Osteoinductive Activity of Selected Demineralized Bone Matrix Products from Donors of Different Ages.

Background: Despite previous confirmation of osteoinductive potential of demineralized bone matrix (DBM) by other researchers, there is not yet any evidence of studies showing the osteoinductive activity of DBM products from South Africa tissue banks using both in vitro and animal models. This work evaluated the osteoinductivity of DBM both in vitro and in vivo.

Method: DBM particles from six donors from the Centre for Tissue Engineering and C2C12 were cultured (5x104) in 24-well plates using DMEM/F-12 medium supplemented with 10% FBS.

Prevalence of coronary artery lesions on the initial echocardiogram in Kawasaki syndrome.

Objectives: To determine whether coronary artery lesions (ectasia and aneurysm) are commonly observed on the initial echocardiogram of patients with acute Kawasaki syndrome, whether coronary artery ectasia and/or aneurysms occur more frequently in patients with incomplete Kawasaki syndrome than in those patients with complete findings, and whether earlier diagnosis and treatment of Kawasaki syndrome are associated with less frequent occurrence of coronary artery ectasia and/or aneurysm.

Design: A retrospective medical record review.

Setting: A tertiary care pediatric hospital.

Effectiveness of pulse oximetry screening for congenital heart disease in asymptomatic newborns.

Objective: To determine the sensitivity, specificity, predictive value, and accuracy of a program of pulse oximetry screening of asymptomatic newborns for critical congenital cardiovascular malformation (CCVM).

Methods: Pulse oximetry was performed on asymptomatic newborns in the well-infant nurseries of 2 hospitals. Cardiac ultrasound was performed on infants with positive screens (saturation 24 hours).

The use of phentolamine in the prevention of dopamine-induced tissue extravasation.

Purpose: The purpose of this study was to determine whether dopamine-induced tissue extravasation injury could be prevented with phentolamine.

Materials And Methods: This was a prospective, randomized, blinded, and controlled animal study. Forty rats were evaluated to document the effects of dopamine compared with normal saline on tissue integrity, whether any tissue damage was concentration or volume dependent, and to determine the minimum concentration of dopamine resulting in tissue injury.

Unique association of a rapidly growing right atrial myxoma in a child with double-outlet right ventricle.

We describe a patient with double-outlet right ventricle in whom a large right atrial myxoma developed over approximately 6 months. This patient represents the first case described of a right atrial myxoma occurring in an unoperated patient with congenital heart disease other than an isolated atrial septal defect. Because the child was followed with serial echocardiograms, we can document the rapid growth of the tumor.

Transcatheter closure of the patient ductus arteriosus in adults using the Gianturco coil.

Background And Hypothesis: Although results of surgical ligation of the patent ductus arteriosus (PDA) in the pediatric age group are excellent, surgical management of the adult with a PDA may be more problematic. The PDA that presents in adulthood may be calcified and friable, rendering simple ligation via a thoracotomy difficult, inadequate, and hazardous. Patch closure of the ductus arteriosus from either the aortic or pulmonary artery orifice using cardiopulmonary bypass or transient aortic cross-clamping is necessary but increases surgical risk.

Additional aortopulmonary collaterals in patients referred for coil occlusion of a patent ductus arteriosus.

Coexisting aortopulmonary collaterals in patients diagnosed with a patent ductus arteriosus (PDA) are rare findings. Percutaneous transcatheter closure of PDA and requisite aortography offer an unique opportunity to identify and treat these systemic arterial anomailes, which would be missed by echocardiographic evaluation alone. The significance of these collaterals is unclear, but it may contribute to left heart dilation from additional left to right shunting in patients with an otherwise isolated small PDA.

Arterial stents in the management of neurofibromatosis and renovascular hypertension in a pediatric patient: case report of a new treatment modality.

A 17-year-old male with neurofibromatosis presented with severe hypertension secondary to an abdominal aortic coarctation and bilateral renal artery stenoses. Despite previous surgical bypass grafts and aggressive medical management, including treatment with diuretics, beta-blocker, calcium channel blocker, angiotensin converting enzyme (ACE) inhibitors, and direct vasodilator agents, severe hypertension persisted. Following intravascular stent placement in the aorta and both renal arteries, blood pressures normalized.

Percutaneous transcatheter coil occlusion of the patent ductus arteriosus aided by the nitinol snare: further observations.

Purpose: To assess the safety and efficacy of the nitinol snare to aid in the delivery of a Gianturco coil in percutaneous occlusion of a patent ductus arteriosus (PDA).

Methods: Seventeen patients (mean age 8.2 years) underwent catheterization and coil occlusion of a PDA (mean minimum diameter 1.

Effect of blood pressure cuffs on neonatal circulation: their potential application to newborns with persistent pulmonary hypertension.

The contribution of vasoactive pharmacologic agents to the care of the infant with primary pulmonary hypertension of the newborn (PPHN) is hampered by their limited ability to act selectively on different vascular beds. In contrast, blood pressure (BP) cuffs decrease flow and increase resistance only in the extremities around which they are applied. They therefore offer a means of increasing systemic vascular resistance without affecting pulmonary vascular resistance, a hemodynamic effect that may be particularly desirable among PPHN patients receiving vasodilators.

Pediatric intrathoracic large airway obstruction: diagnostic and therapeutic considerations.

We describe seven patients who had intrathoracic airway obstruction resulting in severe respiratory distress. The patients were a four month old with bronchial cartilage hypoplasia presenting as congenital lobar emphysema; a one month old with segmental bronchomalacia; a one month old with tracheal bronchus; a two day old and a seven month old with aneurysmal distension of the pulmonary arteries secondary to tetralogy of Fallot, with absent pulmonary valve and atrioventricular canal with pulmonary poststenotic dilatation, respectively; a three year old with double aortic arch forming a vascular ring; and a three month old with tracheomalacia from tracheoesophageal fistula. The patients had various associated congenital defects, and all of them required one or more surgical procedures to repair the defects and relieve the airway obstruction.

Guidelines for long-term management of patients with Kawasaki disease. Report from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association.

Long-term management of patients with Kawasaki disease should be tailored to the degree of coronary arterial involvement. This committee has made recommendations for each risk level about antiplatelet and anticoagulant therapy, physical activity, follow-up assessment by a pediatric cardiologist or primary care physician, and the appropriate diagnostic procedures that may be performed to evaluate cardiac disease. The risk level for a given patient with coronary arterial involvement may change over time because of changes in coronary artery morphology.

Cardiac size and function during adrenocorticotropic hormone-induced systolic systemic hypertension in infants.

The effects of adrenocorticotropic hormone (ACTH) on systolic blood pressure, and echocardiographic indexes of heart size and function were investigated in 14 infants. After 25 days (range 13 to 46) of treatment with ACTH, systolic blood pressure increased from 93 +/- 9 to 118 +/- 20 mm Hg (p < 0.001; mean +/- 1 SD).

Acute myocardial infarction complicating prothrombin complex concentrate therapy in an 8-year-old boy with hemophilia A and factor VIII inhibitor.

Purpose: An 8-year-old boy with mild hemophilia A and inhibitors developed an acute myocardial infarction during treatment with prothrombin complex concentrates.

Conclusions: This rare complication warrants restriction of dosage and length of treatment with these products to the recommended guidelines. It also appears that noninvasive cardiac monitoring of these patients is beneficial.

Second natural history study of congenital heart defects. Ventricular septal defect: echocardiography.

Background: Two-dimensional and Doppler echocardiography can provide structural and hemodynamic information for patients with ventricular septal defects (VSDs). Therefore, two-dimensional and Doppler echocardiographic examinations were performed on patients with VSDs returning for the Second Natural History Study of Congenital Heart Defects.

Methods And Results: Five hundred fifty-six patients with VSDs underwent two-dimensional and Doppler echocardiographic examinations.