Ultrastructural cytochemistry of atrial muscle cells. V. Characterization of specific granules in the human left atrium.
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Biomedical subjects
Publications and source records attributed to Y Castonguay.
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The nature of human auricular specific granules was assessed by a variety of cytochemical and histochemical methods. The specific granules were found to be argentaphobic when ultrathin sections of Araldite-embedded auricular appendages were stained according to the periodic acid-thiocarbohydrazide-silver proteinate technique of Thiery. The entire core of these granules was moderately positive after ultrathin sections of glutaraldehyde-fixed, glycol methacrylate (GMA)-embedded auricles were stained with phosphotungstic acid (PTA) at a low pH. A similar reaction was shown by the cell coat, residual bodies (C-granules), lysosomes, Z-discs as well as by a very small portion of the Golgi complex. Analogous results were obtained in semithin sections of GMA-embedded auricles stained by the periodic acid-Schiff (PAS) technique. Incubation of ultrathin sections (fixed in glutaraldehyde and embedded in GMA) with proteolytic enzymes (pronase, pepsin, trypsin, or alpha-chymotrypsin) elicited selective digestion of atrial specific granules and Z-bands and, to a much lesser degree, of the cell coat. It is concluded that human auricular specific granules, as in rat atrial cardiocytes, are composed mostly of proteins. In addition, these granules may contain complex carbohydrates.
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Preoperative coronary arteriograms were correlated, in a group of 50 patients, with left internal mammary angiograms obtained from 11 to 32 months, with a mean of 17 months, after mammary artery implantation. In all patients in whom the internal mammary artery was patent and considered functional with good angiographic opacification of the anterior descending coronary artery, the preoperative coronary angiogram showed total or subtotal obstruction of the latter vessel, with indirect evidence of decreased flow and pressure distal to the obstruction. This evidence was provided by the presence of a collateral circulation or, in a few cases of subtotal obstruction, delayed opacification of the vessel distal to the obstruction.In patients in whom the internal mammary artery was patent but showed no anastomotic connection with the anterior descending coronary artery or only opacification of small coronary branches, the degree of coronary obstruction was, in most cases, less than 90% of the lumen of the coronary artery in the absence of any collateral circulation or delayed opacification of the vessel distal to the obstruction.Occlusion of the internal mammary artery was seen as often in the presence of total or subtotal obstructions as with lesser degrees of anterior descending coronary artery obstruction, and is believed unrelated to the degree of pre-existing coronary artery disease.Successful internal mammary artery implantation can be related to specific coronary angiographic patterns recognizable before operation; these may serve as reliable criteria for the selection of patients.
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We report on a patient in whom left ventricular outflow obstruction developed after mitral valve repair with a flexible Duran ring. This complication has been reported in 4.5% to 21% of patients when a rigid Carpentier ring was used but was thought to be eliminated with the use of flexible rings.