Walter Zeit

Experiences with the autoplastic cutis vascular graft.

* Presented at the Fourth Annual Convention of The American College of Angiology, San Francisco, June 22, 1958. . z † From the Departments of Surgery, Anatomy, and Pathology, Marquette University School of Medicine, Milwaukee, Wisconsin. The need for arterial substitutes has greatly increased with the rapid advance and development in the field of cardiovascular surgery. As one reviews the progress in this field, the materials employed as a prosthesis indicate by their number and variety that the ideal prosthetic material is still wanting. However, in considering all the materials used to date, it appears that the synthetic prosthesis is supplanting the use of the homograft. The homografts have certainly played

Microincineration of Active Smooth, Transitional and Skeletal Muscles.

The distribution of inorganic salts in the active and inactive smooth muscle of the intestine and the transitional muscle of the gizzard of birds and skeletal muscle is revealed by the technic of microincineration perfected by Scott. 1 He emphasized the distribution of ash in relatively inactive smooth and skeletal muscle by this method. He did not report in detail on the ash distribution in the active smooth, transitional, and skeletal muscles. This method of incinerating microscopic sections of tissue without disturbing the relationship of the mineral components was suggested by Liesegang 2 and developed by Policard. 3 The recent studies of Kruszynski 4 are on the topography of the mineral content in relatively resting muscle after microincineration. The muscle is fixed for 24 hours in 9 parts of absolute alcohol and 1 part of neutral formalin. The mineral salts are neither increased nor decreased by this fixative. The tissue is completely dehydrated by several changes in absolute alcohol. The mineral salts remain intact by this method. It is then cleared in xylol, embedded in paraffin, and cut serially at 4 to 6 microns. Alternate sections are mounted by the usual method, and stained with hematoxylin and erythrosin, whereas, the intervening sections are mounted with liquid petrolatum to spread the tissue evenly. After the section is flat the excess liquid petrolatum is removed carefully by smooth blotting paper. The intervening sections are incinerated in a closed electric furnace at varying temperatures from 400° to 650°C. The temperature is raised 50°C every 10 minutes until the highest temperature is reached. Sudden elevation of temperature with an excess of liquid petrolatum underlying the paraffin section results in explosive distortions due to sudden thermal agitation. The slide is cooled slowly over a period of 8 to 12 hours and the incinerated section is then covered with a number 0 cover glass around the edges of which melted paraffin is applied.

Clinical experience with the cutis vascular graft. Progress reports.

* Grant in Aid, Wisconsin Heart Association (experimental work before clinical application). † Associate, Department of Anatomy, Assistant Clinical Professor of Surgery, Marquette University School of Medicine. ‡ Associate Professor of Anatomy, Marquette University School of Medicine. § Professor and Chief of the Department of Anatomy, Marquette University School of Medicine. Our experience with vascular replacement dates back to 1952, and it has become obvious to us that no vascular substitute is perfect. We wish to acknowledge at this time, and give our sincere thanks to, Dr. W. S. Edwards, who allowed us to use the tubes he developed through The Chemstrand Corporation of Alabama, when they were first being assayed.’ In our hands we

Acute Anatomic Breakdown of Motor End Plates in Hemorrhagic Shock.

Summary The limited evidence in this paper supports the claim that hemorrhagic shock profoundly alters the morphology of the motor end plates and finally produces loss of structural innervation of many muscle fibers in a single voluntary muscle. This histologic change is highly irregular in the different muscles of the rat, therefore large numbers of specimens from different muscles were teased. Gold staining masses of axonic materials drain out into and between the muscle fibers coincident in time with the loss of motor innervation due to the increased permeability of the end plates. The epilemmal axons, exhausted of their substances, are in many places likewise denuded of their hypolemmal end plates. There is therefore a real anatomic breakdown of many motor end plates and histologic alteration of certain skeletal muscles in hemorrhagic shock.

Regional hypothermia and its effect on the brain

Abstract We believe that air distention in a pneumatic balloon is superior to cold hydrostatic pressure in a balloon to arrest gastric bleeding and to reduce gastric digestion. This is true because air pressure may be used on the subject without an anesthetic. Excessive cold causes pain, but air distention of the balloon causes no distress. Digestion in an actively bleeding stomach is held to a minimum without any chemical or physical intervention. In the stomach, a large balloon uniformly distended by air does not cause abdominal pain or distress, and does not affect the pulse. It never causes the heart to develop an abnormal rhythm. On the other hand, the use of a cooled balloon in the esophagus appears to be an ideal tool for the neurosurgeon. Barnard [1] summed up the value of hypothermia in brain surgery by stating that “if procedures could be rendered sufficiently safe, the fields of aneurysmal surgery and other vascular neurosurgery could be extended.” The use of this procedure is especially indicated because it temporarily reduces the size of the brain by reducing the blood volume within the vessels of the brain while it increases the oxygen tension of the blood plasma. Thus, the air-distended balloon is sufficient to stop bleeding alone, but the circulating liquid-cooled balloon in the esophagus is the instrument of choice for brain surgery.

Exaggerated Discharge of Neurosomes into Spastic Muscle by Heat Reflex.

Summary The limited experimental evidence presented tends to support the statement that the reflex effects of heat applied to the skin are associated with the exaggerated discharge of ephemeral, pleomorphic, and lipoidal neurosomes from the motor end plates into spastic or cramp-like muscle. The neurosomes have a variable affinity for gold, silver, and lipoidal stains. There are characteristic instantaneous changes in the morphology of the motor end plates and myoplasm in response to the reflex effects of thermal trauma applied to the skin.