Supplementation of University of Wisconsin solution with Nitroglycerin and Nicorandil in long-term myocardial preservation: effects on the oxidative state, endothelial function and morphology.

The purpose of this study was to assess the effects of the addition of Nitroglycerin or Nicorandil to University of Wisconsin solution in long-term myocardial preservation. In a model of heterotopic heart transplantation in pigs, the donor heart was preserved for 24 hours by means of continuous perfusion in this solution, in the presence or absence of these drugs. During this period, the oxygenation and pH of the solution were measured, as were lactate concentrations and enzyme release. At regular intervals following reperfusion we measured the concentrations of enzymes, antioxidants, glutathione peroxidase, glutathione reductase, malondialdehyde, endothelin and nitrite, and, two hours later, samples of both ventricles were taken for a morphological study. In the treated groups there was a higher lactate production during preservation and, during reperfusion, the signs of contracture and the elevation of enzyme levels were more marked than in the untreated groups. In contrast, the glutathione reductase concentrations did not decrease during the first phase of reperfusion and were directly correlated with those of antioxidants, endothelin levels increased less than in the untreated groups and, in the case of nitroglycerin, the nitrite concentration was significantly greater than in the remaining groups. We conclude that nitroglycerin and nicorandil improved the oxidative state and endothelial function and did not produce substantial morphological changes, but increased cell necrosis and contracture, possibly due to the duration of ischemia.

Sympathetic sprouting in dorsal root ganglia (DRG): a recent histological finding?

During the nineties it was described, as an original finding, the existence of afferent amyelinic nerve endings in animal dorsal root ganglia (DRG) caused by diverse experimental lesions. These works do not take into account the historical studies carried out by Ehrlich (1886), Ramón y Cajal (1890) and Dogiel (1885) among others. Ramón y Cajal (1899) confirmed the existence of these nerve endings naming them after their discoverer as "Dogiel's arborisations". Ramón y Cajal claims that these endings originate from fibres of sympathetic nature, something supported by later authors devoted to this topic. In any case, the same authors remarked already a possible relationship with pathological phenomena, nonetheless always referring to the frequent occasions in which the same images appeared in healthy animals. In this work we review the bibliography about the classically named "Terminal Dogiel's nests" which in modern literature have been referred to as sprouting of sympathetic axons in dorsal root ganglia likely related with sympathetically maintained pain. Furthermore, we present the finding, not described up to date, of multiple afferent amyelinic nervous endings related with the "Terminal Dogiel's nests" observed in different DRG from young adult healthy rabbits.

Histomorphometrical study of the submandibular gland ductal system in the rat.

The duct system of murine submandibular gland is composed, in contrast with other mammals, by four types of ducts, among which the granular duct is unique for rodents. The granular duct shows a typical secretory structure with a clear intersex morphological diversity on which we carried out a morphometrical study in order to determine the relative area of each duct in rats in comparison with the rest of ducts and the whole gland. Our results, in both sexes, show that the duct with the broadest surface is the granular duct, followed by the excretory, striated and the intercalated ducts. In addition, we found a significant intersex difference between the relative surface of the granular and the excretory ducts, being bigger in males than in females. Finally, in both sexes, there is a greater variation in the data related to the excretory ducts than to the other ducts.

Heart transplantation: influence of the surgical technique on sinus function.

This study analyzes the influence of the surgical technique on the development of sinus dysfunction. Cycle length, corrected sinus node recovery time, and sinoatrial conduction time were determined in 4 groups of dogs under the following conditions: group 1, controls; group 2, subjected to heterotopic heart transplantation with conservation of atrial anatomy; group 3, subjected to orthotopic heart transplantation by using a standard technique; and group 4, treated as in group 3, but with an ischemic time of 24 hours. The cycle length was prolonged in all the treated groups when compared with the controls (P < .01), an effect attributed to the disconnection of the autonomic nervous system during the transplantation procedure. The corrected sinus node recovery time and sinoatrial conduction time were significantly longer in all the animals in groups 3 and 4 when compared with those of groups 1 and 2 (P < .01); however, there were no significant differences between groups 3 and 4 or between groups 1 and 2. These results suggest that the atrial anatomy play a more relevant role than the ischemic time in the origin of sinus dysfunction occurring after orthotopic heart transplantation.

Cape Town solution in prolonged myocardial preservation: structural and ultrastructural study.

This study deals with myocardial preservation after 24 hours of continuous, hypothermic and oxygenated perfusion with Cape Town (CT) solution, focusing on the morphological changes produced by preservation and reperfusion, and their possible relationship to the composition of the solution and the immediate hemodynamic findings after orthotopic heart transplantation in dogs. After preservation, aside from mild or moderate mitochondrial changes, the most relevant lesions included edema and vasoconstriction. Reperfusion was followed by the development of areas of necrosis forming contraction bands and an increment in the mitochondrial damage; the intercalated disks conserved their normal structure; edema became more prominent and was invariably accompanied by hemorrhage; vasoconstriction was very pronounced and was accompanied on occasion by evidence of capillary rupture; and inflammatory cells were observed in the interstitium. These results indicate that colloid must be added to Cape Town solution and that reperfusion probably requires selective approaches to deal with vasoconstriction and inflammation.

Structural and ultrastructural study of the myocardium after 24-hour preservation in University of Wisconsin solution.

This study deals with myocardial preservation after 24 hours of continuous perfusion with University of Wisconsin (UW) solution, focusing on the morphological changes produced by preservation and reperfusion, and their possible relationship to the composition of the solution and the immediate hemodynamic findings after orthotopic heart transplantation in dogs. Following preservation, the histological images of the myocardium were normal in almost every case. After revascularization, although 50% of the hearts recovered preoperative functional levels, there were relevant histological changes in all of them. These changes consisted of interstitial edema, damage to at least 50% of the mitochondria, presence of contraction bands, loss of intercellular junction structure and vasoconstriction. According to these results, the association of continuous perfusion and UW solution appears to be effective during the ischemic period of prolonged myocardial preservation, but not during reperfusion. Perhaps the proportion of viable hearts could be increased by preventing vasoconstriction.