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Biomedical subjects

I Dunn

Publications and source records attributed to I Dunn.

6 recordsLinked to original sources

Clinical, morphological, and biochemical alterations in acute intestinal Yersiniosis.

The aim of this study was to examine the intestinal response to Yersinia enterocolitica (YE) infection. Growing New Zealand white rabbits (450-800 g) were infected with 10(10) organisms of a human pathogenic strain (n = 43) or NaHCO3 for controls (n = 30) and studied 3, 6, 10, and 14 days after infection. In a separate experiment infected (n = 6) and pair-fed controls (n = 6) were studied 6 days after infection. Weight gain, excretion of YE, and diarrhea were examined daily. At sacrifice segments of proximal and mid- and distal small intestine, cecum, and colon were obtained for histologic examination and mucosa of small intestine and colon for enzyme determinations. Infection with YE resulted in weight loss and diarrhea within 48-72 h. Microabscesses were present in all sections of small and large intestine by day 3 but became more severe in the ileocecal region by day 6. In infected animals at day 6 there was crypt hyperplasia throughout the small intestine and villus atrophy in the ileum. Disaccharidases were decreased in all regions by day 3 but returned to normal by day 14 in proximal and mid-, but not distal, small intestine. The pair-fed controls experienced a similar weight loss to infected animals, but showed only minor morphologic changes and no mucosal enzyme abnormalities. Our findings demonstrate that infection of weanling rabbits with YE causes diarrhea and weight loss and that, while the weight loss is largely due to reduced food intake, the morphologic and mucosal enzyme alterations are due to intestinal injury by the organism.

Acute Disease

Prosthetic arteriovenous fistula for vascular access in hemodialysis.

Vascular access through subcutaneous prosthetic arteriovenous fistulas was studied in eighteen dogs. Dacron velour and woven Dacron grafts (6 mm diameter) were constructed across the lower abdomen between the common femoral artery and the opposite common femoral vein. In heparinized animals 197 percutaneous punctures were made with a "14 guage hemodialysis cannula at weekly intervals. Over a period of one and a half years there was no instance of infection. One of the fourteen Dacron velous and all four woven Dacron fistulas thrombosed. These data suggested the feasibility of achieving repetitive blood access through Dacron velour vascular prostheses. Nineteen Dacron velour fistula bypasses between the brachial artery and median basilic vein were performed in fifteen selected patients for a total dialysis period of ninety-six months. Failed standard subcutaneous fistulas or absence of suitable vessels in the upper extremity were indications for the primary procedure. Of three looped forearm fistulas, two thrombosed at twenty-two and two months. Complications among sixteen straight bypasses in the arm included two graft infections and one cannula tract infection. There were no instances of thrombosis in this group. The advantages of single needle dialysis in these high risk patients have been emphasized. Eleven grafts are presently functioning two to nine months postoperatively. Our preliminary results suggest that a Dacron velour fistula merits consideration as an alternative for vascular access in maintenance hemodialysis.

Adolescent