Morphometric studies of chronic fibrillating heart.
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Biomedical subjects
Publications and source records attributed to Y Nose.
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The lack of an appropriate and effective technique for prolonged heart-lung preservation has been one of the factors limiting the use of this therapeutic modality. Presently, the donor is transported to the transplant center, which is often an unacceptable burden to the donor's family. A reliable preservation technique that would allow long-distance procurement would markedly increase the use of heart-lung transplantation. Using a dog, a successful heart-lung transplantation was achieved following six hours of preservation of the graft. The experiment was terminated when the animal was able to maintain normal blood gases following extubation.
The purpose of this investigation was to extend previous steady state flow studies with magnetic resonance (MR) to pulsatile flow measurements obtained with gated cardiac techniques in man with a pulsatile artificial heart device. Bovine blood and a solution of MnCl2 were studied. Correlation was made with complex and time-varying MR signals observed in the descending aorta on cardiac gated images obtained through the midthorax. MR signals from flowing fluids represent velocity distribution as shown in a velocity profile, and laminar flow is distinguished from nonlaminar. At very slow flow rates, signal intensity is lower than background. As the rate is increased, paradoxical enhancement occurs followed by loss of signal, which is complete at 7 liters per minute with fluid and 15 liters per minute with blood. These areas correspond to maximum fluid velocities of 41 and 88 cm/sec, respectively.
This report describes 2 siblings with IgA nephropathy. Patient No. 1 was a 38-year-old woman with hematuria and proteinuria of 19 years duration. Her blood ABO type was A and Rh positive. She was found to have HLA-A2,Aw24; Bw54 , Bw48 ;Cwl,C-;DR1,DR4. Her renal specimen was diagnosed as the advanced stage of IgA nephropathy histologically. Patient No. 2 was a 41-year-old man who was a brother of patient No. 1. His blood ABO type was O and Rh positive. His serotype for the HLA was found to be HLA-Aw24,A-;Bw35, Bw54 ;Cw1,Cw3;DR4, DRw9 . His renal histology showed the advanced stage of IgA nephropathy. It is suggested that an abnormal immune response linked to gene coding for HLA-DR4 antigen might be involved in the development of IgA nephropathy.
A modification of Robicsek's autoperfusing heart-lung preparation preserved normal structure in the canine lung for 8 hrs and in the heart for 12 hrs. Applicable to both heart and heart-lung transplantation, the system would permit a safe extension of preservation time limits.
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The technique of cryofiltration has been applied in the treatment of cryoglobulinemia. Good clinical improvement has been demonstrated accompanied by decreases of cryoglobulin levels. Three treatments in a week produced transient improvement of clinical symptoms and reduction of cryoglobulin levels. Follow-up treatments performed at adequate frequency and volume processed maintained relief of symptoms and serologic improvement. The cryofilter demonstrates good selectivity for cryoglobulin removal in cryogel, confirmed by electrophoretic analysis of both the cryogel filtrate from the cryofilter used clinically. Plasma cryofiltration appears to be a safe alternative to plasma exchange, requiring no replacement fluids.
The blood cell and membrane properties are important in determining hemolysis and cell deposition, as shown previously, and thus are determinants of the maximum plasma separation rates. In general, membranes with large mean pore sizes exhibit hemolysis at lower operating transmembrane pressures. Surface structure and not necessarily por tortuosity has been found to be more important, at least for the hollow fiber membranes studied. Mean membrane pore data coupled with SEM observations were useful in correlating red cell lysis with membrane properties. The red cell may be likened to a liquid drop, encased by a flexible deformable membrane. Cell deformation, orientation, and rotation increase as does interfacial surface tension with rising rates of shear. A high correlation of interfacial surface tension with shear rate was determined using a filtration model incorporating cell deformability. Interfacial surface tensions of less than 6 dynes/cm for shear rates up to 1000s-1 were found. Inclusion of blood and membrane properties in the analysis of plasma separation gives significantly better fit of the experimental data to theoretical correlations than do other models which exclude their consideration.
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