21/39. Diffuse and severe ischemic injury of the extremities: a complication of umbilical vein catheterization.We report a case of severe, peripheral, and diffuse tissue ischemia after umbilical vein catheterization (UVC) in a preterm newborn born to a preeclamptic mother. nitroglycerin ointment was used to treat lesions. The recovery was good but partial loss of the distal phalange of one finger and one toe occurred. This is the first report of peripheral vasospasm occurring after UVC. Topical nitroglycerin, traditionally used to treat peripheral artery catheter-induced ischemic injury, may be useful to treat the same lesions occurring after UVC.- - - - - - - - - - ranking = 1keywords = umbilical, artery (Clic here for more details about this article) |
22/39. Neuropathology of central respiratory dysfunction in infancy.We studied the neuropathology of 7 infants who had primary respiratory problems unrelated to increased intracranial pressure. These infants ranged in age from newborn to 2 years. Five were male. In 2 of them the main neuropathological findings were in the brainstem with prominent neuroglial heterotopia in the subarachnoid space, and aplasia of the VI and VII cranial nerves. Two infants had abnormalities of the X and XII nerves together with neuronal heterotopia and migration failure of the inferior olivary nuclei. In 1 infant diagnosed with Ondine's curse, examination showed diffuse neuronal loss and gliosis in the medullary tegmentum. One infant had a unilateral infarction in the medulla and another showed extensive gliosis in the brainstem tegmentum along with a large infarction in the region of the anterior cerebral artery. These infants exhibited a spectrum of abnormalities including neuronal dysplasia, gliosis and hypoxic-ischemic changes. In the differential diagnosis of respiratory dysfunction in infants a rare consideration is a central etiology based on malformation of essential neuronal components of the brainstem.- - - - - - - - - - ranking = 0.0047865319565885keywords = artery (Clic here for more details about this article) |
23/39. Umbilical catheter masquerading at echocardiography as a left atrial mass.The case of a newborn who had an umbilical catheter inserted in the intensive care unit is discussed. This catheter was meant to be inserted into the umbilical artery, but was instead inadvertently inserted into the umbilical vein. It crossed a patent foramen ovale into the left atrium. This fact was not known at the time of echocardiographic evaluation. At echocardiography, abnormal echoes within the left atrium were seen. Findings were typical for a catheter within the heart, and the umbilical catheter was subsequently withdrawn. There is a potential for mistaking the echocardiographic findings for a left atrial abnormality and echocardiographers should be alert to this possibility.- - - - - - - - - - ranking = 6.1757090821087keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
24/39. To-and-fro veno-venous extracorporeal lung assist for newborns with severe respiratory distress.A veno-venous to-and-fro bypass method through a single blood access for extracorporeal lung assist with an artificial membrane lung is introduced. A premature newborn with severe respiratory distress was treated with this method. A 12 Fr. single lumen catheter with a spiral-embedded thin-wall, 0.25 mm in wall thickness, was placed in the right internal jugular vein. Venous blood was withdrawn and oxygenated blood returned alternately through the same catheter. Thus both carotid arteries and other large veins were kept intact. During the extracorporeal bypass, the patient was put on intermittent mandatory ventilation of 2 times/min for lung rest providing adequate arterial blood gases, and he survived.- - - - - - - - - - ranking = 0.00032167254699603keywords = single (Clic here for more details about this article) |
25/39. Systemic air embolism in the respiratory distress syndrome of the newborn.Details of 25 cases of neonatal systemic air embolism, including three of our patients, are reviewed. This rare complication of respiratory distress syndrome (RDS) was observed in 21 premature infants and 4 fullterm newborns, of whom 23 required intermittent positive pressure ventilation (IPPV). In 21 of these patients air embolism was preceded by pulmonary interstitial emphysema, pneumomediastinum, pneumothorax and/or pneumopericardium. air embolism occurred between 3 and 288 hours after delivery. The outcome was lethal in 24 cases, only one patient survived. Two main pathogenic mechanisms are discussed; entrance of air from ruptured alveoli into the lung capillaries and introduction of air via catheters in umbilical vessels.- - - - - - - - - - ranking = 0.19904269360868keywords = umbilical (Clic here for more details about this article) |
26/39. Hirschsprung's disease discordant in monozygotic twins: a study of possible environmental factors in the production of colonic aganglionosis.The occurrence of Hirschsprung's disease, with histologically verified colonic aganglionosis, in only 1 of 2 prematurely born and presumed identical (monozygotic) twins is reported. The occurrence of monozygotic twinning was supported by the observed sharing of a single and common placenta and by ABO and HLA identity of peripheral blood erythrocytes and leukocytes. The affected twin was of a slightly lower birth weight and experienced early respiratory distress, necrotizing enterocolotis, and more prolonged umbilical artery catheterization (no encountered in the unaffected twin). This, to the authors' knowledge, is the first reported occurrence of Hirschsprung's disease discordant in monozygotic twins. The literature relating to genetic and environmental factors in clinical and experimental colonic aganglionosis is reviewed and speculation is presented regarding the occurrence of colonic aganglionosis discordant in monozygotic twins as reported here.- - - - - - - - - - ranking = 5.5787418375561keywords = umbilical artery, umbilical, artery, single (Clic here for more details about this article) |
27/39. Systemic air embolism. A possible complication of artificial ventilation.A baby of 1 100 g and a gestational age of 28 weeks with severe idiopathic respiratory distress syndrome was treated with pressure limited artificial ventilation and positive and expiratory pressure. After 30 hours the infant deteriorated and the chest radiograph showed air in the carotid, subclavian and aortic artery.- - - - - - - - - - ranking = 0.0047865319565885keywords = artery (Clic here for more details about this article) |
28/39. False aneurysm of the descending aorta: a complication of umbilical artery catheterization.A patient had an aneurysm of the descending aorta secondary to aortitis arising from umbilical artery catheterization and in association with coarctation of the aorta. The aortitis probably was the direct result of bacterial contamination of the umbillicus and catheter with staphylococcus aureus and the placement of the catheter tip just distal to a coarctation of the aorta. The patient required surgical resection of the coarctation and aneurysm of the descending aorta and placement of a tubular Dacron graft at 6 month of age. This is, to our knowledge, a hitherto unreported complication of umbilical artery catheterization.- - - - - - - - - - ranking = 33.471486007696keywords = umbilical artery, umbilical, artery (Clic here for more details about this article) |
29/39. longitudinal studies of infants with the Wilson-Mikity syndrome. Clinical, radiological and mechanical correlations.Simple clinical measurements were performed on a group of 23 very low birth weight babies (less than 1500 g and less than 32 weeks gestation), and combined with pulmonary function studies in 13 cases. The studied included a special single-breath analysis, or Tidal Resistance Profile, which enabled us to detect air trapping. 2 infants developed classical Wilson-Mikity syndrome and 2 further infants exhibited a milder, shorter form of the same disorder. All 4 survived. Results suggest that all infants in this maturity group are at risk of developing Wilson-Mikity syndrome, and that it comprises a wide spectrum of respiratory dysfunction.- - - - - - - - - - ranking = 0.00016083627349801keywords = single (Clic here for more details about this article) |
30/39. Surgically correctable hypertension of renal origin in childhood.Since 1960, 22 children were treated for surgically correctable hypertension or renal origin. The series included two children with tumors, two with hydronephrosis from ureteropelvic junction obstruction, nine in whom one kidney was atrophic, and nine with renal artery narrowing from fibromuscular dysplasia (with bilateral involvement in two). hypertension was cured in the cases with tumors and ureteropelvic junction obstruction. It was also cured in four of the nine patients with an atrophic kidney and in five of the nine with a narrow renal artery. In those not cured hypertension was more easily controlled by medication. One patient died from brain hypoxia during surgery. About 10 percent of the children investigated for hypertension at the massachusetts General Hospital proved to have a surgically correctable cause of renal origin.- - - - - - - - - - ranking = 0.009573063913177keywords = artery (Clic here for more details about this article) |
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