Percutaneous transluminal balloon valvuloplasty: the treatment of choice for congenital valvar pulmonary stenosis

Forty-eight children with suspected isolated pulmonary valvar stenosis were evaluated clinically and echocardiographically between January 1987 and December 1988. Fourteen patients with significant transpulmonary peak systolic pressure gradient greater than 30 mmHg on continuous-wave Doppler interrogation were subjected to right heart catheterisation. Percutaneous transluminal balloon valvuloplasty was performed in 11 of these patients with peak systolic pressure gradient than 40 mmHg across the pulmonary valve at cardiac catheterisation. Satisfactory reduction of systolic right ventricular pressure (110 +/- 43 to 46 +/- 17 mmHg, p less than 0.001) and peak systolic pressure gradient across pulmonary valve (92 +/- 44 to 27 +/- 16 mmHg, p less than 0.001), were achieved in all cases. The reduction of peak systolic pressure gradient (64 +/- 37 mmHg, range = 29-158 mmHg), was positively correlated with the initial right ventricular systolic pressure (r = 0.92, p less than 0.0002). There was no significant complication in this series and all patients were discharged the day after the procedure. Percutaneous transluminal balloon valvuloplasty is effective and safe. It should be the treatment of choice for significant valvar pulmonary stenosis in children.

[Management of traumatic injuries of the colon]

We have reviewed our experience with penetrating lesions of the colon at the Santo Tomás Hospital. Good results were obtained with immediate suture of the lesions without need for colostomy when favorable conditions permit.

Knee, ankle, and foot problems in the preadolescent and adolescent athlete

Children are the nearest thing in the human race to tadpoles in that they have tremendous powers of healing and regeneration. It should be remembered that they are subject to overstress injuries, more so than middle-aged adults. Precautions should be taken and the proper radiographs made when any swelling or tenderness occurs about a joint because of the tendency of children to develop injuries involving the growing centers of bone.

Challenge exposure of cattle vaccinated with a chemically altered strain of Pasteurella haemolytica

Calves vaccinated with a chemically altered strain of Pasteurella haemolytica and their nonvaccinated controls were challenge exposed intranasally with the Cooper strain of infectious bovine rhinotracheitis virus. Five days later, the calves were challenge exposed intratracheally with the P haemolytica type A1. Calves that had been vaccinated with large, medium, or small doses of the chemically altered vaccinal strain of P haemolytica had various degrees of resistance to the experimental challenge exposure. Nonvaccinated animals developed severe respiratory tract disease and pneumonia after challenge exposure.

Cross-protection by a chemically altered vaccinal strain of Pasteurella multocida in mice and hamsters

A chemically altered type A strain of Pasteurella multocida was used to vaccinate mice and hamsters. The vaccinated animals were challenge exposed with type A, B, and E isolated of P multocida. A degree of protection was afforded the vaccinated animals against homologous and heterologous challenge-exposure strains.

A study of the interaction of practolol with acetylcholine, histamine, serotonin and bradykinin in the guinea-pig, and with bean-sprout juice in the mouse

1. The interactions of practolol with acetylcholine, histamine, serotonin and bradykinin were studied on the trachea and lung of the guinea-pig, an animal whose sensitivity to bronchoactive endogens is known to be similar to that of human asthmatic bronchi. 2. Practolol, like propranolol, potentiated the action of the first three agonists mentioned above, but, unlike propranolol, it did not potentiate the bronchospastic effect of bradykinin. 3. Practolol, in fact, antagonized the action of bradykinin, but this effect was unlike that produced by nonsteroidal anti-inflammatory drugs. 4. The possibility that beta-adrenoreceptor antagonists might show adverse interactions with certain foodstuffs was investigated, an is discussed. 5. It is suggested that the feasibility of the continued use of practolol (or the newer cardioselective beta-blockers) in asthmatics necessarily depends on the type of allergic reaction involved, and so it is not possible to generalize. Any drug or food that might cause a bronchospastic effect synergistically in the presence of a beta- adrenoreceptor antagonist, even a cardioselective one, should be regarded with suspicion.

Fermentation of L-aspartate by a saccharolytic strain of Bacteroides melaninogenicus

Resting cells of Bacteroides melaninogenicus fermented L-[14C]aspartate as a single substrate. The 14C-labeled products included succinate, acetate, CO2, oxaloacetate, formate, malate, glycine, alanine, and fumarate in the relative percentages 68, 15, 9.9, 2.7, 1.8, 1.0, 0.7, 0.5, and 0.06, respectively, based on the total counts per minute of the L-[14C]aspartate fermented. Ammonia was produced in high amounts, indicating that 96% of the L-aspartate fermented was deaminated. These data suggest that L-aspartate is mainly being reduced through a number of intermediate reactions involving enzymes of the tricarboxylic acid cycle to succinate. L-[14C]asparagine was also fermented by resting cells of B. melaninogenicus to form L-aspartate, which was subsequently, but less actively, fermented.

Influence of amino acids on the growth of Bacteroides melaninogenicus

Addition of individual amino acids to a Trypticase-yeast extract-hemin medium affected growth rates and final yields of an asaccharolytic strain and a saccharolytic strain of Bacteroides melaninogenicus. L-Aspartate or L-asparagine produced maximal growth enhancement for both strains. L-[14C]aspartate was fermented by resting cells of the asaccharolytic strain. L-Cysteine or L-serine also enhanced growth for the saccharolytic strain. However, growth of the saccharolytic strain was inhibited by L-lysine, L-glutamate, L-glutamine, L-isoleucine, L-leucine, and L-proline; growth of the asaccharolytic strain was inhibited by DL-valine and L-serine. Both strains were inhibited by L-histidine, DL-methionine, L-tryptophan, L-arginine, and glycine.