Evolving indications for preoperative intraaortic balloon pump assistance

Over a two-year period about 1,000 operations were performed with cardiopulmonary bypass. Intraaortic balloon pump assistance (IABP) was employed on 150 occasions, and a review of these has permitted clarification of the indications for its use. Sixty patients had IABP for carcinogenic shock either after infarction or cardiotomy, and 37 (62%) survived. Preoperative IABP in 90 high-risk patients resulted in survival for 79 (88%). The indications for prophylactic IABP included: (1) relief of severe pain, which occurred in 42 patients with acute coronary insufficiency, (2) improvement in the coronary perfusion pressure, which was accomplished in 20 patients with significant left main coronary artery occlusion or its equivalent, and (3) protection of left ventricular function, which war carried out in 28 patients with an LV ejection fraction of less than 0.40. The significance of the preoperative endocardial viability ratio (EVR) in relation to prophylactic IABP was also assessed: an EVR below 0.70 appears to be an indication for preoperative IABP.     

Determination of the gliotoxie and demyelinating properties of serum in organ cultures of brain in experimental allergic encephalomyelitis

The report contains some results of a study of the blood serum taken from guinea pigs and macacus rhesus with allergic encephalomyelitis to a glyotoxic and demyelinizing effect in an organ culture of the brain in newborn rats and adult macacus rhesus. It was demonstrated that the test has a high specificity to a glyotoxic effect of the blood serum in experimental allergic encephalomyelitis and a less specificity to demyelinization in vitro. The authors describe in detail the method of studying the serum in organ brain cultures.     

Acute thrombophlebitis of the saphenous veins as a problem of emergency surgery

It is stated that latent spread of thrombosis in v. saphena magna in proximal direction is observed in 37--40%. Radioisotope technic was employed to indicate the level of thrombus. The operative technic is described.     

Several indices of non-specific immunity in staphylococcal sepsis and staphylococcal gastroenterocolitis in children of different ages

A study was made of some nonspecific immunity indices in staphylococcus sepsis and gastroenterocolitis during the infectious process in young children. Results of these investigations pointed to the depression of bactericidal and lysozyme activity of the blood serum and of the immunoadherence reaction at the acute period of the disease, and to some increase at the phase of recovery. There was also found an elevation of the phagocytic activity (of the phagocytolysis percentage) at the acute phase of the staphylococcus sepsis and gastroenterocolitis Antistaphylococcus gamma-globulin produced a positive effect on the lysozyme and bactericidal activity of the blood sera and promoted an increase of the blood phagocytic activity in the sick children.     

Mitogenic activation of human lymphocytes: a protein A plaque assay evaluation of polyclonal B-cell activators

Using the protein A plaque assay, the capacity of various polyclonal B cell activators to induce differentiation in human B lymphocytes was investigated. Dextran sulphate and native dextran were both virtually devoid of mitogenic properties. Lipopolysaccharide, however, was found to be a potent mitogen in human cells that, although giving rise to low DNA synthetic response, induced high numbers of immunoglobulin-synthesizing cells. Mean plaque-forming cell (PFC) numbers in healthy blood donors assayed on the optimal day (days 5-7) were 23,493 IgM/10(6) cells, 11,288 IgG/10(6) cells, and 2643 IgA/10(6) cells. Values obtained in spleen cells, peaking at days 4-6, were slightly higher. Purified protein derivative (PPD) was equally or even more effective than lipopolysaccharide (LPS) in generating PFC of different subclasses in peripheral blood with mean of 29,241 IgM/10(6), 21,269 IgG/10(6), and 3681 IgA/10(6). PPD furthermore induced a marked DNA synthetic response in human lymphocytes. These data suggest that LPS and PPD may both be used as functional markers in human cells when analysing patients with a suspected immunodeficiency state. It is suggested that cultures should be assayed using the protein A plaque assay, thereby being able not only to investigate the individual immunoglobulin classes but also to avoid the possible hazards involved in measuring antigen-specific responses in patients whose prior immunization to the antigen tested can never be totally excluded.     

EDP recipe adjustment by percentage method in a college foodservice system

In a free muscle transfer, great care must be taken in selecting the muscle to be grafted. We have found the pectoralis major to be a good donor muscle. Although most muscles are not nourished by a single artery and a few veins, the vessels which enter the pectoralis major muscle with the nerves are the main nutrient vessels, and these vessels alone can adequately nourish this muscle. Neurorrhaphy should be performed at a site as close as possible to the muscle. Good indications for free muscle transfer are cases in which a flexor muscle has become necrotic, while the extensor muscle is viable--for example, if the flexor muscle has sustained traumatic crushing injury or if there is a Volkmann's contracture.