Increased risk of perioperative hemorrhage has been described in patients with Turner syndrome and coarctation of the aorta. We have operated on 11 patients with Turner syndrome and coarctation of the aorta, two of whom developed bleeding. One patient died. End-to-end anastomosis was performed in all patients. Histologic studies of resected specimens did not reveal any abnormalities. The risk of bleeding was not related to age at the time of repair or postoperative hypertension. Although no specific abnormality has been identified in these patients, the risk of serious hemorrhage appears increased.

Aortic Coarctation↗

PubMedDate not supplied

Temporal bone pathology in drowning.

The temporal bones of a 2-year-old child who had drowned were examined histopathologically. The abnormalities were limited to the submucosa and lumen of the tympanomastoid space. Abnormalities included severe edema, vascular congestion, and focal ecchymosis without inflammation in the submucosa and hemorrhage into the tympanomastoid air space. To determine the incidence of tympanomastoid hemorrhage in autopsy material, 258 temporal bones were reviewed, and 11 were found to have free blood in the tympanomastoid space. When specimens from victims of skull fractures, cerebrovascular accidents, and leukemia were excluded from the 11, the only specimen remaining was found to be that from a drowning victim. Tympanomastoid hemorrhage in the absence of otitis media, head trauma, cerebrovascular accident, or a bleeding diathesis appears to be strong supporting evidence for death by drowning.

Child, Preschool↗

PubMedDate not supplied

15-Deoxyspergualin and primate heart transplantation.

15-Deoxyspergualin is a synthetic polyamine that exhibits a novel spectrum of immunosuppressive activity in lower mammals. To define the clinical potential of this drug, we performed 25 abdominal heterotopic heart transplants in Macaca fasicularis. Donor and recipient pairs were selected from ABO-identical animals with negative erythrocyte crossmatches. All recipients received one dose of methylprednisolone sodium succinate at graft reperfusion. Five control recipients received no subsequent immunosuppression. Five recipients received high-dose 15-deoxyspergualin (7.5 mg/kg IM). Five recipients received low-dose 15-deoxyspergualin (2.0 mg/kg IM). Five recipients received cyclosporine (1.0 mg/kg IM). Five recipients received both 15-deoxyspergualin (2.0 mg/kg IM) and cyclosporine (1.0 mg/kg IM). Immunosuppressive agents were administered daily, beginning with the morning of operation, and were continued until the animal was killed or 30 days had elapsed. Graft function was assessed by daily palpation. Median graft survival among control recipients was 9 days (range, 6 to 34 days). At the dose used, cyclosporine alone did not influence either graft survival time (median survival, 13 days; range, 7 to 23 days) or rejection grade. Graft survival and rejection grade among recipients treated with low-dose 15-deoxyspergualin were not different from control recipients or those treated with cyclosporine alone (median survival, 10 days; range, 8 to 39 days). One recipient, killed on postoperative day 8, had an intraadominal abscess. In each of the recipients treated with high-dose 15-deoxyspergualin systemic toxicity developed, and the animal was killed when death appeared imminent, although graft contraction remained vigorous (median survival, 28 days; range 25 to 30 days).(ABSTRACT TRUNCATED AT 250 WORDS)

Alopecia↗

PubMedDate not supplied

Decade of change. Growth of the Federal Government's program to hire the handicapped.

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Persons with Disabilities↗