Anti-idiotypic antibodies to HLA and their influence on patient sensitization.
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Biomedical subjects
Publications and source records attributed to R McCabe.
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Increased activity of the sympathetic nervous system has been implicated in the genesis of early hypertension in young people. Studies in pregnancy allow observations to be made on evolving, recently established and resolving hypertension in the human. We describe the results of two studies involving women who developed hypertension during pregnancy. In the first study, plasma concentrations of noradrenaline and adrenaline were measured in 17 women with pregnancy induced hypertension (PIH) and 17 normotensive pregnant control subjects. Plasma noradrenaline (nmol/l) was lower in the PIH group compared with control patients in both semi-recumbent (1.11 +/- 0.53 vs 1.98 +/- 0.96, P less than 0.001) and standing positions (1.31 +/- 0.65 vs 2.57 +/- 1.27, P less than 0.005). Five days post partum, plasma noradrenaline had risen in the PIH group compared with pregnant values in semi-recumbent (1.65 +/- 1.0 vs 1.11 +/- 0.52, P less than 0.05) and standing positions (2.46 +/- 1.5 vs 1.31 +/- 0.65, P less than 0.05). In the normotensive patients plasma noradrenaline did not differ between post partum and pregnant values (1.51 +/- 0.73 vs 1.98 +/- 0.96 semi-recumbent; 2.00 +/- 1.16 vs 2.57 +/- 1.7 standing). Logarithmic transformation of the noradrenaline concentration data resulted in a significant (P less than 0.02) negative correlation with diastolic blood pressure in the pregnant patients but not post partum. Plasma adrenaline concentration was the same in both groups. In the second study, plasma concentrations of noradrenaline and adrenaline were measured sequentially through pregnancy in five women who developed PIH and five control subjects who remained normotensive.(ABSTRACT TRUNCATED AT 250 WORDS)
Paired blood samples were obtained from mothers (venous) and babies (cord venous blood) at the time of delivery by caesarean section under epidural anaesthetic. Fetal platelets failed to aggregate in response to adrenaline in vitro although adrenaline could potentiate the threshold response to adenosine diphosphate (1 microM). Fetal platelet responses to collagen and 8 Arg vasopressin did not differ significantly from maternal responses. Maternal and fetal platelets also showed similar inhibition of aggregation after activation of adenylate cyclase (PGE1 and parathormone), in contrast to the inhibition of adenylate cyclase by adrenaline. Alpha 2 adrenoceptors were investigated using [3H] yohimbine binding receptor number and were reduced modestly but significantly on fetal compared to maternal platelets. The failure of fetal platelet aggregation in response to adrenaline appears to be related to a failure of receptor coupling and may represent a delayed maturation of fetal platelet alpha receptors or a response to increased circulating catecholamines during birth.
Delayed graft function is ischaemically induced and the consequence of high energy phosphate depletion. A new perfusate, described by Belzer, has been used in 43 kidney preservations, 16 of which had prolonged cold ischaemia. The overall immediate function rate was 37 of 43 kidneys or 86 per cent. Of 18 kidneys cold-stored during the same period, only nine functioned immediately. Twenty-six of these patients received cyclosporine for immunosuppression without an increase in delayed graft function or evidence of increased nephrotoxicity because of ischaemic injury or prolonged preservation.
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Unidirectional mucosal-to-serosal (Jm leads to s) and serosal-to-mucosal (Js leads to m) fluxes of potassium and sodium were determined simultaneously on paired sections of descending colon from the same rabbit under short-circuit conditions. In 13-16 pairs of tissues, net potassium secretion and sodium absorption averaged 0.49 +/- 0.08 and 4.0 +/- 0.8 mueq.cm-2.h-1, respectively. Short-circuit current (Jsc) averaged 3.7 +/- 0.4 mueq.cm-2.h-1 and was approximately equal to the algebraic sum of net potassium and sodium fluxes. Treatment of both sides of the colon with 10(-4) M ouabain reduced the Jsc and transmural potential difference to near zero. Ouabain abolished net potassium secretion by reducing JKs leads to m and abolished net sodium absorption by inhibiting JNam leads to s. In the presence of ouabain, net potassium absorption averaging 0.15 +/- 0.07 mueq.cm-2.h-1 (n = 11) was observed. In the presence of 10(-3) M 2,4-dinitrophenol, both net potassium and net sodium fluxes were abolished, primarily as a result of a reduction in JKs leads to m and JNam leads to s without altering JKm leads to s and JNas leads to m. These results suggest that the rabbit descending colon has the capacity to secrete and possibly to absorb potassium by active mechanisms requiring metabolic energy. Comparison of potassium and sodium fluxes suggest that the paracellular pathway in the rabbit colon is not potassium selective.
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One hundred fifty human cadaver kidneys have been preserved by a combination of topical hypothermia and pulsatile perfusion with cryoprecipitated plasma in our laboratory. Post-transplant acute renal failure was reduced from 58 to 21 per cent in those kidneys protected with furosemide and methylprednisolone.
Tilorone, a synthetic amino-alkoxyflorenone, has been demonstrated to prolong allografts in rats and dogs. Tilorone, in combination with low dose non-specific immunosuppression, appears to have an additive effect. Tilorone's mechanism of action is unclear at this time but may involve a combination of specific T lymphocyte depletion and interferon induction.
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OBJECTIVE: To compare the biomechanical characteristics and mode of failure of 2 parallel-screw techniques for proximal interphalangeal joint arthrodesis in horses. STUDY DESIGN: Randomized block design, blocking for horse (1-5), method of screw fixation (three 4.5-mm vs two 5.5-mm), side (left limb vs right limb), and end (front limb vs hind limb). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. SAMPLE POPULATION: Twenty limbs (10 limb pairs) from 5 equine cadavers. METHODS: A combined aiming device was used to facilitate consistent screw placement. Three parallel 4.5-mm cortical screws were placed in lag fashion in 1 limb of a pair, and 2 parallel 5.5-mm cortical screws were placed in lag fashion in the contralateral limb. Arthrodesis constructs were tested in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials-testing machine. Loading rate was 19 mm/s. Maximal bending moment at failure and composite stiffness were obtained from bending moment-angular deformation curves. Data were analyzed using ANOVA and chi(2) analysis. RESULTS: There were no significant differences in bending moment (P >.05, power = 0.8 @ delta = 19%) or composite stiffness (P >.05, power = 0.8 @ delta = 19%) between the 2 fixation techniques. Higher maximal bending moment was found in front limbs than hind limbs, and front limbs with two 5.5-mm screws than hind limbs with two 5.5-mm screws. In all cases, constructs completely failed. A greater number of 4.5-mm cortical screws failed than 5.5-mm cortical screws. CONCLUSIONS-In pastern arthrodesis constructs loaded in 3-point bending, end (front limb vs hind limb) affected maximal bending moment at failure of constructs. There was no significant effect of horse, treatment, or side on maximal bending moment or stiffness. Two 5.5-mm cortical screws should provide a surgically simpler pastern arthrodesis than three 4.5-mm cortical screws while maintaining similar biomechanical characteristics. CLINICAL RELEVANCE: Three 4.5-mm screws or two 5.5-mm screws will provide similar biomechanical characteristics in bending when performing equine pastern arthrodesis.