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[Surgical treatment of suppurative anterior mediastinitis after open heart surgery for congenital defects].

After 466 operations performed by the transsternal access under conditions of artificial blood circulation for congenital heart diseases anterior purulent mediastinitis developed in 78 patients (16,73%). Different methods of treatment were used: open wound method, repeated mediastinotomy, drainage of the retrosternal space and a method of flowing-fractional washing. Postoperative lethality was reduced (to 0) and duration of treatment was shortened (from 80 to 24,5 days).

Anti-Infective Agents↗

Congenital defects in a cohort followed for seven years.

A geographically limited cohort of Finnish children was followed from birth for seven years, and all congenital abnormalities were recorded and classified and special attention was given to the cumulative detection rate, and the time of detection of various defects. Of 3674 pregnancies 135 babies with or without defects were stillborn or died during the neonatal period. The remaining 3539 were followed up to seven years, when the percentage follow-up was 81.7%. Detailed information on 76 malformed livebirths registered in the neonatal period was available in 63 cases (82.9%). The diagnosis was found to be incorrect in 6 cases and additional defects were registered in 7 of these children. Additional congenital abnormalities detected in the follow-up study were divided into three groups: all congenital disorders or abnormalities with prenatal etiology (248 children), all congenital defects (111 of these 248) and structural malformations (31 of these 111). The cumulative detection rates in these groups increased with time and at the end of the study when the children were aged seven were 9.4%, 5.6% and 2.6%, respectively.

Abnormalities, Multiple↗

[Radiological assessment of diaphragmatic function in operated cases of congenital defects of the diaphragm].

An investigation was undertaken in a series of 10 children operated upon for congenital diaphragmatic defects in regard to the value of simple thoracic X-ray pictures for functional assessment of the repaired diaphragm. The radiographs were taken in forced inspiration as well as in forced expiration and indices were calculated for the mobility of the diaphragm and the costophrenic angle. Moreover, an attempt was made to estimate diaphragmatic contraction by comparing the length of the hemidiaphragm during inspiration and during expiration. The obtained results gave sufficient information for routine investigations of diaphragmatic function and compared well with those of radiocinescopy. An impairment of the mobility of the diaphragm and the costophrenic angle was statistically demonstrated in our follow-up series as compared with a control group of healthy children.

Child↗

Congenital defects.

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Congenital Abnormalities↗

Congenital defects of the nervous system of lambs.

Sixty-seven defects of the nervous system of lambs were examined during a 3-year investigation. Thirteen (19.4 percent) were single defects, and 54 (80.6 percent) were associated with defects of other body systems. Twice as many male lambs as females were affected. The various defects were: hydrocephalus 15, spina bifida 9, meningocoele 8, perosomus elumbis 8, cyclopia 6, cerebellar agenesis 3, aprosopia 3, cranium bifidum 3, anencephaly 2, cerebellar fusion 2, meningo-encephalocoele 2, congenital ataxia 2, micrencephaly 2, cerebellar hypoplasia 1, and acrania 1. A number of lambs had more than 1 defect of the nervous system. Congenital defects of the nervous system were found in 1.5 percent of the 4,417 lambs autopsied.

Abnormalities, Multiple↗

Murine cytomegalovirus-induced congenital defects and fetal maldevelopment.

The effects of congenital infection with cytomegalovirus on fetal development were studied by injection of murine cytomegalovirus (MCMV) into the endometrial lumina of mice in the early stages of pregnancy. The mice were later killed, and the sites of embryonic implantation were examined. Litter size was reduced and the incidence of abnormal fetuses was significantly increased among MCMV-infected animals. Morbid, moribund, severely growth-retarded, asynchronously developed, and malformed fetuses were found. Virus was reisolated from infected mothers, placentas, and fetal tissues but not from control animals that had received either heat-inactivated virus or culture medium. The recovered virus was identical to the original virus, as verified by restriction enzyme analysis. MCMV-specific DNA was detected in experimental tissue sections by in situ nucleic-acid hybridization. Seroconversion occurred in infected female mice. Thus, the presence of MCMV in the genital tract at the time of embryonic implantation causes not only embryonic infection but also fetal maldevelopment.

Abnormalities, Multiple↗

Abdominal wall expansion in congenital defects.

A method for expanding the skin, fascia, muscle, and peritoneal layers of the abdominal wall is described, and clinical application is demonstrated in two children with cloacal exstrophy and congenital absence of the lower half of the abdominal wall. This technique provides an innervated composite reconstruction of defects in excess of 50 percent of the abdominal surface and is recommended in large secondary defects where peritonealization has been achieved and in congenital defects that do not lend themselves to standard methods of closure. Cadaver dissection confirms that tissue expanders may be placed with preservation of innervation and blood supply to the abdominal wall.

Abdominal Muscles↗