SEQUENTIAL ELECTROCARDIOGRAPHIC ANALYSIS OF STONE HEART SYNDROME IN A PATIENT SUPPORTED SIX DAYS WITH AN ABDOMINAL LEFT VENTRICULAR ASSIST DEVICE (ALVAD).

A 21-year-old male patient underwent aortic and mitral valve replacement for progressive cardiac failure due to acute bacterial endocarditis. Ischemic myocardial contracture developed during attempts to restore cardiac activity following hypothermic, ischemic, cardioplegic arrest. An abdominal left ventricular assist device (ALVAD) was implanted and supported the circulation for nearly six days prior to cardiac transplantation.

Cardiopulmonary parameters and prognosis after severe multiple trauma.

Comprehensive cardiopulmonary and metabolic monitoring of severely traumatized patients for 7 days from the time of injury has allowed us to determine parematers which correlate with survival and nonsurvival. The earliest and most persistent change is an increased pulmonary vascular resistance which results in right heart overload and failure. Left heart "failure" which has been previously described with acute respiratory failure and shock is shown to be a mathematical artifact caused by dilatation of the right heart and encroachment on left ventricular filling volume.

Ruptured thoracic aorta: evolving radiological concepts.

The chest roentgenograms of 18 patients with ruptured aortas were studied and the radiographic features tabulated. Fifteen patients survived to undergo angiography, and 14 aortograms were available for review. Distortion of the normal aortic contour and blurring of the aortic outline occurred on the initial chest film in each of the 18 cases.

ULTRASTRUCTURAL ANALYSES OF STONE HEART SYNDROME AT ONSET AND SIX DAYS LATER FOLLOWING TOTAL SUPPORT OF THE CIRCULATION WITH A PARTIAL ARTIFICIAL HEART OR LEFT VENTRICULAR ASSIST DEVICE (ALVAD).

Ischemic myocardial contracture developed in a 21-year-old man following aortic and mitral valve replacement. The patient's circulation was supported totally for 6 days with an abdominal left ventricular assist device (ALVAD). Cardiac allografting was then undertaken.

Cardiorespiratory and metabolic patterns in multiple trauma patients.

During the last 3 years we have performed a detailed study in 50 patients using the Swan-Ganz catheter to provide prognostic haemodynamic and metabolic values at an early stage. There was a total of 320 severe injuries in these 50 patients with a statistical mean of six to seven. The severity of injuries is documented by the volume replacement necessary within the first 24 hr.

[Bedside determination of extravascular lung water].

Extravascular lung water (EVLW) was measured at the bedside in 12 patients with the thermal-green dye double indicator dilution method using a microprocessor. The EVLW ranged from 3.3 to 17.

PREFABRICATION DESIGN CONSIDERATIONS FOR A LONG-TERM ELECTRICALLY-ACTUATED ABDOMINAL LEFT VENTRICULAR ASSIST DEVICE (E-TYPE ALVAD).

The conceptual design and development of a long-term, low-profile intracorporeal left ventricular assist device is a multifaceted project involving a series of technical, anatomic and physiologic considerations. Patients with severe left ventricular failure refractory to all other forms of therapy could benefit from such a device. Prior to fabrication of such a blood pump, consideration must be given to physiologic parameters of the projected patient population.

UTILIZATION OF HAND-HELD PROGRAMMABLE CALCULATORS FOR RAPID BEDSIDE COMPUTATION OF PHYSIOLOGIC-PHARMACOLOGIC VARIABLES AND PROGNOSTIC INDICES DURING MECHANICAL CIRCULATORY SUPPORT.

This study describes five programs that may be used on compact, low-cost programmable calculators with adequate memory and sufficient numbers of program steps to compute cardiorespiratory variables. These short programs are especially useful in the operating room and at the bedside.

[A new method for combined auto-alloplastic tooth reimplantation with a parallel A1203-ceramic root].

The operative procedure for partially replacing the root with A12O3 ceramic represents a good possibility for preserving teeth in which the pulpa is devitalized. The method used in connection with the well known autoplastic reimplantation not only presents an alternative to the traditional apicoectomy but also provides additional stabilization of the tooth by lengthing the root with cocotostabile and biocompatible A1203 ceramic. The method was tested in humans and monkeys.

Brachial artery disruption following closed elbow dislocation.

Although elbow dislocation occurs frequently, associated brachial artery injury is rare. Adequate treatment of this injury includes prompt arteriography, reduction of the dislocation, vascular repair, and transarticular fixation of the reduction. A case report and review of the literature are presented.

The diagnosis of microscopic carcinoma of the esophagus.

Microscopic squamous cell carcinoma of the esophagus with early submucosal spread was diagnosed in two patients with hiatal hernia and evidence of esophageal reflux. The lesions were not suggestive of malignancy on endoscopic examination. Both patients are known to be alive more than one year after resection and presumably without recurrence.

[Monitoring of cardio-pulmonary parameters in cases of severe multiple injuries (author's transl)].

Haemodynamic parameters were monitored for one week (in greatest detail during the first 24 hours) in 35 severely injured persons who had been admitted for treatment within one hour after the accident and, as judged by the type of injury, had probably lost more than 1 1/2 litres of blood. The estimations included not only blood pressure, heart rate and shock index; but the cardiac index, pulmonary arterial pressure, pulmonary capillary pressure and parameters of oxygen transport were also determined with the aid of Swan-Ganz catheters. The importance of the data as guide-lines for the correct type of intensive therapy and their prognostic significance are discussed.

[Clinical and biometric studies of the adaptive response of shock parameters in patients with multiple injuries and its prognostic significance].

In 35 patients with multiple injuries hemodynamic and renal function parameters measured early after trauma were analysed by biometric methods. Statistically significant prognostic results and differences in the cybernetic behaviour could be demonstrated.

[Early changes of the coagulation system in multiple injuries and their modification with heparin and Trasylol].

In a prospective, randomized study 35 patients with multiple injuries were examined for early changes of blood coagulation. Parameters suggesting a consumption coagulopathy were lower in patients who died subsequently than in survivors. No therapeutic influence of low dose Heparin therapy or of the proteinase inhibiting substance TrasylolR could be demonstrated.

Traumatic aortic rupture: roentgenographic indications for angiography.

The principal radiological indication for thoracic aortography following blunt chest trauma has been a widened mediastinum on chest roentgenogram. The presence or absence of sixteen findings on 100 cm anteroposterior supine chest roentgenograms were noted and compared in 47 consecutive patients who underwent aortography following blunt thoracic trauma and 100 patients without trauma. On the basis of our data, we propose six radiological indications for thoracic aortography following chest trauma: mediastinum greater than 8 cm on 100 cm AP supine chest film; tracheal shift to the right; blurring of the normally sharp outline of the aorta; obliteration of the medial aspect of the apex of the left upper lobe; opacification of the clear space between the aorta and pulmonary artery; and depression of the left main bronchus below 40 degrees.

Renal artery and vein injury following blunt trauma.

Blunt injuries of the renal vascular pedicle occur infrequently. The experience with fourteen cases of blunt renal vascular trauma is presented. Most patients were injured in motor vehicle accidents.

Hemopneumothorax following blunt trauma of the thorax.

Hemopneumothorax is a frequent sequel of blunt trauma of the thorax and is easily treated if it occurs without associated injury. As an isolated injury, it is accompanied by a low mortality rate, 2 per cent in this series of 330 patients. The principal treatment for hemopneumothorax was tube thoracostomy with large bore chest tubes.

Interaction between hydroxystilbamidine and DNA. II. Temperature jump relaxation study. Dynamics of nucleic acids and polynucleotides.

A temperature-jump relaxation study of the interaction of hydroxystilbamidine with DNA and synthetic polynucleotides has been performed. Two concentration dependent relaxation times tau1 and tau2 have been observed in the submillisecond range when detecting relaxation effects by means of light absorption. The longer of these two times (tau1) is also observed when using "blue" or "red" fluorescence detection.

Interaction between hydroxystilbamidine and DNA. I. Binding isotherms and thermodynamics of the association.

Isotherms describing the binding of hydroxystilbamidine to DNA and polydeoxyribonucleotides were obtained by means of sedimentation or dialysis experiments and fluorescence measurements, over a large range of ionic strengths, temperatures and base compositions. Two different sets of binding sites are necessary to explain the shapes of the isotherms. The first one is characterized by a higher binding constant, a topological specificity for the A-T pair, exclusion of four base pairs per bound dye molecule, the involvement of two ion-pairs, an almost purely entropic free energy of binding and a large enhancement of the blue fluorescence (450 nm) when the site corresponds to three adjacent A-T pairs.