case report.

Unilateral adrenal calcification was encountered incidentally in a 9-year-old boy during evaluation of enuresis. He was a large baby at birth, and perinatal history was suggestive of difficult labor. The case has been discussed through the possible causes of adrenal calcification and the management of these children. Once the diagnosis of idiopathic adrenal calcification is made in light of detailed perinatal history, biochemical investigations, and roentgenologic examinations, these children can be observed by control evaluations with regular intervals.

A prospective, randomized, double-blind, placebo-controlled trial of glyceryl-trinitrate ointment in the treatment of children with anal fissure.

BACKGROUND: Anal fissure in children usually is treated by sitz baths, stool softeners, and analgesic ointments. However, some cases are intractable to the treatment. In recent years, it has been reported that nitric oxide donors such as local glyceryl-trinitrate (GTN) ointment causes a reversible chemical sphincterotomy. Although the GTN ointment can be an alternative therapy for adult cases, it has not yet been studied in the children who suffer from anal fissure. METHODS: Sixty-five children with anal fissure were divided randomly into 3 groups. Each group received double-blinded a topical ointment that contained either 0.2% GTN, 10% lidocaine, or placebo. These ointments were applied to the lowest part of the anal canal twice daily. Patients were periodically reviewed, and the study was ended after 8 weeks. RESULTS: Complete healing of the fissure occurred in 26 of 31 (83.9%) patients treated with GTN, 7 of 14 (50%) patients treated with lidocaine, and 6 of 17 (35.2%) treated with placebo. In 29 of 31 (93.5%) GTN-treated patients, a total relief of symptoms was observed, whereas this occurred in 7 of 14 (50%) treated with lidocaine and 6 of 11 (35.3%) in the placebo group. The differences between the study group and control groups were highly statistically significant (P < .001). CONCLUSION: The majority of children suffering from anal fissure will be cured and have relief of symptoms after topical application of GTN ointment to the anal canal.