188. Aortoventrikuloplastik nach Rastan

ZusammenfaBung Der Film zeigt die Erweiterungsplastik der AusfluBbahn der linken Kammer bei einer 5jährigen Patientin mit einer schweren tunnelförmigen Subaortenstenose. Nach AnschluB der Herz-Lungen-Maschine werden die Aorta und die rechte AusfluBbahn eröffnet. AuBchneiden der Aortenklappe und Darstellung der diffusen subvalvulären Stenose. Das Ventrikelseptum wird gespalten. Die aorto-septale Incision wird mit einem Dacron-Patch gedeckt. Die Aortenklappe wird mit einer Björk-Shiley-Prothese ersetzt. Die Incision der rechten AusfluBbahn wird mit einem zweiten Dacron-Patch verschloBen.     

Palliative treatment of complete transposition of the great vessels: First clinical results of closed atrial septectomy with new septectome.

Our initial method of closed atrial septectomy, used in the palliative therapy of transposition of the great arteries (TGA), failed to produce a technical success in 1 of 5 patients. Subsequently, we modified the technique by securing the septum on traction sutures and simplifying the introduction of the septectome. With the new method, we achieved technical success in all 13 patients so treated. In our total of 18 patients treated by closed atrial septectomy, 7 had TGA with no other cardiac anomaly, and none of the 7 died. Of the remaining 11 patients who had TGA and other cardiac anomalies and required procedures such as ductus ligation, pulmonary artery banding, and aorta-right pulmonary artery shunt in addition to septectomy, 5 died. In only 1 of them, death was caused by technical complications with our initial method. Of the remaining four deaths, two were due to pre-existing cerebral damage and two to complications of palliative procedures done in conjunction with atrial septectomy. Side-to-side anastomosis between the superior vena cava and right pulmonary artery, carried out successfully in 1 case, is suggested as an additional palliative measure to supplement atrial septectomy in TGA.     

Towards high resolution maps of the mouse and human genomes--a facility for ordering markers to 0.1 cM resolution

982 progeny produced by a mouse Interspecific backcross betweenC57BL/6 and Mus spretus have been scored for at least 3 markerson each chromosome, completing an anchor map of 78 loci acrossthe mouse genome. The anchor mapping identifies all the availablerecomblnants in each interanchor Interval allowing access topanels of mice that can be used for the high resolution mappingof any chromosome region. The large number of progeny recoveredand scored from the Interspecific backcross allows us to resolvegenetically markers that lie on average 200 kb apart on mousechromosomes and within the cloning capacity of currently availableYAC libraries. EUCIB provides the first genetic mapping resourcespecifically designed for the high resolution mapping of allregions of the mouse genome and will underpin the global physicalmapping of the mouse genome. In addition, with the use of conservedsequences the facility is applicable to the high resolutioncomparative mapping of the mouse and human genomes. A new databasehas been implemented to support the computation of high resolutionand ordered genetic maps.     

Nesfatin-1 Improve Spatial Memory Impairment Following Transient Global Cerebral Ischemia/Reperfusion via Inhibiting Microglial and Caspase-3 Activation

Nesfatin-1, a recently discovered peptide, is involved in important functions such as food intake regulation and energy homeostasis. Previous studies have demonstrated that it has protective effects following myocardial injury and also protects dopaminergic cells against neurotoxicity with the anti-inflammatory and anti-apoptotic mechanisms. In this study, we aimed to assay the neuroprotective effects of Nesfatin-1 after brain ischemia/reperfusion. Twenty-eight male Wistar rats were randomly selected and allocated in the form of four groups (sham, Nesfatin-1, ischemia, ischemia+Nesfatin-1). Ischemia was created by obstruction couple common carotid arteries in 20-min period. Saline as a vehicle and Nesfatin-1 (20 μg/kg, intraperitoneally) were injected at the time of reperfusion. Spatial memory performances were evaluated by the Morris water maze. The level of protein expression was determined by immunohistochemical and immunofluorescence staining. Nesfatin-1 significantly reduced caspase-3 (P?<?0.01) and microglial activation (P?<?0.01) and improved spatial memory impairments (P?<?0.05) induced by brain ischemia. Nesfatin-1 has significant neuroprotective effects and can be introduced as a therapeutic agent against cerebral ischemia-induced injuries.     

Erysipeloid cutaneous leishmaniasis: treatment with a new,topical, pure herbal extract

Fourteen consecutive cases of erysipeloid cutaneous leishmaniasis were seen and evaluated. There were 13 females and one male patient with a mean age of 59 years. Diagnosis was based on clinical grounds and the presence of amastigotes in the lesions. Patients were divided into acute and chronic groups, with chronicity being defined as a disease duration of more than a year. All cases were treated with a fresh preparation of a herbal mixture, namely "Z-HE". The paste was applied once daily for 5 consecutive days and thereafter every 2 weeks, as needed, for a maximum period of 3 months. Two patients didn't appear for their regular follow up, the remaining 12 cases were followed up for more than a year after termination of therapy. Eleven (92%) of patients had complete healing in a matter of 1 to 7 months with no relapse after 12 months of follow up. In spite of a successful initial clinical response, the remaining one patient with the acute type of ECL had a subsequent relapse. Otherwise the acute and chronic cases had similar responses to therapy and outcome. No drug related side effect was noted. The high success rate, low cost, ease of preparation, and lack of toxicity makes "Z-HE" a promising new drug. Further investigations are needed to illuminate its mechanism(s) of action and also controlled trials are recommended to confirm its efficacy.     

Basiskoronarchirurgie

Indications, procedural concepts and technical details of the coronary artery bypass graft (CABG) operation are continuously reassessed by cardiac surgeons and cardiologists. In particular, CABG in patients presenting with complex coronary artery disease is continuously challenged by interventional cardiology. However, considering current comparative studies, CABG remains the first line therapy for patients presenting with coronary three-vessel disease and/or left main stem stenosis. This is even more important for severely diseased coronary arteries or in complex lesions. However, cardiac surgeons now more than ever before need a profound knowledge of their own and the cardiologists’ work scope to be a strong partner in heart team discussions and a reliable guardian of the patient. The current educational paper aims at presenting important and well accepted aspects of coronary artery bypass surgery. Technical aspects as well as updated study results on early and late patient outcome will be discussed.     

4-Dimensionally Guided 3-Dimensional Color-Doppler Ultrasonography Quantifies Carotid Artery Stenosis With High Reproducibility and Accuracy

Objectives

The purpose was to analyze the agreement and binary accuracy of the degree of internal carotid artery stenosis (ICAS) as determined by 4-dimensionally (4D) real-time gray-scale guided 3-dimensional (3D) color-Doppler ultrasonography (3DC-US) (4D/3DC-US) compared with catheter angiography (CA) and duplex ultrasonography (DUS). This study hypothesized that 4D/3DC-US is noninferior to CA and DUS in grading ICAS in selected patients.