Treatment of lingual tonsillitis by transoral CO2 laser endoscopy.

The authors report on their clinical experiences concerning 100 cases of chronic lingual tonsillitis. The surgical treatment employed was endoscopic vaporization of affected tissues with the CO2 laser. Prior to surgical intervention, predisposing conditions such as allergy, rhinosinusitis, and gastroesophageal reflux were identified and treated.

[Recurrent respiratory distress and idiopathic subglottic stenosis: what treatment?].

Background: Idiopathic subglottic stenosis is a rare cause of acute respiratory distress, that is difficult to treat (corticosteroids, tracheotomy).

Case Report: A nine-year-old boy presented with acute respiratory distress due to tracheal stenosis. The symptoms recurred after the endotracheal inflammatory membranes had been removed with forceps, despite 6-months of degressive corticotherapy.

Qualitative and quantitative studies of cytokines synthesized and secreted by non-human primate peripheral blood mononuclear cells.

Non-human primates are being utilized in a variety of pre-clinical studies, including those involved with mechanisms of organ transplant rejection and those being used as models to test the efficacy of vaccines against a variety of infectious diseases, most notably AIDS. These studies clearly involve immunological effector mechanisms, which include the interaction between T cells, B cells, monocytes, and cytokines that regulate these interactions. However, there is very little known about assays and quantitation of cytokines from non-human primates.

Host T-cell primary allosensitization to MHC class-I- and class-II-expressing human cardiac myocytes requires the presence of a second signal.

Normal FHCMs, or transformed cell lines derived from FHCMs, such as W1, even after induction of MHC antigens by pretreatment with IFN-gamma, failed to induce proliferation of allogeneic human PBMCs in vitro. To test the hypothesis that antigen-specific T-cell activation and proliferation require not only the binding of the TCR with its ligand, the MHC molecule, but also a second signal that involves the interaction of T-cell surface molecules with their natural ligands on the stimulating cells, a mAb against CD28 was used. Cocultures of allogeneic PBMCs with IFN-gamma-pretreated irradiated FHCMs or the W1 cell line in microtiter plates containing immobilized anti-CD28 mAb induced marked stimulator cells MHC class-II-specific proliferative responses.

Does flow character of cardiopulmonary bypass make a difference?

The influence of pulsatile bypass flow on the performance of the cardiovascular system, fluids and blood balance, acid-base equilibrium, and splanchnic function was investigated. One hundred patients scheduled for elective coronary artery bypass grafting were randomly divided into a group of standard perfusion (NP) and a group of pulsatile perfusion (PP). At the end of the operation, similar cardiac performance developed in both groups that was higher than before bypass: left ventricular stroke work index after bypass, 56.

Characterization of human heart-infiltrating cells after transplantation. VI. Differences in the cytokines produced by individual CD4+ cloned T-cell lines with apparently identical antiidiotype-like reactivity.

Studies of cultures and cloned T-cell lines from mononuclear cell infiltrates in cardiac biopsy specimens have provided a unique resource to study the cellular basis of human organ allograft rejection. Our laboratory has previously shown that biopsy specimens placed on autologous donor MHC-class-II-specific cloned T-cell lines from previous cardiac biopsies led to the isolation of cloned T-cell lines, which appeared to be functionally "antiidiotypic" in nature. Detailed functional analysis of such CD4+ individual antiidiotype-reactive cloned T-cell lines revealed that although some augmented the proliferative response of autologous idiotype-bearing cloned T-cell lines against donor stimulator cells, others markedly suppressed the proliferative response; thus, although each of these antiidiotype-like reactive cloned T-cell lines appears to specifically react with the same idiotype-bearing donor MHC-class-II-specific cloned T-cell line, they were functionally heterogeneous.

Initial experience with low-potassium cold blood cardioplegia: a clinical comparative study.

This study presents the results of bypass grafting in 96 patients operated on for triple-vessel coronary artery disease between May 1988 and September 1990. In the first 54 patients a cold crystalloid solution was employed, and in the 42 more recent patients cold blood low-potassium cardioplegia was employed. There were no differences in postoperative cardiac index or left ventricular stroke work index.

Abnormal expression of histocompatibility and mitochondrial antigens by cardiac tissue from patients with myocarditis and dilated cardiomyopathy.

Autoantibodies against the adenine nucleotide translocator (ANT), the branched chain alpha-ketoacid dehydrogenase (BCKD) complex proteins, and myosin have been implicated in the pathogenesis of human dilated cardiomyopathy (DCM). Cardiac tissue from patients with DCM and, for control purposes, cardiac tissue from patients with other forms of cardiomyopathy and from patients with no history of cardiac disease were stained with heterologous and ANT-, BCKD-, and myosin-specific affinity-purified sera from DCM patients. Data demonstrate that although anti-myosin stains tissues from both patients and normal controls, the ANT- and BCKD-specific heterologous and affinity-purified sera from DCM patients stain only cardiac tissues from DCM patients.

Establishment of a human fetal cardiac myocyte cell line.

Human cardiac myocytes undergo degeneration, cytolysis, and necrosis in a number of clinical disease conditions such as myocarditis, dilated cardiomyopathy, and during episodes of cardiac allograft rejection. The precise cellular, biochemical, and molecular mechanisms that lead to such abnormalities in myocytes have been difficult to investigate because at present it is not possible to obtain and maintain viable cell cultures of human adult cardiac myocytes in vitro. However, human fetal cardiac myocytes are relatively easy to maintain and culture in vitro, but their limited availability and growth, variability from one preparation to another, and varying degrees of contamination with endothelial and epithelial cell types have made it difficult to obtain reliable data on the effect of cardiotropic viruses and cardiotoxic drugs on such myocytes.

The influence of MHC and non-MHC genes on the nature of murine cardiac allograft rejection. I. Kinetic analysis of mononuclear cell infiltrate and MHC-class I/class II expression in donor tissue.

While normal cardiac tissue expresses low levels of MHC-class I, undetectable levels of MHC-class II antigens, and no mononuclear cell infiltrates, posttransplantation allogeneic donor cardiac tissue demonstrates dramatic increases of MHC-class I/class II expression coincident with the infiltration of the tissue with mononuclear cells. Results of this study demonstrate that the kinetics of MHC-class I/II antigen expression and the phenotype of mononuclear cell infiltrate are influenced, to a great degree, by the genetic H-2, intra-H-2 and non-H-2 incompatibility between donor and recipient strains of mice. Increases of MHC-class I precede class II expression in cells from donor cardiac tissue from completely allogeneic BALB/c, H-2-disparate B10.

Dietary management of D-lactic acidosis in short bowel syndrome.

Manipulation of carbohydrate intake was used to treat severe, recurrent D-lactic acidosis in a patient with short bowel syndrome. Dietary carbohydrate composition was determined after assessment of D-lactic acid production from various carbohydrate substrates by faecal flora in vitro. This approach may be preferable to repeated courses of antibiotics.

Hepatitis B vaccine in the prevention of perinatally transmitted hepatitis B virus infection: final report on a West Midlands pilot study.

A four-dose vaccination schedule was used to interrupt perinatal transmission of hepatitis B virus from carrier mothers to their babies. Of 49 babies immunised and successfully followed up, 43 (88%) became immune: 15 out of 21 (71%) of babies born to HBeAg + mothers became immune, the other 6 becoming the only carrier babies in the study. Without immunisation a carrier rate in excess of 70% would have been expected in this high-risk group.

Subglottic haemangioma in the infant: contribution by CO2 laser.

The availability of the low intensity CO2 laser beam, and the possibility of defocalization that is associated with control of subglottic high frequency jet ventilation, requires a more interventionist attitude regarding dyspnoea caused by a subglottic haemangioma in the infant. It is indeed possible reliably to reduce the size of the subglottic haemangioma, and thus to avoid a lengthy period of intensive care, as well as the problems of prolonged intubation or tracheostomy for drainage, while also avoiding long term steroid therapy. This approach in no way affects the spontaneous evolution of subglottic haemangioma in the infant; there is a tendency for the haemangioma to regress after the age of one year.

An assessment of the mechanical properties of leaflets from four second-generation porcine bioprostheses with biaxial testing techniques.

The aim of this study was to determine whether second-generation porcine bioprostheses, glutaraldehyde fixed at pressures said to be less than 4 mm Hg, exhibit more natural leaflet material properties than earlier valves fixed at 80 to 100 mm Hg. Biaxial mechanical testing techniques were used to compare Carpentier-Edwards SAV, St. Jude Medical BioImplant, Hancock II, and Medtronic Intact bioprostheses (12 leaflets from four valves in each case) with fresh porcine aortic valves and high pressure-fixed Carpentier-Edwards 6625 bioprostheses (14 leaflets from five valves in each case).

Effect of antibiotics on the binding of pargyline to monoamine oxidase in cultured hepatocytes.

The laser dye rhodamine 123 has been used to establish that the binding of [3H]pargyline to monoamine oxidase is a more sensitive indicator of mitochondrial perturbation than measurements of protein synthesis, secretion, or degradation. The amount of monoamine oxidase labelled depends on the antibiotic used. The labelling was considerably lower in the presence of gentamycin than in the presence of either chloramphenicol or of penicillin and streptomycin.

Neuralgia following lumbar sympathectomy.

Between March and October 1986, 33 consecutive patients underwent unilateral lumbar sympathectomy in the Thoracic and Cardiovascular Surgical Unit of the Catholic University in Louvain, Belgium. Ten patients experienced postsympathectomy neuralgia. After a single epidural injection of fentanyl, 50 micrograms, and methylprednisolone 80 mg, pain disappeared completely in six patients.

Intravenous infusion of propofol for induction and maintenance of anaesthesia during endoscopic carbon dioxide laser ENT procedures with high frequency jet ventilation.

Fourteen patients of ASA grades 1-3 were anaesthetised with continuous infusions of propofol and alfentanil for endoscopic carbon dioxide laser ENT microsurgery. Their lungs were ventilated with an oxygen-air mixture using a high frequency jet ventilator. Propofol was given at an initial rate of 120 micrograms/kg/minute for 10 minutes after a bolus dose of 2.

Homozygosity in piebald trait.

A severely affected child born to consanguineous parents is interpreted as being a homozygote for the dominantly inherited piebald trait. The striking phenotypic difference between the parents and the child implies intermediate inheritance of this condition, and the family also illustrates that consanguinity should not always be taken to indicate genetic heterogeneity and recessive inheritance.

Fate of the monoamine oxidase inhibitor pargyline in cultured hepatocytes.

The interaction of the monoamine oxidase inhibitor pargyline with cultured hepatocytes has been studied. [Phenyl-3, benzyl-3H] pargyline (38 nM) rapidly enters the cells and a plateau of incorporation into a trichloroacetic acid insoluble form (monoamine oxidase) is reached after 2 hr. The level of labelling is lower in freshly isolated cells than in those in later culture.

Halothane versus isoflurane for short ENT procedures with spontaneous respiration in children.

This study compares halothane with isoflurane for short ENT procedures performed under spontaneous breathing in 80 children. Monitoring included ECG, arterial pressure, PECO2 and respiratory rate. Induction, maintenance and recovery durations were recorded.