201
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Garcia-Rinaldi R, Lefrak EA, Defore WW, Feldman L, Noon GP, Jachimczyk JA, DeBakey ME. In situ preservation of cadaver kidneys for transplantation: laboratory observations and clinical application. Ann Surg 1975; 182:576-84. [PMID: 1103757 PMCID: PMC1344041 DOI: 10.1097/00000658-197511000-00008] [Citation(s) in RCA: 72] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Many kidneys obtained from cadaver donors undergoing sudden cardiac arrest cannot be transplanted due to the long periods of warm ischemia from the moment of arrest to nephrectomy. A double-ballon-triple-lumen catheter for the rapid in situ preservation of cadaver kidneys has been designed. Used in combination with equipment routinely found in any hospital, it can cool human kidneys in situ to 10-15 C and maintain this temperature until nephrectomy can be performed. Kidenys preserved with this catheter have functioned after transplantation into suitable recipients. This report describes the design and laboratory evaluation of this new device, its clinical effectiveness and technique of insertion.
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202
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DeBakey ME, Noon GP. Aneurysms of the thoracic aorta. MODERN CONCEPTS OF CARDIOVASCULAR DISEASE 1975; 44:53-8. [PMID: 1105135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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203
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Hoff HF, Heideman CL, Noon GP, Meyer JS. Localization of apo-lipoproteins in human carotid artery plaques. Stroke 1975; 6:531-4. [PMID: 1179463 DOI: 10.1161/01.str.6.5.531] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Apoproteins from plasma lipoproteins were localized by immunofluorescence techniques in human carotid artery atherosclerotic lesions. These studies were performed in light of the possible importance of these apoproteins in both lipid metabolism and the pathogenesis of atherosclerosis. ApoA-I from high density lipoproteins, apoB from low density lipoproteins, and apoC-III from very low density lipoproteins were localized also as markers for their respective lipoproteins, since the latter cross-react immunologically. The three apoproteins were localized to the same regions of lesions as neutral lipids and, to some extent, fibrinogen. These regions consisted of bands of collagen fibers, usually deeper within the lesion, and the lipid core or atheroma of such advanced lesions. Although the superposition of localization for the three apoproteins and lipid was only 53%, it was suggested that deviation from complete superposition was due to the abrupt changes in lesion structure resulting from the focal nature of the atherosclerotic process. These results suggest that there is a broader specificity than previously implied of the interaction between such lesion components as connective tissue and extracellular lipid accumulations, and apoproteins from plasma lipoproteins. This interaction is believed to result in a net retention within atherosclerotic lesions of human extracranial arteries of these plasma-derived factors, either as free apoproteins or as native lipoproteins.
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204
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Liddicoat JE, Bekassy SM, Rubio PA, Noon GP, DeBakey ME. Ascending aortic aneurysms. Review of 100 consecutive cases. Circulation 1975; 52:I202-9. [PMID: 1157229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Aneurysms of the ascending aorta, if undiagnosed or untreated, may result in left ventricular failure from aortic valvular insufficiency. Aortic rupture, dissection, or compression of adjacent vital structures may also occur. The application of refined cardiopulmonary bypass devices, prosthetic heart valves, and synthetic grafts now allows successful surgical management of this disorder. This report presents our current diagnostic methods, surgical techniques, and the early and late results of 100 consecutive patients undergoing surgical treatment of aneurysms of the ascending aorta. There were 72 males and 28 females, ranging in age from 25 to 72 (ave 51.2) years. All patients had angiographic studies to demonstrate precisely the location of the aneurysm and the presence or absence of aortic valvular insufficiency. Sixty-three patients required concomitant aortic valve replacement, and the remaining 37 patients had only aneurysm resection and replacement. Pathological studies revealed 69 aneurysms were atherosclerotic, 22 were secondary to cystic medial necrosis, with the remaining 9 considered to be possibly leutic in origin. Despite the magnitude of the surgery and the advanced ages of some of these patients, the overall operative and hospital mortality rates were 4% and 9%. Survival rates by actuarial representation in 82 patients at 2, 4, 6, and 8 years were 82.9%, 78%, 70%, and 69.5%, respectively.
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205
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Solis RT, Kennedy PS, Beall AC, Noon GP, DeBakey ME. Cardiopulmonary bypass. Microembolization and platelet aggregation. Circulation 1975; 52:103-8. [PMID: 1132112 DOI: 10.1161/01.cir.52.1.103] [Citation(s) in RCA: 85] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Particulate microemboli and in vitro platelet aggregation were studied in blood of patients during cardiac operations with an electronic particle size analyzer. A small gradient of microemboli developed on passage of blood through a bubble oxygenator but not through a membrane oxygenator. However, with both types of oxygenators, there was a sustained increase in the volume of microemboli in cardiotomy return blood which was much greater than in aterial blood. After cardiopulmonary bypass with both oxygenators, there was a comparable reduction in the volume of circulating platelets which exceeded that of the hemoglobin concentration, indicating platelet loss exceeded that that expected from hemodilution alone. However, the total volume and mean size of platelet aggregates induced in blood of patients after membrane oxygenation was significantly greater than similar measurements after bubble oxygenation. This study shows that membrane oxygenation reduces particulate microembolization and preserves platelet function in patients undergoing cardiac operations when compared to bubble oxygenation.
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206
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Solis RT, Beall AC, Noon GP, DeBakery ME. Platelet aggregation: effects of cardiopulmonary bypass. Chest 1975; 67:558-63. [PMID: 1126194 DOI: 10.1378/chest.67.5.558] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
This study was designed to determine whether reduction in platelet aggregate microembolization during the first 30 minutes of cardiopulmonary bypass is due to thrombocytopenia or to decreased ability of platelets to aggregate. The total volume of platelet aggregates induced in blood by adenosine diphosphate (ADP) was measured with a Coulter counter. The volume of platelets in blood was calculated by multiplying hemocytometry platelet counts by the mean platelet volume. Immediately before cardiopulmonary bypass, the total volume of aggregates induced in blood by ADP (2muM) was reduced when compared to normal donors because of (1) a slight fall in the volume of platelets, and (2) reduction in the percentage by volume of platelets which aggregated. After 30 minutes on bypass, the volume of both platelets and aggregates fell, but a greater percentage of platelets aggregated. This indicates that reduction of platelet aggregate formation during cardiopulmonary bypass is due to thrombocytopenia. It also suggests that anesthesia, surgical trauma and heparinization alter platelet reactivity more than cardiopulmonary bypass.
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207
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Lefrak EA, Stevens PM, Pitha J, Balsinger E, Noon GP, Mayor HD. Extracorporeal membrane oxygenation for fulminant influenza pneumonia. Chest 1974; 66:385-8. [PMID: 4413399 DOI: 10.1378/chest.66.4.385] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
MESH Headings
- Carbon Dioxide/blood
- Extracorporeal Circulation
- Humans
- Hypoxia/etiology
- Hypoxia/therapy
- Influenza, Human/complications
- Influenza, Human/diagnostic imaging
- Influenza, Human/microbiology
- Influenza, Human/pathology
- Influenza, Human/therapy
- Lung/pathology
- Male
- Microscopy, Electron
- Middle Aged
- Orthomyxoviridae/isolation & purification
- Oxygen/blood
- Oxygenators, Membrane
- Pneumonia, Viral/complications
- Pneumonia, Viral/diagnostic imaging
- Pneumonia, Viral/microbiology
- Pneumonia, Viral/pathology
- Pneumonia, Viral/therapy
- Radiography
- Trachea/microbiology
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208
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MESH Headings
- Adolescent
- Adult
- Aged
- Child
- Child, Preschool
- Diagnosis, Differential
- Female
- Hernia, Diaphragmatic, Traumatic/complications
- Hernia, Diaphragmatic, Traumatic/diagnosis
- Hernia, Diaphragmatic, Traumatic/mortality
- Hernia, Diaphragmatic, Traumatic/surgery
- Humans
- Infant
- Male
- Middle Aged
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209
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210
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Lefrak EA, Stevens PM, Noon GP, Hilbe G, De Bakey ME. [Clinical use of membrane lungs in acute respiratory insufficiency (author's transl)]. THORAXCHIRURGIE, VASKULARE CHIRURGIE 1973; 21:494-500. [PMID: 4594825 DOI: 10.1055/s-0028-1099078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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211
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Normann NA, DeBakey ME, Noon GP, Ross JN. Monitoring and closed-loop control of pneumatic blood pumps. CARDIOVASCULAR RESEARCH CENTER BULLETIN 1973; 12:3-12. [PMID: 4803437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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212
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Beall AC, Morris GC, Howell JF, Guinn GA, Noon GP, Reul GJ, Greenberg JJ, Ankeney JL. Clinical experience with an improved mitral valve prosthesis. Ann Thorac Surg 1973; 15:601-6. [PMID: 4267712 DOI: 10.1016/s0003-4975(10)65352-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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213
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Lefrak EA, Stevens PM, Noon GP, DeBakey ME. Current status of prolonged extracorporeal membrane oxygenation for acute respiratory failure. Chest 1973; 63:773-82. [PMID: 4574171 DOI: 10.1378/chest.63.5.773] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
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214
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De Bakey ME, Lefrak EA, Garcia-Rinaldi R, Noon GP. Aneurysm of the renal artery. A vascular reconstructive approach. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1973; 106:438-43. [PMID: 4696716 DOI: 10.1001/archsurg.1973.01350160056009] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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215
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Lefrak EA, Stevens PM, Nicotra MB, Viroslav J, Noon GP, DeBakey ME. An experimental model for evaluating extracorporeal membrane oxygenator support in acute respiratory failure. Am Surg 1973; 39:20-30. [PMID: 4686133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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216
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Beall AC, Morris GC, Noon GP, Guinn GA, Reul GJ, Lefrak EA, Greenberg SD. An improved mitral valve prosthesis. Ann Thorac Surg 1973; 15:25-34. [PMID: 4264465 DOI: 10.1016/s0003-4975(10)64930-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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217
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218
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Noon GP, Boulafendis D, Beall AC. Rupture of the heart secondary to blunt trauma. THE JOURNAL OF TRAUMA 1971; 11:122-8. [PMID: 5099826 DOI: 10.1097/00005373-197102000-00004] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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219
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Diethrich EB, Noon GP, Liddicoat JE, De Bakey ME. Treatment of infected aortofemoral arterial prosthesis. Surgery 1970; 68:1044-52. [PMID: 5483238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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220
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Beall AC, Weg JG, Stevens PM, Jenkins DE, Noon GP, Johnson P, Bell RL, Knight JV, Rossen RD, Butler WT, Douglas RG, Williams TW, Lewis JM, Morgen R, MacIntyre RS, Anderson MS, Balsaver AM, De Bakey ME. Human lung allotransplantation. Report of two cases. Am J Surg 1970; 119:300-10. [PMID: 4192070 DOI: 10.1016/0002-9610(70)90056-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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221
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Bricker DL, Noon GP, Beall AC, DeBakey ME. Vascular injuries of the thoracic outlet. THE JOURNAL OF TRAUMA 1970; 10:1-15. [PMID: 4906269 DOI: 10.1097/00005373-197001000-00001] [Citation(s) in RCA: 37] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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222
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Noon GP, Diethrich EB, Richardson WP, DeBakey ME. Distal tibial arterial bypass. Analysis of 91 cases. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1969; 99:770-5. [PMID: 5370201 DOI: 10.1001/archsurg.1969.01340180094019] [Citation(s) in RCA: 35] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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223
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De Bakey ME, Diethrich EB, Glick G, Noon GP, Butler WT, Rossen RD, Liddicoat JE, Brooks DK. Human cardiac transplantation: clinical experience. J Thorac Cardiovasc Surg 1969; 58:303-17. [PMID: 4897631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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224
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Noon GP, Beall AC, De Bakey ME. Surgical management of penetrating esophageal injuries. THE JOURNAL OF TRAUMA 1968; 8:458-64. [PMID: 5655165 DOI: 10.1097/00005373-196805000-00012] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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225
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Beall AC, Bricker DL, Crawford HW, Noon GP, De Bakey ME. Considerations in the management of penetrating thoracic trauma. THE JOURNAL OF TRAUMA 1968; 8:408-17. [PMID: 5655161 DOI: 10.1097/00005373-196805000-00007] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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