Successful separation of ischiopagus tripus conjoined twins with comparative analysis of methods for abdominal wall closure and use of the tripus limb.

The authors report the successful delivery, preoperative management, and postoperative courses of ischiopagus tripus twin girls successfully separated at 5 months of age. Surgical objectives were predicated on survival and optimum postseparation reconstructive potential for both girls. Each twin has subsequently undergone additional procedures, and both are doing well 2 years after separation.

A prospective evaluation of the Port-A-Cath implantable venous access system in chronically ill adults and children.

Totally implantable venous access systems are presently widely used, but large-scale, prolonged studies are lacking in evaluating adequately these systems. We prospectively evaluated 198 systems in 191 patients (ages from two months to 80 years) during a three year period, with a median follow-up time of 330 days (a range of two to 1,088 days). Withdrawal of blood was consistently successful in 91 per cent of the systems.

Malignant hyperthermia in infancy.

We have described two infants, aged 2 months and 5 months, who had malignant hyperthermia, an entity not generally believed to occur during infancy. Both children were under general anesthesia when MH occurred, and both responded well to administration of dantrolene and sodium bicarbonate.

Infantile myofibromatosis: the most common fibrous tumor of infancy.

We describe the clinical courses of four infants with infantile myofibromatosis (IM). This entity is a mesenchymal disorder of early infancy characterized by the formation of tumors in skin, muscle, viscera, bone, and subcutaneous tissues. Previously known as congenital generalized fibromatosis, IM was formerly thought to be a rare condition that was frequently fatal.

A totally implantable venous access system for long-term chemotherapy in children.

A totally implantable venous access system consisting of a subcutaneously placed stainless steel portal with a silicone diaphragm attached to a Silastic elastomer central venous catheter was inserted in 39 children with poor venous access. The devices were utilized for blood drawing and the administration of antineoplastic drugs, parenteral nutritional fluids, antibiotics, and blood products. Cumulative duration of access was 6,724 days (range 5-491, median 172 days).