First results from the Cryogenic Dark Matter Search in the Soudan Underground Laboratory.

We report the first results from a search for weakly interacting massive particles (WIMPs) in the Cryogenic Dark Matter Search experiment at the Soudan Underground Laboratory. Four Ge and two Si detectors were operated for 52.6 live days, providing 19.4 kg d of Ge net exposure after cuts for recoil energies between 10 and 100 keV. A blind analysis was performed using only calibration data to define the energy threshold and selection criteria for nuclear-recoil candidates. Using the standard dark-matter halo and nuclear-physics WIMP model, these data set the world's lowest exclusion limits on the coherent WIMP-nucleon scalar cross section for all WIMP masses above 15 GeV/c2, ruling out a significant range of neutralino supersymmetric models. The minimum of this limit curve at the 90% C.L. is 4 x 10(-43) cm2 at a WIMP mass of 60 GeV/c2.

Value of echocardiography in results evaluation of transcatheter atrial septal defect closure in adults.

Transcatheter closure of secundum atrial septal defect using Amplatzer occluder is accepted treatment modality. Transthoracic (TTE) and transoesophageal (TEE) echocardiography provides indispensable informations in the selection of eligible atrial septal defects, evaluates the exact size, location and morphology of the defect. In the closure procedure assistance of TEE enables precise determination of device size, correct placement of the device and immediate and follow-up closure results assessment. The present prospective study was performed in order to investigate the value of both approaches--TTE and TEE in the intermediate-term follow-up. Before, during transcatheter defect closure and in the follow-up echocardiography studies [TTE and TEE] were performed in 33 adult patients with secundum atrial septal defect with fulfilled TEE criteria. Correct placement of the device without interference with surrounding structures under TEE monitoring was possible in all patients. Immediate complete closure was achieved in 49% of patients, after 3 months in 94%. TEE findings corresponded well with TTE. In the follow-up echocardiographic signs of right ventricle overload retreated. Results indicate that TEE provides valued data for the selection and closure procedure. TTE is a sufficient reliable approach for results evaluation in intermediate follow-up. Echocardiography plays crucial role in the safety and efficacy assessment of transcatheter treatment of secundum atrial septal defect.

Brain embolism, left atrial thrombi and cardiosurgery.

Patients with embolization into the brain and mobile thrombus in the left atrium (LA) are in the danger of recurrent embolization. A patient with the history of recent cerebral vascular accident (CVA) would be at higher risk of cerebral complications due to cardiopulmonary bypass and this risk may be as high as that of re-embolization. We present a case of a 41-year old man with an acute ischemic focus (3 x 3 cm) in the temporoparietal lobe verified by computer tomography (CT). Transthoracic echocardiography showed severe aortic insufficiency, low ejection fraction of dilatated left ventricle (LV). Transesophageal echocardiography showed a mobile thrombus (2.2 x 1.1 cm) in LA. The cardiovascular surgeon consultant did not recommend urgent operation. Instead, the patient was treated by low molecular heparin. CT of the brain after 10 days of treatment was normal. Patient underwent a successful aortic valve replacement. At the time of surgery there was no thrombus in the LA. Subsequently, the patient recovered normally with no neurologic sequelae. This case illustrates the difficulty arising from the consideration of the relative risks of acute surgery vs conservative management in patient with recent CVA and a large mobile thrombus in LA.

[Diagnosis and therapy of acute rejection in patients after orthotopic heart transplantation]. / Diagnostika a liecba akútnej rejekcie u pacientov po ortotopickej transplantácii srdca.

OBJECTIVE: In organ allotransplantation represents a serious problem acute rejection, which is the reaction of recipient organism aimed to reject the transplanted organ. AIM: To obtain experience in the field of routine long term are of patients after heart transplantation living in Slovakia. METHOD: 33 patients after orthotopic heart transplantation (HTx) were included in our long term care by the 1. June 1996. According to the accepted protocol we make the whole set of examinations is performed. This includes endomyocardial biopsy which is the only reliable method for the detection of rejection and also the criterion of sufficiency of immunosuppressive therapy. RESULTS: Acute rejection was revealed in 14 (43%) patients. CONCLUSIONS: Tactics of therapy and the length of the interval to subsequent biopsy were determined according to the histological findings of preceding biopsy, the clinical status and the combination of immunosuppression therapy. (Tab. 2, Ref. 13.)

[Pulmonary complications after heart surgery]. / Plúcne komplikácie po operácii srdca.

The authors present a detailed analysis of pulmonary complications after open-heart surgery and of their risk factors. The results of the presented study indicate that COPD patients with functional impairments are more sensitive to complicated postoperative outcome and to respiratory infections, in general. There is a clear relationship between artificial violation of the pleural cavity, diaphragmatic dysfunction and pleural effusion. Diaphragmatic dysfunction appears more frequently in mammarocoronary bypass patients in consequence of pleurotomy. The incidence of dysfunction could be reduced by the use of phrenic nerve insulation. Patients with pulmonary complications suffer from serious pulmonary function deficit. The possibilities of identification of the patients at risk, as well as the prevention and prophylaxis are analysed. (Tab. 7, Fig. 2, Ref. 71.)

[Cardiopathies of unknown origin--a cooperative interdisciplinary study]. / Kardiopatie nejasného pôvodu--kooperatívna interdisciplinárna stúdia.

The authors described aim. objectives, design and criteria of the study which is oriented to the clinical and research problems of heart diseases of uncertain origin. The paper presents the preliminary experience with invasive cardiological techniques in this field. At the same time the authors discuss the potential impact of the basic research on the prevention and effective treatment of cardiopathy which is until now of unknown origin.

[Clinical aspects of cardiopathy of unknown origin]. / Klinický obraz kardiopatií nejasného pôvodu.

Frequently even physical and noninvasive examinations with laboratory analysis do not determine the final aetiology of cardiac symptoms, and it is necessary to complete them with an invasive examination with the aim of ascertaining the primary cause. Our article gives information about the results of clinical, laboratory and noninvasive examinations in the group of patients suspected of cardiopathy of unknown origin.

[Echocardiography of cardiopathies]. / Echokardiografia kardiopatií.

The authors deal with the relation of echocardiography and diseases of the cardiac muscle, draftly classified as cardiopathies. The author's starting point is issued from the presumption that heart diseases which lack the characteristic diagnostic signs in echocardiographic picture affect the heart's systolic and diastolic functions. Echocardiography enables to quantify the extent of affliction of both functions. On the basis of analysis of a set of 22 prospectively examined patients the authors judge as to wether the results of individual volume measurements by means of echocardiographic imaging (one dimensional, two dimensional, Doppler) are correct. In the frame of systolic and diastolic functions examination they highlight the Doppler evaluation due to its technical simplicity and good correlations with literal documents dealing with invasive examinations.

Platelet-activating effect of low-density lipoprotein and its reversal by isradipine.

The effect of the calcium antagonist isradipine on platelet aggregation (induced ex vivo by serotonin and low-density lipoprotein [LDL]) was studied in 17 nonsmoking patients with essential hypertension. Platelet aggregation was measured after a four-week placebo period, and after four and 12 weeks of treatment with isradipine. Both the serotonin-induced and the LDL plus serotonin-induced platelet aggregation were significantly decreased after four weeks of isradipine treatment compared with placebo. The amplifying effect of LDL on the serotonin-induced aggregation was significant both after placebo and after active treatment with isradipine. A further decrease in platelet aggregation induced by LDL plus serotonin was observed after 12 weeks of isradipine treatment so that no amplification of serotonin-induced aggregation by LDL could be detected. In conclusion, it appears that treatment with isradipine restores the impaired platelet response to serotonin and LDL in hypertensive patients. The inhibition of this response may represent a cellular mechanism of thrombovascular protection.