Ray SocietyThe thickness of the bladder wall was measured sonographically in 410 children (1 day to 19 years old) and in 10 adults. None had complaints related to the urinary tract. The bladder wall thickness varied mostly with the state of bladder filling and only minimally with age and gender. The normal bladder wall had a mean thickness of 2.76 mm when the bladder is almost empty and 1.55 mm when ft is distended.There is a linear relationship between bladder fullness and bladder wall thickness; the upper limits are 3 and 5 mm for a full or empty bladder respectively. Materials and MethodsThe study included 41 0 children (age range, 1 day to i 9 years) and 10 adults (age range, 19 to 42 years).

The aim of the present study was to quantify changes in human skeletal muscle pennation angle (F θ ) values during growth and adult life. The human gastrocnemius medialis muscle of 162 subjects (96 males and 66 females) in the age range 0-70 years was scanned with ultrasonography. The subjects were laying prone, at rest, with the ankle maintained at 90° with all muscles relaxed. F θ increased monotonically starting from birth (0 years) and reached a stable value after the adolescent growth spurt. There was a significant (p<0.05) linear relationship between F θ and muscle thickness (TK). F θ = 0.84 (± 0.09) * TK + 3.15 (± 1.13). Human gastrocnemius medialis F θ and TK data found in the literature seem to fit the F θ -TK plot in a coherent manner, i nd epend ent of the phys iological or ana to mical characteristics of the subject. The present findings indicate that F θ is not a constant parameter but evolves, as is the case for bone length and height, as a function of age.

The accuracy of Doppler sonography in the evaluation of testicular torsion was tested in 65 boys (aged 0-18 years) with acute scrotal pain or swelling. All patients underwent pulsed Doppler sonography of both testes, followed by scintigraphy (n = 16) and/or surgery (n = 34) and a close clinical follow-up for 4-8 months (n = 31). Color Doppler sonography was performed in 29 patients. The testicular artery was deemed patent if Doppler shifts from branches within the parenchyma could be found. Surgery revealed 19 cases of testicular torsion, 17 of which were diagnosed with Doppler sonography. There were six technical failures, in which no signals could be found on either side. In four boys, no color signals were obtained in either testis but subsequent examination with a mechanical sector scanner and pulsed Doppler sonography yielded arterial signals. Doppler sonography was successful in 59 of 65 boys (91%) and yielded a sensitivity of 89% and specificity of 100%. Pulsed Doppler sonography with mechanical sector scanners was more sensitive than color Doppler sonography. Intermittent torsion was missed both with Doppler sonography and scintigraphy.

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We present a follow-up of the infant with oral, cranial, facial, and limb abnormalities described by us in 1976. Since then, several other very similar cases have been reported. We propose that this syndrome be called the oto-palato-digital syndrome, type II.

Ureteric jets were studied with conventional duplex Doppler (79 patients) and with color Doppler flow imaging (22 patients). Correlation with voiding cystourethrography (VCUG), performed ont he same day, was obtained in all patients. Thirty-six patients with normal VCUG results and normal renal and bladder ultrasound (US) studies served as the control group for 39 patients with vesicoureteric reflux (VUR) and 26 patients with urinary tract disorders other than reflux. The site of the ureteric orifice and duration, direction, and turbulence of the jets were recorded. Duration varied from 0.4 sec to 7.5 sec and depended largely on fluid intake. Duration varied in an individual patient by up to 2 sec from one jet to another. The direction of the normal jet was anteromedial and upward. Jets from refluxing ureters can appear normal. Severe renal parenchymal scarring reduced frequency and amplitude of the jets. Doppler analysis of the ureteric jet does not allow diagnosis or exclusion of VUR. Color Doppler was more sensitive in demonstrating ureteric jets than was gray-scale, real-time US and facilitated the study, but it was equally unable to help predict reflux.

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