Abstract：
BACKGROUND/PURPOSE:Asphyxiating thoracic dystrophy (ATD) can occur years after a Ravitch-type repair of pectus excavatum, resulting in debilitating alteration in pulmonary function (PFT). An operation was devised to attempt repair of this deformity. METHODS:After institutional review board approval, the records of 10 children (ages 9-18 years) with ATD that developed 4 to 12 years postpectus operation who underwent attempted repair of ATD were reviewed. Data obtained before ATD operation and at 6, 12, and 24 months afterward included chest computed tomography, pulmonary functions (PFT), and a quality of life questionnaire. The operation consisted of sternal split with rib graft placement to permanently hold the sternum apart. RESULTS:All children survived and the bone grafts healed solidly. Computed tomography showed a change from a flat to a round chest contour on cross section, with increased anteroposterior dimension. Two patients had no change in PFT at 24 months whereas the other 8 had 21% to 30% improvement in PFT parameters. All patients reported improved exercise tolerance, and 3 began sports activities who were previously unable to do so. Two patients on oxygen, essentially bedridden, are now active, breathing only room air. Seven of 10 patients continue to have cosmetic concerns. CONCLUSIONS:A small population of patients who had postoperative pectus repair developed severe, debilitating ATD. The repair described improves most patients, some dramatically, but does not significantly improve cosmetic appearance. The operation is undergoing further refinement to address these issues.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Weber TRdoi
10.1016/j.jpedsurg.2004.09.039subject
Has Abstractpub_date
2005-01-01 00:00:00pages
170-3issue
1eissn
0022-3468issn
1531-5037pii
S0022346804006426journal_volume
40pub_type
杂志文章abstract：PURPOSE:In 1992, the Congress implemented a Medicare payment system based on relative value units (RVUs). Today, RVUs are increasingly used to determine surgeon reimbursement from Medicare, Medicaid, and private third-party payers. We questioned whether current RVU assignments accurately reflect the quantity of time th...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2005.10.044
更新日期：2006-01-01 00:00:00
abstract：:Cytokines are immunoregulatory molecules that are important mediators of the host response to stress and infection. Infants and children undergoing major surgery are particularly at risk of developing sepsis and have altered metabolic responses to surgical stress compared to adults. We have investigated the temporal s...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90553-j
更新日期：1992-08-01 00:00:00
abstract：:The effect of whole bowel irrigation (WBI) with a polyethylene glycol electrolyte lavage solution (PEG-ELS; 27 children) was compared to the WBI with two electrolytic solutions: normal saline with added potassium chloride (NS; 25 children) and Ringer's injection (RI; 29 children). The PEG-ELS required less volume and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(88)80423-8
更新日期：1988-08-01 00:00:00
abstract：:We present an unusual case in which an appendage of the liver was the only herniated organ through a small defect on the left lower quadrant of the abdominal wall. To our knowledge this is the first case reported with this malformation. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80111-3
更新日期：1989-11-01 00:00:00
abstract：:The capacity of fetal and newborn hepatic macrophages to produce cachectin/tumor necrosis factor (TNF) has not been previously examined. The role that TNF plays in newborn infection is also unknown. In the present report, fetal and newborn rat hepatic macrophages have been maintained in short-term tissue culture, and ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80296-9
更新日期：1989-01-01 00:00:00
abstract：:The nutritional and metabolic complications following intestinal resection and ileostomy for necrotizing enterocolitis (NEC) in low birth weight preterm infants often necessitate repeated prolonged hospitalization for salt and water imbalance and reliance on total parentaral nutrition (TPN). The traditional concerns a...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(87)80432-3
更新日期：1987-02-01 00:00:00
abstract：:A 17-year-old boy with insulin-dependent diabetes mellitus developed ketoacidosis and transitory shock. After resolution of his metabolic imbalance, he developed an acute abdomen prompting exploratory surgery. A section of necrotic ileum was found and resected. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90798-c
更新日期：1992-09-01 00:00:00
abstract：PURPOSE:Therapy for biliary atresia (BA) typically involves portoenterostomy (PE). In light of the development of liver transplantation (LT) as an option for therapy in infancy, the authors reviewed their experience to determine factors that might predict the requirement for LT. METHODS:Cases of BA diagnosed between S...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(96)90130-x
更新日期：1996-06-01 00:00:00
abstract：:Primitive neuroectodermal tumors (PNETs) are uncommon, representing approximately 1% of all sarcomas. Pancreatic PNETs have been reported only 12 times in the literature. This report presents the first case of a patient with a PNET exhibiting precocious puberty. The clinical presentation, surgical management, and path...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2006.05.046
更新日期：2006-11-01 00:00:00
abstract：OBJECTIVE:The objective of this study is to assess the safety of fibrinolytic therapy using tissue plasminogen activator (tPA) in children with complex intra-abdominal abscesses. SUMMARY BACKGROUND DATA:Intra-abdominal abscesses are common in children. Antibiotics and percutaneous drainage are the mainstays of treatme...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2011.12.006
更新日期：2012-07-01 00:00:00
abstract：:To determine the extent of progress in the treatment of sacrococcygeal teratomas (SCTs), we evaluated the experience with 73 patients over 40 years. The medical records of the children were reviewed for demographics, histology, clinical course, and outcome. Therapy differed depending on the type of SCT, histology, and...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90563-m
更新日期：1992-08-01 00:00:00
abstract：:We report three additional cases of primary extrarenal Wilms' tumor and review those cases previously documented. Analysis of the location, histopathology, treatment, and survival of these cases supports the following conclusions: Wilms' tumor may occur in an extrarenal location without primary renal involvement and m...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(89)80568-8
更新日期：1989-12-01 00:00:00
abstract：:The authors report an unusual case of Wilms' tumor. The tumor grew transureterally into the urinary bladder, became dislodged, and presented as recurrent urinary infection with retention of urine after the child underwent nephroureterectomy. Such a presentation has not been reported earlier. ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(03)00211-2
更新日期：2003-07-01 00:00:00
abstract：:Infants with gastroschisis (GS) commonly require total parenteral nutrition and prolonged hospitalization because of intestinal dysfunction resulting from dysmotility and/or malabsorption. To investigate prepartum small intestinal (SI) nutrient absorption in GS, a fetal rabbit model was surgically created on gestation...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90570-3
更新日期：1994-03-01 00:00:00
abstract：:Diarrhea is an expected problem following Martin's operation. Its cause is obvious. With medical management, the phase of intolerance to enteral feeding can be bridged. Adaptation is usually reached within 3-6 mo of surgery. This is confirmed by our experience with five patients treated in this manner. In two further ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(83)80265-6
更新日期：1983-02-01 00:00:00
abstract：BACKGROUND:Many chronic liver diseases lead to progressive hepatic fibrosis, a condition that can ultimately result in loss of organ function and severe portal hypertension necessitating hepatic transplantation. Within the last few decades, studies have been conducted to demonstrate the possibility of drug modulation o...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2009.05.020
更新日期：2009-11-01 00:00:00
abstract：BACKGROUND:Management of asymptomatic congenital pulmonary airway malformations remains controversial when addressing the optimal timing of surgical resection. Neonatal resection is advocated by some based on the theory that earlier lobectomy results in greater compensatory lung growth. We examined whether age at lobec...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/j.jpedsurg.2012.01.037
更新日期：2012-05-01 00:00:00
abstract：:Eleven patients have been followed from 1 to 6 yr after diagnosis and treatment during infancy of partially obstructing antral web. Seven had surgical correction, six with web excision and pyloroplasty. Four were treated nonoperatively with antispasmodics and small curd formula. Five of the seven operated infants had ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(80)80006-6
更新日期：1980-04-01 00:00:00
abstract：:To evaluate the long-term function and effective motility of a reversed jejunal segment after extensive small bowel resection, the authors continuously measured postoperative bowel motility during interdigestive and postprandial periods in conscious dogs 6 to 10 months after surgery. The long-term findings were compar...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(94)90110-4
更新日期：1994-10-01 00:00:00
abstract：BACKGROUND:Sacrococcygeal tumors (SCT) are relatively uncommon tumors affecting neonates, infants and children. The aim of this article is to clarify any special characterizations in natural history, clinical presentation and outcome of such tumors treated at South Egypt Cancer Institute, the only research center locat...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.04.015
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Patients with repaired esophageal atresia often show persistent motility disorders of the esophagus. METHODS:In this study, the authors used a newly developed method, videomanometry, to study intraluminal pressures and function of the pharynx and upper esophagus in such a group of patients and compared the ...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0022-3468(98)90154-3
更新日期：1998-08-01 00:00:00
abstract：:Calcified caval thrombus should be considered in any infant or child where calcifications are noted in the high right retroperitoneal area on plain x-rays of the abdomen. Although typically bullet-shaped in configuration, the calcium distribution in the neonate may be atypical or incompletely developed, suggesting neu...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80471-0
更新日期：1978-08-01 00:00:00
abstract：:In August 1996, a 7-year-old boy was crushed from behind into the steering wheel of a go-cart, suffering a tear of his right innominate artery into the aortic arch, a 2-inch tear of the posterior trachea into left main bronchus, and 2 4-inch tears in the esophagus. These were all repaired on cardiopulmonary bypass thr...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1053/jpsu.2002.29451
更新日期：2002-01-01 00:00:00
abstract：:The aims of this experiment were: (1) to establish a reovirus type 3-induced murine model of biliary atresia/neonatal hepatitis that as far as possible corresponds to the human disease; (2) to demonstrate that the disease is histologically similar to the human disease, and to investigate the natural history of reoviru...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/0022-3468(92)90380-p
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Primary hyperparathyroidism (PHPT) is uncommon in children. The surgical management of PHPT in children has evolved over the past two decades. METHODS:A retrospective study of patients who underwent parathyroidectomy for PHPT diagnosed at age < 18 years and managed at a tertiary referral center for endocrin...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2013.11.059
更新日期：2014-04-01 00:00:00
abstract：:Anomalies of the biliary system are rare. Anomalies of the gallbladder and anomalies of the bile ducts are distinguished. We observed a newborn with a gallbladder in an extraabdominal malposition, an anomaly that has not been previously described. Ultrasonography revealed a cystic structure with a ductlike connection ...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2008.07.016
更新日期：2008-11-01 00:00:00
abstract：:Serum gastrin determinations were performed in 32 normal-term infants to determine the level of this hormone in normal infants at birth and its response to normal feeding. Significant differences were noted between newborn cord blood and maternal blood at birth. Further significant elevations in fasting serum gastrins...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(78)80204-8
更新日期：1978-02-01 00:00:00
abstract：:A prospective, randomized, double-blind clinical trial was undertaken comparing gentamicin, ampicillin, and clindamycin (GAC) to gentamicin, ampicillin, and placebo (GAP) in children with complicated appendicitis. Of the 64 patients enrolled in this study, 33 were assigned to the GAC group and 31 received GAP. A singl...
journal_title：Journal of pediatric surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0022-3468(83)80051-7
更新日期：1983-12-01 00:00:00
abstract：PURPOSE:Temporary tracheal occlusion induces lung growth in congenital diaphragmatic hernia (CDH) but has significant drawbacks because the device must be removed in utero. We devised a gel plug (GP) that can be placed in the fetal trachea in a rabbit model of CDH to provide temporary tracheal occlusion and evaluated i...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/j.jpedsurg.2012.03.005
更新日期：2012-06-01 00:00:00
abstract：:Intracranial pressure (ICP) monitoring is an important adjunct in the management of the severely injured child with major head trauma. From a series of 18 patients with multiple trauma, smoke inhalation, and near-drowning, we report an illustrative case of head injury and pulmonary aspiration in which ICP monitoring w...
journal_title：Journal of pediatric surgery
pub_type： 杂志文章
doi：10.1016/s0022-3468(80)80769-x
更新日期：1980-08-01 00:00:00
