Noninvasive medical management of fungus ball uropathy in a premature infant.

Unilateral renal obstruction secondary to fungus balls is described in a premature infant. Noninvasive medical management, which included amphotericin B and 5-flucytosine therapy and forced diuresis, resulted in disappearance of fungus balls and resolution of the obstruction.

A new percutaneous renal biopsy device for pediatric patients.

A new automated biopsy technique is described for performing percutaneous renal biopsies in pediatric patients. The biopsy device (Bard Biopty Instrument) employs a relatively small needle (18 gauge). We believe this procedure offers a safer and more effective means of obtaining adequate renal tissue for pathological assessment in pediatric patients.

The role of intraoperative ultrasound in neurosurgery.

High resolution real time intraoperative ultrasound was used in a number of cases to identify, localize, and characterize intracranial abnormalities. Five case reports illustrate the advantage of this technique during neurosurgical operative procedures.

The contrast enhanced paravascular neoplasm: a potential CT pitfall.

Computed tomography (CT) is an accepted diagnostic tool for the evaluation of the known or suspected parenchymal or mediastinal mass. Contrast enhancement of a paravascular mass, proportional to that in an adjacent vascular structure, is strong evidence that the mass is a vascular structure. Based on our series of 200 chest examinations with an 18 sec CT scanner, it is recommended that the contrast enhanced paravascular mass be further evaluated with angiography if there is known primary neoplasm, evidence of mass growth, or clinical findings more consistent with neoplasia. The newer rapid scanning tomographs may obviate the need for angiography because of their ability to appreciate differentials in blood flow.

The antepartum diagnosis of conjoined twins.

This is a case report in which the diagnosis of conjoined twins was made in a woman by ultrasonography in her eigth month of pregnancy. With this diagnosis, the mother-to-be was transported to a hospital with sophisticated obstetrical, neonatal, and pediatric surgical facilities. The twins were delivered by elective caesarian section and were seen to have anomalies requiring immediate surgery. Following stabilization and basic investigations, surgery was performed on the infants at 3 hr of age. This resulted in a condition that permitted a thorough postoperative work-up and elective separation several months later.

Gastric neoplasm: ultrasound and CT evaluation.

Ultrasound may complement conventional barium evaluation of the upper gastrointestinal tract. Thirty cases of gastric neoplasm were evaluated with ultrasound; 8 of these patients also were evaluated with CT. The different sonographic appearances of gastric neoplasms will be presented based on these cases and a review of the literature. The specificity of these changes is discussed. In addition, the complementary role of CT scanning in the evaluation of gastric neoplasms is described.