Quantification of deposition of neutrophilic granulocytes on vascular grafts in dogs with 111In-labeled granulocytes.

A new radioisotopic technique has been developed for quantification of deposition of neutrophilic granulocytes on vascular grafts. Nine healthy mongrel dogs underwent bilateral femoral artery resection and reconstruction with grafts of femoral vein and Gore-Tex. Pure granulocytes that had been separated from whole blood by centrifugal elutriation were labeled with 111In-tropolone in plasma. The granulocyte harvesting efficiency was 25 +/- 12%, and the labeling efficiency was 87 +/- 7%. Three hours after injection of labeled granulocytes and 2 hours after reperfusion, the grafts were harvested and cut into several segments for study of areas of anastomoses and midsections. On the basis of the radioactivity in the blood and in anastomotic and graft sections, the area of graft sections, and the neutrophilic granulocyte and differential leukocyte counts, the number of neutrophilic granulocytes adherent to a unit area and the total number of neutrophilic granulocytes on graft sections were calculated. These quantifications of the deposition of neutrophilic granulocytes indicated that the midsections of Gore-Tex grafts retained more neutrophilic granulocytes than did the midsections of vein grafts. Although the anastomotic areas retained more neutrophilic granulocytes than did the midsections of vein grafts, the opposite finding prevailed for the Gore-Tex grafts. A major fraction of neutrophilic granulocytes on Gore-Tex grafts was incorporated into thrombus. Semiquantitative information obtained by scintigraphy of the deposition of neutrophilic granulocytes on vascular grafts also confirmed this observation.

Current problems in cardiac transplantation.

Since our initial orthotopic heart transplant (OHT) in 1968, the first in Europe, 1130 patients with ages ranging from 1 month to 66 years have been referred to us. The cause of irreversible myocardial damage was idiopathic cardiomyopathy in 74%, ischemic heart disease in 19% and left ventricular failure after valvular replacement in 7%. A total of 540 transplantations, 463 orthotopic, 40 heterotopic and 37 heart-lungs were carried out. Features of the early post-operative course include temporary (first week) cardiac instability treated by isoproterenol. Later complications included rejection (95%) and side-effects of immunosuppressive therapy; infection (83%), osteoporosis, malignancy, graft atherosclerosis (2%). Cyclosporine (Cy) was responsible for diastolic hypertension, renal dysfunction, hirsutism, hyperplasia of the gingiva, hepatic dysfunction, and seizures. The survival rate of the Cy-treated patients was 68% at 7 years. All survivors have virtually normal social and professional lives, included the longest survivor 14 years after the operation. Recently in 34 patients in acute irreversible cardiac failure and who cannot have a transplant in time, we implant a total artificial heart (TAH) type JARVIK 7 during a period from 1-150 days. There has been no mechanical failure, hemolysis or thrombo-embolism and only one right ventricular device malposition; 20 patients died before transplantation, 13 were successfully transplanted, 1 is still on the artificial heart. Heart transplantation, and TAH used as a bridge to transplantation are now an accepted therapeutic means for irreversibly cardiac failure in selected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Early and late comparison of umbilical vein and PTFE grafts in control and piroxicam-treated dogs.

For comparative analysis of small vessel prostheses, 78 dogs underwent femoral artery replacement with autogenous vein, polytetrafluoroethylene (PTFE) or human umbilical vein (HUV) grafts. Thirty-six animals received antiplatelet therapy with piroxicam orally once a day. Three-hour deposition of 111In-labeled platelets was less on HUV than on PTFE grafts but still greater than on autogenous vein grafts. Accordingly, 3-hour patency rates were lowest with PTFE and highest with autogenous vein, although the difference between HUV and PTFE grafts was not statistically significant. One month following implantation, PTFE grafts had a higher patency rate than HUV grafts (p less than 0.05). Treatment with piroxicam decreased 3-hour platelet deposition, improved 1-month patency of both PTFE (p less than 0.05) and HUV (p less than 0.01) grafts, and decreased pseudointimal thickening on PTFE grafts (p less than 0.01). This experimental study did not demonstrate any clearcut difference in the performance of PTFE and HUV grafts. Piroxicam treatment improved the results with both grafts, which would justify future clinical trials with this simple antiplatelet regimen.

Xenograft seeding of Dacron grafts in dogs.

The benefit of autologous endothelial cell seeding in dogs has been widely accepted. This experiment seeks to determine if a similar effect accompanies the use of xenograft (porcine) endothelial cells in dogs. Thirty-two mongrel dogs underwent thoracoabdominal aortic bypass with 25- to 30-cm segments of double velour Dacron 8-mm grafts. Endothelial cell seeding was performed with whole blood suspensions of either autologous endothelial cells (Group I) or heterologous endothelial cells from pigs (Group II). Cell-free culture medium was added to whole blood for preclotting in unseeded control animals (Group III). Ten animals in each group were sacrificed at 30 days and all grafts were patent. Thrombus-free surface areas were Group I = 61.7 (+/- 6.4%, SEM); Group II = 53.2 (+/- 6.8%, SEM); and Group III 42.2 (+/- 8.0%, SEM). There was a significant difference between autologous-seeded and unseeded grafts (P less than 0.04). Endothelialization was confirmed by scanning and transmission electron microscopy in all groups but was better in both seeded groups: Group I-9/10 grafts, Group II-8/10 grafts, and Group III-4/10 grafts. Factor VIII immunofluorescent staining confirmed the presence of endothelium on selected grafts in each group. These results raise questions concerning the proposed mechanism of endothelial seeding since xenograft cells seem to facilitate healing in the canine model. If heterograft cells can be effective, it may not be necessary to harvest cells from the recipient in order to achieve the benefits of seeding.

[Abnormal glycosylation of soluble ABH antigens in tumors of the urinary tract]. / Glicosilación anormal de antígenos ABH solubles en patologías tumorales del tracto urinario.

OBJECTIVE: To determine the secretor expression in patients with bladder cancer, adenoma of the prostate and normal subjects. METHODS: The secretor character was determined in saliva of normal subjects (n = 40), patients with bladder cancer (n = 61) and adenoma of the prostate (n = 44) by the technique of hemoagglutination inhibition. RESULTS: 80% of the normal subjects were found to be secretors, which is in agreement with the data reported in the literature. Only 23 (37.71%) of the patients with bladder cancer were secretors and 24 (54.54%) of the patients with prostate adenoma expressed the secretor gene. CONCLUSIONS: The expression of soluble antigens decreased in patients with bladder cancer or prostate adenoma in comparison to the normal subjects. Deletion of ABH antigens in the membrane of tumor cells has been reported in other studies. This lack of expression results from a genetic alteration in the clones involved in tumor pathology. The decrease in soluble antigens in the patient groups analyzed might be due to the same mechanism of genetic alteration that could involve non tumor tissues. Most of the cancers in humans originate in epithelial cells and the changes in blood group antigens constitute an important aspect in tumor immunology.

Relación entre la expresión de antigenos ABH en cancer de vejiga y caracter secretor / The relationship between the expression of ABH secretor character

Existe amplia evidencia de que el cáncer está asociado con anormalidades en la regulación génetica expresada en la superficie de la membrana celular. El 80 por ciento de los individuos son capaces de secretar los antígenos ABH en saliva y otras secreciones. La presencia de estas sustancias está controlada por un gen que puede adoptar dos formas alélicas: SE dominante y SE recesiva. El objetivo de este trabajo fue investigar la relación entre la expresión antigénica ABH en célkulas de descamación urotelial y el carácter secretor en pacientes con cáncer de vejiga. Se examinaron 33 pacientes con tumores de vejiga clasificados en superficiales y profundos y una población de 40 individuos normales. Se investigó el carácter secretor en saliva y la expresión de los antígenos ABH uroteliales en sedimentos urinario. Se empleó para estos estudios la técnica de inhibición de la aglutinación. En la población normal todos expresaron los antígenos ABH en células de sedimento urinario y sólo el 80 por ciento presentó dichos antígenos en sus secreciones. En los pacientes con cáncer de vejiga el 30,31 por ciento resultó no secretor y de ellos el 70 por ciento presentó deleción antigénica ABH en sedimento urinario con mayor incidencia de tumores profundos. Nuestros resultados indicarían que los pacientes con cáncer de vejiga no secretores desarrollarían tumores con mayor grado de infiltración respecto de los pacientes secretores