Search PubMed⌕ Search

Biomedical subjects

E Kimmel

Publications and source records attributed to E Kimmel.

29 records · Page 2Linked to original sources
PubMed1985

Intrathoracic and abdominal pressure variations as an efficient method for cardiopulmonary resuscitation: studies in dogs compared with computer model results.

Intrathoracic pressure variations are currently proposed as the main flow-generation mechanisms in standard and modified cardiopulmonary resuscitation (CPR) techniques. A method of changing pressure within the thorax and abdomen without any degree of heart compression was developed and tested in dogs. Intrathoracic and abdominal pressure waves were induced by cyclic inflation and deflation of the lungs and of perithoracic and periabdominal balloons. Various modes of CPR, depending on the rate of cycling, the use of a periabdominal balloon inflation, and a delay between the abdominal and thoracic pressure waves, were studied during ventricular fibrillation. During artificial systole (high intrathoracic pressure phase), the pressure which developed in the right ventricle (96.7 +/- 20.5 mmHg) was higher than the pressure in the aorta (89.3 +/- 20.5 mmHg, p less than 0.001). In artificial diastole (low intrathoracic pressure phase), the right ventricular pressure (11.7 +/- 2.6 mmHg) was lower than the aortic pressure (17.5 +/- 3.3 mmHg, p less than 0.001). The average flow in the carotid artery was 21.7 +/- 7.8 ml . min-1, which was 18 +/- 6% of the baseline carotid flow before CPR. Three different factors were found to improve the efficiency of CPR: periabdominal balloon inflation simultaneous with the intrathoracic pressure waves; increased frequency of the pressure waves from 60 to 100 cycles per minute; and inflation of the periabdominal balloon 50 to 100 ms before the thoracic balloon. Blood-gas and acid-base balance analysis during CPR revealed well-oxygenated arterial blood with a marked respiratory alkalosis and a slowly developing metabolic acidosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗
PubMed1985

[Spondyloepiphyseal dysplasia tarda].

The authors report on a case of spondyloepiphyseal dysplasia tarda (SDT). The most important clinical and radiological signs are described and the criteria for differential diagnosis listed. Among the bone dysplasias Maroteaux, Lamy and Bernhard distinguished in 1957 a discrete form which they called spondyloepiphyseal dysplasia tarda. The condition was found in 20 patients from four generations of three families studied. SDT is a rare and little-known abnormality of bone development. There have been very few communications concerning this condition. Furthermore, this very rare condition is not considered often enough in differential diagnosis and the findings are often misinterpreted; this also occurred in earlier examinations of the case reported here. As early as 1937, Volhard et al. saw a clinical picture corresponding to this condition in three brothers, but they did not take the malformation to be an autonomous disease; they merely stated that the clinical picture differed from that of Morquio's disease. Giedeon et al. classified the changes found in their patients as being associated with Morquio-Brailsford dysostosis.

Adult↗
PubMed1983

Pulsatile flow in tapered tubes: a model of blood flow with large disturbances.

Blood flow-through segments of large arteries of man, between adjacent bifurcations, can be modeled as pulsatile flow in tapered converging tubes, of small angle of convergence, up to 2 deg. Assuming linearity, rigid tube and homogeneous Newtonian fluid, the physiological flow field is governed by the Navier-Stokes equation with dominant nonlinear and unsteady terms. Analytical solution of this problem is presented based on an integral method technique. The solution shows that even for small tapering the flow pattern is markedly different from the flow obtained for a uniform tube. The periodic shear stresses at the wall and pressure gradients increase both in their mean value and amplitude with increased distance downstream. These results are highly significant in the process of atherogenesis.

Animals↗
PubMedDate not supplied

Blood gas and acid-base balance during cardiopulmonary resuscitation by intrathoracic and abdominal pressure variations.

The blood gases and acid-base balance in a modified cardiopulmonary resuscitation (CPR) technique, based on intrathoracic and abdominal pressure variations by means of circumferential chest and abdominal balloon inflation, were examined in seven mongrel dogs. CPR proceeded for periods lasting 30 min or more and was monitored by measurements of aortic and right ventricular pressures and carotid blood flow during the compression (artificial systole) and the relaxation phase (artificial diastole). The carotid blood flow was 21.7 +/- 7.8 (mean +/- SD) ml/min, which was 0.18 +/- 0.6 (mean +/- SD) of the baseline mean carotid flow. Arterial blood was well oxygenated throughout the experiments, and low PCO2 levels (5-9 mm Hg) caused an initial severe alkalosis (pH = 7.94). However, a gradual decline in the pH was observed, reaching a value of 7.34 +/- 0.11 in the arterial blood after 30 min of CPR. The venous blood had a very low oxygen content (less than 25.5%) with a low PO2 and a normal PCO2 (43.7 +/- 7.3 mm Hg) throughout the experiment. A gradually developing metabolic acidosis was reflected in the pH values, and an increase in base deficit from 2.25 +/- 5.6 meq/1 prior to CPR to 16.7 +/- 3.2 meq/1 after 30 min of CPR was observed. High arteriovenous differences in oxygen content (greater than 66.4%) and CO2 tension (30.1-41.5 mm Hg) with a slowly developing metabolic acidosis were noted. Thus, CPR by thoracic and abdominal pressure variations is associated with a slowly developing metabolic acidosis which is the result of the combination of hyperventilation and a low perfusion state.

Abdomen↗
PubMedDate not supplied

Parameter estimation for a prosthetic ankle.

The mechanical parameters of a model of an energy storage and return ankle prosthesis are estimated for normal level walking by means of an optimization procedure. The walking cycle is divided into six fields, such that the power does not change sign within each field; the transition between successive fields occurs at zero power. The optimal spring stiffness as a function of time, is found by optimizing a quadratic cost function to minimize the difference between the estimated ankle moments and the moments in normal walking. The optimization is subjected to four continuous constraints within each field and to two continuity constraints for the transitions between successive fields. The time-varying spring stiffness and the implications of additional external energy are discussed and are presented as recommendations for the designer.

Ankle Joint↗