Effect of intra-aortic balloon pumping and calcium antagonist for reducing coronary reperfusion injury

Open heart surgery under aortic cross-clamping is often required, but coronary reperfusion injury after release of aortic cross-clamping is unavoidable irrespective of applications of various protective methods to the myocardium. The anterior descending branch of the left coronary artery of mongrel adult dogs was occluded for 2 hours and then reperfused. The protective effects of intra-aortic balloon pumping (IABP) and of a calcium antagonist "diltiazem hydrochloride" (diltiazem) on the decreased reperfusion of ischemic, border and normal areas were examined by measuring the regional myocardial blood flow (RMBF) using a radioactive microsphere method. Diltiazem could increase significantly the RMBF in the border area. IABP induced a significant increase in the RMBF of the same area more than Diltiazem, with the increase in the endocardial layer tending to be superior to that in the epicardial layer. The results suggested that diltiazem is very effective for reducing the coronary reperfusion injury. It is also suggested that IABP is even more effective than diltiazem because it increases the RMBF significantly and, moreover, has a tendency to increase the blood flow in the endocardial layer which is poor in collateral vessels and thus vulnerable to ischemia.

Application of pulsatile cardiopulmonary bypass for profound hypothermia in cardiac surgery

Profound hypothermia with core cooling has been considered unsafe as compared with surface cooling because of the induced metabolic acidosis. We carried out studies on mongrel dogs to determine whether or nor conventional cardiopulmonary bypass with pulsatile blood flow for core cooling could replace the bypass with non-pulsatile flow. The recovery time from anoxic damage of the brain due to circulatory arrest was also studied. Cerebral excess lactate (delta XL) (Huckabee) was determined throughout the course of hypothermia. During the cooling period from 30 degrees C down to 20 degrees C, the mean value of delta XL in the pulsatile group was significantly lower than that in the non-pulsatile group (p less than 0.01). After forty minutes of the first total arrest at 20 degrees C, thirty minutes of pulsatile perfusion tended to eliminate the anaerobic metabolism of the brain caused by the first total circulatory arrest (p less than 0.1). Thus, the anaerobic metabolism in the brain appears to be highly suppressed with pulsatile cardiopulmonary bypass during the cooling period. Correction of congenital heart disease in infancy can probably be more safely performed if pulsatile cardiopulmonary bypass for cooling and rewarming is employed instead of the non-pulsatile bypass.

Reduced and oxidized glutathione in brain and convulsions

Concentration changes of reduced glutathione (GSH) and oxidized glutathione (GSSG) were studied by fluorometric assay with omicron-phthalaldehyde to clarify the relationship between seizure mechanism and the glutathione redox state. In cerebellum the GSH/GSSG ratio was significantly decreased in the interictal stage of E1 mice (stimulated group), but in ddY mice this ratio was decreased before convulsions induced by pentylenetetrazol and during submaximal ECS. No change was found in the GSH/GSSG ratio of the cerebellum during and after convulsions induced by pentylenetetrazol and maximal ECS. GSH levels in cerebrum in the interictal stage of E1 mice (stimulated group) were lower compared to control E1 mice. In ddY mice submaximal ECS increased GSSG levels in cerebrum so that the GSH/GSSG ratio was decreased.

[Immunological monitoring of patients operated on for epidermoid bronchogenic carcinoma]

Sequential monitoring of non specific immunity has been carried out in 16 patients with squamous cell bronchogenic carcinoma undergoing radical surgery. At the time of diagnosis total lymphocyte counts, T-lymphocyte counts and the blastogenic response of lymphocytes to PHA were only slightly depressed; on the contrary C3c and C4 serum levels were significantly increased (P less than 0.01). Sequential determinations of the immunologic profile at monthly intervals up to the 12th postoperative month showed a transient increase of total lymphocyte and T-lymphocyte levels; the lymphocyte blastogenic response to PHA and also C3c and C4 serum levels progressively decreased. Delayed hypersensitivity response to cutaneous antigens, neutrophil chemotaxis, serum levels of IgG, IgA, IgM and B-lymphocyte counts were constantly found within normal range.

A preliminary double-blind study on the efficacy of carbamazepine in prophylaxis of manic-depressive illness

A preliminary double-blind controlled study on the prophylactic effect of carbamazepine on recurrent manic-depressive psychotics was conducted with 22 patients using an inert placebo in ten subjects as a control drug. Carbamazepine in the dosage of 200-600 mg was administered for 1 year. Among the 22 carbamazepine subjects, carbamazepine was found to be effective in 60% of the cases and inert placebo in 22.2% (U-test, P less than 0.10). It is suggested that carbamazepine is a useful drug for the prophylaxis of manic-depressive illness.

alpha-Guanidinoglutaric acid in cobalt-induced epileptogenic cerebral cortex of cats

Guanidino compounds in the cobalt-induced epileptogenic cerebral cortex of cats were fluorometrically analysed by a JASCO G-520 guanidino compounds analyser, and an unknown high peak was observed in the chromatogram that was identical to the peak of authentic alpha-guanidinoglutaric acid. In another experiment, the substance was extracted from the cobalt focus tissue, converted into dimethylpyrimidyl derivative-butylester, and analysed by a GC/MS technique. The mass spectrum of the substance was identical to the dimethylpyrimidyl derivative of alpha-guanidinoglutaric acid butylester (M+ = 365).

Clinical effect of Encephabol (pyritinol) in the treatment of cerebrovascular disorders

The results of a series of multicentre, controlled, double-blind trials of the clinical efficacy of Encephabol compared with placebo in patients with a variety of cerebrovascular disorders are reported.