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Biomedical subjects

D E Jenkins

Publications and source records attributed to D E Jenkins.

At least 37 records · Page 2Linked to original sources
PubMed1983

Ventilatory functions of normal children and young adults: Mexican-American, white, and black. III. Sitting height as a predictor.

We studied the ventilatory functions of 1800 normal children ranging in age 7 to 20 years. Boys and girls of black, white, and Mexican-American ethnic groups were represented adequately. The FVC and FEV1 of normal black children were fully 1 SD lower than those of white children with the same standing height. Such racial differences could not be corrected by a scaling factor, because the differences vary with sex and also with height as the children grow. Using sitting height as a predictor greatly reduced the racial differences of ventilatory functions and permitted the application of one set of prediction equations for children of all three groups.

Adolescent↗
PubMed1981

Perioperative management of patients with paroxysmal nocturnal hemoglobinuria.

During the past two decades, we have had the opportunity to study a large number of patients with the rare hemolytic anemia, paroxysmal nocturnal hemoglobinuria. Sixteen surgical procedures have been performed upon ten patients with paroxysmal nocturnal hemoglobinuria. From this experience, we have developed certain recommendations for preoperative evaluation and preparation, intraoperative management and post-operative care. Any proposed surgical procedure for a patient with paroxysmal nocturnal hemoglobinuria should be closely managed by a team consisting of a surgeon, hematologist and anesthesiologist. In the preoperative evaluation, particular attention should be paid to the hematologic, renal and hepatic status. Transfusion requirements, whether precipitated by hemolytic episodes or surgical blood loss, should be met with either washed or perviously frozen erythrocytes, with consideration of the use of dextran for volume replacement. Dextran is the treatment of choice for thrombotic epidsodes. Close attention should be given to avoiding hypoxia and dehydration. Anesthetic agents which may activate complement or may be hepatotoxic are to be avoided.

Adult↗
PubMed1981

The kidneys in paroxysmal nocturnal hemoglobinuria.

Long-term study of 21 PNH patients revealed an unexpectedly high incidence of functional and anatomic renal abnormalities. Most patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. Evaluation of renal function revealed hyposthenuria, abnormal tubular function, and declining creatinine clearance. Radiologically these patients had enlarged kidneys, cortical infarcts, cortical thinning, and papillary necrosis which were confirmed by autopsy studies. Hypertension developed in eight patients. Urinary tract infection was uncommon. The renal findings bear striking similarity to those of sickle cell anemia. Contrary to the usual opinion, out studies clearly showed evidence of widespread renal pathology in PNH most likely due to repeated microvascular thrombosis similar to the venous thrombosis involving other organs in this disorder.

Adolescent↗
PubMed1980

Fulminant hepatic venous thrombosis (Budd-Chiari syndrome) in paroxysmal nocturnal hemoglobinuria: definition of a medical emergency.

Hepatic venous thrombosis (HVT) should be recognized as a distinct and highly lethal thrombotic complication of paroxysmal nocturnal hemoglobinuria. In a patient with fulminant onset prompt recognition of a triad of clinical, laboratory and liver scan findings facilitated early, aggressive and prolonged heparinization followed by coumadin maintenance, all with good results. Additionally a case of asymptomatic, smoldering HVT was unearthed by liver scan survey and confirmed by hepatic venogram; the patient was started on a regimen of Coumadin (crystalline sodium warfarin, Endo).

Budd-Chiari Syndrome↗
PubMed1979

Ventilatory functions of normal children and young adults--Mexican-American, white, and black. I. Spirometry.

This is a study of the ventilatory functions of 1,805 normal Mexican-American, white, and black students of six public schools in Houston, Texas, with ages ranging from 7 to 20. A roll-seal piston type spirometer was used. The best performed forced vital capacity curve of each student was selected by the computer program from which the following measurements were extracted: FVC, FEV1, FEV1/FVC ratio, PEFR, and MMEF. Each student also had the peak expiratory flow rate measured by the Wright peak flowmeter to establish normal values with this instrument. Significant differences of lung volume and flow rate exist among the three races, and between male and female subjects. Prediction equations and prediction curves for each race and sex are presented. The results of the present study are compared with those of previously published works.

Adolescent↗
PubMed1979

Ventilatory functions of normal children and young adults--Mexican-American, white, and black. II. Wright peak flowmeter.

A study was undertaken to establish the normal values of peak expiratory flow rate using the WPFM in three ethnic groups. This report is based on the testing of 1,805 healthy students 7 to 20 years of age in the Houston public schools. Significant differences of WPFR are noted among the three races, and between boys and girls. Prediction equations and regression lines are presented for each sex/race group. The performance of the WPFM is compared with that of the spirometer.

Adolescent↗
PubMed1979

Complement lysis of human erythrocytes. Differeing susceptibility of two types of paroxysmal nocturnal hemoglobinuria cells to C5b-9.

Although enhanced sensitivity of erythrocytes to complement-mediated lysis is a hallmark of paroxysmal nocturnal hemoglobinuria (PNH), subpopulations of erythrocytes in such patients vary significantly in this respect. One PNH erythrocyte subpopulation (termed type III) comprises exquisitely sensitive cells, whereas type II PNH erythrocytes are intermediate in complement sensitivity between PNH type III and normal human erythrocytes. Differences in the action of the terminal complement components that would account for the differing lytic behavior of types II and III PNH erythrocytes have been proposed but not directly demonstrated. The present studies, making use of carefully selected cases with pure populations of type II or type III erythrocytes, confirm a prior observation that antibody-coated PNH erythrocytes of both types II and III display comparably supranormal C3 binding in whole human serum. However, when lysis was induced by the isolated C5b-9 membrane attack mechanism, bypassing the requirement for C3 binding, only type III PNH cells exhibited greater than normal lysis. This finding suggests that type III PNH erythrocytes have an additional membrane abnormality not present in type II cells. Thus, the differing lytic behavior of these two cell types in whole serum may reflect the additive effects on type III cells of both exaggerated C3 binding and enhanced sensitivity to C5b-9, whereas the more moderate lysis of type II PNH cells may be determined mainly or entirely by the earlier-acting mechanism producing augmented C3 binding. The failure of guinea pig C8 and C9, as opposed to human C8 and C9, to reveal the true lytic sensitivity of PNH-III E in our earlier study is illustrated, and its implications briefly discussed.

Animals↗
PubMed1975

Urologic manifestations of paroxysmal nocturnal hemoglobinuria.

A long-term study of 17 patients with paroxysmal nocturnal hemoglobinuria revealed an unexpectedly high incidence of functional and anatomic renal abormalities. All patients demonstrated varying degrees of hematuria and proteinuria distinct from hemoglobinuria. All patients also had granular casts in multiple urinalyses. Evaluation of renal function revealed hyposthenuria, abnormal tubular function and declining creatinine clearance. Radiologically, one or more of these demonstrated enlarged kidneys, renal cortical infarcts and thinning, papillary necrosis, acute renal atrophy, retroperitoneal hematoma and ureteral infarction, which were confirmed by autopsy studies. Hypertension developed in 7 patients. Urinary tract infection was uncommon and no patient had a clinical history compatible with chronic or acute pyelonephritis. Contrary to usual opinion our compatible clearly showed evidence of frequent and widespread renal pathology in paroxysmal nocturnal hemoglobinuria most likely due to repeated microvascular thromboses similar to the venous trombosis involving other organs in this disorder. Since most of these patients present initially to urologists knowledge of this entity is mandatory.

Adolescent↗
PubMed1975

Xanthomatous inflammatory pseudotumor of the lung.

A case of xanthomatous inflammatory pseudotumor of the lung is reported. Large lipid-laden macrophages were the most prominent microscopic feature of thelesion. Within the lung parenchyma three possible sources of alveolar lipids are serum lipids that pass into the alveolar spaces after injury to alveolar capillary walls, lipoproteins secreted by type 2 alveolar epithelial cells, and lipoproteins formed within alveolar macrophages. Phagocytosis and retention of such lipids by alveolar macrophages are proposed as important factors in the pathogenesis of the xanthomatous inflammatory pseudotumor of the lung.

Humans↗
PubMed1975

The effect of bronchofiberscopic examination on oxygenation status.

Arterial blood gases were measured in 62 patients, none of whom was critically ill, to determine the effect of transnasal fiberoptic bronchoscopy on oxygenation status. Blood samples were obtained at regular intervals during the procedure. Thirty-four patients who were bronchoscoped while breathing room air had a significant drop in the arterial P02 following saline solution lavage. Twenty-eight patients who were given 28 percent oxygen via a Ventimask during the procedure were protected from this hypoxemia. Simultaneously measured arterial pH and Pco2 were unchanged during the procedure. Premedication alone resulted in a minimal but insignificant drop in PaO2 in 7 patients. These observations suggest that if the initial PaO2 is less than 70 mm Hg on room air, bronchoscopy by the transnasal approach is best performed with the administration of oxygen through an appropriate mask. If the patient is at risk of developing hypercapnia with supplemental oxygen, a 28 percent Ventimask should be utilized to prevent significant hypoxemia without causing hypercapnia.

Blood Gas Analysis↗