[One-year follow-up of radiologic and clinical findings in children with prenatal and neonatal hydronephrosis]

Hydronephrosis is a common problem in prenatal and newborn infants diagnosed by ultrasonography. Bladder to ureter reflux, the upper or lower urinary tract obstruction, and neurogenic bladder are the most common causes of hydronephrosis in newborns and infants. In this study, 100 neonates and infants with hydronephrosis were observed clinically and laboratorically for one year. Patients were allocated to two groups of fetal and newborn infants by the time of detection of hydronephrosis. Classification of the severity of hydronephrosis was based on the anteriorposterior diameter of renal pelvis including: mild hydronephrosis [5-9 mm], moderate [10-15 mm], and severe [more than 15 mm]. Fifty four patients were boy and 46 were girl. Mean age of patients in first visit of fetal and newborn infants hydronephrosis were respectively 2.5 [79% asymptomatic] and 5 month [100% symptomatic]. Causes of fetal hydronephrosis were: bladder to ureter reflux [45%], idiopathic hydronephrosis [41%], ureteropelvic junction obstruction [UPJO] [3.11%], physiological hydronephrosis [7.5%], and posterior urethral valve [8.3%]. Bladder to ureter reflux was the most common cause of hydronephrosis in all of the patients [57%]. The most common causes of mild and severe hydronephrosis were bladder to ureter reflux and ureteropelvic junction obstruction, respectively. In patients with fetal hydronephrosis, 100%, 30% and 6% of cases of severe, moderate, and mild hydronephrosis need surgery, respectively. Using ultrasonography in pregnancy led to the discovery of most asymptomatic fetal hydronephrosis more than infant hydronephrosis

Prolapsing ureterocele in two infant boys

Ureterocele prolapse is a rare complication that obstructs the bladder outlet. This disease rarely presents in infant boys. In this case report, we present two 2.5 and 5-month-old infant boys with suspected posterior urethral valve diagnosis. Sonography demonstrated significant bilateral hydroureteronephrosis and unilateral interavesical ureterocele in both our patients. Voiding cystourethrography showed a filling defect in the posterior urethra associated with severe unilateral reflux. The diagnosis of prolapsing ureterocele should be considered whenever there is a ureterocele associated with bilateral uropathy

Doppler ultrasound assessment of well-functioning native hemodialysis access: comparison with sufficient dialysis

Malfunction of vascular accesses is a common cause of morbidity in hemodialysis patients. The purpose of the present study was to evaluate the flow volume and the diameter of the feeding artery in asymptomatic, well-functioning hemodialysis access with Doppler ultrasound. From March 2006 to February 2007, we examined the functioning mature arteriovenous fistula [AVF] of 69 hemodialysis patients by Doppler ultrasound in Imam Reza hospital, Mashhad. The measured flow volume, primary renal disease, AVF type and location, and the demographic data were recorded. All statistical analyses were performed with the Chi square test, the Student's t test and one-way ANOVA. Pearson correlation coefficient was also calculated. Of the 69 patients, 30 [43%] had an antecubital AVF. Overall, the mean +/- SD flow volume was 1665 +/- 554 mL/min. The majority of accesses [n = 52] had normal flow volume [500-1200 mL/min], 15 patients had high-flow fistulas [>1200 mL/min] and 4 had critical flow rates of < 500 mL/min. The flow volume was significantly higher in the antecubital AVF than that placed in more distal positions. The mean diameter of the feeding artery at the measurement site was 6.0 mm. There is a linear correlation between the diameter of the feeding artery and the mean flow rate [r = 0.76, p < 0.001]. No significant difference was observed between the type of anastomosis and the flow rate [p = 0.14]. There is a high level of abnormalities, especially high flow volume, in well-functioning mature AVFs. Color Doppler ultrasonography makes early detection of the patients with a higher risk possible and it can also guide the surgeon to select the surgical procedure

Ultrasound-guided core needle biopsy of liver hemangiomas: three-year experience

In patients with atypical hemangiomas who have inconclusive imaging features, performing other diagnostic procedures, especially biopsy, is indicated. Bleeding is the most feared complication due to the high vascular nature of hemangioma. The objective of this study was to present our experience on ultrasound-guided core needle biopsy of liver hemangiomas. We carried out ultrasound-guided core needle biopsies in 443 patients with focal hepatic lesions of whom 32 were subsequently diagnosed as having cavernous hemangiomas. Biopsies were done using a 16-18 G cutting needle at Mashhad Imam Reza Hospital and Isfahan Baharestan Hospital during 2004-07. The mean age of patients with hemangioma was 49.3 years [F/M = 2/1]. The lesions were 0.8-14 [mean: 6.5] cm long. 13 patients had multiple [2-10] lesions; others had solitary lesions with atypical imaging features. We did not observe any complications including hemorrhage during or after the procedure. Ultrasonically-guided core needle biopsy seems to be a relatively safe procedure even when "atypical hemangioma" is a diagnostic possibility

Juvenile granulosa cell tumour of the ovary in a 7 month-old infant

Juvenile granulosa cell tumor [JGCT] is one of the rare sex cord-stromal tumours of the ovary occurring in the first two decades of life .It makes less than 5% of ovarian tumours in childhood and adolescence

It is different from adult granulosa cell tumor that is seen in older females with respect to clinical and pathological features as well as biological behaviour. In this article we report a case of juvenile granulosa cell tumor of the right ovary in a 7-month-old infant which was presented with vaginal bleeding