Ultrasonographic Bladder Parameters for Successful Suprapubic Bladder Aspiration / 소아과

PURPOSE: Suprapubic bladder aspiration(SBA) is a widely accepted method of obtaining sterile urine for culture in neonates but has a relatively low success rate and a few serious complications during SBA procedure. To improve the chance of obtaining urine, we determined the ultrasonographic bladder parameters(diameters and volume) to confirm that the bladder is adequately distended for successful aspiration of urine. METHODS: In 94 newborn infants who required sterile collection of urine, ultrasonographic examination and SBA procedure were carried out. On the patient's suprapubic area, the maximal cephalocaudal and anteroposterior diameters were measured by sagittal scanning, and the maximal anteroposterior and transverse diameters by transverse scanning. Bladder volume was calculated using the formula for elliptic volume, and then urine was aspirated to maximum of 10 mL and the amount of urine aspirated was recorded. RESULTS: Sufficient urine for culture(>1 mL) was obtained by SBA in 86(91.5%) of 94 infants. In the sagittal view, when the cephalocaudal diameter of the bladder was greater than 20 mm and the anteroposterior diameter was greater than 15 mm, the success rate was 100%. The cephalocaudal diameter of the bladder in sagittal view showed a more significant positive correlation with aspirated urine amount(r=0.65, P<0.001). CONCLUSION: The ultrasonographic sagittal view improved the success rate of SBA in neonates. A SBA was more likely to be successful when the cephalocaudal diameter of the bladder was above 20 mm and the anteroposterior diameter was above 15 mm.

A Case of Congenital Cystic Adenomatoid Malformation of the Lung in the Patient with Recurrent Pneumonia (Mixed type I and II) / 소아알레르기및호흡기학회지

Congenital cystic adenomatoid malformation (CCAM) of the lung is an uncommon embryonic developmental anomaly, characterized by the presence of one or multiple interconnecting cysts. This disease may present various clinical aspects, stillborn or perinatal death, respiratory distress in newborns, and acute and chronic pulmonary infections in older infant and children. We experienced a case of CCAM in a 3-years, 8-month-old male who had frequent upper respiratory tract infection and recurrent pneumonia. Chest X-ray and chest CT showed a cavitary lesion in the right middle lobe. Histologic examination revealed numerous small and large sized cysts in the parenchyma. The large cysts were mainly lined by pseudostratified ciliated cells and the small cysts are lined by simple cuboidal cells and subclassified Stocker type mixed I and II. Wedge resection was done with satisfactory postoperative courses clinically and radiologically. We report a case of CCAM (I and II mixed type) with a brief review.

A Case of Nutcracker Syndrome Presenting with Orthostatic Proteinuria

Orthostatic proteinuria is documented as a benign condition and the most common cause of isolated proteinuria. The etiology and pathogenesis of orthostatic proteinuria is not clear yet. Recently there were a few report that nutcracker syndrome seemed to cause orthostatic proteinuria. We experienced a case of a twelve-year-old female patient with incidently discovered orthostatic proteinuria who was suspected to have nutcracker phenomenon by doppler sonography. We confirmed this patient as nutcracker syndrome by renal venography.

A Case of Trisomy 10p with Vertebral Anomaly and Hypospadias / 대한주산의학회잡지

Tisomy 10p syndrome is a rarely reported chromosomal abnormality with distinct craniofacial anomalies, severe growth and psychomotor retardation, osteoarticular anomalies, and organ malformations. Most of reported cases were due to translocation of 10p to the other chromosome. Rare causes are tandem duplication, maternal pericentric inversion, isochromosome formation. We experienced newborn infant with craniofacial anomaly, hypospadias and extra vertebra and rib. The characteristic craniofacial anomalies were frontal bossing, wide opened fontanel and suture line, sparse eyebrow, turtle beak mouth, Cytogenic analysis showed 46, XY, rec(10) dup(10p) inv (10)(p11.2q26.1). Karyotype of the father was normal(46, XY). However, karyotype of the mother showed 46, XX, inv(10)(p11.2q26.1). Therefore, chromosome 10 recombination resulting from a maternal pericentric inversion formed trisomy 10p. We report rare chromosome abnormality syndrome, trisomy 10p, with brief review.