Validity of transcutaneous PO2 monitoring as compared with intra-arterial PO2 monitoring in newborn infants.
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Arteries↗
Biomedical subjects
E Nilsson
Publications and source records attributed to E Nilsson.
Arterial pH monitoring with monocrystalline antimony sensors. A study of sensitivity for PO2 variations.
Monocrystalline antimony catheter electrodes were studied intra-arterially in non-heparinized dogs. The sensitivity for variations in arterial PO2 (PaO2) was evaluated for this kind of metal-metal oxide pH sensor. The influence of PaO2 compensation on a previous pH sensitivity estimate was calculated. When the mV signal from the antimony sensor, after compensation for pH and temperature variations, was expressed as a function of log10 PaO2, a non-linear relation was found for the PaO2 range studied, 2.9-50 kPa. After calculations this range was divided into a lower and a higher sub-range. A first-order linear approximation was applied for these subranges. The sensitivity for oxygen was 70 mV/log10 PaO2 in the range 2.9kPa less than PaO2 less than 10 kPa, and 20.7 mV/log10 PaO2 in the range 10 kPA less than PaO2 less than 50 kPa. The non-logarithmic sensitivity for intra-arterial oxygen is contradictory to results from in vitro studies in test solutions. The present study indicates that the monocrystalline antimony pH sensor has a sensitivity for PaO2 variations which is closely correlated to the haemoglobin-oxygen dissociation function. When compensation for PaO2 variations was performed on an earlier evaluated study over a wide pH range but limited PaO2 range, the pH sensitivity previously found was not influenced.
Animals↗
Physostigmine for post-operative somnolence after diazepam-nitrous oxide anaesthesia.
The antidotal effect of physostigmine in a dose of 1 mg and 2 mg was investigated in 44 patients after diazepam-nitrous oxide anaesthesia. The degree of recovery was estimated using the Bender Motor Gestalt test, the post-operative recovery scores, the changes in hand force, and the cerebral function monitor (CFM) trace. Diazepam plasma levels were also determined. The improvement in the patients' alertness assessed by psychomotoric tests and the CFM trace was significant, but the recovery of the vital functions measured by the recovery scores (PARS) was marginal. Thus the indications for physostigmine in the treatment of postoperative somnolence induced by diazepam-nitrous oxide are relative and only in grave oversedation with diazepam can physostigmine be recommended as an antidote.
Adult↗
Radiosensitive t cell suppression in relation to the TG cell level in synovial fluid of patients with rheumatic disease.
Radiosensitive T cell suppression was studied in relation to the level of T cells with IgG-Fc receptor (TG cells) in synovial fluid and blood of nine patients with rheumatic diseases. Irradiation of T cells significantly decreased the proportion of TG cells in the blood of patients and healthy controls. The proportion of synovial TG cells was low in all patients before as well as after irradiation. Irradiation enhanced the helper effect of T cells on pokeweed-mitogen induced immunoglobulin production by allogeneic B cells. This increased helper effect was taken as an expression of decreased suppressor activity following irradiation. By this method suppressor activity was demonstrable in synovial T cells of six out of nine patients and in blood T cells of six out of eight patients and six out of eight healthy subjects. Thus the low level of synovial TG cells was in most patients not associated with a lack of radiosensitive synovial suppressor cell activity.
Adult↗
[Research in Karlskrona Central Hospital. Patient information prior to rectoscopic examination].
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Humans↗
T lymphocyte subpopulations defined by monoclonal antibodies in synovial fluid of patients with rheumatic disease.
The proportion of T lymphocytes reacting with monoclonal antibodies to suppressor or helper T cell subsets and the proportion of T lymphocytes with Fc receptors for IgG or IgM were determined in synovial fluid and blood of 16 patients with rheumatic diseases including rheumatoid arthritis (RA), psoriatic arthritis, ankylosing spondylitis and juvenile rheumatoid arthritis. The percentage of T cells reacting with monoclonal antibodies (Leu 2a or OKT 8) directed at the suppressor/cytotoxic T cell subpopulation, was significantly higher in synovial fluid than in blood of patients or healthy donors. Monoclonal antibodies (Leu 3a or OKT 4) with specificity for the helper T cell subpopulation, reacted with a lower percentage of synovial T cells than of blood T cells of patients or controls. This distribution pattern was found in patients with RA as well as in the other patients with chronic arthritis. The percentage of T cells with Fc-IgG receptors (TG cells) was much lower in synovial fluid than in blood of patients or controls. Thus, in synovial fluid the percentage of T cells reacting with monoclonal antibody to the suppressor/cytotoxic cell subset was fairly high (mean 45%) whereas the proportion of TG cells, considered to represent suppressor cells, was low (mean 4%).
Adult↗
Thrombectomy and arteriovenous fistula for iliofemoral venous thrombosis in fertile women.
Thirteen women of fertile age with left-sided iliofemoral venous thrombosis were treated with thrombectomy and a temporary arteriovenous fistula in the groin. In nine patients, the appearance of thrombosis could be related to pregnancy; in three of these, obstetric complications occurred. Diagnosis was obtained by antegrade and retrograde phlebography. After three months, the arteriovenous fistula was closed. Anticoagulant treatment was given from the time of diagnosis and for a total of six months. Patency of the iliac vein was determined by phlebography or venous occlusion plethysmography, or both. Based upon these findings, a short term patency rate of 85 per cent was achieved. Analysis of the material indicates a multifactorial pathogenic mechanism in the development of iliofemoral venous thrombosis. Important factors are pregnancy, obstetric complications, mechanical factors causing flow resistance in the iliac vein, hormonal factors and defective fibrinolysis.
Adult↗
Continuous intra-arterial PO2 monitoring with a surface heparinized catheter electrode. A study of conformity in conventional blood gas analysis and of long-term electrode function in the non-heparinized dog.
Surface-heparinized catheter PO2 electrodes were used for continuous intra-arterial monitoring in non-heparinized dogs. During one-day experiments the read-out of the electrode monitoring unit was compared with that of conventional blood gas analysis. Furthermore, the electrodes were studied after long-term implantation. The intra-arterial PO2 electrodes have previously been reported to be linear in the gas phase, water phase and in heparinized blood. The present study demonstrates that the catheter electrodes remain linear after surface heparinization. As compared with the conventional blood gas analysis it was found that the desk analyser in the range PaO2 greater than 18 kPa underestimated the actual PaO2 as compared to the invasively monitored PaO2, but in the range below 7 kPa the desk analyser overestimated the PaO2. Surface-heparinized PO2 catheter electrodes were studied after up to 23 days of implantation. No coagulation phenomenon was found around the catheters, neither macroscopically nor by scanning electron microscopy. The electrical function withstood 7 days of implantation. After more extended periods the electrical leads were broken without any damage to the catheter itself. When compared with acutely implanted surface-heparinized electrodes, there was no difference in monitoring characteristics between the acutely implanted and the long-term implanted PO2 electrodes.
Animals↗
Carcinoma of the colon and rectum. Delay in diagnosis.
During the period 1971-1975 284 patients were treated for adenocarcinoma of the colon or rectum; 52% were aged 70 years or more, and 37% had incurable disease at the time of diagnosis. When staged according to Dukes' classification, tumours of the right colon (coecum and ascending colon) were more advanced than those in other parts of the colon and rectum (p less than 0.05). In retrospect, local symptoms from colon and rectum were present in 95% of the patients, whereas 49% had symptoms and signs possibly indicating malignant disease. Local and/or general symptoms of more than six months' duration were noted for 38%. Only 3 patients were asymptomatic at the time of diagnosis. Evidence of at least one risk factor for colorectal cancer was obtained in 11%. Those admitted as emergencies (34%) showed a significantly higher incidence of incurable disease than those admitted electively (p less than 0.01). In 22% of all patients an abdominal mass could be palpated and in 32% a tumour was found on rectal exploration. X-ray examination of the colon was performed on 218 patients, with apparently normal findings in 30. However, in 18 of the latter 30 new scrutiny aroused suspicion of tumour in the large bowel. Before admission only 45 patients had undergone rectosigmoidoscopy. Doctor's delay exceeded 5 months for 45 patients (16%); these tumours did not differ from those of other patients with respect to Dukes' classification.
Adenocarcinoma↗
Physostigmine treatment in various drug-induced intoxications.
Eighty three patients who were comatose or confused due to intoxication with various drugs were treated repeatedly with 2 mg doses of physostigmine until maximal neurological improvement or side effects appeared. During therapy special attention was paid to the level of consciousness (Glasgow coma score) and to the general cardiorespiratory state. According to the main drug ingested the patients were divided into the following groups: anticholinergic (35 patients), benzodiazepine (12 patients), non-anticholinergic (22 patients) and unclassified (14 patients). The best antidotal effect of physostigmine was in the anticholinergic group (91%) and in the benzodiazepine group (67%), whereas in the non-anticholinergic and in the unclassified group only 32% and 50% of the patients, respectively, showed any improvement in mental condition during the physostigmine application. After the antidotal therapy, relapses occurred in 21/32 patients in the anticholinergic group, whereas the figures for the benzodiazepine and the non-anticholinergic groups were only 2/8 and 0/7. Major side effects of physostigmine were noted in two patients, one had ventricular extrasystoles and the other an acute grand mal attack. In this series the diagnostic value of physostigmine was considerable, but the therapeutic benefit was limited.
Adolescent↗
Status epilepticus treated by barbiturate anaesthesia with continuous monitoring of cerebral function.
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Adult↗
The effect of intravenous prostacyclin on resting pains and healing of ischaemic ulcers in peripheral artery disease.
Prostacyclin (PGI2) was given intravenously in doses of 1 to 5 ng/kg/min to eight consecutive patients with end stage peripheral arteriosclerosis and ischaemic ulcers. Seven patients had intense ischaemic pains. Complete or partial healing of ulcers were seen in six cases (complete in three). In those whose ulcers healed (complete or partially) relief of ulcer pain was remarkable. Acute studies of the effect of prostacyclin on skin temperature of ischaemic areas showed no correlation with clinical effects. Seven patients had more or less pronounced subjective side effects, most often flushing, nausea, headache and uneasiness. As we previously have seen equally good healing and pain relieving effects by the administration of prostaglandin E1 without these side effects the latter compound is so far preferred in the treatment of severe peripheral artery disease. Controlled studies of the effect are needed.
Aged↗
Comparison of physostigmine and neostigmine for antagonism of neuromuscular block.
The ability of physostigmine alone and in combination with neostigmine to reverse d-tubocurarine-induced neuromuscular block was evaluated in surgical patients. The relaxation was maintained at a level of 90% twitch suppression during balanced anesthesia, and antagonism was attempted with physostigmine 1.5 mg x 3; neostigmine 0.5 mg x 3; neostigmine 1.0 mg x 3; or with a combination of physostigmine 0.75 mg and neostigmine 0.5 mg x 3. The measured parameters included the twitch force or EMG amplitude of the adductor pollicis brevis muscle after supramaximal 0.1 Hz stimulation and fading of these responses after repetitive 2 and 50 Hz stimuli. Although the restitution rate of twitch height and EMG amplitude were essentially the same with both antagonists, there was a considerable time-lag in regeneration of the fades after repetitive stimuli with physostigmine as compared with the neostigmine group. The addition of physostigmine to a subeffective dose of neostigmine resulted in antagonism comparable to that seen in other groups. The clinical antagonism was satisfactory in all patients receiving physostigmine. The divergence of relaxation-indicating parameters (twitch responses and fades) after physostigmine suggests dissimilar modes of action of two antagonists at the neuromuscular junction.
Adult↗
Lung uptake and antianaphylactic effects of KWD 2131 (a beta-adrenergic agonist) in perfused guinea-pig lungs.
The lung uptake and modulating effects of KWD 2131 [1-(3,5-dihydroxyphenyl)-2-(1,1-dimethyl-2-hydroxyethyl) amino ethanol], a beta-adrenergic agonist, on pulmonary perfusion flow and histamine release from anaphylactic guinea-pig lungs were studied using an isolated perfused lung model. The lung extraction ratio, as calculated from the concentration of drug in the inflowing and outflowing medium in single pass studies was less than 0.05 at steady state which was achieved within 3 min. after start of drug infusion. Statistically significant protection to antigen elicited reduction in perfusion flow and inhibition of histamine release were obtained at the inflowing concentration 1.5 x 10(-6) mol/l but not at 1.5 x 10(-7) mol/l. The observed inhibition of the anaphylactic decrease in the perfusion flow can partly be explained by the decreased histamine release.
Adrenergic beta-Agonists↗
Influence of acid-base changes on carbachol- and potassium-induced contractions of taenia coli of the rabbit.
The influence of acid-base changes (variations of extracellular pH within the range 6.2-8.2 and parallel changes in (HCO3-) and PCO2 at constant external pH) on contractions induced by carbachol and K+ was studied on preparations from taenia coli of the rabbit. Extracellular acidosis increased the concentration of carbachol necessary to evoke a given muscle tension and reduced the maximum response. During a carbachol-induced contraction acidosis reduced and alkalosis enhanced muscle tension. Changes in extracellular pH within the range 6.2-8.2 did not affect the initial, rapid phase of the contraction induced by 145 mmol/l of K+. However, with 40-80 mmol/l of K+ acidosis reduced the phasic response. The tonic contraction following the initial phasic response in 145 mmol/l K+ was enhanced by extracellular acidosis and decreased by alkalosis, whereas at a K+-concentration of 70 mmol/l the amplitude of the tonic contraction was greater at pH 7.4 than at pH 6.2. Propranolol 10(-6) mmol/l did not affect the influence of extracellular pH upon the K+-contracture. An increase of both PCO2 and (HCO-3) at constant extracellular pH did not alter the response of the muscle to carbachol. The tonic contraction during K+-stimulation was diminished by a parallel increase in PCO2 and (HCO-3) and at 47 mmol/l (HCO-3) it was almost abolished. A rise in PCO2 from 5 to 14 kPa without changes in (HCO-3), which caused extracellular pH to drop from 7.4 to 6.3, increased the tonic contraction in the same way as a fall in extracellular pH alone. These results seem to indicate that extracellular acidosis within the pathophysiological range (1) decreases the sensitivity of the polarized smooth muscle membrane to cholinergic stimulation, (2) reduces: the rate of release of stored Ca++, the transmembrane flow of Ca++ into the muscle cell, and the rate of Ca++ inactivation or extrusion during K+-contraction. The reduction of the tonic contracture with increasing PCO2 and (HCO-3) at constant extracellular pH is most likely attributable to the (HCO-3) ion.
Acid-Base Equilibrium↗
Polarographic pO2 sensors with heparinized membranes for in vitro and continuous in vivo registration.
The membranes of the pO2 sensor in a conventional blood gas analyser and a commercially available catheter pO2 electrode were coated with a glutardialdehyde stabilized heparin layer. It was analysed whether or not the "non-thrombogenic" heparin surface could improve the accuracy of in vitro pO2 registration and continuous in vivo paO2 monitoring. The in vivo experiments were performed on anaesthetized and non-anticoagulated dogs. Two identical blood gas analysers were used, one furnished with a heparin coated pO2 membrane and the other with a standard pO2 membrane. In vitro pO2 determinations exhibited--when simultaneously analysing the same blood sample--identical mean values. For repeated pO2 determinations, however, the standard deviation was significantly lower on the analyser furnished with a heparinized membrane. The non-heparinized catheter pO2 electrode showed a marked deterioration in accuracy with time as compared with blood-gas analysis on reference blood samples. Falsely low paO2 values were presented. The heparinized catheter electrode monitored values in full agreement with those of the conventional blood gas analyser using standard membranes. It is concluded that the heparin surface on the oxygen diffusible membranes diminishes the variability of the diffusion characteristics both at contact with anticoagulated blood in vitro and during in vivo paO2 monitoring. The "non-thrombogenic" heparin surface prevents diffusion impeding clot formations when an arterial catheter pO2 sensor is used.
Animals↗
Continuous intra-arterial pH-monitoring using monocrystalline antimony as sensor. A study in non-heparinized dogs.
Continuous intra-arterial pH-monitoring was performed on anaesthetized and artificially ventilated dogs. The pH sensor consisted of monocrystalline antimony. The sensor was placed on the tip of a catheter, length approximately 35 cm and diameter 0.8 mm. No anticoagulation was undertaken. The pH range studied was 7.01-7.53, the pH being changed by infusion of sodium bicarbonate ro ammonium chloride. Arterial reference blood samples for in vitro blood gas analyses were taken under stable monitoring conditions and analysed with a minimal delay. The millivolt signal from the antimony sensor was found to be a linear function of the pH of the reference blood samples in the intra-arterial pH range studied. The sensitivities of the different antimony sensors were closely correlated but not identical. When the antimony sensor was used completely uncalibrated, the standard deviation of the registered potential corresponds to 0.06 pH units. After single point calibration a standard deviation of 0.03 pH units was obtained. These standard deviations include a suspected influence of minor changes in the partial pressure of oxygen during the experiments.
Ammonium Chloride↗
[Adrenergic hyperactivity in tetanus].
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Adrenergic alpha-Antagonists↗