Shelhigh No-React porcine pulmonic valve conduit: a new alternative to the homograft.

BACKGROUND: The Shelhigh No-React pulmonic valve conduit is a new porcine conduit that is glutaraldehyde-treated and detoxified using a proprietary heparin process. In our institution it has been implanted in 25 patients. The aim of this present contribution is to evaluate the short-term follow-up after its implantation. METHODS: From November 1997 to August 1999, 25 patients (mean age, 20.2 years; range, 0.6 to 28.3 years) were operated on using this conduit. Seventeen patients underwent a Ross procedure for aortic valve disease, with the conduits implanted in anatomic position; 6 patients underwent right ventricular outflow tract reconstruction; 2 patients underwent the Rastelli operation. The follow-up was complete. Preoperative and postoperative two-dimensional echocardiography data were collected. RESULTS: There were two non-conduit-related deaths. Two conduits needed to be exchanged because of an increase in the gradient. Overall, all patients were improved in terms of New York Heart Association class. Comparison of preoperative and postoperative two-dimensional echocardiography gradient showed significant improvement. At the 30-month follow-up, no calcification was seen on the explanted conduits or on the two-dimensional echocardiography, although many of the patients are children. CONCLUSIONS: The Shelhigh conduits seem to be an alternative to homograft especially in infants. These experiences are preliminary, and longer follow-up is required.

[The role of a bidirectional cavopulmonary anastomosis in the correction and palliation of complex congenital cardiopathies]. / Ruolo dell'anastomosi cavo-polmonare bidirezionale nella correzione e palliazione delle cardiopatie congenite complesse.

Between May 1990 and January 1998, 68 patients underwent bidirectional cavo-pulmonary anastomosis. We evaluated all patients in whom the bidirectional cavo-pulmonary anastomosis was associated with additional pulmonary flow (group A) and those in whom it was associated with biventricular repair (group B). Group A included 23 patients (33.8%), 14 males and 9 females, mean age 25 years and 6 months (range 4 months-16 years). Diagnoses were double outlet right ventricle (6), univentricular heart (6), tricuspid atresia (5), congenitally-corrected transposition of the great arteries with ventricular septal defect and pulmonary stenosis (3), right isomerism (2) and pulmonary atresia with atrioventricular canal (1). Group B included 13 patients (19.1%), 6 males and 7 females, mean age 13 years and 7 months (range 1 year-37 years). Diagnoses were pulmonary atresia with intact ventricular septum (4), Ebstein's anomaly (3), tetralogy of Fallot (3), atrioventricular canal (1), hypoplastic right ventricle (1), and pulmonary and tricuspid insufficiency (1). Four patients (17.3%) in group A died in the postoperative period, whereas there was no postoperative mortality in group B. Follow-up data were available in 31 patients (19 from group A, 13 from group B). Mean follow-up was 1 year and 6 months (range 30 days to 6 years). Evaluation was done by NYHA class functional status. In group A, 14 patients are doing well (NYHA I or II), while five patients (26.3%) underwent Fontan operation with one death. All group B patients are currently doing well (NYHA class I or II). In group A, complications were pericardial effusion (7), transient superior vena cava syndrome (5), pleural effusion (4), chylothorax (1) and rhythm disturbance (1). Complications in group B involved neurological events (2), pleural effusion (1) and rhythm disturbance (1). Bidirectional cavo-pulmonary anastomosis can be associated with additional pulmonary flow with good short- and intermediate-term outcome. Concern remains for the ability to properly regulate the amount of effective pulmonary blood flow. Bidirectional cavo-pulmonary anastomosis can be associated with biventricular repair in patients with diminutive right ventricles, amenable to anatomic complete correction, with good clinical outcome.

[Different behavior of phagocytes in young and old subjects]. / Differente comportamento dei fagociti in soggetti giovani e anziani.

Ageing is a dynamic phenomenon in which there is a physiological decay in all the functions of the individual. The consequence is an increased susceptibility to infections, autoimmune diseases and cancer. Phagocytic cells as polymorphonuclear leukocytes (PMNL) and monocytes (Mo) are of prime importance in the defence against invasive agents, PMNL and Mo seek out and destroy invading micro-organisms. Chemotaxis and phagocytosis are two mechanisms that are activated by these cells for this purpose. In this study, using "in vitro" techniques, we have verified if, at the level of such functions of cell defense, there could be variations in elderly subjects with respect to younger subjects. Our results show a chemotactic activity of PMNL in the elderly that is higher and a phagocytic activity that is lower. As regards Mo, there is a lower chemotactic activity in the elderly and only a slight difference in phagocytic activity with respect to the younger subjects. These results are in agreement with those found at the clinical level showing the elderly less protected from infection with respect to younger subjects.

Effect of immunization against human chorionic gonadotropin (hCG) on transplantation of Yoshida ascitic tumour.

The human chorionic gonadotropin (hCG) is considered a marker of DNA derepression on neoplastic cells. The human chorionic gonadotropin antibodies (anti-hCG antibody) inhibit the growth of yoshida tumour cells in preimmunized recipient rats. A close relationship between the anti-hCG antibodies and tumour cell transplantation has been observed. This relationship and further experimental implications are briefly discussed.

[Effects of lymphocyte stimulation in vitro of alkaline salts of some aroyl-hydrazino-carbodithioic acids and 1,3,4-oxadiazole derivatives: preliminary research]. / Effetti sulla stimolazione linfocitaria in vitro di sali alcali ni di alcuni acidi aroil-idrazino-carboditioici e di derivati dell'1,3,4-ossadiazolo: ricerche preliminari.

The behaviour of alkaline salts of some aroyl-hydrazine-carbodithioic acids [comp. Ia,b,c,] and derivatives of 1,3,4-oxadiazole [comp. IIa,b,c, e IIIa,b,c] , has been studied, on the capability of lymphoblasts in vitro, in consequence of stimulation by some mitogen agents (PHA, PWM). It has been pointed out that the considered compounds inhibit the cellular mitosis in variable percentage in relation to their structure and to the used mitogen agent, frequently causing some mitogen-like morphological modification, also revealable under a optical microscope. The higher inhibition has been obtained by the Ic, IIc, and IIIc compounds, in which Ar is the 3,4-dihydroxymethylenephenyl radical, proving selective, in some cases, for the T lymphocytes.