Radical correction of tetralogy of Fallot in infants under 1 year of age

The article generalizes the experience in surgical treatment of Fallot's tetrad in 20 infants. Radical correction of the anomaly was carried out under extracorporeal circulation and deep hypothermia with reduced volume rate of perfusion. Plastics of the conus arteriosus alone was performed in 6 patients, transanulus and the pulmonary trunk in 4 patients. Two patients died, the hospital lethality was 10%. A clinical effect was produced in all the other patients. The relation of systolic pressure in the left ventricle to that in the right ventricle was 0.56 +/- 0.1, the systolic pressure gradient between the right ventricle and the pulmonary artery was 18 +/- 4.2 mm Hg. Various degree of regurgitation at the pulmonary valve was revealed after the operation in all patients. It was maximum (34 +/- 10%) in transanulus plastics.     

2,3,7,8-Tetrachlorodibenzo-p-dioxin-induced oxidative stress in female rats

Oxidative stress may play a role in the toxic manifestations of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Therefore, the time-dependent effects of 100 micrograms TCDD/kg on various indices of oxidative stress including lipid peroxidation. DNA damage, membrane fluidity, calcium homeostasis, nonprotein sulfhydryl content, and NADPH content of hepatic subcellular fractions of female rats were followed for 12 days. Increases in lipid peroxidation of 400-500% occurred in mitochondrial and microsomal membranes and nuclei, with maximum increases occurring 5-6 days post-treatment. Decreases in the nonprotein sulfhydryl content of mitochondrial and microsomal fractions of approximately 80% were observed by Day 12 posttreatment. Membrane fluidity gradually decreased following administration of TCDD, with decreases of 30-40% being observed in mitochondria, microsomes, and plasma membranes. A sharp increase in the incidence of hepatic nuclear DNA single strand breaks was observed 3 days after treatment with an increase of approximately 600% by Day 9. Following the administration of TCDD, increases of 70-80% occurred in the calcium content of mitochondria and microsomes. An 18% increase in cytosolic calcium was present 12 days after the administration of TCDD. Cytosol and mitochondria both exhibited an initial increase in NADPH content following administration of TCDD, but by Day 12 both had decreased to approximately two-thirds of control values. The results clearly demonstrate that TCDD administration induces an oxidative stress in rat liver. The most pronounced effects were observed in membrane lipid peroxidation and DNA damage with gradual changes being observed in calcium and nonprotein sulfhydryl contents and membrane fluidity.     

Adenosine and its analogs stimulate phosphoinositide hydrolysis in the kidney

Renal blood flow, glomerular filtration rate and sodium excretion are known to be affected by adenosine. The present studies were undertaken to investigate the actions of adenosine and its analogs (both agonists and antagonists) on phosphoinositide (PI) hydrolysis in the outer medullary slices. Adenosine was found to cause a dose-dependent stimulation of PI hydrolysis (ED50, 2.8 microM) in renal slices from outer medulla. The adenosine analogs 5'-(N-cyclopropyl)-carboxamidoadenosine (NCCA) and 5'-N-ethylcarboxamidoadenosine (NECA) also stimulated PI hydrolysis in renal medulla. Stimulation of PI hydrolysis was blocked by the adenosine antagonists: aminophylline, 1,3-dipropyl-7-methylxanthine (DMX) and 8-(p-sulfophenyl)-theophylline (8-SPT). Caffeine not only antagonized adenosine-stimulated PI hydrolysis but also increased PI hydrolysis independently. These results indicate that adenosine stimulates PI hydrolysis in renal medulla through a receptor-mediated mechanism.     

Possibilities of the clinical use of a new Soviet laser device on the anterior and posterior segments of the eye

A new Soviet laser device for multiple-purpose ophthalmologic application is described. The design is based on neodymium-doped glass laser with radiation at a 1.06 micron wavelength in a Q-spoiled mode and YAG laser with radiation frequency doubling at a wavelength of 0.532 micron in continuous operation. Clinical potentialities of this laser design in the treatment of abnormalities of the anterior and posterior segment of the eye were studied in the treatment of 48 patients (48 eyes). The results evidence that the device is fit for coagulation as well as for mechanical destruction of tissue.     

A study of patients referred from A&E for coroners post-mortem.

A review of 179 autopsies was undertaken over a 1-year period to determine if clinically useful information was obtainable from coroners post mortems performed on patients referred from the A&E department. Fifty-six patients had undergone unsuccessful resuscitation. The leading causes of death were heart disease and trauma. Discrepancies between the diagnosis made during resuscitation and the cause of death found at autopsy were revealed especially in those dying from noncardiac causes. Iatrogenic trauma from resuscitation attempts occurred in a significant number of cases. It is suggested that review of selected Coroners post mortems should be part of departmental audit, with a view to improving clinical skills.     

Use of sanative fibrobronchoscopy with controlled high-frequency pulmonary ventilation after operations on the thoracic organs

The authors developed a method of sanative fibrobronchoscopy with the use of directed high-frequency stream ventilation with oxygen. A total of 108 procedures were conducted in 64 patients for removal of pulmonary complications after operations on the thoracic organs. The positive results of the method were confirmed by authentic improvement of the indices of external respiration function and increase of blood pO2 by 102% on the average. No improvement of similar indices was encountered in patients of the control group, while the blood pO2 reduced by 13.4% on the average. It is concluded that the method is very effective and safe, as compared to the traditional method of sanative fibrobronchoscopy in patients after interventions on the thoracic organs.     

Features of head injury in a developing country--Taiwan (1977-1987)

Certain features of head-injured patients admitted to the Chang Gung Memorial Hospital in Taiwan during the period 1977 to 1987 were reviewed. The most common causes of injury were motorcycle accidents (56.3%) and street accidents with pedestrian injury (29.47%). The age groups with the greatest incidence of injury were aged 16-20 years, 21-25 years, and 25-30 years. The pedestrian group involving the highest incidence of injury was less than 10 years of age. Overall mortality was 17.26%. The injured pedestrian group had the highest mortality (19.1%). Initial clinical assessment was recorded using the Glasgow Coma Scale. Head-injured patients with a GCS less than 8 had a mortality in the injured pedestrian group of 46%, whereas the mortality rate in the motorcycle accident group was 41%. Additional features studied were time of occurrence of injury and pattern of injury. Information gathered from this study would suggest the need to establish a Head Injury Prevention Program in Taiwan. This of course implies major cooperation among the providers of health care delivery, the medical profession, legislators, and the government at all levels.     

8-OH-DPAT and buspirone analogs inhibit the ketanserin-sensitive quipazine-induced head shake response in rats

Behavioral syndromes mediated by serotonergic mechanisms may reflect interactions between distinct effects initiated by specific 5-HT receptors, such as the 5-HT1A and the 5-HT2 receptor. This hypothesis was tested by examining the effect of various 5-HT1A agonists on the 5-HT2 receptor-mediated quipazine-induced head shake response in rats. Subcutaneous administration of 8-OH-DPAT, buspirone, gepirone, and ipsapirone produced a dose-dependent inhibition of the ketanserin-sensitive quipazine-induced head shake response. These effects were produced by doses of agonists which did not induce reciprocal forepaw treading. Furthermore, pretreatment with a partial 5-HT1A agonist (+/-)pindolol blocked the inhibitory effects of 8-OH-DPAT to the level of inhibition produced by (+/-)pindolol itself. These results suggest that stimulation of central 5-HT1A receptors can modulate the expression of a central 5-HT2 receptor-mediated behavior.