[Pulmonary atresia with open septum: analysis of therapeutic management apropos of 47 cases]. / L'atrésie pulmonaire à septum ouvert: analyse de la prise en charge thérapeutique à partir de 47 observations.

Pulmonary atresia with ventricular septal defect (VSD) accounts for 2% of all congenital heart disease. The prognosis is poor (30% survival at 1 year) and early medico-surgical management is essential. A natural history of retrospective analysis of 47 consecutive patients with this abnormality born between 1962 and 1992, hospitalised between 1971 and 1992 and followed up for an average of 9.6 years (range: 1 month to 24 years) allowed identification of several anatomical groups: Group I (N = 19, 40.4%) comprised patients who underwent complete correction; Group II comprised patients who had undergone one or more palliative procedures. In Group II, there were 13 survivors at the end of the study (Group IIA); 14 patients died (Group IIB) and one was lost tot follow-up. The global mortality was 38% (21% in Group I and 52% in Group II). Overall management was intense: 166 cardiac catheter studies, 109 surgical operations including 48 systemico-pulmonary anastomoses, 34 right ventricular outflow reconstructions, I Ilbawi procedure. The survival was higher in Group I (79%) than in Group II (48%) indicating a clear advantage in reestablishing as normal as possible anatomic and haemodynamic status. Patients in Group I had a higher incidence of pulmonary artery confluence, patent ductus and an anatomically simple form of pulmonary atresia with VSD, all good surgical prognostic factors. The first palliative procedure was performed on average at 35 months in Group I, 46 months in Group IIA and 24 months in Group IIB; complete correction, when possible, was performed at about the 10th year, after an average of 3 operative procedures per patient.(ABSTRACT TRUNCATED AT 250 WORDS)

[Mitral commissurotomy with extracorporeal circulation. Apropos of 200 cases with a median survival of 15 years]. / Commissurotomie mitrale sous CEC. A propos de 200 cas avec un suivi moyen de 15 ans.

This is a retrospective study of 200 patients, with long-term results operated upon from October 1965 to July 1984. 83% women, 17% men. The mean age was 42.40 +/- 11.03 years. In 87% mitral stenosis was pure and 13% systolic murmur was heard. 60% were in classes III and IV and 40% in classes I and II (NYHA). Hemodynamically mean C.W.P. was 21 +/- 6.27 mm Hg and mean P.A. pressure 30 +/- 9.5 mm Hg. Right anterior thoracotomy was done in every case with canulation of femoral artery and V.C. extracorporeal circulation consisted of a bubble oxgenation (RYGG) and a Roller Pump. In 88.5% both commissures were opened and in 11.5% only the anterolateral commissure. In 58% both papillary muscles were incised, in 15% anterolateral and in 13% posteromedial papillary muscles were incised. In 17% valves or commissures were decalcified. In 5.5% a thrombus was removed from the auricle. Postoperative mortality was 0%. 13% of patients experienced a postoperative complication: 4% hemothorax, 2.5% gaz embolism without sequela, 0.5% lower extremity embolism, 3% pulmonary embolism, 2% phlebitis and 1% gastrointestinal haemorrhage. Postoperatively in 75% of cases no murmur was heard, and in 25% a systolic murmur was found over pericardium. 167 patients were assessed at a mean interval of 129.88 months. 11 patients died at a mean interval of 98.56 +/- 48.56 months with non cardiac cause in 9 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of antibodies to specific infectious agents in bovine fetuses from a slaughterhouse in Minnesota.

Sera from 486 bovine fetuses, approximately 60 to 270 days of gestation, were collected at slaughter and tested for the presence of immunoglobulins (Ig). One hundred ten (27%) of the sera were positive for IgG and/or IgM. The earliest age at which fetuses tested positive for IgM and IgG was estimated to be 100 and 120 days, respectively. Ig concentration increased with increased age of the fetus. Sera that were positive for Ig were tested for the presence of specific antibodies to five different infectious agents. Bovine parvovirus antibodies were found in 99 of 110 sera (90%) by hemagglutination inhibition (HI) test. However, only 35 (31.8%) of these sera were positive by serum neutralization (SN) test. Antibodies to parainfluenza-3 virus were detected in 30 sera (27%) by HI test and in 20 sera (18%) by SN test. Five (4%) sera contained SN antibodies to bovine viral diarrhea virus. Only one (0.9%) serum sample contained SN antibodies to infectious bovine rhinotracheitis virus. None of the sera had antibodies against five Leptospira spp. Results of this study suggest that bovine parvovirus may be a potential cause of reproductive problems in cattle.

Role of blood cells in degradation of progesterone in bovine blood.

The nature of progesterone decline in samples of bovine blood as affected by whole blood incubation time and temperature was investigated in 3 experiments. In 2 experiments, progesterone concentrations were determined in plasma, in hemolyzed (by freezing and thawing) blood, and in washed blood cells and blood cell washes before and after 8 hours of incubation at 22 C to study the effect of RBC on detected progesterone. In the third experiment, the effect of alteration in RBC metabolism on progesterone degradation by these cells was studied by using potassium oxalate-sodium fluoride as anticoagulant. Results of these experiments indicated that (a) progesterone was significantly reduced because of whole blood incubation time and temperature, (b) lost progesterone was not detectable on or in blood cells indicating chemical degradation of progesterone, (c) intact blood cells were needed to obtain the decrease in the progesterone, (d) a small amount of circulating blood progesterone was associated with blood cells, and (e) degradation of bovine blood progesterone by blood cells was dependent on the glycolytic process. Potassium oxalate-sodium fluoride anticoagulant and refrigeration provided the best progesterone results when blood samples were not processed immediately after collection.

Effects of intrauterine challenge with Leptospira interrogans serovar hardjo on fertility in cattle.

The purpose of this study was to determine the effects of Leptospira interrogans serovar hardio on fertility in cattle. Twenty seronegative mature dairy cows were assigned to two groups. Group I (challenged cows) was bred by a seronegative bull followed by intrauterine infusion (within 30 minutes) of Leptospira interrogans serovar hardjo. Group II was bred by the same bull followed by intrauterine infusion of 5 ml of sterile culture medium. Blood samples were collected at two-day intervals to monitor serum antibody titers. Daily blood cultures for 10 days and weekly urine cultures for five weeks were performed to monitor the animals for leptospiremia and leptospiuria. Cows were slaughtered 35 days post-breeding, and their reproductive tracts were examined. All animals remained clinically normal following intrauterine challenge. There was no difference in pregnancy rates (Group I, 7/10; Group II, 6/10). All embryos, reproductive tracts, and kidneys appeared normal. A microscopic agglutination test (MA) showed that 4 of 10 challenged cows developed serum antibody titers between 8 and 20 days after challenge. However, on the basis of the hamster passive protection test, all challenged cows had serum antibodies present. All blood and urine cultures were negative through the experimental period, as were the final kidney and uterine cultures. In a second experiment, six seronegative cows were infused with killed microorganisms immediately after insemination. Results of a microscopic agglutination test and a hamster passive protection test indicated that these cows did not develop humoral antibodies against serovar hardjo. These results indicated that intrauterine inoculation of Leptospira interrogans serovar hardjo (hamster-adapted strain) following breeding did not affect pregnancy rates despite an intrauterine challenge which caused the development of humoral antibodies.

Decline in assayable progesterone in bovine plasma: effect of time, temperature, anticoagulant, and presence of blood cells.

Jugular vein blood samples collected from 5 Holstein-Friesian cows during the luteal phase of the estrous cycle were incubated at 4 C, 22 C, and 37 C for 0, 0.5, 1, 2, 4, 6, 8, 12, and 24 hours. Blood samples were centrifugated after each incubation period, and plasma was frozen for later progesterone assay. Mean progesterone concentration in blood samples incubated at 4 C, 22 C, and 37 C decreased from 5.7 ng/ml at 0 hour to minimum concentrations of 3.5 ng/ml at 12 hours, 0.9 ng/ml at 12 hours, and 1.0 ng/ml at 8 hours, respectively. The first progesterone concentration which was significantly different from the initial value (0 hour) was at the 8-hour incubation period for blood samples incubated at 4 C and at the 1-hour incubation period for blood samples incubated at 22 C and 37 C. Progesterone concentration decreased similarly when blood samples were collected into heparinized tubes or EDTA tubes and incubated at 22 C for 0, 6, and 12 hours. Incubating harvested plasma or serum for 0 to 6 hours at 37 C had no effect on progesterone concentrations (7.9 and 8.2 ng/ml for plasma, and 6.9 and 6.6 ng/ml for serum.

[Interpretation of the right bundle-branch block appearing after repair of ventricular septal defect]. / Interprétation du bloc de branche droit apparaissant après réparation d'une communication interventriculaire

Based on a study of 43 cases the authors attempt to assess the exact aetiology of the appearance of right bundle branch block, which is seen very frequently after repair of a ventricular septal defect. A comparison of the electrocardiograms with the anatomical type of VSD, the surgical approach, and the size of the septal defect would seem to indicate that a monofascicular block by a lesion of the right branch of the bundle of His is responsible. The correlations are not, however, absolute, and in a certain number of cases a simple peripheral lesion was to blame. The importance of precise knowledge of the case of the branch is that it is possible that first a bi- and then a tri-fasicular block will develop; this means that complete atrioventricular block is one of the long-term sequelae of surgery. In the authors' experience of 43 cases, only one tri-fascicular block developed.