Tuna cornea as biomaterial for cardiac applications.

Among available biomaterials, cornea is almost completely devoid of cells and is composed only of collagen fibers oriented in an orderly pattern, which contributes to low antigenicity. Thunnus thynnus, the Atlantic bluefin tuna, is a fish with large eyes that can withstand pressures of approximately 10 MPa. We evaluated the potential of this tuna cornea in cardiac bioimplantation.

Cardiac surgery in patients with acute intermittent porphyria.

Acute intermittent porphyria (AIP) is a disorder of the heme biosynthesis pathway of a specific inherited enzymatic defect. Many different environmental factors such as drugs, calorie restriction, infection etc., often play a key role in triggering a porphiric acute attack.

[Left atrial thrombosis in patients with antiphospholipid antibody syndrome and mesenchymal abnormal septum].

Antiphospholipid antibodies are a heterogeneous family of immunoglobulins that includes lupus anticoagulant and anticardiolipin antibodies. They are strongly associated with a clinical syndrome characterized by venous and arterial thrombosis and spontaneous fetal losses. This syndrome may be primary or else secondary to autoimmune or neoplastic diseases.

The reliability of urinary albumin assay by immunonephelometry in the clinical practice. The critical role of medical surveillance on laboratory routine.

Measurement of the urinary albumin excretion rate (UAER) is essential for the early diagnosis and monitoring of diabetic nephropathy; immunonephelometry is a procedure used worldwide for routine screening of diabetic patients. Since we have met with occasional inconsistent values of UAER in serial urine collections, we searched for possible sources of analytic error. To assess the best working conditions of the instrument in use, the stability of urine samples during storage and the need for previous urine centrifugation, we assayed repeatedly the six automatically diluted points of the standard curve (55.

Cardiac metastasis of rectal adenocarcinoma. Surgical treatment.

The authors report a case of cardiac metastasis of a rectal adenocarcinoma that infiltrated the right ventricle and partially obstructed its outflow tract. Surgical treatment was performed because of syncopal attacks. The differential diagnosis between organized thrombi and intracardiac tumor is considered.

Thickening of the gallbladder wall in ascites.

The thickening of the gallbladder wall in patients with ascites is commonly related to hypoalbuminemia and/or portal hypertension. To evaluate the pathogenetic role of these two factors, we correlated gallbladder wall thickness (GBWT) with the albuminemia and the serum-ascites albumin gradient (SAAG), an index of portal hypertension, in 47 patients with ascites caused by cirrhosis of the liver or abdominal malignancy. We found a thickened gallbladder wall in 30/47 patients.

Diagnostic accuracy of sialic acid in the diagnosis of malignant ascites.

The authors evaluated the diagnostic accuracy of sialic acid and its lipid-bound fraction in ascites and compared these tests with others (fibronectin, cholesterol) recently claimed as valuable in the differential diagnosis of ascites. Fibronectin yielded the best diagnostic accuracy (85%) with no false-positive and 37% of false-negative (10/27). The authors also found higher concentration of sialic acid in malignant ascites than in nonmalignant ascites (P less than 0.

Disposition of a flow-limited drug (lidocaine) and a metabolic capacity-limited drug (theophylline) in liver cirrhosis.

The plasma clearance after oral administration of a completely absorbed drug that is metabolized by the liver depends on its intrinsic clearance. In cirrhosis the bioavailability of a flow-dependent drug increases because of both portosystemic shunting and hepatocyte dysfunction. A drug with a high extraction ratio, lidocaine, and a drug with a low extraction ratio, theophylline, were administered to 27 patients with cirrhosis and 16 control subjects.

Ticlopidine-theophylline interaction.

Ticlopidine, a new antithrombotic agent, and theophylline, a widely used bronchodilator drug, are both almost completely metabolized in the liver. To evaluate an interaction between these two drugs, we studied theophylline pharmacokinetics before, after 10 days of ticlopidine administration, and 1 month later in 10 healthy volunteers. We found a highly significant increase in the theophylline elimination half-life (P less than 0.

Diagnostic accuracy of fibronectin in the differential diagnosis of ascites.

To evaluate the diagnostic accuracy of fibronectin levels in ascites to differentiate malignant from non-malignant ascites, the authors studied 30 patients with sterile uncomplicated ascites in chronic liver disease, 18 patients with malignant ascites and four patients with spontaneous bacterial peritonitis. Fibronectin concentration was significantly higher in malignant ascites than in sterile ascites (P less than 0.001).

Abdominal heart transplantation: description of a new allograft extrathoracic pump.

This study describes a new kind of abdominal heart transplantation for left ventricular assistance carried out in a series of 12 experiments in pigs weighing 15-25 kg. This was achieved making three connections between the donor's left atrium, aorta and pulmonary artery with the recipient's aorta, still aorta and inferior vena cava, respectively. The hemodynamic data were satisfactory, the best survival rate with a transplanted working heart was 1 month.

Coronary artery revascularization without cardiopulmonary bypass.

At the Texas Heart Institute between October 1969 and August 1983, there were 191 single bypass procedures performed without pump oxygenator support. These cases have been divided into two groups: Group I (160 patients) represents the time period from October 1969 through December 1981 and includes our experience with single vessel left anterior descending (LAD) coronary artery bypass without pump oxygenator support; Group II (31 patients) represents the period between January 1982 and August 1983 and includes our initial operative experience in patients with failed percutaneous transluminal coronary angioplasty (PTCA). Of 145 primary operations in Group I patients, 113 were single bypasses to the right coronary artery with a postoperative infarction rate of 3.

[Cerebral protection in surgery of the carotid arteries].

The authors, starting from the larger and larger spreading of the carotid surgery, consider the risks of cerebral ischemia involved and the measures suitable to reduce its incidence. So, they analyse the measures, both pharmacologic and mechanical, which, before, during and after operation, may contribute in reducing the possibility of incidence of such a deprecable complication.

[Technical variations in abdominal heterotransplants of the heart].

The Authors describe the innovations by them introduced in a series of 15 experiments of abdominal heart heterotopic transplantation done in the Institute of Veterinary Physiology and Biochemistry University of Milano. Particularly they recommend the use of cardioplegia and the prolene as suture's material to reduce the ischemic time. Also they signal the importance of a new position of the transplanted heart with the apex looking at the head of the recipient.

[Surgical valve therapy combined with aorto-coronary bypass (author's transl)].

The AA. analyse a series of 720 patients who have undergone an aorta coronary by-pass combined with surgical valve therapy at the Texas Heart Institute up to an including 1977. 384 of these cases involved the aortic valve, 306 the mitral valve and 30 both valves.

[Interatrial communications of the ostium secundum type in the adult (author's transl)].

On the basis of personal observations made during their first year of activity in cardiac surgery, the authors review the existing literature concerning surgical indications for interatrial communications in the adult. While they recognize that there is a strong correlation between patient age and mortality, they argue that corrective surgery for such defects can be done also in the older patients, with due regard to limiting criteria relative to pulmonary arterial pressure, pulmonary arteriolar resistance, and cardiac failure.

[Myocardial protection during open heart operations].

The need for adequate protection of the myocardial tissue during open heart operations has proved to be of considerable importance in view of the conditioning value of the functional anatomical state of the myocardial fibre on the outcome of the surgery itself. After a review and description of the most widely used methods of protection, the Authors draw on the data in literature in order to trace a critical profile of each method, outlining its merits and defects in the light of present experience.