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A Ting

Publications and source records attributed to A Ting.

At least 37 records · Page 2Linked to original sources
PubMed2000

Thoracoabdominal compression and respiratory system compliance in HIV-infected infants.

The thoracoabdominal compression technique (TAC) is used to measure expiratory flow in infants. We investigated whether TAC caused a change in total thoracic compliance (Crs), resistance (Rrs), and respiratory system time constant (Trs). We studied 41 infants (mean age, 12.4 mo; SD, 7.5) from five centers studying longitudinal lung and cardiovascular function of infants from HIV-infected mothers. We measured Crs, Rrs, and Trs before and after TAC. Changes in Crs, Rrs, and Trs after TAC were not dependent on the length of time since TAC. Crs and Trs were reduced after TAC, p = 0.013 and p = 0.003, respectively, whereas Rrs did not change. When compared with uninfected infants, HIV-infected infants had a larger post-pre TAC percent decline in Crs (p = 0.003) and a post-pre TAC rise in mean Rrs (p = 0.03). These differences remained significant after adjusting for sex and age. When performing infant pulmonary function testing, TAC itself produces a temporary decrease in Crs and Trs that is more significant in infants at risk for abnormal lung volume or compliance. Therefore, the sequence of performing the infant lung function parameters should be the same each time the testing is repeated with TAC as the last parameter tested at each testing session.

Abdomen↗
PubMed2000

Reply

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Journal Article↗
PubMed1999

Is laparoscopic approach to lumbar spine fusion worthwhile?

BACKGROUND: Laparoscopic lumbar spine fusion has been recently described. The aim of this study is to evaluate the safety and efficacy of this procedure for single- and multiple-level degenerative disc disease. METHODS: Twenty-four consecutive laparoscopic interbody lumbar fusions were evaluated prospectively (18 single-level were compared with 6 multiple-level procedures). Results of the laparoscopic multiple-level procedures were further compared with 12 open multiple-level operations. RESULTS: Twenty procedures were completed laparoscopically. The conversions were related to iliac vein lacerations (3 cases) and a mesenteric tear. Single-level cases had lower morbidity (22% versus 83%), shorter hospital stay (2 versus 10 days), and higher fusion rate (88% versus 50%) than multiple-level procedures. Overall results in the latter group were worse than in the matched open group. CONCLUSIONS: Laparoscopic single-level fusion (L5-S1) is safe and carries the benefits of minimal access surgery. Morbidity after multiple level approach is high, and this procedure cannot be advocated at this time.

Adult↗
PubMed1999

High efficiency guiding of terawatt subpicosecond laser pulses in a capillary discharge plasma channel.

Transmission efficiencies in excess of 75% were obtained in the optical guiding of subpicosecond, terawatt laser pulses in a 2-cm-long capillary discharge plasma channel at the Naval Research Laboratory. The guided laser beam size at the exit of the channel was measured using far field imaging and Thomson scattering techniques. The guided laser intensity was >1 x 10(17) W/cm(2) at a guided beam diameter of 35 microm for a propagation length of 22 Rayleigh ranges. There is evidence that the plasma channel extends beyond the ends of the capillary and affects the far field beam structure of the transmitted laser pulse.

Journal Article↗
PubMed1999

Analysis of Gaussian beam and Bessel beam driven laser accelerators.

This paper presents a comparison of Gaussian and Bessel beam driven laser accelerators. The emphasis is on the vacuum beat wave accelerator (VBWA), employing two laser beams of differing wavelengths to impart a net acceleration to particles. Generation of Bessel beams by means of circular slits, holographic optical elements, and axicons is outlined and the image space fields are determined by making use of Huygens' principle. Bessel beams-like Gaussian beams-experience a Guoy phase shift in the vicinity of a focal region, resulting in a phase velocity that exceeds c, the speed of light in vacuo. In the VBWA, by appropriate choice of parameters, the Guoy phases of the laser beams cancel out and the beat wave phase velocity equals c. The particle energy gain and beam quality are determined by making use of an analytical model as well as simulations. The analytical model--including the v x B interaction--predicts that for equal laser powers Gaussian and Bessel beams lead to identical energy gains. However, three-dimensional, finite-emittance simulations, allowing for detuning, transverse displacements, and including all the electromagnetic field components, show that the energy gain of a Gaussian beam driven VBWA exceeds that of a Bessel beam driven VBWA by a factor of 2-3. The particle beam emerging from the interaction is azimuthally symmetric and collimated, with a relatively small angular divergence. A table summarizing the ratios of final energies, acceleration lengths, and gradients for a number of acceleration mechanisms is given.

Journal Article↗
PubMed1998

Alveolar vascularization of the lung in a lamb model of congenital diaphragmatic hernia.

Pulmonary hypoplasia and pulmonary hypertension are factors limiting the survival of infants with congenital diaphragmatic hernia (CDH). A reduction in the number of pre-acinar pulmonary vessels and increased muscularization are the structural lesions implicated as causes of irreversible hypoxemia. Whether there is a reduction in the number of air-blood barriers, which represent the capillary surface area of the lung involved in gas exchange, is unknown. We sought to determine if the lungs of CDH lambs have: (1) a reduction in total capillary surface area proportionate to the reduction in the total alveolar surface area of the lung; and/or (2) a disproportionate reduction in the number of capillaries (air blood barriers) within each acinus. The latter measurement was determined by calculating the capillary load which we defined as the number of air blood barriers/unit of surface density. At 80 d gestation (pseudoglandular period), a diaphragmatic hernia was created surgically in one lamb fetus of a twin gestation. At term, the fetuses were removed, the chests opened and the lungs fixed by a tracheal infusion of 1.5% glutaraldehyde at 25 cm of water pressure. Tissues from the lower lobes were examined by light and electron microscopy. Using computerized interactive morphometry, alveolar and capillary surface area, and capillary load were determined by intersection and point counting for the right and left lungs. The data show that the total alveolar surface area of the left CDH and control lungs were 1.8 +/- 0.8 m2 and 6.1 +/- 1.1 m2 (p < 0.01), respectively, and for the right CDH and control lungs 2.5 m2 +/- 0.1 and 11.2 +/- 1.9 m2 (p < 0.01), respectively. The total capillary surface area for the left CDH and control lungs were 0.7 +/- 0.3 m2 and 2.8 +/- 1.2 m2 (p < 0.05), respectively, and for the right CDH and control lungs 0.9 +/- 0.3 m2 and 3.8 +/- 1.5 m2 (p < 0.05), respectively. The capillary load was not statistically different. These findings demonstrate that the lungs in CDH are deficiently vascularized at the alveolar surface due to a reduction in the total alveolar surface area. Each acinus contains the same number of air blood barriers per unit of alveolar surface area indicating a normal acinar composition.

Animals↗
PubMed1996

Risk factors for the development of obliterative bronchiolitis after lung transplantation.

BACKGROUND: Acute rejection has emerged as an important risk factor for obliterative bronchiolitis after lung transplantation. We performed a multivariate analysis to assess the impact of additional variables. METHODS: Seventy-four recipients (48 heart-lung, 18 single-lung, and 8 bilateral-lung recipients) who survived longer than 90 days and underwent transplantation more than 15 months before data analysis were included in this study. Several variables were entered into a Cox regression analysis to determine their association with the development of bronchiolitis obliterans syndrome. RESULTS: Bronchiolitis obliterans syndrome developed in 48 (65%) of 74 patients. Significant correlations were detected for acute rejection score, defined as the sum of pathologic grades of each separate acute rejection episode (p = 0.0004, likelihood ratio test value = 12.4) and for lymphocytic bronchiolitis (p = 0.03). In a bivariate model, episodes of organizing pneumonia and bacterial or fungal pneumonia significantly increased the likelihood ratio test value of the acute rejection score. The addition of the cytomegalovirus infection score, reflecting the frequency and severity of infection, to the combination of the acute rejection score and episodes of bacterial or fungal pneumonia resulted in a further significant increase in the likelihood ratio test value. Significant risk factors for moderate to severe stages of airflow limitation were at least one episode of acute rejection of grade > or = 2, younger recipient age, and any acute rejection episode 180 days or longer after transplantation. CONCLUSIONS: Increasing frequency and severity of acute rejection episodes are strongly associated with the development of bronchiolitis obliterans syndrome. Lymphocytic bronchiolitis appeared to be significant by univariate analysis, but in a two-risk factor model, it did not augment the influence of acute rejection. Organizing pneumonia, bacterial or fungal pneumonia, and increasing severity and frequency of cytomegalovirus infections potentiate the effect of acute rejection. Late episodes of acute rejection and younger recipient age increase the risk for development of advanced disease.

Adolescent↗
PubMed1995

Effect of zidovudine on human fetal lung development.

Zidovudine (AZT) is currently used to treat human immunodeficiency virus (HIV)-positive women during pregnancy to prevent the prenatal transmission of HIV type 1 (HIV-1). However, AZT not only inhibits HIV replication but also affects the DNA polymerases of human cells; hence AZT is not recommended during the first trimester of pregnancy. The lung is a unique organ because it continues to grow and develop throughout fetal life. Using a human fetal lung organ culture system, we sought to determine the effect of AZT on morphogenesis and epithelial cytodifferentiation of developing alveoli. Lung tissues from three fetuses, 14-15 weeks gestational age, were grown in culture for 24 hours (day 0). AZT at a concentration of either 0.4, 4.0, 8.0, or 40.0 mumol/L was added on days 1, 5, and 10 of growth. The cultures were interrupted on days 6 and 15 and examined by light and electron microscopy for alveolar saccular development, interstitial thinning, and epithelial cell differentiation. On day 6 of growth the treated cultures demonstrated fewer alveolar saccules and a thicker, more cellular interstitium compared to the controls. After 15 days of growth the cultures treated with 0.4 mumol/L of AZT appeared structurally similar to the controls. The cultures treated with AZT concentrations of 4.0 to 40.0 mumol/L appeared unchanged from day 6, implying arrested maturation of the culture. However, epithelial cell differentiation was unaffected. We conclude that AZT at concentrations of 4.0 mumol/L and greater affects the structural development of the human fetal lung in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Cell Differentiation↗
PubMed1993

Clinical and socioeconomic benefits of serological HLA-DR matching for renal transplantation over three eras of immunosuppression regimens at a single unit.

The efficacy of HLA-DR matching in cadaveric renal transplantation is controversial in the cyclosporine (CsA) era. Reports have questioned both the reliability of serological HLA-DR typing as well as the benefit of matching in terms of improved graft survival. Analysis of 1,000 consecutive cadaver donor transplants performed at Oxford between 1975 and 1992 has shown that with improved immunosuppressive regimens and increased transplant success there has been a steadily diminishing influence of HLA-DR matching measured in terms of first graft outcome. For patients treated with azathioprine and prednisolone (n = 278) overall one-year first graft survival was 65%, but there was a 20% improvement associated with HLA-DR matching which has been maintained for up to 15 years. With the introduction of CsA, used either alone or in conjunction with low dose steroids (n = 96), one-year first graft survival was 69% and the difference between HLA-DR-matched and -mismatched transplants was 14%. Our current maintenance immunosuppressive protocol is triple therapy (N = 425) with an 81% one-year first graft survival for both matched and mismatched transplants. However, we do continue to find a marked correlation between HLA-DR matching and clinical course. HLA-DR-mismatched patients suffer more rejection episodes, spend a longer time in the hospital, and have higher creatinine levels at 3 months. This costs, on average, an extra 1,500 pounds for each mismatched transplant. The effect is most apparent in unsensitized males. For cadaveric regrafts, one-year graft survival for patients on triple therapy is 80% (n = 116) which does not differ from first graft survival rates.(ABSTRACT TRUNCATED AT 250 WORDS)

Graft Rejection↗
PubMed1991

Production and characterization of human monoclonal lymphocytotoxic autoantibodies from a renal dialysis patient.

We have produced human monoclonal lymphocytotoxic autoantibodies from a renal dialysis patient by the generation of a mouse/human heterohybridoma. The antibodies are of the IgM class and react with the patient's autologous cells, the B-lymphoblastoid cell line producing the antibody, normal T and B lymphocytes, B cells from chronic lymphatic leukemia patients (CLL cells), and the autoantibody-sensitive cell line K562. Screening of the monoclonal antibodies (mAb) against panels of normal T and B cells and CLL cells demonstrated that different reactivity profiles could be generated at different dilutions of the mAb. These profiles were identical to those seen with autoantibodies from different renal patients and this suggests that these profiles do not imply different antibody specificities but differing target cell sensitivity. Reactivity profiles seen in the fluorescence binding assays suggest that the target cell sensitivity is dictated not by antigen density alone but also by antibody/antigen affinity. The results from studies of enzyme treatment of target cells and lectin inhibition of the molecular specificity suggest that the autoantibodies are polyreactive, capable of binding sialic acid-dependent epitopes and other negatively-charged cell surface molecules.

Animals↗