Biomedical subjects

A Coumbe

Publications and source records attributed to A Coumbe.

25 records · Page 2Linked to original sources

PubMed1993

The lining of textured surfaces in implantable left ventricular assist devices. An immunocytochemical and electronmicroscopic study.

OBJECTIVE: The aim was to examine and identify some components of biological linings developed upon the textured surfaces of a circulatory assist device. The development of biological linings upon a textured surface circulatory assist device was evaluated in patients implanted for periods ranging from 84 to 132 days. METHODS: Explanted devices were examined macroscopically. Light microscopy, transmission electron microscopy and immunocytochemistry techniques were employed to evaluate the histogenesis of the tissue deposits upon the device surfaces. Visible material was essentially limited to focal areas upon the static housing and the periphery of the pusher-plate diaphragm (Biomer). RESULTS: Microscopy of the linings showed fibrin-rich areas with platelets, monocytes and few spindle-shaped surface cells. Central areas were composed of multiple layers of spindle-shaped cells separated, mainly, by collagen. Giant-cell foreign-body reaction to Biomer fibrils was seen. CONCLUSION: Transmission electron microscopy and immunocytochemistry indicated the presence of at least two cell populations: fibroblasts and smooth muscle-like cells, or 'myofibroblasts'. There was no evidence of endothelial cell presence.

Adult↗

PubMed1992

The development of an in-vitro perfusion system for studies on cultured cells.

The design and use of a perfusion system, using a modified flow chamber for studies on cultured animal cells, is described. Rat thoracic aorta smooth muscle cells were isolated by an explant method and grown on Thermanox coverslips. These were introduced into the flow chamber. A flow rate of 25ml/min and a shear stress of 14.6 dynes/cm2 (12 dyne = 10 microN) (both within physiological limits) were maintained. Cells remained attached to the coverslips after 8h of perfusion with culture medium. The effect of exposing rat smooth muscle cells to the cardiovascular toxin, allylamine, is also described. The components of the system are routinely available, simple to clean, easy to assemble and sterilize. The incorporation of an in-line sensor that monitors pH, PO2, PCO2 and temperature ensures that the perfusion conditions remain within physiological limits. Automation means that minimal supervision is required. This system provides a potential mechanism in which cultured vascular cells may be perfused under controlled haemodynamic conditions, and their response to a cytotoxin may be evaluated.

Allylamine↗

PubMed1990

Neo-intimal development on textured biomaterial surfaces during clinical use of an implantable left ventricular assist device.

Implantable left ventricular assist systems are being developed for long term clinical use. Prototype devices are currently used as extended mechanical bridges to cardiac transplantation. The Thermo Cardiosystems Inc. (TCI) pneumatic pusher plate left ventricular assist device (LVAD) features textured blood contacting surfaces to encourage the formation of an adherent fibrin-cellular coagulum. This serves as the foundation for the development of a neo-intimal lining. The TCI LVAD was implanted in 6 male patients (age range 22-53 years) between 1986 and 1988. The duration of implantation ranged from 1-41 days. No clinical thromboembolic events or pump-related thromboembolism occurred and none was evident at necropsy. The six device linings have been fully evaluated. Explanted devices were free of thrombus and calcification. Lining samples for light and electron microscopy were collected from areas of the diaphragm identical for flex and blood shear conditions and from high and low shear areas on the static housing. Islands of collagenous tissue were deposited on the static housing amongst compact fibrin. By day 13, cells populated the surface of the developing neo-intima overlying the diaphragm. By 41 days, the surface cell density increased and the cells became spindle shaped and relatively orientated in the high shear/flex area. Immunohistochemical techniques suggest that these cells are of mesenchymal origin. Textured blood contacting surfaces appear satisfactory in the preliminary clinical use of this device.

Adult↗

PubMed1990

The use of an implantable left ventricular assist device following irreversible ventricular fibrillation secondary to massive myocardial infarction.

A TCI1 rough surface left ventricular assist device (LVAD) was implanted in a 47-year-old man who had sustained a recent massive myocardial infarction complicated by ventricular failure which remained unresponsive to intra-aortic balloon pump therapy and which was further complicated by irreversible ventricular fibrillation. Following implantation of the device and while awaiting a suitable donor organ for transplantation, further extension of the previous infarct resulted in left ventricular rupture and massive haemorrhage which led to his death. We report the successful use of the device in providing haemodynamic support, but caution against inordinate delay in bridging to transplantation patients who are at risk of extension of infarction.

Heart-Assist Devices↗

PubMed1990

Nucleolar organiser regions in endometrial hyperplasia and neoplasia.

Nucleolar organiser regions (NORs) were counted in the nuclei of both epithelial and stromal cells in cases of endometrial hyperplasia and carcinoma. The scores for each case were expressed as a ratio. No significant difference was found between the ratios for cystic hyperplasia and hyperplasia with architectural atypia, confirming the view that these are morphological variants of the same benign hyperplastic process. The ratios for hyperplasia with cytological atypia and adenocarcinoma differed significantly from the benign hyperplasias. This adds support to the view that hyperplasia with cytological atypia should be considered a neoplastic condition.

Adenocarcinoma↗

PubMed1990

Cytomegalovirus and human herpesvirus-6 in sudden infant death syndrome: an in situ hybridization study.

Thirty lung, spleen, and thymus sections and four lymph node sections from 40 sudden infant death syndrome (SIDS) cases were probed with biotinylated DNA probes specific for human herpesvirus-6 (HHV-6) and cytomegalovirus (CMV). Control material gave a strong, distinct signal with little or no background staining and no cross-reactivity. No staining was found with the SIDS material. We find no evidence to implicate an overwhelming infection by either virus in SIDS.

Cytomegalovirus Infections↗

PubMed1987

Vitamin A and D status of black South African women and their babies.

Knowledge of the vitamin D status of pregnant and lactating women in developing countries is very limited. An elective visit to the Transkei therefore provided us with the opportunity to study the relationship between the vitamin A and D status of dark-skinned mothers and babies resident in an environment of high sunshine exposure. 25-hydroxyvitamin D, retinol and retinol binding protein (RBP) were measured in serum samples collected from 43 black South African women and their babies, shortly after delivery. The results were compared with values obtained on sera from pregnant white and black women resident in the UK. The values for serum retinol in the Transkei mothers and babies were low. This accords with the poor nutrition and consequent high childhood mortality observed in this population. In contrast, the serum 25-OHD values were normal. This suggests that in these malnourished black South African mothers, normal vitamin D status is maintained by actinic synthesis.

Adult↗