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Changing Roman Catholic attitudes toward termination of life-sustaining treatments.
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I have a conscience, too: the plight of medical personnel confronting the right to die.
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The constitution in a brave new world: a century of technological change and constitutional law.
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The significance of the legacy of Karen Ann Quinlan.
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Effects of cold storage on the subsequent structure and function of microvenous autografts.
A study was undertaken to evaluate the structure and patency of cold stored rabbit femoral veins following reinsertion as autografts for 3 weeks. The periods of cold ischaemic storage were 1, 2, 3 and 4 weeks (n = 10/gp) and 6 and 10 weeks (n = 6/gp). All rabbits were subject to 3 operations under general anaesthesia. In the first, a 4 cm segment of left femoral vein was harvested and stored at 4 degrees C for the specified ischaemic interval. Following storage the graft was microsurgically reinserted at a second operation into the right femoral artery of the donor rabbit. Three weeks later, graft patency was assessed by surgical exploration and the graft processed for light and electron microscopy. Patency rates remained over 80% after 3 weeks in all groups except the 10 week storage group where only 1 of 6 (17%) grafts was patent at 3 weeks. In all groups normal vein structure was absent, being replaced by thin walled necrotic areas or by neointimal ingrowth. The excellent patency rates achieved indicate it is possible to cold preserve extra lengths of vein grafts harvested at initial operation for reuse should regrafting be necessary.
The functional and structural effects of hypothermic storage on ischaemic arterial grafts.
The effects of hypothermic ischaemia on blood vessels are unknown. This study aimed to determine the 3 week patency rate and the pathology of 9 experimental groups of hypothermically stored ischaemic arteries and one control group in a rabbit femoral artery model. Ischaemia times were 0 h, 24 h, 1, 2, 4, 6, 8 and 10 weeks (Groups 1-8). Patency was over 80% in all groups after 3 weeks reinsertion. Following reinsertion control grafts maintained normal arterial structure, but cellular degeneration had occurred in all ischaemic grafts and appeared complete after 4 weeks ischaemia. The graft connective tissue framework frequently remained intact. Repair was evident in central graft regions after 2 weeks ischaemia and 3 weeks reinsertion, but occurred only adjacent to the anastomosis in 4-10 week ischaemic arteries. Four week ischaemic arteries (Groups 9 and 10) reinserted for 6 and 12 weeks respectively exhibited near complete repair but patency dropped to 60% in the 12 week group.