No abstract

Solid pseudopapillary neoplasms (SPNs) may have an aggressive clinical course, but clinical predictors of this condition have not been thoroughly evaluated. We performed a retrospective study of 11 cases of SPN managed in our hospital between January 2007 and April 2015. Of these 11 cases, we encountered a single case with an aggressive clinical course. Histological, immunohistochemical, and clinical features were compared to identify predictors of poor prognosis. The 11 patients comprised four women and seven men with a median age of 41 years (range, 26-58 years). Clinical symptoms were nonspecific and the median tumor size was 4.6 cm (range, 1.4-18 cm). The patient with an aggressive clinical course developed multiple liver metastases within three months and died seven months after surgery. Pathological features of the tumor in this case included lymph node metastases, a diffuse growth pattern, extensive tumor necrosis, high mitotic rate, and immunohistochemistry. These features were not observed in patients who survived without recurrence at a median follow-up of 25 months (range, 6-82 months). Characteristic pathological features and a high proliferative index, as assessed by Ki-67 staining, may predict poor outcome in cases of SPN.

No abstract

For the treatment of uncomplicated intussusception in infants and children, we attempted air reduction without x-ray study to avoid the genetic and carcinogenic effects of radiation. Intussusception could generally be diagnosed by ultrasonography in addition to the history and typical clinical signs without using a barium enema. The success of reduction could also be safely evaluated from the disappearance of both the characteristic sonographic target sign and the abdominal palpable mass, and improvement in the general condition 2 or 3 hours after completing this procedure. This simple, cheap and clean reduction method was applied to 127 patients under strict indications and sedation with diazepam. The successful reduction rate was high (90.6%) and equal to that by hydrostatic reduction. Accordingly, this procedure appears to be safely applicable to the management of uncomplicated intussusception in infancy and childhood.