Characteristics and outcome of impacted button batteries among young children less than 7 years of age in China: a retrospective analysis of 116 cases.

BACKGROUND: Ingestion of button batteries occurs in about ten persons per one million persons each year, with most of them children, and one in every 1000 battery ingestions leads to serious injuries. This study aimed to describe the clinical features and outcome of ingestion or inhalation of button batteries in children spanning a decade from January, 2006 to December, 2016 at a tertiary care hospital. METHODS: We reviewed the clinical records of children who sought treatment for inhaled or ingested button batteries at our hospital during the study period. Data on gender, age, time from ingestion to treatment, site of impaction, imaging findings, and outcomes were retrieved and analyzed. RESULTS: We identified 116 pediatric cases of ingestion or inhalation of button batteries. Their mean age was 26 months. The time from ingestion or inhalation of button batteries to treatment was 0.5 hours to 2 weeks. Ninety-seven (83.6%) button batteries were located in the nasal cavity, 13 (11.2%) in the gastrointestinal (GI) tract including 6 in the esophagus, and 7 in the stomach and lower GI tract, and 6 (5.2%) in the auditory tract. Twenty-one (21.6%) children with nasal button batteries had preoperative septal perforations and one (1.0%) had postoperative septal perforation. One child with esophageal button battery developed esophageal stricture and one died of sudden cardiac arrest perioperatively. One child had auditory damages in the right tympanic membrane and ossicles. CONCLUSIONS: Inhalation or ingestion may occur in the nasal cavities, the esophagus and GI tract and the auditory tract. Prompt diagnosis and treatment are required for a satisfactory outcome and ingested or inhaled button batteries require different treatment protocols.

[The clinical analysis of tympanoplasty in treating children's chronic otitis media].

OBJECTIVE: To study the effectiveness of tympanoplasty for treatment of chronic otitis media and cholesteatoma in children. METHOD: Twenty-three cases with chronic otitis media and cholesteatoma treated by tympanoplasty were retrospectively studied, among which 15 cases had complete clinical data. The condition of surgical cavities, the duration of getting dry ears, the hearing improvements, the growth of new ear drums and whether the recurrence of cholesteatomas occurred or not were observed. RESULTS: In all patients, the chief complains were ear discharging and hearing loss. The tympanum membranes(pars flaccid or pars tensa) became retracted or perforated and CT scan showed mastoid processes were poor developed in some cases with lesions mainly located at attic, middle tympanum cavity and/or petrous parts. The duration of getting dry ear was (6.0 +/- 1.5) weeks after surgery. The effective rate was 80%. The hearing of 12 cases has been improved, that of 2 cases has no changed, that of 1 case has been descended, and 1 case exhibited recurrent cholesteatoma after surgery. CONCLUSION: This study demonstrated that children's chronic otitis media and cholesteatoma have their own clinic features of wide erosiveness and strong aggressiveness, and tympanoplasty has been proved to treat this disease effectively, also been proved to improve these patients' hearing cognitions and eventually improve their life qualities.

[Clinical analysis of foreign body ingestion of button cell in children].

OBJECTIVE: To improve diagnosis and treatment level of foreign body ingestion of button cell in children. METHOD: Among the 14 cases with foreign bodies ingestion of button cell, 6 cases in esophageal, 7 cases in stomach and lower gastrointestinal tract, 1 case with multiple foreign bodies both in esophagus and stomach. Seven cases in stomach and lower gastrointestinal tract were closely observed without special treatment, 6 cases in esophageal, underwent esophagoscopy and removal of foreign body under general anesthesia, 1 case with multiple foreign bodies in esophagus and stomach underwent esophagoscopy and electronic gastroscopy and then removal of foreign body. All patients had symptomatic treatments after removal of foreign body. The average age is 2 years and 1 month. RESULT: After the removal of button cell, Foreign bodies in stomach and lower gastrointestinal tract in 7 cases were all discharged spontaneously. For the 6 cases in esophagus, 4 cases were cured, 1 case had esophageal stricture, 1 cased died. 1 case with multiple foreign bodies in both esophagus and stomach was cured. CONCLUSION: Esophageal foreign body has strong corrosiveness and would cause serious damages even to threaten children's life. It also may lead to esophageal stricture. The key point to cure this disease is to diagnose timely and to operate as soon as possible. Because neutralize of digestive juices and low probability of incarceration, with close observation, the foreign bodies of stomach and lower gastrointestinal tract can discharge spontaneously.

[CT and MRI study in severe sensorineural hearing loss in children].

OBJECTIVE: To investigate the value of CT and MRI in diagnosing the children with sensorineural hearing loss. METHOD: Ninety-six cases suspected as severe sensorineural hearing loss were examined by CT/MRI system and 3D reconstruction. RESULT: Of 96 cases, 15 cases were found malformation these malformation included Michel, cochlear hypoplasia, commun cavity, Mondini, inner canal straitness, cochlear nerve undeveloped and vestibular aqueduct enlargements. CONCLUSION: There are 15.63% inner ear malformation occurred in sensorineural hearing loss children. CT and MRI of inner ear have a great clinical value in diagnosing children sensorineural hearing loss by learning the anatomy.

[Experience in the removal of difficult and high risk tracheobronchial foreign body by bronchoscopy].

OBJECTIVE: To explore the best methods and skill for the removal of difficult and high risk tracheobronchial foreign body under bronchoscope. METHODS: A retrospective review was performed between August 1995 to August 2012. There were 4217 children with tracheobronchial foreign body, among them, 272 were diagnosed as high-risk, highly difficult tracheobronchial foreign bodies confirmed by clinical manifestations, foreign body type and bronchoscopy. RESULTS: In 271 children, the tracheobronchial foreign body was removed under bronchoscope, the success rate was 99.6%; only one child with a pen cap blocking the left lower lobe bronchus was transferred to the department of thoracic surgery, and the foreign body was finally removed by thoracotomy. Eighty-five children (among them, 82 children were under 1 year of age) had II-II degree laryngeal obstruction, the emergency surgery was performed to remove the foreign body and to relieve the laryngeal obstruction. Twenty-six children had lung infection and 27 children had failed foreign body removal surgery before, in all these children, the foreign body was removed after infection control. There were 17 children with the pen cap as the tracheobronchial foreign body, direct removal was successful in 12 children with the history less than two weeks; in 4 children, the foreign body was removed after 0.1% epinephrine saline flush, and 1 case with the homemade bronchial foreign body hook remove. There were 26 children with the whistle as the foreign body, and 32 children had large and sharp foreign bodies. In these cases, the foreign bodies were removed together with the bronchoscope. Forty-two children had multiple or fragile foreign bodies, and 16 children had subsegmental bronchial foreign bodies. In these cases, the foreign bodies were removed with forceps under direct vision and intraoperative bronchial lavage.In This series, 129 children received intraoperative bronchial lavage, among them, 127 children showed normal X-ray changes one week after operation. Two children with a history of more than 1 month complicated with pulmonary consolidation. After bronchial lavage, pneumothorax and subcutaneous emphysema occurred, which recovered after treatment. No glottic edema, asphyxia, and other complications were found, the complication rate of surgery was 0.7%. CONCLUSION: For the removal of highly difficult and high risk tracheobronchial foreign bodies, preoperative analysis and discussion should be sufficient, appropriate surgical skill and surgical instruments may improve the success rate of the surgery and prevent the operation complications.

All-optical UWB generation and modulation using SOA-XPM effect and DWDM-based multi-channel frequency discrimination.

An all-optical UWB pulses generation and modulation scheme using cross phase modulation (XPM) effect of semiconductor optical amplifier (SOA) and DWDM-based multi-channel frequency discrimination is proposed and demonstrated, which has potential application in multiuser UWB-Over-Fiber communication systems. When a Gaussian pulse light and a wavelength-tunable CW probe light are together injected into the SOA, the probe light out from the SOA will have a temporal chirp due to SOA-XPM effect. When the chirped probe light is tuned to the slopes of single DWDM channel transmittance curve, the optical phase modulation to intensity modulation conversion is achieved at DWDM that serves as a multi-channel frequency discriminator, the inverted polarity Gaussian monocycle and doublet pulse is detected by a photodetector, respectively. If the probe lights are simultaneously aimed to different slopes of several DWDM channels, multi-channel or binary-phase-coded UWB signal generation can be acquired. Using proposed scheme, pulse amplitude modulation (PAM), pulse polarity modulation (PPM) and pulse shape modulation (PSM) to UWB pulses also can be conveniently realized.

Switchable microwave photonic filter between high Q bandpass filter and notch filter with flat passband based on phase modulation.

We propose and demonstrate a novel switchable microwave photonic filter based on phase modulation. Both a microwave high Q bandpass filter and a microwave notch filter with flat passband are achieved respectively. And the switchability between them by tuning the two tunable optical bandpass filters is demonstrated. We also present a theoretical model and analytical expression for the proposed scheme. A frequency response of a high Q bandpass filter with a Q factor of 327 and a rejection ratio of exceeding 42 dB, and a frequency response of a notch filter with flat passband with a rejection ratio exceeding 34 dB are experimentally obtained. The operation frequency of microwave photonic filter is around 20 GHz.

Ultrahigh-Q microwave photonic filter with Vernier effect and wavelength conversion in a cascaded pair of active loops.

A new cascaded microwave photonic filter that can realize a high Q value is presented. It consists of two infinite impulse response filters based on two active loops. Owing to wavelength conversion employing cross-gain modulation of the amplified spontaneous emission spectrum of the semiconductor optical amplifier in one loop, the interference between the modulated optical signals of different taps from two loops can be avoided, and stable transmission characteristics of the filter can then be achieved. Using this cascaded structure, the free spectral range and Q value can be increased significantly, and tunability can also be realized. Measured results of a high Q of 3338 and a rejection ratio of about 40 dB are achieved.