354 protect against infection. A complete repair is then suggested, in the first 10 days of life. Repair of the thoracoabdominal defect is suggested with an acrylic p r o s t h e s i s . Robert W. Feldtman Chest Wall Sarcoma of Childhood With a Good Prognosis.
A. J. Benson, A. Ahmed, A. .4. M. Gibson, et at. Arch Dis Child 53:882-889, (November), 1978.
Four cases are described in which chest wall tumors in children (aged 8 to 14 yr) were found to be small round-cell sarcomata originating in soft tissues and differentiated from Ewing's tumor mainly by the presence of vasoformative features. Secondary invasion of bone occurred but, in three cases, surgery, radiotherapy and chemotherapy (only 2 cases) resulted in survival to 6, 8, and 16 yr after presentation. One boy died, despite further surgery and chemotherapy, from recurrent and metastatic tumour 21/2 yr after initial treatment of a massive right thoracic tumor by chemotherapy and surgery; this patient received radiotherapy only late in the course of his illness. The histologic and electronmicroseopic features and relatively good prognosis of this apparently distinct entity are emphasized.--P. A. M. Raine Simultaneous Correction of Pectus Excavatum and Breast Hypoplasia. E. R. Finger. Ann Plast Surg 3:448-451,
(November), 1979. Pectus excavatum is generally corrected with a custom made subpectoral implant. The repair is then followed at a later date by an augmentation mammaplasty, if indicated. This case deals with a seventeen year old woman, who had a simultaneous correction of both pectus excavatum deformity with a custom made implant placed in the presternal position and in addition, an augmentation mammaplasty was carried out in a subpectoral fashion, utilizing a silicone prosthesis. The postoperative course was entirely unremarkable with the exception of a small seroma, which we absorbed spontaneously. The postoperative results are both pleasing to the doctor as well as to the patient.--A. B. Sokol Congenital Cystic Adenomatoid Malformation of the Lung.
A. Queizhn, 1. Lbpez, J. Cuadros. Ann Esp Pediatr 12:297, 1979.
During a 12-yr period (1965-1977) a total of 288,720 births and 4,304 pediatric necropsies were carried out, finding 4 cases of congenital cystic adenomatoid malformation of the lung (1 stillborn, 3 newborns). Pathologic, clinical, and radiologic features are discussed and compared with 70 previously reported cases (till 1973).--Carlos M. Almoyna
ABSTRACTS Neonatal Lung A b s c e s s . J. D. Siegal and G. H. McCracken.
Am J Dis Child 133:947-949, (September), 1979. Six infants under 8 wk of age were treated for lung abscess between 1957 and 1977. The duration of symptoms prior to diagnosis, the etiologic organisms, and the therapeutic approach differed from those of older children and adults. Escherichia coli, group B streptococcus and Klebsiella pneumonia were the pathogenic organisms. Therapy consisted of a penicillin and aminoglycoside until identification and susceptibility results were available on organisms isolated from the abscess cavity. Four of the six patients required lobectomy for adequate therapy. One was treated by decortication and one did not require surgery. In 2 of the 6 patients the abscess was located in a previously undiagnosed cystic m a l f o r m a t i o n . ~ . J. Tepas II1 Posterolateral (Bochdalek's} Diaphragmatic Hernia in Sisters. L. D. Pollack and J. G. Hall. Am J Dis Child
133:1186-1188, (November), 1979. Two sibling sisters with congenital posterolateral diaphragmatic hernias are presented. Since there is only one other report of siblings with posterolateral diaphragmatic defects, the authors suggest that genetic heterogeneity rather than sporadic incidence may have been etiologically important in these families. Although recurrence risk is less than 3% in sporadic cases, fluoroscopic examination of the diaphragmatic function of both parents should be considered when counselling parents concerning future pregnancies. Likewise, prenatal diagnosis by ultrasound should be possible and may improve perinatal management in future cases. J. J. Tepas II1 Postnatal Lung Growth After Repair of Diaphragmatic Hernia. William M. Thurlbeck, K. Kida, Claire Langston, et
al. Thorax 34:338-343, (June), 1979.
This report originating from three major centers in North America details necropsy findings in the lungs of two patients who died some time after repair of a developmental diaphragmatic hernia undertaken on the first postnatal day. One weighed 2500 g at birth and 3500 g when death occurred at 8 mo, the other weighed 3420 g at birth and 17.2 kg when dying aged 64 mo. The lung sizes and the volume ratio were normal for the build of each subject. All four lungs were abnormal in other respects, the left lungs being most affected. Qualitative and quantitative study revealed evidence of enlargment and destruction of the respiratory elements. Alveolar multiplication appeared to have been impaired, the number of bronchioles being smaller than in normal lungs. John F. R. Bentley
Case Records of the Massachusetts General Hospital. Case
41-1979. N Engl J Med 301:829 835, I979. This discussion in CPC form is of a 5-yr-old boy with growth retardation and x-ray findings of hyperinflation of the left upper lobe. A ventilation perfusion scan revealed absence of perfusion and ventilation of the left upper lung. No left upper lobe orifice was visualized on bronchoscopy or bronchography. A left upper lobectomy was performed. Pathologic examination confirmed the diagnosis of bronchial atresia.--Eugene S. Wiener
HEART A N D GREAT VESSELS Tricuspid and Pulmonic Valve Echoes in Tricuspid and Pulmonary Atresia. O. Takahashi, E. Eshaghpour, M. N.
Ketler. Chest 76:437440, (October), 1979:
Two neonates presenting with early cyanosis and C H F underwent echocardiographic evaluation. In the first patient a tricuspid valve was felt to have been demonstrated but catheterization revealed tricuspid atresia. In the second patient four valves were identified but at her second catheter-