Vascular ring: left cervical aortic arch, right descending aorta, and right ligamentum arteriosum.

A rare form of vascular ring is presented consisting of a left cervical aortic arch, a right descending aorta, and a right ligamentum arteriosum in a symptomatic infant. The planning of its surgical interruption was complicated by absence of the left pulmonary artery and hypoplasia of the left lung. This case provides an exception to the surgical axiom that all vascular rings can be divided through the left side of the chest.

A comparative study of the nutritional status, parasitic infections and health of male roadworkers in four areas of Kenya.

The nutritional status, parasitic infections and general health of 801 male roadworkers living in four different areas of Kenya, namely, the highlands, coastal lowlands, Lake Victoria basin and the semiarid north-west, were investigated. Undernutrition was common in all areas but was most marked among men in the semi-arid area. Anaemia was most prevalent in the coastal lowlands where 41% of men had a haemoglobin level less than 13.

Intestinal parasitic infections of men in four regions of rural Kenya.

Faecal samples were obtained from 906 men living in four different regions of rural Kenya: the cool Highlands, the humid coastal lowlands, the equatorial Lake Victoria basin and the arid marginal highlands. The prevalence of intestinal parasitic infections is reported and compared, contrasted and discussed in terms of the typical environmental conditions in each region. Almost 70% of men appeared to be infected with intestinal helminths; hookworm was most common.

Metabolic and thermoregulatory responses to exercise during the human menstrual cycle.

Metabolic and thermoregulatory responses to exercise during the human menstrual cycle. Med. Sci.

Perceived exertion and anaerobic threshold during the menstrual cycle.

Six adult females with normal menstrual cycles (28-31 d in length) volunteered to exercise on a bicycle ergometer on five different days of their menstrual cycles (days 2, 8, 14, 20, and 26; day 1 = onset of menstruation). Each day the subjects exercised at a maximum work load (184.4 W) and at four submaximal exercise intensities (45.

Erythrocyte indices during a competitive marathon.

Three adult male volunteers ran a competitive marathon (42.2 km) during which there was an average ambient air (dry bulb) temperature of 19.4 degree C, with an average ambient water vapor pressure of 9.

Tetracycline pleurodesis during active pulmonary-pleural air leak for prevention of recurrent pneumothorax.

Pleurodesis with a sclerosing agent was attempted in an animal model in which a pneumothorax with an active air leak was created. Adult rabbits had a small left thoracotomy and then a 1-cm controlled cut in the lung surface. Animals served as control, or tetracycline was administered.

Comparison of effects of prostaglandin E1 and nitroprusside on pulmonary vascular resistance in children after open-heart surgery.

Prostaglandin E1 (PGE1) is a vasodilator. Because the drug is metabolized by lung, we postulated a selective effect on pulmonary vasculature. Twenty-six patients aged 3 months to 16 year (mean, 6.

Effect of electrical stimulation on diaphragmatic muscle used to enlarge right ventricle.

The effect of chronic electrical stimulation on muscle mass of pedicled diaphragmatic muscle grafts (DMGs) implanted into the right ventricle was studied in 21 dogs. Nineteen dogs, followed up to 70 days (mean, 34 days), were divided into three groups. In six dogs (control) the DMG was not stimulated.

Subclavian--left coronary artery anastomosis (Meyer operation) for anomalous origin of the left coronary artery from the pulmonary artery.

Six patients, ages 2--76 months, had subclavian--coronary artery anastomosis (the Meyer operation) through a left thoracotomy without cardiopulmonary bypass for anomalous origin of the left coronary artery. Five of the six had congestive heart failure and ischemic abnormalities on the ECG. All six had cardiomegaly by chest x-ray.

Taenia saginata (Cestoda) in western Kenya: the reliability of faecal examinations in diagnosis.

The prevalence of Taenia saginata (Cestoda) among 146 predominantly Pokot tribesmen in western Kenya was studied in an attempt to assess the reliability of detecting infections by faecal examinations. firstly, a single faecal sample was microscopically examined after being processed by a standard ether sedimentation technique. Secondly, all subjects were treated with niclosamide and a purgative and the tapeworms were recovered.

Replacement of ventricular myocardium with diaphragmatic skeletal muscle: short-term studies.

A pedicled diaphragmatic skeletal muscle graft was used to replace a portion of resected right ventricle in 35 dogs. The graft contracted when electrically stimulated directly or via the phrenic nerve before and after insertion. The electrical pacing threshold was lower for phrenic nerve stimulation (0.

External stent for repair of secondary tracheomalacia.

Tracheomalacia was created in anesthetized piglets by submucosal resection of 3 to 5 tracheal cartilages. Measurements of airway pressure and flow showed that expiratory airway resistance is maximal at low lung volumes and is significantly increased by creation of the malacic segment. Cervical flexion increases expiratory airway resistance, whereas hyperextension of the neck reduces resistance toward normal.

Coarctation resection in children with Turner's syndrome: a note of caution.

Eight children were recognized to have Turner's syndrome, among 353 patients over 1 year of age who had undergone surgical treatment for coarctation of the aorta. Of these eight children, three developed a significant perioperative hemorrhage from aortic rupture, resulting in one death and one instance of paraparesis related to a period of prolonged hypotension. In two of the other five patients with Turner's syndrome, a decision was made to perform an angioplasty rather than a resection of the coarctation because of apparent friability of the aortic wall.

The contribution of Ascaris limbricoides to malnutrition in children.

There is a need for more applied and experimental research to determine more precisely the relationships between nutrition, particularly childhood malnutrition, and intestinal parasitic infections, particularly Ascaris infection. Nevertheless, it is clear that in certain communities Ascaris infection is associated with poor growth in malnourished children and that deworming improves growth. Periodic deworming of children using a mass treatment approach may be needed to control soil-transmitted helminths in areas where parasites and protein energy malnutrition are highly prevalent.

The intraaortic baloon pump: an analysis of five years' experience.

During a five-year period, 178 patients had the intraaortic balloon pump (IABP) inserted for circulatory support. The IABP was used most frequently as an adjunct for weaning patients from cardiopulmonary bypass. Seventy-seven of 103 patients (75%) were successfully weaned from cardiopulmonary bypass with the IABP, and 36 of them (35%) ultimately survived hospitalization.

Relationships between Ascaris infection and growth of malnourished preschool children in Kenya.

A longitudinal study in Ascaris-infected and noninfected children was conducted in two Kenyan villages. Anthropometric, clinical, and stool exams were performed three times at 14-week intervals. All children received an anthelmintic drug (levamisole) at the second examination.

Propranolol for prevention of postoperative cardiac arrhythmias: a randomized study.

Two hundred twenty-three patients were randomly selected to receive propranolol, 10 mg orally every 6 hours, or to serve as controls after coronary artery bypass grafting. The study began at the time of discharge from the intensive care unit. Patients were ineligible if they had cardiac arrhythmias while in the intensive care unit, low cardiac output requiring catecholamine support, or bradycardia requiring a pacemaker.

Effects of nitroprusside and dopamine on pulmonary arterial vasculature in children after cardiac surgery.

The hemodynamic effects of nitroprusside and dopamine were studied in 28 children early after intracardiac repair. Children were placed in six groups, five according to their anatomic lesion and one made up of those who had postoperative pulmonary artery hypertension, to evaluate the possible differences in response of the pulmonary arterial vasculature to the drugs. Seven children had repair of an atrial septal defect; six, repair of tetralogy of Fallot; four, repair of ventricular septal defect; five, surgery for pulmonary stenosis; one, closure of a left ventricular to right atrial tunnel; and five, postoperative pulmonary artery hypertension.

Tricuspid valvular incompetence and rupture of the ventricular septum caused by nonpenetrating trauma.

A young adult involved in an automobile accident had tricuspid valvular incompetence and rupture of the ventricular septum owing to blunt trauma. He had a successful repair of the ventricular septal defect and replacement of the tricuspid valve. Tricuspid valvular incompetence owing to nonpenetrating trauma is uncommon.