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Biomedical subjects

D L Rice

Publications and source records attributed to D L Rice.

18 recordsLinked to original sources

Psychological research on the martial arts: an addendum to Fuller's review.

Most psychological research on the martial arts has been conducted from a positivist stance, and Fuller's (1988) review of research reflected a positivist tone while suggesting that therapeutic influences may be achieved from martial arts training methods abstracted from their traditional setting. This addendum cites two important contextual problems influencing martial arts research. First, the martial arts are influenced by Oriental styles of thinking such as Taoism and Zen Buddhism that are difficult to grasp from a Western positivist point of view. We suggest that phenomenology seems to have some stylistic parallels with Oriental thinking and appears to offer the Westerner a point of entry toward understanding the martial arts as Oriental arts. Second, the cultural and psychological values and meanings of the Oriental martial arts may change when situated in a Western context, thus changing their method, content, and therapeutic influence. We suggest that a non-positivist and context-sensitive approach such as phenomenology might clarify the contextual intricacy of the martial arts and thereby facilitate improved theoretical foundations and empirical research of martial arts participation as a psychological phenomenon.

Cross-Cultural Comparison↗

Flow-dependence of extravascular thermal volume as an index of pulmonary edema.

Using a double indicator (dye and heat) dilution technique of extravascular lung water measurement, we examined the effect of a reduction in cardiac output and positive pressures on the extravascular thermal volume (EVTV) in dogs. Following baseline EVTV measurements, cardiac output was lowered by inflation of balloons in the superior and inferior vena cavas, as well as by bleeding, and positive pressures were applied to the airways. There was good agreement between the baseline EVTV and post-mortem lung water; however, as the cardiac output was lowered there was a reduction in the measured EVTV. In other animals following application of positive airway pressure there was a decrease in the EVTV which appeared to be related to the reduction in cardiac output caused by positive airway pressure. At least in part, loss of thermal indicator appeared to explain the reduction in EVTV. Measurement of EVTV as an index of pulmonary edema may not be accurate in the face of a changing cardiac output.

Animals↗

Effect of methylprednisolone on experimental noncardiogenic pulmonary edema.

Methylprednisolone, 30 mg/kg body weight, was given to dogs 30 min and 4 h after injection of monocrotaline to produce noncardiogenic pulmonary edema. Control animals received monocrotaline but not corticosteroids. After 6 h the steroid-treated animals demonstrated significantly butter gas exchange and significantly less pulmonary edema. A possible mechanism of this beneficial effect of steroids is inhibition of complement-leukocyte interactions which may mediate pulmonary microvascular injury. The results lend some support to the clinical practice of short-term pharmacologic doses of steroids in noncardiogenic pulmonary edema.

Animals↗

Effect of PEEP on lung water content in experimental noncardiogenic pulmonary edema.

After administration of monocrotaline to dogs to produce noncardiogenic pulmonary edema, one-half of the animals (controls) were treated with intermittent positive pressure breathing (IPPV), and one-half with that ventilation plus the addition of 10 cm H2O of positive end-expiratory pressure (PEEP). After 6 h, the animals treated with PEEP demonstrated significantly better arterial oxygenation and reduced AaDO2, but lung water, quantitated either postmortem or in vivo by indicator-dilution techniques, was no less than controls. Although PEEP improves gas exchange, it fails to modify the degree of pulmonary edema represent.

Animals↗

Closing volumes with variations in pulmonary capillary wedge pressure.

Increased closing volumes have been documented in patients in whom there was suspected to be early pulmonary edema due to increased pulmonary capillary wedge pressure. However, the relationship between the actual pulmonary capillary wedge pressure and closing volume has not been established. To attempt to define this relationship and to determine whether the closing volume might be a useful indicator of the onset of pulmonary edema, we measured the closing volume in dogs while sequentially increasing the pulmonary capillary wedge pressure by way of a left atrial balloon. We found a small but significant increase in closing volume (p less than 0.01) when a pulmonary capillary wedge pressure of 25 mm Hg was achieved, and it was at this pressure that pulmonary edema would hypothetically be expected to begin.

Animals↗

A comparison of oral terbutaline and fenoterol in asthma.

The effects of fenoterol and terbutaline, new beta 2 selective bronchodilators each administered orally in five mgm doses, was assessed in 33 asthmatics treated for six weeks. Both agents appeared to be equally potent bronchodilators with equally prolonged duration of action. Adrenergic side effects were half as frequent with fenoterol as compared to terbutaline. With both agents statistically significant drug tolerance developed--the clinical significance of which is unknown.

Administration, Oral↗

Respiratory failure in cancer patients.

A review of 180 cancer patients requiring mechanical ventilation disclosed that 26% survived to extubation, and 13% and 7% were alive at two and six months, respectively. Mortality was related to several factors individually and the cumulative number of organ systems dysfunctioning in a given patient. Compared with general intensive care patients, those with respiratory failure and neoplastic disease demonstrated a high incidence of drug-induced pulmonary disease, hematologic abnormalities, pneumothorax, and infections with multiple and unusual organisms--all of which alter the approach to management. Although the long-term survival was poor, immediate survival was comparable with that of many groups of patients with respiratory failure.

Adolescent↗

Inhaled atropine in asthma.

Ten adult asthmatics inhaled atropine and isoproterenol to determine the site of action in the airways and relative effectiveness of the two drugs. The two agents were equal in their effect on lung volumes and airway resistance but isoproterenol produced significantly better flows. Atropine was shown to be an effective bronchodilator with a predominant site of action in large airways. The authors believe atropine and atropine derivatives deserve ongoing investigation, especially regarding potential side effects of retarding mucociliary clearance and the clinical significance of apparent failure to dilate small airways.

Administration, Intranasal↗

Monocrotaline model of noncardiogenic pulmonary edema in dogs.

Monocrotaline, a plant alkaloid shown histologically to produce pulmonary endothelial damage and edema, was used in dogs to produce an acute model of noncardiogenic pulmonary edema. Following intravenous injection there was no change in pulmonary vascular pressures or heart rate; cardiac output fell and pulmonary vascular resistance increased. After 2 h measurement of lung water demonstrated modest pulmonary edema in all animals. The degree of edema produced was more consistent and reproducible than that following alloxan or alpha-naphthylthiourea.

Alkaloids↗

Contribution of systemic venous hypertension to the development of pulmonary edema in dogs.

Systemic venous hypertension (SVH) is a frequent finding in pulmonary edema. To study the possible contributory or even causal role of SVH in pulmonary edema, a dog model was developed in which balloon catheters were placed in the left and right atria. Inflation of the left atrial balloon produced a tendency to pulmonary edema by causing pulmonary venous hypertension (PVH) (pulmonary artery wedge pressure of 20 mmHg). Inflation of the right atrial balloon produced SVH (central venous pressure of 15 mm Hg). After 2 hours, dogs with SVH with or without PVH demonstrated a greater amount of lung fluid accumulation (P less than 0.01) compared to controls or PVH alone. There was no significant difference in lung water in SVH dogs with or without PVH. Pulmonary blood flow was not significantly different between the experimental groups, each of which was less than control. Impairment of pulmonary lymphatic flow is one possible mechanism producing the worsening edema; however, bronchial venous hypertension or neurogenic reflexes cannot be excluded. We conclude that the contribution of systemic venous hypertension to the development of pulmonary edema may have therapeutic implications.

Animals↗

Minocycline treatment failure in pneumonia caused by minocycline-sensitive Streptococcus pneumoniae.

A previously healthy 23-year-old white woman had fulminant pneumococcal pneumonia complicated by empyema and bilateral pneumothoraces. Despite early treatment with the recommended doses of minocycline, the disease progressed. The S pneumoniae isolate was resistant to a 30microgram tetracycline disk and showed an MIC of 3.13microgram/ml for minocycline and 12.5 microgram/ml for tetracycline; these levels are considered by the manufacturer to indicate sensitivity to minocycline and intermediate sensitivity to tetracycline. The tetracyclines, including minocycline, should not be used to treat bacterial pneumonia since resistant strains of pneumococci are not uncommon and inffective treatment can lead to rapid progression of the infection. This case suggests that the levels of minocycline considered to indicate sensitivity in vitro be reassessed.

Adult↗

Chemical pneumonitis secondary to inhalation of epoxy pipe coating.

Two patients with chemical pneumonitis secondary to inhalation of an epoxy curing material used in the coating of pipes had similar patterns of cough, hemoptysis, and dyspnea associated with diffuse bilateral alveolar infiltrates shortly following the exposure. Pulmonary function studies showed a volume-restrictive defect with severe hypoxemia, but an elevated diffusing capacity. All lung function studies returned toward normal within 1 month of exposure. One patient underwent an open lung biopsy which showed changes consistent with a nonspecific injury to the alveolar wall. This epoxy curing material, trimellitic anhydride, represents another cause of diffuse lung injury that can result in pulmonary edema.

Adolescent↗

Left ventricular function during respiratory failure.

Indirect measures of left ventricular function were studied in seven patients with respiratory failure secondary to chronic obstructive pulmonary disease to determine if there were a relationship between left ventricular function and treatment of the pulmonary disease. All patients were studied during acute episodes while in respiratory failure having arterial Pco2 (Paco2) values greater than 49 torr with no clinical evidence of left ventricular failure. Indirect methods to evaluate left ventricular function included the use of the Swan-Ganz catheter for pulmonary capillary wedge pressure measurement, systolic time intervals, and cardiac output. There was improvement in left ventricular function with treatment of the respiratory failure manifested by decreases in the wedge pressure and pre-ejection period/left ventricular ejection time ratio, and an increase in the dp/dt/pulmonary capillary wedge pressure with treatment of the chronic obstructive pulmonary disease. The improvement in left ventricular function suggests that there is a depression of left ventricular function in respiratory failure. The depressed function improved with therapy of the lung disease without additional medication directed at cardiac function.

Adult↗

A forum for foster children.

As part of a joint conference, foster children from five to 20 years of age attended a group session to explore their thoughts and feelings about foster care. The professional leaders reported their observations to a subsequent meeting of foster parents and caseworkers. The comments and behaviors of the children at this meeting were both illuminating and moving. Foster children must be heard.

Adolescent↗