Perinatal stimulation and adaptation of the neonate

The present report describes psychobiological studies of behavior around the time of birth. An adaptive, ecological perspective is presented in which stimulation of the fetus and newborn is purported to instigate adaptive postpartum behavior. Studies describing the perinatal sensory environment are reviewed, with a consideration of emergent sensory function of the fetus. It is asserted that afferent input associated with parturition perturbs the fetus and neonate, producing a general arousal state that facilitates breathing, suckling, and early learning. The view developed herein is that perinatal sensory input induces and canalizes the newborn's behavior, thereby regulating adaptive postpartum function. Deviations in afferent input may alter ontogenetic trajectories and compromise developmental outcome by reducing availability of conditions necessary for adequate postpartum adaptation.     

Reoperation for aortic coarctation: techniques, results, and indications for various approaches

To define the safety and efficacy of operation for recurrent thoracic aortic coarctation, we reviewed the hospital records and subsequent courses of 53 patients who underwent such procedures over a 23-year period. Previous operations included end-to-end anastomosis, prosthetic patch or subclavian flap aortoplasty, and prosthetic interposition or bypass grafts, performed in patients ranging from 1 day to 44 years old. Several different reoperative procedures were used, including an ascending-descending aortic bypass graft in 4 patients who had had two previous repairs. There were no hospital or late deaths and only 3 relatively minor complications. Only 2 patients have hypertension requiring drug therapy at follow-up, which now averages 7 years. We conclude that operative management of severe, recurrent coarctation is both safe and effective, and that several techniques of reconstruction may have a place in such therapy.     

Effect of therapeutic radiation on peripheral blood lymphocytes in patients with carcinoma of the breast.

Effects of radiation therapy for carcinoma of the breast on responsiveness to mitogens of blood lymphocytes of patients at different clinical stages were analysed. Patients at different clinical stages had comparable numbers and responses of lymphocytes. During therapy the mean lymphocyte numbers decreased to 31 per cent of the pre-treatment value and mean responses to mitogens in whole-blood cultures decreased to 15 to 39 per cent of pre-treatment values. Similar decreases occurred whether or not mastectomy was performed.     

Single (left) superior vena cava draining into the left atrium. Surgical repair

Anomalous drainage of a single left superior vena cava into the left atrium is rare, and correction presents a technical problem. This report describes a patient with absent right superior vena cava, a persistent large left superior vena cava draining to the left atrium, and an intact interatrial septum.Surgical correction was accomplished by removing the entire septum and placing a cloth baffle to cover the orifices of the pulmonary veins and mitral valve, thus partitioning pulmonary venous blood into the left ventricle. This technique of septal excision and replacement is applicable to other complicated anomalies involving the systemic and pulmonary venous channels and their relationship to the two atria.The surgical management of related anomalies of the superior vena cava is also discussed.