Controversies in the management of gastroschisis: a study of 40 patients

Article Abstract:

Gastroschisis is a congenital fissure in the abdominal wall that remains open. The disorder occurs in 1 in 10,000 births and is apparently increasing. There is uncertainty about whether affected fetuses should be referred for treatment before or after birth, and also about which are the best methods of childbirth and surgical treatment. The outcome of 40 newborns with gastroschisis was evaluated from their medical records. Ninety percent of the babies survived. Infants whose mothers were transferred before delivery to hospitals where the babies would later undergo surgery were operated on significantly sooner, at 4.6 hours after birth, compared with 6.7 hours after birth for those transferred to a different hospital after birth. The former group also required significantly less respiratory ventilation and tended to be discharged from the hospital sooner. Problems such as decreased body temperature and loss of body fluids were observed during the transfer. Primary closure, in which a single operation is used to close the entire abdominal wall defect, was more frequently successful in the prenatally transferred group than the group transferred after birth. Outcome of surgery was not different between infants born vaginally and those born by cesarean section. Infants treated by primary closure achieved full oral feeding significantly earlier and were discharged sooner than those who were treated by a series of operations which used prosthetic material to close the defect. All early deaths were in postnatally transferred infants, namely two with complications after primary repair, one with intestinal dysfunction after serial repair, and one with severe systemic complications. The study suggests that when feasible, prenatal transfer and primary surgical repair of affected infants may be the best therapeutic choices. (Consumer Summary produced by Reliance Medical Information, Inc.)

Surgery, Birth defects, Infants (Newborn), Newborn infants

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Customs Ombudsman hitting it off with traders

Article Abstract:

Kent S. Foster was appointed Customs Ombudsman in Jan 1990 and since then, he has always strived to rebuild a strong relationship between the US Customs Service and the importing community. Through his efforts, several improvements were made in the agency's manner of transacting business with both importers and exporters, earning him and the Service praises from officials of the trade community. Foster is expected to play a key role in strengthening this bond further as global trade enters the 21st century.

Finance, taxation, & monetary policy, Officials and employees, Column, Behavior, Powers and duties, Ombudsmen, United States. Bureau of Customs and Border Protection, Foster, Kent S.

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When a thick film is thin

Article Abstract:

A polymer film remains effectively thin, even when it is hundreds of atom layers thick, because of the deposition of deuterated polystyrene on the silicon surface. The adsorption of a large number of chains on the surface hinders other chains and results in slow diffusion of polymer chains. Thin film polymers find application in electronics, controlling the alignment of liquid crystals, and high-temperature polymers for insulating layers in integrated circuits.

Research, Analysis, Polymers, Observations, Thin films, Multilayered, Multilayered thin films, Adsorption, Polystyrene

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