[Multiple intestinal hemangioma: report of two cases].

Hemangioma of the small intestine is a rare disease which is sometimes very difficult to diagnose because of its anatomical location. This report concerns two cases of multiple intestinal hemangiomas treated surgically. The first case was a four-year-old boy who suffered from recurrent abdominal pain and progressive hemorrhage from the gastrointestinal tract for four months. The character of his abdominal pain was non-specific. On physical examination, whole abdominal tenderness was evident. Serial laboratory and radiological examinations, including abdominal sonogram, barium enema, Tc-99m pertechnetate scan, upper gastrointestinal series failed to reveal abnormality. Multiple intestinal hemangiomas were found at exploratory laparotomy. The second case was a new-born suffering from fetal ascites. Abdominal sonogram, barium enema, voiding cystourethrography were performed without significant findings, and the diagnose of multiple intestinal hemangiomas was proved by laparotomy. In both, symptoms improved after segmental resection of the bowels. The purpose of this paper is to draw attention to the possibility of intestinal hemangioma as a source of recurrent abdominal pain, tarry stool or ascites in children.

Early furosemide therapy in premature infants (less than or equal to 2000 gm) with respiratory distress syndrome: a randomized controlled trial.

Pulmonary edema has been demonstrated in the early stages of respiratory distress syndrome in premature infants. To evaluate whether early furosemide therapy (0 to 8 hours after birth) would affect the electrolyte balance, pulmonary status, and outcome, 57 infants (less than or equal to 2000 gm) with respiratory distress syndrome who required mechanical ventilation shortly after birth were randomized into two groups: 29 given furosemide (1 mg/kg/day intravenously for three doses) and 27 control. The clinical, biochemical, and laboratory characteristics of the groups were comparable before entry into the study. Administration of furosemide significantly enhanced the urinary excretion of Na and Cl at 0 to 24, 24 to 48 and 48 to 72 hours and of Ca at 24 to 48 and 48 to 72 hours after drug administration. There was no significant difference between the groups in urinary excretion of K and in serum Na, Cl, K, and Ca values. A spontaneous increase in urine output occurred in the control group at 48 to 72 hours after the initiation of the study (mean +/- SD 7.0 +/- 3.5 hours postnatal age), along with a decrease in mean airway pressure for mechanical ventilation. The use of furosemide (7.3 +/- 3.5 hours postnatal age) enhanced urine output at 24 to 48 and 48 to 72 hours after medication, resulting in further decrease in mean airway pressure and facilitating extubation. There was, however, no significant difference between the groups with respect to incidence of patent ductus arteriosus, morbidity from bronchopulmonary dysplasia, and mortality.

Increased O2 consumption and energy loss in premature infants following medical care procedures.

Oxygen consumption (VO2) and CO2 production (VCO2) were measured continuously for 24 h in 10 premature infants during their ongoing nursing care. Using a flow-through technique, the total VO2 and VCO2 over a given period of time were determined from the area under the O2-and CO2-concentration-time curve of the mixed expired gas. Following chest physiotherapy, heel stick and i.v. needle insertion, there was a significant (p less than 0.01) increase in VO2 and VCO2. When measured for 24 h, the total daily increase of VO2 attributed to these procedures ranged from 2.1 to 11.7% of total daily VO2, equivalent to an estimated energy loss of 0.6-4.1 kcal/kg/day.

Simple daily technique to calculate total and interim changes of daily O2 consumption and CO2 production in premature infants.

A simple method to calculate oxygen consumption (VO2) and CO2 production (VCO2) over a 24-h period is described. VO2 and VCO2 were measured using flow-through technique and the total VO2 and VCO2 over a given period of time were determined from the area under the O2 and CO2 concentration-time curve of the mixed expired gas. The system was tested in vitro by burning 100% ethyl alcohol. The average error between measured and theoretical values for VO2 was 4.9% and for VCO2 was 4.7%. With a flow rate greater than 5340 ml/min through the system, the correlation coefficient between theoretical VO2 or VCO2 and measured VO2 or VCO2 was 0.99. The method was tested in vivo in 5 premature infants who were nursed under neutral thermal environment and received routine medical care. The results indicate that this simple method can be used to study the total and interim changes of daily VO2 and VCO2 in infants during their ongoing nursery care.