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Biomedical subjects

D Parsons

Publications and source records attributed to D Parsons.

At least 55 records · Page 3Linked to original sources
PubMed1988

Anesthetic mishaps and the cost of monitoring: a proposed standard for monitoring equipment.

Review of insurance data indicates that approximately 1.5 claims are paid per 10,000 anesthetic procedures, a conservative estimate of the incidence of preventable serious injury associated with anesthesia. Insurance data permit estimation of the premium cost for the anesthesiologist and hospital, per operating room per year, of $69,429.00. We propose the use of an enhanced monitoring standard requiring a pulse oximeter, capnograph, spirometer, halometer, automatic sphygmomanometer, breathing circuit oxygen analyzer, stethoscope, electrocardiographic monitor, and temperature monitor. We suggest that this premium cost, together with the estimate that 50% of incidents would be avoided, predicts a resultant saving of over $27,000/operating room/year, a savings equal to the entire cost of the enhanced monitoring system in approximately 8 months, or a yearly savings of over five times the annualized expense of the monitoring system. Thus, in addition to the moral imperative to monitor a patient during anesthesia to avoid injury and death, there is an economic incentive to monitor effectively.

Anesthesia↗
PubMed1987

Cholinergic neurons, learning, and recovery of function.

Two experiments were designed to examine the role of the cholinergic septo-hippocampal projection in spatial and nonspatial learning processes. In Experiment 1 the interaction of individual learning strategies and recovery of function was investigated following medial septal lesions, by assessing individual learning styles and number of trials to recovery on a standard radial eight-arm-maze task. Experiment 2 addressed the relevance of the cholinergic septo-hippocampal pathway in the acquisition of spatially mediated behavior, by employing medial septal lesions, prior to acquisition learning of a modified version of the radial eight-arm-maze task. The data from these two experiments demonstrated that (a) the cholinergic septo-hippocampal projection is important for the acquisition and maintenance of spatial learning strategies, (b) loss of cholinergic function leads to alteration of learning strategies, (c) different learning strategies can be employed to acquire the same behaviors, and (d) the rate of recovery following brain injury can be influenced by preoperative learning strategies.

Animals↗
PubMed1985

Electromechanical changes during electrically induced and maximal voluntary contractions: surface and intramuscular EMG responses during sustained maximal voluntary contraction.

Changes in the electrical activity of the human gastrocnemius and soleus muscles during fatiguing maximal plantar flexions were studied with computer-aided EMG frequency power spectral analysis and intramuscular spike amplitude-frequency histogram analysis. In some experiments, brief supramaximal nerve stimulations of 80 Hz were given at 15-s intervals during sustained maximal voluntary contractions (MVCs). Multiple muscle biopsy samples were also obtained from the gastrocnemius muscle for fiber type determination. The surface EMG frequency spectral analysis showed a highly significant reduction in mean power frequency and root mean square EMG amplitude during sustained MVCs. The intramuscular spike amplitude-frequency histograms showed that the gastrocnemius muscle had a progressive reduction in the motor unit discharge frequency, particularly those with a relatively high amplitude, whereas the soleus muscle hardly showed a reduction in motor unit activity. Reduction in motor unit activity was also found to be more pronounced in gastrocnemius muscles with higher proportions of type II fibers. Brief maximal tetanic stimulations initially matching the MVC failed to increase the contraction force. Similarly, the evoked compound mass action potentials showed little change in the amplitude in subjects with different muscle fiber compositions. Results of this study suggest that during sustained MVCs, force fatigue could not be attributed to a failure of muscle membrane electrical propagation; a progressive reduction in motor unit activation does not result in a functional disadvantage, but may optimize excitation-contraction coupling by avoiding a muscle electrical conduction failure; and the extent of the reduction in motor unit activation seems to be muscle-fiber-type-dependent which may account for the reduction in amplitude and frequency of the surface EMG.

Biomechanical Phenomena↗
PubMed1985

Spina bifida occulta: lesion or anomaly?

Failure of fusion of the posterior arches of the lumbosacral spine above S3 was sought on frontal radiographs of 653 patients attending an accident and emergency (A & E) department. The patients were aged from 2 months to 98 years and represent all those with relevant information discharged as A & E outpatients over a 2-year period. Presenting complaints of backache or enuresis and inadequate radiographs were excluded. Spina bifida occulta was diagnosed in 22% of the whole group. The incidence was much higher in those below the age of 40 years (29.2%) compared with those above (9.8%). The overall age-adjusted incidence was 17.3%. Our study is an attempt to judge the off-the-street' prevalence of spina bifida occulta. It supports the notion that spina bifida occulta is a common anomaly, of no clinical significance on its own.

Adolescent↗
PubMed1985

Dynamic exercise training in foxhounds. II. Analysis of skeletal muscle.

The purpose of this study was to determine whether 8-12 wk of endurance training produces biochemical and histochemical adaptations in skeletal muscle in foxhounds. Analyses were performed on samples removed from gastrocnemius, triceps, and semitendinosus muscles of foxhounds before and after a treadmill running program. Biochemical analysis showed that training did not alter the activities of phosphofructokinase, beta-hydroxyacyl-CoA dehydrogenase, succinate dehydrogenase, or total phosphorylase. Histochemical analysis of myofibrillar actomyosin ATPase demonstrated three distinct classes of type II fibers and one type I fiber in the semitendinosus and triceps muscles and two type II and two type I fibers in the gastrocnemius muscle. Fiber type distribution and oxidative and glycolytic potentials, as indicated by nicotinamide adenine dinucleotide tetrazolium reductase or alpha-glycerophosphate dehydrogenase staining intensity, were unaltered by training. Similarly, capillary density, capillary-to-fiber ratios, and capillary area-to-fiber area ratios did not change with training. Thus, unlike humans and other mammals (i.e., rat), these foxhounds did not manifest biochemical or histochemical adaptations in skeletal muscle as the result of endurance training. This is consistent with the results of the study in which endurance training produced a 27% increase in maximal cardiac output and a 4% increase in maximal arteriovenous O2 extraction in foxhounds.

3-Hydroxyacyl CoA Dehydrogenases↗
PubMed1985

Alterations of ultrastructure and elemental composition in cultured neonatal rat cardiac myocytes after metabolic inhibition with iodoacetic acid.

The purpose of this study was to document changes in cellular fine structure and elemental composition, and their relationship to progression of cell injury, in cultured neonatal rat cardiac myocytes in which impaired energy metabolism was produced by the metabolic inhibitor, iodoacetic acid (IAA). In order to quantitate changes in the concentrations of elements and their subcellular distribution in individual myocytes, electron probe x-ray microanalysis was performed on freeze-dried cryosections of rapidly frozen cells. After 1 hour of exposure to IAA, ATP level was not significantly reduced. Most cells exhibited minimal ultrastructural alterations and had normal elemental profiles, whereas some cells (10 to 25%) had increased sodium and calcium in mitochondria and cytoplasm. After exposure to IAA for 1.5, 2, or 4 hours, the ATP level was reduced to below one third of control, and remained decreased 24 hours after removal of IAA, indicating irreversible depression of this variable. After exposure to IAA for 1.5 hours no longer, many cells showed severe ultrastructural alterations, including contraction or swelling of mitochondria and distortion of the cristae, myofibrillar hypercontraction, and formation of fluid-filled blebs. At 1.5 and 2 hours, approximately 75% or more of the myocytes had increased sodium and calcium and decreased potassium and magnesium in mitochondria, nuclei, and cytoplasm. Thus, the development of an increased calcium concentration in cytoplasm as well as mitochondria of most myocytes was a feature of this transitional period. These data indicate that progressive alterations in the levels and distribution of elements accompany the development of severe ultrastructural changes and irreversible injury in response to impaired energy metabolism in cultured myocytes. These elemental alterations include accumulation of calcium in cytoplasm and mitochondria of myocytes in this model.

Adenosine Triphosphate↗
PubMed1983

Differentiation of fiber types in skeletal muscle from the sequential inactivation of myofibrillar actomyosin ATPase during acid preincubation.

A method is described for identifying fiber types of skeletal muscle from several mammalian species on the basis of the sequential inactivation of myofibrillar actomyosin ATPase during acid preincubation. When this method is used in combination with the standard alkaline preincubation at least 5 types of fibers can be identified. Of these, 2 are type I fibers with those of the slow twitch soleus muscle being different from those that exist in mixed muscles. The 3 subtypes of type II fibers exist independent of their metabolic properties. The need for careful standardization of histochemical methods for the visualization of myofibrillar actomyosin ATPase and the implication of the existence of different fiber types in apparently homogeneous muscle for the preparation of antibodies used for immunocytochemical methods of fiber identification are discussed.

Adenosine Triphosphatases↗
PubMed1983

Fiber number and size in overloaded chicken anterior latissimus dorsi muscle.

The relative contribution of increases in fiber area and number was evaluated in the chicken anterior latissimus dorsi (ALD) muscle in which enlargement was induced by hanging a weight on one wing. ALD muscles from wings to which weights had been attached for periods ranging from 6 to 65 days weighed an average of 105% (range 22-225%) more than control muscles. Total muscle fiber number, determined by direct counts after nitric acid digestion and fiber dissection, and the frequency of branched fibers were unchanged by muscular enlargement. Fiber cross-sectional area was greater (P less than 0.01) in the enlarged muscles. A close relationship existed (r = 0.78) between actual muscle weight and weight calculated as the product of fiber volume, total fiber number, and muscle density for the control and enlarged muscles. Histochemical staining revealed a conversion of type IIa to type I fibers in the stretched muscles. These results support the concept that skeletal muscle enlargement in response to chronic overload is produced by hypertrophy of preexisting fibers and not be a formation of new fibers.

Animals↗
PubMed1982

Acute fasting and fiber number in rat soleus muscle.

The influence of fasting on fiber number in the soleus muscle (SM) of weanling male and female rats was investigated. For female rats, comparisons were made among groups of animals fed normally, rats fasted and then fed until prefast body weight was regained, and animals that grew to maturity. For male rats, comparisons were made only between control and fasted groups. Prior to the experimental treatments the SM was surgically removed from one leg. There was a 40% loss in body weight after fasting. Although major weight losses occurred in most muscles and organs, there was no change in the SM. Over the same period SM weight increased 31% in normal animals. Total fiber number (direct counts after nitric acid digestion) was unaltered by the treatments. Although wide variation existed between animals, total fiber number between legs for the same animal was closely correlated (r = 0.98). SM weight for male rats calculated from fiber length, cross-sectional area, and total fiber number could account for from 91 to 99% of the total muscle weight. There was no change in fiber number from weaning to maturity. It is concluded that fiber number is unchanged by fasting or during normal maturation.

Animals↗
PubMed1974

Analysis of alpha-lipoprotein cholesterol in 50 microl of plasma.

A micromethod for quantitation of alpha-lipoprotein cholesterol was devised for gas-liquid chromatography to minimize plasma sample size and facilitate lipid studies using capillary blood from children or small animals. alpha-Lipoprotein cholesterol was measured by gas-liquid chromatography in 20 micro l of the centrifuged supernate obtained after addition of 5 micro l of mixed heparin-manganese chloride solution 1:1 (v/v) to 50 micro l of plasma. Comparison of venous alpha-lipoprotein cholesterol measured by gas-liquid chromatography with venous alpha-lipoprotein cholesterol measured by conventional heparin-manganese precipitation and ferric chloride (colorimetric) cholesterol determination gave a correlation coefficient of 0.98 for 80 plasma samples. Capillary alpha-lipoprotein cholesterol and venous alpha-lipoprotein cholesterol were closely correlated in 31 patients (r = 0.97).

Adult↗
PubMedDate not supplied

Distal tracheal compression.

The consultants concur that distal tracheal stenosis is a challenging problem in the pediatric patient but don't all agree on the presentation or management. Drs. Cotton and Crysdale agree that these children are usually seen with biphasic stridor. Dr. Parsons believes that biphasic stridor is not particularly common but inspiratory stridor is. The experts divide the differential diagnosis into intrinsic and extrinsic categories. Dr. Cotton lists tracheomalacia, complete tracheal rings and masses, such as an isolated hemangioma or granuloma. The usual extrinsic lesion is a vascular anomaly, the most common being an innominate artery. Dr. Crysdale's differential diagnosis includes tracheal stenosis, either congenital or acquired, and tracheomalacia. Vascular compression is most common as an extrinsic cause. Dr. Parsons includes tracheomalacia, complete tracheal rings, segmental tracheal stenosis, isolated masses, and vascular anomalies, such as an aberrant innominate artery. He also states that a tracheoesophageal fistula must be considered. Dr. Cotton prefers MRI and possibly a barium swallow for assessing vascular architecture. Even finding an air bronchogram on a chest x-ray can pinpoint an area of stenosis. The best test is direct laryngoscopy with video-photography. While Drs. Parsons and Crysdale agree that direct laryngoscopy is the best, Dr. Crysdale also suggests MRI or CT and adds that a contrast bronchogram is a most useful test.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Obstruction↗
PubMedDate not supplied

Anger inhibition potentiates the association of high end-tidal CO2 with blood pressure in women.

OBJECTIVE: High resting end-tidal CO2 (PetCO2) has been shown to be an independent predictor of systolic blood pressure (SBP) in women, particularly older women. The study reported in this article investigated whether the tendency to experience, express, and/or suppress anger contributes to the association of PetCO2 and SBP in women and in men. METHODS: The Spielberger Anger Expression Inventory was administered to 403 healthy male and female participants in the Baltimore Longitudinal Study on Aging. Resting PetCO2 was obtained by means of a respiratory gas monitor, and resting blood pressure was obtained with an oscillometric device. The associations of resting PetCO2 and the anger scales with SBP and diastolic blood pressure (DBP) were investigated using multivariate regression analyses. RESULTS: PetCO2, as well as age and body mass index, was an independent predictor of SBP in women with low, but not high, trait anger and in women with low, but not high, anger-out. PetCO2 was not an independent predictor of SBP in men with either high or low anger. In addition, PetCO2 was not an independent predictor of DBP in either men or women. CONCLUSIONS: The results of this study indicate that inhibition of anger potentiates the relationship of high PetCO2 with SBP in women but not men. Additional studies are needed to determine the origins of the observed gender differences and the psychophysiological pathways by which high resting PetCO2 contributes to elevated resting blood pressure in women.

Adult↗