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Introduction: This study aimed to assess the preventive or therapeutic effects of blenderized food (BF) on selenium deficiency in pediatric patients with severe motor and intellectual disabilities (SMID). Methods: The medical records of all 40 consecutive pediatric patients with SMID who underwent nutritional assessment were retrospectively reviewed and compared between two groups: the enteral formula (EF) group and the BF group fed with BF providing more than 10% of total caloric intake. Next, for the selenium-deficient patients who were newly started on blenderized tube feeds after the first nutritional assessment, improvement of selenium deficiency and change of dietary contents were assessed. Results: The BF group patients had a significantly lower prevalence of selenium deficiency and higher serum selenium levels than the EF group patients. In all 7 selenium-deficient patients who started blenderized tube feeds after the first nutritional assessment, serum selenium levels were significantly increased at the second nutritional assessment, even though total selenium intake, selenium intake by EF, and total caloric intake did not differ significantly, and, in fact, caloric intake was significantly decreased by EF. Conclusion: Combined feeding of BFs can be useful for prevention and therapy of selenium deficiency in pediatric SMID patients. [ABSTRACT FROM AUTHOR]

A high-frequency radio wave (HFRW) scalpel has been reported to achieve a fine smooth incision with good hemostasis and minimizes the surrounding tissue destruction. Since an umbilicoplasty was performed for cosmetic purposes, we introduced the HFRW scalpel for umbilical hernia repair in July 2016. This retrospective study aimed to investigate the safety and efficacy of an HFRW scalpel for umbilical hernia repair in children, compared to a surgical scalpel with electrocautery. We reviewed the medical records of 139 patients who underwent umbilical hernia repair using a surgical scalpel with electrocautery or an HFRW scalpel between January 2013 and November 2018. Patients were divided into two groups: the surgical scalpel with electrocautery (SE) group (n = 62) and the HFRW scalpel (HFRW) group (n = 77), for comparison of surgical outcomes. Umbilical hernia repair using the HFRW scalpel was successful without intraoperative complications in all 77 patients. Although the HFRW scalpel was directly used for skin incision, no burn injury was observed. Procedure duration was significantly shorter in the HFRW group than the SE group (P < 0.01). Two (3.2%) and five (6.5%) patients in the SE and HFRW groups, respectively, developed wound infection, which was not a clinically significant difference. Wound appearance in the HFRW group was well tolerated as well as that in the SE group. The HFRW scalpel is a simple, safe, and feasible device for pediatric umbilical hernia repair, with a shorter operative time. [ABSTRACT FROM AUTHOR]

Background: Persistence of blastemal components after chemotherapy is a marker of poor outcome in Wilms tumor (WT). Recent reports from local Japanese areas have described pre‐chemotherapy blastemal predominant type WT to also be a risk factor for relapse. The significance, however, of blastemal predominant WT remains to be evaluated in a larger study. This study retrospectively evaluated the prognostic significance of pre‐chemotherapy blastemal predominant type WT in the Japan Wilms tumor Study (JWiTS) trials. Methods: The JWiTS trial (1996–2013) was a prospective, single‐arm study. The outcomes of blastemal predominant type WT were retrospectively evaluated compared with non‐blastemal type WT excluding anaplasia between 1996 and 2013. Relapse‐free survival (RFS) and overall survival (OS) were estimated. Results: Of 319 primary renal tumors diagnosed by the central pathology review system, advanced stage of pre‐chemotherapy blastemal predominant type WT (n = 53; 16.1%) occurred more frequently in older children than non‐blastemal type WT (n = 225), and was especially frequent in female patients registered in the JWiTS trials. No significant difference in 10 years RFS and OS (78.8% vs 84.5; P = 0.201) or in 10 years RFS and OS (89.3% vs 93.5; P = 0.45) was seen between pre‐chemotherapy blastemal predominant type and non‐blastemal type WT. Conclusions: Relapse‐free survival and OS are not significantly different between pre‐chemotherapy blastemal predominant type and non‐blastemal type WT. [ABSTRACT FROM AUTHOR]

CT-guided localization followed by video-assisted thoracoscopic surgery was performed in three children with pulmonary nodules less than 5 mm in diameter. The patients' respective primary diagnoses were Wilms tumor, hepatoblastoma, and osteosarcoma of the femur. The pulmonary nodules were marked preoperatively by a percutaneously placed hook-wire or dye under CT guidance. Although none of the nodules was grossly detected during the operation, they were correctly resected under the guidance of the hook-wire wound or dye. A histological assessment revealed viable metastatic lesions in the case of hepatoblastoma, completely necrotic lesions in the case of Wilms tumor, and inflammatory nodules in the case of osteosarcoma. CT-guided localization followed by video-assisted thoracoscopic surgery appears to be a beneficial procedure in children with tiny pulmonary nodules. [ABSTRACT FROM AUTHOR]

Transmesenteric hernia is abdominal visceral herniation through a congenital or acquired mesenteric defect. Treves' field is the area of terminal ileal mesentery circumscribed by the ileocolic artery and its last ileal branch. It is very susceptible to congenital defects. To clarify the clinical course of congenital Treves' field transmesenteric hernia (cTFTH), we retrospectively reviewed pediatric cases and conducted a literature review. Five consecutive pediatric cTFTH cases (one male, four females) underwent emergency laparotomy at our institutions from April 2009 and December 2014. We analyzed their demographics, preoperative findings, surgical procedures, and outcomes, along with a literature review. Abdominal plain X-ray showed displaced intestinal gas with gas paucity in the center of the abdomen in two cases and diffusely increased intestinal gas in two others. Abdominal computed tomography (CT) in four cases showed intestinal loop clusters, mesenteric vessel changes, small-bowel obstruction, and ascites. All cases underwent emergency laparotomy for ileal resection with ileocecal valve preservation. Simultaneous anastomoses were performed in four cases; the remaining case underwent ileostomy because of prematurity. Although one case needed reoperation for postoperative bowel obstruction, all patients survived. Literature review of pediatric cTFTH showed a high frequency of necrosis (70.5%) and mortality (26.5%). Among pediatric cTFTH cases, 67.6% were aged <5 years. Mesenteric defect was <5 cm in 70% cases. We should be aware of the clinical importance and radiological features of pediatric cTFTH. Abdominal CT may provide useful information. [ABSTRACT FROM AUTHOR]

Abstract: We report an extremely rare case of dermatofibrosarcoma protuberans located on the face of an 8-year-old boy. Although dermatofibrosarcoma protuberans typically has intermediate malignancy, the tumor in the present case was highly invasive and required a multistaged operation, including wide resection and full-thickness skin grafting. These operations were successfully performed, and the patient is alive without recurrence for 7 years. [Copyright &y& Elsevier]

In the JPLT3 study, a real-time central surgical reviewing (CSR) system was employed aimed at facilitating early referral of candidates for liver transplantation (LTx) to centers with pediatric LTx services. The expected consequence was surgery, including LTx, conducted at the appropriate time in all cases. This study aimed to review the effect of CSR on institutional surgical decisions in cases enrolled in the JPLT3 study. Real-time CSR was performed in cases in which complex surgeries were expected, using images obtained after two courses of preoperative chemotherapy. Using the cloud-based remote image viewing system, an expert panel consisting of pediatric and transplant surgeons reviewed the images and commented on the expected surgical strategy or the necessity of transferring the patient to a transplant unit. The results were summarized and reported to the treating institutions. A total of 41 reviews were conducted for 35 patients, and 16 cases were evaluated as possible candidates for LTx, with the treating institutions being advised to consult a transplant center. Most of the reviewed cases promptly underwent definitive liver surgeries, including LTx per protocol. [ABSTRACT FROM AUTHOR]