In the systemic RV as in the normal LV, there was predominant circumferential over longitudinal free wall shortening, opposite from findings in the normal RV. This may represent an adaptive response to the systemic load. Noticeably, however, the systemic RV did not display torsion as found in the normal LV.
This case illustrates that even in progressing, complicated multifocal infantile myofibromatosis (without visceral involvement) the lesions can resolve without antitumour treatment if high quality intensive care is supplemented.
Seven cases of unilateral, spontaneous pneumothorax were found in a retrospective study of 63 patients with osteogenic sarcoma who were admitted to The Norwegian Radium Hospital (NRH) in the period 1970--1977. The relative risk of pneumothorax developing doubled, from 7--14%, after the introduction of chemotherapy for this disease at NRH. This difference was not statistically significant. Pneumothorax developed in two of 18 patients (11%) with lung metastases who never received chemotherapy. Pneumothorax occurred in four of 19 patients (21%) treated with chemotherapy for manifest lung metastases, and in one of eight patients (13%) who received adjuvant chemotherapy, but in whom lung metastases developed later. Pneumothorax did not develop in 79 patients treated with chemotherapy for disseminated testicular cancer, despite the fact that 82% of these patients had manifest lung metastases.
We report our initial experience in three children with percutaneous transvenous closure of significant atrial septal defects. A newly developed one-piece nitinol device is delivered through a long venous sheath of 7 French calibre under fluoroscopic and transoesophageal echocardiographic monitoring. Complete closure of all defects was verified by echocardiography on the morning after the procedure. No complication occurred. In the first two patients, the device slipped sideways into the defect. This was easily discovered and corrected. Our experience shows that the Amplatzer® device is reliable, easy to implant, and presents very clearly on transoesophageal echocardiography and fluoroscopy. This makes implantation a controlled procedure. Until release, the device can easily be retracted into the sheath at any time and removed. The results suggest that closure of an atrial septal defect with this device is feasible, rapid, and safe.
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