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At least 127 records · Page 7Linked to original sources
PubMed2003

Transplant recipients' conceptions of three key phenomena in transplantation: the organ donation, the organ donor, and the organ transplant.

Thirty-five heart and kidney transplant patients were interviewed on five separate occasions during the first 2 yr after transplantation. The aim was to explore their experiences of phenomena that distinguish the transplantation from other kinds of medical treatment. The selection of informants was designed to permit comparisons between recipients with heart and kidney transplants and with living and necro-transplants. The qualitative analysis of the informants' reactions was focused on three themes; nine categories emerged. The first theme concerned general aspects of the donation and the donor and was differentiated in four categories: joy and sorrow, gratefulness and indebtedness, guilt, and inequity. The second theme related to the donor as a unique individual and included three categories: recognition and identification with the donor, influences of the donor, and relationship to the living donor. The third theme pertained to incorporation of the transplant and included two categories related to the naturalness of having a transplant, and the benevolent transplant. The informants' reactions were discussed in terms of primary and secondary processes. All informants were in an emotionally charged situation after transplantation and warded off anxiety-provoking impulses, most intensively during the first 6 months. Avoidance, suppression, and denial were the most common defence mechanisms, all of which seemed to be supported by the medical context. Other, more constructive strategies are suggested. The recipients' own interpretations of causes to possible personality changes are discussed. There were few differences between heart and necro-kidney patients concerning the reactions to the donation, the donor, and the transplant; the dividing line was more prominent between recipients with living and necro-transplants.

Attitude to Health↗
PubMed1996

The Logistic Organ Dysfunction system. A new way to assess organ dysfunction in the intensive care unit. ICU Scoring Group.

OBJECTIVE: To develop an objective method for assessing organ dysfunction among intensive care unit (ICU) patients on the first day of the ICU stay. DESIGN AND SETTING: Physiological variables defined dysfunction in 6 organ systems. Logistic regression techniques were used to determine severity levels and relative weights for the Logistic Organ Dysfunction (LOD) score and for conversion of the LOD score to a probability of mortality. PATIENTS: A total of 13 152 consecutive admission to 137 adult medical/surgical ICUs in 12 countries from the European/North American Study of Severity Systems. OUTCOME MEASURES: Patient vital status at hospital discharge. RESULTS: The LOD System identified from 1 to 3 levels of organ dysfunction for 6 organ systems: neurologic, cardiovascular, renal, pulmonary, hematologic, and hepatic. From 1 to 5 LOD points were assigned to the levels of severity, and the resulting LOD scores ranged from 0 to 22 points. Model calibration was very good in the developmental and validation samples (P=.21 and P=.50, respectively), as was model discrimination (area under the receiver operating characteristic curves of 0.843 and 0.850, respectively). CONCLUSION: The LOD System provides an objective tool for assessing severity levels for organ dysfunction in the ICU, a critical component in the conduct of clinical trials. Neurologic, cardiovascular, and renal dysfunction were the most severe organ dysfunctions, followed by pulmonary and hematologic dysfunction, with hepatic dysfunction the least severe. The LOD System takes into account both the relative severity among organ systems and the degree of severity within an organ system.

Adult↗
PubMed1992

Organization of the septal organ projection to the main olfactory bulb in adult and newborn rats.

The septal organ, which is regarded as an olfactory subsystem, is a small patch of sensory epithelium located ventral to the main olfactory sheet on the septal wall of the nasal cavity. The only consensus to date regarding some proper area of projection of this subsystem is that the septal organ projects to the medial aspect of the main olfactory bulb. The purpose of our study was to analyze precisely the topographical organization of the bulbar projection of the septal organ in adult rats and in 3- to 15-day-old rats following WGA-HRP placements at the level of the septal epithelium. Results show that the septal organ projects exclusively to the posterior half of the main olfactory bulb and its projection area is mainly restricted to the ventromedial bulbar aspect. When the septal organ was fully injected, the pattern of bulbar projection was characterized by two types of glomerular labeling: 1) presence of single heavily labeled glomeruli identified as "septal" glomeruli, since they were mainly built up by afferents coming from the septal organ and (2) presence of a thin network of labeled septal fibers distributed in glomeruli which were mainly formed by afferents coming from the main olfactory epithelium. Although the pattern of mucosobulbar projection of the septal organ is already established in newborns, a significant increase in the number of "septal" glomeruli occurs during the first 15 postnatal days. Anatomical data indicate that even if the projection of the septal organ does not appear completely segregated in the olfactory bulb, this projection is not either exactly similar to that of the main olfactory epithelium.

Aging↗
PubMed1991

Vascular anatomy and organ-specific tumor growth as critical factors in the development of metastases and their distribution among organs.

We have examined with 19 tumor cell lines the discrete roles that vascular anatomy and tumor-cell-organ-affinity play in the development of metastases and their distribution among organs. Spontaneous metastases of B16-G3.26 melanoma cells from a primary tumor growing in the foot pad of mice, or experimental metastases 21 days after intravenous tumor-cell injection resulted in tumor colonies only in the lungs. In contrast, when the lung microvasculature was bypassed, and the same cells given by systemic intra-arterial (s.i.a.) injection, large tumor colonies developed selectively in the ovaries, adrenal glands and bones, but rarely in the lungs. When animals injected i.v. were allowed to live with lung metastases for a long period of time, small tumor colonies began to develop in extra-pulmonary organs with a distribution identical to that seen after s.i.a. injection. Seven murine tumor cell lines (previously characterized by their ability to colonize primarily the lungs after i.v. injection) and 7 of the 8 studied human tumor cell lines colonized different specific extra-pulmonary organs after s.i.a. injection, frequently producing metastatic syndromes commonly described in patients with cancer, but rarely seen in animal models of metastasis. These results suggest that metastatic cells, even those capable of colonizing specific organs, do not freely circulate in the blood stream and lodge in specific tissues. In contrast, the cells must establish a vascular route of access to the target organ, e.g., through the systemic circulation from metastatic tumors in the lungs. Two cell lines considered to be tumorigenic but non-metastatic failed to colonize the lungs or extra-pulmonary organs after i.v. injection, but readily colonized specific organs after s.i.a. injection. Thus, tumor cells considered to be non-metastatic may be indeed metastatic if they are provided with vascular access to an organ more congenial to their growth requirements.

Animals↗