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Biomedical subjects

R Acland

Publications and source records attributed to R Acland.

14 recordsLinked to original sources

Effect of human IgG antiphospholipid antibodies on an in vivo thrombosis model in mice.

High levels of IgG antiphospholipid antibodies (aPL) have been associated with clinical thrombosis. It is uncertain however whether these antibodies play a direct role in thrombosis or are merely epiphenomena. To investigate whether antiphospholipid antibodies might play a role in thrombosis, we utilized a novel mouse model in which the dynamics of in vivo thrombosis can be studied. CD1 mice (26-30 g) were passively immunized with 25 mg of human IgG from a patient with the Antiphospholipid Syndrome (IgG-APS) (n = 17), IgG from normal pooled sera (IgG-NHS) (n = 9), or saline solution (n = 12), followed by 40 mg of the same preparations at 48 h. At 72 h, levels of human aPL antibodies, detected using the anticardiolipin ELISA test (aCL ELISA test), in mice immunized with IgG-APS, were 50-100 GPL units. Each animal was anesthetized, femoral vein minimally mobilized and subjected to a standardized "pinch" injury to induce thrombosis. The vessel was transilluminated using acrylic optical fibers connected to a light source, and clot formation and dissolution were visualized by a standard surgical microscope equipped with a video camera, video recorder, and computer assisted analysis system. Results showed that average clot size was significantly larger in mice immunized with IgG-APS compared to those treated with saline (p < 0.037). In addition, the thrombus persisted longer in a significantly higher number of mice immunized with IgG-APS (10/17) compared to mice immunized with IgG-NHS (1/9) or saline (2/12) (p < 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Continuous quantitative monitoring of mural, platelet-dependent, thrombus kinetics in the crushed rat femoral vein.

A new in vivo method to study the size and dynamics of a growing mural thrombus was set up in the rat femoral vein. The method uses a standardized crush injury to induce a thrombus, and a newly developed transilluminator combined with digital analysis of video recordings. Thrombi in this model formed rapidly, reaching a maximum size 391 +/- 35 sec following injury, after which they degraded with a half-life of 197 +/- 31 sec. Histological examination indicated that the thrombi consisted mainly of platelets. The quantitative nature of the transillumination technique was demonstrated by simultaneous measurement of the incorporation of 111In labeled platelets into the thrombus. Thrombus formation, studied at 30 min interval in both femoral veins, showed satisfactory reproducibility overall and within a given animal. With this method we were able to induce a thrombus using a clinically relevant injury and to monitor continuously and reproducibly the kinetics of thrombus formation in a vessel of clinically and surgically relevant size.

Animals

Reconstruction with free bowel autografts after pharyngoesophageal or laryngopharyngoesophageal resection.

Reliability has become a foremost requirement in pharyngoesophageal reconstruction because of the disastrous consequences after a failure. Our institution has achieved a 97 percent success rate using the free bowel autograft. We believe that this represents a significant accomplishment and designates the free bowel autograft as the reconstructive method of choice after pharyngoesophageal resection.

Aged

The osteocutaneous scapular flap for mandibular and maxillary reconstruction.

Microfil injections in 8 cadavers and clinical experience with 26 patients have demonstrated a reliable blood supply to the lateral border of the scapula based on branches of the circumflex scapular artery. This tissue has been used successfully for reconstruction of a variety of defects resulting from maxillectomy and mandibular defects from cancer and benign tumor excisions. Advantages of this tissue over previous reconstructive methods include the ability to design multiple cutaneous panels on a separate vascular pedicle from the bone flap allowing improvement in three-dimensional spatial relationships for complex mandibular and maxillary reconstructions. The lateral border of the scapula provides up to 14 cm of thick, straight corticocancellous bone that can be osteotomized where desired. The thin blade of the scapula provides optimum tissues for palate and orbital floor reconstruction. There have been no flap failures and minimal donor-site complications.

Adolescent

Microvascular surgical techniques used to provide skin cover over an ununited tibial fracture.

A case is described in which a large area of unstable skin overlying a tibial fracture was replaced by a single stage skin flap transfer, using microvascular surgical techniques. The shortening of treatment time and the improvement in the local blood supply compared to that provided by orthodox skin flaps are noted. The improved blood supply at the fracture site may have encouraged bony union.

Adult

Notes on the handling of ultrafine suture material.

For the convenient handling of microsurgical suture materials, suitable forceps are needed and these must be finely adjusted and well cared for. Only a short length of thread should be used on the needle. Difficulties arise in picking up the needle, in making a loop in the thread, in keeping the loop on the forceps while tying, and in picking up the end of the thread. Simple methods of avoiding entanglement and exasperation in these situations are described.

Microsurgery