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Total parenteral feeding in infants using peripheral veins
ABSTRACTS
276
Anterior Angulation Deformity of the Radial Head.. . . . . . . . . . . . . . Subtrochanteric Fractures of the Femur.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Chondromalacia Patellae . . . . . . . . . . Study of the “Capsular” Shadow in Disorders of the Hip . . . . . . . . . . Legg-Perthes’ Disease . . . . . . . . . . . . . Acetabuloplasty in the Treatment of Congenital Dislocation of the Hip.. . . . _.. . . . . _._.. . . . . . . . . . . . . Surgical Prophylaxis of Subluxation and Dislocation of the Hip in Cerebral Palsy . . . . . . . . . . . . . . . . . External Rotation Contracture of the Extended Hip . . . . . . . . . . . . . . . . Tuberculosis of the Hip . . . . . . . . . . . .
GENERAL Metabolic
ing
Changes
Surgical
281 28 1 282 282
282
in Newborn
Operations.
Plasma
Free
Nitrogen,
Plasma Amino
Nitrogen.
A. Pint&. Acta
I.
Infants Blood
Fatty
Acid Ratio, Paediotr
Osteosarcoma
282 283
Followof
Amino
and Urea
Acod
Sci Hung
1975.
In 29 newborn infants subjected to surgery for congenital anomalies, the blood glucose. free fatty acid (FFA). amino acid. amino nitrogen. and blood urea levels were estimated for a period from the first to seventh postoperative day. The blood glucose level showed moderate changes in the postoperative period. while the FFA decreased significantly. The combined concentration of nonessential amino acids (glycine + glutamine + serine + taurine) and that of essential amino acids (leucine + isoleucone + valine + methionine). their quotient (Whitehead’s ratio), as well as the amino nitrogen level indicated dynamic changes in the postoperative period. The gradual return of the blood urea to the preoperative level is explained by the diminished breakdown excretory function of the kidney following surgical procedures.-A. Pintir Metabolic
Changes
ing Surgical of Whole
in Newborn
Opemtions.
II.
Infants
Follow-
Acid-base
Status
Blood and Erythrocytes,
283 283
283
283 284
Neoplasms
Abdominal, Embryonic
. . . . . . . . . . . . . . . . . . . . . . . 284
Pelvic and Sarcomas..
and Electrolytes.
Levels
Acids,
Infantile Idiopathic Scoliosis . . . . . . Familial Scoliosis . . . . . . . . . . . . . . . . . . Combined Stage Anterior and Posterior Correction and Fusion of the Spine in Scoliosis, Following Poliomyelitis ......... Stabilization of the Spine in the Surgical Treatment of Severe Spinal Tuberculosis in Children . Battered Spinal Lesions in Babies. _. ..____.....................
282
CONSIDERATIONS
Glucose,
16:171-180,
28 1
Blood lactate
Sci Hung l&181-188,
A. Pint&.
Perineal . _._.. . . . . 284
Acta Poediatr
Acad
1975.
In 29 newborn infants subjected to surgery for congenital anomalies, the extracellular and intracellular acid-base state, and the sodium, potassium, and plasma lactate levels were estimated for a period from the second to the seventh postoperative day. During anaesthesia and surgery metabolic acidosis developed but improved spontaneously by the end of the first postoperative day. The metabolic acidosis gradually developing during the postoperative phase was probably due to hypoalimentation. The plasma lactate level decreased in the first days, then it increased slightly; the level showed no statistically significant correlation with the acid-base equilibrium. In the postoperative period the sodium level decreased gradually in the plasma while in the erythrocytes it remained relatively constant. The diminished plasma sodium/potassium ratio was mainly the result of the decreased plasma sodium concentration.--d. Pi&r Feeding in Infants Using PeVeins. P. Puri, E. I. Guiney, and 8. O’Don-
Total Parenteral
ripheml
nell. Arch Dis Child 50:133 (February), 1975.
The technique and results of intravenous feeding of II neonates and four infants for periods of IO-54 days are reported. Vamin,
ABSTRACTS
277
Intralipid, and 10% Dextrose with the addition of calcium, potassium, magnesium, and multivitamins were infused into peripheral veins. The total volume given was 137 ml/Kg/24 hr supplying 97 calories/Kg/24 hr. Two infants died. One infant born with multiple small bowel atresias died of peritonitis due to anastomotic leak while having intravenous feeding; the other death occurred from bronchopneumonia after cessation of intravenous feeding. The remaining I3 patients responded well. The authors report there was no thrombophlebitis observed although they record that frequent changes in drip sites were necessary to ensure adequate flow of the infused solutions.--D.G. Young INTEGUMENT CONNECTIVE Extra
Abdominal
Syndrome.
AND TISSUE
Manifestation
N. W. kale,
of
Gardner’s
K. Pickrell, and G. W.
Quinn. 56:92-96 (July), 1975. The Gardner’s Syndrome consisting of a triad of intestinal polyposis, multiple bony osteomas, and multiple soft tissue tumors or cyst has been well known since its early report in 1950. To this syndrome has been added desmoid-like tumors of the abdominal wall and retroperitoneal areas as well as abnormal dentition. This report deals with the surgical management of the extra abdominal clinical manifestations of the syndrome. The specific management of a case in a white female with Gardner’s Syndrome is detailed. The patient presented has been followed from age 3 to 18. The report discusses the occurance and location of the extra intestinal tumors. In addition, a dominant mode of inheritance of this condition is suggested. Suggestions are made for the early detection of the Gardner’s Syndrome, especially in the young patient with familial polyposis.--A.B. Sokol The Surgical
Treatment
(Pterygium)
of the Popliteal
M. T. Edgerton.
(September),
of Congenital
Webbing
Area. D. Tuerk and
Plast Reconstr Surg 56:339-344
1975.
Although a review of the literature describing this condition is given, there is a lack of agreement on the proper management of its treatment. The limitation of the successful surgical results are due apparently to heretofore unsuccessful attempts in the elongation of the taut nervous structures. A case report of a Syr-old girl who was born
with multiple congenital anomalies is given in order to describe the surgical management of this condition. She was born with cleft lip and palate and pitting and sinuses of the lower lip. In addition, there were adhesions of the eyelid, external genital anomalies, and defects of the great toes, manifested by cleft and hypoplastic nails. There was a bilateral popliteal webbing more prominent on the left than on the right, At age five, she underwent a successful elongation and repair of the webbing deformity of the left lower extremity by soft tissue release of the tendons, fibromuscular bands and necessary Z-plasty. Because of the taut sciatic nerve, this was dissected out into its sensory and motor branches and identified exactly by the use of a nerve stimulator. Cable grafts using the sural nerve, partial sacrifice of the intrinsic and sensory branches and cross innervation to the ankle dorsiflexors was accomplished by microsurgical techniques resulting in elongation. This apparently pioneering case is reported and was made possible by the above listed technique and the use of microsurgical anastomatic techniques. Excellent initial results are reported but the authors caution that time and follow-up electromyographic tracings will be done in an etTort to establish a final report.--dnrhony B. Sokol
HEAD
AND
NECK
loss of Columella and Septum From an Unusual Form of Child Abuse. C. 1. Orton. Plast Reconstr Surg 56:345-346 (September), 1975. A review of the literature associates the loss of a columella with accidental trauma and chronic infections such as syphillis, leishmaniasis, and pyogenic infections. Congenital aplasia is a rare occurance. In the adult, loss is usually due to a neoplasm most often squamous cell carcinoma. Only one case in the literature of columella loss has been associated with child abuse trauma to the head and face. A case report consisting of two sibling patients ages six and eight presented with varying degrees columella loss. The etiology of this loss was found to be due to an obsessional neurosis of the mother concerning the children’s nasal hygiene. She consistently cleansed the children’s nasal secretions since infancy, frequently using a bobby pin to scour their noses. This obsessional cleansing resulted in total columellar loss in one with septal involvement and partial loss in the other.
276
Anterior Angulation Deformity of the Radial Head.. . . . . . . . . . . . . . Subtrochanteric Fractures of the Femur.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . Chondromalacia Patellae . . . . . . . . . . Study of the “Capsular” Shadow in Disorders of the Hip . . . . . . . . . . Legg-Perthes’ Disease . . . . . . . . . . . . . Acetabuloplasty in the Treatment of Congenital Dislocation of the Hip.. . . . _.. . . . . _._.. . . . . . . . . . . . . Surgical Prophylaxis of Subluxation and Dislocation of the Hip in Cerebral Palsy . . . . . . . . . . . . . . . . . External Rotation Contracture of the Extended Hip . . . . . . . . . . . . . . . . Tuberculosis of the Hip . . . . . . . . . . . .
GENERAL Metabolic
ing
Changes
Surgical
281 28 1 282 282
282
in Newborn
Operations.
Plasma
Free
Nitrogen,
Plasma Amino
Nitrogen.
A. Pint&. Acta
I.
Infants Blood
Fatty
Acid Ratio, Paediotr
Osteosarcoma
282 283
Followof
Amino
and Urea
Acod
Sci Hung
1975.
In 29 newborn infants subjected to surgery for congenital anomalies, the blood glucose. free fatty acid (FFA). amino acid. amino nitrogen. and blood urea levels were estimated for a period from the first to seventh postoperative day. The blood glucose level showed moderate changes in the postoperative period. while the FFA decreased significantly. The combined concentration of nonessential amino acids (glycine + glutamine + serine + taurine) and that of essential amino acids (leucine + isoleucone + valine + methionine). their quotient (Whitehead’s ratio), as well as the amino nitrogen level indicated dynamic changes in the postoperative period. The gradual return of the blood urea to the preoperative level is explained by the diminished breakdown excretory function of the kidney following surgical procedures.-A. Pintir Metabolic
Changes
ing Surgical of Whole
in Newborn
Opemtions.
II.
Infants
Follow-
Acid-base
Status
Blood and Erythrocytes,
283 283
283
283 284
Neoplasms
Abdominal, Embryonic
. . . . . . . . . . . . . . . . . . . . . . . 284
Pelvic and Sarcomas..
and Electrolytes.
Levels
Acids,
Infantile Idiopathic Scoliosis . . . . . . Familial Scoliosis . . . . . . . . . . . . . . . . . . Combined Stage Anterior and Posterior Correction and Fusion of the Spine in Scoliosis, Following Poliomyelitis ......... Stabilization of the Spine in the Surgical Treatment of Severe Spinal Tuberculosis in Children . Battered Spinal Lesions in Babies. _. ..____.....................
282
CONSIDERATIONS
Glucose,
16:171-180,
28 1
Blood lactate
Sci Hung l&181-188,
A. Pint&.
Perineal . _._.. . . . . 284
Acta Poediatr
Acad
1975.
In 29 newborn infants subjected to surgery for congenital anomalies, the extracellular and intracellular acid-base state, and the sodium, potassium, and plasma lactate levels were estimated for a period from the second to the seventh postoperative day. During anaesthesia and surgery metabolic acidosis developed but improved spontaneously by the end of the first postoperative day. The metabolic acidosis gradually developing during the postoperative phase was probably due to hypoalimentation. The plasma lactate level decreased in the first days, then it increased slightly; the level showed no statistically significant correlation with the acid-base equilibrium. In the postoperative period the sodium level decreased gradually in the plasma while in the erythrocytes it remained relatively constant. The diminished plasma sodium/potassium ratio was mainly the result of the decreased plasma sodium concentration.--d. Pi&r Feeding in Infants Using PeVeins. P. Puri, E. I. Guiney, and 8. O’Don-
Total Parenteral
ripheml
nell. Arch Dis Child 50:133 (February), 1975.
The technique and results of intravenous feeding of II neonates and four infants for periods of IO-54 days are reported. Vamin,
ABSTRACTS
277
Intralipid, and 10% Dextrose with the addition of calcium, potassium, magnesium, and multivitamins were infused into peripheral veins. The total volume given was 137 ml/Kg/24 hr supplying 97 calories/Kg/24 hr. Two infants died. One infant born with multiple small bowel atresias died of peritonitis due to anastomotic leak while having intravenous feeding; the other death occurred from bronchopneumonia after cessation of intravenous feeding. The remaining I3 patients responded well. The authors report there was no thrombophlebitis observed although they record that frequent changes in drip sites were necessary to ensure adequate flow of the infused solutions.--D.G. Young INTEGUMENT CONNECTIVE Extra
Abdominal
Syndrome.
AND TISSUE
Manifestation
N. W. kale,
of
Gardner’s
K. Pickrell, and G. W.
Quinn. 56:92-96 (July), 1975. The Gardner’s Syndrome consisting of a triad of intestinal polyposis, multiple bony osteomas, and multiple soft tissue tumors or cyst has been well known since its early report in 1950. To this syndrome has been added desmoid-like tumors of the abdominal wall and retroperitoneal areas as well as abnormal dentition. This report deals with the surgical management of the extra abdominal clinical manifestations of the syndrome. The specific management of a case in a white female with Gardner’s Syndrome is detailed. The patient presented has been followed from age 3 to 18. The report discusses the occurance and location of the extra intestinal tumors. In addition, a dominant mode of inheritance of this condition is suggested. Suggestions are made for the early detection of the Gardner’s Syndrome, especially in the young patient with familial polyposis.--A.B. Sokol The Surgical
Treatment
(Pterygium)
of the Popliteal
M. T. Edgerton.
(September),
of Congenital
Webbing
Area. D. Tuerk and
Plast Reconstr Surg 56:339-344
1975.
Although a review of the literature describing this condition is given, there is a lack of agreement on the proper management of its treatment. The limitation of the successful surgical results are due apparently to heretofore unsuccessful attempts in the elongation of the taut nervous structures. A case report of a Syr-old girl who was born
with multiple congenital anomalies is given in order to describe the surgical management of this condition. She was born with cleft lip and palate and pitting and sinuses of the lower lip. In addition, there were adhesions of the eyelid, external genital anomalies, and defects of the great toes, manifested by cleft and hypoplastic nails. There was a bilateral popliteal webbing more prominent on the left than on the right, At age five, she underwent a successful elongation and repair of the webbing deformity of the left lower extremity by soft tissue release of the tendons, fibromuscular bands and necessary Z-plasty. Because of the taut sciatic nerve, this was dissected out into its sensory and motor branches and identified exactly by the use of a nerve stimulator. Cable grafts using the sural nerve, partial sacrifice of the intrinsic and sensory branches and cross innervation to the ankle dorsiflexors was accomplished by microsurgical techniques resulting in elongation. This apparently pioneering case is reported and was made possible by the above listed technique and the use of microsurgical anastomatic techniques. Excellent initial results are reported but the authors caution that time and follow-up electromyographic tracings will be done in an etTort to establish a final report.--dnrhony B. Sokol
HEAD
AND
NECK
loss of Columella and Septum From an Unusual Form of Child Abuse. C. 1. Orton. Plast Reconstr Surg 56:345-346 (September), 1975. A review of the literature associates the loss of a columella with accidental trauma and chronic infections such as syphillis, leishmaniasis, and pyogenic infections. Congenital aplasia is a rare occurance. In the adult, loss is usually due to a neoplasm most often squamous cell carcinoma. Only one case in the literature of columella loss has been associated with child abuse trauma to the head and face. A case report consisting of two sibling patients ages six and eight presented with varying degrees columella loss. The etiology of this loss was found to be due to an obsessional neurosis of the mother concerning the children’s nasal hygiene. She consistently cleansed the children’s nasal secretions since infancy, frequently using a bobby pin to scour their noses. This obsessional cleansing resulted in total columellar loss in one with septal involvement and partial loss in the other.