Inhibition of murine natural killer cell-mediated cytotoxicity by pretreatment with ammonium chloride.

In the present study the effect of ammonium chloride on murine natural killer (NK) cell-mediated cytotoxicity to T cell lymphoma, YAC-1 was studied. It was found that ammonium chloride treatment significantly reduced the cytotoxicity of splenic NK cells without any detectable change in cell viability. It is, therefore, suggested to avoid ammonium chloride treatment in order to obtain the realistic reflection of murine NK cell activities.     

Malignant melanoma of the external ear: Review of 102 cases

The medical records of 102 patients with a diagnosis of melanoma of the external ear seen at The M.D. Anderson Hospital over approximately a 30 year period were reviewed. Survival was correlated with the sex, the clinical appearance of the lesion, the anatomic site of origin, the microscopic thickness and level of invasion, the absence or presence of clinical and pathologic nodal metastasis, the type of neck dissection and the type of definitive surgical treatment to the ear. The thickness and nodal metastasis adversely affected prognosis. Proper surgical treatment usually involves less than total amputation of the ear. A randomized prospective study should answer the question of whether elective neck dissection of the periauricular, parotid and upper posterior cervical and jugulodigastric nodes is justified. The use of chemoimmunotherapy offers negligible therapeutic benefits for disseminated disease but may be of prophylactic value in a planned, adjunctive protocol for poor risk patients.     

Retrospective analyses of the need for mechanical circulatory support (intraaortic balloon pump/abdominal left ventricular assist device or partial artificial heart) after cardiopulmonary bypass: A 44 month study of 14,168 patients

Data on 14, 168 adult patients undergoing surgery in the 44 months from November 1, 1975 to July 1, 1979 were analyzed to determine the incidence of need for escalating degrees of mechanical support of the failing circulation (intraaortic balloon pump, abdominal left ventricular assist device, or both) after cardiopulmonary bypass. Analyses were performed using a TRS-80 microcomputer to categorize the postoperative course of all adult patients undergoing open heart surgery. It was assumed that any patient who died despite pharmacologic and intraaortic balloon support was a candidate for more profound mechanical circulatory support, that is, the left ventricular assist device, which is 6 to 10 times more hemodynamically effective; on this basis, the latter device was needed in 430 cases (3 percent). A total of 12,669 patients (89.4 percent) were weaned from bypass without difficulty, 1,499 patients (10.6 percent) required pharmacologic agents and volume loading during weaning, 326 patients (2.3 percent) demonstrated inadequate responses to conventional pharmacologic therapy and required intraaortic balloon support during weaning, 94 patients (0.7 percent) demonstrated an inadequate response to conventional pharmacologic and balloon support and 21 patients (0.1 percent) underwent profound mechanical circulatory support (abdominal implantation of a left ventricular assist device).     

Arterial fibromuscular disease. Observations on pathogenesis and surgical management

Fibromuscular dysplasia is being recognized more often as a significant pathologic vascular disease separate from atherosclerosis. The pathogenesis and pathology are still being investigated. This disease involves mainly three areas--renal, carotid and iliac arteries--with the renal area being the most common. Surgery has been used almost exclusively for symptomatic lesions, and the indications and procedures have been refined since the original procedures of resection and grafting. In patients with renal involvement, we first attempt to treat hypertension medically, followed by surgery if this is unsuccessful. In those with carotid involvement, we are very aggressive with symptomatic lesions since there is a 22 percent incidence of a significant preceding event in the patients operated on. In patients with iliac involvement, we treat according to symptoms. Graduated internal dilatation has been used very successfully alone and in combination with other methods. Postoperative follow-up and arteriography have shown the effects of surgery to be lasting and rewarding, with minimal morbidity and mortality and no recurrence.     

Bidimensional electrophoresis in the diagnosis of mucopolysaccharidosis.

Using the modified bidimensional electrophoresis method, characteristic patterns of urinary glycosaminoglycans were obtained for nine different syndromes of mucopolysaccharidoses and normal. Each pattern, portrayed on a 55 mm square cellulose acetate membrane, was visualized by staining the electrophoretically separated GAGs with alcian blue. The method, tested with 38 cases, was precise and sensitive; the first direction of electrophoresis was run for 25 min and the second direction for 60 min. Because the method is qualitative, the usual quantitative measurements and calculations are circumvented. Moreover, any irregular pattern can readily be verified by repeating the bidimensional electrophoresis. Thus, the clarity of the pattern itself offers assurance of its diagnostic reliabilty; consequently, false negative and false positive results should be minimized.     

Severe supravalvular aortic stenosis: successful surgical correction by extended aortoplasty

Surgical treatment of severe discrete supravalvular aortic stenosis by placement of a patch graft across the narrowed area of aorta at one point has been associated with a substantial incidence of residual stenosis. Successful relief of a severe stenosis was achieved by a modification of a previously reported technique in which the stenotic area is expanded at two points. Use of this technique should be considered in cases of severe discrete supravalvular aortic stenosis.