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Biomedical subjects

W D Wallace

Publications and source records attributed to W D Wallace.

7 recordsLinked to original sources

Phosphorylated S6 ribosomal protein: a novel biomarker of antibody-mediated rejection in heart allografts.

We tested the hypothesis that phosphorylation of S6 ribosomal protein (S6RP), a downstream target of the PI3K/Akt/mTOR pathway, is a biomarker of antibody-mediated rejection (AMR) in heart allografts. Primary cultures of human aortic and microvascular endothelial cells (EC) were treated with anti-HLA class I and class II antibodies (Ab) and cell lysates were studied for phosphorylation of S6 ribosmal protein at Serine235/236 (p-S6RP). Treatment of cultured EC with anti-class I and class II Ab stimulated S6RP phosphorylation. Immunohistochemical techniques were used to detect the level of p-S6RP in endomyocardial biopsies (n = 131) from 46 heart transplant recipients and the results were correlated with histopathological diagnosis of rejection, C4d staining, production of posttransplant anti-HLA Ab and clinical outcome. Increased phosphorylation of S6RP in endomyocardial biopsies was significantly associated with the diagnosis of AMR (p < 0.0001). No significant association between acute cellular rejection (ACR) and p-S6RP was observed. C4d staining was positively associated with both AMR and p-S6RP. Posttransplant anti-HLA class II Ab production was also significantly associated with a positive p-S6RP status in cardiac biopsies. These results indicate that p-S6RP is a useful biomarker for the diagnosis of AMR.

Acute Disease↗

Instrumentation for monitoring gas exchange and metabolic rate in critically ill patients.

In the critically ill patient the monitoring of oxygen consumption (VO2) and carbon dioxide production (VCO2) can identify abnormalities in tissue perfusion and metabolism. A patient's metabolic utilization can be calculated by indirect calorimetry, once VO2 and VCO2 are measured. This paper evaluates a compact instrument designed for monitoring VO2 and VCO2 in the critically ill adult. Accuracy was measured under controlled laboratory conditions using oxygen-enriched air, PEEP, and intermittent mandatory ventilation (IMV). Accuracy averaged 1.3% for VO2 and 0.9% for VCO2 when room air was used. Accuracy was 11.7% for VO2 and 6.8% for VCO2 when 80% oxygen was used. PEEP of 30 cm H2O had little effect on accuracy. IMV at 2 breath/min (room air) resulted in an accuracy of 4.0% and 4.1% for VO2 and VCO2, respectively.

Basal Metabolism↗

Blood-gas analyzer calibration and quality control using a precision gas-mixing instrument.

We describe a new instrument that performs on-site mixing of oxygen (O2), carbon dioxide (CO2), and nitrogen (N2) to create compositions that can replace gases from standard premixed cylinders. This instrument yields accurate and predictable gas mixtures that can be used for two-point gas calibration of blood gas/pH analyzers or for liquid tonometry of either an aqueous buffer or blood used as quality-control material on blood-gas electrodes. The desired mixture of O2, CO2, and N2 is produced by microprocessor control of the sequential open-times on three solenoid valves that meter these pure gases through a common small-bore orifice. Any combination of O2 and CO2 can be chosen by dialing the front panel thumbwheels and pressing a button. Gas chromatographic evaluation of this gas-mixing instrument demonstrates its accuracy and precision to be better than +/- 0.1% absolute full scale for O2, CO2, and N2, making this instrument calibration and tonometry.

Blood Gas Analysis↗

New gas-liquid equilibration method: syringe tonometer.

This new apparatus for gas-liquid equilibration (tonometry) in a transportable vessel is designed for tonometry of blood or buffer solution in a specially designed syringe. Gas enters the syringe chamber through small holes in the tip of the syringe plunger and bubbles upward through the sample. The syringe plunger is a second chamber, which is used for warming and humidifying the gas before it enters the tonometer chamber. The entire syringe is housed in a transparent, temperature-controlled environment during equilibration. After equilibration, the sample is easily entered into a blood-gas analyzer. At most, gas-liquid O2/CO2 equilibration for 2.5 mL of buffer or blood requires less than 13 min. Comparisons with a standard thin-film tonometer show good agreement for pO2 and pCO2 over the range 0-93 kPa (0-700 mmHg) and 2-20 kPa (14-150 mmHg), respectively. The syringe tonometer eliminates contamination of the sample during transfer and transport to the analyzer, thus making tonometry more technique-independent. The apparatus is simple and easy to use, with definite advantages over existing methods of tonometry.

Blood Gas Analysis↗