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Biomedical subjects

M King

Publications and source records attributed to M King.

At least 343 records · Page 19Linked to original sources

Physicochemical characterization of a hydrophilic microporous polyurethane vascular graft.

There is still a need for a viable small-diameter synthetic vascular graft. The expanded PTFE device appears to be the best presently available, but is still inferior to the autologous saphenous vein. Recently, a novel microporous, small-diameter vascular graft fabricated from Mitrathane, a polyether urethane urea (PEUU), has been developed. In this article, we report the findings of an in vitro evaluation of the morphological, mechanical, and chemical properties of this new device. The results are compared with those of established vascular prostheses made from alternative materials including expanded PTFE and bovine heterograft, and with natural blood vessels. The PEUU graft displays good mechanical properties in spite of the presence of some structural defects or anomalies. In particular it compares favorably to the expanded PTFE device by providing both superior radial compliance and improved suture tearing strength.

Animals↗

Cardiac T1 calculations from MR spin-echo images.

Normally, cardiac triggering in MR spin-echo imaging restricts repetition times (TR) to integral values of the cardiac period (TC), and introduces irregularities in TR due to variations in TC. We have investigated how much these restrictions decrease the accuracy and precision of spin-lattice relaxation (T1) values of the myocardium calculated from two cardiac-triggered spin-echo images. By introducing additional excitation pulses, TR can effectively be reduced to a fractional value of TC and considerable improvement in T1 precision is possible. For TC = 800 ms, the improvement in T1 precision is 30% when two spin-echo images of TR = 1/2 X TC and TR = 2 X TC are used to calculate T1 instead of two images with TR = TC and TR = 2 X TC. The irregularities in TR decrease both T1 precision and accuracy. Irregularities of the order of 15% in a mean TR of 800 ms produce a fourfold decrease in precision. Since irregularities in TC easily exceed 15%, MRI data should be acquired when individual TR values are approximately within +/- 15% of the subject's mean TC.

Animals↗

In vitro and in vivo characterization of an impervious polyester arterial prosthesis: the Gelseal Triaxial graft.

Over the years, textile polyester arterial prostheses have acquired an excellent reputation for easy handling and good healing characteristics. Until recently, the main drawback in using them was the need for preclotting. This, however, is no longer true. Nonporous polyester grafts which have been coated with an impervious bioerodible layer during manufacture are now commercially available. The Gelseal Triaxial prosthesis is one of this new generation of grafts. It is manufactured by impregnating a Triaxial prosthesis with a gelatin coating. An in vivo and in vitro evaluation of this new device has found that its water permeability is almost zero. It has good handling and conformability characteristics, and its bursting strength is slightly greater than that of the uncoated prosthesis due, no doubt, to the presence of the gel. The rates of degradation of the gelatin coating have proven to be rapid under both in vitro and in vivo conditions. In fact, only a few traces of the gel were found remaining on the graft after 2 wk in the canine thoracic aorta. In addition, this study has demonstrated that the use of a bioerodible gelatin coating, with its ability to promote cellular regeneration, is a feasible approach with which to achieve earlier and more complete biological healing.

Animals↗

Chromosomal rearrangements, speciation and the theoretical approach.

Many theoretical papers investigating the relationship between chromosomal change and speciation are found to have been based on erroneous data. For rather than considering those negatively heterotic, or at least potentially negatively heterotic rearrangements which can have a possible role in speciation, these papers have included substantial amounts of information on rearrangements which are not implicated in this process. Common forms of chromosomal repatterning such as heterochromatic addition and polymorphism are in this category. Their inclusion in theoretical studies, often cited as supporting or opposing a chromosomal involvement in speciation, invalidates these findings. A new approach is suggested.

Biological Evolution↗

Effect of airway wall flexibility on clearance by simulated cough.

In our previous study, we investigated the relationship between mucus rheology, depth of mucus layer, and clearance by simulated cough. The purpose of the present study was to examine the effect of airway wall flexibility on the clearance of mucuslike gels. Transient airflows similar to cough were generated by both positive and negative pressure, the latter to mimic the dynamic compression that occurs during real cough. As in the previous study, the trachea was modeled as a trough of rectangular cross section with only the bottom lined with the mucus simulant. Clearance was followed by observing the displacement of marker particles. Since cough clearance is intimately related to wave formation in the mucus blanket, we hypothesized that clearance might be impeded if the wave formation occurred simultaneously in the wall and its lining layer. Thus, in one set of experiments the bottom rigid surface of the model trachea was replaced with a frame over which a flexible membrane could be drawn, whereas in the other set the rigid top was replaced by the frame. We also examined the effect of negative-pressure cough in excised canine tracheae, comparing the case where the tracheal membrane was free to deform vs. the case where it was secured. For the rigid-walled model, clearance by positive or negative pressure, with matched flow pattern, was the same. With the mucus simulant lining the flexible bottom surface, clearance increased with increasing membrane flexibility for negative-pressure cough and decreased for positive-pressure cough.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Hyporesponsiveness to aerosolized but not to infused methacholine in cigarette-smoking dogs.

Seven beagles were exposed via a tracheostomy to smoke from 10 cigarettes/day, 5 days/wk for 10 months; 2 other dogs were exposed for 6 months only. Four dogs served as sham-exposed control animals. Mucus was collected 2 times/wk prior to and during the exposure period by resting a cytology brush on the lower trachea for 2 to 5 min. At least once prior to and as often as 3 times during exposure, transpulmonary pressure and flow were monitored under anesthesia to determine resistance RL. Two airway responses to methacholine were determined: the infusion response delta Ri, the increment in RL 4 to 6 min after infusion of 4 micrograms/kg/min, and the aerosol response delta Ra, the increment in RL 2 min after aerosolization of 2 mg/ml, the highest common dose reached. Eight of 9 smoking dogs developed persistent mucus hypersecretion. In 5 dogs, tracheal mucus flux increased 5- to 10-fold; in 3 dogs, the increase was 2 to 3 times that of control animals. One of the sham-exposed dogs developed moderate hypersecretion. After 10 months of smoke exposure, delta Ri increased to 2.24 times that of the initial value (+/- 0.47 SE) (n = 7, p less than 0.05), whereas delta Ra decreased to 0.28 times that of the control value (+/- 0.21 SE) (n = 6, p less than 0.02). The difference between aerosol and infusion response, delta Rai = delta Ra - delta Ri, is an index of relative hyporesponsiveness to methacholine aerosol.(ABSTRACT TRUNCATED AT 250 WORDS)

Aerosols↗

Lack of effect of hydration on sputum production in chronic bronchitis.

Patients with chronic lung disease productive of sputum are generally encouraged to drink a large amount of fluid to facilitate sputum production. This clinical practice has not been tested systematically. Twelve outpatients with chronic obstructive pulmonary disease in clinically stable condition who had daily sputum production were asked in random sequence: 1) to drink one glass of fluid every waking hour after supper and upon waking the next morning (hydration), 2) to drink no fluid after supper and upon waking the next morning (dry), and 3) to drink fluid ad lib (ad lib). Each morning sputum collection was started upon waking and continued for four hours. The differences in volume, elasticity of sputum, respiratory symptoms, and ease of expectoration were not significant. We conclude that moderate hydration and dehydration have no effect on volume expectorated, the elasticity of sputum, respiratory symptoms or forced expiratory volume in one second.

Aged↗

Albumin-coated polyester arterial prostheses: is xenogenic albumin safe?

This paper adds a new dimension to the series of studies concerned with the development of an albumin-coated polyester vascular prosthesis by addressing the question of the origin of the albumin. Previous experiments in dogs have used canine albumin-coated polyester arterial grafts. This study evaluated the biocompatibility of xenogenic material by implanting in dogs prostheses coated with bovine albumin and cross-linked with glutaraldehyde. Two series of albuminated grafts, one gamma radiation sterilized, the other ethylene oxide sterilized, as well as a preclotted control series were undertaken. The origin of the albumin did not appear to be significant. In fact, the healing pattern of the xenogenic albumin coated grafts was identical to that found previously with isogenic albumin. Nor did the method of sterilization produce significantly different pathological results. However, a slower rate of healing with the coated grafts compared to the preclotted controls did appear to be related to the slow rate of albumin erosion and the potentially cytotoxic effect of the glutaraldehyde cross-linking agent.

Albumins↗

The role of mucus viscoelasticity in cough clearance.

The relationships between mucus rheology, depth of mucus layer and clearance by simulated cough were examined in a study employing a model plexiglass trachea lined with gels formed from locust bean gum crosslinked with sodium tetraborate. The viscoelastic properties of the mucus simulants were determined by magnetic rheometry at 100 rad/s and expressed as mechanical impedance (dynamic stress/strain ratio) and loss tangent. Cough was simulated by opening a solenoid valve connecting the model trachea to a pressurized tank, using an upstream flow-constrictive element to shape the flow profile to approximate the pattern seen in a normal adult. Mucus clearance was quantitated by observing the movement of contrasting marker particles placed in the mucus layer. The median particle displacement was defined as the clearance index, Cl. For any initial depth of mucus, Cl increased with driving pressure in the tank, and for a given driving pressure, Cl increased linearly with increasing mucus depth. For a given driving pressure and depth, Cl decreased with increasing mechanical impedance of the mucus. At constant mechanical impedance, Cl increased with increasing loss tangent, in other words, cough clearance was impeded more by elasticity than viscosity. Mucus clearance was associated with transient wave formation in the lining layer. Thus dependence on viscoelasticity is consistent with observations that airflow-mucus interaction and wave formation are impeded by elasticity. The clearance vs. loss tangent relationship for cough is opposite to that found for ciliary clearance (Biorheology 1980, 17, 249), suggesting a natural balance in viscosity and elasticity for mucus to be cleared by both mechanisms.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Rôle of mucus viscoelasticity in clearance by cough.

We examined the relationship between mucus rheology, depth of mucus layer, and clearance by simulated cough. A model trachea constructed of rigid plexiglass was lined with mucus simulants--borate-crosslinked locust bean gum gels. Their viscoelastic properties were determined by magnetic rheometry and expressed as mechanical impedance (dynamic stress/strain ratio or vectorial sum of elasticity and viscosity) and loss tangent (viscosity/elasticity ratio). Cough was simulated by opening a solenoid valve connecting the model trachea to a pressurized tank, using an upstream flow-constrictive element to shape the flow profile to approximate the pattern seen in a normal adult. Mucus clearance was quantitated by observing the movement of contrasting marker particles placed in the mucus layer. The median particle displacement per cough manoeuvre was defined as the clearance index, C.I. We found that C.I., for any initial depth of mucus, increased with the driving pressure in the tank. For a given driving pressure, C.I. increased linearly with increasing mucus depth. For a given driving pressure and depth, C.I. decreased with increasing mechanical impedance of mucus. At constant mechanical impedance, C.I. increased with increasing loss tangent. Mucus clearance was associated with transient wave formation in the lining layer. Thus the dependence on viscoelasticity is consistent with the observations that airflow-mucus interaction and wave formation are impeded by elasticity. The clearance vs. loss tangent relationship for cough is opposite to that found for ciliary clearance, suggesting a natural balance in viscosity and elasticity for mucus to be cleared by both mechanisms.

Airway Resistance↗

[Progressive complications associated with polyester arterial prostheses. Study of 61 specimens following surgical excision].

Reports of individual surgical cases tend to be anecdotal because of the unique circumstances surrounding the patient, the surgeon, the intervention and, where applicable, the prosthetic device. To overcome this limitation the authors have taken a wider collaborative approach and report the analysis of 61 explanted polyester arterial prostheses associated with delayed complications on 53 patients reoperated upon in six different French hospitals. One advantage of such an independent and centralized retrieval programme is that the impact of centre specific factors, such as patient selection and surgical techniques, is minimized. Consequently, by following a standardized protocol for the evaluation of the morphologic, pathologic and mineralogic characteristics of the tissue surrounding the excised grafts, as well as the textile structure of the prostheses themselves, it has been possible to distinguish between iatrogenic and disease related complications and to demonstrate a number of general findings associated with the clinical performance of polyester arterial prostheses. Complications such as thromboses, infections and false aneurysms appear to occur randomly after different lengths of implantation, thicker fibrous tissue capsules are associated with velour grafts with highly textured yarns, the incidence of mineralized tissue and of endothelialized luminal surfaces is rare, weft knitted textile prostheses appear less mechanically stable and more sensitive to iatrogenic trauma than warp knitted, and the incidences of lipid and cholesterol adsorption, bacterial colonization and sterile fluid loss need further investigation. These observations lead to the recommendation that for patients with longer life expectancies surgeons should consider selecting low porosity, woven or warped knitted prostheses which contain yarns that have not been highly textured.

Adult↗