Fluorescein angiography in retrolental fibroplasia: experience from 1969-1977

Acute proliferative retrolental fibroplasia (RLF) has been studied in premature infants employing a Zeiss fundus camera and fluorescein angiography. A total of 164 angiograms have been performed on 122 infants. At the present time, angiography is reserved for studying infants with peculiar or puzzling fundus pictures. A dose of 0.1-0.4 cc of 10% sodium fluoresceinate is employed, depending on the age and the weight of the baby. Fluorescein clearly outlines the major arteriovenous shunt in the retina, which is the hallmark of acute RLF. The shunt fills with fluorescein and leaks it profusely. On regression, a fine brush border of capillaries is seen in the region where the shunt previously had been located. Study of the population susceptible to RLF reveals it to be the smallest sickest babies in the premature nursery.     

Chylothorax after Myocardial Revascularization with Internal Mammary Graft

Chylothorax following an intrapericardial cardiac operation is rare, and we are aware of only 12 reported cases. Nine followed median sternotomy for treatment of congenital heart disorders or acquired valvular disease; more than expected were reoperations (23%). This report documents that this complication may also occur following myocardial revascularization with internal mammary graft and describes the anatomy that makes this possible. This rare complication is important because of the high morbidity of prolonged tube drainage and the fact that nearly half of the affected patients underwent reoperation (5 of 13). Dilated lymphatics exuding chyle have been found at operations undertaken to control lymph fistulas and were located in anterior thymic tissue previously divided by electrocautery. Awareness of the significance of lymph encountered during cardiac operations, particularly during reoperation and near the origin of the internal mammary artery, may alert the surgeon that the stage is set for a disabling complication. Electrocautery may be an unreliable means of control as lymph contains little coagulable material; suture is recommended instead.     

Self-concept and body-image of children during physical illness

The authors explored children's understanding of their physical illnesses and their effects on body-image and self-concept. A majority of 19 hospitalized boys of latency age realistically understood the nature of their illness and their treatment when health care personnel provided them with adequate information. Interviews and psychological tests showed that acute physical illness did not have a significant impact on general self-concept but did alter body-image in 37% of the children during the period of acute illness.     

Knowledge,attitudes, and behavior: Correlates of health in childhood diabetes

Childhood diabetes is a life-long chronic illness placing complex and daily demands on the patient and family. Although the role of psychological factors in diabetes has long been recognized, only recently have investigators begun to systematically explore the relationship between parent and child knowledge about diabetes, attitudes toward diabetes, compliance or adherence behaviors, and health status. The available literature is limited, but supportive of further inquiry of this type. Suggestions for future research include: (1) The use and development of psychometrically adequate measures; (2) The use of independent methods of measurement; (3) The development of highly specific measures; (4) The delineation of clear a priori models specifying the nature of relationships between variables; (5) Greater consideration for the effect of psychological variables on patients' health as well as the impact of health status on patients' knowledge, feelings, and behavior; (6) Increased attention to the child's cognitive developmental level and social roles as these relate to daily management tasks and health status; and, (7) Methods for improving the effectiveness of patient intervention programs.