Single hospital experience with emergency cardiopulmonary bypass using the portable CPS (Bard) system.

One hundred four patients were placed emergently on the Bard CPS portable femoro-femoral bypass system over a 4 year period. Thirty-two patients (31%) were discharged from the hospital. Seventy-six of these patients (73%) required emergency bypass following cardiac arrest, and twenty-eight patients (26%) were in cardiogenic shock or respiratory failure. In the arrest group, no one survived an unwitnessed arrest and those with cardiopulmonary resuscitation times less than 30 minutes had a better survival rate. The highest survival rate was in those patients who did not arrest prior to bypass. Fifty-two percent of these patients were released. The 74 patients receiving interventional therapy on bypass had a higher survival rate than those unable to be treated. Of the thirty patients receiving no intervention, only three (10%) were eventually discharged. For the 19 patients receiving treatment only in the cardiovascular laboratory, the discharge rate was 26%. Of the 55 patients taken to the operating room for surgical correction, 24 (44%) were discharged from the hospital. No patients placed on bypass at an outlying hospital or treated using CPS within 72 hours of a previous open heart procedure survived.

Light and electron microscopical immunolocalization of neuropeptide Y-containing nerves in the hamster gallbladder.

Neuropeptide Y (NPY)-containing nerve structures were detected in the Syrian hamster gallbladder by using peroxidase-antiperoxidase immunohistochemical staining and immunoelectron microscopic techniques. In addition, Alcian blue-P.A.S. was used to differentiate two types of surface cells in the epithelium of the gallbladder: the columnar cells and the tuft cells. NPY-immunoreactive varicose nerve fibers were detected in the adventitial layer of the arterioles, precapillary arterioles and around axial venules of mucosal folds; they were not observed in the capillary beds. Since NPY is associated with norepinephrine (NE) in the sympathetic nerves, it could prolong the adrenergic vasoconstrictive effects. We propose that NPY and NE are simultaneously released to restrict the blood flow in the subepithelial capillary beds by increasing vascular resistance thereby perturbing the absorption of water and electrolytes.