[Dr. S.M. Kropveld; the beginning of Dutch heart surgery].

The first successful cardiac operation in The Netherlands (ligature of a patent ductus arteriosus) was performed in the Central Jewish Hospital at Amsterdam by the Jewish surgeon dr.S.M.

Results of regional isolation perfusion with cytostatics in patients with soft tissue tumors of the extremities.

From 1975 to 1986, 26 patients with soft tissue tumors of the extremities underwent a total of 29 perfusions. The cytostatics used were doxorubicin (Adriamycin, Adria Laboratories, Columbus, OH) (19 perfusions), melphalan (two perfusions), and a combination of these agents (eight perfusions). Before perfusion most patients had been treated by surgical excision(s), radiotherapy, or systemic chemotherapy.

Functional morbidity after regional isolated perfusion of the limb for melanoma.

A series of 57 patients still in follow-up after regional isolated perfusion (RIP) of Stage I-II high-risk melanoma is described. Functional morbidity of the perfused limb was investigated. Median interval after RIP was 5 years.

Regional perfusion treatment with melphalan for melanoma in a limb: an evaluation of drug kinetics.

The time course of tissue levels of melphalan during normothermic isolated limb perfusion, and the overall tissue levels per 60 min of perfusion, were estimated from the known pharmacokinetic parameters for a fixed dose of drug per liter of tissue (Benckhuijsen et al., J. Pharmacol Exp Ther 1986; 237: 583-8).

Normothermic isolation perfusion with melphalan for advanced melanoma of the limbs.

Eighteen patients with advanced melanoma of the limbs underwent a single isolation perfusion with melphalan under normothermic conditions, i.e. tissue temperatures between 37.

Pharmacokinetics of melphalan in isolated perfusion of the limbs.

The pharmacokinetics of melphalan (L-phenylalanine mustard) in isolated perfusion treatment of patients with melanoma in the limbs have been studied at standardized pseudo-physiological perfusion conditions. Perfused tissue volumes ranged from 2.1 to 16 liters as measured by water displacement.

Dosimetry in isolation perfusion of the limbs by assessment of perfused tissue volume and grading of toxic tissue reactions.

The optimal single dosage of melphalan in isolation perfusion of the limbs for malignant melanoma was assessed. For this purpose a method to determine the volume of the isolated region in the individual patient and a grading system for the reaction of the normal tissues were introduced. A strictly standardized pharmacosurgical routine was developed that permitted an analysis of the correlation between dosage and the grade of toxic reaction in 90 perfusions.

Effects of transmyocardial punctures on left ventricular performance after coronary occlusion in the acute experiment.

The results of multiple transmyocardial punctures were studied in 12 dogs in which ligation of the left descending coronary artery had been performed. Instead of improvement, deterioration in the electrocardiogram, paradoxical movement, left ventricular pressure, left ventricular dp/dt max, and mean aortic flow were observed. These results are in contrast to the acute effects observed by Sen (1965, 1968) but do not exclude the possibility of beneficial long-term effects.

Safe per-operative anticoagulation.

Pre-, per-, and post-operative anticoagulation at the therapeutic level is nowadays the most, if not the only, available effective method to prevent post-operative thrombo-embolism. There is no increased tendency to bleeding to be feared during the operation. The real danger of this prophylaxis consists of a treacherous tendency to acute relative overdosage after the operation.