Arthrogryposis multiplex congenita and hypotonia in a male neonate.
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Arthrogryposis↗
Biomedical subjects
A Solimano
Publications and source records attributed to A Solimano.
Effects of high-frequency and conventional ventilation on the premature lamb lung.
Twelve sets of twin lambs were delivered prematurely by cesarean section at 133-136 days gestational age and ventilated for 3 h with either high-frequency oscillation (HFO) or conventional mechanical ventilation (CMV). Blood gases and pH values were monitored at 30-min intervals, and ventilator settings were adjusted to maintain CO2 partial pressure (PCO2) values within the normal range. There were no differences in the sequential blood gas or pH values between the HFO or CMV lambs. Mean airway pressures (MAP) between 8.0 and 20.4 cmH2O were required, indicating lung disease of variable severity in the lambs. The bidirectional protein leak from the vascular space to the airways and alveoli and vice versa was measured with radiolabeled albumins given by intravascular injection and with fetal lung fluid at birth. The albumin leaks in both directions increased as MAP required to normalize PCO2 increased, but the degree of leak was independent of type of ventilation. Pathological findings of epithelial necrosis and hyaline membranes occurred to a similar extent in lung sections from both groups of lambs. In the HFO animals less phosphatidylcholine in the alveolar wash and more of a tracer dose of radiolabeled natural surfactant that had been given at birth became tissue associated. These results indicate a decrease in the initial secretion of surfactant and/or a stimulation of reuptake in the HFO animals. HFO did not protect the immature lung from the development of large protein leaks or the pathological changes of the respiratory distress syndrome.
Animals↗
Prenatally diagnosed fetal neck teratoma. Case report and novel management options.
A case of fetal neck teratoma diagnosed at 32 weeks' gestation is reported. Planning before delivery included consultations with the neonatologist, the anesthesiologist, the otolaryngologist and the social worker. Delivery by cesarean section under epidural anesthesia was carried out at 34 weeks because of preterm labor. The head was delivered and the fetus was intubated within 4(1/2) min using a rigid bronchoscope. Magnesium sulfate and nitroglycerin provided uterine relaxation allowing fetal oxygenation via the uteroplacental circulation. Umbilical artery blood gases were satisfactory. The early neonatal course was complicated by hemorrhage from the teratoma externally as well as intratracheal bleeding and ventilatory problems. The baby died at 40 min of age in his mother's arms.
Adult↗