Splenectomy in children. A correlative review of indications and complications in fifty patients

We have reported our experience with splenectomy in fifty patients less than fourteen years old. The indications, results, and complications were enumerated. These data were then correlated with the recent literature regarding pediatric splenctomy. Of special note is the problem of immunologic incompetency associated with splenectomy in the patients less than five years old.     

The response of transplants of cultured fetal mouse ovaries in kidneys of ovariectomized adult mice

Whole ovaries from 16-day fetal mice were cultured for 6 to 20 days and then transplanted to the kidneys of ovariectomized adult mice where they remained for one to four weeks. After three weeks in the host's kidneys, many follicles developed within the transplants and became vesiculated. Many of the oocytes within these follicles had formed the first metaphase spindle of meiosis and several had completed the first polar body. Host mice bearing transplants that contained vesiculated follicles showed uterine stimulation and keratinization of their vaginae. However, ovaries that had been in culture for more than ten days before transplantation showed a limited response to the gonadotropins and never matured sufficiently to stimulate the host's reproductive tract. No ovulations occurred in any of the transplants.     

Clinical and hemodynamic criteria for use of the intra-aortic balloon pump in patients requiring cardiac surgery

In order to establish criteria for elective use of the intra-aortic balloon pump (IABP) in patients having cardiac surgery, we conducted a retrospective study of 43 patients who required counterpulsation, because of inability to be weaned from cardiopulmonary bypass, between May, 1972, and June, 1974. Patients in cardiogenic shock preoperatively were excluded. The 43 patients included 23 (Group A) who had severe preoperative left ventricular dysfunction with a mean cardiac index less than 1.8 L. per minute per square meter, ejection fraction less than 30 per cent, and end-diastolic pressure greater than 22 mm. Hg; 20 patients (Group B) had a combination of moderate cardiac dysfunction (cardiac index less than 2.2, ejection fraction less than 40, end-diastolic pressure less than 18) in the presence of acute infarction or severe aortic stenosis (gradient greater than 80 mm. Hg) with or without coronary disease. An inverse relationship was noted between survival and delay from completion of operation to the use of 1ABP. Thirty-two of 43 patients were weaned off bypass and were balloon assisted for 12 to 96 hours postoperatively; 25 patients were discharged (58 per cent). In Subgroup A, 14 of 23 (60 per cent) and, in Subgroup B, 9 of 20 (45 per cent) were long-term survivors. Based on these findings, 45 patients were operated upon between June, 1974, and December, 1975, with elective use of 1ABP and were assessed by serial hemodynamic studies. Sixteen had severe preoperative left ventricular dysfunction similar to Subgroup A and 29 had moderate dysfunction in combination with pathology similar to Subgroup B. Fifteen of these patients were hemodynamically unstable at time of arrival in the operating room; 1ABP was inserted under local anesthesia. Thirty-nine patients (87 per cent) were weaned off bypass and were hospital survivors. In Subgroup A, 13 of 16 (81 per cent) and, in Group B, 21 of 29 (72 per cent) were long-term survivors. Criteria for elective use of 1ABP in cardiac surgery should include severe preoperative left ventricular dysfunction or a combination of moderate dysfunction with coronary or valvular pathology. Elective 1ABP improves the survival with trivial iatrogenic morbidity.     

Maturation of ribosomes in yeast. II. Position of the low molecular weight rRNA species in the maturation process

This paper describes a study of the physico-chemical and radioimmunological properties of three antialdosterone antisera which permitted practical conclusions to be drawn. By its high degree of specificity, anti-aldo-3-oxime-BSA constitutes the most useful antiserum for the clinical assay of aldosterone. The principal advantage of this antiserum is that it allows both urinary and blood aldosterone radioimmunoassay without the necessity of including a chromatographic step. No problems arise with the blanks. This work also includes the study of two anti-deoxycorticosterone antisera. The aldosterone and deoxycorticosterone values, obtained from normal subjects under various physiological conditions, are in agreement with the values given in the literature.     

A copulatory system in the hypothalamus and tegmentum of the domestic chick

A tract in the chick is described that runs from the posterior nucleus paraventricularis magnocellularis (PVM) through the lateral hypothalamus to a small area of the anterior tegmentum, which is adjacent to the ventral tegmental area. Bilateral lesions of the posterior PVM or of the PVM tract or of its tegmental destination abolish the facilitation of copulation in male chicks by testosterone. The effect is specific in that the facilitation of attack is either unaffected or only slightly depressed by such lesions, while being itself specifically depressed by other hypothalamic lesions. No other hypothalamic tracts were found that were necessary for the facilitation of copulation. An equivalent copulatory system probably exists in the mammal, with a more diffuse distribution in the preoptic area but with similar connections back to the tegmentum.     

The role of cholecystokinin in radiographic opacification of the gallbladder

Studies of the effect of cholecystokinin (CCK) on hepatic elimination of intravenously administered iopanoate and on gallbladder opacification were performed using nonoperated dogs with intact enterohepatic circulation and normal endogenous bile salt pool. Intravenous administration of CCK (3 units/kg) resulted in a 32% increase in apparent transport maximum (maximum rate of elimination) of iopanoate and earlier and enhanced gallbladder opacification. This increase in apparent transport maximum was abolished by cholecystectomy, indicating that the increase was a result of the release of bile salts from the gallbladder rather than a direct effect of the hormone on the hepatic elimination of iopanoate. The early gallbladder opacification and increased density of contrast material in the gallbladder were related to CCK-induced emptying of the gallbladder and subsequent filling with opacified bile.