The art of internal marketing.
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Biomedical subjects
Publications and source records attributed to D A Schmidt.
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Thirty canine urinary calculi, most of which had been qualitatively classified as struvite calculi, were analyzed by instrumental neutron activation analysis at the University of Missouri Research Reactor. Measurements of sodium, magnesium, aluminum, silicon, phosphorus, chloride, potassium, and calcium were possible, using a dual irradiation procedure. Magnesium was used to calculate the percentage of struvite mineral, Mg(NH4) (PO4) X 6H2O, in the calculi by making use of the stoichiometric relationship of the element magnesium to the mineral. For those calculi containing greater than 80% struvite, the mean elemental concentrations were found to be 0.12% Na, 9.35% Mg, 0.0033% Al, 12.1% P, 0.02% Cl, 0.85% K, and 2.05% Ca. A new method for determination of silicon in urinary calculi also was discussed. Two calculi were found to contain 45.0% and 37.3% silicon, and 1 mixed calculus was composed of 1.4% silicon.
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UNLABELLED: Skeletal-muscle necrosis was evaluated in previously pressurized canine compartments using technetium-99m stannous pyrophosphate and classic histological criteria. Intracompartmental necrosis was quantitated in the anterolateral muscle compartment of each dog by uptake of 99mTc stannous pyrophosphate using the contralateral anterolateral compartment as an internal control. Representative specimens of muscle were sampled in experimental and control legs of each dog and were analyzed by qualitative histological techniques. Muscle necrosis was assessed in compartments forty-eight hours after pressurization to levels of ten to 120 millimeters of mercury for eight hours in thirty-seven dogs. In another dog, neither anterolateral compartment was pressurized so that both compartments acted as control muscle. The results in these experiments identify a threshold pressure level (thirty millimeters of mercury) and duration (eight hours) at which significant muscle necrosis occurs at normal blood pressure. Our findings imply that a quantitative relationship exists between incorporation of 99mTc stannous pyrophosphate and the level of intracompartmental pressure. This uptake technique, however, is not suitable for diagnosing compartment syndrome in patients with a threatened compartment syndrome. We suggest that intracompartmental pressure measurements by the wick-catheter technique, in conjunction with clinical findings, offer the best means for diagnosing compartment syndrome. CLINICAL RELEVANCE: Significant muscle necrosis associated with an impending compartment syndrome occurs at a threshold intracompartmental pressure of thirty millimeters of mercury after eight hours. Since time variables are often unknown in suspected compartment syndromes, fasciotomy is recommended when intracompartmental pressure exceeds thirty millimeters of mercury in a patient with normal blood pressure. The use of this threshold pressure level as an indication for fasciotomy requires a device for measuring intracompartmental pressure such as the wick catheter.
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Forty-three female and 44 male, sexually mature normal African sand rats (Mystromys albicaudatus) provided serum and urine for determining normal ranges of selected serum chemistry and electrolyte determinations and for routine nonfasted urinalyses. Serum chloride and serum glucose levels were greater and serum sodium levels lower for female rats. An unusually high physiological level of urine protein was detected, and it was determined that standard dipstick methods for determining urine protein levels in this species gave artificially high results. Ketouria and glycosuria were more common in males than in females, but these determinations were not correlated to blood urea nitrogen or to serum glucose levels. No association was found between body weight and any of the serum chemistry, electrolyte or urinalysis variables examined.
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Fluid homeostasis within muscle compartments is maintained by four pressures: capillary blood pressure, capillary blood oncotic pressure, tissue-fluid pressure, and tissue fluid oncotic pressure. As determined in the canine anterolateral compartment, capillary blood pressure is 25 +/- 3 millimeters of mercury; capillary blood oncotic pressure, 26 +/- 3 millimeters of mercury, tissue-pbessure, -2 +/- 2 millimeters of mercury; and tissue-fluid oncotic pressure, 11 +/- 1 millimeters of mercury. The wick technique allows direct measurement of tissue-fluid pressure in skeletal muscle and, with minor modifications, is adapted to collect microsamples of interstitial fluid for determinations of tissue-fluid oncotic pressure. The wick technique detects very slight fluctuations in intracompartmental pressure such as light finger compression, injection of small volumes of fluid, and even pulsation due to adjacent arterial pressure. Adjacent muscle compartments may contain different tissue-fluid pressure due to impermeable osseofascial barriers. Our results obtained in canine muscle compartments pressurized by infusion of autologous plasma suggest that risks of muscle damage are significant at intracompartmental pressures greater than thirty millimeters of mercury.