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Biomedical subjects

D A Lane

Publications and source records attributed to D A Lane.

At least 217 records · Page 12Linked to original sources

A comparison of the sulphite and thrombin methods for measuring fibrinogen concentration of plasma from patients undergoing thrombolytic therapy.

A thrombin method for the determination of fibrinogen concentration has been compared with a non-enzymatic sulphite precipitation method on plasma from patients undergoing thrombolytic therapy with an intermittent plasminogen/streptokinase regime. There was very good agreement between the methods even when the determinations were made in the presence of high levels of fibrinogen degradation products (FDP), provided that the thrombin clottable fibrinogen was greater than 1 mg/ml. However, after extensive fibrinogen depletion, when the thrombin method underestimates fibrinogen concentration due to significant clot inhibition by FDP, an overestimate due to co-precipitation of fragments X and Y will be obtained by the sulphite method. This suggests that the simultaneous application of both techniques may provide a simple method of assessing the presence of high levels of anticoagulant FDP in various clinical disorders.

Evaluation Studies as Topic↗

Effect of low-dose subcutaneous heparin on whole-blood viscosity.

The change in blood-viscosity at low shear-rates (0.77 s-1 and 2-62 s-1 was measured in eighteen normal subjects and postoperatively in sixteen patients after administration of 5000 I.U. of subcutaneous heparin. In both groups there was a significant decrease in the mean blood-viscosity 4 to 6 hours after the injection of heparin. This fall in blood-viscosity may be involved in the prophylactic effect of low-dose subcutaneous heparin in preventing venous thrombosis.

Blood Viscosity↗

Soluble high-molecular-weight E fragments in the plasmin-induced degradation products of cross-linked human fibrin.

1. The factor XIII-mediated cross-linked alpha chains in fibrin have no effect on the nature of the fragments released during the solubilization of fibrin by plasmin. 2. Besides the known D dimer and E fragments solubilized during the lysis of cross-linked fibrin, other fragments have been observed on sodium dodecyl sulphate-polyacrylamide gel electrophoresis which have a molecular weight of about 135 000. After prolonged plasmin digestion, these fragments (U fragments) were no longer evident on the gels and the high-molecular-weight E antigen was absent. It is assumed that the E antigen was associated with the U fragments. These fragments also cross-reacted with an anti-D serum. 3. The U fragments have been tentatively presumed to be a factor XIII-mediated cross-linked D-E complex since they degrade only after prolonged degradation with plasmin. Whereas it is known that the fibrin D dimer fragment contains the cross-linked gamma chain residues of the originating fibrin, the presumed covalent cross-linking of the D-E fragments has not been proved. 4. The presence of these high-molecular-weight fragments, containing the E antigen, in cross-linked human fibrin digests should be taken into account in the development of D dimer assays to monitor fibrin lysis in vivo.

Animals↗

The variation of indicator dilution curves with velocity profile.

A theoretical analysis has been made of the effect of different velocity profiles on the dispersion of a non-diffusable solute in fluid flow down a straight tube. An experimental investigation of this type of dispersion was made by monitoring the transport of radioactively labelled red blood cells in whole blood at flow rates within the non-Newtonian viscosity range. The dispersion curves obtained are consistent with a progressive flattening of the velocity profile as the flow rate is reduced, though a more rapid clearance than that predicted theoretically occurs in the tail region of the curves. The accepted indicator dilution techniques of estimating the flow rate and vessel volumes are considerably in error. An alternative method of accurately estimating the vessel volume is suggested.

Blood Circulation↗

The dispersion of solutes during blood flow through a straight tube.

1. The dispersion of solutes in plasma and blood has been studied by observing the clearance at a point down-stream of a bolus of labelled solution by the steady flow of unlabelled solution.2. With a low molecular weight solute the clearance curve is qualitatively similar in 2N-KCl solution, plasma and whole blood.3. The dispersion of a high molecular weight protein, [(131)I]HSA, in plasma is dominated by the velocity profile of the flow.4. The clearance curves for HSA in whole blood are similar to those of plasma, except that the red blood cells speed the clearance of protein in the tail region of the curve.5. An analysis of the data suggests that the dispersion of solutes during blood flow through a straight tube can be attributed to the combined effects of solute diffusion and laminar convection. There is no evidence that induced motion of the erythrocytes produces significant mixing, in the bulk of the flow.

Animals↗

Early postpartum discharges. Impact on distress and outpatient problems.

OBJECTIVE: To determine the impact of shortened postpartum hospital stays on common clinical phenomena in a sociodemographically diverse, unselected group of general maternity patients. DESIGN: Observational cohort study in which the preapproved hospital stay duration of either 1 or 2 nights was set by third-party payers before each mother's admission. SETTING: Yale-New Haven Hospital, New Haven, Conn, from June 19 through August 10, 1995. PATIENTS: Two hundred forty-four volunteers from among 400 eligible deliveries. MAIN OUTCOME MEASURES: Readmission within 1 month of hospital discharge, report of outpatient morbidity and use of outpatient health services within 1 week of discharge, status of breast-feeding during the first post-discharge week, and patient satisfaction. RESULTS: At discharge from the hospital, the hospital stay was regarded as "too short" by 80 (47%) of 171 mothers and 19 (26%) of 73 mothers in the 1- and 2-night groups, respectively (P = .002). Although readmission rates were similar (5% vs 3%, P = .48), the 1-night group reported significantly more morbidity in the newborns (31% vs 16%, P = .03) and averaged more pediatric visits (96 vs 54 per 100 newborns, P = .002). Mothers in the 1-night group also reported more fatigue (49% vs 29%, P = .001) and more worries about their newborns' health (24% vs 11%, P = .02). They were less likely to start breast-feeding (64% vs 77%, P = .06), and, if they started, were somewhat more likely to stop prematurely (14% vs 8%, P = .43). A series of disturbing events was reported only in the 1-night group. CONCLUSIONS: In a relatively unselected group, mothers who stayed 1 night after routine vaginal delivery reported more distress and more pediatric problems and had greater use of outpatient health services than mothers who stayed 2 nights.

Adolescent↗