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Biomedical subjects

J C Barbenel

Publications and source records attributed to J C Barbenel.

At least 19 recordsLinked to original sources

Mechanical and optical anisotropy of bovine pericardium.

A Moiré fringe method was used to determine the shape of inflated disks of fresh bovine pericardium. The results suggested that the tissue was anisotropic and allowed the identification of the directions of the axes of elastic symmetry. Quantitative biaxial inflation and simple tension tests confirmed the anisotropy. In the circumferential direction the tissue was more extensible and had greater mean strength (18 MPa against 2.5 MPa) and mean terminal modulus (46 MPa against 14 MPa) than in the root-to-apex direction. The tissue was also optically anisotropic when viewed by transmitted polarised light and the directions of mechanical and optical anisotropy were related.

Animals

Novel quantitative methods for the determination of biomaterial cytotoxicity.

Two novel methods for the determination of biomaterial cytotoxicity using cell culture are presented. The methods combine a standardized protocol for producing extracts from medical devices with either the established MTT assay or a new fluorimetric assay. The suitability of both methods for evaluating the toxicity of candidate materials was demonstrated by resolution of the differences in the toxic effects of serial dilutions of a PVC extract on BHK21 and HT1080 cells. The tests yield highly reproducible, quantitative results and can be applied to materials in the usual physical forms applicable to artificial organs.

Animals

The influence of model parameter values on the prediction of skin surface temperature: II. Contact problems.

A model of heat transfer and temperature distribution in the skin and superficial tissues which is based on a finite difference numerical solution of the one-dimensional multilayer coupled bioheat equation is presented. The model is used to investigate the influence of the values chosen to represent the physiological and thermal properties of the tissues on the skin surface temperature after contact with an external medium. It was found that the skin blood flow and dermal conductivity were the main cutaneous parameters which influence the contact response, but in terms of normalized temperature the response was little influenced by cutaneous metabolic heat generation and deep dermal temperature. For contact with a good conductor, the transient behaviour was sensitive to the heat transfer coefficient on the outer surface and the thickness of the contact material, but insensitive to the conductivity of the material.

Humans

Influence of age on postischaemic reactive hyperaemia.

This work was carried out to evaluate the response of skin microcirculation to ischaemia in younger and older subjects, to determine if there were functional changes in microcirculation in the older skin. Skin perfusion during reactive hyperaemia was measured at volar sites on the forearms in five younger (mean age: 25.2 years) and five older normal subjects (mean age: 64.6 years). Ischaemia was produced by the application of loads of 22.3 N (24.5 kPa) and 44.5 N (49.0 kPa) applied to the skin surface for 3 min by means of a hollow cylindrical indentor. The skin perfusion within the area indented was continuously monitored by a laser Doppler flowmeter before, during and after loading. In the pre-loaded condition, there was no difference in skin perfusion between the younger and the older groups. Following loading with 22.3 N a significantly lower value of the peak perfusion relative to the pre-loaded value was observed in the older group (P less than 0.05). The perfusion in the older group following loading with 44.5 N was significantly reduced compared to the younger group (P less than 0.05). It is concluded that postischaemic reactive hyperaemia in the older skin was reduced compared with the younger skin.

Adult

Pressure management.

The prevention or minimisation of the occurrence of pressure sores is an important consideration in the rehabilitation of physically disabled people, especially for the wheelchair user with a spinal cord injury. Although there is little definitive information on the cause of pressure sores, several intrinsic and extrinsic factors have been highlighted. Probably the most significant causative factor is the application of force to the skin surface. The relationship between the magnitude of pressure and its duration; the temperature and humidity at the interface; and the physiological effects that this has on the microcirculation and lymphatic drainage are discussed in this article. It is suggested that a rationale for the prevention of pressure sores includes the limitation of the duration of pressure applied to the skin surface and the reduction of the peak pressures particularly at vulnerable sites. In this context the design criteria for a clinical interface pressure measurement system, and the uses and limitations of the commercially available options, are considered. The development of a structured programme of wheelchair and support surface provision, assessment and follow-up is required.

Equipment Design

Mechanical and failure behaviour of the stratum corneum.

The load-deformation-time behaviour of heat-separated human stratum corneum was investigated using a pure shear specimen geometry. The tissue displayed non-linear load-deformation behaviour and stress relaxation, although the extensibility and amount of stress relaxation was considerably less than that shown by other soft connective tissues. Controlled failure tests were carried out after an edge cut had been made in the pure shear specimen. Sources of secondary failure, either at the free edge of the specimen, or due to the presence of inhomogeneities in the tissues, were common. Analysis of the test results suggested that the fracture surface energy of stratum corneum has a mean value of 3.6 kJ m-2 which is comparable with the tougher synthetic polymers.

Biomechanical Phenomena

Device for measuring soft tissue interface pressures.

This paper describes the construction and performance of a simple pressure sensing device with a continuous electrical output. It was constructed utilizing a commercially available transducer, an electropneumatic sensor capsule and a 1 m long tube. The transducer used was a piezo-resistive pressure-sensitive device producing an output voltage proportional to the applied pressure. This low cost, high accuracy device is temperature compensated and shows good linearity and negligible hysteresis. The sensor cell has a good thickness-to-diameter ratio and is sufficiently flexible to conform to most contours of the body. The tubing that conveys the pressure transmitting fluid also serves as a means of keeping the transducer distant from the measuring site. The device showed a highly satisfactory performance under laboratory conditions and has proven to be robust and reliable when used for clinical studies.

Equipment Design

The influence of model parameter values on the prediction of skin surface temperature: I. Resting and surface insulation.

A model is presented of heat transfer and temperature distributions in the skin and superficial tissues. It is based on a finite difference numerical solution of the one-dimensional multilayer coupled bioheat equation. In this paper, the model is used to investigate the influence of the values of parameters chosen to represent the physiological and heat transfer processes on the temperature of the skin under resting conditions and after insulation of the skin surface. Equilibrium resting temperatures were strongly influenced by deep body temperature especially at lower heat transfer coefficients on the skin surface, but slightly affected by the values chosen for skin blood flow and metabolic heat generation; both the heat transfer coefficients and environmental temperature strongly influenced the surface temperature. After surface insulation the temperature elevation was strongly influenced by the thermal conductivities of tissues, skin blood flow and deep boundary temperature; metabolic heat generation was only significantly at unphysiologically high values.

Humans

Further evidence that the residual vWf:Ag in porcine FVIII:C induces human platelet aggregation.

Porcine or bovine factor VIII concentrates (FVIII:C) have been used during the past 3 decades to control bleeding in patients who have developed antibodies to human factor VIII. Since current preparations of animal FVIII:C are not known to transmit infectious agents such as hepatitis or human immunodeficiency virus, they are of potential therapeutic interest. A purified porcine FVIII:C (Hyate:C) is now widely used as an alternative to human FVIII:C in patients with inhibitor. Unlike earlier preparations of porcine FVIII:C, thrombocytopaenia is rare with the current preparation. Nonetheless, it causes the aggregation of human platelets in vitro. Our aim was to identify precisely the plasma factor which induces platelet aggregation. The effects of commercial porcine FVIII:C, porcine fibrinogen, porcine fibronectin and the corresponding preparations from human origin on platelet aggregation were studied. Platelet aggregation was quantified by measuring the fall in single platelet count in human whole blood. Of these preparations, only porcine FVIII:C (0.1-1 U/ml) and porcine fibrinogen (80-600 micrograms/ml) induced a fall in single platelet count of up to 85% due to aggregation. The extent of aggregation was directly proportional to the amount (0.007-0.1 U/ml test aliquot) of residual von Willebrand factor antigen (vWf:Ag) in the preparations. A monoclonal antibody to vWf:Ag inhibited the aggregation. We believe that the aggregation of human platelets induced in vitro by porcine FVIII:C is mediated by vWf:Ag which also may be responsible for thrombocytopaenia reported following administration of porcine FVIII:C in vivo.

Animals

Dipyridamole inhibits red cell-induced platelet activation.

We have recently shown that red blood cells can induce spontaneous platelet aggregation (SPA) in whole blood ex vivo, which could be inhibited by dipyridamole. Since this drug, at therapeutic doses is not an effective inhibitor of platelet aggregation in platelet rich plasma, the inhibition of platelet interaction with the red cell was thought to be the mechanism of its action. Values for the percentage fall in the single platelet count due to SPA in whole blood after 3 and 6 min rollermixing were: control 15 +/- 2.2 and 42 +/- 2.9; 6 microM dipyridamole 6 +/- 1.1 (P less than 0.001) and 31 +/- 2.6 (P less than 0.01); 12 microM dipyridamole 2 +/- 0.9 (P less than 0.0005) and 22 +/- 2.3 (P less than 0.0005) (mean +/- SEM, n = 10). Electron microscopic observation revealed that the aggregation involves an initial platelet adhesion to the red blood cell; the adherent platelets then become activated and serve as foci for the growing aggregates. Dipyridamole appeared to inhibit the initial platelet adhesion to the red cell (the principal trigger mechanism for SPA) which may mimic the initiation of thrombosis in some situations in vivo. The inhibitory effect of dipyridamole on the platelet-red cell interaction suggests that this drug has antithrombotic potential in situations where red blood cells have a trigger role in platelet activation and may explain why the drug has been more effective in some situations than in others.

Adult

Human whole-blood granulocyte aggregation in vitro.

1. Aggregation assays are a commonly used technique for the study of granulocyte activation. These studies are usually performed using a pure cell suspension in buffer. This necessitates a separation procedure which is time-consuming and may modify the function of the cells. Interaction between different cell types is precluded. 2. To avoid these disadvantages a method was developed which quantifies granulocyte aggregation in whole blood. Samples drawn from an incubated vessel before and after the addition of a chemotactic stimulus were fixed with formaldehyde to prevent disaggregation. Erythrocytes were then removed by chemical lysis and using an electronic cell-sizing device the number of single cells and aggregates could then be easily measured. 3. Results from a group of volunteers showed a rapid and reversible response to a chemotactic tripeptide, with a fall in single granulocyte count and the appearance of doublets and triplets. Lymphocytes were unaffected. Intra-assay reproducibility was better than +/- 5%. 4. Using this assay, a significant elevation in aggregability was observed in blood from patients after acute myocardial infarction. 5. This novel technique, by avoiding the separation step, is faster, simpler and more physiological than previous methods, and as such is useful for both assays of drug action in vitro and the study of cell activation in disease states.

Adult

Modelling transient heat transfer through the skin and a contact material.

Two thermal models of the skin and superficial tissues are described, both of which incorporate the thermal effects of subcutaneous and dermal blood flow through temperature-dependent heat sources. The model which represents the dermal blood flow as the perfusion of a region of finite thickness gives rise to purely numerical solutions for the transient temperatures. Representing the dermal blood flow by a heat generating surface gives rise to a model which yields explicitly analytical expressions. Although these analytical expressions require numerical integration techniques to finally evaluate them, they are of a form which allows temperature values to be derived more efficiently than by the purely numerical method. Both models are used to predict the time-dependent temperature profiles resulting from the interaction between the tissues and thermally passive materials in intimate contact with the skin surface. The predictions of the two models are compared and the limitations of the analytical model highlighted.

Aluminum

Mouthpiece forces produced while playing the trumpet.

A transducer for measuring the force applied to the trumpet mouthpiece during performance is described. The device allowed the players to perform on their own instrument and in their usual manner. The results of tests on 60 subjects showed that during playing the force between the mouthpiece and instrument increased with increasing loudness and ascending pitch but that there was no significant correlation between mouthpiece force and proficiency or style. The maximum force which the players could tolerate was greater for high proficiency players than for medium.

Biomechanical Phenomena

Red blood cells mediate spontaneous aggregation of platelets in whole blood.

The influence of red blood cells on spontaneous platelet aggregation (SPA) has been studied ex vivo. Platelet aggregation was quantified by measuring the fall in single platelet count using a new whole blood platelet counter. When aliquots of whole blood and autologous platelet rich plasma (PRP) were roller-mixed at 37 degrees C, a marked fall in platelet count occurred in whole blood due to SPA but platelet count remained almost unchanged in PRP. When blood from healthy young controls, aged 20-35 years, was compared with healthy old controls, aged 48-80 years, and patients with thrombotic complications, the extent of SPA was in the order: thrombotic patients greater than old controls greater than young controls. Prostacyclin and the new stable prostacyclin analogue Iloprost, at 8 nM effectively inhibited SPA. 2-Chloroadenosine (10 microM) which is an inhibitor of ADP-induced platelet aggregation was also an effective inhibitor of SPA. Acetylsalicylic acid (56 microM) and the thromboxane A2 receptor blocker BM13.177 (0.5 microM) only partially inhibited SPA. ADP from red blood cells is suspected to mediate red cell-induced SPA. However, the possibility that the red cells have an important physical role in SPA cannot be ruled out.

2-Chloroadenosine

Comparison of inhibitory actions of prostacyclin and a new prostacyclin analogue on the aggregation of human platelet in whole blood.

Prostacyclin (PGI2), an unstable endogenous prostanoid, is a potent vasodilator and inhibitor of platelet aggregation. The use of exogenous PGI2 as an antithrombotic agent is limited by its chemical instability and lack of dissociation between its vasodilatory and antithrombotic actions. Iloprost (ZK36374) is a recently developed, chemically stable, carbacyclin analogue of PGI2. Preliminary evaluation studies have shown a significant dissociation between vasodilatory and antithrombotic actions of Iloprost. We have compared the effects of PGI2 and Iloprost on platelet aggregation in human whole blood. Platelet aggregation was induced by ADP (4 microM), adrenaline (Adr, 0.4 microM) and arachidonic acid (AA, 0.4 mM). Aggregation was quantified as a fall in the number of single platelets counted using the Clay Adams Ultra Flo 100 whole blood platelet counter. In the absence of any PGI2 or Iloprost, each aggregating agent induced up to an 80% fall in the number of single platelets counted. When blood was pre-incubated with PGI2 (1-6 nM) or Iloprost (1-6 nM), aggregation responses to all three aggregating agents were inhibited in a dose-dependent manner. Iloprost was equipotent to PGI2 against ADP-induced aggregation but was more potent than PGI2 against Adr- and AA-induced aggregation. It is concluded that Iloprost, as a chemically stable PGI2 analogue, may be superior to PGI2 as an antithrombotic agent.

Adenosine Diphosphate