Edson Samesina Tatsuo

Predictive factors of ultrasonographic involution of prenatally detected multicystic dysplastic kidney

To evaluate possible predictive factors of involution on ultrasonography (US) or disappearance of a prenatally detected multicystic dysplastic kidney (MCDK).

Morphological Comparison of Processus Vaginalis from Boys with Undescended Testis and Hernia Sacs from Boys with Inguinal Hernia

INTRODUCTION The aim of this study was to compare the morphological features of processus vaginalis (PV) and hernia sacs obtained from boys with undescended testis and inguinal hernia, respectively, in order to investigate whether these structures have similar histology. MATERIAL AND METHODS Samples of PV (n=61) and hernia sacs (n=68) obtained from boys operated for undescended testis (n=58) and inguinal hernia (n=64), respectively, were stained with hematoxylin-eosin for optical qualitative microscopy analysis. The histological structures of each group of samples were compared by a pathologist blinded to the specific pathology. RESULTS The most prevalent histological findings were connective tissue, smooth muscle, mesothelium, nervous elements, striated muscle and mesonephric remnants with no statistical differences between the groups. The amount of smooth muscle was greater in the hernia sac group where it appeared as a layer. In contrast, the smooth muscle present in the form of sparse bundles around the connective tissue in the PV. CONCLUSIONS Sacs obtained from boys with inguinal hernia and PV obtained from boys with undescended testis shares a similar histology except for the amount of smooth muscle when analyzed qualitatively by optical microscopy using hematoxylin-eosin stain.

Percutaneous central venous catheterization through the external jugular vein in children: is inserting the guide wire into the superior vena cava essential for successful catheterization?

BACKGROUND/PURPOSE The external jugular vein (EJV) is an attractive alternative for percutaneous central venous catheterization (PCVC), with fewer complications. The inability to pass the guide wire into the superior vena cava (SVC) is, however, a major reason for the failure of this approach. The authors report a modification of the Seldinger technique to increase the effectiveness of this procedure in children. METHODS Between May 2008 and June 2009, we performed 100 PCVCs consecutively in children using the Seldinger technique through the EJV (Step 1). In cases in which the guide wire could not be passed into the SVC, the guide wire was kept in the EJV; and only the catheter was introduced into the central venous position (Step 2). Differences between the standard and modified Seldinger techniques were analyzed. RESULTS The procedure with the standard Seldinger technique (Step 1) was successful in 13 (13%) out of 100 patients. In 84 (96.5%) of the 87 remaining patients, PCVC was achieved with the modified Seldinger technique, without the insertion of the guide wire until the SVC (Step 2). Altogether, 97 catheters (97%) were successfully inserted, with 85 (87.6%) correctly positioned in the SVC. In addition, there were 7 (7%) clinically irrelevant hematomas during catheterization. CONCLUSIONS The EJV is an excellent alternative anatomical location for the completion of PCVC in children. Placing the guide wire in a central position is not essential to the success rate of this approach. The proposed modified Seldinger technique allowed PCVC to be performed through the EJV safely and with a high success rate in children and adolescents.