Imaging in secondary tumors of the ovary

Abdominal Radiology - Metastatic involvement of the ovaries is not rare. The most common tumor types metastasizing to the ovaries, from non-gynecological organs, are breast, colorectal, gastric,...     

Acute generalized exanthematous pustulosis due to ceftriaxone: Report of a pediatric case with recurrence after positive patch test

Acute generalized exanthematous pustulosis (AGEP) is seen uncommonly in children and sometimes shows atypical clinical features in this population. Patch testing can be used effectively in children for the confirmation of the culprit drug in cases of multiple drug use. Here, we report a rare, pediatric case of ceftriaxone‐induced AGEP confirmed by patch testing with subsequent recurrence of the skin eruption.     

Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand

Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml ^-1), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml ^-1) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-² week^-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis.     

Clinical response of hard tissue replacement (HTR) polymer as an implant material in oral surgery patients.

This study evaluated the performance of a synthetic implant material, Hard Tissue Replacement Polymer, for: (1) ease of handling, (2) compatibility with bone and soft tissue, (3) stability of augmentation over time, and (4) development of untoward effects. HTR (a registered trademark of HTR Sciences, a division of United States Surgical Corporation, Norwalk, CT 06856) was implanted into 34 patients by means of five different surgical procedures. The material was found to be easy to manipulate during surgery. Tissue and bone compatibility, defined as absence of inflammation, was present in 32/34 surgical sites (94%). In extraction sites during the 18-month follow-up, no measurable decrease in bone height or width was seen. One patient with a large periodontal endodontic defect developed a post-operative infection necessitating extraction of the tooth. No induction of bone was seen in response to placement of HTR material.     

A review of 43 cases of tetanus neonatorum.

Forty-three patients with neonatal tetanus admitted to the Infectious Diseases Ward of the Istanbul University Faculty of Medicine Children's Hospital at Capa from 1982-1989 are presented. Thirty-two (74.4%) of the subjects were boys. The overall mortality was found to be 60 percent and the mean incubation period 6.1 +/- 20 days. The mean period between onset of symptoms and hospital admission was 1.7 days. Thirty-nine (90.7%) of the 43 patients were unhygienic home deliveries and only two cases were delivered with a midwife in attendance. None of the mothers of the children in our series had been immunized with tetanus toxoid. The incidence of neonatal tetanus in Turkey is on the decline, but a fraction of the population, the so-called urban poor, is still at high risk for preventable diseases. Every contact an unvaccinated person has with a health care professional should be viewed as an opportunity for tetanus immunization.     

The role of surgery in intraabdominal Burkitt's lymphoma in children.

The role of surgery in intraabdominal Burkitt's lymphoma remains controversial and different opinions are present in the literature. In our institution, forty patients (30 boys and 10 girls) with intraabdominal Burkitt's lymphoma with ages ranging from 3 to 12 years have been treated and followed from 1989 through 2000. In ten cases, the patients underwent surgery because of their acute abdominal diseases (intestinal obstruction in 5, intussusception in 3, intestinal perforation in one, and acute appendicitis in one). The remaining thirty patients were referred to our clinic because of their abdominal masses, pain, anorexia and fatigue. Twelve children had localized tumors and total resection could be performed. There was one death in this group due to central nervous system involvement during chemotherapy. In the remaining 28 children, extensive intraabdominal diseases were detected. In four of them, debulking procedures were performed, while in 24 children only biopsies could be made; 8 of them underwent a second-look operation. In the debulking procedures group, two children were lost (50 %) due to tumorlysis and acute renal failure. In the biopsy group, there were six deaths (25 %). All patients received chemotherapy after operative recovery. In conclusion, our results suggest that when the tumor is localized, total resection results in a good outcome. However, in the presence of extensive intraabdominal diseases instead of resection, the operation should be limited to biopsy only.     

Traumatic rupture of hydatid cyst with unusual localization without liver involvement: a case report.

Primary hydatid disease of the intestinal mesentery is rare. We report on a 12-year-old male patient who presented with abdominal pain and urticaria lesions after blunt abdominal trauma. At laparotomy the cyst was found to be ruptured and was totally removed from the surrounding mesenteric tissue.The postoperative course was uneventful. This case is the first child reported with traumatic rupture of a hydatid cyst in a mesenteric location.