[Surgical treatment of total anomalous pulmonary venous return].
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Biomedical subjects
Publications and source records attributed to V Kucera.
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Nineteen cases of unilateral absence of the pulmonary artery (UAPA) were found in a group of 2,960 patients investigated consecutively by cardiac catheterization, angiocardiography, and pulmonary perfusion scintigraphy. The incidence of UAPA was 0,6%. In 8 cases (40%) UAPA was found in isolation, and in 11 cases (60%) it was combined with other congenital heart defects (CHD). In 30% of our patients the diagnosis of UAPA was suggested by clinical symptoms and plain chest X-ray. Pulmonary perfusion scan was made in 2,600 children before catheterization. Though it can provide strong evidence of the diagnosis, this should be confirmed by cardiac catheterization and selective angiography. Eight patients were operated upon. Systemic-pulmonary shunt operations were performed in 6, and ligation of PDA in 2 patients. In one of the latter severe hemoptysis occurred following ligation of the PDA. The pathophysiological and diagnostic aspects of UAPA are discussed.
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Unextracted heparinized plasma samples containing L-DOPA can be refrigerated or frozen with negligible losses in drug for at least two weeks. This stability of L-DOPA in the sample obviates difficulties in collection and processing of plasma samples within clinical settings which may be remote from the analytical laboratory facilities.
Sodium nitroprusside is an excellent agent for lowering blood pressure in hypertensive emergencies, for producing controlled hypotension during anesthesia, and for treating acute myocardial infarction and chronic heart failure. Toxic effects of this drug have been reported and above-normal cyanide and thiocyanate concentrations have been observed in the blood of a small proportion of subjects receiving nitroprusside. Nitrite, syanide, and thiocyanate are major decomposition products of nitroprusside, resulting from an in vitro reaction with human blood. On the basis of the conversion mechanism, we suggest that, in the cyanide/thiocyanate cycle, only cyanide is directly responsible for any acute toxicity attributed to sodium nitroprusside. In this work, the extent of cyanide production by erythrocytes in vitro was studied. The rate of detoxification of cyanide by human liver in vitro was experimentally determined and data from a search for a possible inhibitor of the nitroprusside/hemoglobin reaction are presented. Also, the possible mechanism of the nitroprusside/hemoglobin reaction is discussed.
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