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Biomedical subjects

C Blauth

Publications and source records attributed to C Blauth.

10 recordsLinked to original sources

Immunoelectron microscopic studies reveal differences in distribution of sialo-oligosaccharide receptors for Mycoplasma pneumoniae on the epithelium of human and hamster bronchi.

Long-chain sialo-oligosaccharides with poly-N-acetyllactosamine backbones (Ii antigen type) are major host cell receptors for the human pathogen Mycoplasma pneumoniae. Previous immunofluorescence studies of the human bronchial epithelium, using sequence-specific monoclonal antibodies to the branched I-type and linear i-type backbones, have indicated that sialylated and nonsialylated long-chain sequences of both types are richly expressed on the ciliated cells, where they are polarized at the apical aspects. These sequences are lacking in the goblet cells. In the present study, the display of these oligosaccharides has been investigated by electron microscopy (immunogold labelling) in the human bronchial epithelium and in that of the hamster, an animal model commonly used for M. pneumoniae infection. In the human bronchial epithelium, the long-chain branched sequences have been detected along the entire length of the cilia and on microvilli, whereas the linear sequences are confined to the microvilli and the basal aspects of the cilia. On the ciliated epithelial cells of the hamster, by contrast, the branched and linear sequences (sialo- and asialo-) have been detected exclusively on microvilli. A further striking difference is that in the hamster these structures are expressed in abundance on the goblet cells and in the intracellular globules. We suggest that the latter finding may partly explain the relatively large doses of M. pneumoniae required to establish experimental infection in the hamster, as the receptor-bearing secreted mucus may have a protective role in binding to the microorganisms, leading to their clearance by bronchociliary action.

Animals

False aneurysm of the right internal mammary artery.

False aneurysm of the internal mammary artery is an uncommon complication of median sternotomy. Clinical and radiological findings of 2 such cases are presented. At operative exploration neither was directly related to the presence of a sternal wire.

Aged

Method of endoscopic esophageal intubation using a rigid esophagoscope.

Endoscopic intubation of malignant esophageal strictures carries a substantial risk of esophageal perforation. We have developed a method of endoscopic intubation that reduces to a minimum the elements of the procedure that have to be performed "blind." The use of this method has been associated with a reduction in perforation rates when compared with other series.

Equipment Design

Retinal microembolism and neuropsychological deficit following clinical cardiopulmonary bypass: comparison of a membrane and a bubble oxygenator. A preliminary communication.

To observe and quantify cerebrovascular microembolic events in the central nervous system during cardiopulmonary bypass, 40 patients having elective uncomplicated coronary surgery had retinal fluorescein angiograms 5 min before bypass was discontinued. Each patient also had 10 neuropsychological tests before and after surgery. A Harvey H1700 bubble oxygenator was used for 23 patients and a Cobe CML sheet membrane oxygenator was used for 17 patients. All 23 (100%) of patients in the bubble oxygenator group had retinal microvascular occlusions consistent with microembolism compared to 8/17 (47%) in the membrane oxygenator group (P less than 0.001). In those retinas with occlusions, the mean resultant area of non-perfusion was less in the membrane oxygenator group (0.11 mm2; n = 8) than in the bubble oxygenator group (0.29 mm2; P less than 0.01). Arterial PO2 levels during bypass were similar in both groups at moderate hypothermia, but the mean PaO2 during rewarming was higher in the bubble oxygenator group (27 kPa) than in the membrane group (13 kPa; P less than 0.001). Neuropsychological deficits were more common and more severe after bubble oxygenation than after membrane oxygenation, but in this small patient group, the difference was not statistically significant. We conclude that flat sheet membrane oxygenation during cardiopulmonary bypass may confer significant protection against cerebrovascular microembolism.

Cardiopulmonary Bypass

Retinal microembolism during cardiopulmonary bypass demonstrated by fluorescein angiography.

Fluorescein angiography was used to study retinal microvascular perfusion in 20 patients undergoing coronary artery surgery. Colour retinal photographs and fluorescein angiograms were obtained preoperatively and at 5-14 days postoperatively. In 10 patients retinal fluorescein angiograms were also obtained intraoperatively during cardiopulmonary bypass, and all were found to have retinal microvascular occlusions after 40-160 min of extracorporeal circulation. 3 patients had in addition focal leakage of fluorescein, and 6 had foci of abnormal drainage of dye. These changes are consistent with retinal microembolism, and appeared to have resolved by the time of the postoperative study. No new pathological features appeared in the retina after surgery. Intraoperative fluorescein angiography of the retina may prove valuable for investigation of cerebrovascular microembolism in the territory of the internal carotid artery during cardiopulmonary bypass in man.

Aged

Intracardiac metastases from malignant teratoma of the testis.

Cisplatin-based chemotherapeutic regimens are highly successful at controlling testicular teratomas, returning tumor markers to normal in 76% of patients. However, bulky residual disease persists in 24%, and surgical excision of these deposits is becoming increasingly common. This approach is justified, because the histologic characteristics of such deposits gives valuable prognostic information, allowing a decision to be made regarding additional therapy, and relapse of apparently stable disease may occur. Excision of residual bulky disease may be achieved safely. We have recently successfully excised an intracardiac metastasis in a patient with no demonstrable extrathoracic disease and normal serum marker levels.

Adult