Spontaneous pneumoperitoneum in pediatric patients: A case series.

Introduction: Pneumoperitoneum frequently results in emergent surgery because it typically indicates an abdominal viscus perforation. However, this may not always be the case. There have been few recent reports in the pediatric population that document cases of pneumoperitoneum which could be considered for non-surgical management.

Prenatal diagnosis of a neonate with fetus in fetu.

Fetus in fetu is a rare condition not usually considered in the differential of a neonatal abdominal mass. This article illustrates the importance of prenatal ultrasound in the treatment of this condition as it facilitated the assembly of a multispecialty healthcare team that intervened within days of birth.

Linoleic acid enhances mitogen response and survival of septic weanling rats.

Immunologic responses to various dietary fats and concentrations remain controversial. The authors examined the effect of dietary omega-3 and omega-6 polyunsaturated fatty acids (PUFA) on the immune system of weanling rats. Male weanling Sprague-Dawley rats were fed special liquid diets based on a standard enteral formula: (I) control: 2.

Malignant fibrous histiocytoma arising from the superficial femoral artery.

Primary sarcomatous arterial tumors are rare. We have reported a case of malignant fibrous histiocytoma in an elderly woman successfully treated by resection of the involved femoral vessel and reconstruction with a PTFE graft. The long-term result in this patient is presently uncertain.

Blunt rupture of the heart in a child.

The spectrum of blunt cardiac trauma ranges from injuries with no actual cellular damage (myocardial concussion) to cardiac chamber rupture. Although blunt injuries to the heart are common and potentially lethal, rupture of a cardiac chamber is rare. This injury should be suspected in any patient who presents with cardiac tamponade after blunt trauma.

Wilms' tumor in horseshoe kidney: presentation due to ureteropelvic junction obstruction.

Children with horseshoe kidney usually develop urinary tract symptoms and often require operative correction of the anomaly. The incidence of Wilms' tumor in horseshoe kidney is higher than that for the general population. We present the case of a child whose Wilms' tumor was diagnosed early because of ureteropelvic junction obstruction secondary to a horseshoe kidney.

The effects of an arginine-free enteral diet on wound healing and immune function in the postsurgical rat.

Critically ill patients have increased rates of sepsis partly due to a down-regulated immune system. Nutrients may modulate the immune system. The following studies were performed to determine whether arginine is one of these "essential" nutrients for the immune system.

Low-fat, high-carbohydrate diets improve wound healing and increase protein levels in surgically stressed rats.

The specific effects of omega 3 and omega 6 polyunsaturated fatty acids on wound healing, nutrition status, or immune function are controversial. Therefore, we investigated the effects of fatty acid supplementation on wound healing and nitrogen retention in a surgically stressed rat model. Male Sprague-Dawley rats (weighing 250 g) were placed into three isocaloric, isonitrogenous feeding groups (controls [standard Vivonex]; 30% safflower oil [omega 6]; or 30% fish oil [omega 3]) for 8 days prior to receiving subcutaneous vascular graft wound cylinders in their dorsal midline.

The effects of age and various fat/carbohydrate caloric ratios on nitrogen retention and wound healing in rats.

Recent reports have indicated a possible age-related component to the ability of various species to utilize either fat or carbohydrate as their preferential energy source. These studies have demonstrated that infant rats given a high-fat diet (50% fat, 35% carbohydrate, 15% protein) retain a significantly higher amount of nitrogen than do infant rats on a high-carbohydrate diet (82% carbohydrate, 3% fat, 15% protein). Conversely, adult rats maintain a higher positive nitrogen balance when given the high-carbohydrate diet.

Continuous EGF application impairs long-term collagen accumulation during wound healing in rats.

Continuous topical application of epidermal growth factor (EGF) to granulation tissue has been demonstrated to increase the rate of collagen accumulation in wounds. Studies from this laboratory have indicated that a single topical application of EGF leads to a short period of elevated wound collagen content, followed by a rapid breakdown of this newly acquired collagen. In light of recent clinical trials of EGF as an aid to wound healing, we studied the long-term effects of continuous EGF injection.

Pheochromocytoma and acute myocardial infarction.

When a pheochromocytoma is manifested as an acute myocardial illness, diagnosis may be difficult to make. If the tumor is suspected early enough, a workup can be done while the complications of the myocardial illness are being controlled (as in our case). The tumor can then be expeditiously removed before any further problems develop.

Blunt trauma to the heart: the pathophysiology of injury.

Blunt injuries to the heart are common and potentially lethal. These injuries often go undetected while more obvious problems are treated. A cardiac injury should be suspected in any patient who sustains severe chest trauma.