En bloc heart and lung transplantation in Finland 1988-1996.

Unlabelled: The purpose of the study was to review the first clinical experience in combined heart-lung transplantation in our institution.

Material: From June 1988 to December 1996 15 en bloc heart and lung transplantations were performed. There were nine men and six women, aged 17-61 (mean 42.

Heart transplantation in Finland 1985-1995.

Background And Aims: Since improved immunosuppression in the 1980's, heart transplantation is a well established procedure to treat patients with end-stage heart failure. The first heart transplantation in Finland was performed in 1985. Since then the activity has gradually increased to a level of about 25 annual transplants.

Value of high-resolution computed tomography in routine evaluation of lung transplantation recipients during development of bronchiolitis obliterans syndrome.

Background: Chronic rejection is a major long-term complication after lung transplantation. The purpose of our study was to evaluate the role of repeated high-resolution computed tomographic examinations in monitoring the development of bronchiolitis obliterans syndrome after lung transplantation.

Methods: A total of 126 high-resolution computed tomographic examination in 13 lung transplant recipients was analyzed.

Time course of beta 2-integrin CD11b/CD18 (Mac-1, alpha M beta 2) upregulation on neutrophils and monocytes after coronary artery bypass grafting. CD11b upregulation after CABG surgery.

Although upregulation of CD11b/CD18 receptor, i.e. activation of neutrophils and monocytes, during cardiopulmonary bypass is well documented, the duration of the active state after uncomplicated operation is less understood.

Perivascular sympathectomy does not remove adrenergic nerves from distal vessels. The effect of various denervations on the rat saphenous bundle: a histochemical study.

It has been claimed earlier that perivascular sympathectomy removes distal adrenergic innervation of the vessels. Based on preliminary results suggesting the contrary, the purpose of this work was to reconsider the denervation effect of perivascular sympathectomy. We operated on 40 rats using different denervation methods mainly to test the effects of perivascular sympathectomy on the distal saphenous vessels of the leg.

Surgical treatment of ventricular septal defect secondary to myocardial infarction.

13 patients were operated on during 1974-88 for ventricular septal defect secondary to myocardial infarction. 7 infarctions were inferior and 6 anterior. At the time of operation 5 patients were in shock.

Popliteal artery entrapment.

External compression of the popliteal artery is probably still underdiagnosed. Young patients with atypical claudication, with isolated popliteal changes, deserve thorough investigation. Subdividing the entrapment syndrome into three subgroups (I-III) highlights the clinically important characteristics of the different types.

Early and late results of surgery for atrial septal defect in patients aged over 60 years.

To assess the risks and benefits attending the surgical repair of atrial septal defect in the elderly the case histories of all patients operated on at the age of 60 years or more were reviewed and follow-up study, including cardiac catheterization, was performed. A total of 17 patients (12 females and 5 males) were identified. The left-to-right shunt ratio averaged 2.

Life-threatening complications of cardiac operations and occurrence of myocardial catecholamine bombs.

Myocardial catecholamine bombs (huge local intra-axonal accumulations of catecholamine, mainly norepinephrine, within cardiac tissue) were observed in (right auricular) myocardial biopsy specimens in 16 of 65 adult patients selected randomly from a series of elective cardiac operations. The occurrence of catecholamine bombs was in highly significant correlation (p less than 0.001) with the occurrence of life-threatening complications of cardiac operations (life-threatening arrhythmias [ventricular tachycardias, ventricular fibrillation, asystole], clinically evident perioperative myocardial infarction/postoperative low-output syndrome, death).

Adrenergic innervation of aortic patch-grafts in rats.

The regeneration of vascular adrenergic nerves was studied using the glyoxylic acid-induced fluorescence method for the specific demonstration of adrenergic nerves in syngeneic patch-grafts of the right atrium of the heart, vena cava and glutaraldehyde-treated vena cava transplanted into the abdominal aorta of the rat. Glutaraldehyde-treated segments of the supradiaphragmatic inferior vena cava were transplanted into the abdominal aorta of rats as well. At the end of the observation period of 24 weeks limited, patchy and defective innervation was observed in the syngeneic vena cava and atrial patches.

Bronchospasm during cardiopulmonary bypass--a potentially fatal complication of open-heart surgery.

Severe bronchospasm at the termination of cardiopulmonary bypass is an unusual but dangerous complication of open-heart surgery. We report two cases. In both of them the final etiology remained unsettled.

Abdominal aortic aneurysm and dissection after blunt trauma.

A case of abdominal aortic aneurysm and dissection after blunt trauma is presented. Unlike traumatic lesions of the thoracic aorta, this condition seems to be extremely rare, and may therefore deserve publication. Conservative surgery (resection of the dissected intimal flaps, closure of the aortotomy with a Blalock-type vascular suture) gave good early and late (6 years follow-up) results.

Effect of addition of magnesium to potassium-containing fluorocarbon cardioplegic preparations. An experimental study.

The effect of magnesium on potassium fluorocarbon cardioplegia was studied in 20 rabbits. Isolated hearts with ascending aortas were perfused with oxygenated and cooled (+4 degrees C) fluorocarbon solutions. In 10 experiments, the solution contained 20 mmol/l of potassium, in 10 further experiments, 20 mmol/l of potassium and 15 mmol/l of magnesium.

Congruence of adrenergic and cholinergic intrinsic innervation of human and rat atria.

Right atrial biopsies from rat and human hearts were studied using combined methods for the demonstration of glyoxylic acid-induced fluorescence (GIF) of catecholamines and acetylcholinesterase (AChE) reactions in the same specimens. In specimens from the rat heart, the GIF and AChE reactions were performed either simultaneously or consecutively. In biopsies of the human right atrium, obtained at right atria cannulation during open-heart surgery, the reactions were performed consecutively.

Long-term survival rates after prolonged aortic cross-clamping with St. Thomas' Hospital cardioplegia.

Prolonged aortic cross-clamping (in excess of 120 min) was necessary in 154 cardiac surgical patients. St. Thomas' Hospital cardioplegia was used for myocardial preservation.

Peptidergic innervation of human atrial myocardium: an electron microscopical and immunocytochemical study.

Nerve terminals of human cardiac muscle were studied using an electron microscope. Substance P-, Leu-enkephalin- and vasoactive intestinal polypeptide-like (VIP) immunoreactive nerves were demonstrated by use of the light microscope. In addition, VIP- and substance P-like immunoreactive nerves were localized ultrastructurally by the peroxidase-antiperoxidase-method.

Rod-like intramitochondrial inclusions after hypothermic chemical cardioplegia during cardiac operations.

Rod-like intramitochondrial inclusions in the myocardial cells were observed after hypothermic chemical cardioplegia in three out of 20 patients who underwent coronary bypass operations. They were not seen in another group of 20 patients who underwent an aortic valve replacement operation in whom only topical cooling was used for myocardial protection. The occurrence of rod-like intramitochondrial inclusions could not be correlated with other signs of ischemic myocardial injury.

Plasma cell granuloma of lung and pleura.

A report is presented of seven patients with plasma cell granuloma of the lung or pleura. Two were operated on in 1970, three in 1971, one in 1973 and one in 1984. None of the patients had smoked cigarettes.