A new antithrombogenic right ventricular (RV)-pulmonary artery (PA) valved conduit was developed using a bovine jugular vein containing a natural valve. To maintain the natural and mechanical properties of the venous tissue, a hydrophilic cross-linking reagent, glycerol polyglycidyl ether polyepoxy compound (PC) was used instead of glutaraldehyde (GA). Moreover, to induce antithrombogenicity, heparin was bonded to the inner surface of the bovine jugular vein cross-linked with PC. Conduits of 18 to 20 mm inner diameter (ID) were implanted between the RV and PA in nine dogs weighing 7-17 kg, with the native main PA being ligated proximally. The handling and suturing of the graft was easy and adaptable, and the anastomosis was completed with excellent coaptation and no blood leakage at the suture lines. All animals were chronic survivors, but one animal died of hematemesis on the 438th postoperative day. Grafts were explanted from 182 to 385 days after implantation. The luminal surface of the conduits were white, glistening, and smooth with good coaptation of the cusps, without calcification or degenerative changes except for one cusp that showed a minimal deformation with a small thrombus. Macroscopic and microscopic observation showed that there were no thrombi at the anastomotic lines, but small thrombi on the luminal surface of the conduits near the cusps and in some cusps. Endothelium-like cells were noticed on the luminal surface of the graft, except in the area near the cusps, and on one cusp at 196 days after surgery. These results indicated that the new RV-PA valved conduit provided adequate antithrombogenicity by temporary slow heparin release, followed later by endothelialization of the graft in a low pressure system at 1 year after implantation.

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Measurement of cytokine levels by coronary sinus blood sampling during cardiac surgery with cardiopulmonary bypass.

Interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase levels in coronary sinus blood were measured and compared with those in arterial blood drawn from the radial artery before and immediately after cardiopulmonary bypass (CPB) during coronary artery bypass grafting in 20 patients. We introduced coronary sinus blood sampling as a useful method for evaluation of myocardial metabolism, myocardial protection, and reperfusion injury during CPB, especially by measurement of cytokines. Because interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase are inflammatory mediators, we speculated that they might show higher levels in coronary sinus blood than in systemic arterial blood. The results obtained from the 20 patients showed that levels of interleukin-6, interleukin-8, and polymorphonuclear leukocyte elastase increased immediately after CPB (p < .01), but there was no significant difference in these levels between coronary sinus and systemic arterial blood. We conclude that the myocardium is not a predominant source of their release during CPB. Our results also showed that the measurement of these cytokines in systemic arterial blood reflected their levels in the whole body, including the myocardium, even during cardiac operation with CPB.

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Social behavior and aggression among ringtailed lemurs.

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Reduction of VX2 transplanted tumor by granulocyte depletion using extracorporeal circulation on rabbit models.

To investigate the role of granulocytes and the effect of granulocytosis on malignancies, we studied the relationship between white blood cell and granulocyte (Gr) counts, and tumor size. As we have reported that cancer patients with high granulocyte (G/L) ratio have a poor clinical prognosis, normalization of the G/L ratio could contribute to improvement in their condition. Tumor bearing rabbits treated with the extracorporeal granulocytte depletion device showed a decrease in tumor size and no tumor necrosis. Tumor-bearing rabbits with no extracorporeal granulocyte depletion showed a remarkable tumor progression and an increase in Gr count. Depletion of granulocytes considerably improved the survival ratio of tumor-bearing animals. The device used in this study could be a potential treatment for malignant tumors.

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Iliofemoral venous thrombectomy (follow-up studies of 88 patients).

A review of our 93 consecutive thrombectomies performed on 88 patients for acute and subacute iliofemoral venous thrombosis led us to the following conclusion. 1. Venous thrombectomy is an effective and safe operation and should be continued to be utilized in the management of iliofemoral venous thrombosis. 2. Thrombectomy should be recommended for in many types of patients, and the indication should include not only those whose symptoms occurred less than 2 weeks prior to the operation, but also those whose symptoms had been present for more than 2 weeks before surgery, in as much as the patients are suffering from severe pain, swelling and incapacity to walk. 3. The thrombectomy is useful for relief of complaints and plays an important role in the prevention of postphlebitic syndrome.

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Granulocytapheresis as a possible cancer treatment.

We assessed the effect of granulocyte apheresis in patients exhibiting increased granulocyte-to-lymphocyte ratio in order to overcome granulocytosis occurring in the terminal stages of malignancies. 17 patients with post-operative recurrent metastatic tumors including 6 gastric, 3 colonic, 2 rectal, 1 esophageal and 5 breast cancers were selected. The granulocytapheresis was performed by extracorporeal vein-to-vein circulation equipped with an apheresis column filled with cellulose acetate beads. Each week the patients underwent one or two sessions of treatment that lasted 30 to 50 minutes per session at a flow rate of 30 to 50 ml/min. 15 sessions formed 1 therapeutic cycle. The effect of granulocytapheresis resulted in partial response (PR) in 4 cases, no change (NC) in 7 cases and partial disease (PD) in 6 cases. The performance status showed 30% remission. None of the patients exhibited significant side effects. Since the treatment demonstrated anti-tumor effects, granulocytapheresis may be applied during combined cancer treatments.

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A single-blind comparison of bromperidol and sulpiride in hospitalized schizophrenics.

Fourty-five schizophrenic inpatients were randomly assigned to bromperidol or sulpiride in an 8 week single-blind clinical trial. No statistically significant differences were observed for final global improvement rating. Regarding BPRS items and compared to sulpiride, bromperidol was particularly effective to relieve emotional withdrawal and hallucinatory behavior, although the only significant between group difference was in favour of sulpiride for improvements of somatic concern. No significant differences were observed for all PES items, although sulpiride was found more effective for hypochondriasis and neurotic complaint as was bromperidol for hallucination and disturbance of self-conscious. The rate of side-effects and abnormal laboratory test results were comparable in the two groups. They were not severe enough to require termination of administration. Bromperidol and sulpiride are concluded to have different clinical profile in the treatment of schizophrenic hospitalized patients.

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