American journal of perinatology
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Three pairs of female conjoined twins--a xiphoomphalopagus, a pygopagus, and a thoracopagus--were encountered during the past 10 years. Surgical separation was successful in the xiphopagus, and both twins survived. Separation was also successful in the pygopagus, but only one of the twins survived; the twin that died had sustained cerebral hemorrhage before the operation. ⋯ Separation surgery of conjoined twins is often successful with a high survival rate of both twins unless vital organs such as the brain or the heart are fused. However, unlike other operations, separation surgery entails ethical considerations pertaining to matters such as the distribution of organs in addition to surgical considerations. Furthermore, separation of conjoined twins is certain to cause various degrees of anatomical as well as functional disorders associated with the surgical procedure, and provision for the postoperative care for these disorders is indispensable.
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Xanthines are frequently being used in the management of premature babies. Studies in adult subjects have demonstrated a diuretic effect of aminophylline due to the inhibition of solute reabsorption in various segments of the nephron. We evaluated the effects of aminophylline on the developing kidney. ⋯ Most of the effects were no longer evident after 24 hours, despite continuing aminophylline maintenance therapy. In premature infants the aminophylline loading dose, but not maintenance therapy, affected renal functions. Because heart rate, blood pressure, and creatinine clearance did not change, it appears that aminophylline acts directly on tubular reabsorptive functions.