Coronary artery spasm following coronary artery revascularization

Coronary artery spasm is a well-documented phenomenon in patients undergoing medial treatment. We describe coronary artery spasm occurring in the immediate postoperative period following coronary artery bypass operation. The spasm occurred in a vessel that was not operated on and that had no apparent lesion. The diagnosis of spasm was made by coronary angiography immediately after operation. Complications associated with this spasm are discussed. Emphasis is placed on early postoperative angiography for patients whose condition is inexplicably unstable after operation.

Routine colonic lavage is unnecessary for double-contrast barium enema in outpatients

Four different cleansing regimens were assessed in a prospective survey of 435 patients referred for barium enema. A regimen using simple dietary instructions and laxatives is as effective as a preliminary cleansing enema. It is suggested that routine cleansing enemas in outpatients represent an unnecessary and uncomfortable ritual that might usefully be abandoned.

The structures of paraensidimerin A and C, two bisquinolinone alkaloids from Euxylophora paraensis

Single-crystal X-ray diffraction studies and n.m.r. spectral measurements have now shown structure of paraensidimerin A, a bisquinolinone alkaloid from the heartwood of Euxylophora paraensis (Rutaceae), to be (6aα,7β,15β,16aα)-(�-6,6,9,15,18-pentamethyl-6,6a,7,9,15,16,16a,18-octahydro-7,15-methano-8H,17H-quino[3',4' :5',6'] pyrano[3',4':5,6] oxocino[3,2-c] quinoline-8,17-dione (8). Paraensidimerin C is a stereoisomer, (6aα,7β,15β,16aβ)-(�)-6,6,9,15,18-pentamethyl-9,15,16,16a,18-octahydro-7,15-methano-8H,17H-quino [3',4':5',6'] pyrano [3',4': 5,6] oxocino [3,2-quinoline-8,17-dione (9). Possible biosynthetic routes to these and other dimeric quinolinone alkaloids are suggested.

A prospective comparative clinical analysis of the first-generation knee replacements: polycentric vs. geometric knee arthroplasty

A prospective study of 119 polycentric and 92 geometric knee replacements was performed to determine and compare the clinical effectiveness of these two prostheses. All kneex were followed for a minimum of 2 years and a mean time of 3 1/2 years (2--6 years). Data were collected using a specially designed proforma for subsequent computer analysis. Failure occurred in 11% of the polycentric and in 16% of the geometric knees. Males (8 of 47) and patients with osteoarthritic knees (22 of 68) failed most frequently. Both prostheses provided excellent relief of pain, the same degree of flexion and improvement in flexion contracture. However, walking, function, alignment, stability, muscle strength and patellar mobility varied as to the degree of improvement and the type of prosthesis. Present results with prosthetic knee replacement using a completely new operative technique can be used as a basis for comparison with other contemporary and future arthroplasty designs.

Emergency coronary artery revascularization: a possible therapy for acute myocardial infarction

Cardiac muscle death caused by coronary artery occlusion is a dynamic process that often takes hours or days. Emergency revascularization (saphenous vein bypass graft (SVBG) during acute myocardial infarction (MI) can interrupt myocardial necrosis, salvage ischemic myocardium and revascularize vessels with obstructive lesions not involved in the MI. In this report we describe a preliminary experimental study of 75 patients in which emergency SVBG was the therapy for acute MI. Group 1, 16 patients, required vasoactive medications and/or intraaortic balloon pumping to maintain their blood pressure preoperatively. There was one operative death and two late deaths. Group 2 consisted of 59 hemodynamically stable patients. There were no deaths. The average preop CPK in group 1 was 892 vs 504 in group 2 (p greater than 0.05). Surgical techniques were routine. The average time from the onset of chest pain that continued to surgery was 6.5 hours. Forty patients were restudied. Post- vs presurgical hemodynamics revealed ejection fraction increased by 34% (p greater than 0.05), left ventricular end-diastolic pressure reduced by 40% (p greater than 0.01). End-systolic and end-diastolic volume reduced by 30% (p greater than 0.05), and 15% (p greater than 0.01), and stroke volume improved 25% (p greater than 0.05). Operative mortality was 1.3% and late mortality 2.8%. These results suggest that cautious continued trial of emergency SVBG in patients with evolving MI is warranted.

The SJL/J mouse: a new model for spontaneous age-associated amyloidosis. I. Morphologic and immunochemical aspects

A high incidence of spontaneous amyloidosis is described in SJL/J mice. Amyloid was detected as early as 30 weeks of age and the incidence rose to 90 per cent by 60 weeks of age. Amyloid deposits were most prominent in the perifollicular zones of the spleen and the lobular areas of the liver. Ultrastructural analysis revealed rigid, nonbranching fibrils indistinguishable from those observed in casein-induced murine amyloidosis. On the other hand, immunochemical studies indicated that amyloid deposits in SJL/J mice differ from those found in casein-treated CBA mice with respect to size, amino acid content, and antigenic properties. Since the SJL/J mouse also develops spontaneous reticulum cell tumors and serum M components, it appears to be a useful model for study of the pathogenesis of amyloidosis and its relationship to aging, neoplasia, and certain B-cell dyscrasias.

Examination of Two Theories for Absorption of Microwave and Far Infrared Radiation by Polar Liquids

The far infrared spectra of twenty polar organic liquids have been obtained using a cube interferometer spectrometer. Some new liquids have been examined and some of the previously studied liquids have been re-examined over a wider frequency range and the integrated absorption of the broad band with its peak absorption frequency below about 100 cm−1 evaluated, while any contribution from any overlapping higher frequency band has been subtracted. In general, this has not been taken into account in previous such work. Two approaches which have been previously examined to account for the far infrared absorption of such liquids have been tested for a wider variety of liquids and neither mechanism appears to explain quantitatively the observed absorption intensities. Thus the absorption cannot be accounted for by a simple rotational type of mechanism based on Gordon's equation, plus a contribution similar to that which is found in a non polar liquid as has been suggested earlier. In addition, the parameters of the continuous distribution function approach do not match up to those determined experimentally.