The fatty acid profile in the yolk and yolk sac from incubated goose eggs depends on the breeder age and laying period.

1. The study analysed the content of fatty acids in the lipids of the yolk and yolk sac of hatching eggs obtained from geese in four reproductive flocks and three laying periods at different incubation dates.2. A total of 1080 hatching eggs were used in the study (90 eggs from each age group in three laying periods). The geese were kept on one farm under the same conditions.3. On days 0, 16, 22, and 28 of incubation, the yolk/yolk sac was sampled. Saturated and unsaturated (mono- and poly-) fatty acids were determined, including myristic acid, palmitic acid, palmitoleic acid, margaric acid, stearic acid, oleic acid, linoleic acid, α-linolenic acid, behenic acid, eicosapentaenoic acid. The ratio of unsaturated to saturated fatty acids was calculated.4. Embryo fatty acid utilisation in eggs from different age groups of geese was similar. The fatty acid profile depended mostly on the laying period. The different proportions of fatty acids in the yolk during incubation indicated changes in the activity of various enzymatic processes in the membrane of the yolk sac of embryos from the beginning and at the end of the laying period.5. When analysing the interactions between the age of the parent flock and the laying period, the most significant effect on the fatty acid composition was found in fresh eggs. On d 16 of lay the myristic, stearic, linoleic, and behenic acids and PUFA; on d 22 of lay linolenic acid, and on day 28th palmitoleic and margaric acids were involved in this interaction.

Mitral valve repair for ischemic mitral regurgitation: review of current techniques.

INTRODUCTION: Ischemic mitral regurgitation can be defined as moderate to severe mitral leak precipitated by acute myocardial infarction. Valve repair is now the procedure of choice, but some cases can pose difficult anatomy. This review will illustrate current techniques for repairing complex ischemic mitral regurgitation. METHODS: Most patients with ischemic mitral regurgitation have predominant annular dilatation at the posterior commissure and require only ring annuloplasty. Full rigid rings are used preferentially. With leaflet tethering, adjunctive autologous pericardial patches are effective in restoring leaflet coaptation. If papillary muscle elongation or rupture occurs, Gore-Tex artificial chordal replacement performs well. With ischemic mitral regurgitation accompanying posterior ventricular aneurysms, standard trans-atrial mitral repair provides the best results, with associated aneurysms being repaired concurrently. RESULTS: Surgical approaches and technical outcomes of mitral repair in ischemic mitral regurgitation are illustrated in 5 patients using operative images and echocardiograms. Each method is illustrated, including ring annuloplasty, pericardial leaflet augmentation, artificial chordal replacement, and ventricular aneurysm repair. Using these techniques, virtually all ischemic mitral regurgitation can be repaired, with consequential patient benefits, even in the most complex anatomy. CONCLUSIONS: Ischemic mitral regurgitation has been shown to have better outcomes when managed with valve repair. Using combinations of annular, leaflet, and chordal procedures, even complex ischemic mitral regurgitation can undergo autologous reconstruction with excellent long-term results.

Arterial bypass grafting of the coronary circulation.

Surgical coronary bypass has evolved continually, and recent developments favor performing coronary grafts with all-arterial conduits in order to obtain better long-term graft patencies. With bilateral internal mammary artery grafts and both radial arteries, four excellent arterial conduits exist for revascularization of the majority of multivessel disease patients, including those with valve disorders. Using contemporary surgical techniques, it is possible to obtain greater than 95% overall long-term graft patencies that translate into better outcomes, including improved survival, freedom from myocardial infarction, percutaneous coronary intervention , and redo coronary bypass. Two-thirds of patients receive a right internal mammary artery to the left anterior descending , a left internal mammary artery to the circumflex coronary artery system, and a radial artery to the right coronary artery Using newer management techniques, early postoperative complications, including the incidence of sternal infections, are extremely uncommon, and all-arterial grafts currently are used in over 75% of multivessel patients including those with concomitant valve disease. Because patencies and outcomes are so much better than with standard coronary bypass or percutaneous coronary intervention, referring physicians frequently favor all-arterial bypass as the primary therapy for patients with prognostically serious multivessel obstruction. Thus, all-arterial bypass could play an increasingly important role in the future treatment of severe coronary atherosclerosis.

Prolonged function of macrophage, von Willebrand factor-deficient porcine pulmonary xenografts.

Porcine von Willebrand factor (vWF) activates human and primate platelets. Having determined the importance of pulmonary intravascular macrophages (PIMs) in pulmonary xenotransplantation, we evaluated whether, in the absence of PIMs, vWF might play a role in pulmonary xenograft dysfunction. Utilizing a left single-lung transplant model, baboons depleted of anti-alphaGal antibodies received lungs from either vWF-deficient (n = 2); MCP-expressing (n = 5); MCP PIM-depleted (n = 5); or vWF-deficient PIM-depleted swine (n = 3). Two out of three of the PIM-depleted, pvWF deficient grafts survived longer than any previously reported pulmonary xenografts, including PIM-depleted xenografts expressing human complement regulatory proteins. Depletion of PIM's from vWF-deficient lungs, like depletion of PIM's from hMCP lungs, resulted in abrogation of the coagulopathy associated with pulmonary xenotransplantation. Thus, in terms of pulmonary graft survival, control of adverse reactions involving pvWF appears to be equally or even more important than is complement regulation using hMCP expression. However, based on the rapid failure of PIM-sufficient, pvWF-deficient pulmonary xenografts, pVWF-deficient pulmonary xenografts appear to be particularly sensitive to macrophage-mediated damage. These data provide initial evidence that vWF plays a role in the 'delayed' (24 h) dysfunction observed in pulmonary xenotransplantation using PIM depleted hMCP organs.

Oral feeding with pig peripheral lymphocytes decreases the xenogeneic delayed type hypersensitivity reaction in galactosyltransferase knockout mice.

PURPOSE: Oral tolerance induction has shown promising results in experimental allotransplantation models but is not well investigated in xenotransplantation. We investigated the possibility to induce tolerance against pig peripheral lymphocytes (pPBL) in galactosyltransferase knockout mice (gal -/-), which produce antibodies against Galalpha1-3Gal. MATERIAL AND METHODS: Female (gal -/-) mice 6 to 8 weeks old weighing 35 to 40 g (n = 10) were fed orally every third day five times with 2 x 10(7) isolated, viable pPBL, or with phosphate-buffered saline (PBS) only (n = 7). They were then immunized subcutaneously on day 0 with a subcellular lysate from 4 x 10(7) isolated, viable pPBL. On day 13, 25 microL of a subcellular lysate corresponding to 1 x 10(7) isolated, viable pPBL was injected in the right dorsal foot pad, and the delayed type hypersensitivity (DTH) reaction was calculated after 24 hours by subtracting the swelling response from 25 microL PBS in the left footpad. Anti-Galalpha1-3Gal immunoglobulin IgG and IgM antibody titers were measured in the serum before oral feeding and at day 14. RESULTS: The DTH reaction of the pPBL fed mice was 0.07 +/- 0.05 mm vs 0.57 +/- 0.23 mm for the controls (P < .001). No significant differences in anti Gal alpha1-3 Gal IgG and IgM antibody titers were seen. CONCLUSIONS: This study demonstrates for the first time that oral delivery of pPBL can counteract the indirect T-cell reaction against xenogeneic subcellular antigens from pPBL. These observations warrant further investigation in immunologically modified mice and perhaps in primate models of xenotransplantation.

Solid-phase extraction clean-up of soil and sediment extracts for the determination of various types of pollutants in a single run.

A new sample clean-up procedure based on solid-phase extraction (SPE) sorbents was proposed for the determination of pesticides, polycyclic aromatic hydrocarbons and polychlorinated biphenyls in soils and sediments. The main purpose of the research was to find a combination of sorbents for the SPE method that would permit the determination of many types of analytes (polycyclic aromatic hydrocarbons, polychlorinated biphenyls, N-, P- and Cl-containing pesticides) in a single run. Elution profiles for both the analytes and the interfering components were determined for several types of SPE sorbents (alumina, silica and surface-modified silica) and combinations of them. The efficiency of the clean-up method developed was evaluated using real soil samples.

A porcine model of intimal-medial hyperplasia in polytetrafluoroethylene arteriovenous grafts.

PURPOSE: Vascular access polytetrafluoroethylene (PTFE) graft failure is a major cause of morbidity in the hemodialysis population. The most common cause of graft failure is thrombosis secondary to stenosis at the venous outflow tract. Venous outflow stenosis is characterized by intimal-medial hyperplasia. We have developed a porcine arteriovenous (AV) graft model that may be used to investigate this proliferative response and aid in the development of new therapies to prevent intimal-medial hyperplasia and improve graft patency. METHODS: Left carotid to right external jugular vein PTFE (6 mm) grafts were implanted in the necks of swine. Immediately following anatomosis, flow rates were recorded. In one group of animals (n = 4) the venous outflow tract was harvested after 7 days and morphometric analysis of intimal and medial area was performed. In a second group (n = 8) the graft patency was monitored until 28 days. RESULTS: All porcine PTFE fistula grafts were patent at 7 days and 100% patency was maintained until 14 days. After 28 days, 75% of the grafts failed due to thrombosis. The venous outflow tract developed a significant proliferative response. After 7 days the intimal and medial areas were 469 +/- 9 microm2 and 875 +/- 26 microm2 respectively. At 28 days the intimal and medial areas were 913 +/- 55 microm2 and 1437 +/- 182 microm2 respectively. Luminal flow rate of the venous outflow tract was reduced significantly (344 +/- 11 ml/min at Day 0 to 129 +/- 14 ml/min at Day 7, p < 0.05). CONCLUSIONS: This porcine model rapidly, reliably and robustly reproduces the flow reducing stenosis and intimal-medial hyperplasia at the venous outflow tract of PTFE arteriovenous fistula. It represents a promising tool for investigating the mechanisms of intimal-medial hyperplasia, evaluating therapeutic interventions and new graft materials.

Laparoscopic antireflux surgery in the lung transplant population.

BACKGROUND: Lung transplantation has emerged as a viable therapeutic option for patients with a variety of end-stage pulmonary diseases. As immediate posttransplant surgical outcomes have improved, the greatest limitation of lung transplantation remains chronic allograft dysfunction. Gastroesophageal reflux disease (GERD) with resultant aspiration has been implicated as a potential contributing factor in allograft dysfunction. GERD is prevalent in end-stage lung disease patients, and it is even more common in patients after transplantation. We report here on the safety of laparoscopic fundoplication surgery for the treatment of GERD in lung transplant patients. METHODS: Eighteen of the 298 lung transplants performed at Duke University Medical Center underwent antireflux surgery for documented severe GERD. The safety and benefit of laparoscopic fundoplications in this population was evaluated. RESULTS: The antireflux surgeries included 13 laparoscopic Nissen fundoplications, four laparoscopic Toupets, and one open Nissen (converted secondary to extensive adhesions). Two of the 18 patients reported recurrence of symptoms (11%), and two others reported minor GI complaints postoperatively (nausea, bloating). There were no deaths from the antireflux surgery. After fundoplication surgery, 12 of the 18 patients showed measured improvement in pulmonary function (67%). CONCLUSIONS: GERD occurs commonly in the posttransplant lung population. Laparoscopic fundoplication surgery, when indicated, can be done safely with minimal morbidity and mortality. In addition to the resolution of reflux symptoms, improvement in pulmonary function may be seen in this population after fundoplication. Lung transplant patients with severe GERD should be strongly considered for antireflux surgery.

Evidence for polyreactive xenoreactive antibodies in the repertoire of human anti-swine antibodies: the 'next' humoral barrier to xenotransplantation?

The xenoreactive nature of anti-Galalpha1-3Gal antibodies, and to a lesser extent, polyreactive antibodies, has been characterized by a number of investigators. With the advent of therapies that avoid hyperacute xenograft rejection due to anti-Galalpha1-3Gal antibodies coupled with the possible development of Galalpha1-3Gal deficient swine, the Galalpha1-3Gal antigen may soon cease to be a barrier to xenotransplantation. With this in mind, the potential xenoreactive nature of polyreactive antibodies was investigated using several approaches. The levels of polyreactive antibodies from the serum of newborn (n = 2) and adult (n = 4) baboons undergoing pulmonary xenotransplantation were evaluated. Depletion of 95% and 94% of total serum IgM, without any decrease in albumin levels, was observed in the newborn baboons. This finding indicates that the IgM present at birth and germ line polyreactive IgM was adsorbed by the xenografts. The depletion of polyreactive antibodies (43-83% reduction of anti-DNP IgM) from adult baboons was also observed following pulmonary xenotransplantation or immunoadsorption therapy plus pulmonary xenotransplantation. Additional experiments using human cord serum indicated that most human polyreactive IgM were adsorbed by pig lung homogenate and that the human polyreactive IgM bound approximately two-fold more to immobilized pig lung antigens than to immobilized human lung antigens. These findings indicate that germline polyreactive antibodies are, for the most part, xenoreactive. These data suggest that polyreactive antibodies, although autoreactive, may be more xenoreactive than autoreactive.

Preliminary experience with synchronized coronary sinus retroperfusion in humans.

Synchronized coronary sinus retroperfusion (SCSR) with arterial blood has been extensively tested in animals. This intervention offers temporary support to areas of ischemic myocardium while a method of definitive revascularization is being sought. The feasibility and safety of this procedure for patients with unstable angina was therefore tested. A No. 7F autoinflatable retroperfusion balloon catheter (USCI) was inserted percutaneously into the coronary sinus of the study patients. Arterial blood was obtained through a No. 8F catheter placed in the femoral artery. Arterial blood was infused in a retrograde fashion into the coronary venous system during cardiac diastole by means of a piston-driven pump that was electrocardiographically synchronized with the drainage of the venous system during systole. This procedure was performed in five patients with unstable angina refractory to maximum medical therapy. SCSR significantly decreased the frequency of anginal episodes and the requirement for antianginal medications. SCSR also provided time for patient stabilization before diagnostic cardiac catheterization or therapeutic intervention. This preliminary experience suggests that synchronized coronary sinus retroperfusion is a feasible and safe procedure. It can be performed at the bedside with no apparent adverse effects to the patient. Retroperfusion also appears to be effective in relieving ischemic symptoms as assessed by clinical parameters. Based on our preliminary experience, further delineation of its clinical applications is warranted.