Evaluation of 7,000+ patients with two different routes of cardioplegia

BACKGROUND: This study examined the efficacy and safety of retrograde cardioplegia in comparison with an antegrade/retrograde approach. METHODS: Between January 1, 1991, and December 31, 1995, 7,032 coronary artery bypass procedures, alone or in combination with valve replacement/repair, were performed using either retrograde cardioplegia (R) or an antegrade/retrograde (AR) approach. There were 4,224 patients in the R group and 2,808 in the AR group. These included elective, urgent, emergent/salvage, first operative, and redo cases. RESULTS: All preoperative, intraoperative, and postoperative variables listed in The Society of Thoracic Surgeons National Cardiac Surgery Database were used to compare the two groups using univariate analysis. The pump time was longer in the AR group, with fewer grafts per patient. The R group had higher predicted risk (3.2% versus 3.0%; p = 0.04), more postoperative atrial fibrillation (34% versus 31%; p = 0.006), and longer postoperative length of stay (8.8 versus 8.0 days; p < 0.001). Using The Society of Thoracic Surgeons National Cardiac Surgery Database predicted risk group model, a subgroup of 221 coronary artery bypass grafting patients in the retrograde (s-R) and 132 coronary artery bypass grafting patients in the antegrade/retrograde (s-AR) group fell into a greater incidence of predicted mortality group (> or = 10%). The s-R subgroup had more patients in New York Heart Association functional class IV. Univariate analysis revealed higher postoperative atrial fibrillation (51% versus 41%; p = 0.05) and longer postoperative length of stay (12.8 versus 10.8 days; p = 0.03) in the s-R subgroup versus the s-AR subgroup. CONCLUSIONS: The results appear to favor neither approach. Preoperatively, both retrograde groups (R and s-R) had higher preoperative predicted risk, but operative mortality or complications were not significantly increased when compared with the AR and s-AR groups. Retrograde cardioplegia alone was shown to be effective in the R and s-R groups, but atrial fibrillation developed in more patients, which could have contributed to longer length of stay in these groups. Antegrade/retrograde cardioplegia offers good immediate outcome but the delivery method can be cumbersome and confusing during the adjustments of flow clamps for antegrade/retrograde delivery and may contribute to prolonged pump times. From this retrospective, nonrandomized review, it appears that retrograde cardioplegia alone provides as good myocardial protection and safety as an antegrade/retrograde approach in either the low-risk or high-risk patient.     

Comparison of glycoprotein components, tryptophan, lipid peroxidation and antioxidants in borderline and severe hypertension and myocardial infarction

Between 1957 and 1993, the Siberian Chemical Complex (Tomsk-7) located in the Tomsk region (Russia) regularly discharged radioactive liquid wastes into the Tom River which resulted in an extensive contamination of large territories with long lived radionuclides such as cesium-137 and strontium-90. In the summers of 1996 and 1997, Research Team of Siberian Medical University conducted biodosimetry and cytogenetic monitoring of pikes (Esox lucius) caught in the Tom River at various distances downstream from the Siberian Chemical Complex (SCC) using the micronucleus test and the gamma spectroscopy. Our findings demonstrated that the difference in frequency of micronucleated erythrocytes between the radiation-exposed fish caught downstream from the SCC and the controls was statistically significant (P < 0.01). Moreover, we found a good correlation between radiocesium concentration and micronucleated erythrocyte frequency in pikes. It was found that both the micronucleated erythrocyte frequency in pike blood and the level of the pike radiocesium concentration depended on the age of pikes. The micronucleated erythrocyte frequency gradually increased from the 1-year-old pikes to the over 20-year-old pikes. On the other hand, the average level of radiocesium concentration gradually increased from the 1-year-old pikes only up to the 10-year-old pikes. There is no correlation between radiocesium concentration and micronucleated erythrocyte frequency in the over 10-year-old pikes.     

Expression of growth factor mRNAs by human Tenon''s capsule fibroblasts

We determined the nucleotide sequences of Norwalk-like viruses in 10 PCR products from stool or oyster specimens obtained from four outbreaks of gastroenteritis in which shellfish was suspected as the cause in Shizuoka prefecture in Japan between 1987-94. The sequences were determined from nucleotide positions 4561-4852 (292 bp) in the polymerase region. Two types of sequences were detected. One (genotype 1) had 87% sequence homology with the prototype Norwalk virus, and the other (genotype 2) had 59% sequence homology. The sequences from isolates belonging to the same genotype were almost the same regardless of the year of isolation. Because sequences of 2 genotypes were detected in 2 of the 4 outbreaks, nested PCR was performed with genotype-specific primers to detect the presence of 2 genotypes in the same specimen. In 5 of 10 specimens, PCR bands were detected with both genotype-specific primers, indicating the coexistence of 2 genotypes in 1 specimen. We also detected two genotypes of Norwalk-like virus in an oyster from a sample implicated in one of the outbreaks which may provide direct evidence of oysters as the cause of the gastroenteritis.     

Portal hypertension changes following selective splenorenal shunt surgery. Evaluation by percutaneous transhepatic portal catheterization, venography, and cinefluorography

A series of ergot alkaloids, together with the DA agonists apomorphine and piribedil, were tested for protective effects against audiogenic seizures in an inbred strain of mice (DBA/2) and for induction of circling behaviour in mice with unilateral destruction of one nigrostriatal DA pathway. The order of potency against audiogenic seizures was apomorphine greater than ergocornine greater than bromocryptine greater than ergometrine greater than LSD greater than methysergide greater than piribedil while that observed in the rotating mouse model was apomorphine greater than ergometrine greater than ergocornine greater than bromocryptine greater than piribedil. LSD caused only weak circling behaviour even when administered in high doses (greater than 1 mg/kg). Methysergide was ineffective. Prior administration of the neuroleptic agent haloperidol blocked the effect of DA agonists and of ergot alkaloids in both animal models. The possible action of ergot alkaloids as DA agonists is discussed.     

Indicine-N-oxide: the antitumor principle of Heliotropium indicum

Extracts of Heliotropium indicum Linn. (Boraginaceae) showed significant activity in several experimental tumor systems. The active principle is isolated and shown to be the N-oxide of the alkaloid, indicine, previously isolated from this plant. Supporting structural data and anti-tumor data are provided.     

Aspirating vs. nonaspirating nozzles for making fire fighting foams — Evaluation of a nonaspirating nozzle

The use of nonaspirating nozzles for effective application of aqueous film-forming foam is almost a controversial topic. Fire tests on gasoline compared several commercial nozzles (aspirating and nonaspirating), revealing significant difference in the extinguishment of large fires. A new variable stream nonaspirating nozzle was tested, and by comparison found to be marginally acceptable. Consequences of choosing the wrong equipment for use with various foams and their use on a variety of flammable liquids are discussed. Mobil Research and Development Corporation Reference: L. R. DiMaio, R. F. Lange, and F. J. Cone, “Aspirating vs. Nonaspirating Nozzles for Making Fire Fighting Foams — Evaluation of a Nonaspirating Nozzle,” Fire Technology, Vol. 20, No. 1, February 1984, p. 5.