Pharmacological analysis of the action of diuretics in the newborn pig.

The effects of furosemide, ethacrynic acid, hydrochlorothiazide and amiloride on renal function of newborn piglets, 5 to 10 days old, were evaluated. Furosemide and ethacrynic acid were the most effective diuretics. Furosemide infusion at 0.5 mg/kg/hr inhibited reabsorption of 21% filtered sodium and ethacrynic acid, 1 mg/kg/hr, increased fractional sodium excretion to 29%. Hydrochlorothiazide infusion produced a milder natriuresis than furosemide or ethacrynic acid. Infusion of hydrochlorothiazide at 1.0 mg/kg/hr increased fractional sodium excretion from 0.3% during the control period to 7.2%. Furosemide, ethacrynic acid and hydrochlorothiazide each increased potassium excretion to near 20 microEq/min. amiloride (1.0 mg/kg/hr) increased fractional sodium excretion from 0.2% during control period to 2.8% during drug infusion but did not affect potassium excretion. When infused in combination with furosemide and hydrochlorothiazide, amiloride increased the natriuresis and decreased the kaliuresis of both diuretics. It is concluded that the unanesthetized piglet is a good model for renal function of immature mammals and responds to diuretics in a manner qualitatively similar to adults.

Accuracy of oral cholecystography in cholelithiasis.

The accuracy of oral cholecystograms in the detection of cholelithiasis was assessed by comparing 100 patients who were examined both roentgenographically and by ultrasonography of the gallbladder. All normal oral cholecystograms had normal ultrasonography of the gallbladder. This study supports previous reviews indicating that the reliability of cholecystography in cholelithiasis is in the 98% range.

Anesthetic management of an intracranial arteriovenous malformation in infancy.

The prevention and control of massive bleeding has always been a problem in neurosurgical procedures, particularly in patients with arteriovenous malformations, intracranial aneurysms, and large vascular tumors. During the past 25 years, new technics have reduced the risk of hemorrhage; however, these have been most suitable for adult patients. Vascular intracranial lesions during infancy present even more complex problems. This is a report of the anesthetic management of a 7-month-old infant with an aneurysm of the v cerebri magna (great vein of Galen). Anesthetic management consisted of (1) halothane-N2O-O2 general endotracheal anesthesia, (2) surface-induced profound hypothermia, and (3) low-flow extracorporeal circulation. Phenothiazine premedication was used with halothane anesthesia to antagonize reflex vasoconstriction during hypothermia, hypothermia and low cardiac output to lessen the possibility of hemorrhage, aneurysmal rupture, and neurologic damage, and surface-induced hypothermia because it provides better core perfusion than central cooling. This technic allowed a successful outcome in an otherwise high-risk procedure.

Gonadoblastoma: an ovarian tumor with characteristic pelvic calcifications.

Typical circumscribed mottled calcifications in the pelvis are a frequent finding in gonadoblastomas. Six patients with this tumor are reviewed. Radiologically visible calcifying gonadoblastomas were found in three cases.