Unusual malignant neoplasms of ovary in children: two cases report / 소아과

Sex cord tumors with annular tubules are known to originate from the sex cord of embryonic gonads that synthesize Sertoli cells, Leydig cells, granulosa cells, and theca cells of the ovarian stroma, while ovarian small cell carcinoma of the hypercalcemic type is a type of neuroendocrine tumor. Both these tumors are uncommon, potentially malignant neoplasms in children. We report the case of a sex cord tumor with annular tubules in an 11-year-old girl and a case of small cell carcinoma of the hypercalcemic type in a 10-year-old girl. We also discuss the prognosis and management of these tumors.

Gastric perforation in the newborn

Gastric perforation in neonates is an uncommon condition. It could be spontaneous but a contributing cause should be sought. To review our experience of treating 8 neonates with gastric perforation over the past 20 years. We reviewed the records of all newborns admitted to our hospital between 1990 and 2010 with regard to gender, age at admission, contributing factors, associated anomalies, site of perforation, type of operation, and outcome. Of the eight neonates, five were female and three male. The average weight was 2130 g. Four babies were premature. Three infants were ventilated for respiratory difficulty. Five patients had associated anomalies. Perforation occurred in the lesser curvature in 4, at the greater curvature in 3, and at the anterior antrum surface in 1. All patients were treated with gastrorrhaphy. Four neonates required additional gastrostomy. Mortality was 75% [6 infants]. Active perinatal management, early treatment of primary pathologies, and protection of the stomach against distension in neonates at risk are essential in the management of neonatal gastric perforation

Ropivacaine 0.2% versus bupivacaine 0.25% in para-umbilical block in children

Para-umbilical block was an old block that regains a new interest. No study was available using Ropivacaine in this block. To compare quality of analgesia after using Ropivacaine 0.2% to Bupivacaine 0.25% in para-umbilical blocks. In a prospective randomized double blind study we included one to six years old children, scheduled for umbilical herniorrhaphy. The children were randomized in two groups to receive in para-umbilical block by side: Ropivacaine 0.2%: 0.2 ml.kg-1 [group GR] or Bupivacaine 0.25%: 0.2 ml.kg-1 [group GB]. The data of 75 children [GR= 38; GB= 37] were analyzed. The groups were comparable regarding the demographics' characters. The scores of Children's Hospital of Eastern Ontario Pain Scale in different postoperative times were comparable between the two groups. No difference was noted in the time of the first analgesic request. The two groups were comparable regarding the peroperative analgesia. No complication was recorded in this study. Ropivacaine 0.2% is equivalent to the Bupivacaine 0.25% concerning postoperative and peroperative analgesia in the para-umbilical block for umbilical herniorrhaphy