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J Thorac Cardiovasc Surg 1995;110:284
© 1995 Mosby, Inc.

LETTERS TO THE EDITOR

Further comments concerning: Biochemical and cellular characterization of cardiac valve tissue after cryopreservation or antibiotic preservation (J THORAC CARDIOVASC SURG 1994;108:63-7)

Senior Research Fellow
The University of Auckland
Auckland, New Zealand

To the Editor:

Because of my own recent work on valve viability, it has been of particular interest to me to be involved in commenting on the paper by Lang and colleagues. I am indeed very pleased to see this type of study being undertaken and published.

In our companion letter we raised two issues that seem particularly controversial. There are, however, several aspects of Dr. Lang's article that I find questionable or inadequate. I suspect that it could have been substantially improved by rather more rigorous reviewing, and I venture to mention some examples of my points because of my concern that your Journal should be publishing potentially important investigations in less than optimal form.

First, with respect to the analytical parameters used, there is too little methodologic detail, which is not supplied by the references quoted. At least some of the omitted details may have had a bearing on the major findings. For example, could there have been a differential sensitivity of cell types to the enzymes used for tissue digestion, which resulted in the survival of only endothelial cells? (Enzyme concentrations, vehicle, and temperature and duration of digestion should have been quoted.)

Second, the reasons for the use of certain procedures are not made clear. For example, why were both frozen and paraffin sections used for histologic study if only hematoxylin and eosin staining was carried out? If immunohistochemistry for cell-type recognition in the intact tissue and/or histochemistry for specific components had been performed, the use of both would be understandable. Furthermore, the reference given for structural examination (which is from my own group) used only paraffin sections but a whole battery of special stains, not just hematoxylin and eosin.

Third, the significance of some of the observations is not brought out adequately. For example, the persistence of the marker enzyme activities despite the loss of viability implies that only cell fragments are necessary for this "metabolic activity" (not at all surprising for membrane-associated enzymes). It should therefore be stressed that "metabolic status" determined in this way is not necessarily associated with the presence of intact, viable cells and should never be the sole method used to assess the status of valves.

Fourth, the whole approach to cell-type recognition seems questionable when (a) fibroblasts are not even considered as a normal constituent of the tissues examined (summary paragraph, point (1), pp 66-67), (b) the reference quoted as the basis of the immunochemical methods used is a book on the endothelial cell only, and (c) the nature of the cells in the intact tissue was not determined, as touched on earlier.

References

1. Lang SJ, Giordano MS, Cardon-Cardo C, Summers BD, Staiano-Coico L, Hajar DP. Biochemical and cellular characterization of cardiac valve tissue after cryopreservation or antibiotic preservation. J THORAC CARDIOVASC SURG 1994;108:63-7.[Abstract/Free Full Text]
   

This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Armiger, L. C. Search for Related Content PubMed PubMed Citation Articles by Armiger, L. C.