Surgical Considerations for Avoiding Disc Interference Based on A Ten-year Experience with the Medtronic Hall Heart Valve

All low profile valves are susceptible to problems related to implant technique, especially immobilization of the occluder. Because the disc-valve-ring clearance may be only a fraction of a millimeter, this complication is a small yet ever present possibility of which the surgeon must be aware. Special care must be taken when implanting low profile valves to eliminate the possibility of disc interference caused by suture ends or intracardiac structures. The surgeon can minimize the risk of disc immobilization by careful attention to precautionary surgical measures described herein.     

ADP-induced Platelet Aggregation and Metoprolol Treatment of Myocardial Infarction Patients

ABSTRACT The effect of metoprolol on platelet aggregation was investigated in a group of postmyocardial infarction (MI) patients. The study was double-blind and included 63 subjects; 30 patients were maintained on metoprolol and 33 received placebo treatment. Adenosine diphosphate (ADP)-induced platelet aggregation was carried out in each subject close to 4 weeks after the acute MI. It was demonstrated that metoprolol as compared to placebo did not influence ADP-induced platelet aggregation in the present clinical setting.     

Left Heart Assist for Ischemic Postoperative Ventricular Dysfunction in an Infant with Anomalous Left Coronary Artery

A baby weighing 6.2 kg with anomalous origin of the left coronary artery from the pulmonary artery developed profound left ventricular failure during surgical repair. He was supported for 41 hours with centrifugal pump left heart assist. Recovery following cessation of ventricular assist was uneventful and ventricular function was improved compared to preoperative status.     

Antibodies against lipopolysaccharide from Bacteroides gingivalis before and after periodontal treatment

Abstract – Specific serum antibody activities of the IgG, IgA and IgM isotypes against lipopolysaccharide (LPS) prepared from Bacteroides gingivalis were measured by an enzyme-linked immunosorbent assay (ELISA) in a group of 12 periodontally healthy subjects and a group of 26 patients with periodontitis. The latter group received periodontal therapy, completed within about 1 yr. A serum sample was obtained from each participant at the first periodontal examination; a second sample was taken about 2 yr later. The mean antibody levels calculated for the healthy group did not change significantly between the first and second examination. The correlation coefficients computed between the two sets of measurements were 0.93, 0.90 and 0.96 for IgG, IgM and IgA respectively ( P < 0.05). Periodontal treatment significantly improved the clinical status of the patients and was followed by a statistically significant mean reduction in specific antibody levels to the LPS preparation (IgG: 15%, IgA: 30% and IgM: 15%).     

Pelvic inflammatory disease after hysterosalpingography associated with Chlamydia trachomatis and Mycoplasma hominis

Summary. A total of 116 women were referred for hysterosalpingography because of primary or secondary infertility. Chlamydia trachomatis was isolated from the cervix of four (3.4%) of the patients whereas Mycoplasma hominis was isolated from 39 (33.6%) of them. Four patients developed acute pelvic inflammatory disease after hysterosalpingography; two of them were chlamydia culture-positive and developed a significant chlamydial antibody response during the course of the disease. One of the other two patients, who developed upper genital-tract infection, was culture positive for M.hominis and developed a significant antibody response to this micro-organism. The results indicate that C.trachomatis should be sought in patients before hysterosalpingography and, if detected, appropriate antibiotic cover should be instituted before the procedure.     

HLA-DR3 in dermatitis herpetiformis

Twenty-one patients with dermatitis herpetiformis were typed for HLA-ABC and -DR determinants. The incidence of HLA-AI, -B8 and -DR3 antigens was found to be significantly higher (P: = 10^?3, <10^?6 and <10^?6, respectively) among patients with dermatitis herpetiformis than among the normal population. HLA-DR3 was found in 85.7% of patients, HLA-B8 in 66.7% and HLA-Ai in 61.9% only. These results indicate that HLA-DR3 is the antigen primarily associated in dermatitis herpetiformis and the latter antigens (HLA-Ai and -B8) are present in increased incidence, probably due to the known linkage disequilibrium of these antigens with HLA-DR3.     

Unilaterality of obstruction after acute nasal allergen provocation. Relation of allergen dose, nasal reactivity and the nasal cycle

We examined unilaterality of obstruction after acute bilateral nasal allergen provocation in two groups of pollen-sensitive volunteers studied out of season. One group was challenged on one occasion with a threshold allergen dose and on another with placebo. We measured nasal airway resistance (NAR) unilaterally for 3.5 hr before the challenges and for 40 min after. Most subjects' noses had marked asymmetry of response. Over half showed marked obstruction on one side and none at all on the other side. The side which showed higher resistance and greater lability before challenge was typically more obstructed after. In a second group we compared responses to threshold and x 10 threshold doses. Threshold challenge produced results similar to those seen with the first group. After the higher allergen dose, there was some obstruction in the less responsive side and the rate of rise was much slower. Obstructive response after acute threshold allergen challenge is typically one-sided. This pattern may be related to the stage of the nasal cycle in which the challenge was delivered. Higher allergen doses produce more obstruction in the less responsive side but the response is still asymmetrical.