Biomedical subjects
Publications and source records attributed to E V Sunderrajan.
A patient with lymphomatoid granulomatosis and focal transformation to lymphoma limited to the central nervous system presented with severe central neurogenic hyperventilation. The hyperventilation resolved as the underlying pathologic condition was treated with prednisone and cyclophosphamide.
The effect of 0.25 mg of terbutaline sulfate, a beta 2-adrenergic agent, on the right and left ventricular ejection fractions (RVEF and LVEF, respectively) was studied in 30 patients with severe stable chronic obstructive pulmonary disease (COPD) with a mean forced expiratory volume in 1 s of 0.79 +/- 0.06 L. All bronchodilator therapy was withdrawn 48 hours before the study. The ECG-synchronized gated equilibrium radionuclide ventriculography showed decreased RVEF in 27 patients and LVEF in 16 patients. Both the RVEF and LVEF significantly increased after the terbutaline injection; this increase was noted both in patients with normal and decreased ejection fractions. We conclude that the increase in ejection fractions after terbutaline injection may contribute to the good clinical response to this drug seen in patients with severe stable COPD even though the bronchodilator effect may be minimal.
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Extensive and severe bronchiectasis was found in 7 heroin-addicted individuals with pulmonary symptoms whose chest roentgenograms were not suggestive of severe airway disease. Abnormalities consisted of varicose and cylindrical alterations. Pulmonary function tests revealed airflow obstruction, decreased lung volumes, and diffusion capacity impairment. Arterial blood gas analysis demonstrated mild hypoxemia in all patients and chronic hypocapnia in 4. Serial pulmonary function tests in 2 patients revealed only modest improvement in the degree of airflow obstruction. The occurence of bronchiectasis appeared to be related to episodes of heroin-induced pulmonary edema and infection.
The respiratory and circulatory effects of orally administered ephedrine sulfate, 25 mg, aminophylline, 400 mg, terbutaline sulfate, 5 mg, and placebo were evaluated in 20 patients with ventricular arrhythmia by a double-blind crossover method. The bronchodilator effect of terbutaline was similar to that of aminophylline over four hours but superior to ephedrine at the fourth hour. Both terbutaline and ephedrine exhibited chronotropic effects, with the effect of terbutaline greater than that of ephedrine at the fourth hour. The effect of aminophylline on heart rate did not differ from placebo. Only terbutaline was associated with an increase in ventricular ectopic beats. Ventricular tachycardia occurred in three patients treated with terbutaline and in one patient with ephedrine. There were no significant changes in blood pressure. Orally administered terbutaline should not be regarded as safer than orally administered ephedrine or aminophylline in patients with arrhythmias.