A rainbow trout Oncorhynchus mykiss strain with higher aerobic scope in normoxia also has superior tolerance of hypoxia.

This study compared parr from three strains of rainbow trout Oncorhynchus mykiss to examine intraspecific variation in metabolic traits, hypoxia tolerance and upper thermal tolerance in this species. At the strain level, variation in absolute aerobic scope (AAS), critical oxygen level (O2crit ), incipient lethal oxygen saturation (ILOS) and critical thermal maximum (CTmax ) generally exhibited consistent differences among the strains, suggesting the possibility of functional associations among these traits. This possibility was further supported at the individual level by a positive correlation between ILOS and O2crit and a negative correlation between O2crit and AAS. These results indicate that intraspecific differences in hypoxia tolerance among strains of O. mykiss may be primarily determined by differences in the ability to maintain oxygen uptake in hypoxia and that variation in aerobic scope in normoxia probably plays a role in determining the ability of these fish to sustain metabolism aerobically as water oxygen saturation is reduced.

In vivo flow dynamics of the total cavopulmonary connection from three-dimensional multislice magnetic resonance imaging.

BACKGROUND: The total cavopulmonary connection (TCPC) design continues to be refined on the basis of flow analysis at the connection site. These refinements are of importance for myocardial energy conservation in the univentricular supported circulation. In vivo magnetic resonance phase contrast imaging provides semiquantitative flow visualization information. The purpose of this study was to understand the in vivo TCPC flow characteristics obtained by magnetic resonance phase contrast imaging and compare the results with our previous in vitro TCPC flow experiments in an effort to further refine TCPC surgical design. METHODS: Twelve patients with TCPC underwent sedated three-dimensional, multislice magnetic resonance phase contrast imaging. Seven patients had intraatrial lateral tunnel TCPC and 5 had extracardiac TCPC. RESULTS: In all patients in both groups a disordered flow pattern was observed in the inferior caval portion of the TCPC. Flow at the TCPC site appeared to be determined by connection geometry, being streamlined at the superior vena cava-pulmonary junction when the superior vena cava was offset and flared toward the left pulmonary artery. Without caval offset, intense swirling and dominance of superior vena caval flow was observed. In TCPC with bilateral superior vena cavae, the flow patterns observed included secondary vortices, a central stagnation point, and influx of the superior vena cava flow into the inferior caval conduit. A comparative analysis of in vivo flow and our previous in vitro flow data from glass model prototypes of TCPC demonstrated significant similarities in flow disturbances. Three-dimensional magnetic resonance phase contrast imaging in multiple coronal planes enabled a comprehensive semiquantitative flow analysis. The data are presented in traditional instantaneous images and in animated format for interactive display of the flow dynamics. CONCLUSIONS: Flow in the inferior caval portion of the TCPC is disordered, and the TCPC geometry determines flow characteristics.

Fluid dynamic studies for the year 2000.

The authors recommend changes to the paradigm employed in the current ISO Heart Valve Standard (ISO 5840) so that future patients who receive a heart valve prosthesis are assured of a device that will function with minimal complications for at least 25 years. Based on valve failures of the past decade, it is clear that current standards are inadequate because present-day Standards and Regulatory Agencies operate in a manner which inhibits innovation and creativity. Thus, engineers and scientists in this field react to problems, rather than proact. As we approach the new millennium, the authors consider it time to rethink the ground rules.

Velocity measurements and flow patterns within the hinge region of a Medtronic Parallel bileaflet mechanical valve with clear housing.

BACKGROUND AND AIMS OF THE STUDY: During recent clinical trials the Medtronic Parallel bileaflet mechanical heart valve was found to have an unacceptable number of valves with thrombus formation when implanted in the mitral position. Thrombi were observed in the hinge region and also in the upstream portion of the valve housing in the vicinity of the hinge. It was hypothesized that the flow conditions inside the hinge may have contributed to the thrombus formation. METHODS: In order to investigate the flow structures within the hinge, laser Doppler anemometry (LDA) measurements were conducted in both steady and pulsatile flow at approximately 70 predetermined sites within the hinge region of a 27 mm Medtronic Parallel mitral valve with transparent housing. The pulsatile flow velocity measurements were animated in time using a graphical software package to visualize the hinge flow field throughout the cardiac cycle. RESULTS: The LDA measurements revealed that mean forward flow velocities through the hinge region were on the order of 0.10-0.20 m/s. In the inflow channel, a large vortical structure was present during diastole. Upon valve closure, peak reverse velocity reached 3 m/s close to the housing wall in the inflow channel. This area also experienced high turbulent shear stresses (> 6000 dynes/cm2) during the leakage flow phase. A disturbed, vortical flow was again present in the inflow channel after valve closure, while slightly above the leaflet peg and relief the flow was essentially stagnant. The high turbulent stresses near the top of the inflow channel, combined with a persistent vortex, implicate the inflow channel of the hinge as a likely region of thrombus formation. CONCLUSIONS: This experimental investigation revealed zones of flow stagnation in the inflow region of the hinge throughout the cardiac cycle and elevated turbulent shear stress levels in the inflow region during the leakage flow phase. These fluid mechanic phenomena are most likely a direct result of the complex geometry of the hinge of this valve. Although the LDA measurements were conducted at only a limited number of sites within the hinge, these results suggest that the hinge design can significantly affect the washout capacity and thrombogenic potential of the Medtronic Parallel bileaflet mechanical heart valve. The use of LDA within the confines of the hinge region of a mechanical heart valve is a new application, made possible by recent advances in manufacturing technologies and a proprietary process developed by Medtronic that allowed the production of a transparent valve housing. Together, these modalities represent a new method by which future valve designs can be assessed before clinical trials are initiated.

An in vitro investigation of the retrograde flow fields of two bileaflet mechanical heart valves.

BACKGROUND AND AIM OF THE STUDY: Fluid stresses occurring in retrograde flow fields during valve closure may play a significant role in thrombogenesis. The squeeze flow and regurgitant jets can cause damage to formed blood elements due to high levels of turbulent shear stress. The aim of this study was to characterize in detail the spatial structure and temporal behavior of the retrograde flow fields of the St. Jude Medical and Medtronic Parallel bileaflet mechanical heart valves. METHODS: Three-component, coincident laser Doppler anemometry (LDA) velocity measurements were obtained facilitating the determination of the full Reynolds stress tensor and the principal stresses in the valve flow fields. The experiments were performed in the Georgia Tech aortic flow chamber under physiologic pulsatile flow conditions. Data were collected over several hundred cardiac cycles for subsequent phase window averaging and generation of mean velocity and turbulence statistics over 20 ms intervals. A region approximately 8 mm x 10 mm was mapped 1.0 mm upstream of one hinge of each valve with an incremental resolution of 0.13-0.25 mm. Animation of the data allowed the visualization of the flow fields and a quantitative display of mean velocity and turbulent stress values. RESULTS: In the St. Jude Medical squeeze flow, the peak turbulent shear stress was 800 dynes/cm2 and the peak reverse velocity was 0.60 m/s. In the Medtronic Parallel squeeze flow, the peak turbulent shear stress was 1,000 dynes/cm2 and the peak velocity 0.70 m/s. The leakage jet fields of the two valves were very different: in the case of the St. Jude Medical valve, turbulent shear stresses reached 1,800 dynes/cm2 and peak jet velocity was 0.80 m/s; in the case of the Medtronic Parallel valve, turbulent shear stresses reached 3,690 dynes/cm2 and the peak jet velocity was 1.9 m/s. CONCLUSIONS: The retrograde flow fields of these two bileaflet mechanical heart valves appear to be design-dependent. The elevated turbulent shear stresses generated by both valve designs may indicate a propensity for blood element damage during the reverse flow phase of the cardiac cycle, but the extent of flow disturbance was twice as high with the Medtronic Parallel than with the St. Jude Medical valve. This research should yield a better understanding of the significance of retrograde flow to the functionality and potential thrombogenicity of bileaflet mechanical heart valves and aid in the development of new designs.

Identification of peak stresses in cardiac prostheses. A comparison of two-dimensional versus three-dimensional principal stress analyses.

This study assessed the accuracy of using a two-dimensional principal stress analysis compared to a three-dimensional analysis in estimating peak turbulent stresses in complex three-dimensional flows associated with cardiac prostheses. Three-component, coincident laser Doppler anemometer measurements were obtained in steady flow downstream of three prosthetic valves: a St. Jude bileaflet, Bjork-Shiley monostrut tilting disc, and Starr-Edwards ball and cage. Two-dimensional and three-dimensional principal stress analyses were performed to identify local peak stresses. Valves with locally two-dimensional flows exhibited a 10-15% underestimation of the largest measured normal stresses compared to the three-dimensional principal stresses. In nearly all flows, measured shear stresses underestimated peak principal shear stresses by 10-100%. Differences between the two-dimensional and three-dimensional principal stress analysis were less than 10% in locally two-dimensional flows. In three-dimensional flows, the two-dimensional principal stresses typically underestimated three-dimensional values by nearly 20%. However, the agreement of the two-dimensional principal stress with the three-dimensional principal stresses was dependent upon the two velocity-components used in the two-dimensional analysis, and was observed to vary across the valve flow field because of flow structure variation. The use of a two-dimensional principal stress analysis with two-component velocity data obtained from measurements misaligned with the plane of maximum mean flow shear can underpredict maximum shear stresses by as much as 100%.

Lung cancer diagnosis: evaluation of diagnostic techniques.

In 200 patients with histologically proven lung cancer, retrospective analysis of the relative diagnostic value of sputum cytology, bronchial washings cytology, bronchial biopsy, scalene node biopsy, mediastinoscopy and thoracotomy was undertaken. Bronchial biopsy proved positive in 80 percent of patients with central tumours (those lying between the origin of a main brochus and the origins of lobar segmental bronchi) against 35 percent of patients with peripheral tumours (those lying distal to the origins of the lobar segmental bronchi). Sputum cytology was positive in 27 percent of patients so investigated and bronchial washings cytology in 14 percent--both techniques being more effective with central tumours. Thoracotomy, as the sole method of obtaining histological confirmation of the clinical diagnosis, accounted for 20.5 percent of all cases, being used more often in patients with peripheral tumours. In 15 percent the first histologically positive result came from distal spread. The relative indications for needle biopsy and endobronchial fibroscopy are discussed.

The cellular reaction during carcinogenesis: Variations in the numbers of mast cells, plasma cells and eosinophils.

Squamous carcinoma was produced in the hamster cheek pouch with D.M.B.A. The underlying cellular reaction of lymphocytes, plasma cells, mast cells and eosinophils was studied quantitatively during the various stages of development of the tumours. Between the early stage of hyperplasia and that of squamous carcinoma the eosinophils increased from 2 per cent to 17 per cent of all the cells present under the growths. There was a complementary fall in plasma cells as malignancy developed but the lymphocytes and mast cells remained at a fairly constant level. Possible reasons for these changes are discussed.

Efficacy of a new quarternary ammonium compound against TB.

Ten of 12 strains of Mycobacteria (11 M. tuberculosis, 1 M. bovis) including 7 resistant strains were found to be sensitive to tetradecyl-dimethyl-benzyl-ammonium fluoride (TDBAF) at a concentration of 15-7.75 micrograms/ml (end point 10 micrograms/ml). A single multi-resistant strain of M. tuberculosis and a culture of M. bovis were also sensitive but at a slightly higher level.

Responses to temperature and hypoxia as interacting stressors in fish: implications for adaptation to environmental change.

Anthropogenic environmental change is exposing animals to changes in a complex array of interacting stressors and is already having important effects on the distribution and abundance of species. However, despite extensive examination of the effects of stressors in isolation, knowledge of the effects of stressors in combination is limited. This lack of information makes predicting the responses of organisms to anthropogenic environmental change challenging. Here, we focus on the effects of temperature and hypoxia as interacting stressors in fishes. A review of the available evidence suggests that temperature and hypoxia act synergistically such that small shifts in one stressor could result in large effects on organismal performance when a fish is exposed to the 2 stressors in combination. Although these stressors pose substantial challenges for fish, there also is substantial intraspecific variation in tolerance to these stressors that could act as the raw material for the evolution of improved tolerance. However, the potential for adaptive change is, in part, dependent on the nature of the correlations among traits associated with tolerance. For example, negative genetic correlations (or trade-offs) between tolerances to temperature and hypoxia could limit the potential for adaptation to the combined stressors, while positive genetic correlations might be of benefit. The limited data currently available suggest that tolerances to hypoxia and to high-temperature may be positively correlated in some species of fish, suggesting the possibility for adaptive evolution in these traits in response to anthropogenic environmental change.