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N D Smith

Publications and source records attributed to N D Smith.

29 records · Page 2Linked to original sources
PubMed1983

Phonocardiographic profile of the porcine bioprosthesis in the aortic position.

The phonocardiographic characteristics of the porcine bioprosthesis in the aortic position were evaluated in 24 asymptomatic patients. A medium to high frequency early systolic sound (AO) was present in 16 of 24 patients; abrupt "halting" of the stiff cusps of the porcine bioprosthesis during early left ventricular ejection seems to be the likely mechanism for the genesis of this sound. An unusually high amplitude aortic closing sound (AC) was present in all patients. A high frequency crescendo-decrescendo systolic murmur in early to mid systole was present in 22 patients. Possible mechanisms for the systolic murmur include: 1) altered resonating properties of the cusps, 2) functional bioprosthetic stenosis, and 3) the presence of a flexible stent. An early systolic opening sound preceding a short systolic murmur and a loud closing sound are common phonocardiographic findings of an uncomplicated porcine bioprosthesis in the aortic position. Therefore, absence of the aortic opening sound, alterations in the amplitude of the aortic closing sound, or an increase in the length of the systolic murmur may suggest bioprosthetic malfunction.

Adult↗
PubMed1982

Permeability characteristics of bile duct in the rat.

To determine the permeability of the bile duct epithelium of the rat to several hydrophilic nonelectrolytes, isolated segments of rat bile duct (1-2 cm) were perfused with Ringer solution in situ. [14C]urea, [14C]erythritol, [14C]sucrose, or [3H]inulin was administered intravenously, and drops of duct perfusate were collected. Perfusate-to-plasma ratios for each solute were inversely related to their molecular weight (MW): inulin [0.13 +/- 0.06 (SD)], sucrose (0.20 +/- 0.08), erythritol (0.32 +/- 0.11), and urea (0.34 +/- 0.13). Permeability coefficients (P) expressed in cm.s-1 X 10(5) were determined for inulin (4.5 +/- 1.5), sucrose (8.5 +/- 2.6), erythritol (12.6 +/- 3.9), and urea (15.8 +/- 1.6). These values vary directly with their respective nonaqueous-aqueous partition coefficients (K) and inversely with their MW. Although P is directly related to K in both olive oil and isobutanol systems, the bile duct behaves as if its permeability barrier is more hydrophilic than isobutanol. These results indicate that the inert solutes urea, erythritol, sucrose, and inulin cross the epithelium of the rat bile duct by a polar route, possibly via intercellular junctions, and that erythritol may not be an ideal marker of canalicular bile flow.

Animals↗
PubMed1982

Hemodynamic effects on oxygen consumption and bile flow in isolated skate liver.

A technique is described for perfusion of livers from the little skate, Raja erinacea, in the isolated state at 15 degrees C utilizing a recirculating, well-oxygenated elasmobranch Ringer solution. Bile flow and oxygen consumption were optimal and remained relatively constant over a 4- to 5-h perfusion at portal vein pressures of 2.5-5.0 cm Ringer. At these pressures, bile flow rates were comparable to values previously observed in the free-swimming skate. In contrast to mammalian species, bile secretion in the elasmobranch is particularly sensitive to small changes in perfusion pressure. Hepatic clearance of sulfobromophthalein and [14C]sodium taurocholate demonstrated initial fractional disappearance rates that were also similar to values obtained in vivo. Only small amounts of sulfobromophthalein appeared in bile by 5 h, whereas 78.5 +/- 6.5% of [14C]sodium taurocholate was recovered in bile at this time. These experiments establish portal vein perfusion pressures for study of skate livers in the isolated state in which oxygen consumption is maximal and organic anion clearance from perfusate to bile exceeds values obtained in vivo.

Animals↗
PubMed1982

Determinants of biliary secretion in isolated perfused skate liver.

In the isolated perfused liver of the little skate, Raja erinacea, bile flow averaged 5.07 +/- 0.58 (mean +/- SE) microliters.h-1.g liver-1 in 21 experiments at a perfusion pressure of 5.0 cm Ringer compared to 3.79 +/- 0.32 in 38 experiments at 2.5 cm (P less than 0.05). [14C]inulin readily entered skate bile. Bile-to-plasma [14C]inulin ratios corrected for delay in transit time, averaged 0.46 +/- 0.07 at 1 h and rose to 0.74 +/- 0.06 by 4 h, although bile flow remained constant. In experiments in which [14C]inulin reached equilibrium between bile and plasma, the bile-to-plasma ratio conformed to the theoretical relationship between bile flow, solvent drag, and inert solute diffusion predicted at extremely low bile flows, but demonstrated that the skate biliary tree is more permeable to inulin than that of the rat. Electron microscopic studies demonstrated that ionic lanthanum could traverse the tight junctions. However, freeze-fracture studies of junction structure did not differ qualitatively from similar studies in the rat. Partial dependence of bile flow on perfusion pressure, high bile-to-plasma inulin ratios, and permeability of the canalicular tight junctions to ionic lanthanum all suggest that the paracellular pathway may be an important component of bile formation in the skate.

2,4-Dinitrophenol↗
PubMed1981

Auscultation of the normally functioning prosthetic valve.

Before prosthetic function can be adequately assessed, physicians must be acquainted with the normal acoustic events associated with these devices. The auscultatory findings of the most commonly used devices--ball, disk, porcine, and bileaflet valves--are reviewed. The mechanisms of sound production and their timing are discussed.

Aortic Valve↗
PubMed1979

Spontaneous return of patency in a completely occluded coronary artery.

We observed a 56-year=old man in whom an occluded right coronary artery was observed to be widely patent on a subsequent angiogram 40 months later. This "regression," which occurred without a change in his risk factors, shows that manipulation of risk factors can be proven to be a cause of regression only in controlled studies.

Coronary Angiography↗
PubMedDate not supplied

Effect of albumin binding on extraction of sulfobromophthalein by perfused elasmobranch liver: evidence for dissociation-limited uptake.

We investigated the role of serum albumin in the hepatic uptake of organic anions by determining the effect of added bovine albumin on sulfobromophthalein (BSP) uptake in skates, an animal which naturally lacks this protein. A single-pass perfused liver model was used to determine steady-state net uptake rates as the BSP or BSP and albumin concentrations were systematically varied. Results indicated that two different steps in the uptake process are capable of limiting the uptake rate depending on the albumin and BSP concentrations selected. At higher rates of uptake corresponding to higher BSP concentrations (up to 112 microM), saturation kinetics were observed as the BSP concentration was varied, with apparent Km and Vmax values which were independent of the albumin concentration (0.05 to 0.75%). These data suggest that under these conditions uptake is limited by a saturable step intrinsic to the liver. In contrast, for lower BSP concentrations and albumin concentrations below about 0.5%, a different kinetic pattern was seen which suggested that the rate-limiting step in uptake was transfer of BSP from albumin to the liver. The latter data were found to be consistent with a model in which the limiting step in the transfer process is spontaneous dissociation of the BSP from binding sites on albumin within the sinusoid. These results suggest that skate liver clears BSP from albumin solutions by a two-step mechanism in which dissociation from albumin is followed by a saturable process consistent with carrier-mediated transport. The albumin concentration and uptake velocity are important factors in determining which of these steps limits the uptake rate. Clearance is efficient and irreversible even though elasmobranch liver lacks high-affinity cytosolic binding proteins for BSP, and elasmobranch plasma does not normally contain albumin.

Animals↗