Ex vivo evaluation of a Taylor-Couette flow, immobilized heparinase I device for clinical application

Efficient and safe heparin anticoagulation has remained a problem for continuous renal replacement therapies and intermittent hemodialysis for patients with acute renal failure. To make heparin therapy safer for the patient with acute renal failure at high risk of bleeding, we have proposed regional heparinization of the circuit via an immobilized heparinase I filter. This study tested a device based on Taylor-Couette flow and simultaneous separation/reaction for efficacy and safety of heparin removal in a sheep model. Heparinase I was immobilized onto agarose beads via cyanogen bromide activation. The device, referred to as a vortex flow plasmapheretic reactor, consisted of two concentric cylinders, a priming volume of 45 ml, a microporous membrane for plasma separation, and an outer compartment where the immobilized heparinase I was fluidized separately from the blood cells. Manual white cell and platelet counts, hematocrit, total protein, and fibrinogen assays were performed. Heparin levels were indirectly measured via whole-blood recalcification times (WBRTs). The vortex flow plasmapheretic reactor maintained significantly higher heparin levels in the extracorporeal circuit than in the sheep (device inlet WBRTs were 1.5 times the device outlet WBRTs) with no hemolysis. The reactor treatment did not effect any physiologically significant changes in complete blood cell counts, platelets, and protein levels for up to 2 hr of operation. Furthermore, gross necropsy and histopathology did not show any significant abnormalities in the kidney, liver, heart, brain, and spleen.

Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of 15 000 Swedish men and women born 1915-29

Objective: To establish whether fetal growth rate (as distinct from size at birth) is associated with mortality from ischaemic heart disease.

Grs 1915+105: a superluminal source in the Galaxy.

We present the results of additional observations of the high energy source GRS 1915+105, which produces ejecta with apparent superluminal motions. The observations reported here were carried out with the Very Large Array at 3.5 cm and 20 cm. The 3.5-cm observations made during 1994 May allowed us to continue following the proper motions of the bright 1994 March 19 ejecta, as well as those of a subsequent, fainter ejection. The proper motions of the 1994 March 19 ejecta continued to be ballistic (i.e., constant) over the period of about 75 days where they remained detectable. From the observations in 1994 March-May we have identified three ejections of pairs of plasma clouds moving ballistically in approximately the same direction on the sky with similar proper motions. The 20-cm observations made during 1994 November and December were used to search, yet unsuccessfully, for extended jets or lobes associated with GRS 1915+105.