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Biomedical subjects

Y Nose

Publications and source records attributed to Y Nose.

At least 163 records · Page 9Linked to original sources
PubMed1985

Laryngeal pacemaker. II. Electronic pacing of reinnervated posterior cricoarytenoid muscles in the canine.

A fully reliable means of rehabilitating patients with bilateral vocal cord paralysis has not yet been developed. In order to improve upon existing solutions to this problem, the authors have recently described a laryngeal pacemaker, initially tested through stimulation of a cross-over nerve-muscle pedicle from one sternohyoid muscle to the other in the canine. Afferent stimuli, initiated through elongation of the airway during inspiration, were detected by a linear strain gauge sutured to the tracheal rings and appropriately amplified. The current report deals with the application of this concept to pace a nerve-muscle pedicle reinnervating the posterior cricoarytenoid muscle. Videoscopic and cinematographic documentation of electrically paced abduction of the reinnervated vocal fold, synchronous with inspiration, was clearly demonstrated. Only miniaturization of an implantable electronic amplifier remains to permit an attempt at pacing of the paralyzed larynx in humans.

Animals↗
PubMed1985

The artificial heart: is it a wise option for health care?

Through Interdisciplinary Grand Rounds we hope to analyze new directions in the organization and delivery of health and medical care. Discussion will focus on current trends, their impact on the health care field and attempts to find solutions to the problems they present. These discussions are selected from the interdisciplinary conferences held at Case Western Reserve University, Cleveland, Ohio. Prepared from transcriptions, they are edited by the presenters and by the Health Matrix editorial staff. The following presentation was co-sponsored by the CWRU Medical School Committee for Student Representatives and the Student Bar Association of the CWRU Law School.

Ethics, Medical↗
PubMed1985

Experimental evaluation of complete electrically powered ventricular assist system.

The LVAS utilizing an intrathoracic blood pump and a parathoracic, electrohydraulic energy converter has a number of promising features. These include: transcutaneous energy transmission and an implanted variable volume device which eliminate the need for percutaneous access; utilization of an intrathoracic blood pump and variable volume device which allow the diaphragm and abdominal cavity to remain intact; parathoracic or subcutaneous location of the transformer secondary, energy converter, internal battery and interconnecting elements allowing replacement with a minor surgical procedure; employment of the "biolized" continuous blood contacting surface which has the potential of long-term use without anticoagulants and utilization of an electrohydraulic energy converter which provides synchronization without requiring transducers and associated electronics and which provides lubrication of mechanical components. The development effort, which began separately in 1977 and has been conducted jointly by Nimbus and the Cleveland Clinic since 1980, has demonstrated that the above features can be incorporated in a reliable LVAS. In particular, the system in vivo test series have demonstrated the soundness of the basic concepts and led to refinements which were demonstrated in the 6-1/2 mo test. All elements of the system have been utilized during the in vivo test program. Component tests of significance include: LVAS and total heart blood pump in vivo experiments of up to 7 mos duration which demonstrate the blood compatibility of the biolized surface without the use of long-term anticoagulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

A mathematical model to predict the optimal control mode for a pusher-plate total artificial heart (TAH).

Table I lists the physiological criteria for ranking each control mode (hemodynamic conditions assumed are listed in Figure 4). For each criteria, each mode was given a ranking of 0 to 3, with 3 the best. At the bottom of the table is the total of all criteria grades. The ranking from best to worst mode is in order: IND, LMA/LMS, Low FR/High FR, RMA/RMS. A discussion of Table I follows: FR is a reliable control mode and has been used extensively clinically, including the recent TAH human implants. The advantage of this mode is its simplicity: if the venous return is below pump capacity, then all incoming blood can be pumped out without any sophisticated controller. However, when the flow demand exceeds the pump capacity, HR must be increased. The ideal situation would be to set FR at one HR and %S, and leave these settings over the life of the recipient. However, a high HR like this would result in relatively high atrial pressures and low flow rates with respect to IND (as shown theoretically, in vitro, and in vivo). Although the patient would have a high maximum COR, the daily COR would be low, resulting in a relatively high AVO2 difference. Finally, FR lacks afterload sensitivity. RMA and RMS received the lowest grade of all modes. Because of the L-L shunt, the stroke length of these modes are smallest, and thus the CO curves and FPS are poorer than any other mode.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure↗
PubMed1985

Apheresis: clinical response to patients unresponsive to conventional therapy.

Ten of 13 (76.9%) rheumatoid arthritis (RA) patients having intensive cryofiltration treatment showed improvement and 5 of 7 (71.4%) of RA patients treated on maintenance cryofiltration therapy showed improvement. Encouraged by these results, 2 centers were established for controlled trial studies of RA patients. Four of 4 (100%) rheumatoid vasculitis patients treated by cryofiltration and 4 of 7 (57.1%) patients treated with plasma exchange showed clinical improvement. An SLE patient with thrombocytopenia showed a dramatic rise in platelet count during intensive (3 day/wk) plasma exchange treatments despite little prior response to drugs, platelet infusions and splenectomy. Plasmapheresis was effective in improving clinical symptoms and lipid abnormalities in a primary sclerosing cholangitis patient without causing hypoproteinemia during the long-term therapy (4 yrs).

Adult↗