Central effects of somatostatin: pressor response, AVP release, and sympathoinhibition.

The effects of intracerebroventricular (icv) administration of somatostatin(1-14) (SS1-14) on mean arterial blood pressure (MAP), heart rate (HR), plasma arginine vasopressin (AVP) concentration, and splanchnic nerve activity (SpNA) were studied in conscious rats. In addition, the effects of peripheral alpha-adrenergic receptor blockade with prazosin, vasopressinergic V1-receptor blockade with [d(CH2)5Tyr(Me)]AVP, and chronic bilateral sinoaortic denervation (SAD) on central SS1-14-induced MAP, HR, and SpNA responses were investigated. SS1-14 icv elicited dose-dependent increases in MAP and plasma AVP concentration as well as decreases in HR and SpNA.

Coronary arteries in the hypoplastic left heart syndrome. Histopathologic and histometrical studies and implications for surgery.

The subepicardial coronary arteries (CAs) in the hypoplastic left heart syndrome (HLHS) were studied for pathology dependent on the patency of the mitral valve and the presence of endocardial fibroelastosis (EFE) of the left ventricle (LV). Nine heart specimens with aortic and mitral atresia (group 1) were studied and compared with 19 hearts with aortic atresia and mitral stenosis (group 2) (EFE of the LV was present in all cases) and 10 normal hearts. The median age at death was 3 days.

Atrioventricular septal defect complicated by right ventricular outflow tract obstruction. Analysis of risk factors regarding surgical repair.

Eighteen patients with complete atrioventricular septal defect (AVSD) were found to have either associated tetralogy (n = 15) or pulmonary atresia (n = 3). Their pre- and post-operative course was reviewed focusing attention on risk factors for complete repair. These included right ventricular (RV) hypoplasia, identified by cineangiographic volume determinations in two cases (11%) and inadequate pulmonary artery size in one patient.

Competition of coronary arteries and ventriculo-coronary arterial communications in pulmonary atresia with intact ventricular septum.

Pulmonary atresia with intact ventricular septum can be complicated by the presence of large ventriculo-coronary arterial communications which disturb normal myocardial perfusion. In the selection of patients for surgery the presence of these communications provides an additional problem. On the basis of previous cineangiocardiographic study, we performed a histopathological study of 16 cases.

[Sonographic diagnosis of liver tumors. Results of comparative studies of ultrasound, computerized tomography, laparoscopy, biopsy and scintigraphy in 413 patients].

Based on a retrospective study of 413 patients, the accuracy of sonography compared to CT, laparoscopy, biopsy and scintigraphy in the primary diagnosis of liver masses is shown. False positive sonographic reports are analysed in retrospect. 190 of 338 solid space-occupying growths of the liver have sonographically been called definite growths and 148 have been considered suspicious of being such growths.

Aortic intramural coronary artery in three hearts with transposition of the great arteries.

Three hearts with transposition of the great arteries had an aberrant coronary artery coursing between the aortic and pulmonary roots. This coronary artery remained embedded in the aortic wall for some distance. In each case, on external inspection, the abnormal artery presented as a separate vessel at the site from which it usually originates in the left sinus of Valsalva.

[Clinical uses of digital subtraction angiography for imaging anatomy immediately following heart operations in childhood].

Within the last three years, digital subtraction angiography (DSA) was performed 60 times in 58 children with congenital heart disease (coarctation of the aorta, tetralogy of Fallot or transposition of the great vessels) in the immediate post-operative period to delineate residual defects. The DSA was carried out 3.7 +/- 1 days postoperatively with a total of 3.

Hypoplasia of the intrapulmonary arteries in children with right ventricular outflow tract obstruction, ventricular septal defect, and major aortopulmonary collateral arteries.

Postmortem injection studies have been carried out on the pulmonary vasculature of four children dying with pulmonary atresia and ventricular septal defect or severe tetralogy of Fallot with major aortopulmonary collateral arteries, in which nearly all bronchopulmonary segments had more than one source of blood supply. Despite regional variations in the source of blood supply, there was remarkable uniformity of arterial size and number within the respiratory unit throughout each case. In all cases, there was a normal number of arterial pathways, but both pre- and intraacinar arteries were considerably smaller than normal.

Tetralogy of Fallot. Development of hypoplastic pulmonary arteries after palliation.

Thirty-one patients with tetralogy of Fallot were studied angiographically before and after palliation with Blalock-Taussig operation (n = 9), Brock operation (n = 12), or enlargement of the right ventricular outflow tract with extracorporeal circulation (ECC) (n = 10). The relative diameter of the pulmonary vascular ring (PVR), pulmonary trunk (PT), and right and left pulmonary arteries (RPA, LPA) were measured before and 24.8 +/- 20.

Pharmacodynamic effects of ouabain following single sublingual and intravenous doses in normal subjects.

In this intraindividual, placebo-controlled, double blind study the dynamic effects of single doses of ouabain 0.5 mg i.v.

Reduced left ventricular size and endocardial fibroelastosis as correlates of mortality in newborns and young infants with severe aortic valve stenosis.

30 patients with severe aortic valve stenosis presented in severe congestive heart failure within the first 2 months of life. In 25 of them, left ventricular volume and contractility were assessed; five of them had a left ventricle of normal size, in 11 left ventricular size was diminished, and in nine patients it was enlarged. Eleven of the infants had extensive endocardial fibroelastosis (EFE) evidenced angiographically by myocardial sinusoids in ten of them and established at autopsy in six.

[Anomalous coronary drainage from the pulmonary artery with associated heart and vascular abnormalities. Report on 3 patients and review of the literature].

The clinical and cineangiocardiographic findings of three children with anomalous coronary artery origin were analyzed: in the first case, associated with Scimitar syndrome, the left coronary artery arose from the left posterior pulmonary sinus; in the second case, in addition to Fallot's tetralogy, the left coronary artery had its origin from the right pulmonary artery; and in the third case, the left circumflex artery arose anomalously from the right pulmonary artery in association with coarctation of the aorta, aortic valve stenosis and diverticulum of the left ventricle. The findings of 46 cases reported in the literature to have anomalous origin of one or both coronary arteries, a single coronary artery, or of the left anterior descending coronary artery reveal that additional cardiovascular anomalies can also be found in 4 to 17% of the cases described in collectives of more than ten patients. Almost any type of cardiovascular malformation can coexist with anomalous origin of a coronary artery from the pulmonary artery.

Compression of intrapulmonary bronchi by abnormally branching pulmonary arteries associated with absent pulmonary valves.

In 3 patients with absent pulmonary valve syndrome and absent ductus arteriosus, the lungs were injected and analyzed postmortem using morphometric techniques. Two patients had tetralogy of Fallot and 1 had D-transposition of the great arteries, the latter being the first autopsy-proved case of absent pulmonary valve with transposition. In addition to the expected dilatation of the central pulmonary arteries and compression of the mainstem bronchi, postmortem pulmonary arteriography revealed a bizarre pattern of hilar branching.

[Experimental Klebsiella pneumonia (author's transl)].

Experimental pneumonia was investigated by light microscopic, electron microscopic and morphometric methods in mice infected with the problem spore Klebsiella pneumoniae. In the early stage (2 to 7 hours post infection) we found Klebsiellae and aggregates of platelets in the pulmonary capillaries, but we could not establish significant structural alterations with morphometric methods. The ultrastructural investigation revealed alterations of the alveolar lining cells and the endothelial cells of capillaries and an infiltration of the interalveolar septula with polymorphonuclear and mononuclear leucocytes.

Effect of prostaglandin E1 on pulmonary circulation in pulmonary atresia. A quantitative morphometric study.

The structural effect of prostaglandin E1 on the pulmonary circulation in pulmonary atresia has been studied by applying quantitative morphometric techniques to the injected and inflated lungs of eight babies who had received prostaglandin E1 for between 30 hours and 12 days. The most striking effect was on the pulmonary arterial smooth muscle. Relative arterial medial thickness was reduced and muscle did not extend as far along the arterial pathway as compared with the normal and with untreated cases of pulmonary atresia, dying at a similar age.

Haemodynamics studies in patients with univentricular hearts.

The catheterization data including angiocardiography of 30 infants and children with different types of univentricular heart were used to study the influence of pulmonary and systemic flow as well as the position of the outlet chamber on systemic arterial saturation. All patients with normally connected great arteries displayed favourable streaming and differed significantly from those with 1-TGA as well as d-TGA, who showed varying streaming characteristics. Taking into account, however, the position of the outlet chamber, favourable streaming could be demonstrated to occur in most patients with TGA and lateral outlet chamber, and significantly less in patients with TGA and anterior outlet chamber.

Angiocardiographic left ventricular volume determination in tricuspid atresia. Comparison of patients with and without palliative surgery.

Group A (n = 10) had reduced pulmonary blood flow and no previous surgery, group B (n = 9) had decreased pulmonary blood flow despite a systemic-to-pulmonary artery shunt and those in group C (n = 10) had increased pulmonary blood flow 9 of whom had no previous surgery and 1 a large Waterston anastomosis. Left ventricular end-diastolic volume (LVEDV) and left ventricular systolic output (LVSO) were higher than normal in all 3 groups with an order of descending magnitude of group C (278 +/- 20% and 264 +/- 32%), group B (264 +/- 19% and 243 +/- 37%) and group A (189 +/- 14% and 190 +/- 13%). For the entire group A, left ventricular ejection fraction (LVEF) was normal (0.

[Effect of prostaglandin E1 on the hemodynamics in newborn infants with pulmonary atresia (author's transl)].

The effect of prostaglandin E1 (PGE1) on the haemodynamics during cardiac catheterisation was studied in 6 newborn infants with pulmonary atresia and ductus-dependent pulmonary perfusion. In 4 patients with initial arterial O2-saturations between 24% and 45% pulmonary blood flow increased from a mean value of 1.0 to 4.

[Surgery in newborns and infants with cyanotic cardiac malformations: indication and technique of emergency operations and urgent early surgical interventions (author's transl)].

Between April 1974 and September 1977, 368 infants underwent surgery at the German Heart Center. 287 were less than 1 year of age, and 81 were between the ages of one and two years. In 90 patients (= 24.

Development of the pulmonary circulation in ventricular septal defect: a quantitative structural study.

The application of quantitative morphometric techniques to evaluation of the lungs of nine children who died with a ventricular septal defect between the ages of 3 months and 4 years showed that the presence of pulmonary hypertension interferes with the growth and development of the pulmonary circulation. In all cases the preacinar arteries were of normal size and not dilated, and arterial size and number within the acinus were reduced and similar to those seen in the normal child at birth. Arterial and venous muscularity was increased as judged by an increase in wall thickness and by the presence of muscle in smaller and more peripheral arteries than is normal.

[Pulmonary atresia with ventricular septal defect. Follow up and surgical results from 1963 to 1976 and diagnostic measures with special reference to large systemic-pulmonary collaterals (author's transl)].

Clinical course, surgical results, and diagnostic procedures of 76 patients with pulmonary atresia and ventricular septal defect between 1963 and 1976 were reviewed. 50 patients had bilateral intrapericardial pulmonary arteries with confluence (group A) and 4 patients had a unilateral intrapericardial pulmonary artery (group B). In 22 patients intrapericardial pulmonary arteries could not be demonstrated (group C).

[Transposition of the great arteries: natural history and indications for surgery after balloon-atrioseptostomy (author's transl)].

The natural history of 162 children with transposition of the great arteries is referred, whose first heart catheterization fell between 1967 and June 1975. In 149 of them balloon atrial septostomy (BAS) was performed, with a mean increase in arterial oxygen saturation of 21 %. In 11 cases BAS was repeated after inadequate first BAS, but again without success.

[Surgical treatment of wilms' tumour and neuroblastoma with particular reference to staging (author's transl)].

Combined surgical, irradiation and cytostatic therapy has considerably improved the outlook in cases of Wilms' tumour over the past years. Unfortunately the therapeautic results in neuroblastoma have not shown improvement to the same extent. Staging of the tumour is an essential basis for thee establishment of optimum therapeutic management and prognosis.