摘要:

AbstractWith improved medical and surgical care, more patients with congenital heart disease are now surviving to adulthood and presenting with previously unobserved problems. This review discusses the course of older operated and unoperated patients as far as physical and psychosocial problems and suggests methods of dealing with these previously unencountered clinical situations.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03095.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe modernized limulus lysate assay on cerebrospinal fluid pretreated by the new perchloric acid (PCA) treatment was evaluated in one patient withEscherichia colimeningitis and four non‐meningitis patients. The endotoxin (ET) concentration was much higher by the new PCA treatment than by the ordinary dilution method in the exacerbation phase ofE. colimeningitis. The recovery rate of added ET also demonstrated the superiority of the new PCA treatmen

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03096.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractTo evaluate erythropoietin (Ep) levels in normal labor and cesarean section we studied the cord serum of 111 term pregnancies, divided into three groups: (i) those born by normal vaginal delivery (n= 69); (ii) those delivered vaginally from mothers who were smokers (n= 20); and (iii) those delivered by elective cesarean section (n= 22).The three groups did not differ in maternal age, gestational age, birthweight, infant sex and Apgar scores. No correlation was found between Ep and hematocrit in all three groups of normal terms studied. Although not statistically significant the lower mean Ep value observed in cesarean section compared with the values obtained from normal deliveries could suggest that the process of labor may be a cause of these differences.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03097.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractSmall bowel obstruction, excluding postoperative adhesive ileus, in patients>1 month old treated between June 1982 and May 1992 at Gunma Children's Hospital Medical Center is reviewed. There were 32 patients, 22 boys and 10 girls, whose ages ranged from 1 month to 6 years (median 9 months). Intussusception was the most frequent cause of obstruction and was seen in 17 patients (53.1%). Causative lesions were identified in five patients, and were ileal duplication cysts in four and Meckel's diverticulum in one. Incarcerated inguinal hernia and mesenteric cysts resulted in bowel obstruction in six and three patients, respectively. Other causes included mesodiverticular band, ileal volvulus without malrotation, abnormal adhesion of omentum, abnormal band, vitelline duct remnant and trapping in a mesenteric defect. As for the age distribution, there was no significant correlation between the causes of obstruction and the age of patients. Ultrasonography was useful in differential diagnosis, and this modality should therefore be used in every patient with signs of small bowel obstruction.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03098.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe purpose of this study was to determine whether pulmonary hemodynamic abnormalities relate to manifestations of allergic asthma.In 448 patients with congenital heart disease the relationships between asthma and age or pulmonary arterial blood (PA) flow were studied. Asthma (allergic and non‐allergic) was more common in 39 (19%) of 201 patients with high PA flow, compared with the incidence in those with normal PA flow (6/117, 5%;P<0.001) and reduced PA flow (1/130, 1%;P<0.05). In the high PA flow group, the frequency of asthma declined significantly (P<0.01) with age, from 25–26% in the 6 month‐5 year patient group to 5% in the 6–12 year old patients.The frequency of asthma, including allergic type, was significantly (P<0.01) greater in patients with pulmonary hypertension (15/24, 63%) than in those without (10/77, 13%) at the age of 6 months to 1 year.Asthma in the high PA flow group was associated with other allergic diseases in 30 (77%) of 39 patients, including food allergy in nine (23%), atopic dermatitis in 14 (36%), allergic rhinitis in seven (18%) and abnormally high total IgE levels in 14 (36%).These findings suggest that high pulmonary flow or pulmonary hypertension enhances the manifestation of allergic disease, particularly

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03099.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractThe aims of this study were to define the antagonistic effects of atropine sulfate to halothane‐induced cardiovascular depression in children, and to clarify whether or not a larger dose of atropine is more effective in attenuating the cardiovascular depression.Thirty‐four children aged 1–12 years who had undergone minor surgery, free from cardiac or pulmonary disease, were assigned at random to two groups. M‐mode echocardiographic evaluation of left ventricular function in each patient was performed at three points (before induction, point A; after induction, point B; and following administration of atropine, point C). Results were compared between points A and B, B and C and C and A, and between the two study groups with different doses of atropine (0.01 mg/kgvs0.02 mg/kg).Heart rate (HR), mean blood pressure (MBP) and left ventricular shortening fraction (LVSF) decreased, and left ventricular end‐diastolic dimension (LVEDD) were increased significantly by halothane induction. Although HR and MBP recovered following atropine, LVSF and LVEDD remained unchanged. There were no differences found between the values after vagolysis in both study groups, except for HR and mean velocity of circumferential fiber shortening (mVcf). Heart rate increased above that of pre‐induction, even following the smaller dose of atropine.The myocardial depression cannot be necessarily attenuated by vagolysis regardless of the dosage of atropine. The smaller dose (i.e. 0.01 mg/kg) seems to be sufficient only to antagonize the bradycardia and hypotension during halothane anesthesia

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03100.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractAlthough percutaneous transluminal balloon aortic valvuloplasty (PTAV) has been performed for congenital aortic stenosis in infants and children for several years, its efficacy and the associated aortic regurgitation (AR) have not been widely discussed. Percutaneous transluminal balloon aortic valvuloplasty using an Inoue balloon catheter was performed for congenital aortic stenosis in 12 patients (4–16 years old) in this study. The systolic aortic valve pressure gradient ranged from 42 to 111 mmHg before PTAV and became<50 mmHg immediately after PTAV in 10 cases (83%). Eight of these 10 patients had no increase in the gradient during subsequent observation for a period of 9–40 months. Aortic regurgitation increased immediately after PTAV in nine cases (75%). It increased from grade 1 to grade 2 in eight cases and from grade 1 to grade 3 in one patient; no significant enlargement of the left ventricular end‐diastolic diameter and no significant change in the left ventricular end‐diastolic pressure (LVEDP) or the cardiac index was observed during follow‐up in these patients. There was a correlation between the diameter of the balloon and efficacy; an appropriate diameter was considered to be about 90% of the aortic annular diameter. Changes in the hemodynamic parameter after PTAV with an Inoue balloon were small in most patients and this procedure is considered to be a treatment that should be attempted prior to surgery for congenital aortic

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03101.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractAn intriguing relationship between idiopathic mitral valve prolapse (MVP) and cardiomyopathy has been reported in adult cases of MVP. This paper reports a girl with idiopathic MVP, who presented with progressive cardiomegaly and cardiomyopathic findings on cardiac biopsy; right ventricular endomyocardial biopsy at the age of 15 years showed myocardial hypertrophy, disarray, myocardial degeneration, interstitial fibrosis and endocardial thickening. To our knowledge, this is the first case of idiopathic MVP in childhood that has been shown to have positive biopsy findings for cardiomyopathy.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03102.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractIn the prediction of neurological sequelae after hypoxic‐ischemic encephalopathy (HIE) in the newborn, the electroencephalogram (EEG) burst suppression pattern (BS) and subcortical leukomalacia can mean grave neurodevelopmental problems will develop.This study presents an infant with HIE associated with BS and subcortical leukohypodensity (SLH) on computed tomography scan. At first her neurodevelopmental outcome was considered poor, but unexpectedly she showed good development in 32 months follow‐up. The findings of BS and SLH do not always result in a poor neurodevelopmental outcome, if the subsequent clinical state and EEG return to normal at an early st

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03103.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

AbstractA case of leukemoid reaction in a premature baby whose mother was antenatally treated by betamethasone is reported. The neonatal and maternal factors which might lead to leukocytosis or leukemoid reaction were excluded. The presented case is the last in a series of eight previously reported cases of leukemoid reaction, in which the common denominator was the antenatal administration of betamethasone.

ISSN:1328-8067    

DOI:10.1111/j.1442-200X.1993.tb03104.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY