Congenital diaphragmatic hernia in older children.
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Biomedical subjects
Publications and source records attributed to V M Wright.
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131I macro-aggregated albumin perfusion scanning and conventional radiography were used to study the lungs of 108 men who had been exposed to asbestos dust. The presence or absence of basal crackles was recorded in all cases. Forced vital capacity (FVC) was measured in 94 cases. Underperfusion of the lower zones of the lungs was considered to be present in only 8 of 39 cases with small irregular opacities classified as category 1/0 or higher on the 1971 International Labour Organization classification for pneumoconiosis. In 5 of 69 cases classified in categories less than 1/0, perfusion in the lower zones appeared to be impaired. Details of these cases are given. Underperfusion was more common among men with basal crackles or reduced FVC (less than 80% of predicted value) but this trend was not statistically significant.
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A retrospective study of 76 infants with small bowel atresia treated in two neonatal surgical units between 1970 and 1979 is presented. The overall survival rate was 75% and there was no significant difference between the two centres. The mortality rose according to the number of atresias and the distance of the first atresia from the ileo-caecal valve. The 19 deaths were classified as inevitable or avoidable. Of the latter group, 5 out of 14 deaths were due to neonatal necrotising enterocolitis, and the remainder to respiratory problems associated with prematurity or to surgical complications producing peritonitis and septicaemia.
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The use of a plastic sump catheter for continuous suction of the blind upper pouch in esophageal atresia has been widely accepted since the method was first described. The following case illustrates a complication which resulted from the use of such a catheter, namely, perforation of the upper pouch.
We describe a familial case of Marfan's syndrome with associated intrathoracic stomach detected during the neonatal period. The patient developed a primitive leukemia at 3 months of age. Acute leukemia in a patient with Marfan's syndrome has not previously been reported.
A brother and sister of first cousin Pakistani parents presented with recurrent mouth ulcers and chronic diarrhoea in the neonatal period. Diarrhoea persisted in spite of treatment with oral prednisolone and sulphasalazine. Both children required subtotal colectomy with ileostomy. Histopathology of the resected colons was virtually identical and showed multiple deep "flask"-shaped ulcers, often penetrating to the serosa, in the presence of chronic inflammation, but without any of the characteristic histological features of Crohn's disease. The appearance closely resembled the colitis of Beh,cet's syndrome. Both children (aged 6 and 3.5 years, respectively) have continued to have recurrent perianal disease with intermittent bloody diarrhoea since the operation. Apart from the initial symptoms of oral aphthous ulcerations in both children, no other major criteria have developed so far. Intestinal Behçet's syndrome should be considered in the differential diagnosis of chronic inflammatory bowel disease in childhood.
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