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Further development of an artificial placenta with the use of membrane oxygenator and venovenous perfusion
~[8 9,
INTERNATIONAL
7.39 per cent [5.2] and combined malformations in 31.5 per cent [20].---V. Kafka. FURTHER DEVELOPMENT OF AN ARTIFICIAL PLACENTA WITH THE USE OF MEMBRANE OXYGENATOR AND VENOVENOUS PERFUSION. C. L.
Sarin, A. SenGupta, H. P. Taylor and W. J. Kolff. Surgery 60:754-760, September 1966. Cardiorespiratory distress in the newborn resuits from failure of the lungs to effect the transfer normally of oxygen and carbon dioxide. A workable artificial placenta must satisfy the objectives of sufficient mechanical blood flow to balance the oxygen deficiency, and adequate nmchanical removal of CO 2 to maintain pH. A device that could offer even repeated intervals of short-term relief might well allow survival in a n u m b e r of babies who would otherwise expire. ttyperbaric oxygen produces satisfactory oxygenization, but does not prevent retention of CO 2 with acidosis. The authors describe an artificial placenta consisting of a Silastic membrane oxygenator and a pump. The apparatus is portable, self contained and self powered. The results of perfusion in 20 pups are presented. There were 16 survivors, and most of the perfusions were two hours or more in length. Satisfactory oxygenation and lowering of pCO 2 were obtained. The apparatus is awaiting clinical trial.--D. T. Cloud. ]tEREDITARY
CONGENITAL
LYMPHEDEMA
( Mm-
ROY'S DISEASE). R. A. Ersek, C. A. Danese and ]. M. Howard. Surgery 60: 1098-1103, November 1966. Three generations of a family in which 5 members are afflicted with Milroy's disease are studfed. Serum protein electrophoresis in one patient was normal. Intradermal blue dye injection and surgical exploration failed to reveal lymphatics. Chromosomal studies were normal. In this family the disease appeared to be transmitted in a sexlinked dominant pattern.--D. T. Cloud.
H E A D A N D NECK CONGENITAL TUMORS OF TtIE GUM IN THE NEWBORN. M. Pasquid and S. Juskiewenski. Ann. Chir. Infan. 7:189-194, 1966. Congenital epulis is a very rare malformation. Authors report two cases in newborn babies. In
ABSTRACTS OF PEDIATItlC SURGERY
both cases the tumor was so big that excision had to be done as an emergency because of respiratory distress.--M. Bettex. FIBItOMATOSIS OF THE HEAD AND NECK. John
Conley, William V. Healey and Arthur Purdy Stout. Amer. J. of Surgery, Vol. 112, 609-614 October 1966. Forty cases of fibrous proliferation of the head and neck are reported. Since 25 per cent of these 40 cases were under the age of 15, the importance of reviewing this paper is obvious. The term fibromatosis is used to clarify these cases, and b y it is meant a neoplasm of fibrous tissue, probably arising from true fibroblasts, which exhibits wild cellularity and progressive local invasion, but probably never metastasizes. Congenital torticollis, pseudosarcomatous fasciitis, fibrous dysplasia, etc., are excluded. The most impressive feature of these cases is the persistence of the tumor after nmltiple surgical attempts at its removal, although local invasion has to date not killed any of these patients. Even when wide resection was initially planned and undertaken there were 6 recurrences (40%). In the opinion of the authors, surgical removal is the only satisfactory treatment and radiotherapy and steroids are equivocal in their effect at best.--N. K. Connolly. DESMOID TUMORS OF THE HEAD AND NECK. J. K. Masson and E tt. Soule. Amer. J. Surg. 1 1 2 ( 4 ) : 615-622, October 1966. Thirty-four cases of desmoid tumors of the head and neck are reported. Ten of these occurred under 15 years of age. Desmoid tumor is d e f n e d as an aggressive form of fibromatosis that presents as a circumscribed, locally infiltrative, well differentiated, firm overgrowth of fibrous tissue arising in the musculoaponeurotie structures of the body. The degree of cellularity is variable from area to area, from tumor to tumor. Mitotic figures may be found in the more cellular areas but there is no evidence of cellular anaplasia or abnormal mitotic figures. These tumors grow slowly and present as painless lumps, though the history in these cases was relatively short, between a month and a year or two, prior to coming for treatment. 70 per cent of the 30 patients that were able to be traced had recurrences after their initial treatment. Local radical excision of the tumor should be planned as the primary treatment even w h e n it is necessary to
INTERNATIONAL
7.39 per cent [5.2] and combined malformations in 31.5 per cent [20].---V. Kafka. FURTHER DEVELOPMENT OF AN ARTIFICIAL PLACENTA WITH THE USE OF MEMBRANE OXYGENATOR AND VENOVENOUS PERFUSION. C. L.
Sarin, A. SenGupta, H. P. Taylor and W. J. Kolff. Surgery 60:754-760, September 1966. Cardiorespiratory distress in the newborn resuits from failure of the lungs to effect the transfer normally of oxygen and carbon dioxide. A workable artificial placenta must satisfy the objectives of sufficient mechanical blood flow to balance the oxygen deficiency, and adequate nmchanical removal of CO 2 to maintain pH. A device that could offer even repeated intervals of short-term relief might well allow survival in a n u m b e r of babies who would otherwise expire. ttyperbaric oxygen produces satisfactory oxygenization, but does not prevent retention of CO 2 with acidosis. The authors describe an artificial placenta consisting of a Silastic membrane oxygenator and a pump. The apparatus is portable, self contained and self powered. The results of perfusion in 20 pups are presented. There were 16 survivors, and most of the perfusions were two hours or more in length. Satisfactory oxygenation and lowering of pCO 2 were obtained. The apparatus is awaiting clinical trial.--D. T. Cloud. ]tEREDITARY
CONGENITAL
LYMPHEDEMA
( Mm-
ROY'S DISEASE). R. A. Ersek, C. A. Danese and ]. M. Howard. Surgery 60: 1098-1103, November 1966. Three generations of a family in which 5 members are afflicted with Milroy's disease are studfed. Serum protein electrophoresis in one patient was normal. Intradermal blue dye injection and surgical exploration failed to reveal lymphatics. Chromosomal studies were normal. In this family the disease appeared to be transmitted in a sexlinked dominant pattern.--D. T. Cloud.
H E A D A N D NECK CONGENITAL TUMORS OF TtIE GUM IN THE NEWBORN. M. Pasquid and S. Juskiewenski. Ann. Chir. Infan. 7:189-194, 1966. Congenital epulis is a very rare malformation. Authors report two cases in newborn babies. In
ABSTRACTS OF PEDIATItlC SURGERY
both cases the tumor was so big that excision had to be done as an emergency because of respiratory distress.--M. Bettex. FIBItOMATOSIS OF THE HEAD AND NECK. John
Conley, William V. Healey and Arthur Purdy Stout. Amer. J. of Surgery, Vol. 112, 609-614 October 1966. Forty cases of fibrous proliferation of the head and neck are reported. Since 25 per cent of these 40 cases were under the age of 15, the importance of reviewing this paper is obvious. The term fibromatosis is used to clarify these cases, and b y it is meant a neoplasm of fibrous tissue, probably arising from true fibroblasts, which exhibits wild cellularity and progressive local invasion, but probably never metastasizes. Congenital torticollis, pseudosarcomatous fasciitis, fibrous dysplasia, etc., are excluded. The most impressive feature of these cases is the persistence of the tumor after nmltiple surgical attempts at its removal, although local invasion has to date not killed any of these patients. Even when wide resection was initially planned and undertaken there were 6 recurrences (40%). In the opinion of the authors, surgical removal is the only satisfactory treatment and radiotherapy and steroids are equivocal in their effect at best.--N. K. Connolly. DESMOID TUMORS OF THE HEAD AND NECK. J. K. Masson and E tt. Soule. Amer. J. Surg. 1 1 2 ( 4 ) : 615-622, October 1966. Thirty-four cases of desmoid tumors of the head and neck are reported. Ten of these occurred under 15 years of age. Desmoid tumor is d e f n e d as an aggressive form of fibromatosis that presents as a circumscribed, locally infiltrative, well differentiated, firm overgrowth of fibrous tissue arising in the musculoaponeurotie structures of the body. The degree of cellularity is variable from area to area, from tumor to tumor. Mitotic figures may be found in the more cellular areas but there is no evidence of cellular anaplasia or abnormal mitotic figures. These tumors grow slowly and present as painless lumps, though the history in these cases was relatively short, between a month and a year or two, prior to coming for treatment. 70 per cent of the 30 patients that were able to be traced had recurrences after their initial treatment. Local radical excision of the tumor should be planned as the primary treatment even w h e n it is necessary to