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Biomedical subjects

J D Milam

Publications and source records attributed to J D Milam.

At least 37 records · Page 2Linked to original sources
PubMed1982

Autologous transfusion and the preservation of frozen red blood cells.

Freezing red blood cells for indefinite lengths of time for subsequent transfusion has become an accepted blood banking procedure. Its advantages over 35-day preserved citrated blood are reviewed and the technical aspects of freezing outlined. As the number of known hazards of homologous transfusion increases, the advantages of autologous transfusion are increasingly being recognized. The combination of frozen preservation and autologous transfusion is the ideal method of blood replacement. Plastic surgeons can frequently anticipate their blood needs in view of the large number of elective procedures, and should utilize this method of blood replacement.

Blood Preservation↗
PubMed1982

Calcification in chronically-implanted blood pumps: experimental results and review of the literature.

Blood compatibility is a major objective in the development of long-term, implantable circulatory assist (left ventricular assist devices) and replacement (total artificial heart) devices. An important problem in experimental studies in animals has been the propensity for calcification to occur at the blood/material interface. Presented is a summary of our experience (27 studies) with blood pump calcification and a review of the current literature regarding this complication.

Journal Article↗
PubMed1981

Plasma exchange in selected patients with juvenile rheumatoid arthritis.

Plasma exchange with either fresh-frozen plasma or 5% albumin solution as replacement fluid was performed in four selected patients with juvenile rheumatoid arthritis unresponsive to standard therapy. One 13-year-old boy with life-threatening systemic disease experienced a partial remission of disease and tolerated a decrease in prednisone dose from 15 to 4 mg daily following 14 exchanges with FFP. A 14-year-old girl, dwarfed by systemic disease and long-term corticosteroid therapy, was able to discontinue prednisone and grew 6.3 cm in 11 months following 18 plasma exchanges with FFP. An 8-year-old girl with pauciarticular disease, antinuclear antibody, and uncontrollable iridocyclitis underwent 16 plasma exchanges with 5% albumin solution as replacement; despite removal of antinuclear antibody, her eye disease and arthritis were not helped. A 16-year-old girl with erosive, polyarticular JRA showed no detectable change in her articular disease following nine exchanges. Transient decreases in hematocrit, complement components, and immunoglobulin concentrations occurred. In three patients Westergren sedimentation rate decreased for up to five months after exchanges. One patient died suddenly during an exchange with FFP; the cause of death appeared related to microemboli of unknown nature found in the lungs at autopsy. Plasma exchange should be done only in an intensive care setting and as a research procedure for children with JRA.

Adolescent↗
PubMed1981

Alteration of coagulation and selected clinical chemistry parameters in patients undergoing open heart surgery without transfusions.

Alteration of coagulation status and certain clinical chemistry laboratory determinations of 75 adult patients undergoing cardiopulmonary bypass procedures for acquired heart disease was studied during and after surgery. None of the patients was given transfusions of blood or blood components. With hemodilution, the mean hematocrit value dropped from 38% to 28% during the procedure. Fibrin degradation products and euglobulin lysis time were transiently abnormal. Factor V diminished somewhat during the procedure, whereas factors VIII and IX increased after surgery. Clottable fibrinogen values decreased slightly, but increased to an abnormally high value at 24 and 48 hours. Mean value of platelet counts decreased from 194,000 to 144,000/microliter immediately after surgery. Knowledge of expected deviation of coagulation factors and certain clinical chemistry tests following open heart surgery is helpful in evaluating the status of the postoperative patient.

Blood Coagulation↗
PubMed1979

ULTRASTRUCTURAL ANALYSES OF STONE HEART SYNDROME AT ONSET AND SIX DAYS LATER FOLLOWING TOTAL SUPPORT OF THE CIRCULATION WITH A PARTIAL ARTIFICIAL HEART OR LEFT VENTRICULAR ASSIST DEVICE (ALVAD).

Ischemic myocardial contracture developed in a 21-year-old man following aortic and mitral valve replacement. The patient's circulation was supported totally for 6 days with an abdominal left ventricular assist device (ALVAD). Cardiac allografting was then undertaken. Samples of myocardium taken at the original operation and 6 days later at transplantation were analyzed ultrastructurally. At the onset of ischemic cortracture, left ventricular abnormalities included hypercontraction of myofibrils, loss of normal A-band and Z-band patterns, mitochondrial swelling with fusion of cristae, interfibrillar edema and glycogen depletion. Capillaries demonstrated swelling of endothelial cells and basement membrane disruption. Six days later, ultrastructural morphology showed further degeneration. The myofibrils remained hypercontracted, but were more fragmented. Degenerative changes in mitochondria were more advanced and calcium deposition in cristae was present. No glycogen was seen. The right ventricular myocardium exhibited significantly fewer ultrastructural abnormalities. The principal right ventricular changes were endothelial swelling and basement membrane disruption. Glycogen granules were present. Ischemic contracture affects the left ventricle more than the right, and the morphology becomes more abnormal with time. To our knowledge, this is the first instance wherein morphologic progressions of the ultrastructural alterations of ischemic contracture have been documented.

Journal Article↗