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Basket willow (Salix viminalis L.) was grown in open-field experiment. The brown forest soil (sand texture, pHKCl 7.7, humus 1.6%, CEC 11.5 cmolc/kg; Cd-0.11, Cu-7.1, Pb-8.1, Zn-25.0 mg/kg in aqua regia extract) was treated with municipal sewage sludge compost (MSSC) (25 t/ha wet weight, 12.8 t/ha dry weight in 2009; 50 and 100 t/ha wet weight, 25.4 t/ha and 50.8 t/ha dry weight in 2008). The MSSC was moderately contaminated with toxic metals (Cd

A 274-day long cadmium (Cd) feeding trial was carried out with broiler cockerel chickens. The diet of the control group (Cd-0, n = 6) contained no added Cd, whereas to the diet of group Cd-25 and group Cd-75 (n = 10 each) 25 ppm and 75 ppm Cd was added, respectively, in the form of CdSO4. The chickens were subjected to examinations described in detail earlier (Bokori et al., 1995b). In addition, the relative mass of five different organs (heart, liver, testis, spleen and brain), expressed as % of the body mass, was also determined. The clinical, gross and histopathological examinations and the assay of organs for mineral element content led to the following main findings. The feeding of diets containing 25 or 75 ppm Cd for more than 9 months did not cause signs indicative of acute Cd toxicosis or mortality in either group. The body mass gain of group Cd-75 chickens markedly decreased. Prolonged Cd exposure of the cockerels increased the relative mass of the liver and heart and markedly decreased that of the testes. The change in mass was proportional to the Cd load. The Cd-fed chickens developed focal pathological fatty infiltration of the liver, histiocytic infiltration of the jejunal mucosa and focal lympho-histiocytic interstitial infiltration and fibrosis of the kidney, which supports the view that prolonged Cd exposure leads to the development of subacute-chronic tissue changes in the kidney. The Cd content of the organs increased by one to three orders of magnitude, in direct proportion to the Cd load. The Cd content of most organs was 2 to 3 times as high as the value reported for broilers exposed to a similar Cd load lasting for 68 days (Bokori et al., 1995b). This indicates that the degree of Cd accumulation is markedly influenced by the duration of the Cd exposure. The highest Cd content was demonstrated in the kidney (724 mg/kg of dry matter). The Cd exposure markedly lowered the Zn, Mo and B content of the bones and the Ni content of the myocardium.

Cadmium (Cd) loading trials were conducted on a total of 110 (3 x 10 and 4 x 20) broiler chickens prereared for 21 days. The control chickens received no cadmium, while chickens in the six treatment groups were given different doses of Cd as an aqueous solution of CdSO4 administered either into the crop or mixed in the feed. The chickens were kept in a climatized animal house and treated usually for 3-5 weeks (maximum 68 days), with the exception of group Cd-75 chickens which were treated up to 239 days of age. The chickens' health status, body mass and feed consumption were monitored throughout the trial. On days 14-20 and on day 42 of the trial 2 chickens per group, then at the end of trial a total of 25 chickens were killed in anaesthesia. These birds, together with chickens that died or were killed during the trial, were subjected to detailed gross pathological examination. From 11 organs (kidney, liver, spleen, testicle, brain, myocardium, skeletal muscle, lungs, digestive tract, pancreas, tubular bones) of these chickens samples were taken for assay for a total of 16 elements, as well as for light and electron microscopic examination. With the exception of groups Cd-30 and Cd-600, no abnormal clinical signs were observed in the first two weeks of the trial. Chickens of group Cd-30 died before day 8-12 of the trial among signs of complete anorexia, rapid emaciation, huddling and diarrhoea, while chickens of group Cd-600 died before day 28, showing similar clinical signs. The body mass of chickens fed a Cd-supplemented diet either remained constant or decreased substantially, in a degree proportional to the Cd load. The only exception was group Cd-2.5, in which the average body mass of birds at the end of week 8 slightly exceeded that of the controls. Four out of the 10 cockerel chicks fed a diet containing 75 ppm Cd up to 239 days of age died of intercurrent diseases; the remaining six grew well and reached a body mass of 3.8-4.3 kg. Feed conversion efficiency was satisfactory in the control group and in group Cd-2.5 (2.1 and 2.4 kg, respectively) and could not be evaluated in a realistic manner in the other groups. At necropsy, the cockerel chicks of groups Cd-30 and Cd-600 showed severe emaciation, liver and kidney degeneration, myocardial hypertrophy and cardiac dilatation.(ABSTRACT TRUNCATED AT 400 WORDS)

Only 9 of more than 900 operated patients with ventricular septal defects suffered from this rare combination. The problems of the diagnosis are discussed. Only in one case this diagnosis was made praeoperatively, in 6 cases intraoperatively and in two cases only postoperatively. In the last two cases a reoperation was necessary. The surgical methods are described and the results of surgery are communicated.

Aortoventriculoplasty is a new method of treatment for left ventricular outflow tract obstructions. The concept is based on creating a surgical defect which is patched in such a way as to provide the largest possible outflow to the left ventricle. The incision of the aorta continues down as far as necessary, with the right ventricular wall, the aortic ring, and the septum being cut. Reconstruction with an inner Dacron patch on the septum is completed by replacing the aortic valve with an adequate prosthesis, covering the aortic incision with the same patch, and patching the right venticular opening with an outer patch. This method was used in 4 children with tunnel-like subaortic stenosis, 3 of whom had had unsuccessful previous surgical attempts. Other associated lesions including parachute mitral valve were also corrected during aortoventriculoplasty. Hemodynamic results were excellent following this operation. Two patients died postoperatively, one from advanced myocardial damage and progressive failure and the other from cerebral ischemia caused by insufficient retrograde perfusion through an aortic coarctation that was not repaired earlier. No arrhythmias were observed following the procedure. The other 2 patients are well 7 and 5 months postoperatively with excellent hemodynamic function.

Nach Diskussion der Probleme der portacavalen Anastomose bes. im Hinblick auf die Encephalopathie und das postoperative Leberversagen wird ein Uberblick uber die von 1958–1975 behandelten Patienten mit Pfortaderhochdruck gegeben. Von insgesamt 722 Patienten, 88% hatten einen intrahepatischen Block, erhielten 479 einen portosystemischen Shunt, und zwar 292 PCA, 175 SRA und 12 MCA. Unabhangig von der Art der Shuntoperation liegt die 6-Jahre-Uberlebensrate der operierten Patienten mit stationarer Lebercirrhose bei etwa 70%, wahrend nur 40% der operierten bzw. konservativ behandelten Patienten mit progredienter Cirrhose 6 Jahre uberleben.

A new operative technic for widening the stenotic left ventricular outflow ("left ventricular tunnel") is described and a clinical case is reported. A vertical incision along the anterior aspect of the aorta descends with a slight angle across the outflow tract of the right ventricle. After aortic valvectomy the ventricular septum is cut between the left and right coronary commissure through its full thickness and the incision extended inferiorly across the stenotic area. A dacron patch is sewn into the gap of the septum and aortotomy in order to widen the area of previous stenosis and prosthetic replacement of the aortic valve is performed. Finally another dacron patch is used to close the defect in the right ventricular outflow tract.

Results of aortoventriculoplasty (AVP) are reported in 21 patients with various types of left ventricular outflow tract obstruction (LVOTO). The concept of AVP is based on creating a surgical aortoseptal defect which is patched to provide the largest possible outflow tract to the left ventricle. Lesions consisted of isolated diffuse fibromuscular subaortic stenosis in six patients, diffuse subaortic stenosis and associated other cardiovascular anomalies in five, hypoplastic aortic anulus in two, idiopathic hypertrophic subaortic stenosis (IHSS) in two, and stenosis of a previously implanted aortic valvular prosthesis in three patients. Ten patients had had at least one unsuccessful previous surgical attempt to relieve the LVOTO. The coexisting mitral incompetence in IHSS disappeared after AVP alone. Immediate postoperative hemodynamic results were excellent in all cases. Postoperative death in five patients was due to advance myocardial failure in two, brain damage in one, transection of a dominant septal artery in one, and severe acidosis with renal failure in the last case. However, in the last 16 patients (17 operations) the only death (5.8 percent) was that caused by uncontrollable acidosis. Follow-up results indicate that 16 patients are clinically doing well, and hemodynamic studies in 14 patients are rated as excellent or good from 1 to 25 months postoperatively. It is concluded that AVP is an effective operation for managing all types of LVOTO and can be used routinely with an acceptably low mortality rate.

Corrected transposition of the great arteries is often associated with other cardiac anomalies. We report our experience with the correction of the associated cardiac defects in 13 cases: ventricular septal defect with pulmonary hypertension (5 cases), ventricular septal defect with obstruction of pulmonary outflow tract (5 cases), obstruction of pulmonary outflow tract (2 cases), ostium primum defect (1 case). The possible surgical approaches for repair of the cardiac anomalies are described and the results of the operative correction are communicated. Precise diagnosis, the knowledge of the unusual disposition of the conducting tissues and new surgical approaches are prerequisite for successful correction.

Nineteen patients with tricuspid atresia and reduced lung perfusion (valvular-and/or subvalvular pulmonary stenosis, transposition of the great arteries and/or single atrium) were operated in the period 1975--1979. The surgical procedures employed varied according to the additional cardiac defects. The age of the patients was between 2 and 18 years. Eleven children received a contuit with a Hancock valve, 8 children a valveless conduit. In 9 patients it was possible to connect the conduit to the right ventricle using the pumping action of the right ventricle with an anatomically intact pulmonary valve. Six patients died (4 early deaths, 2 late deaths, early mortality rate 21%). In this study, the postoperative courses, which were complicated in several cases, are related to the hemodynamical findings. Thirteen children were examined between 1 and 38 months following the operation. Cardiac catheterization was performed in 10 patients. Of the 13, 10 had fully saturated arterial blood. A remnant atrial defect was demonstrated in one child, and 2 displayed intrapulmonary shunts attendant to Glenn anastomoses which had been in place for 10 to 12 years. Among the patients the right atrial pressure ranged from 10 to 20 mmHg with a mean value of 14.5 +/- 0.9 mmHg. An increase in size of the right ventricle was demonstrated angiographically in the case of 2 patients who had valve-bearing conduits to the right ventricle.

A new indication for the External Conterpulsation (ECP) is demonstrated. Due to the venous augmentation a "pulse wave" is created in the V. cava inferior and in the right atrium and the ECP acts as a "peripheral pumpventricle", thus increasing pulmonary blood flow and left ventricular enddiastolic pressure. This new application of ECP is of valve in cases with low output syndrome after physiological repair of tricuspid atresia as demonstreated in a case report.

Die Haufigkeit zerebraler Storungen nach Operationen am offenen Herzen war in Gottingen von 1969–1971 mit 3,6 % eher geringer als in anderen Zentren. Einerseits war es moglich, hinsichtlich der Ursachen der zerebralen Storungen eine Klarung herbeizufuhren, auf der anderen Seite blieb bei einem Teil des Krankengutes die Atiologie im Dunkeln. Nach orthograder Kanulierung im Jahre 1970/71 fiel vergleichsweise eine hohere Komplikationsrate von 7,6 % bei den zerebralen Storungen auf, was auf die Anwendung unterschiedlicher Kanulierungstechniken und verschiedener Aortenkanulen zuruckgefuhrt wird. The frequency of cerebral disturbances after open heart surgery was 3.6 % in Gottingen between 1969 and 1971. This is somewhat less than in other centres. In some cases it was possible to discover the causes of the cerebral disturbances wheras in others the aetiology was unknown. In comparison, a higher complication rate of 7.6% in the cerebral disturbances was observed in 1970/1971. This was thought to be due to different cannulation techniques and varying aortic cannulas.

Die Spatresultate nach alloplastischem Klappenersatz mit der Starr-Edwards-Prothese werden zum einen beeinflust durch Komplikationen, die mit der Prothese selbst zusammenhangen: namlich physikalischen Veranderungen der Kugel und thrombembolischen, durch den Fremdkorper hervorgerufene Komplikationen und zum anderen durch Komplikationen, die in dem Zustand des Herzens begrundet liegen, d. h. also auf Veranderungen des Myokards und der Koronargefase zuruckgehen. The late results of alloplastic valve replacements with the Starr-Edwards prosthesis are influenced partly by complications connected with the prosthesis itself, namely physical changes of the sphere and trombo-embolic complications due to the foreign body and partly by complications due to the condition of the heart, i. e. changes in the myocardium and coronary vessels. Les resultats tardifs du remplacement d'une valvule alloplastique d'une prothese de Starr-Edwards sont influences par des complications provenant de la prothese elle-meme: en particulier les modifications physiques de la sphere, les complications de thrombo-embolies resultant de la presence du corps etranger et en outre par d'autres complications qui proviennent de l'etat du coeur, c. a d., par des modifications du myocarde et des coronaires.

Nach einer kurzen Beschreibung des von Jensen, Schmidt u. Garamella angegebenen Verfahrens zur Korrektur der Trichterbrust wird uber die Operationsspatergebnisse bei 26 nach dieser Methode operierten Patienten, von denen 14 nachuntersucht werden konnten, berichtet. Die besten funktionellen und kosmetischen Resultate fanden sich nicht, wie bisher im Schrifttum mitgeteilt, bei Kindern und Jugendlichen, sondern bei Erwachsenen jenseits des Wachstumsalters.