Prolonged aortic cross-clamping in early infancy and method of myocardial preservation.

A cardioplegic solution containing blood with a low level of ionic calcium was prepared independent of pump-oxygenator perfusate blood, so as to contain a constant concentration of each component at any given time. Using this solution, Jatene's anatomic repair under prolonged periods of aortic cross-clamping ranging from 117 to 184 minutes (mean: 149 min) was performed on seven young infants with simple complete transposition. The ages of the patients ranged from 34 days to 3 months, with a median age of 2 months. Four patients, aged 39 days, 41 days, 2 months and 3 months, survived and showed uneventful postoperative hemodynamics. Two of the three non-survivors were considered retrospectively to have been unsuitable candidates for Jatene's anatomic repair due to their low left ventricular pressure (LV/RV pressure ratio less than 0.60 in both). The remaining infant who died had TGA with a large ventricular septal defect of the muscular type and developed a postoperative residual shunt. It was considered unreasonable to attribute the cause of death in this case to inadequate myocardial protection. Judging from our experience with these four survivors who underwent prolonged aortic clamping ranging from 117 to 160 minutes, our cardioplegic solution and the technique of its administration were considered to be effective and promising for heart surgery in young infants and neonates.

Application of immunoperoxidase staining in the cytodiagnosis of herpes simplex keratitis.

In corneal scraping smears from 13 patients with clinically suspected herpes simplex keratitis (HSK), HSK is demonstrated by means of peroxidase-antiperoxidase (PAP) technique with antisera to herpes simplex virus (HSV) in Papanicolaou-destained cellular samples. The staining for HSV antigen was present in seven cases of corneal scraping smears with superficial keratitis (dendritic and geographic ulcers) while six cases of stromal keratitis (deep keratitis) failed to show HSV antigen except in one case. Specific antigen for HSV was predominantly present in the cytoplasm rather than in the nucleus. Immunoreactions were negative with HSV antisera in patients with other infections and in those in a normal control group. Using the PAP technique, detection of HSV antigen in corneal scraping smears was of great value in the diagnosis of HSK, especially in cases of superficial keratitis.

Cytodiagnosis of herpes simplex keratitis by means of an immunoperoxidase technique. A case report.

Typical herpes simplex keratitis that developed in a 5-year-old boy was initially diagnosed cytologically in Papanicolaou-stained samples. Subsequently, an immunoperoxidase staining technique was used to identify the specific type of herpes simplex virus (HSV) in the destained cellular samples. The positive staining helped to establish the diagnosis of a type 1 HSV infection, permitting early treatment with acyclovir and subsequent complete recovery from the ocular herpetic infection. Emphasis is placed on the value of the immunoperoxidase technique for the rapid and specific diagnosis of cases of suspected HSV infection.

Color reaction of sugars with cysteine. II. Pigment formation from sugars and biological materials.

Among carbohydrates, D-glucose, D-mannose, D-galactose, and glycogen yielded a previously described fluorescent pigment, reddish in alkaline medium and yellowish in acid, when heated with L-cysteine in hydrochloric acid solution. D-Fructose and some pentoses yielded other patients. Among tissue hydrolysates, liver, small intestine, brain, and spleen were found rich in the cysteine pigment but little or none was produced from skeletal muscle, blood, or urine. Among subfractions of rat liver cells, the microsomal fraction proved the richest source of the pigment in nmol/mg protein, though the total yield from the soluble fraction was comparable to that from the microsomal fraction. In the latter fraction, only ribosomal particles yielded the pigment; smooth membrane did not. The pigment yield from yeast was comparable to that from liver. Yield from Escherichia coli K-12 was about one-forth that from yeast.