Diagnosis of acute and chronic cardiac rejection by magnetic resonance imaging: a non-invasive in-vivo study.

To evaluate the potential usefulness for characterization of tissue and anatomical changes associated with cardiac transplantation rejection by nuclear magnetic resonance imaging (MRI), sixteen dogs underwent heterotropic cardiac transplantation with six not immunosuppressed serving as controls. Myocardial biopsy and MRI were obtained and compared on a weekly basis. Untreated allografts showed a significant increase in T2 and intensity values by MRI compared to the native heart as early as one week after transplantation.

Report of the Ad Hoc Committee on Risk Factors for Coronary Artery Bypass Surgery.

The Society of Thoracic Surgeons remains greatly concerned about the use of raw mortality data as the sole measure to determine quality of care following coronary artery bypass surgery. Use of such data without consideration of risk factors that are predictors of hospital mortality and of other indices of quality of care is inappropriate and misleading and may adversely affect the care of the high-risk cardiac surgical patient. The Society is committed to the principle of providing the public with accurate information regarding the conduct of coronary artery surgery.

The fate of the 12 mm porcine valved conduit from the right ventricle to the pulmonary artery. A ten-year experience.

The 12 mm Dacron conduit containing a porcine valve is the smallest valved conduit manufactured and is used in the youngest infants with the most diminutive pulmonary arterial system. The outcome of patients with such a conduit is unknown. Between 1975 and 1985 there were 49 hospital survivors after placement of a 12 mm extracardiac valved conduit from the right ventricle to the pulmonary artery.

Surgical options for treating ventricular tachyarrhythmia and sudden death.

From 1981 to 1987, 62 patients with ventricular tachyarrhythmias and associated sudden death required treatment after unsuccessful initial medical therapy (51 patients) and previous surgical therapy (11 patients). Surgical options included direct revascularization (group I, 11 patients), endocardial resection (group II, 7 patients), automatic internal cardiac defibrillators (group III, 18 patients), and these combinations of operations: revascularization and endocardial resection (group IV, 18 patients), revascularization and insertion of automatic internal cardiac defibrillators (group V, 5 patients), and endocardial resection and insertion of cardiac defibrillator (group VI, 3 patients). Five underwent repeat revascularization (4) or endocardial resection (4) with mitral valve replacement (1) or papillary muscle reconstruction (2).

Indications and techniques for midline approach to aortic coarctation in infants and children.

A variety of techniques have been described for the repair of aortic coarctation. Most of these use operative exposure through a left thoracotomy. There are, however, instances when a median sternotomy provides a more versatile approach and allows for equally acceptable repair.

Infant total anomalous pulmonary venous connection: factors influencing timing of presentation and operative outcome.

The surgical experience in 75 patients with total anomalous pulmonary venous connection (TAPVC) between 1975 and 1986 was reviewed. Most of these patients underwent operation at less than 1 month of age (39 of 75, 52%). Operative approaches used were the standardized left-sided approach for supracardiac and infracardiac TAPVC, reserving transatrial repair for only the intracardiac lesions.

Identification of an essential upstream element in the nopaline synthase promoter by stable and transient assays.

We studied the fine structure of the nopaline synthase (nos) promoter, which is active constitutively in a wide range of plant tissues, by both transient and stable transformation expression analyses. 3' and 5' deletion fragments were linked to form a set of internal deletion and duplication mutants that scanned the nos promoter. These mutated promoters were linked to the gene for the marker chloramphenicol acetyltransferase (CATase) as a means to readily assay promoter strength.

Aspirin anticoagulation in children with mechanical aortic valves.

The optimal method of anticoagulation in children with mechanical heart valves is controversial. Between 1975 and 1986, aspirin or aspirin with dipyridamole has been used for anticoagulation in children receiving a mechanical aortic valve at the University of California, San Francisco. Fifty-one patients (ages 1 to 23 years, mean 12.

Infant coarctation: a spectrum in clinical presentation and treatment.

Between 1975 and 1985, 125 infants 2 to 365 days old (majority, 30 days old or less) with coarctation of the aorta underwent surgical repair. Forty-seven patients (38%) had severe congestive heart failure (CHF), metabolic acidosis, and poor systemic perfusion. The predominant operative technique was synthetic patch aortoplasty (100 patients); the remaining 25 had an end-to-end anastomosis.

A gene essential for Agrobacterium virulence is homologous to a family of positive regulatory loci.

The vir region of Agrobacterium tumefaciens spans at least six transcriptional loci required for crown gall tumorigenesis. The transcriptional induction of two of these vir loci in response to cocultivation with tobacco suspension cells was measured by using bacteria containing mutations in each of the six vir loci located on the Ti plasmid. Induction of these vir genes occurred only in bacteria that had functional copies of virA and virG.

Prevention of ischemia-induced myocardial platelet deposition by exogenous prostacyclin.

The antithrombotic effects of prostacyclin infusion on myocardial platelet deposition were studied in a canine model during and after global ischemia. Eleven isolated heart preparations were subjected to 1 hour of cardioplegic arrest under moderate hypothermia (27 degrees to 28 degrees C), including a control group (n = 7) and a prostacyclin-treated group (n = 4). The hearts of four other dogs were continuously perfused for 180 minutes.

Right-sided cardiac transplantation: importance of functional valves.

An original surgical procedure had been developed entailing the implantation of a right-sided heterotrophic cardiac graft in 14 dogs. The benchwork preparation included creation of both atrial and ventricular septal defects which allowed transplantation with the avoidance of extracorporeal circulation and the utilization of all transplanted myocardium and parts. The structure and function of this graft were sequentially evaluated using rapid cine-computed tomograms which permitted assessment of forward graft flow, ventricular wall contraction, and diastolic thickness for both the native and grafted hearts.

Intracoronary platelet aggregation: pattern of deposition after ischemia, cardioplegia, and reperfusion.

Platelet deposition in the coronary microvasculature has not been completely defined in the temporal relationship to acute myocardial ischemia, the application of crystalloid cardioplegia, and during reperfusion on heart bypass. Twenty-two canine hearts were serially biopsied for the analysis of radioactively tagged platelets. Eleven hearts underwent an isolated heart support preparation with seven followed by potassium cardioplegic arrest and reperfusion while the remaining 4 were maintained on continuous bypass.

Promoters of Agrobacterium tumefaciens Ti-plasmid virulence genes.

The DNA sequences of the promoter and 5' upstream regions of six Agrobacterium tumefaciens Ti-plasmid encoded virulence (vir) genes were determined. The transcription initiation sites were mapped by the S1 nuclease protection assay. In the -10 region, the vir promoters share a consensus sequence that is homologous to a DNA sequence found in the same region of E.

Transposition of the great arteries in the neonate: failed balloon atrial septostomy.

The authors discuss the early management of patients with transposition of the great arteries in the neonate. The success of early operative procedures in the neonatal period has limited the usefulness of the Rashkind balloon septostomy. The authors propose that both the Senning and arterial switch procedure may be better accomplished if the septostomy is not performed.

Does prostacyclin (PGI2) cardioplegic infusion improve myocardial protection after ischemic arrest?

To determine whether prostacyclin (PGI2) plays a beneficial role in the blood-perfused heart undergoing global ischemia, 20 isolated canine hearts were studied after sustaining one hour of cardioplegic arrest under moderate hypothermia (27 degrees to 28 degrees C). Left ventricular function (peak systolic pressure, rate of rise of left ventricular pressure [dP/dt], and compliance change in left ventricular volume), myocardial edema, coronary blood flow, and oxygen content were measured during the preischemic period and at 15 and 30 minutes during reperfusion. Results showed an improved hemodynamic recovery (peak systolic pressure, p = 0.

Changes in the respiratory gas tensions of a pneumonectomy space and their application to the diagnosis of bronchopleural fistula.

The oxygen (pO2) and carbon dioxide (pCO2) gas tensions of a pneumonectomy space were studied in an animal model. The 2 gases were measured in a standard blood gas analyser. The space gas pO2 and pCO2 equilibrated to a steady state within 48 hours of thoracotomy (pO2 mean 53.

Effects of succinylacetone on growth and respiration of L1210 leukemia cells.

4,6-Dioxoheptanoic acid (succinylacetone, SA), a potent inhibitor of heme biosynthesis, suppressed growth and decreased respiration of L1210 leukemia cells in vitro. Growth of cells incubated in the presence of 2--4 mM SA for the first 2 days declined, and after 3 days virtually ceased. L1210 cells in the logarithmic growth phase exhibited active respiration (40 +/- 9.

Two-dimensional echocardiographic recognition and repair of subvalvular mitral aneurysm of the left ventricle in an infant.

The clinical features, diagnostic studies and surgical treatment of a subvalvular mitral aneurysm of the left ventricle are described. The infant presented at 9 weeks of age with large apical ventricular septal defects and pulmonary hypertension. The subvalvular aneurysm was an incidental finding.