Red cell aplasia due to host type isohemagglutinins with exuberant red cell progenitor production of donor type in an ABO-mismatched allogeneic bone marrow transplant recipient.

ABO-mismatched bone marrow transplants have resulted in delayed red cell production in patients who have persistently elevated anti-ABO isohemagglutinin titers. We present a patient with chronic myelogenous leukemia who received an HLA-matched, ABO-incompatible bone marrow transplant from his sister. Post-transplant, he developed pure red cell aplasia with exuberant production of donor red cell precursors by in vitro BFU-E assay.

Short-duration, high-dose urokinase infusion for recanalization of occluded saphenous aortocoronary bypass grafts.

Thrombolytic recanalization of arterial bypass grafts has been pursued aggressively in the peripheral circulation but not in the coronary circulation. In an attempt to apply peripheral transcatheter thrombolytic techniques to the coronary circulation, nine patients with 10 occluded saphenous aortocoronary bypass grafts underwent recanalization procedures using a short-duration, high-dose urokinase infusion. Urokinase was infused at the occluded graft orifice at a rate of 600 units/min.

Computer model of ventricular interaction during left ventricular circulatory support.

The authors used a computer model of the heart and circulation to test the hypothesis that anatomic ventricular interactions are responsible for the observed instances of right ventricular failure during use of a left ventricular assist device. The model predicts that left ventricular pressure-unloading with a LVAD, in the presence of isolated systolic interaction, results in impairment of RV function, whereas with isolated diastolic interaction, RV function is improved. Due to competition between these two interactions, there is a negligible overall effect of ventricular anatomic interactions in determining right ventricular function in the normal heart.

24-hour rabbit heart storage with UW solution. Effects of low-flow perfusion, colloid, and shelf storage.

A new technique for 24-hr cardiac preservation is described utilizing very low flow perfusion (microperfusion) with a cold flush solution. Rabbit hearts were arrested with UW solution and then perfused with the same solution through the aortic root at 0 degrees C at a rate of 3-6 ml/gm heart weight/24 hr. When tested on an ex vivo working heart model, the cardiac output (CO) was 28.

Acute ischemic ventricular septal defect.

Thirty-one published reports (366 patients) and 48 consecutive patients treated for postinfarction ventricular septal defect at four institutions in northern California were reviewed. Overall hospital mortality was 43% in the reviewed group and was not affected by age, concomitant myocardial revascularization, date of operation, presence of cardiogenic shock, or location of the defect. Mortality for the 48 consecutive patients, all of whom had surgery within 30 days of acute infarction, was 67%.

The benzodiazepine receptor ligands RO 5-4864 and RO 15-1788 do not block the inhibition of PAF-induced platelet aggregation seen with the hetrazepine WEB2086.

The hypothesis was tested that the hetrazepine WEB 2086 acts as an inhibitor of PAF-induced platelet aggregation via interaction with the platelet benzodiazepine receptor(BDZR). WEB 2086 is a potent inhibitor of rabbit platelet aggregation and ATP secretion induced by 370 nM PAF. The two BDZR ligands RO 5-4864 and RO 15-1788 (7-96 microM) are inactive as PAF antagonists.

Aesthetic refinements in reconstructive microsurgery.

The vast array of free tissue options available to reconstructive surgeons plus our knowledge of vascular systems now provide us with the wherewithal to not only fill a defect but to do so aesthetically and with minimal donor site morbidity. The authors discuss setting reconstructive goals that include refined and aesthetic results for deficit and donor site alike and demonstrate how, in many situations, these goals can be achieved.

Psychophysical changes in glaucoma.

Chronic glaucoma has been thought to spare the central vision until quite late in the disease process. This assumption is based on the use of the relatively insensitive Snellen chart to measure central vision and the relatively sensitive kinetic and static perimetry to measure the peripheral vision. In recent years, new measures of visual function have been utilized to assess patients with glaucomatous damage.

Non-Hodgkin's lymphoma in a population with or at risk for acquired immunodeficiency syndrome: indications for intensive chemotherapy.

Purpose: An increased risk of malignancies, including Kaposi's sarcoma and non-Hodgkin's lymphoma, is found in patients infected with the human immunodeficiency virus type 1 (HIV-1). Treatment of such patients may be complicated by their underlying immunodeficiency, especially when aggressive regimens are used. Clinical presentation and treatment outcomes were assessed in 31 patients with non-Hodgkin's lymphoma who had or were at risk for infection with HIV-1 at a single community institution.

Class II antigens on retinal vascular endothelium, pericytes, macrophages, and lymphocytes of the rat.

Class II histocompatibility complex antigens on the retinal vascular endothelium may allow these cells to function as antigen-presenting cells to circulating T cells. The present study investigated induction of class II antigens in vitro to characterize the response under controlled conditions. Retinal vascular endothelium from Lewis and Brown Norway rats (high versus low responders in experimental autoimmune uveitis) were exposed in vitro to recombinant rat gamma interferon, interleukin-1, interleukin-2, or Concanavalin-A spleen supernatant.

Bridging to cardiac transplantation.

Unilateral or bilateral prosthetic ventricles and artificial hearts have been used in bridging to transplantation for 4 years. Candidates for bridging to transplantation comprise patients who otherwise would be elective cardiac transplantation candidates who deteriorate rapidly before a donor heart can be found, or persons with sudden cardiac decompensation (eg, massive myocardial infarction with cardiogenic shock). In selecting patients for bridging to cardiac transplantation it is crucial that people are chosen who are good candidates for heart transplantation despite their rapidly deteriorating condition.

Orbital surgery. The technique of coronal scalp flap approach to the qateral orbitotomy.

Lateral orbitotomy may be performed using a coronal scalp flap to provide exposure of the lateral orbital wall and rim. A coronal incision is made across the scalp. The scalp flap is developed anteriorly to expose the orbital margin from the superior orbital rim to the zygomatic arch.

Pneumatic retinopexy. Surgical results.

We reviewed 55 consecutive cases of rhegmatogenous retinal detachment treated with pneumatic retinopexy. Eyes with inferior retinal breaks from the 4- to 8-o'clock positions or macular holes with retinal detachment were excluded. Forty-five eyes (82%) were reattached with one operation.

Ineffectiveness of continuous quinidine gluconate infusion in the treatment of severe chloroquine-resistant Plasmodium falciparum malaria.

The drug of choice in the treatment of chloroquine-resistant Plasmodium falciparum malaria is parenteral quinine dihydrochloride. Due to limited use, the drug is not commercially available in the U.S.

Visual manifestations of occipital lobe infarction in three patients on a geriatric psychiatry unit.

The authors present three cases of hospitalized patients on a geriatric psychiatry floor who were found to have previously undiagnosed occipital lobe infarctions associated with visual manifestations. The manifestations discussed are visual field defects, visual hallucinations, and color anomia. The incidence of undiagnosed occipital lobe infarctions and the contribution of these infarctions to visual perception changes in this patient population are unknown.

An atlas of a rare neuronal surface antigen in the rat central nervous system.

The mature nervous system contains functional synaptic networks composed of neuronal sets and subsets whose identity and maintenance may rely on external surface molecules specific for these neuronal subdivisions. Such molecules may reside permanently on specific neurons, serving to identify those neurons within a complex population. From a collection of monoclonal antibodies made to the Torpedo cholinergic synaptosome preparation, we have identified several antibodies that bind the surface of some, but not all, neurons of the mature rat brain (Kushner and Stephenson, 1983; Kushner, 1984).

Multidisciplinary approach to the management of complex bony and soft tissue orbitocranial disorders.

Orbital reconstructive surgery is entering a new age as progress in surgical techniques and diagnostic imaging are applied to the patient with severe acquired orbital and periorbital deformities. The authors present a series of six patients with orbitocranial neoplasms and congenital and traumatic deformities whose management involved a multidisciplinary approach. Particular emphasis is placed on the use of reformatting two-dimensional orbital scans into three-dimensional images and surgical techniques using composite flaps and periorbital microsurgical vascular anastomoses.