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Biomedical subjects

J Rees

Publications and source records attributed to J Rees.

154 records · Page 9Linked to original sources
PubMedDate not supplied

Effects of cyclosporine and antibody adsorption on pig cardiac xenograft survival in the baboon.

The problem of donor heart supply would be solved if hearts could be transplanted from readily available animals such as the pig or sheep. We have investigated heterotopic heart transplantation (in the neck) with the pig as donor and baboon as recipient. Five experimental groups were studied. Control hearts (group 1, n = 4) were rejected within 4 minutes to 8 hours. Splenectomy done before transplantation (group 2, n = 3) did not extend survival significantly (30 minutes to 8 hours). Donor heart survival in baboons receiving immunosuppressive therapy of cyclosporine and methylprednisolone (group 3, n = 5) was from 15 to 75 minutes only in four animals and for 5 days in one animal. Anti-pig antibody adsorption from baboon blood by pretransplant donor-specific kidney hemoperfusion (group 4, n = 7) resulted in cardiac function for 6 to 12 hours in three cases and from 4 to 5 days in four cases (p less than 0.02). A combination of pretransplant antibody adsorption and immunosuppression (group 5, n = 4) resulted in graft survival of 8 to 20 hours in three cases and of 4 days in one case (p less than 0.03). Histopathologic features of vascular (hyperacute) rejection were seen in all hearts except one (the 5-day survivor in group 3). Pretransplant adsorption of antibody clearly prolonged survival of discordant cardiac xenografts in some cases. Further exploration of this technique appears justified.

Adsorption↗
PubMedDate not supplied

Hyperacute rejection in a discordant (pig to baboon) cardiac xenograft model.

Eight freshly excised pig hearts were hemoperfused by baboons in vivo. Cardiac function ceased in six hearts after a mean period of 90 minutes of perfusion (range 30 to 190 minutes). Two hearts continued functioning for the 4-hour study period. On microscopic examination, seven hearts, including one that continued beating, showed histopathologic features of hyperacute rejection. IgG, IgM, and C3 were strongly present on the myocardium in all cases. Hemoperfusion was associated with significant increases in heart mass (p less than 0.002) and circulating polymorphonuclear leukocytes (p less than 0.03) and reductions in coronary blood flow (p less than 0.0001), circulating lymphocytes (p less than 0.03), and C4 (p less than 0.03). Preformed circulating anti-pig antibodies disappeared in all but one baboon. Hyperacute rejection in this discordant xenograft model that used a nonhuman primate as "recipient" differs in few aspects from that seen in other experimental models. Possible methods of prolonging xenograft survival are discussed.

Animals↗
PubMedDate not supplied

Screening for hyperlipidaemia in childhood. Recommendations of the British Hyperlipidaemia Association.

Children with familial hypercholesterolaemia are at high risk of developing coronary artery disease in early adulthood. The diagnosis should therefore be made in childhood. Population screening identifies a small number of children with major genetically determined disorders of lipid metabolism and a large number with polygenic hypercholesterolaemia of uncertain prognostic significance. Selective screening based on a family history of familial hypercholesterolaemia or premature coronary artery disease is an appropriate strategy for identifying most children with familial hypercholesterolaemia. A non-fasting total cholesterol measurement is a suitable screening test: if the concentration exceeds 5.5 mmol/l, a fasting measurement of total cholesterol, high-density lipoprotein cholesterol and triglyceride is required. The diagnosis in a child under 16 years should be based on finding a total cholesterol concentration greater than 6.7 mmol/l and a low-density lipoprotein cholesterol concentration above 4.0 mmol/l on at least two measurements taken more than one month apart. Children should not usually be screened before the age of two years, but the aim should be to diagnose heterozygous familial hypercholesterolaemia before the age of 10 years. Affected children should be referred for specialist care.

Adolescent↗
PubMedDate not supplied

Domiciliary oxygen.

Major studies have shown that LTOT improves survival in patients with COPD, although the precise mechanism remains unclear. There are established guidelines for prescription, but these are often disregarded. This is perhaps partly because oxygen concentrators and cylinders are prescribed by general practitioners unable to carry out a full assessment of patients' suitability for oxygen therapy. Patients who are thought to be suitable for oxygen therapy should be referred to a respiratory physician with the facilities to carry out a full evaluation of their needs. It is important not to neglect other aspects of treatment when assessing a patient for domiciliary oxygen. Bronchodilator therapy should be maximised with or without inhaled steroids, and patients will often also benefit from a moderate amount of regular exercise as part of the overall pulmonary rehabilitation programme.

Home Care Services↗
PubMedDate not supplied

Skin cancer.

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Humans↗