Immediate-early gene expression in ovine brain after hypothermic circulatory arrest: effects of aptiganel.

Background: Altered gene expression occurs in the brain after global ischemia. We have developed a model to examine the effects of cardiopulmonary bypass and hypothermic circulatory arrest (HCA) on the induction of the immediate-early gene c-fos in the brains of neonatal lambs. We then tested the effects of the noncompetitive N-methyl-D-aspartate antagonist, aptiganel hydrochloride (Cerestat), on c-fos expression and neuronal injury.

Pneumostasis of experimental air leaks with a new photopolymerized synthetic tissue sealant.

Air leak is a major contributor to increased length of stay and postoperative morbidity following pulmonary surgery. The effectiveness of a new photopolymerized synthetic hydrogel (FocalSeal, Focal, Inc., Lexington, MA) as a sealant for pulmonary air leaks was determined in 10 mongrel dogs (20-35 kg).

Coronary artery bypass and valve replacement in octogenarians.

A total of 325 patients, aged 80 to 92 (mean 82), underwent cardiac operations with cardiopulmonary bypass over a 4-year period (1991-1995). Hypothermia (22 degrees C) and hyperkalemic cardioplegia were used in each. Coronary bypass procedures only (Group I) were performed in 255 patients with 22 early deaths (8.

Carotid endarterectomy based on preoperative duplex ultrasound.

Recent studies have suggested that carotid endarterectomy can be performed safely based solely on the noninvasive duplex ultrasound evaluation in selected patients. We have prospectively evaluated 60 consecutive patients who underwent 65 carotid endarterectomies, 48 patients without preoperative angiography and 12 with angiography. Forty-two patients were operated on for symptomatic disease, and 23 procedures were done for critical, asymptomatic stenoses.

Evaluation of outcome following open lung biopsy.

The utility of open lung biopsy in the management of patients with acute pulmonary infiltrates and/or progressive respiratory failure remains controversial, particularly in regard to its timing and impact on therapy. We reviewed our most recent 10-year experience with open lung biopsies in 73 patients and evaluated its effect on patient management and outcome. A total of 62 biopsies were done for progressive infiltrating disease, 53 with diffuse bilateral disease, and 9 with more focal infiltrates; 11 biopsies were done for nodular disease.