Biomedical subjects
Publications and source records attributed to M King.
Direct endoscopic visualization of in utero fetal muscle biopsy was performed in 2 cases for which the primary guidance for the procedure remained real time ultrasound. Direct visualization aids in the precise placement of the biopsy gun which may enable the procedure to be done at earlier gestational ages. At the currently used gestational ages (i.e. 18+ weeks), it does not substantially improve the procedure.
Vesicoamniotic shunting is typically reserved for treatment of fetal obstructive uropathy. We report a case of congenital megacystis without anatomic urinary obstruction in whom a vesicoamniotic shunt was used to improve fetal hemodynamics as measured by Doppler velocimetry.
The primary purpose of this study was to compare the personality profiles of adults with learning disabilities attending a large state university (8 females, 8 males) to those participating in training programs in a rehabilitation setting (8 females, 18 males), in an attempt to identify affective variables that should be considered in transitional and postsecondary program planning. A secondary purpose of the study was to compare the performance of two groups of adults with learning disabilities (i.e., university and rehabilitation) to a normative group of college students. The mean age for all subjects was between 20 and 23 years. Findings from the study indicated that the personality profiles of individuals with learning disabilities in either a rehabilitation setting or seeking a university degree are significantly different from those of the normative population of normally achieving college students. The rehabilitation group in this study demonstrated feelings of social isolation, poor self-concept, self-doubt, and extreme restlessness. Somewhat different profiles were seen with the university group as they indicated feelings of fear, obsessive thoughts, lack of self-confidence, self-doubt, and extreme self-criticism. Both groups demonstrated profiles of individuals under extreme short- and long-term stress leading to anxiety. The study also reviewed the relevance and appropriateness of using the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) that will have direct application for the assessment and intervention of adults with learning disabilities either in a rehabilitation setting or seeking a university degree.
Fifty-four patients who had surgery to repair a chronic rotator cuff tear (54 shoulders) were followed for an average of 25.9 months (range, 16 to 43). Forty-nine of 54 patients had at least 20 months of followup. The average age of the male patients (N = 37) was 52 (range, 24 to 80) and of the female patients (N = 17) was 56 (range, 38 to 72). All of these patients received a functional evaluation based on the Shoulder and Elbow Surgery Society classification system. Forty-eight patients had an individual examination and 33 patients had an isokinetic strength evaluation. There were 43 patients (80%) with a satisfactory functional result and 11 (20%) with an unsatisfactory result. Unsatisfactory results were associated with large and massive tears and decreased postoperative range of motion. Good functional results were obtained by open repair and subacromial decompression for rotator cuff tear. Arthroscopic evaluation and treatment did not affect the functional outcome, but it did increase costs by about $2000 per patient. Arthroscopy is useful to define tear size, which may affect the surgical approach, but the arthroscopic treatment of glenohumeral problems did not alter the functional result. The routine use of arthroscopy before rotator cuff repair is costly, not effective, and therefore not recommended.
There are two extreme types of middle ear effusion leading to hearing loss (a) a rubber-like effusion seen in secretory otitis media and (b) a water-like effusion seen in serous otitis media. The possibility is considered that the degree of crosslinking in these two extreme cases is the basis of an altered mucus transport rate that leads to an accumulation of effusions and hence impaired hearing. It has been shown (King et al., 1974) that the requisite rheological property for transport activity is not unique to mucus structural macromolecules but is found with other polymeric systems that are loosely crosslinked e.g. guaran, polyacrylamide, gelatin and agarose. Studies on one of these systems guaran, indicate that the transport rate is dependent on the degree of crosslinking with a maximum rate found close to the gel point, i.e. in a region where there are very few crosslinks per macromolecule. The finding that mucus from different mucociliary epithelial sources involves a chemically similar structural glycoprotein suggests that differences observed in transport rate between various mucus samples are more likely due to differences observed in transport rate between various mucus samples are more likely due to differences in crosslinking than chemical variations of the glycoprotein units.
The role of NK-1 and NK-2 receptors on the pulmonary response to capsaicin in guinea pigs was evaluated using intravenous infusion of selective nonpeptide antagonists of NK 1 (CP 96345, 300 nmol/kg, and SR 140333, 300 nmol/kg) and NK-2 (SR 48968, 100 nmol/kg) neurokinin receptors. Maximal values of pulmonary dynamic elastance (Edyn) and pulmonary resistance (RL) after capsaicin infusion were significantly lower in the presence of SR 48968 (p < .005). Morphometric analysis of lungs obtained by quick-freezing showed significant attenuation of airway contraction and peribronchiolar edema formation in the presence of NK-2 antagonist (p < .001). When compared to guinea pigs that received only capsaicin, animals that received SR 140333 or CP 96345 showed lower values of Edyn, RL, airway contraction, and peribronchiolar edema, but only the difference in Edyn values was significant. The combination of NK-1 and NK-2 antagonists was not more effective than NK-2 antagonist alone in attenuating capsaicin effects. The results suggest that airway effects of capsaicin are mainly mediated by activation of NK-2 receptors although NK-1 receptors may also play a role.
Myxalin is a glycopeptide extracted recently from a gram-negative bacterium. It has blood anticoagulant properties and can enhance endothelial cell growth. With the ultimate objective of using this bioactive molecule to promote vascular graft healing, this study assessed its biocompatibility in vivo by comparing the cellular and immunological responses of gelatin-coated knitted polyester grafts with and without myxalin following implantation in the peritoneal cavity of rats for prescheduled periods of 3 days and 1, 2, and 4 weeks. A nongelatin-coated virgin polyester graft was included as the reference material. The biological response to gelatin alone was characterized by a slower rate of cellular infiltration into the implant, reduced collagen synthesis, and higher levels of acid phosphatase and esterase activity in the surrounding tissue. The addition of myxalin to this coating resulted in a significant reduction of hydrolase secretion in the tissue surrounding the implant and an enhancement of cellular ingrowth.
An organotypic culture assay has been used to assess the biocompatibility and cytotoxicity of an arterial prosthesis developed at the University of Texas-Arlington (the UTA graft) from a structurally modified polyurethane (PU) elastomer (Tecoflex). The cell culture test was applied to the UTA graft after sterilization by ethylene oxide and by gamma radiation in two separate series. First, small specimens of the prosthesis were incubated for 7 days on a semisolid nutrient medium with their luminal surface in direct contact with endothelium explanted from the aorta of chick embryos. Second, the possibility of cytotoxic contaminants being leached from the polyurethane was assessed by immersing the biomaterial in the liquid culture medium for 5 days at 37 degrees C prior to conducting the organo-typic culture assay on a standard control surface. The structure of the UTA polyurethane prosthesis is porous, but the graft wall is impervious because it contains closed (i.e., noncommunicating) pores. In addition, four other vascular prostheses were included in the study for comparison. They were the Hydrophilic Mitrathane PU graft with a similar impervious, closed pore structure, an experimental Hydrophobic Mitrathane PU graft with a fibrous, open pore structure, and the commercial Impra and Reinforced Goretex expanded PTFE grafts. Following 7 days of cell culture, the biocompatibility and cytotoxicity of the various biomaterials were measured in terms of the area of migrating cells, the density of cells surrounding the explants, and the level of cell adhesion. Comparison of the results against control cultures demonstrated that the UTA graft, along with the other four prostheses, does not release cytotoxic extractables. Microscopic observations of its cultured surface indicated that the UTA graft promotes a high density of cell growth over a limited area, similar to the Hydrophilic Mitrathane graft. This level of biocompatibility is considered inferior to that of the two PTFE and the Hydrophobic Mitrathane prostheses, which promote more extensive cell migration, greater cell adhesion, and cell growth in a continuous single layer.
A novel microporous polyurethane blood conduit developed at the University of Texas at Arlington was implanted as an infra-renal substitute in dogs. The prosthesis was fabricated by precipitating a solution of the polymer with dry nitrogen onto a rotating mandrel. The grafts were sterilized either by gamma radiation (series I) or ethylene oxide (series II); they were implanted for the following prescheduled periods: 4, 24, 48 hours, and 1 week (short-term) and 2, 4 weeks, 3 and 6 months (medium-term). The thrombohematological characteristics of each animal were evaluated prior to implantation and confirmed that the index of blood coagulability was normal. In the short-term group, five out of eight grafts were patent and three were partially occluded; four grafts in the medium-term group were patent; one was partially occluded; and three were thrombosed at retrieval. One week after implantation, the prostheses were surrounded by an external capsule, which was present mainly at the two anastomoses. The external capsule covered the entire graft at 3 months. No kinking of the grafts was observed and the presence of a mild yellow stain related to bilirubin uptake was detected at 2 weeks, 1, 3, and 6 months. Histological studies have revealed the formation of a thin internal capsule at both anastomoses, 2 weeks postimplantation, which was not anchored to the graft wall. In the medium-term group, the thrombosed grafts failed to develop an internal capsule, whereas the patent graft exhibited a thick internal capsule made of neocollagenous tissue over the entire graft. This new microporous polyurethane prosthesis did not perform satisfactorily as an infra-renal substitute in dogs and its in vivo stability requires further assessment. Thus, the concept of a polyurethane with closed pores does not achieve what was anticipated.
The relationship between mucus rheologic variables and in vitro ciliary transport was investigated in mucus samples collected from the upper airways of 30 Wistar rats. In vitro mucus transportability was determined by means of the frog palate preparation. Rheologic evaluation was done by measuring the rigidity modulus (log G*, representing the vectorial sum of viscosity and elasticity) and the loss tangent (tan delta, i.e. the ratio between viscosity and elasticity) at 1 and 100 radian/s using a magnetic microrheometer. The correlation between the rheologic variables and in vitro mucus transportability was made by stepwise multiple linear regression analysis, with frog palate transport rate considered as the dependent variable. A significant relationship was obtained between the rheologic parameters (log G* and tan delta) measured at 1 radian/s and the frog palate transport ratio. The relative speed of mucus samples was related to rheology according to the following relationship: rat/frog speed ratio = 1.666-0.434 log G*-0.331 tan delta, for G* and delta determined at 1 radian/s (multiple r = 0.666, p < 0.001). Transport rates predicted from the above formula gave a satisfactory fit to those observed in a second set of 30 rats. The present results indicate that the overall mucus impedance, as well as the ratio between viscosity and elasticity, are important in determining the efficiency of clearance. In addition, it was shown that measurements performed by applying relatively low frequency deformations are preferable for predicting ciliary transport.
Under some conditions, such as inhalation injury, an array of longitudinal channels without cilia may be formed on the epithelial surface, affecting mucus transport in the lung during coughing. Moreover, in certain cases of the diseased state of the lung, immotile cilia remain embedded in the serous fluid and may form channels in the direction of air motion during coughing, providing a resistance-free pathway for serous layer fluid and assist in mucus clearance. To understand this phenomenon, we have conducted experiments with mucous gel simulants (MGS) in a simulated cough machine (SCM) using soap solution as a serous layer simulant (SLS). The channel structure of the airway surface was modeled by introducing bottom plates with longitudinal grooves about 10 cm long having different depths, widths and number of grooves. It was shown that mucous gel transport increases as the cross-sectional area occupied by channel grooves increases. The effects of sinusoidal constriction and mucous gel filance were also investigated in this model system. It was found that mucous gel transport increases in the constricted case (minimum gap, 3 mm, and maximum gap, 9 mm) in comparison with that in the parallel case (constriction gap of 9 mm). The effect of increasing the mucous gel filance was to decrease the transport,, as reported in previous studies.
This in vitro study addressed the question of clearance-related changes in the physical properties of mucous gel simulants (MGS) subjected to oscillating air flow. Delineating some of the possible mechanisms of action for the reported beneficial effects of high-frequency chest compression (HFCC) therapy constituted the rationale. The rheological variables measured were spinnability by filancemeter and viscoelasticity (mechanical impedance, G*, and loss tangent, tan delta) by magnetic microrheometry. Two derivative parameters, mucociliary clearability index (MCI) and cough clearability index (CCI), were computed from the rheological variables, based on relationships established from model studies of clearance. Two ranges of air flow oscillation frequencies used previously in animal and clinical studies, i.e., 12-13 Hz or 22-23 Hz, were applied. The measurements were made after application of oscillating air flow for 15, 30 and 60 minutes, and compared with those at baseline and negative control. A significant decrease in log G* with administration of oscillations was observed (p = 0.06 at 30 minutes, p < 0.01 at 60 minutes, for G* measured at 1 rad/s). Spinnability also decreased by 19.3% and 30.7% after 15 minutes; 32.9% and 41.1% after 30 minutes; 36.4% and 50.5% after 60 minutes, for 12 Hz and 22 Hz, respectively (all significantly different from baseline). There was a positive correlation between viscoelasticity and spinnability, and a negative correlation between spinnability and CCI, but no correlation between spinnability and MCI. Oscillating air flow seemed to act as a physical "mucolytic" that affected mostly the cough clearability of the mucus simulant.
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