1969

The Value of Earthworms by Eric Johnson (page 1) Golf Course Bridge Construction by Robert A. Huntley (2) Importance of Trees and Care by Donald Pipczinski (3) Management Practices Help Control Turf Diseases by Larry Bunn (3) Class Will of \u2769 (5) Famous Sayings of \u2769 (6) The Reluctant Human by John Denison (A-1) Communicating by Frank Gallagher (A-4) Vandalism on the Golf Course by Edward B. Patroski (A-7) The GCSAA Organization - What it Means to You (A-13) Role of Potash in Turf Production by Lindsay D. Brown (A-17) Dew is Note Dew by Tom Mascaro (A-28) Insects in Turf and Their Control by John C. Schread (A-36) Turf Treatment and the Balance of Nature by Haim B. Gunner (A-39) The After-Effects of Irrigation by John C. Harper, II (A-40) Athletic Field Specifications by John C. Harper, II (A-45) Pennsylvania Turfgrass Survey by John C. Harper, II (A-52) Seeding Vs. Sodding by Norman Gray (A-54) Synthetic Turf by R. Spencer Thompson (A-58) Why Do We Have Dealers .. Does He Justify His Existence? (A-61) The Importance of Suppliers of Turf materials by John N. Magovern (A-64) Golf Course Maintenance at St. Andrews by John C. Campbell (A-68) Ground Covers for Golf Courses by Jack Eggens (A-75) Gardening - 600 BC to Country Club Road by Warren Bidwell (A-79) Blues Vs. Bents for Fairway Turf by James L. Holmes (A-87

LV reverse remodeling imparted by aortic valve replacement for severe aortic stenosis; is it durable? A cardiovascular MRI study sponsored by the American Heart Association

<p>Abstract</p> <p>Background</p> <p>In patients with severe aortic stenosis (AS), long-term data tracking surgically induced effects of afterload reduction on reverse LV remodeling are not available. Echocardiographic data is available short term, but in limited fashion beyond one year. Cardiovascular MRI (CMR) offers the ability to serially track changes in LV metrics with small numbers due to its inherent high spatial resolution and low variability.</p> <p>Hypothesis</p> <p>We hypothesize that changes in LV structure and function following aortic valve replacement (AVR) are detectable by CMR and once triggered by AVR, continue for an extended period.</p> <p>Methods</p> <p>Tweny-four patients of which ten (67 ± 12 years, 6 female) with severe, but compensated AS underwent CMR pre-AVR, 6 months, 1 year and up to 4 years post-AVR. 3D LV mass index, volumetrics, LV geometry, and EF were measured.</p> <p>Results</p> <p>All patients survived AVR and underwent CMR 4 serial CMR's. LVMI markedly decreased by 6 months (157 ± 42 to 134 ± 32 g/m^<b>2</b>, p < 0.005) and continued trending downwards through 4 years (127 ± 32 g/m^<b>2</b>). Similarly, EF increased pre to post-AVR (55 ± 22 to 65 ± 11%,(p < 0.05)) and continued trending upwards, remaining stable through years 1-4 (66 ± 11 vs. 65 ± 9%). LVEDVI, initially high pre-AVR, decreased post-AVR (83 ± 30 to 68 ± 11 ml/m2, p < 0.05) trending even lower by year 4 (66 ± 10 ml/m^<b>2</b>). LV stroke volume increased rapidly from pre to post-AVR (40 ± 11 to 44 ± 7 ml, p < 0.05) continuing to increase non-significantly through 4 years (49 ± 14 ml) with these LV metrics paralleling improvements in NYHA. However, LVmass/volume, a 3D measure of LV geometry, remained unchanged over 4 years.</p> <p>Conclusion</p> <p>After initial beneficial effects imparted by AVR in severe AS patients, there are, as expected, marked improvements in LV reverse remodeling. Via CMR, surgically induced benefits to LV structure and function are durable and, unexpectedly express continued, albeit markedly incomplete improvement through 4 years post-AVR concordant with sustained improved clinical status. This supports down-regulation of both mRNA and MMP activity acutely with robust suppression long term.</p

Linear muscle power for cardiac support: current progress and future direction

The use of electrically-stimulated skeletal muscle as an endogenous power source is an attractive approach to long-term cardiac assistance. The principle advantage of this technique over current methods is that it obviates the need for extracorporeal power sources and provides a reliable, low-cost, self-sustaining source of energy without immune compromise or loss of patient autonomy. This article briefly examines the various approaches to harnessing muscle power, details the rationale for the use of muscle in a linear configuration, and reviews our progress to date regarding development of a ventricular assist device powered by in situ skeletal muscle. Key words: skeletal muscle, cardiac assist, electrical stimulation, conditioning, linear contraction, prosthesis, latissimus dorsi. Basic Appl. Myol. 9 (4): 175-186, 1999 Cardiovascular disease is the leading killer in the United States, claiming more than 954,000 lives annually. Despite intense efforts to prevent and treat thes

Recent Clinical Experience With Left Heart Bypass Using a Centrifugal Pump for Repair of Traumatic Aortic Transection

OBJECTIVE: To analyze the indications, results, and limitations of using left atrial to femoral artery (LA-FA) bypass to provide distal perfusion during repair of traumatic aortic injuries. SUMMARY BACKGROUND DATA: There is no consensus about the best method for repair of traumatic aortic transection. Distal aortic perfusion with LA-FA bypass and a centrifugal pump has been the authors’ preferred technique for injuries to the aortic isthmus and descending thoracic aorta. METHODS: From 1988 to 1998, the authors operated on 30 patients with traumatic aortic transection using LA-FA bypass. The mean age of the group was 36 ± 2 years. The mechanism of injury was from a motor vehicle accident in 97% of the cases. Distal aortic perfusion was maintained at 50 to 75 mm Hg with flow rates of 1.5 and 3 L/min. The mean aortic cross-clamp time was 38 ± 2 minutes, and the mean bypass time was 49 ± 2 minutes. RESULTS: No complications related to cannulation, arterial thromboembolism, renal failure, mesenteric ischemia, or hepatic insufficiency occurred. There were no cases of postoperative paraplegia and no deaths. CONCLUSION: Left atrial to femoral artery bypass is a safe, simple, and effective adjunct to the repair of traumatic injuries to the thoracic aorta. Active distal aortic perfusion preserves spinal cord, mesenteric, and renal blood flow and eliminates the potential catastrophic consequence of spinal cord ischemia from an unexpectedly prolonged aortic cross-clamp time

901-12 Long-term Results of Right Latissimus Cardiomyoplasty

Initial experimental and clinical studies have shown that cardiomyoplasty using the right latissimus dorsi can improve left ventricular (LV) function early after operation. This study presents the long-term results of clinical application of this procedure. Between March 1991 and November 1992, 16 patients (12 men, 4 women; mean age 57; range 33-77 years) underwent operation. Survivors have now been followed for 18 months with serial right heart catheterization and radionuclide angiography at 6 month intervals. The operative mortality was 6% (1/16), but 3 additional patients experienced sudden death within 6 months of operation. Survival was 62.5% (10/16) at 12 months and 56.3% (9/16) at 18 months. The LV stroke work index (LVSWI) was improved at each postoperative interval, but the differences were not statistically significant. Left ventricular ejection fraction (LVEF) significantly increased from 26.1 ± 5.3 to 33.4 ± 10.3 (p&lt; 0.05), 6 weeks after operation and was not different from baseline thereafter. The LV end-diastolic volume decreased significantly at 6 months from 306.1 ± 71 to 249.4 ± 69 mL (p&lt; 0.01), and remained lower than the preoperative value in subsequent follow-up. Comparison of preoperative LVEF in 24 month survivors (51 and non-survivors (8) revealed that survivors had an LVEF of 30.2 ± 4.38 and nonsurvivors were 22.7 ± 2.58 (p&lt; 0.05). Preoperative LVSWI was also significantly greater in survivors 36.4 ± 6.91 gm-cm/m2vs 20.1 ± 8.26 gm-cm/m2, (p&lt; 0.05). Overall survival was limited by the occurrence of sudden death, but survivors had improved functional capacity and stabilization of cardiac size and function. We conclude that careful selection of patients with better preserved, preoperative LV function may yield improved long-term survival in right latissimus cardiomyoplasty