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Biomedical subjects

R Guidoin

Publications and source records attributed to R Guidoin.

At least 199 records · Page 11Linked to original sources
PubMed1977

Blood filter evaluation.

Massive blood transfusion and extracorporeal circulation result in bombardment of the small pulmonary arterioles with micro-aggregates which are mainly composed of cellular degradation products, damaged platelets and leukocytes, fibrin strands, portions of cellular membrane and protein precipitates. Such amorphous material can cause patients to die of respiratory insufficiency without underlying chest trauma. Increasing amounts of stored blood are transfused to patients and extracorporeal circulation has become one of the most useful techniques for surgeons. Unfortunately, these procedures are often accompanied by disturbing post-operative consequences. This is because micro-aggregates invade the capillary network of several organs, especially lungs, kidneys, brain and retina. It is why blood filtration has recently gained added interest because of widespread efforts to minimise the number or emboli which are either transfused or reinfused to the patient through the blood return line.

Blood↗
PubMed1977

Implantable artificial lung. Preliminary report.

The ultimate treatment of chronic respiratory insufficiency is pulmonary replacement by an artificial organ, homologous lung transplantation, or chronic paracorporeal respiratory supplementation. The woven capillary membrane oxygenator appears to be a major development toward implantable artificial organs. The four units tested are made up of screens 3.5 by 4.0 cm. of capillary tubing 0.3 mm. I.D. by 0.64 mm. O.D. assembled into rectangular blocks. Units made up by five, ten, twenty, and forty screens have been assembled and tested according to the protocol suggested by Galletti. The maximum oxygen transfer rate with blood was 48 ml. per minute per square meter. Water carbon dioxide transfer rate was 23.1 ml. per minute per square meter. The pressure drops in the liquid phase were 8.5, 15.3, 13.8, 17.6 mm. Hg at 1 L. per minute flow. These results indicate that the woven capillary membrane lung is an acceptably efficient oxygenator. The characteristics of design and performance suggest that this oxygenator can be made to be implanted into the chest or used as a paracorporeal respiratory assistance device.

Artificial Organs↗
PubMed1976

Intra-uterine devices, A SEM study on the Dalkon Shield.

A SEM study carried on intra-uterine devices (Dalkon Shield) is reported. The poor manufacturing of the devices is stressed, which could increase their efficiency but also the risks of penetration, or worse, perforation. The solution for the future could be copper bearing intra-uterine devices coated by hydrogels. This should maintain efficiency and improve security.

Female↗
PubMed1976

Disposable filters for microaggregate removal from extracorporeal circulation.

A comparative study of three commercially available blood filters for use in extracorporeal circuits was made in dogs. All filters were efficient in removing infused microclots from the circulation, but all caused mild thrombocytopenia and two produced minimal hemolysis. In dogs infused with microclots, only those animals without blood filters in the infusing circuit showed evidence of pulmonary microembolism at autopsy. It was concluded that while the filters have minimal disadvantages, their potential in reducing microembolism in extracorporeal circuits far outweighs these disadvantages.

Animals↗
PubMedDate not supplied

Polyester prostheses as substitutes in the thoracic aorta of dogs. II. Evaluation of albuminated polyester grafts stored in ethanol.

In an attempt to find an alternative procedure to the preclotting of porous textile vascular prostheses, the feasibility of an albumin coating and ethanol preservation technique has been evaluated by implanting albuminated polyester prostheses as substitutes in the thoracic aorta of dogs. Nine different grafts representing woven, knitted, and velour constructions were implanted for periods ranging from 4 h to 6 months. At the sacrifice, the grafts were excized for measurement of the thrombogenicity of the flow surface, for pathological examination by light microscopy and SEM, and for quantifying the changes in the textile structure during implantation. Also the kidneys were removed and examined for infarcts caused by trapped circulating emboli. The healing characteristics of the nine different grafts proved similar and followed the same sequence of events as preclotted control grafts. The albumin coating and ethanol preservation resulted in a somewhat slower rate of healing. Yet, given sufficient time, a more completely healed graft was achieved as evidenced by the presence of endothelial-like cells throughout the length of the graft. In addition, the albumin is believed to reinforce the textile structure by reducing the tendency to stretch and dilate in vivo.

Albumins↗
PubMedDate not supplied

Low Reynolds number turbulence modeling of blood flow in arterial stenoses.

Moderate and severe arterial stenoses can produce highly disturbed flow regions with transitional and or turbulent flow characteristics. Neither laminar flow modeling nor standard two-equation models such as the kappa-epsilon turbulence ones are suitable for this kind of blood flow. In order to analyze the transitional or turbulent flow distal to an arterial stenosis, authors of this study have used the Wilcox low-Re turbulence model. Flow simulations were carried out on stenoses with 50, 75 and 86% reductions in cross-sectional area over a range of physiologically relevant Reynolds numbers. The results obtained with this low-Re turbulence model were compared with experimental measurements and with the results obtained by the standard kappa-epsilon model in terms of velocity profile, vortex length, wall shear stress, wall static pressure, and turbulence intensity. The comparisons show that results predicted by the low-Re model are in good agreement with the experimental measurements. This model accurately predicts the critical Reynolds number at which blood flow becomes transitional or turbulent distal an arterial stenosis. Most interestingly, over the Re range of laminar flow, the vortex length calculated with the low-Re model also closely matches the vortex length predicted by laminar flow modeling. In conclusion, the study strongly suggests that the proposed model is suitable for blood flow studies in certain areas of the arterial tree where both laminar and transitional/turbulent flows coexist.

Arteries↗
PubMedDate not supplied

Histopathologic findings in synthetic and biologic explanted grafts used in peripheral arterial reconstruction.

Surgically explanted vascular grafts, including 47 autografts, 14 allografts, 103 chemically processed human umbilical vein (HUV) grafts, and 406 polytetrafluoroethylene (PTFE) grafts, were studied histopathologically. Autografts, HUV, and PTFE grafts were implanted mostly in the femoropopliteal position, whereas allografts were used as a blood access for hemodialysis. The main cause for explantation in autografts (53.6%), HUV (74.8%), and PTFE (61.3%) was thrombosis, whereas allograft failure was usually related to aneurysmal degeneration (72.7%). The infection rates of HUV (20.9%) and PTFE (25%) grafts were higher than those of autografts (4.8%) and allografts (9.1%). Furthermore, bacterial colonization occurred more frequently in HUV (63.9%) and PTFE (64.7%) than in autografts (6.7%) and allografts (0%). Leukocyte infiltration was detected mostly in HUV (39.4%) and PTFE (27%) explants. Autografts and allografts both showed a 7.1% rate of lipid uptake, whereas lipid retention was observed in 84.9% of HUV and 79.8% of PTFE grafts. These results suggest that biologic vascular grafts are to be used preferentially in small diameter arterial reconstruction because of their resistance to bacterial colonization and lipid uptake.

Adult↗
PubMedDate not supplied

Measurement of CD11/CD18 integrin expression on the polymorphonuclear cell surface after incubation with synthetic vascular prostheses.

Polymorphonuclear (PMN) cell activation in the presence of synthetic vascular grafts was studied by using flow cytometry to measure CD11/CD18 leukocyte adhesion molecule expression at the cell surface. Polymorphonuclear cells isolated from the blood of 10 healthy human donors were incubated with six knitted polyester vascular prostheses (Vasculour II, Albumin-Coated Graft, Triaxial, Gelatin-Impregnated Gelseal, Dialine I, and Bovine Collagen-Impregnated Dialine II) for 60 min at 37 degrees C. The authors' study demonstrated that CD11/CD18 integrin expression varies among donors for a given vascular prosthesis, and that each donor has his or her own pattern of responsiveness toward synthetic vascular grafts. The current study indicates that PMN activation measured by CD11/CD18 integrin expression is a sensitive method of measuring the blood compatibility of a given foreign surface for a given patient.

Animals↗
PubMedDate not supplied

The benefits of fluoropassivation of polyester arterial prostheses as observed in a canine model.

The effect of treating the surface of a polyester vascular prosthesis with a novel fluoropolymer before sealing the graft with gelatin has been evaluated in a canine thoracoabdominal bypass model. The healing behavior of the Fluoropassiv graft was compared with that of the Gelsoft ERS prosthesis used as control for prescheduled periods of implantation ranging from 4 hr to 6 months. Both series of explanted grafts were analyzed using macroscopic, histologic, and scanning electron microscopic observations, and by determining the prostacyclin/thromboxane A2 ratio (PGI2/TXA2) and the thrombogenicity of the luminal surface by means of labelled platelets and fibrin deposition. Chemical analysis of explanted and cleaned graft segments was performed using electron spectroscopy for chemical analysis, differential scanning calorimetry, and contact angle methods. No difference in platelet and fibrin deposition or PGI2/TXA2 secretion by the luminal surface was observed between the treated and the control grafts at any implantation period. On the other hand, pathologic investigation has revealed that, although there is no difference between the two grafts during the first month, the healing sequence of the Fluoropassiv graft appeared more complete and mature than the control graft after 3 and 6 months. Differences were observed in the extent of collagenous internal capsular development, endothelialization, and tissue penetration into the knitted structure. The presence of fluorine and a higher contact angle at the surface of all the explanted fluoropassivated grafts is believed to have been responsible for reducing the inflammatory response and enhancing the long-term healing behavior of this novel prototype device over the control gelatin sealed prosthesis.

Animals↗
PubMedDate not supplied

Localization of atherosclerosis in arterial junctions. Concentration distribution of low density lipoproteins at the luminal surface in regions of disturbed flow.

To investigate the role of fluid mechanical factors in atherogenesis and anastomotic intimal hyperplasia, the effect of blood flow on the transfer of low density lipoproteins from flowing blood to the luminal surface was studied theoretically using a two dimensional T-junction model. The flow fields in the junction were obtained by solving the Navier-Stokes equations numerically and the concentration distribution of low density lipoproteins at the luminal surface was determined using a finite difference analysis. The transfer of low density lipoproteins from flowing blood to the surface of the vessel wall was greatly enhanced in the two regions of disturbed flow, one in the main vessel, the other in the subsidiary vessel. The highest concentration of low density lipoproteins on the inner surface of the vessel wall was predicted to occur in the areas of the reattachment points. The slower the recirculation flow, the higher the lipid accumulation at the luminal surface in the disturbed flow regions and the wider the highly concentrated low density lipoprotein area. In summary, the authors' mathematical model predicts that locally disturbed blood flows at arterial bifurcations and surgically created junctions provide favorable conditions for the accumulation of atherogenic substances at the luminal surface, thus increasing the potential for lipid infiltration into the vessel wall.

Anastomosis, Surgical↗