The creation and repair of diaphragmatic hernia in fetal lambs: morphology of the type II alveolar cell.

A model for creating and repairing diaphragmatic hernia in fetal lambs has been developed. Morphometric studies of the type II alveolar cells were carried out in three groups of term lambs. The upper lobes only were sampled.

Anorectal manometry for the exclusion of Hirschsprung's disease in neonates.

We studied the usefulness of anorectal manometry in excluding Hirschsprung's disease in 25 neonates with signs and symptoms of intestinal obstruction. An intraluminal pressure transducer or perfused side-opening catheters were used to evaluate anal tone, anal rhythmicity, and internal sphincter relaxation during rectal distention. Hirschsprung's disease was diagnosed by rectal biopsy in 16% of the neonates.

The effect of chick embryo hyperflexion on tracheoesophageal development.

Chick embryos were hyperflexed by placement of a ligature at two critical stages in the development of the foregut, in order to test the theory that esophageal atresia and tracheoesophageal fistula result from embryonic hyperflexion. Only one "H-type" tracheoesophageal fistula was found. There were no significant disturbances of either tracheal or esophageal growth.

Creation and repair of diaphragmatic hernia in the fetal lamb: lung development and morphology.

Left-sided diaphragmatic hernias were created in 26 lambs at about 78 days' gestation and repaired at 106 to 124 days' gestation. Nine of these lambs were delivered at term and lived much longer than the nonrepaired lambs delivered at term. The normal development of the fetal lamb lung is compared and contrasted with the development of the lung after creation of a diaphragmatic hernia and also with the changes in morphology resulting from in-utero repair.

Creation and repair of diaphragmatic hernia in the fetal lamb: techniques and survival.

Diaphragmatic hernias were created in 54 fetal lambs at 72 to 82 days gestation via a left thoracotomy. The diaphragmatic hernia was repaired in 30 lambs at 106 to 123 days gestation, and 14 of these lambs subsequently aborted. The majority of those surviving to term were delivered for survival.

Glucose-6-phosphatase as a marker for tumors of liver and kidney origin.

Glucose-6-phosphatase is primarily a liver and kidney enzyme. This enzyme was studied in various tumors, however, glucose-6-phosphatase activity was found only in tumors of liver, kidney, or adrenal origin. Glucose-6-phosphatase activity was useful in identifying the tissue origin of extrarenal Wilms'.

Cholelithiasis in childhood and adolescence. A review.

Cholelithiasis and cholecystitis are uncommon in childhood and adolescence. Misconceptions as to the aetiology, natural history, diagnosis, and therapy of these conditions prompted us to review our experience. Nineteen patients ranging in age from 7 to 18 years underwent cholecystectomy for gallstones at the University of Illinois Hospital, Chicago, between June 1970 and June 1979.

Partial splenic embolization in the management of thalassemia major.

Six patients with beta-thalassemia major underwent partial splenic embolization as an alternative to splenectomy. One patient required 2 embolizations. All 6 patients showed a marked reduction in transfusion requirements.

Aortic thrombosis after umbilical artery catheterization.

Neonatal arterial thrombosis has become more common with the use of umbilical artery catheters; however, catheter-induced aortic thrombosis is rare. A review of the literature disclosed a 100% mortality from medically managed neonatal aortic thrombosis. Two cases of umbilical artery catheterinduced acute neonatal thrombosis were managed successfully by surgical thrombectomy.

The role of imaging modalities in diagnosis and management of pyomyositis.

A case of tropical pyomyositis in a temperate climate is reported and 29 more cases are reviewed from the literature. Because of its rarity and deceiving clinical presentation, the disorder may go unrecognized for weeks in nontropical regions. The role of various imaging modalities in timely and accurate diagnosis and nonsurgical management of this disorder is discussed.

Sequestration of ureteric segments in dogs.

In 2 separate series of dogs a segment of ureter was isolated from both bladder and kidney and left in situ with an intact blood supply. Tense cysts formed in these sequestered segments regardless of whether the ends were occluded or the segments were split longitudinally and left open. The formation of these cysts can be prevented by the removal of the urothelium.

Preoperative and postoperative care of the pediatric surgical patient.

The preoperative and postoperative care of the pediatric surgical patient is considered under the headings of elective surgery, urgent surgery, surgery for trauma, and other emergency surgery. The specialized care of the neonatal surgical patient is not discussed. The approach outlined is the personal approach of the authors.

Immunologic response in splenectomized and partially splenectomized rats.

One of the following procedures was carried out in 112, 200-gr, Sprague-Dawley rats: (A) sham operation, (B) hemisplenectomy, (C) 90% splenectomy, (D) total splenectomy and autologous spleen transplants in either omental, muscle, or subcutaneous pouch after total splenectomy, and (E) homologous splenic transplants after splenectomy. The rats were challenged intravenously with sheep, cat and guinea pig erythrocytes 6 wk, 3 mo, and 6 mo postoperative. All totally splenectomized rats had significantly reduced primary responses, regardless of whether fragments of splenic tissue had been grafted or not.

Splenic embolization.

While transcatheter embolization of the spleen has shown promise in the treatment of a wide spectrum of disorders, the incidence of serious complications with this technique has limited its use as an alternative to operative splenectomy. In our institution 41 patients were treated with a modified technique involving partial splenic embolization, careful antibiotic prophylaxis, and adequate pain control. There was no mortality and only few instances of clinically significant complications: a splenic abscess in one patient, pancreatitis in one patient, severe pleural effusions in two patients, and pneumonia in five patients.

Antibiotic sensitivity in hand infections.

A survey of patients presenting for primary treatment of infected lesions on their hands was carried out. Eight-nine lesions were cultured from which 116 organisms were isolated. The main organisms were coagulase-positive staphylococci.