Persistent fetal circulation: an evolving clinical and radiographic concept of pulmonary hypertension of the newborn

The roentgenographic presentations of 11 newborn infants with hypoxemia secondary to pulmonary vasospasm and subsequent right-to-left shunting of blood through the foramen ovale and/or ductus arteriosus (persistent fetal circulation) are described (P. F. C. Syndrome). One infant had radiographically normal lungs, while ten had pulmonary parenchymal abnormalities including hyaline membrane disease [4], meconium aspiration syndrome [4], or an ill defined pattern of retained lung fluid [2]. The roentgenographic appearance of the lungs, however, was discordant with the severe hypoxemia observed in most. Heart size was variable but some degree of cardiomegaly was commonly present. Tolazoline, a potent vasodilator, was useful diagnostically and may have resulted in increased survival. An expanded clinical and roentgeonographic concept of the PFC syndrome is suggested.

[Terminal vascular bed of the connective tissue membrane in hypoxic hypoxia]

Morphological changes of all links of the terminal vascular bed during acute hypoxic hypoxia were studied in experiment and in postmortem material. A complex of methods was used including microdissection, injection with India ink - gelatin, clearing, silver nitrate impregnation after V. V. Kuprijanov, staining after Van Gieson and with hematoxylin-eosin, biomicroscopy and reoencephalography. Signs of desorganization of the vascular bed were revealed which manifested themselves as changes in microangioarchitectonics and diameters of vascular lumens, increased permiability of their walls with saturation of them with white and escape of its forming elements of the blood outside the limits of the vessels, as well as in destruction of the aggregate state of the blood. It considerably enlarges our knowledge of the state and changes in the vascular bed during hypoxic hypoxia.