The combination of tracheoesophageal and pulmonary malformations is unusual and reportedly carries a high mortality. We have observed six patients with esophageal atresia and tracheoesophageal fistula and one with a bronchoesophageal fistula who had associated bronchopulmonary anomalies ranging from lobar hypoplasia and agenesis to unilateral pulmonary hypoplasia or agenesis. All of the pulmonary malformations were right-sided. Vertebral or rib anomalies were present in five patients, congenital heart disease in two, imperforate anus in one and one patient had radial aplasia and Pierre Robin syndrome. The bronchopulmonary anomalies complicated the surgical care of tracheoesophageal malformations and required radiologic differentiation from aspiration pneumonia and atelectasis. Six of the seven patients survived. Mortality and morbidity were related to complications and associated cardiac anomalies as well as severity of the lung anomaly.
The rationale for freezing carcinoma adjunctively with chemotherapy is synthesized from published data on tumor cytokinetics, regional chemotherapy, cryopathology, and the microvascular hemodynamics of proliferating tumors. Acute cryolesions in the dog’s tongue, arterially infused with methylene blue solution demonstrated early central ischemia, increasing porosity of marginal circulation and extravascular trapping of dye for 5 h. The dog intestine tolerated transmural cryonecrosis without perforation. 27 patients with cancer of the oral cavity received Methotrexate arterial infusion with cryosurgery without complications since May 1969. Bleeding with later surgery occurred in 2 patients, and a possible relationship to cryosurgery is discussed.
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