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Present criteria for lung surgery in infancy
431
ABSTRACTS
chord presenting as a rounded mass covered with normal mucosa. Treatment consisted in exploration of the trachea through a midline anterior incision. injection of cortisone into the mass, and tracheostomy. Repeated injections of cortisone were performed under general anesthesia through a laryngoscope. One and a half months after treatment, the mass and the resptratory obstruction disappeared. ‘The tracheostomy was kept open for 4 mo. C. A. Montagnani Clinical
and
Isolated
Immunologic
Response
Tracheal
Secretions
From
to
Bacteria
Fifteen patients without previous pulmonary infection had tracheostomies. They were studied bacteriologically and for immunologic response. Pseudomonas and Proteus were the predominant organisms in the tracheal aspirate in the six patients who developed pneumonia. There was a variety of organisms in patients who had only tracheobronchitis. The serum antibody titers increased in all patients with pneumonia while they did not in patrents with tracheobronchitis. Immunoglobulins and antibodies in tracheal secretions did not change significantly in either group. In the patients with initial high serum antibody titer to P.teudomonn.s there was less chance of developing pneumonia. It was suggested that P\eudomona.r vaccine may be of value in the future. ~Thorna.5 M. Holder
laryngeal
Dysphagia
Nerve
and
Recurrent
Palsy.
R. D. Henderson, A. Boszko, ond A. W. P. YCI” Nostrand. J. Thoroc. Cardiovosc. Surg. 68507-512, 1974. Eighteen patients (all adults) with recurrent laryngeal nerve palsy are presented. Many developed dysphagia at the time of vocal cord paralysis. The recurrent nerve supplies the and cricopharyngeus. proximal esophagus Aspiration was a prominant clinical feature and in three patients pharyngoesophageal myotomy relieved all symptoms of aspiration. Thornus M Branchial
M.
Cleft
Cysts
Twenty-two
Years’
Management
Experience
in
Juvenile
of
the
Medical
Thyrotoxicosis.
Vonitho A. Vaidyo, Alfred M. Rongiovanni, John Tenore, and Rebecca 1. Kirkland. Pediatrics 54565-570 (November), 1974.
S. Parks, Alfred
Ninety-five patients with juvenile thyrotoxicosis have been studied over the period I952 1974. Medical treatment with propylthiouracil has been the treatment of choice Of 75 who have been adequately followed, 40’ ,, have achieved remission with medical treatment alone. The average duration of medical treat-ment was 3.2 yr. Toxic reactions have been few and mild. Thirty-two patients were treated surgically. I3 because of noncompliance with drug treatment and 13 because of recurrence after discontinuation of the drug. In the absence of exceptionally skilled surgical services drug treatment is to be preferred and may be continued virtually mdefinitety in the absence of drug reaction. according to the authors. s. L. Gan5 On 20 Cases of Cystic Infancy. M. Montinori, 36, 1974.
Hygroma
of the
Neck
Iin 16:28--
Riv. Chir. Pediatr.
Five of 20 cervical lymphangiomas operated upon are described and illustrated by micr’oscopic slides and the gross appearance of the mass. No ography.
mortality is reported. C‘. .4. Monragnani
Ciood
bibll-
THORAX Present
Criteria
for
Lung
Surgery
in
Infancy.
E.
Sontoro, G. f. Colon;, P. C. Mineo, and C. R&i, Riv. Chir. Pediat. 16:58-84, 1974.
Holder
Buckinghorn Clin. Proc. 49:172-175
John
Ganr
Following
Tracheostomy, H. Espinoza, D. 1. Palmer, A. 1. Kisch, J. Ulrich, 6. Eberle, and W. P. Reed. J. Thorac. Cordiovasc. Surg. 68:432-439 (September), 1974.
Pharyngoesophageal
1972, when 35 children received surgrcal treatment for branchial cleft remnants. The anatomtc types and sites are described and surgical treatment is outlined. Only one incision was needed in every patient except one. in whom the “stepladder” incisions were used Otherwise the surgical techniques differ little from those described by other authors. The incidence of infection was high, occurring in I4 01 35 patients. This supports the recommendation that operation should be undertaken at an earl+ s. 1 age once the dragnosis has been made.
and
Sinuses
in
Children.
and Hugh 6. Lynn. Mayo (March), 1974.
This paper reports the experience of the Mayo Clinic during the period 1961 through
Out of X7 cases submrtted to surgery of the lung. 52 were affected with echinococcus cysts, I8 with bronchiectasis. five with tuberculosis, one with a lung abscess, two with lobmar emphysema. three with polycystic disease 01
432
ABSTRACTS
the lung. one with subpleural sequestration, one with foreign one with bronchial adenoma, plastic metastases. There were two deaths. Some of the more are described and illustrated grams.-C. A. Montagnani Pulmonary taneous
Lung
cysts, two with body aspiration, one with neo85 recoveries and interesting cases with roentgeno-
Sequestration
Intropleural
with
Hemorrhage.
Spon-
G. 1.
Zumbro, D. C. Green, W. Brotf and R. L. Treasure. J. Thorac. Cordiovasc. Surg. 68:673-674 (October), 1974.
mobility was slightly, in three markedly reduced. Complete immobility or paradoxical movements were not seen. The authors point out that the clinical signs did not correspond to the severity of the x-ray findings as nearly all the children did well clinically.V. Ku/&a Congenital
Retrosternal
Containing
liver.
Hupka.
Cesk.
in Congenital
The
Anneliese 1974.
Effect
D.
of Steroids
Shunting.
M.
Nicoloff,
and
M.
Cardiovasc.
on Adaptation
L. Schwartz, f.
W.
W.
to AtelecF.
Northrup,
Humphrey.
Surg. 68:822-829
J. Thorac. (November), 1974.
This is an experimental study utilizing dogs in which left lower-lobe atelectasis was produced by occluding the left lower-lobe bronchus with a balloon catheter. On control animals there was an initial increase in pulmonary vascular shunting which returned to near normal after 2 hr of atelectasis. This decrease in shunting was abolished by methylprednisolone 35 mg/kg. Steroids failed to alter pulmonary vascular hypertensive response to 89; 0, inhalation. It was felt that the steroids partially desensitized the chemoreceptors of the lung to all stimuli and that the decreased O2 ventilation was such a strong stimulus that it was not blocked by the steroids.Thomas M. Holder Results
of
Children Eventration. Vojtko,
Late
Radiographic
Operated
Upon
Examination for
in
Diaphragmatic
M. Mac&, V. Pohl, J. Hrk, and Cesk. Pediotr. 29:315-317, 1974.
M.
Seventeen patients with diaphragmatic eventration operated upon at the Dept. of Pediatric Surgery. Komensky-University Bratislava (Slovakia) were followed for periods of 2- 15 yr. The diaphragm on the operated side was usually found to be at the normal level. and in seven cases it was of normal shape. In six cases the
Hernia and
i.
A case report of a boy is described where radiography performed because of pulmonary infection revealed a right paracardiac tumor. Precise diagnosis was obtained by performing a pneumoperitoneum and gamagraphy. As the patient suffered from Down’s syndrome and had no clinical signs surgery was not recommended.V. Kafka
A 32-yr-old male was diagnosed by chest x-ray to have a right lower lobe sequestration. Because he had leukemia, removal was not recommended. Two months later while the leukemia was in remission and his coagulation studies were normal he developed a spontaneous massive pleural hemorrhage from the sequestered lobe. Emergency thoracotomy with resection of the sequestration was successful. He has remained in remission from leukemia for 2 yr.- Thomas M. Holder
tatic
Diaphragmatic
V. Horonski, A. G&k, Pediatr. 29:85-86, 1974
HEART Pyelogram
AND GREAT
as Side
Effect
Heart
SchwingshockL
VESSELS
of Angiocardiography
Disease.
Piidiotr.
1. Hammerer
and
Piidol. 9&S-59,
In 170 infants angiography was performed for investigation of cardiovascular anomalies. The resulting pyelograms were studied retrospectively and in 22 patients (20.5”;) malformations of the urinary tract, mainly duplications and dilatations of calyces and renal pelvis were detected. In contrast to pathological reports, these studies revealed a high incidence of renal malformations in children with congenital heart diseases. This can be explained embryologically as both organ systems develop at the same time. The coincidence of cardiac and renal malformations is well known to exist in a number of syndromes.-G. BrandeskJ Open-heart Months
of
Surgery
During
the
First
Three
Life.
A. R. Costonedo, J. Lomberfi, R. M. Sode, R. G. Williams, and A. S. Nodos. J. Thorac. Cordiovasc. Surg. 68, 719-731 (November), 1974. Twenty-eight patients less than 3 mo of age underwent open intracardiac corrective procedures at the Boston Children’s Medical Center. Deep hypothermia. surface cooling, limited cardiopulmonary bypass, and circulatory arrest were used. There were six deaths (21.5”,). There were no deaths in 12 patients with transposition of the great arteries or in the six patients with tetralogy of Fallot. There were three deaths in the nine patients with ventricular septal defect.
ABSTRACTS
chord presenting as a rounded mass covered with normal mucosa. Treatment consisted in exploration of the trachea through a midline anterior incision. injection of cortisone into the mass, and tracheostomy. Repeated injections of cortisone were performed under general anesthesia through a laryngoscope. One and a half months after treatment, the mass and the resptratory obstruction disappeared. ‘The tracheostomy was kept open for 4 mo. C. A. Montagnani Clinical
and
Isolated
Immunologic
Response
Tracheal
Secretions
From
to
Bacteria
Fifteen patients without previous pulmonary infection had tracheostomies. They were studied bacteriologically and for immunologic response. Pseudomonas and Proteus were the predominant organisms in the tracheal aspirate in the six patients who developed pneumonia. There was a variety of organisms in patients who had only tracheobronchitis. The serum antibody titers increased in all patients with pneumonia while they did not in patrents with tracheobronchitis. Immunoglobulins and antibodies in tracheal secretions did not change significantly in either group. In the patients with initial high serum antibody titer to P.teudomonn.s there was less chance of developing pneumonia. It was suggested that P\eudomona.r vaccine may be of value in the future. ~Thorna.5 M. Holder
laryngeal
Dysphagia
Nerve
and
Recurrent
Palsy.
R. D. Henderson, A. Boszko, ond A. W. P. YCI” Nostrand. J. Thoroc. Cardiovosc. Surg. 68507-512, 1974. Eighteen patients (all adults) with recurrent laryngeal nerve palsy are presented. Many developed dysphagia at the time of vocal cord paralysis. The recurrent nerve supplies the and cricopharyngeus. proximal esophagus Aspiration was a prominant clinical feature and in three patients pharyngoesophageal myotomy relieved all symptoms of aspiration. Thornus M Branchial
M.
Cleft
Cysts
Twenty-two
Years’
Management
Experience
in
Juvenile
of
the
Medical
Thyrotoxicosis.
Vonitho A. Vaidyo, Alfred M. Rongiovanni, John Tenore, and Rebecca 1. Kirkland. Pediatrics 54565-570 (November), 1974.
S. Parks, Alfred
Ninety-five patients with juvenile thyrotoxicosis have been studied over the period I952 1974. Medical treatment with propylthiouracil has been the treatment of choice Of 75 who have been adequately followed, 40’ ,, have achieved remission with medical treatment alone. The average duration of medical treat-ment was 3.2 yr. Toxic reactions have been few and mild. Thirty-two patients were treated surgically. I3 because of noncompliance with drug treatment and 13 because of recurrence after discontinuation of the drug. In the absence of exceptionally skilled surgical services drug treatment is to be preferred and may be continued virtually mdefinitety in the absence of drug reaction. according to the authors. s. L. Gan5 On 20 Cases of Cystic Infancy. M. Montinori, 36, 1974.
Hygroma
of the
Neck
Iin 16:28--
Riv. Chir. Pediatr.
Five of 20 cervical lymphangiomas operated upon are described and illustrated by micr’oscopic slides and the gross appearance of the mass. No ography.
mortality is reported. C‘. .4. Monragnani
Ciood
bibll-
THORAX Present
Criteria
for
Lung
Surgery
in
Infancy.
E.
Sontoro, G. f. Colon;, P. C. Mineo, and C. R&i, Riv. Chir. Pediat. 16:58-84, 1974.
Holder
Buckinghorn Clin. Proc. 49:172-175
John
Ganr
Following
Tracheostomy, H. Espinoza, D. 1. Palmer, A. 1. Kisch, J. Ulrich, 6. Eberle, and W. P. Reed. J. Thorac. Cordiovasc. Surg. 68:432-439 (September), 1974.
Pharyngoesophageal
1972, when 35 children received surgrcal treatment for branchial cleft remnants. The anatomtc types and sites are described and surgical treatment is outlined. Only one incision was needed in every patient except one. in whom the “stepladder” incisions were used Otherwise the surgical techniques differ little from those described by other authors. The incidence of infection was high, occurring in I4 01 35 patients. This supports the recommendation that operation should be undertaken at an earl+ s. 1 age once the dragnosis has been made.
and
Sinuses
in
Children.
and Hugh 6. Lynn. Mayo (March), 1974.
This paper reports the experience of the Mayo Clinic during the period 1961 through
Out of X7 cases submrtted to surgery of the lung. 52 were affected with echinococcus cysts, I8 with bronchiectasis. five with tuberculosis, one with a lung abscess, two with lobmar emphysema. three with polycystic disease 01
432
ABSTRACTS
the lung. one with subpleural sequestration, one with foreign one with bronchial adenoma, plastic metastases. There were two deaths. Some of the more are described and illustrated grams.-C. A. Montagnani Pulmonary taneous
Lung
cysts, two with body aspiration, one with neo85 recoveries and interesting cases with roentgeno-
Sequestration
Intropleural
with
Hemorrhage.
Spon-
G. 1.
Zumbro, D. C. Green, W. Brotf and R. L. Treasure. J. Thorac. Cordiovasc. Surg. 68:673-674 (October), 1974.
mobility was slightly, in three markedly reduced. Complete immobility or paradoxical movements were not seen. The authors point out that the clinical signs did not correspond to the severity of the x-ray findings as nearly all the children did well clinically.V. Ku/&a Congenital
Retrosternal
Containing
liver.
Hupka.
Cesk.
in Congenital
The
Anneliese 1974.
Effect
D.
of Steroids
Shunting.
M.
Nicoloff,
and
M.
Cardiovasc.
on Adaptation
L. Schwartz, f.
W.
W.
to AtelecF.
Northrup,
Humphrey.
Surg. 68:822-829
J. Thorac. (November), 1974.
This is an experimental study utilizing dogs in which left lower-lobe atelectasis was produced by occluding the left lower-lobe bronchus with a balloon catheter. On control animals there was an initial increase in pulmonary vascular shunting which returned to near normal after 2 hr of atelectasis. This decrease in shunting was abolished by methylprednisolone 35 mg/kg. Steroids failed to alter pulmonary vascular hypertensive response to 89; 0, inhalation. It was felt that the steroids partially desensitized the chemoreceptors of the lung to all stimuli and that the decreased O2 ventilation was such a strong stimulus that it was not blocked by the steroids.Thomas M. Holder Results
of
Children Eventration. Vojtko,
Late
Radiographic
Operated
Upon
Examination for
in
Diaphragmatic
M. Mac&, V. Pohl, J. Hrk, and Cesk. Pediotr. 29:315-317, 1974.
M.
Seventeen patients with diaphragmatic eventration operated upon at the Dept. of Pediatric Surgery. Komensky-University Bratislava (Slovakia) were followed for periods of 2- 15 yr. The diaphragm on the operated side was usually found to be at the normal level. and in seven cases it was of normal shape. In six cases the
Hernia and
i.
A case report of a boy is described where radiography performed because of pulmonary infection revealed a right paracardiac tumor. Precise diagnosis was obtained by performing a pneumoperitoneum and gamagraphy. As the patient suffered from Down’s syndrome and had no clinical signs surgery was not recommended.V. Kafka
A 32-yr-old male was diagnosed by chest x-ray to have a right lower lobe sequestration. Because he had leukemia, removal was not recommended. Two months later while the leukemia was in remission and his coagulation studies were normal he developed a spontaneous massive pleural hemorrhage from the sequestered lobe. Emergency thoracotomy with resection of the sequestration was successful. He has remained in remission from leukemia for 2 yr.- Thomas M. Holder
tatic
Diaphragmatic
V. Horonski, A. G&k, Pediatr. 29:85-86, 1974
HEART Pyelogram
AND GREAT
as Side
Effect
Heart
SchwingshockL
VESSELS
of Angiocardiography
Disease.
Piidiotr.
1. Hammerer
and
Piidol. 9&S-59,
In 170 infants angiography was performed for investigation of cardiovascular anomalies. The resulting pyelograms were studied retrospectively and in 22 patients (20.5”;) malformations of the urinary tract, mainly duplications and dilatations of calyces and renal pelvis were detected. In contrast to pathological reports, these studies revealed a high incidence of renal malformations in children with congenital heart diseases. This can be explained embryologically as both organ systems develop at the same time. The coincidence of cardiac and renal malformations is well known to exist in a number of syndromes.-G. BrandeskJ Open-heart Months
of
Surgery
During
the
First
Three
Life.
A. R. Costonedo, J. Lomberfi, R. M. Sode, R. G. Williams, and A. S. Nodos. J. Thorac. Cordiovasc. Surg. 68, 719-731 (November), 1974. Twenty-eight patients less than 3 mo of age underwent open intracardiac corrective procedures at the Boston Children’s Medical Center. Deep hypothermia. surface cooling, limited cardiopulmonary bypass, and circulatory arrest were used. There were six deaths (21.5”,). There were no deaths in 12 patients with transposition of the great arteries or in the six patients with tetralogy of Fallot. There were three deaths in the nine patients with ventricular septal defect.