Selective Coronary Angiography Using a Percutaneous Femoral Technique

Successful use, in 650 patients over a period of two years, of a percutaneous femoral technique of selective coronary angiography is described. This technique is carried out with the use of mouldable, manually preshaped polyethylene catheters. Preparation of the material and the different steps of the technique are discussed. Excellent flexibility and plastic memory of this catheter material allow easy, rapid and consistent percutaneous insertion and removal of catheters and intubation of the coronary arteries.     

Criteria for Internal Mammary Artery Implantation Based on Cine Coronary Arteriography

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.     

Some Effects of Protein Deficiency in Young Growing Pigs. II. Blood Plasma Free Amino Acids

The influence of protein deficiency, rehabilitation and total starvation on the free amino acid levels in the blood plasma of pigs has been investigated. It was found that the concentration of most amino acids was reduced during protein deficiency. The levels of leucine, isoleucine and valine were diminished by the greatest proportion, followed by threonine, tyrosine and citrulline. During the first few weeks of protein deficiency the levels of lysine, histidine and arginine were slightly increased, but later decreased below control values. Concentrations of glycine and alanine were altered in a similar way except that the initial increase was much more pronounced. The concentrations of most of these amino acids returned to control levels after rehabilitation. Total starvation led to an increase in concentration of leucine, isoleucine, valine, threonine and to a smaller extent phenylalanine, lysine, citrulline and arginine. The concentration of glycine, alanine and glutamic acid were very much reduced. The level of urea in the circulation dropped reversibly during protein deficiency and increased very much during total starvation.