11/77. Severe perinatal liver disease associated with fetal thrombotic vasculopathy.Three neonates with fetal thrombotic vasculopathy in the placenta and severe neonatal liver disease are described. Symptoms included a bleeding disorder on the first day of life, followed by direct hyperbilirubinemia and elevated liver transaminases. All patients also had evidence of thrombosis outside the placenta, including cerebral infarct in two infants and thrombosis of the inferior vena cava in one infant. liver disease was demonstrated to be thrombotic in one infant who died with budd-chiari syndrome. Two infants survived and had liver biopsy with cholestasis, bile duct proliferation, and portal fibrosis demonstrated at 4 weeks and 11 weeks of age, respectively. The etiology of thrombosis is unknown, though in one patient an excessively long and coiled umbilical cord may be implicated. The prenatal onset of thrombosis suggests an inherited or acquired thrombophilic state. In cases of enigmatic neonatal liver disease, an association with thrombosis should be considered and thrombi sought in placenta, umbilical cord, major blood vessels, and other organs. Evaluation for a hypercoagulable state is also suggested.- - - - - - - - - - ranking = 1keywords = umbilical (Clic here for more details about this article) |
12/77. Serious complications after umbilical artery catheterization for neonatal monitoring.Umbilical artery catheterization in critically ill neonates caused major complications, including five deaths, in 15 of 165 infants with respiratory distress syndrome who underwent autopsy at the UCLA Hospital during the past eight years. Arterial occlusion leading to visceral infarction occurred in 12 patients, and vascular perforation caused hemoperitoneum in three patients. Repeated catheter manipulation and protracted catheter use were common factors identified in patients in whom complications developed. Restricted indications for catheter use, routine roentgenographic confirmation of catheter tip location below the kidneys, low-dosage heparin sodium infusion, use of cannulas with decreased thrombogenicity, avoidance of catheter manipulation, and vigilance to remove catheters when no longer required should reduce the incidence of this iatrogenic neonatal complication while still permitting arterial pressure and blood gas monitoring when clinically indicated.- - - - - - - - - - ranking = 22.884898246216keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
13/77. Neonatal cerebral infarction diagnosed by diffusion-weighted MRI: pseudonormalization occurs early.BACKGROUND: seizures in the neonatal period may be the single symptom of acute ischemic cerebral infarction. It may be difficult to establish the diagnosis in the acute phase by the use of ultrasound, CT, and conventional MRI because of the high water content of the immature brain. diffusion-weighted (DW) MRI is a very sensitive and fast imaging modality to visualize acute ischemic stroke in infants even before conventional MR images become abnormal. Signal abnormality in DW MRI, however, seems to follow a different time course than in older patients. CASE DESCRIPTION: DW MRI became falsely negative 1 week after stroke (pseudonormalization) in 2 newborn patients during persistence of signal abnormalities on turbo spin-echo images, whereas the so-called pseudonormalization in adults normally occurs within 10 to 14 days. CONCLUSIONS: T2-weighted sequences should supplement DW images to reliably detect subacute ischemic infarctions in the neonatal period.- - - - - - - - - - ranking = 0.00049200852520739keywords = single (Clic here for more details about this article) |
14/77. Abnormal umbilical vessels and systemic circulatory reversal in thoracopagus twins.A human thoracopagus of slightly unequal twins having a common umbilical cord with exomphalos is described with special reference to the cardiovascular system. The larger twin had single umbilical artery. The smaller twin had a large left umbilical artery which was in direct continuity with the aorta, a small right umbilical artery with sole connection to the right external and internal iliac arteries (right common iliac artery was absent), missing umbilical vein, a rudimentary nonfunctional heart with atresia of the truncus arteriosus, and a right-sided aortic arch. Exomphalos of both twins is accounted by the possible defective growth of umbilical mesoderm caused by abnormal umbilical vessels. Reversal of sustemic circulation in the upper part of the body of small twin is discussed. The importance of a careful study of umbilical veins is emphasized.- - - - - - - - - - ranking = 21.665264691635keywords = umbilical artery, umbilical, artery, single (Clic here for more details about this article) |
15/77. Prenatal sonographic diagnosis of klippel-trenaunay-weber syndrome associated with umbilical cord hemangioma.klippel-trenaunay-weber syndrome (KTW), also known as angio-osteohypertrophy syndrome, is a complex developmental disorder characterized by asymmetric hemi-hypertrophy of limbs and trunk due to bony and soft tissue overgrowth that may extend across the midline, varicose veins, and cutaneous hemangiomata. This rare syndrome has been previously described in the prenatal period by ultrasonography, and in literature, there are quite different presentation of cases. We describe a case suggested as a KTW syndrome by prenatal ultrasonography. The sonographic appearance of an unilateral leg hypertrophy associated with irregular echolucent cystic areas was consistent with KTW syndrome. A spheric, weak-echogenic mass without any active blood flow located in the umbilical cord revealed by color Doppler ultrasonography was an unexpected finding. The postpartum examination confirmed the prenatal diagnosis.- - - - - - - - - - ranking = 2.5keywords = umbilical (Clic here for more details about this article) |
16/77. pathology of the umbilical cord in adrenal fusion syndrome.We report the placental findings of a newborn with multiple anomalies that include small and fused adrenal glands, meningomyelocele, lobar holoprosencephaly, cerebellar hypoplasia, short pancreas, and small spleen, fitting with the features of the so-called adrenal fusion syndrome. The placenta was small and presented a short, undercoiled and segmentally uncoiled umbilical cord with a short constriction in the middle of its length. We speculate that adrenal fusion syndrome and abnormal spleen lobulation and short pancreas may represent part of the same complex and probably related to the one including midline anomalies and defects of laterality formation in which horseshoe (fused) adrenal gland also may be found. Undercoiled umbilical cord might represent the placental component of this malformation complex. We also underline the value in identifying abnormalities of the umbilical cord to establish the cause of death.- - - - - - - - - - ranking = 3.5keywords = umbilical (Clic here for more details about this article) |
17/77. Early bone grafting in Tessier number 4 cleft: a case report.Rare craniofacial clefts have an incidence of at least 1 per 100,000 live births. A Tessier number 4 cleft is one of the most rare craniofacial clefts, with less than 50 cases being reported in the literature. Both soft and bony tissue abnormalities take place in the cleft morphology, so not only clinical examination of the maxillofacial region but a detailed radiological workup is needed to assess clearly the nature of the clefts. A patient with a Tessier number 4 cleft is presented, whose bony defect was obliterated with autogenous iliac bone graft chips and soft tissue reconstruction was performed with multiple Z-plasty flaps. Postoperative clinical and radiological results demonstrate fine healing and good cosmesis. Although controversy still exists about the treatment of facial clefts with early bone grafts, advantages of performing both bony and soft tissue reconstructions in a single session make this treatment a good alternative with satisfactory clinical and radiological results.- - - - - - - - - - ranking = 0.00049200852520739keywords = single (Clic here for more details about this article) |
18/77. Vein of Galen malformation combined with atrial septal defect in a neonate.An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein, whereby the interconnecting capillary network is missing. Such a malformation frequently occurs in the deep midline regions of the brain, and the subsequent increased flow into the draining vein of Galen substantially dilates in an aneurysmal manner. Congenital forms of the aneurysmal dilatation of the vein of Galen (AVG) often lead to death in the neonatal period, predominantly due to cardiac failure caused by the increased venous inflow as a consequence of the intracerebral arteriovenous shunting. In the presented case a male baby suffered from a rare combination of a cerebral AVF and an atrial septal defect (ASD). He was born at week 38 of pregnancy and subsequently developed tachydyspnoe. Ultrasound (US) and CT scans revealed a large bilateral AVF with dilated basal venous sinuses, hydrocephalus and brain atrophy. In the heart, severe right ventricular hypertrophy, patent ductus arteriosus and an ASD were detectable by US. Neurosurgical consultation rejected the possibility of an operative treatment due to size and localization of the lesion and the existing irreversible brain damage. The child died because of cardiac failure 6 days after birth. autopsy examination in the brain demonstrated a large conglomerate of dilated blood vessels predominantly in the midline and left occipital lobe, edema and hydrocephalus. In the heart, the ASD detected by US proved to be an ostium secundum-type lesion. Histologically, the conglomerate of vessels revealed features of an AVF and matched the characteristics of AVG. Consequences of chronic ischemic brain injury were also present, with ferruginated neurons suggesting intrauterine damage caused by a congenital AVF. Based on data in the literature, we assume that the left-to-right shunt due to increased venous influx into the heart caused not only cardiomegaly, but may have also interfered with the normal development of the atrial septum leading to an ASD, contributing to the rapid progression of the cardiac failure.- - - - - - - - - - ranking = 0.0043959937908794keywords = artery (Clic here for more details about this article) |
19/77. Nursery outbreak of scalded-skin syndrome. Scarlatiniform rash due to phage group I staphylococcus aureus.From Aug 6 to 14, 1973, scariatiniform eruptions that were considered to be mild forms of the staphylococcal scalded-skin syndrome developed in four neonates. One infant had mild epidermal peeling. All had generalized, finely papular erythema that cleared rapidly after treatment with antibiotics. Cultures from the umbilical stumps or anterior nares of three of the infants yielded colonies of group I staphylococcus aureus, phage type 29/52/79/86/D11/81, that were able to produce epidermal exfoliation in suckling mice. These data indicate that the nursery outbreak was caused by phage group I staphylococci rather than group II organisms previously associated with staphylococcal scalded-skin syndrome. The demonstration that a group I Staphylococcus can produce exfoliative toxin suggests that the same mechanism for toxin production may exist for phage groups I and II staphylococci.- - - - - - - - - - ranking = 0.5keywords = umbilical (Clic here for more details about this article) |
20/77. Single film retrograde umbilical aortography in the diagnosis of hypoplastic left heart syndrome with aortic atresia.Single film retrograde umbilical aortography was used successfully in confirming the diagnosis of hypoplastic left heart in three neonates. The method involves injecting Renografin 75% (1.25 cc/kg body weight) into the umbilical artery catheter according to the following sequence. First, the tip of the catheter is positioned at the level of the ductus arteriosus. The infant heart beats are then counted from one to three. The contrast media injection is begun manually on the count of one and an anterior-posterior chest film is taken on the count of three. Thus the film is taken one diastolic period after completion of the injection. The proper timing of the contrast media injection and filming is essential for obtaining a diagnostic film. This procedure was diagnostic in the three infants studied and eliminated the need of transferring two sick infants from affiliated hospitals.- - - - - - - - - - ranking = 8.2201255631063keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
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