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1.
J Mater Sci Mater Med ; 24(11): 2611-21, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23888352

RESUMO

Extracorporeal CO2 removal from circulating blood is a promising therapeutic modality for the treatment of acute respiratory failure. The enzyme carbonic anhydrase accelerates CO2 removal within gas exchange devices by locally catalyzing HCO3 (-) into gaseous CO2 within the blood. In this work, we covalently immobilized carbonic anhydrase on the surface of polypropylene hollow fiber membranes using glutaraldehyde activated chitosan tethering to amplify the density of reactive amine functional groups for enzyme immobilization. XPS and a colorimetric amine assay confirmed higher amine densities on the chitosan coated fiber compared to control fiber. Chitosan/CA coated fibers exhibited accelerated CO2 removal in scaled-down gas exchange devices in buffer and blood (115% enhancement vs. control, 37% enhancement vs. control, respectively). Carbonic anhydrase immobilized directly on hollow fiber membranes without chitosan tethering resulted in no enhancement in CO2 removal. Additionally, fibers coated with chitosan/carbonic anhydrase demonstrated reduced platelet adhesion when exposed to blood compared to control and heparin coated fibers.


Assuntos
Anidrases Carbônicas/metabolismo , Quitosana/química , Enzimas Imobilizadas/metabolismo , Glutaral/química , Pulmão/química , Membranas Artificiais , Animais , Dióxido de Carbono/isolamento & purificação , Microscopia Eletrônica de Varredura , Espectroscopia Fotoeletrônica , Ovinos
2.
Ann Biomed Eng ; 50(4): 387-400, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35171393

RESUMO

Immunohistochemistry for vascular network analysis plays a fundamental role in basic science, translational research and clinical practice. However, identifying vascularization in histological tissue images is time consuming and markedly depends on the operator's experience. In this study, we present "blood vessel detection-BVD", an automatic algorithm for quantitative analysis of blood vessels in immunohistochemical images. BVD is based on extraction and analysis of low-level image features and spatial filtering techniques, which do not require a training phase. BVD algorithm performance was comparatively evaluated on histological sections from three different in vivo experiments. Collectively, 173 independent images were analyzed, and the algorithm's results were compared to those obtained by human operators. The developed BVD algorithm proved to be a robust and versatile tool, being able to quantify number, area, and spatial distribution of blood vessels within all three considered histologic datasets. BVD is provided as an open-source application working on different operating systems. BVD is supported by a user-friendly graphical interface designed to facilitate large-scale analysis.


Assuntos
Algoritmos , Engenharia Tecidual , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imuno-Histoquímica , Neovascularização Patológica
3.
J Dent Res ; 100(10): 1039-1046, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33906502

RESUMO

Few university-based regenerative medicine innovations in the dental, oral, and craniofacial (DOC) space have been commercialized and affected clinical practice in the United States. An analysis of the commercial translation literature and National Institute for Dental and Craniofacial Research's (NIDCR's) portfolio identified barriers to commercial translation of university-based DOC innovations. To overcome these barriers, the NIDCR established the Dental Oral Craniofacial Tissue Regeneration Consortium. We provide generalized strategies to inform readers how to bridge the "valley of death" and more effectively translate DOC technologies from the research laboratory or early stage company environment to clinical trials and bring needed innovations to the clinic. Three valleys of death are covered: 1) from basic science to translational development, 2) from translational technology validation to new company formation (or licensing to an existing company), and 3) from new company formation to scaling toward commercialization. An adapted phase-gate model is presented to inform DOC regenerative medicine teams how to involve regulatory, manufacturability, intellectual property, competitive assessments, business models, and commercially oriented funding mechanisms earlier in the translational development process. An Industrial Partners Program describes how to conduct market assessments, industry maps, business development processes, and industry relationship management methods to sustain commercial translation through the later-stage valley of death. Paramount to successfully implementing these methods is the coordination and collaboration of interdisciplinary teams around specific commercial translation goals and objectives. We also provide several case studies for translational projects with an emphasis on how they addressed DOC biomaterials for tissue regeneration within a rigorous commercial translation development environment. These generalized strategies and methods support innovations within a university-based and early stage company-based translational development process, traversing the many funding gaps in dental, oral, and craniofacial regenerative medicine innovations. Although the focus is on shepherding technologies through the US Food and Drug Administration, the approaches are applicable worldwide.


Assuntos
Indústrias , Medicina Regenerativa , Humanos , National Institute of Dental and Craniofacial Research (U.S.) , Estados Unidos , Universidades
4.
J Control Release ; 299: 44-52, 2019 04 10.
Artigo em Inglês | MEDLINE | ID: mdl-30797003

RESUMO

Tissue engineering has gained considerable attention in the development of small diameter tissue engineered vascular grafts (TEVGs) for treating coronary heart disease. A properly designed acellular and biodegradable TEVG must encourage the infiltration and growth of vascular smooth muscle cells (SMCs). Our group has previously shown that increasing levels of TGFß2 can differentially modulate SMC migration and proliferation. In this study, tubular electrospun scaffolds loaded with TGFß2 were fabricated using various ratios of gelatin/polycaprolactone (PCL), resulting in scaffolds with porous nano-woven architecture suitable for tissue ingrowth. Scaffold morphology, degradation rate, TGß2 release kinetics, and bioactivity were assessed. TGFß2 was successfully integrated into the electrospun biomaterial that resulted in a differential release profile depending on the gelatin/PCL ratio over the course of 42 days. Higher TGFß2 elution was obtained in scaffolds with higher gelatin content, which may be related to the biodegradation of gelatin in culture media. The biological activity of the released TGFß2 was evaluated by its ability to affect SMC proliferation as a function of its concentration. SMCs seeded on TGFß2-loaded scaffolds also showed higher densities and infiltration after 5 days in culture as compared to scaffolds without TGFß2. Our results demonstrate that the ratio of synthetic and natural polymers in electrospun blends can be used to tune the release of TGFß2. This method can be used to intelligently modulate the SMC response in gelatin/PCL scaffolds making the TGFß2-loaded conduits attractive for cardiovascular tissue engineering applications.


Assuntos
Portadores de Fármacos/química , Miócitos de Músculo Liso/efeitos dos fármacos , Alicerces Teciduais/química , Fator de Crescimento Transformador beta/administração & dosagem , Animais , Materiais Biocompatíveis/química , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Gelatina/química , Humanos , Miócitos de Músculo Liso/citologia , Proteínas Recombinantes/administração & dosagem , Proteínas Recombinantes/farmacologia , Suínos , Engenharia Tecidual , Fator de Crescimento Transformador beta/farmacologia
5.
Materials (Basel) ; 12(24)2019 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-31835752

RESUMO

Scanning magnetic microscopy is a tool that has been used to map magnetic fields with good spatial resolution and field sensitivity. This technology has great advantages over other instruments; for example, its operation does not require cryogenic technology, which reduces its operational cost and complexity. Here, we presented a spatial domain technique based on an equivalent layer approach for processing the data set produced by magnetic microscopy. This approach estimated a magnetic moment distribution over a fictitious layer composed by a set of dipoles located below the observation plane. For this purpose, we formulated a linear inverse problem for calculating the magnetic vector and its amplitude. Vector field maps are valuable tools for the magnetic interpretation of samples with a high spatial variability of magnetization. These maps could provide comprehensive information regarding the spatial distribution of magnetic carriers. In addition, this approach might be useful for characterizing isolated areas over samples or investigating the spatial magnetization distribution of bulk samples at the micro and millimeter scales. This technique could be useful for many applications that require samples that need to be mapped without a magnetic field at room temperature, including rock magnetism.

6.
J Am Coll Cardiol ; 30(3): 689-93, 1997 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-9283527

RESUMO

OBJECTIVES: We hypothesized that sonicated 5% human albumin microbubbles (Albunex) adhere to disrupted vascular endothelium and that this interaction is a marker of endothelial integrity. This study sought to identify sites and determinants of Albunex-endothelial cell (EC) attachment. BACKGROUND: Under normal conditions, Albunex microbubbles used in myocardial contrast echocardiography (MCE) pass unimpeded through the coronary microcirculation. During pathophysiologic states associated with endothelial dysfunction, however, microbubbles linger in the myocardium despite normal flow. The sites and conditions regulating microbubble adhesion are unknown. METHODS: Coverslips with cultured human coronary artery ECs were mounted in a parallel plate perfusion system and perfused with a suspension of fluorescein-labeled Albunex in culture medium, followed by a bubble-free wash at a wall shear rate of 100 s-1. To create inflammatory ECs, phorbol myristate acetate was added 4.5 h before perfusion, and flow cytometry was used to confirm an inflammatory response. Perfusions were performed under normal and inflammatory conditions using surfaces of confluent and subconfluent ECs and isolated extracellular matrix. Bubble adherence was quantified in 20 random fields per cover-slip using epifluorescent video microscopy. RESULTS: No microbubbles adhered to normal confluent ECs, although small numbers adhered to inflamed ECs (0.03 +/- 0.01 bubbles/cell, p < 0.01 vs. normal cells). Fever microbubbles attached to normal versus inflamed matrix of both partially exposed (1,800 +/- 520 vs. 4,100 +/- 1,000 bubbles/mm2, p = 0.05) and completely denuded (2,700 +/- 1,300 vs. 7,200 +/- 1,100 bubbles/ mm2, p < 0.03) endothelium. CONCLUSIONS: Albunex microbubbles preferentially adhere to inflammatory endothelial extracellular matrix. These data suggest that MCE can be used to noninvasively study endothelial integrity and may have implications for the assessment of preclinical atherosclerotic heart disease.


Assuntos
Albuminas , Meios de Contraste , Ecocardiografia , Endotélio Vascular , Adesividade , Células Cultivadas , Vasos Coronários/citologia , Endotélio Vascular/citologia , Matriz Extracelular , Humanos , Inflamação , Microesferas
7.
Biol Psychiatry ; 42(4): 290-5, 1997 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-9270907

RESUMO

Clinical depression has recently been recognized as an independent risk factor for cardiac mortality in patients after myocardial infarction. The underlying mechanisms of this increased mortality remain unclear. This study investigated the hypothesis that patients suffering from ischemic heart disease (IHD) and depression concurrently may have abnormal platelet activation resulting in an increased risk of thrombosis. Platelet factor 4 (PF4) and beta-thromboglobulin (beta-TG) were measured in young healthy control subjects, in nondepressed patients with IHD, and in depressed patients with IHD. Mean PF4 and beta-TG plasma levels in the IHD group with depression were found to be significantly higher than those of the control and IHD groups. This increase was not related to age, gender, racial difference, aspirin use, or severity of cardiac disease. This finding suggests that in depressed patients with IHD there is greater platelet activation, and may indicate an increased risk of thrombotic complications.


Assuntos
Transtorno Depressivo/sangue , Transtorno Depressivo/complicações , Isquemia Miocárdica/sangue , Isquemia Miocárdica/complicações , Fator Plaquetário 4/metabolismo , beta-Tromboglobulina/metabolismo , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Trombose/sangue
8.
Am J Psychiatry ; 158(12): 2074-6, 2001 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-11729031

RESUMO

OBJECTIVE: Depression has been associated with increased platelet activation. Variations in the serotonin-transporter-linked promoter region (5-HTTLPR) polymorphism may influence the degree of activation. The authors examined the association among depression, platelet activation, and 5-HTTLPR genotype. METHOD: Elderly subjects with (N=61) and without (N=12) major depression were assessed for cognitive impairment, cardiovascular disease, and two indices of platelet activation. The depressed subjects were genotyped for the 5-HTTLPR polymorphism. RESULTS: The depressed subjects were older, were more cognitively impaired, and had higher platelet factor 4 and beta-thromboglobulin levels; cardiovascular disease was minimal in both groups. In the depressed group, subjects with the 5-HTTLPR l/l genotype had significantly higher platelet factor 4 and beta-thromboglobulin levels. CONCLUSIONS: Platelet activation is increased in elderly depressed patients, especially those with the 5-HTTLPR l/l genotype. This finding suggests how genetic differences may influence cardiovascular mortality in depressed patients with ischemic heart disease.


Assuntos
Proteínas de Transporte/genética , Transtorno Depressivo Maior/genética , Glicoproteínas de Membrana/genética , Proteínas de Membrana Transportadoras , Proteínas do Tecido Nervoso , Ativação Plaquetária/genética , Polimorfismo Genético/genética , Regiões Promotoras Genéticas/genética , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/sangue , Doença de Alzheimer/genética , Trombose Coronária/sangue , Trombose Coronária/genética , Transtorno Depressivo Maior/sangue , Feminino , Humanos , Masculino , Entrevista Psiquiátrica Padronizada , Fator Plaquetário 4/metabolismo , Fatores de Risco , Proteínas da Membrana Plasmática de Transporte de Serotonina , beta-Tromboglobulina/metabolismo
9.
Thromb Haemost ; 67(4): 461-7, 1992 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-1321510

RESUMO

The effect of the ADP receptor antagonists ATP and adenosine 5'-(beta, gamma-methylene)triphosphate (AMP-PCP), and the ADP-utilizing enzyme systems creatine phosphokinase/creatine phosphate (CPK/CP) and pyruvate kinase/phosphoenol pyruvate (PK/PEP) on platelet deposition onto type I collagen was examined. An in vitro perfusion system was used, which allowed continuous visualization of the deposition of fluorescently labelled platelets. This system also provide well-controlled rheology, precise quantification of deposition, and allowed the use of heparinized whole human blood (3 u/ml). Heparinization at this level permits the local generation of thrombin near surface platelet aggregates. The contribution of ADP is thus studied with the combined effects of thrombin, thromboxane A2, and other aggregating agents present. Results from these studies indicate that ATP was capable of inhibiting deposition by 60% at 1 microM and 90% at 5 microM (whole blood conc.). AMP-PCP inhibited deposition in a dose dependent manner with a Ki of approximately 80 microM and a maximum inhibition of 60%. Inhibition by CPK/CP was measured at 20, 40, and 60 u/ml, with approximately 45% inhibition achieved for the latter two concentrations. PK/PEP at 60 u/ml resulted in 70% inhibition. These results support a role for ADP in mediating platelet recruitment in thrombus growth on collagen. Previous work utilizing animal bleeding times supports this conclusion; the present study demonstrates that this role is not dependent upon endothelial or vasoconstrictive effects. Intraplatelet cAMP levels were raised with respect to controls upon exposure to ATP at 8.3 microM (p less than 0.025), and 15 microM (p less than 0.005), as well as AMP-PCP at 42-500 microM (p less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Difosfato de Adenosina/sangue , Plaquetas/efeitos dos fármacos , Antagonistas Purinérgicos , Trifosfato de Adenosina/análogos & derivados , Trifosfato de Adenosina/farmacologia , Plaquetas/metabolismo , Colágeno , Creatina Quinase/sangue , AMP Cíclico/sangue , Humanos , Técnicas In Vitro , Cinética , Piruvato Quinase/sangue , Propriedades de Superfície
10.
Thromb Haemost ; 65(5): 601-7, 1991 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-1871723

RESUMO

Laser-light scattering was used to observe and quantify the dynamics of human blood platelet aggregation in platelet-rich plasma (PRP). Aggregation was performed in a controlled shear environment by placing the PRP in the annular space between a rotating cylindrical rod and a stationary cylindrical tube. The instrument was capable of very sensitive continuous semi-quantitative measurements of chemically-induced microaggregation. As a demonstration of the technique, results are presented for ADP-induced aggregation at doses of 10, 1, and 0.1 microM and collagen-induced aggregation at a dose of 5 micrograms/ml, each at shear rates of 1,000 s-1 and 500 s-1. Extensive aggregation was observed in response to ADP at even the low dose of 0.1 microM, indicating a high sensitivity to microaggregates. The sensitivity of the ultimate size of the ADP-induced aggregates to ADP concentration was shear dependent. The formation of microaggregates by collagen stimulation was shown to be almost immediate, as contrasted with a 10-20 s typical lag when observed turbidometrically. Disaggregation was observed with 1 microM ADP, but this was only partial, as contrasted with the complete recovery of transmittance observed in the turbidometric technique. Electronic particle sizing and counting was employed to semiquantitatively verify the aggregate size distributions found from mathematical conversion of the laser-light scattering data.


Assuntos
Lasers , Agregação Plaquetária/fisiologia , Difosfato de Adenosina , Colágeno , Humanos , Luz , Agregação Plaquetária/efeitos dos fármacos , Espalhamento de Radiação , Estresse Mecânico
11.
Biomaterials ; 20(10): 977-85, 1999 May.
Artigo em Inglês | MEDLINE | ID: mdl-10353652

RESUMO

A hydroxylapatite (HA) coating with approximately 97% crystalline HA content (MP-1 treated HA coating, MP-HA) was tested in vitro for its biosolubility and cellular biocompatibility. The MP-HA coating was compared with a standard HA coating with approximately 63% crystallinity (SHA) and an amorphous HA coating with approximately 25% crystallinity (AHA), as well as a titanium (Ti) surface without HA coating as a control. The topographic study with scanning electron microscopy indicated that MP-HA appeared more coarse, with projected nodules which altered the shape of cells attached to the substrate. Biosolubility study indicated that MP-HA had the least effect on the culture medium pH, while AHA (P < 0.01) and SHA (P < 0.05) significantly raised the medium pH up to 8.2 and 7.75, respectively. X-ray diffraction (XRD) analysis showed essentially unchanged levels of the total soluble phases of all coatings after incubation with culture medium, except that the CaO phase was rapidly dissolved from AHA coatings and completely eliminated from SHA coatings. Cultures of human gingival fibroblasts on these HA coatings showed that MP-HA and SHA had about the same cell attachment efficiency which was relatively lower than that of AHA coatings. MP-HA generated significant higher cell proliferation rate relative to AHA (P < 0.01) and SHA (P < 0.05). This study indicated that surface chemistry and topography of lower crystallinity might be favorable to cell attachment, but that elevated medium pH might result in a cytotoxic effect that inhibits the proliferation of attached cells on coating surfaces.


Assuntos
Materiais Biocompatíveis , Durapatita , Materiais Biocompatíveis/química , Adesão Celular , Divisão Celular , Células Cultivadas , Cristalização , Meios de Cultura , Durapatita/química , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Teste de Materiais , Microscopia Eletrônica de Varredura , Solubilidade , Propriedades de Superfície
12.
Biomaterials ; 21(11): 1155-64, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10817268

RESUMO

Covalent attachment of polymers to cells and tissues could be used to solve a variety of problems associated with cellular therapies. Insulin-dependent diabetes mellitus is a disease resulting from the autoimmune destruction of the beta cells of the islets of Langerhans in the pancreas. Transplantation of islets into diabetic patients would be an attractive form of treatment, provided that the islets could be protected from the host's immune system in order to prevent graft rejection. If reaction of polyethylene glycol (PEG) segments with the islet surface did not damage function, the immunogenicity and cell binding characteristics of the islet could be altered. To determine if this process damages islets, rat islets have been isolated and treated with protein-reactive PEG-isocyanate (MW 5000) under mild reaction conditions. An assessment of cell viability using a colorimetric mitochondrial activity assay showed that treatment of the islets with PEG-isocyanate did not reduce cell viability. Insulin release in response to secretagogue challenge was used to evaluate islet function after treatment with the polymer. The insulin response of the PEG-treated islets was not significantly different than untreated islets in a static incubation secretagogue challenge. In addition, PEG-isocyanate-treated islets responded in the same manner as untreated islets in a glucose perifusion assay. Finally, the presence of PEG on the surface of the islets after treatment with the amine-reactive N-hydroxysuccinimide-PEG-biotin (not PEG-isocyanate) was confirmed by indirect fluorescence staining. These results demonstrate the feasibility of treating pancreatic islets with reactive polymeric segments and provide the foundation for further investigation of this novel means of potential immunoisolation.


Assuntos
Ilhotas Pancreáticas/efeitos dos fármacos , Polietilenoglicóis , Animais , Sobrevivência Celular , Corantes Fluorescentes , Ilhotas Pancreáticas/citologia , Ilhotas Pancreáticas/fisiologia , Masculino , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/farmacologia , Ratos , Ratos Sprague-Dawley
13.
Biomaterials ; 19(20): 1885-93, 1998 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-9855190

RESUMO

For cardiovascular biomaterials, thrombosis, thromboembolism and vascular graft occlusion are believed to be precipitated by the adsorption of proteins containing adhesive ligands for platelets. Polyethylene-glycol-diisocyanate (PEG-diisocyanate, 3400 MW) may potentially react with protein amines to form molecular barriers on adsorbed proteins on biomaterials, thereby masking adhesive ligands and preventing acute surface thrombosis. To test this notion, PE, PTFE, and glass microconduits were pre-adsorbed with fibrinogen and treated with PEG-diisocyanate, non-reactive PEG-dihydroxyl, or remained untreated. Following perfusion of 111In-labeled platelets in whole human blood for 1 min (wall shear rate = 312 s(-1)), PEG-diisocyanate treated surfaces experienced 96% (PE), 97% (PTFE) and 94% (glass) less platelet deposition than untreated surfaces. Similar reductions were seen for PEG-diisocyanate versus PEG-dihydroxyl treatment. Low shear perfusions of plasma for 1 h prior to blood contact did not reduce the inhibitory effect of PEG-diisocyanate. Platelet adhesion onto collagen-coated glass coverslips and platelet deposition onto preclotted Dacron were also reduced by treatment with PEG-diisocyanate (93 and 91%, respectively). Protein-reactive PEG may thus have utility in forming molecular barriers on surface-associated proteins to inhibit acute thrombosis on cardiovascular biomaterials.


Assuntos
Materiais Biocompatíveis/efeitos adversos , Cardiopatias/prevenção & controle , Isocianatos , Polietilenoglicóis , Proteínas/metabolismo , Trombose/prevenção & controle , Adsorção , Colágeno/metabolismo , Fibrinogênio/metabolismo , Cardiopatias/etiologia , Humanos , Adesividade Plaquetária/efeitos dos fármacos , Polietilenotereftalatos , Trombose/etiologia
14.
Biomaterials ; 20(2): 101-9, 1999 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10022779

RESUMO

For cardiovascular biomaterials, thrombosis, thromboembolism and vascular graft occlusion are believed to be precipitated by the adsorption of proteins containing adhesive ligands for platelets. Polyethylene-glycol-diisocyanate(PEG-diisocyanate, 3400 MW) may potentially react with protein amines to form molecular barriers on adsorbed proteins on biomaterials, thereby masking adhesive ligands and preventing acute surface thrombosis. To test this notion, PE, PTFE, and glass microconduits were pre-adsorbed with fibrinogen and treated with PEG-diisocyanate, non-reactive PEG-dihydroxyl, or remained untreated. Following perfusion of 111In-labeled platelets in whole human blood for 1 min (wall shear rate = 312 s(-1)), PEG-diisocyanate treated surfaces experienced 96%(PE), 97%(PTFE) and 94% (glass) less platelet deposition than untreated surfaces. Similar reductions were seen for PEG-diisocyanate versus PEG-dihydroxyl treatment. Low shear perfusions of plasma for one hour prior to blood contact did not reduce the inhibitory effect of PEG-diisocyanate. Platelet adhesion onto collagen coated glass coverslips and platelet deposition onto preclotted Dacron was also reduced by treatment with PEG-diisocyanate (93 and 91%, respectively). Protein-reactive PEG may thus have utility in forming molecular barriers on surface associated proteins to inhibit acute thrombosis on cardiovascular biomaterials.


Assuntos
Materiais Revestidos Biocompatíveis , Colágeno , Fibrinogênio , Isocianatos , Polietilenoglicóis , Trombose/sangue , Trombose/prevenção & controle , Adsorção , Proteínas Sanguíneas/metabolismo , Prótese Vascular , Humanos , Adesividade Plaquetária , Polietilenotereftalatos
15.
Ann Thorac Surg ; 65(4): 1071-6, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9564930

RESUMO

BACKGROUND: Ongoing complement activation in patients with a ventricular assist device may contribute to observed hemostatic abnormalities and cellular aggregation by mediating leukocyte and platelet activation, formation of leukocyte-platelet conjugates, and the tissue factor pathway of coagulation. METHODS: Blood from 30 patients was collected before ventricular assist device implantation and during the implantation period. Plasma levels of thrombin-antithrombin III complexes, C3a, and SC5b-9 were measured by commercial enzyme-linked immunosorbent assay. Flow cytometry was used to measure circulating monocyte tissue factor expression and circulating monocyteplatelet and granulocyte-platelet conjugates. RESULTS: Thrombin-antithrombin III complex level and monocyte tissue factor expression peaked in the early postoperative period, with maxima occurring on postoperative days 5 and 3, respectively. Levels of C3a and SC5b-9 remained dramatically elevated over normal values for the duration of the study (6 and 5 times upper normal, respectively). Levels of monocyte-platelet conjugates were normal before implantation, decreased during the first 4 postoperative days, and then increased and remained elevated. Levels of granulocyte-platelet conjugates were elevated over the normal range before implantation and remained elevated from postoperative days 3 to 21. A positive correlation was found between levels of SC5b-9 and granulocyte-platelet conjugates (Spearman R=0.66; p < 0.001), and between levels of C3a and thrombin-antithrombin III complex (Spearman R=0.13; p=0.021). CONCLUSIONS: The data suggest a model in which complement mediates formation of leukocyte-platelet aggregates and may indirectly contribute to thrombin generation through monocyte tissue factor expression.


Assuntos
Proteínas do Sistema Complemento/biossíntese , Coração Auxiliar , Monócitos/fisiologia , Tromboplastina/análise , Adulto , Idoso , Antitrombina III/análise , Agregação Celular , Ativação do Complemento , Complemento C3a/análise , Complexo de Ataque à Membrana do Sistema Complemento , Proteínas do Sistema Complemento/análise , Ensaio de Imunoadsorção Enzimática , Feminino , Citometria de Fluxo , Seguimentos , Regulação da Expressão Gênica , Glicoproteínas/análise , Granulócitos/fisiologia , Hemostasia , Humanos , Leucócitos/fisiologia , Masculino , Pessoa de Meia-Idade , Peptídeo Hidrolases/análise , Ativação Plaquetária , Trombina/biossíntese , Tromboplastina/genética , Fatores de Tempo
16.
Ann Thorac Surg ; 58(3): 734-40; discussion 741, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7944696

RESUMO

This prospective, randomized study involving patients undergoing isolated coronary artery bypass grafting investigated whether the use of heparin-coated bypass circuits with an uncoated cardiotomy reservoir (n = 10) compared with standard uncoated bypass circuits (n = 10) resulted in differences in patient outcome and hemostatic alterations. There were no differences in postoperative blood loss, transfusion requirements, and routine coagulation test results between groups. Immunoassays for platelet alpha-granule constituents platelet factor 4 and beta-thromboglobulin, thrombin generation by-product F1.2, fibrinopeptide A, thrombin-antithrombin complex, and fibrinolysis by-product D-dimer also demonstrated no significant differences between groups, although trends for lower platelet secretion with heparin coating were noted. Increases were found in beta-thromboglobulin and platelet factor 4 concentrations at 10 (p < 0.03) and 30 minutes (p < 0.001) of CPB, respectively, and continuing throughout CPB (p < 0.001) for both groups versus values measured before incision. No significant differences were seen between levels 5 minutes prior to aortic cross-clamp release and those obtained 8 and 45 minutes after cross-clamp release. Conversely, no significant increases in F1.2, thrombin-antithrombin complex, and D-dimer were seen prior to release of the aortic cross-clamp, but afterward increases occurred that were highly significant (p < 0.001). The temporal data suggest that platelet activation occurs primarily as a result of contact with the cardiopulmonary bypass circuitry, whereas thrombin generation and fibrinolytic activity are not significant until reperfusion of the heart and lungs.(ABSTRACT TRUNCATED AT 250 WORDS)


Assuntos
Ponte Cardiopulmonar/instrumentação , Doença das Coronárias/cirurgia , Vasos Coronários/cirurgia , Hemostasia Cirúrgica/instrumentação , Heparina/farmacologia , Idoso , Antitrombina III/análise , Antitrombina III/efeitos dos fármacos , Testes de Coagulação Sanguínea , Perda Sanguínea Cirúrgica/prevenção & controle , Ponte Cardiopulmonar/métodos , Constrição , Doença das Coronárias/sangue , Doença das Coronárias/fisiopatologia , Vasos Coronários/efeitos dos fármacos , Feminino , Fibrinopeptídeo A/análise , Fibrinopeptídeo A/efeitos dos fármacos , Hemostasia/efeitos dos fármacos , Hemostasia Cirúrgica/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeo Hidrolases/análise , Peptídeo Hidrolases/efeitos dos fármacos , Fator Plaquetário 4/análise , Fator Plaquetário 4/efeitos dos fármacos , Cuidados Pós-Operatórios , Cuidados Pré-Operatórios , Estudos Prospectivos , Propriedades de Superfície , beta-Tromboglobulina/análise , beta-Tromboglobulina/efeitos dos fármacos
17.
Neurol Clin ; 11(2): 463-74, 1993 May.
Artigo em Inglês | MEDLINE | ID: mdl-8316196

RESUMO

Neurologic complications are associated with the use of total artificial hearts and with ventricular support systems. Among these complications, thromboembolic events are the most severe and the most frequent, resulting from flow disturbances associated with the artificial devices or occurring within the artificial heart. However, alterations in blood viscosity, abnormalities in the coagulation system, and infection all may play a part in the generation of thrombi. Anticoagulation may play a role in controlling the events that lead to thromboembolism, but the most effective therapeutic regimen has yet to be defined. Although neurologic complications constitute a significant risk, disabling strokes have been relatively rare and appear to relate to the duration of support on the device. The majority of subjects who sustained device-related strokes have made an excellent recovery following transplantation. LVADs constitute an important therapeutic development in the treatment of end stage heart failure. They may cause neurologic complications, but they have the capability of sustaining life until a suitable donor heart is found.


Assuntos
Transtornos Cerebrovasculares/etiologia , Transplante de Coração/efeitos adversos , Procedimentos Cirúrgicos Cardíacos/efeitos adversos , Feminino , Coração Artificial/efeitos adversos , Humanos , Masculino , Falha de Prótese , Tromboembolia/etiologia
18.
Clin Plast Surg ; 26(4): 605-16, ix, 1999 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-10553216

RESUMO

The generation of tissue replacements or supplements for diseased tissue within the cardiovascular system has been the target of recent tissue engineering efforts. While clinically applicable methodologies remain to be achieved, important foundational experimentation has been performed in recent years to begin the move toward engineered tissue replacement therapy. Inadequacies of current valve, vessel, and other heart prostheses are reviewed briefly, followed by the discussion of selected progress in the supplementation or replacement of each cardiovascular component with tissue constructs. Topics addressed include the endothelialization of bio-prosthetic valves and synthetic vascular grafts, the generation of tissue valve leaflets and vascular conduits, the genetic manipulation of endothelial cells with implications for graft endothelialization, and cardiomyoplasty achieved through cellular and genetic means.


Assuntos
Materiais Biocompatíveis , Biotecnologia , Vasos Sanguíneos/citologia , Técnicas de Cultura de Células , Transplante de Células , Miocárdio/citologia , Animais , Técnicas de Transferência de Genes , Engenharia Genética , Humanos
19.
Int J Oral Maxillofac Implants ; 13(6): 749-57, 1998.
Artigo em Inglês | MEDLINE | ID: mdl-9857585

RESUMO

Cylindrical dental implants coated with cancellous structured titanium (CSTi) were studied in a dog model. CSTi-2-coated and hydroxyapatite-coated (HA) implants were placed in 8 mongrel dogs. The porosity of the CSTi-2 coating was 9% less than that of the previously studied CSTi-1, resulting in greatly improved mechanical strength and cosmetic appearance. A slightly lower level of bone ingrowth was observed for CSTi-2 than for CSTi-1. However, the in vivo attachment strength of the CSTi-2 coating was comparable both to CSTi-1 and to an HA-coated control after 8 weeks. Measured porosity is technique dependent; digital analysis of in vitro samples yielded higher porosity values than in vivo histology cross sections.


Assuntos
Materiais Revestidos Biocompatíveis , Implantes Dentários , Planejamento de Prótese Dentária , Titânio , Animais , Materiais Revestidos Biocompatíveis/química , Implantação Dentária Endóssea , Modelos Animais de Doenças , Cães , Durapatita/química , Estética Dentária , Fêmur/patologia , Fêmur/cirurgia , Processamento de Imagem Assistida por Computador , Mandíbula/patologia , Mandíbula/cirurgia , Microscopia Eletrônica de Varredura , Osseointegração , Porosidade , Estresse Mecânico , Propriedades de Superfície , Resistência à Tração , Fatores de Tempo , Titânio/química
20.
ASAIO J ; 41(3): M665-9, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8573888

RESUMO

Thrombus formation within artificial organs has been shown, at least in part, to be caused by retarded or stagnant blood flow. The goal of this work was to develop a magnifying fiber optic probe capable of visualizing particle flow and cellular deposition in a physiologically relevant cellular suspension (blood). The probe has minimal cross sectional area to allow for access to confined areas and to minimize flow disturbance. The probe consists of a germanium oxide fiber optic bundle and a gradient index imaging lens. Fluorescent microspheres of 48 microns, 7 microns, and 3 microns in diameter were imaged after deposition on to a cover slip. The flow (1.44 mm/sec) of 3 microns microspheres suspended in buffer alone and with red cell hematocrits of 10%, 25% and 45% were also visualized. To investigate the potential for this probe to detect ongoing thrombosis, fluorescently labeled human platelets were observed depositing on surfaces from a stagnant platelet rich buffer. These initial data suggest that this probe may offer a technique for the visualization of blood cell adhesion on the interior of artificial organs and the local quantification of flow in such devices.


Assuntos
Tecnologia de Fibra Óptica/instrumentação , Órgãos Artificiais/efeitos adversos , Células Sanguíneas/citologia , Adesão Celular , Hematócrito , Hemorreologia/instrumentação , Humanos , Técnicas In Vitro , Microscopia de Fluorescência , Microesferas , Fibras Ópticas , Adesividade Plaquetária , Soluções , Trombose/sangue , Trombose/diagnóstico , Trombose/etiologia
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