Anorexia nervosa and bulimia nervosa in children and adolescents: a review of the past 10 years.

Objective: To critically review the research in juvenile anorexia nervosa and bulimia nervosa over the past 10 years and highlight recent advances in normal development as it pertains to these disorders and their diagnosis, prevention, and treatment.

Method: Computerized search methods were combined with manual searches of the literature. A detailed review of the most salient articles is provided.

BTS 67 582 stimulates insulin secretion from perifused rat pancreatic islets.

The novel antidiabetic agent BTS 67 582 (1,1-dimethyl-2-[2-(4-morpholinophenyl)]guanidine monofumarate) demonstrated a concentration-dependent stimulation of insulin release in perifused rat pancreatic islets. EC50 values of 7.7 microM and 6.

Fontan operation in five hundred consecutive patients: factors influencing early and late outcome.

Objectives: The purpose of this study was to review a large, evolving, single-center experience with the Fontan operation and to determine risk factors influencing early and late outcome.

Methods: The first 500 patients undergoing modifications of the Fontan operation at our institution were identified. Perioperative variables were recorded and a cross-sectional review of survivors was undertaken.

Clinical course and hemodynamic observations after supraannular mitral valve replacement in infants and children.

Objectives: We report the clinical course and unique hemodynamic findings after placement of a supraannular mitral valve prosthesis.

Background: Children with symptomatic mitral valve disease whose annulus is too small for the smallest prosthesis are difficult to manage. One option is valve replacement with a prosthesis positioned entirely within the left atrium (LA).

Apical muscular ventricular septal defects between the left ventricle and the right ventricular infundibulum. Diagnostic and interventional considerations.

Background: Effective transcatheter or surgical closure of apical muscular ventricular septal defects (VSDs) requires accurate delineation of variable and often complex anatomy. These defects have generally been considered as communications between the apexes of both left and right ventricles.

Methods And Results: Among 50 consecutive patients with multiple muscular VSDs referred for transcatheter device closure between October 1987 and April 1993, a subset of 10 patients (aged 7 days to 28 years) with apical muscular VSDs shared a unique set of anatomic characteristics: (1) large and often single opening in the left ventricle; (2) multiple right ventricular openings in the anterior aspect of the apical septum; and (3) separation of the right ventricular apical region into which the VSDs open from the rest of the right ventricular inflow and outflow by prominent muscle bundles.

Transvascular balloon dilation for neonatal critical aortic stenosis: early and midterm results.

Objectives: We evaluated our immediate and midterm (mean 4.3 years) results of balloon dilation of critical valvular aortic stenosis in 33 neonates.

Background: Balloon dilation has been used as an alternative to surgical treatment.

Transcatheter fenestration dilation and/or creation in postoperative Fontan patients.

There are very few therapeutic options for severely symptomatic Fontan patients after spontaneous complete or virtual fenestration closure. Its reopening in 14 such patients led to dramatic hemodynamic improvement in most. The clinical experience with transcatheter fenestration creation and/or dilation in symptomatic Fontan patients is reported demonstrating feasibility, safety, and a novel management option for these patients.

Multipolar endocardial mapping of the right heart using a basket catheter: acute and chronic animal studies.

The development of catheter-based ablative techniques for primary atrial and ventricular arrhythmias is likely to be assisted by improved techniques for systematic endocardial activation sequence mapping. RA mapping using a multielectrode basket catheter has been shown to be feasible with minimal acute toxicity in a prior study. The objectives of the current study are to investigate: (1) the utility of the basket catheter for mapping RV activation; and (2) the evolution of acute endocardial lesions produced by basket catheter use in both the RA and RV over 4-8 weeks time.

Far-field scattering of a non-Gaussian off-axis axisymmetric laser beam by a spherical particle.

Experimental laser beam profiles often deviate somewhat from the ideal Gaussian shape of the axisymmetric TEM(00) laser mode. To take these deviations into account when calculating light scattering of an off-axis beam by a spherical particle, we use our phase-modeling method to approximate the beam-shape coefficients in the partial wave expansion of an experimental laser beam. We then use these beam-shape coefficients to compute the near-forward direction scattering of the off-axis beam by the particle.

Outcome of patients with ectopia cordis and significant intracardiac defects.

Background: Previous reports suggest a poor prognosis for patients with ectopia cordis and significant congenital heart disease.

Methods And Results: To determine the outcome of affected patients in a recent medical and surgical era, we reviewed the clinical course, echocardiograms, catheterization data, and operative reports of all patients with ectopia cordis and significant heart disease encountered at Children's Hospital from 1982 to the present. We identified 13 patients with conotruncal defects and either thoracic (TEC, n = 4) or thoracoabdominal (TAEC, n = 9) ectopia cordis.

Blood clotting in minimally altered whole blood.

The sequences of events regulating thrombin generation during tissue factor-initiated clotting in whole blood at 37 degrees C in which the contact pathway was suppressed with corn trypsin inhibitor are studied using quantitative Western blotting of factor V, prothrombin, platelet factor 4, antithrombin III, and fibrinogen. In addition, fibrinopeptide A (FPA), thrombin-antithrombin III (TAT) complex formation, and prothrombin fragment 1.2 (F1.

Far-field scattering of an axisymmetric laser beam of arbitrary profile by an on-axis spherical particle.

Experimental laser beam profiles often deviate somewhat from the ideal Gaussian shape of the TEM(00) laser mode. In order to take these deviations into account when calculating light scattering, we propose a method for approximating the beam shape coefficients in the partial wave expansion of an experimental laser beam. We then compute scattering by a single dielectric spherical particle placed on the beam's axis using this method and compare our results to laboratory data.

Conversion of modified Fontan procedure to lateral atrial tunnel cavopulmonary anastomosis.

After modified Fontan procedures with atriopulmonary anastomoses or right atrium-right ventricle conduits, some patients have progressive exercise intolerance, effusions, arrhythmias, or protein-losing enteropathy. Theoretic advantages of a lateral atrial tunnel cavopulmonary anastomosis and published clinical results suggest that conversion of other Fontan procedures to the lateral atrial tunnel may afford clinical improvement for some patients. Eight patients (8 to 25 years old) with tricuspid atresia (n =4), double-inlet left ventricle (n = 3), and double-outlet right ventricle (n=1) underwent conversion to a lateral tunnel procedure between December 1990 and November 1994.

Tetralogy of Fallot with diminutive pulmonary arteries: preoperative pulmonary valve dilation and transcatheter rehabilitation of pulmonary arteries.

Objectives: This study sought to determine the results of a novel transcatheter management approach in tetralogy of Fallot with diminutive pulmonary arteries.

Background: Tetralogy of Fallot with diminutive pulmonary arteries and severe pulmonary stenosis is rare and resembles tetralogy of Fallot with pulmonary atresia: There is a high incidence of aortopulmonary collateral channels, arborization abnormalities, stenoses and need for multiple operations. Because a combined catheter-surgery approach facilitates repair in these patients, such an approach may benefit those with diminutive pulmonary arteries and pulmonary stenosis.

Isolated peripheral pulmonary artery stenoses in the adult.

Background: Isolated peripheral pulmonary artery stenosis (PPS) in the adult is rare and frequently unsuspected. We review in this article our experience with 12 adult patients with isolated PPS, half of whom had been previously diagnosed with chronic pulmonary thromboembolic disease.

Methods And Results: The presentation, evolution, and management of 12 adults with isolated PPS, 17 to 51 years of age (mean, 36.

Midterm results of balloon dilation of congenital aortic stenosis: predictors of success.

Objectives: We evaluated patient and procedural characteristics that influence the midterm success of balloon dilation of congenital aortic stenosis.

Background: Balloon dilation is a new treatment for congenital aortic stenosis. Factors that influence midterm success are unknown.

Ray scattering by an arbitrarily oriented spheroid. II. Transmission and cross-polarization effects.

Transmission of an arbitrarily polarized plane wave by an arbitrarily oriented spheroid in the short-wavelength limit is considered in the context of ray theory. The transmitted electric field is added to the diffracted plus reflected ray-theory electric field that was previously derived to obtain an approximation to the far-zone scattered intensity in the forward hemisphere. Two different types of cross-polarization effects are found.

Ray scattering by an arbitrarily oriented spheroid. I. Diffraction and specular reflection.

Diffraction and reflection of an arbitrarily polarized plane wave by an arbitrarily oriented spheroid in the short-wavelength limit are considered in the context of ray theory. A closed-form solution for both diffraction and reflection is obtained, and the polarization character of the diffracted plus reflected electric field is obtained. It is found that the magnitude of the reflected electric field is multivalued for forward scattering.

Prolongation of RV-PA conduit life span by percutaneous stent implantation. Intermediate-term results.

Background: Right ventricle-to-pulmonary artery (RV-PA) homografts and bioprosthetic conduits are commonly used to palliate various types of complex congenital heart disease. These conduits frequently develop progressive obstruction and require surgical replacement. This report reviews our experience implanting balloon-expandable stents to relieve conduit obstruction and delay reoperation.

Orthodeoxia-platypnea due to intracardiac shunting--relief with transcatheter double umbrella closure.

The safety and efficacy of transcatheter clamshell occlusion of patent foramen ovale for relief of severe arterial desaturation and dyspnea in the upright position due to intracardiac shunting were examined in eight patients with excessive risk of surgical patent foramen ovale closure. All patients had successful reduction of intracardiac shunting with an immediate rise in oxygen saturation > or = 95% by implantation of a clamshell device on the atrial septum. Despite two early incidents of device embolization, retrieval and immediate re-implantation, and one patient with nonsustained atrial and ventricular arrhythmias, there were no adverse clinical sequelae.