[Successful new method for surgery of the postinfarctional left ventricular free wall rupture]. / Postinfarctusos bal kamra szabadfali rupturájának sikeres mútéti megoldása új módszerrel.

Authors discuss a history of a 78-years old male who suffered from left ventricular free wall rupture due to acute transmural myocardial infarction. Cardiac surgical intervention was carried out immediately after the ECHO examination which established the diagnosis. First time in Hungary authors used a sutureless technique to close the rupture and utilised double component glue and synthetic patch for this purpose. The patient had uneventful recovery and remained free of symptoms throughout his three months period of follow up. Current available data and knowledge are summarised about this life threatening disease.

[Coronary revascularization on beating heart]. / Koszorúérmútétek dobogó szíven.

At authors clinic 563 coronary artery bypass graft procedures were done from 1. January 1998 to 15. September 1999. 134 coronary revascularizations were performed from the same surgical team on beating heart using the same surgical technic at normothermia. Out of them, 98 operations were done with and 36 without ECC support respectively. Patients were operated on with this sophisticated technic exclusively during this period. Conversion to cardiac arrest was not necessary in any case. Male/female ratio was 76/58, 84% of the patients suffered from one or more preoperative myocardial infarction. The average bypass number was 2.7/patient. Arterial revascularization was performed in 94%. Postoperative mortality was 2.2% (3 pts). The postoperative inotropic demand, myocardial infarction rate (CK-MB release) and the amount of bleeding was very low. Mean postoperative stay in the ICU decreased to the average of 19 hrs. Patients normally left hospital on the 7th postoperative day. This operative technique--performed by an experienced surgeon--is less invasive for the heart and other organ systems, the incidence of complications can be decreased and the principle of complete revascularization is not compromised.

Muscle stimulation related to a nonfunctioning epicardial pacemaker electrode.

Noninfected retained pacemaker leads produce fewer complications than infected electrodes. Epicardial electrodes are rarely used, thus complications associated with such electrodes are seldom reported. We report a case with muscle stimulation due to a retained epicardial pacemaker electrode.

Runaway pacemaker syndrome and intermittent nonoutput as manifestations of end of life of a VVI pacemaker.

A case of a runaway pacemaker with intermittent nonoutput failure of a VVI Intermedics pacemaker is presented. This is the first report of such a phenomenon in that type of pacemaker with no apparent reason other than approaching battery end-of-life. The reported case warrants a close follow-up of patients with the same type of device.

[Aortic regurgitation caused by quadri-cuspid aortic valve]. / Négyhegyü aortabillentyü okozta regurgitatio.

Authors report the surgical treatment of a rare malformation of the aortic valve associated with coronary artery stenosis. The aortic valve had a supernumerary cusp which was revealed intraoperatively. The supernumerary cusp appeared to be similar in size to the three other. Surveying the literature it is stated, that the number of similar entities are about 50 in number. Autopsy findings note, that the prevalence is about 0.008-0.012%. During the past 25 years, in aortic valve replacement cases such entity could have not been explored. The possible significance of the entity lays in--that without rheumatic or degenerative origin-in the life span (above 40 years of age) it may lead to severe regurgitation leading to functional deterioration.

Protostrongylidae in Cervidae and Ovibos moscatus: a clustering based on isoelectric focusing on nematode body proteins.

Isoelectric focusing for protein separation and evaluation by Unweighted Pair Group Method with Arithmetic averages (UPGMA) clustering was tested as an alternative to a morphological approach to taxonomical studies of the family Protostrongylidae and the genus Elaphostrongylus. These analyses revealed a close relationship among first stage protostrongylid larvae from roe deer, muskoxen and Varestrongylus alces first stage larvae. Furthermore, first stage larvae collected from moose faeces and adult Elaphostrongylus in moose were found related. Adult Elaphostrongylus in moose and reindeer maintained their separate taxonomical status.

Fibronectin binding by Salmonella strains: evaluation of a particle agglutination assay.

Thirty-five Salmonella strains isolated from human cases of salmonellosis were tested and compared for their fibronectin (fn) binding capacities by using two fn-particle agglutination assays (fn-PAAs) prepared by coating with human fn either (i) latex beads (Difco; 0.81-micron diameter) (L-fn-PAA) or (ii) heat-killed formalin-treated Staphylococcus aureus Cowan 1 cells (C-fn-PAA). Six S. aureus strains were also included in this study as controls. The strains were cultured on colonization factor antigen agar and blood agar and in tryptic soy broth and brain heart infusion broth. The Salmonella and S. aureus strains were cultured at 33 and 37 degrees C, respectively, for optimal expression of fn-binding proteins. Bacterial cells (approximately 10(10) cells per ml) harvested from growth in various culture media and suspended in 0.02 M potassium phosphate buffer (pH 6.8) agglutinated the fn-PAA reagents. These reactions were scored semiquantitatively from + to + depending on the speed or intensity of the reactions within 2 min. Maximum agglutination in fn-PAA systems was observed when the cells were grown in brain heart infusion broth, while tryptic soy broth proved to be least suitable media for culturing cells for fn-PAAS. Although a statistically highly significant correlation was obtained between results of assays of radiolabeled fn and 29-kDa fragment binding, no significant correlation was observed (i) between the results of strains cultured in different media or (ii) when semiquantitative score results of the two fn-PAA systems were compared with those of the conventional radiolabeled fn assay. To enhance the efficiency of the test system, the C-fn-PAA reagent was stained with methylene blue (2% in 0.17 M glycine-NaOH buffer [pH 6.8]). This facilitated easy interpretation of results, which could be performed on hydrophobic paper instead of glass slides. The results obtained with both unstained C-fn-PAA and stained C-fn-PAA were comparable to each other and reproducible. Although the fn-PAAs are simple and easy to perform, the results did not differentiate between negative, low, moderate, and high binding abilities when Salmonella strains were evaluated for fn binding, and the results were not comparable to those obtained by the conventional radiolabeling method.

Evaluation of an indirect ELISA for the detection of antibodies to bovine leukaemia virus in milk and serum.

An indirect enzyme-linked immunosorbent assay (ELISA) was developed to detect antibodies to BLV in milk and serum (Juntti et al., 1989). The conjugate consists of a monoclonal anti-bovine IgG1 and IgG2 labelled with horseradish peroxidase (HRP). The indirect ELISA was calibrated with EEC reference serum E 4. Standard serum E 4 was scored positive when diluted 8192 times in negative milk and between 12,800 and 25,600 times in negative serum. The sensitivity and specificity of the indirect ELISA relative to the agar gel immunodiffusion test (AGID) were 100% and 99.8%, respectively. ELISA results for milk and sera from 614 dairy cows agreed to 100%. The absorbance value in bulk milk could be used to roughly predict the rate of BLV infection among lactating cows in a herd. An infection rate of 4 to 5% in a herd could be detected in the ELISA. Results were applied in a nation-wide screening of more than 24,000 bulk-milk samples, and the subsequent introduction of an eradication programme for BLV. The aim is to eliminate the infection from Swedish herds in 5 to 10 years.

[Coronary revascularization in post-infarction patients]. / Coronaria revascularisatio postinfarctusos betegeken.

Authors report the type of revascularization, the result of noninvasive and invasive investigations carried out 6-9 months after surgery, improvement of functional status of 56 postinfarction patients with recurrent angina pectoris. They conclude, that recoronarography performed in 12 patients revealed diminished patency rate compared to the estimated predictive one, especially in those, where complete revascularization was considered to have been carried out. Ejection fraction, wall motion score by ventriculography and echocardiography did not seem to improve significantly. However Dipyridamol Thallium scintigraphy showed marked improvement in perfusion in all cases. NYHA functional status has noticeably improved in the reexamined patients.

Coronary artery revascularization after myocardial infarction.

Authors report on the revascularization resulted by noninvasive and invasive interferences carried out 6-9 months after surgery and on the improvement of functional status of 56 postinfarction patients with recurrent angina pectoris. They conclude that recoronarography performed in 12 patients revealed diminished patency rate as compared to the estimated rate, especially in those cases, where complete revascularization was considered to have been carried out. Ejection fraction, wall motion score by ventriculography and echocardiography did not seem to improve significantly. However Dipyridamole Thallium scintigraphy showed marked improvement in perfusion in all cases. NYHA functional status noticeably improved in the re-examined patients.

Endocavital cooling in intraoperative myocardial protection during extracorporeal circulation.

The possible protective effect of endocavital cooling with a balloon left ventricular vent was studied by post cross clamp time rhythm, ECG, DC shock need, dynamics of temperature changes in the interventricular septum, and positive inotropic support requirement in 60 extracorporeal operations (18 aortic valve replacement, 26 aortocoronary bypass and 16 combined procedures) performed by the same team of surgeons with an identical technique and anaesthetic protocol. The results were compared to the data of 60 similar procedures carried out earlier by the same team but without the balloon technique. We conclude that endocavital cooling may have certain additive effects to chemical cardioplegia, especially in cases with left ventricular hypertrophy, multiple coronary stenoses, and in combined procedures.

Bacteriological quality of on-farm manufactured goat cheese.

The bacteriological quality of 198 ripened soft or semi-soft goat cheeses obtained from dairy farms and the retail trade was investigated. The cheeses were examined for total counts of aerobic bacteria, coliform bacteria (37 and 44 degrees C respectively), enterococci, coagulase positive staphylococci, Bacillus cereus and Clostridium perfringens. Cheeses obtained from dairy-farms were also determined for pH value. In terms of all tests performed, cheeses made of heat-treated milk with starter culture had the best prospects for fulfilling the criteria for 'fit for consumption'. Cheeses made of raw milk without starter culture made up the most unsatisfactory group from a food-hygiene point of view. Bacteriological guidelines for on-farm manufactured goat cheese are suggested.