Successful Orthotopic Heart Transplantation With Positive Crossmatch in a Hyperimmunized Child on Mechanical Circulatory Support-Case Report.

In the pediatric population there is a shortage in the number of hearts available for transplantation. However, sometimes a heart transplant is urgently required to save lives. The problem arises when the patient is hyperimmunized and there is a positive crossmatch with the only available donor. We present such a case of a 9-year-old patient with dilated cardiomyopathy on ventricular assist device, in whom it was possible to perform a successful HT and also apply a successive prevention against graft rejection.

Intracranial hemangiopericytomas. Histological and immunohistochemical study.

The authors report on 8 cases of intracranial supratentorial tumors which clinically corresponded to meningeal neoplasms. Only one patient revealed the recurrence. The age of patients was 39-74, prevailed women (5). Histological features of tumors, except some variations in two cases agreed with common morphologic pattern of hemangiopericytomas. Immunohistochemical study with following antibodies was performed: vimentin, epithelial membrane antigen, cytokeratin, S-100 protein, fibronectin, desmin, collagen IV, factor RAg, and glial fibrillary acidic protein. Two atypical cases which presented scarce pseudocalcifications and tendency to concentric cellular structures did not differ from other hemangiopericytomas by their intrinsic immunohistochemical properties such as negative reaction to epithelial membrane antigen and cytokeratin. Atypical positive immunostaining with S-100 protein and with glial fibrillary acidic protein was found solely in the group or perivascular cells in one of those atypical cases reflecting probably local astrocytes embedded in tumor tissue. Immunohistochemical investigations did not present univocal data to explain controversial origin of hemangiopericytomas either from meningeal cup cells or from vascular pericytes.

Choroid plexus carcinoma. Case report.

Report concerns the uncommon cerebellar neoplasm of choroid plexus in 57-year-old woman, which was devoid of some anaplastic features causing doubts about degree of tumor differentiation. Immuno- and histochemical study presented positive CK, VIM, GFAP, S-100 immunostaining and positive PAS-dimedone reaction conforming histological diagnosis.

[Intraoperative support of trabeculectomy with mitomycin]. / Sródoperacyjne wspomaganie trabekulektomii mitomycyna.

The authors evaluated the efficacy of pharmacological support of trabeculectomy by intraoperative application of mitomycin. It was used in selected cases, those of high risk glaucoma as regards to poor surgical effect, in concentrations 0.2 mg/ml and 0.5 mg/ml. There were 32 eyes with following types of secondary glaucoma: neovascular glaucoma in diabetes, glaucoma in aphakic and pseudophakic eyes and simple glaucoma in the eyes after uneffective trabeculectomy. Normalization of the intraocular pressure was achieved in 21 eyes (65.6%). The 1.5-year follow-up revealed that with higher concentrations of mitomycin normalization of the pressure was more frequent lait there occurred more complications than with lower concentrations. Long-lasting hypotony is a difficult complication.

[Various clonidine drops in treatment of glaucoma]. / Rodzaje kropli isoglauconu w leczeniu jaskry.

Seventeen patients with glaucoma were given bilaterally a single drop of Isoglaucon (Clonidine hydrochloride) of various volume (15 microliters and 40 microliters) and various concentrations of the drug (0.125%, 0.25%, 0.50%) according to the principle of a double blind trial. In comparison with placebo all sorts of Isoglaucon drops cause a statistically important reduction of intraocular pressure; an essential lowering of the general systolic and diastolic pressure (a side effect of the treatment) appeared after application of a larger drop (40 microliters) of a 0.5% concentration. By reducing the content of the drug in the drop or reducing its volume one can avoid the fall in the general blood pressure.

[Naclof and dexamethasone in topical application after trabeculectomy]. / Naclof i deksametazon w miejscowym stosowaniu po trabekulektomii.

Evaluated was the topically applied solution of natrium salt of diclofenac--Naclof (22 eyes) and a 0.1% solution of dexamethasone phosphate (23 eyes) on the healing of postoperative wounds after trabeculectomy in a clinical examination in patients with simple glaucoma. After the filtering operation the authors observed in the group of patients treated by dexamethasone a longer and more pronounced flattening of the anterior chamber (up to 14 days) a greater hypotensive effect and a more increased facility of the outflow (in an observation period of 6 months). In the case of a considerable flattening of the anterior chamber after trabeculectomy application of Naclof gives a better prognosis than of dexamethasone.

[Surgical treatment of low pressure glaucoma]. / Chirurgiczne leczenie jaskry z niskim cisnieniem.

Eyes with non-controlled--in spite of a conservative treatment--bilateral low-tension glaucoma with a decreased facility of outflow (10 patients, 20 eyes) were subjected to antiglaucoma operations. Trabeculectomy was performed in one eye, a filtering operation in the second one. During the observation period of 1.5 years it showed that in the low-tension glaucoma the visual function undergoes more frequently stabilization after a more radical glaucomatous procedure (of filtration type) when the postoperative fall in the intraocular pressure exceeds 20% and its daily oscillations are considerably reduced.

[Probability of successful operation in very severe retinal detachment using scleral buckling procedure]. / Prawdopodobienstwo powodzenia operacji w bardzo ciezkich odwarstwieniach siatkówki przy stosowaniu technik wglabiajqcych twardówke.

The aim of this study was to study the efficacy of operation of scleral invagination in the treatment of very severe retinal detachment with proliferative vitreoretinopathy (PVR). The investigations comprised 36 eyes operated in the Department of Ophthalmology in Krakow in the period 1986-1990. The authors performed in 24 patients a encircling operation with a silicone band, in 12-meridional or parallel extrascleral silicone sponge implants. Reattachment of the retina was achieved in 58 p.c. of eyes and an improvement of the visual acuity in 47 p.c. The performed analysis showed a substantial dependence of the attained effect of surgery on the grade of advancement of the PVR; it enabled to ascertain that the limit of possibilities of the scleral buckling procedure determines PVR stadium C3.