[Surgical treatment of chronic pulmonary embolism. Description of a case].
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Biomedical subjects
Publications and source records attributed to R Russo.
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Two almost identical groups of 258 patients each who underwent surgery for the substitution of one or more than one cardiac valve were taken into consideration. After surgery all patients, with the exception of those who received a porcine allograph, were given coumarin drugs for 1 year for thrombosis prophylaxis. In the first group of patients operated in 1972 and 1973 the laboratory follow-up and the therapeutic range were neither constant nor uniform. In the case of the second group, which included patients operated in 1974 and 1975, adequate laboratory follow-up and constantly adequate therapeutic ranges were always kept. This retrospective study has shown a statistically significant decrease in mortality due to thromboembolism and to unknown causes in the second group of patients (x2 = 8,313, "p" less than 0,0025). A decrease of the non-lethal embolic complications was also noted in the second group of patients (x2 = 6,813, "p" less than 0,0025). On the other hand, bleeding complications were greater in the second group of patients (x2 = 3,485, "p" less than 0,05) and this was interpreted as secondary to the higher anticoagulation administered to the latter patients. The results indicate that an adequate coumarin anticoagulation seems able to decrease the incidence of lethal or non-lethal thromboembolic complications after cardiac valve replacement significantly.
Plasma from 14 patients with severe and diffuse coronary atherosclerosis has been compared with that obtained from a normal control group. While a decreased heparin-thrombin clotting time was demonstrated in the patient group, suggesting an increased level of circulating platelet factor 4, there was no significant alteration in plasma antithrombin III level. These results do not support a recent suggestion of a mild chronic intravascular coagulation in atherosclerosis.
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42 patients who had undergone aortic valve replacement with the Lillehei-Kaster prosthesis were studied. Phonocardiographic and physical examinations were carried out on these patients to determine the typical auscultatory pattern of this prosthesis. In the majority of the cases, the first sound was slight. The second sound was made up of two components, both produced by the artificial valve. A prosthetic opening sound was also detected. Moreover, a sistolic ejection murmur was present in all of the patients, and a diastolic murmur in 25%.
1. No transformation of 6-aminochrysene took place during its incubation with rat liver microsomes under oxygen or anaerobic conditions. 2. 6-Aminochrysene inhibited the hydroxylation of aniline, O-demethylation of p-nitroanisole, and N-demethylation of aminopyrine by rat liver microsomes. 3. Pre-treatment of rats with 6-aminochrysene markedly decreased the N-demethylation in vitro but significantly increased the hydroxylation and the O-demethylation. Similar effects were observed also with microsomal preparations from livers perfused with 6-aminochrysene.
1. New quantitative assays of 6-aminochrysene by spectrophotometric and g.l.c. methods and t.l.c. separation systems are described. 2. The decline in blood levels of the antitumoral agent 6-aminochrysene was due to its distribution rather than to metabolism to polar metabolites, during liver perfusion experiments. 3. No marked changes in kinetics of 6-aminochrysene were observed during perfusion of livers isolated both from normal and from Walker 256 carcinosarcoma-bearing rats.
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