Effects of Intravenous Acetaldehyde, Acrolein, Formaldehyde and Propionaldehyde on Arterial Blood Pressure Following Acute Guanethidine Treatment

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TRANSPLANTATION

The Technique of Major Amputations for Malignant Tumors

C. P.

KARAKOUSIS, Department of Surgical Oncology, New York State Department of Health, Roswell Park Memorial Institute, Buffalo, New York

J. Surg. Oncol., 23: 43-55 (May) 1983 The incidence of major amputations owing to malignant tumors has decreased considerably with the use of combinations of modalities to avoid a major functional deficit without compromising local control. It is only when all of the gross tumor cannot be removed, as with major bone or joint invasion, that an amputation is performed. Familiarity with the anatomy involved in these procedures is extremely important and, with fine dissection, excessive blood loss or neurological impairment may be avoided. Major arteries can be replaced without difficulty if they are adjacent to tumor. Replacement of veins has been less successful. Major amputations should be planned carefully, with allowance for modifications depending upon location and extent of the tumor or local effects resulting from other treatment modalities. Technical details are described relating to hemipelvectomy (hindquarter amputation), internal hemipelvectomy and forequarter (interscapulothoracic) amputation. M. G. F. 31 figures, 13 references

M. A. GREEN AND J. L. EGLE, JR., Department of Pharmacology, Medical College of Virginia, Virginia Commonwealth University, Richmond, Virginia

Res. Comm. Chem. Path. Pharm., 4: 337-340 (May) 1983 Guanethidine currently is used in the treatment of essential hypertension. Aldehydes are breakdown products of ethanol ingestion and cigarette smoking. Using rats the authors attempted to determine if the therapeutic efficacy of guanethidine was altered by drinking or smoking. Baseline intra-arterial pressures were obtained and 15 mg./kg. guanethidine were given intravenously. Recordings were made during 30 minutes and varying doses of acetaldehyde, acrolein, formaldehyde and propionaldehyde were given. The pressor response to acetaldehyde was potentiated by guanethidine. Two possible mechanisms were invoked to explain this response. Acetaldehyde could replace the intraneuronal guanethidine from its binding site, causing subsequent release of norepinephrine. Another possible mechanism was acetaldehyde acting on the tyraminereleasable pool, yielding an even greater release of norepinephrine. Propionaldehyde appeared to act in a similar manner as acetaldehyde. On the other hand, acrolein and formaldehyde caused a decrease in blood pressure that was attributed to vagal stimulation. The authors believed that the adverse effects of acetaldehyde assume some importance in patients receiving guanethidine who continue to drink and smoke. G. W. K. 1 figure, 8 references

DISEASES OF BLOOD VESSELS, HYPERTENSION AND RENOVASCULAR SURGERY Hypertension Screening in the Follow-Up of Premature Infants D. N. SHEFTEL, V. HUSTEAD AND A. FRIEDMAN, Department of Pediatrics, University of Wisconsin, Madison and Section of Neonatology, Lutheran General Hospital, Park Ridge, Illinois

Pediatrics, 71: 763-766 (May) 1983

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The authors report on the results of hypertension screening using the Doppler technique in a group of premature newborns following discharge from the intensive care nursery. The criteria for inclusion in the study consisted of gestational age <37 weeks, intensive care or observation for >48 hours and no known congenital anomalies. The systolic blood pressure was measured at followup in 79 of 99 premature neonates who were cared for in the special care nursery for 9 months. Seven newborns with a blood pressure > 113 on 3 separate occasions were identified as hypertensive (>95th percentile). Of these hypertensive neonates 3 had a specific etiology requiring treatment: neuroblastoma, coarctation of the aorta and unilateral ureteropelvic junction obstruction. No difference was found between the hypertensive and normotensive newborns for a variety of perinatal and neonatal factors, including the presence or duration of an umbilical arterial catheter. Hypertension screening may be a useful part of the evaluation of premature neonates following discharge from an intensive care nursery. P.R.R. 1 figure, 2 tables, 18 references

Effects of Intravenous Acetaldehyde, Acrolein, Formaldehyde and Propionaldehyde on Arterial Blood Pressure Following Acute Guanethidine Treatment

TRANSPLANTATION Cadaver Renal Transplant Outcome in Recipients With Autolymphocytotoxic Antibodies R. B. ETTENGER, S. C. JORDAN AND R. N. FINE, Division of Pediatric Nephrology, Department of Pediatrics, University of California, Los Angeles, School of Medicine, Los Angeles, California Transplantation, 35: 425-428 (May) 1983 The major impact of autolymphocytotoxic antibodies on renal transplantation has been in the interpretation of the pretransplant crossmatch as a cause of falsP, positive results. Less attention has been paid to the direct effects of autolymphocytotoxic antibodies on renal allografts. The authors have examined the sera of 38 recipients of 41 cadaver renal allografts for the presence of autolymphocytotoxic antibodies. In 9 patients who received 10 allografts with autolymphocytotoxic antibodies actuarial graft survival was significantly improved over that of 31 transplants without antibodies (p <0.05). In recipients with autolymphocytotoxic antibodies graft survival was 90 per cent at 6 months and 60 per cent at 1 and 2 years, while in recipients without antibodies graft survival was 48 per cent at 6 months, 35 per cent at 1 year and 24 per cent at 2 years. Autolymphocytotoxic antibodies may be exerting graft-enhancing properties by means of an autoregulatory effect upon the recipient's immunologic system. G. P. M. 1 figure, 2 tables, 25 references

Plasma Exchange in Acute Renal Allograft Rejection. A Controlled Trial

N. H. ALLEN, P. DYER, T.

GEOGHEGAN,

K. HARRIS, H. A. LEE