Surgical strategies in very-low-birthweight neonates with necrotizing enterocolitis

Very-low-birthweight (VLBW) neonates are more prone to complications and death than term infants are. In a 15-year period, 19 neonates with VLBW were operated on for necrotizing enterocolitis (NEC). Indications for operation were pneumoperitoneum in 12 and deterioration of general condition in 7. Bowel resection and intestinal diversion was performed in 12, a lateral enterostomy at the site of perforation was created in 5, and 2 neonates with necrosis of the whole bowel underwent an exploratory laparotomy without any further surgical treatment. Surgical complications were found in one-third of the patients. The mortality rate was significantly higher when the ileum was affected. The survival rate was 68%. Prior to 1984 the survival rate was 37% (3/8); subsequently, it has improved to 91% (10/11) as a result of improved intensive therapy.     

Electrophysiological correlates of selective attention: modality specific changes in thalamocortical evoked potentials

At a moment when dogs were anticipating the presentation of a visual stimulus which would predict the delivery of food, the second of a pair of thalamocortical evoked potentials (30 msec interstimulus interval) in the visual system decreased in amplitude relative to control periods whereas similar measures in the auditory system increased. Opposite effects were obtained in dogs anticipating an auditory stimulus. These data were interpreted as reflecting selective changes in sensory channels during selective attention.     

Use of nitrogen-specific detector for GLC determination of plasma bucainide.

A sensitive and specific GLC determination of plasma bucainide was developed using a nitrogen-specific detector. The method permits the determination of bucainide as low as 5.0 ng/ml of plasma and provides sufficient sensitivity and reproducibility for clinical use.     

Epidemiological features and control of an outbreak of scarlet fever in a Perth primary school

Scarlet fever was associated with feared outbreaks and mortality in the 19th Century. It occurs sporadically in modern society and infection is readily treated with antibiotics. We report on a scarlet fever outbreak in children attending a primary school in Perth, Western Australia, in late 2003. A total of 13 cases were identified over a five week period. Six of the cases were pre-primary children (ages 4 to 5) from the same class of 26 children (attack rate 23.1%). Three of the remaining seven cases were older siblings of pre-primary cases who developed scarlet fever after their younger siblings. Screening of the children and teachers from the two pre-primary classes at the school yielded 12 positive pharyngeal swabs for group A Streptococcus. Emm-typing of the screening isolates indicated that a common strain was circulating within the outbreak pre-primary class, with four of six isolates identified as emm-type 3. The overall group A Streptococcus carriage rate in screened students in this class was 31.6 per cent and the carriage rate for emm-type 3 was 21.1 per cent. Carriers were treated with oral penicillin V to eradicate carriage and control the outbreak. No further cases of scarlet fever were reported after the treatment of pharyngeal carriers. Outbreaks of scarlet fever still occur in young children and identification and treatment of carriers may still be valuable.     

Fibroelastic hamartoma of the aortic valve producing ischemic heart disease Associated pulmonary glomus bodies

A 67 year old woman died suddenly following an 18 month history of periodic attacks suggesting cardiac ischemia. Histopathologic examination showed the presence of a pedunculated aortic valvular hamartoma and plexiform vascular structures of the lungs. It is suggested that the former were responsible for the clinical attacks and sudden death by completely obstructing the orifice of the right coronary artery. The pulmonary lesions resulted in some right ventricular hypertrophy and possibly contributed to the unusual clinical features.