There has been a resurgence of interest in the concept of presealing high-porosity knitted Dacron prostheses with an absorbable biologic material. Such a material should provide reliable porosity control, preferably reducing water porosity from 2000 ml/cm2/min to less than 50 ml/cm2/min. It should not interfere with the fibrous and vascular ingrowth that securely anchors the developing pseudointima. In previous studies, we have examined fibrin glue and two forms of aldehyde cross-linked insoluble collagen used as Dacron sealants. We concluded that delayed resorption of the sealant as seen with glutaraldehyde cross-linked insoluble collagen results in undesirable healing characteristics, particularly lack of adhesion between pseudointima and the luminal surface of a prosthesis. This study examines a new sealant. Soluble collagen (gelatin) is treated to reduce the number of free amino groups available for aldehyde cross-linking. It is then weakly cross-linked with an aldehyde mixture and applied to a knitted Dacron prosthesis. Water porosity studies have confirmed satisfactory porosity control. Both rat subcutaneous and canine circulatory implants for 6 months reveal relatively rapid and complete sealant resorption without undesirable modification of the normal healing process of knitted Dacron.
A 68-year-old female with moderate to severe aortic stenosis and severe mitral stenosis, deemed too high risk for surgery (STS mortality risk = 12.3%) with a porcelain aorta, was successfully treated with a transcatheter aortic and mitral valve implantation (TAMVI) via a transapical approach. A 23 mm Sapien valve (Edwards Lifesciences, Irvine, CA, USA) was placed in the aortic position and a 29 mm inverted Sapien valve (Edwards Lifesciences) in the mitral position.
Blockade of tonic hindlimb extension (THE) in the maximal electroshock seizure test was demonstrated for C-28'882-Ba, a muscle spindle suppressant, chlorpromazine, a depressant of fusimotor drive, and gallamine, a neuromuscular blocking drug. These agents also blocked THE produced by very large doses of pentylenetetrazol. Dantrolene, a muscle contraction antagonist, and MI-65-S, a muscle spindle suppressant, significantly delayed THE. The data indicate that blockade of THE may be effected at a multiplicity of loci and may not be an expression of an "anticonvulsant" effect.
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