1/5. Aplasia of the right lung in a 4-year-old child: surgical stabilization of the mediastinum by diaphragm translocation leading to complete recovery from respiratory distress syndrome.lung aplasia is defined as unilateral absence of the lung with preservation of main bronchus remnant at the tracheal bifurcation. patients usually die soon after birth and there is no specific therapy for this condition, as evidenced by the literature. The authors present a case of an infant that was asymptomatic with this malformation until 3 months of age, when the child had respiratory distress syndrome. Subsequently, lung aplasia was diagnosed. The authors performed an extrapleural dissection and cephalad translocation of diaphragm to reduce the mediastinal shift and heart rotation, to relieve a kink and compression of the trachea by the aortal arch and truncus arteriosus, as well as to relieve hyperinflation of lung parenchyma and provide recovery from respiratory distress syndrome. This new approach resulted in complete recovery from respiratory distress syndrome and full tolerance of physical exercise. The child underwent follow-up for 4 years. Diaphragmatic translocation may be useful in treatment of respiratory disorders associated with lung aplasia.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/5. Adjusting the endotracheal tube tip in management of tracheomalacia in an infant.tracheomalacia (TM) is an occult central airway problem that may block the endotracheal tube (ETT) tip and cause ventilation risk. Traditional physical examination, chest radiograph, end-tidal CO2 monitoring and blood gas analysis do not easily make the correct diagnosis. Ultra-thin flexible bronchoscopy (FB) is convenient and useful to verify this rare type of ETT obstruction and can also guide the adjustment of the ETT tip to a correct location. We report two TM infants who were successfully diagnosed and managed by FB to correctly reposition the ETT tip.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/5. Hairy polyp of the pharynx obscured on physical examination by endotracheal tube, but diagnosed on brain imaging.We report a case of hairy polyp of the pharynx diagnosed on brain MRI in order to stress the need to examine carefully all tissues included on an imaging study, even those outside the clinically stated region of interest, and to remind practitioners to consider unusual as well as common etiologies for neonatal respiratory distress. Our case is unique in that thorough examination of a brain MRI, ordered in the evaluation of presumed central apnea, led to the correct diagnosis.- - - - - - - - - - ranking = 4keywords = physical (Clic here for more details about this article) |
4/5. gallbladder distention in ill preterm infants.Four ill preterm infants each had a severely dilated gallbladder that was detected as a right-upper-quadrant abdominal mass. In each infant, the diagnosis was suspected on physical examination and confirmed by ultrasound study. One extremely premature infant with respiratory distress syndrome died, and at autopsy, the gallbladder and biliary tree showed no abnormalities, except for severe gallbladder distention. In the other three infants, distention of the gallbladder resolved spontaneously.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/5. Respiratory distress and selective muscle involvement in central core disease: report of a case.A 10-year-old girl who had suffered life-threatening respiratory distress in late infancy and mild muscle weakness in the extremities was found to have central core disease (CCD). Her developmental milestones were markedly delayed and she became ambulant at the age of 6 years. On physical examination, she had a high-arched palate, nasal tone vocalization, a positive Gowers' sign, waddling gait, and decreased deep tendon reflexes. On magnetic resonance imaging (MRI) examination, the thigh, calf, arm, and paravertebral muscles were selectively involved, especially in the paravertebral, biceps brachii, gluteus maximus and medius, vastus lateralis and medialis, sartorius, adductor magnus, tibialis anterior, soleus, lateral head of gastrocnemius, and peroneus longus muscles. Two biopsy specimens from the left biceps brachii and rectus femoris muscles showed the common histochemical findings of CCD, including type 1 fiber atrophy and predominance, and core structures. Proliferation of adipose tissue was only present in the biceps brachii muscle. The patient improved clinically in muscle strength after three year follow-up. Muscle MRI may provide a non-invasive evaluation of gross muscle involvement in CCD.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |