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Heat loss from the skin of preterm and fullterm newborn infants during the first weeks after birth
INTERNATIONAL ABSTRACTS
288
temporally correlated with a decline in cardiac output. The opiate antagonists naloxone and naltrexone were capable of improving cardiovascular performance in this experimental model, which is felt to more closely mimic the clinical situation in humans.--Richard R. Ricketts
Proceedings of the First National Conference on Pediatric Trauma.
B.H. Harris. Ped Emerg Care 2:113-143, (June), 1986. The editor has brought together 31 concise yet fact-filled articles written by 27 authors on diverse topics in pediatric trauma care ranging from particular organ injury to socioeconomic issues. Each of the articles is extensively referenced.-- Thomas V. Whalen
lateral or posterolateral thoracotomy incisions as children were studied with volume and linear measurements. Sixty percent of the patients had >20% difference in volume between the two sides following an anterolateral thoracotomy. The smaller breast or chest was on the side of the thoracotomy in each instance. Earlier age at the time of operation and the anterolateral incision resulted in a more severe maldevelopment. When necessary, the authors advocate an anterolateral thoracotomy incision that begins in the seventh and eight interspace and extends laterally no higher than the sixth interspace, with elevation rather than division of the pectoralis muscle. These methods would theoretically avoid interruption of blood supply to the pectoralis muscle and breast, partial amputation of breast tissue, or the development of subsequent atrophy of the inferior portion of the pectoralis muscle.--Marleta Reynolds
Heat Loss From the Skin of Preterm and Fullterm Newborn Infants During the First W e e k s After Birth. K. Hammarlund, B. Strom-
Bronchopulmonary Foregut Malformations. B.M. Rodgers, P.K.
berg, G. Sedin. Biol Neonate 50:1-10, (July), 1986.
Harman, andA.M. Johnson. Ann Surg 203:517-524, (May), 1986.
In 68 infants appropriate for gestational age, born after 25 to 41 weeks of gestation, the evaporation rate from the skin and ambient skin and body temperatures were measured repeatedly during the first 4 weeks after birth. The heat exchange due to evaporation, radiation, and convection was calculated. All measurements were made at an ambient humidity of 50%, with the infants calm and quiet. High evaporative heat losses were found in preterm infants on their first days of life, with gradually decreasing values with increasing gestational and postnatal age. It was only during the first week of life in infants born at 25 to 27 weeks of gestation that evaporative heat loss was higher than radiative heat loss. The high evaporative heat losses in very preterm infants were balanced by low losses or even a gain through radiation and convection, because of the high ambient temperature needed to maintain a stable body temperature. Total heat loss increased with increasing gestational and postnatalage. Prem Puri
The cases of ten children with bronchopulmonary foregut malformations are reviewed. The authors review proposed embryologic events leading to these anomalies as based on their observations of the anatomic malformations in these 10 patients. An in-depth discussion is presented on diagnosis, surgical treatment, and followup. An attempt is made to organize three decades of ambiguous terminology and numerous proposed theories of etiology. The discussion of bronchopulmonary foregut malformations is complete and concise.--Edward G. Ford
T r e a t m e n t of Intractable Lymphangioma by Micrcvascular Anastomotic Free Omental Transplantation. T. Ogawa, K. Suruga, T.
Miyanao. Pediatr Surg lnt 1:135-137, (June), 1986. Three cases of massive recurrent lymphangioma of the left foot, left axilla, and right leg in patients aged 15 to 17 years were successfully treated by free omental transplantation using microvascular anastomosis. After lymphangioma excision, the omentum was removed with the right gastroepiploic vessels and transferred to the operative surface. The omental vessels were anastomosed to the regional vessels by microvascular anastomotic technique. The skin was closed primarily or by split-skin graft. The transferred omentium acted as a fat pad for the operative surface, served as a base for the skin graft to absorb lymphatic fluid, and prevented recurrence. The longest postoperative follow-up time was 5 years. All three cases showed good wound healing, and there was no lymphorrhea, infection, or recurrence. This new method is effective in the treatment of massive recurrent lymphangioma unresponsive to conventional means.--Prem Puri
THORAX Breast and Pectoral Muscle Maldevelopment After Anterolateral and Posterolateral Thoracotomies in Children. L.L. Cherup, R.D.
Sievers, and J.W. Futrell. Ann Thorac Surg 41:492-497, (May), 1986. Thoracic procedures performed early in life may result in maldevelopment of the chest. The chests of 28 patients who had antero-
The Use of Computed Tomography in the Evaluation of Mediastinal
G. Graeber, C.D. Shriver, R.A. A/bus, et al. J Thorac Cardiovasc Surg 91:662-666, (May), 1986. Masses.
A comparison of the preoperative evaluation of 42 patients with mediastinal masses was undertaken to determine the benefits of computed tomography (CT) as a diagnostic modality. CT was better at differentiating solid v cystic lesions when compared with conventional studies (88% v 31%). The group of patients studied with CT underwent fewer tests per patient (1.7% v 2.8%). CT also improved the identification of invasion of mediastinal structures by malignancy. Nine of 11 patients in the CT group were correctly diagnosed as having tumor invasion. No evidence of tumor invasion was diagnosed preoperatively without CT. A CT scan of the mediastinum should become an integral part of the preoperative workup of any mediastinal mass.--Marleta Reynolds
Diaphragmatic Paralysis and Eventration in Infants. C.D. Smith, R.M. Sade, F.A. Crawford, et al. J Thorac Cardiovasc Surg 91:490-497, (April), 1986.
Diaphragmatic paralysis and eventration of the diaphragm was treated by plication of the diaphragm in 21 of 26 infants. Operative phrenic nerve injury was responsible for diaphragmatic paralysis in 12 infants, was congenital in ten infants, and resulted from birth trauma in four infants. The operative procedure most commonly responsible for nerve injury was a Blalock-Taussig shunt (6 of 12). Most infants had other significant associated conditions. Recurrent or residual eventration necessitated reoperation in four patients. Successful weaning from ventilatory support within 1 week of surgery was a good prognostic sign. Prematurity and major associated anomalies contributed to the high mortality in this group of patients. Of the 14 postoperative deaths, three were directly related and nine were partially related to the diaphragmatic eventration and respiratory insufficiency.--Marleta Reynolds
288
temporally correlated with a decline in cardiac output. The opiate antagonists naloxone and naltrexone were capable of improving cardiovascular performance in this experimental model, which is felt to more closely mimic the clinical situation in humans.--Richard R. Ricketts
Proceedings of the First National Conference on Pediatric Trauma.
B.H. Harris. Ped Emerg Care 2:113-143, (June), 1986. The editor has brought together 31 concise yet fact-filled articles written by 27 authors on diverse topics in pediatric trauma care ranging from particular organ injury to socioeconomic issues. Each of the articles is extensively referenced.-- Thomas V. Whalen
lateral or posterolateral thoracotomy incisions as children were studied with volume and linear measurements. Sixty percent of the patients had >20% difference in volume between the two sides following an anterolateral thoracotomy. The smaller breast or chest was on the side of the thoracotomy in each instance. Earlier age at the time of operation and the anterolateral incision resulted in a more severe maldevelopment. When necessary, the authors advocate an anterolateral thoracotomy incision that begins in the seventh and eight interspace and extends laterally no higher than the sixth interspace, with elevation rather than division of the pectoralis muscle. These methods would theoretically avoid interruption of blood supply to the pectoralis muscle and breast, partial amputation of breast tissue, or the development of subsequent atrophy of the inferior portion of the pectoralis muscle.--Marleta Reynolds
Heat Loss From the Skin of Preterm and Fullterm Newborn Infants During the First W e e k s After Birth. K. Hammarlund, B. Strom-
Bronchopulmonary Foregut Malformations. B.M. Rodgers, P.K.
berg, G. Sedin. Biol Neonate 50:1-10, (July), 1986.
Harman, andA.M. Johnson. Ann Surg 203:517-524, (May), 1986.
In 68 infants appropriate for gestational age, born after 25 to 41 weeks of gestation, the evaporation rate from the skin and ambient skin and body temperatures were measured repeatedly during the first 4 weeks after birth. The heat exchange due to evaporation, radiation, and convection was calculated. All measurements were made at an ambient humidity of 50%, with the infants calm and quiet. High evaporative heat losses were found in preterm infants on their first days of life, with gradually decreasing values with increasing gestational and postnatal age. It was only during the first week of life in infants born at 25 to 27 weeks of gestation that evaporative heat loss was higher than radiative heat loss. The high evaporative heat losses in very preterm infants were balanced by low losses or even a gain through radiation and convection, because of the high ambient temperature needed to maintain a stable body temperature. Total heat loss increased with increasing gestational and postnatalage. Prem Puri
The cases of ten children with bronchopulmonary foregut malformations are reviewed. The authors review proposed embryologic events leading to these anomalies as based on their observations of the anatomic malformations in these 10 patients. An in-depth discussion is presented on diagnosis, surgical treatment, and followup. An attempt is made to organize three decades of ambiguous terminology and numerous proposed theories of etiology. The discussion of bronchopulmonary foregut malformations is complete and concise.--Edward G. Ford
T r e a t m e n t of Intractable Lymphangioma by Micrcvascular Anastomotic Free Omental Transplantation. T. Ogawa, K. Suruga, T.
Miyanao. Pediatr Surg lnt 1:135-137, (June), 1986. Three cases of massive recurrent lymphangioma of the left foot, left axilla, and right leg in patients aged 15 to 17 years were successfully treated by free omental transplantation using microvascular anastomosis. After lymphangioma excision, the omentum was removed with the right gastroepiploic vessels and transferred to the operative surface. The omental vessels were anastomosed to the regional vessels by microvascular anastomotic technique. The skin was closed primarily or by split-skin graft. The transferred omentium acted as a fat pad for the operative surface, served as a base for the skin graft to absorb lymphatic fluid, and prevented recurrence. The longest postoperative follow-up time was 5 years. All three cases showed good wound healing, and there was no lymphorrhea, infection, or recurrence. This new method is effective in the treatment of massive recurrent lymphangioma unresponsive to conventional means.--Prem Puri
THORAX Breast and Pectoral Muscle Maldevelopment After Anterolateral and Posterolateral Thoracotomies in Children. L.L. Cherup, R.D.
Sievers, and J.W. Futrell. Ann Thorac Surg 41:492-497, (May), 1986. Thoracic procedures performed early in life may result in maldevelopment of the chest. The chests of 28 patients who had antero-
The Use of Computed Tomography in the Evaluation of Mediastinal
G. Graeber, C.D. Shriver, R.A. A/bus, et al. J Thorac Cardiovasc Surg 91:662-666, (May), 1986. Masses.
A comparison of the preoperative evaluation of 42 patients with mediastinal masses was undertaken to determine the benefits of computed tomography (CT) as a diagnostic modality. CT was better at differentiating solid v cystic lesions when compared with conventional studies (88% v 31%). The group of patients studied with CT underwent fewer tests per patient (1.7% v 2.8%). CT also improved the identification of invasion of mediastinal structures by malignancy. Nine of 11 patients in the CT group were correctly diagnosed as having tumor invasion. No evidence of tumor invasion was diagnosed preoperatively without CT. A CT scan of the mediastinum should become an integral part of the preoperative workup of any mediastinal mass.--Marleta Reynolds
Diaphragmatic Paralysis and Eventration in Infants. C.D. Smith, R.M. Sade, F.A. Crawford, et al. J Thorac Cardiovasc Surg 91:490-497, (April), 1986.
Diaphragmatic paralysis and eventration of the diaphragm was treated by plication of the diaphragm in 21 of 26 infants. Operative phrenic nerve injury was responsible for diaphragmatic paralysis in 12 infants, was congenital in ten infants, and resulted from birth trauma in four infants. The operative procedure most commonly responsible for nerve injury was a Blalock-Taussig shunt (6 of 12). Most infants had other significant associated conditions. Recurrent or residual eventration necessitated reoperation in four patients. Successful weaning from ventilatory support within 1 week of surgery was a good prognostic sign. Prematurity and major associated anomalies contributed to the high mortality in this group of patients. Of the 14 postoperative deaths, three were directly related and nine were partially related to the diaphragmatic eventration and respiratory insufficiency.--Marleta Reynolds