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Biomedical subjects

F L Glauser

Publications and source records attributed to F L Glauser.

At least 73 records · Page 4Linked to original sources
PubMed1982

The effect of oral hydralazine on the pulmonary hemodynamics of patients with pulmonary foreign body granulomatosis.

Six patients, age 32 +/- 5 yr, had biopsy-proven foreign body granulomatosis secondary to the chronic injection of crushed, suspended pentazocine tablets. All patients complained of exercise-induced dyspnea. Measurements were made of mean pulmonary artery pressures (PAP), cardiac outputs (CO), pulmonary vascular resistance (PVR), and systemic vascular resistance (SVR) at rest and following 9 minutes of steady-state upright exercise. Following this, 50 mg of hydralazine was administered orally. The exercise PAP increased, and exercise PVR following hydralazine rose also. Exercise-induced dyspnea improved in all patients. In patients with foreign body granulomatosis, exercise-induced increases in PAP and PVR are common. This increase in PAP and PVR can be ameliorated somewhat by the acute oral administration of hydralazine. Exercise-induced dyspnea also improves.

Administration, Oral↗
PubMed1981

Sensitivity of scintigraphy for detection of pulmonary capillary albumin leak in canine oleic acid ARDS.

Computerized gamma scintigraphy was shown in this study to be a sensitive technique for the detection and kinetic analysis of a pulmonary capillary protein leak. A rising lung:heart radioactivity of 'slope of injury' was found at each dose of intravenous oleic acid in dogs from 0.01 to 0.20 ml/kg (p less than 0.01). This 'slope of injury' was proportional to the dose of oleic acid (r = +0.97; p less than 0.004) and was more sensitive than changes in arterial oxygen tension, standard chest radiography, bloodless wet:dry lung weight, or alveolar epithelial membrane permeability. Only standard light microscopy and right lymphatic duct flow were able to document the leakage of protein detected by gamma scintigraphy at 0.01 ml/kg oleic acid.

Albumins↗
PubMed1981

Increases in lung lymph and albumin clearance with ethchlorvynol.

We studied anesthetized dogs with right lymph duct (RLD) preparations and measured lymph flow, albumin concentrations in lymph (L) and plasma (P), pulmonary artery pressure (PAP), and pulmonary capillary wedge pressure (PCWP). Intravenous (iv) injection of ethchlorvynol (15-25 mg/kg) was followed by significant (p less than 0.02) increases in right lymph duct flow from 0.9 +/- 0.3 to 5.4 +/- 1.6 ml/h with stable PAP, PCWP, and L/P albumin (0.8 +/- 0.05 and 0.9 +/- 0.1). Similar results in RLD flow were obtained in dogs given 1) diphenhydramine, 3 mg/kg iv loading dose and 1.5 mg.kg-1 .h -1 infusion; 2) indomethacin, 4 gm/kg iv loading dose and 4 mg.kg-1h-1 infusion; 3) methylprednisolone, 30 mg/kg iv; 4) cyclophosphamide (40 mg/kg iv) to induce leukopenia (900 WBC/mm3) prior to ethchlorvynol injection. Cardiac lymph flow increased also and cardiac L/P albumin remained stable. Total hemolytic complement remained normal. We conclude that lung vascular permeability is increased following ethchlorvynol injection. Ethchlorvynol may have a direct effect on lung vascular permeability since, unlike other experimental models, complement activation, leukocytes, prostaglandins, and histamine play insignificant roles. A "final common pathway" may not exist for all forms of increased permeability pulmonary edema.

Animals↗
PubMed1981

Pulmonary microvascular and alveolar epithelial permeability characteristics in N-nitroso-N-methylurethane-injected dogs.

The subcutaneous injection of 5 to 6 mg/kg of body weight of N-nitroso-N-methylurethane (NNNMU) has been reported to cause acute alveolar injury in animals. To determine the permeability characteristics of the alveolar epithelium, we employed the in vivo saline-filled dog lung model and determined the time to 50 percent equilibration in minutes of a specific tracer in the blood and the lung model and determined the time to 50 percent equilibration in minutes of a specific tracer in the blood and the lung liquid (T 1/2) for endogenous serum albumin (MW 69,000 daltons, molecular radius 35 A) and exogenously administered 500,000 MW polydispersed dextrans (molecular radius 200 A). Compared to control animals, T1/2 decreased (permeability increased) in NNNMU-injected dogs from 3,500 +/- 100 to 682 +/- 160 minutes for albumin and from 20,000 +/- 250 to 2,790 +/- 750 minutes for 500,000 MW dextran (P less than 0.001). To determine the permeability characteristics of the pulmonary microvasculature, we employed the right lymph duct cannulation dog model and measured lymph flow/30 minutes, lymph albumin and dextran concentration, and lymph/plasma albumin and dextran ratios in control and NNNMU-injected dogs. Compared to control animals, lymph flow was significantly greater in NNNMU dogs, 2.07 +/- 1.1 vs .71 +/- .50 ml/30 minutes (P less than 0.01), respectively. We conclude that NNNMU injection increases permeability in both the alveolar epithelium and the pulmonary microvasculature.

Albumins↗
PubMed1981

Transient pulmonary hypertension from the intravenous injection of crushed, suspended pentazocine tablets.

We describe a patient with biopsy-proven pulmonary talc granulomas (secondary to the long-term intravenous injection of crushed tablets of pentazocine) who had two episodes of transient pulmonary hypertension following the injection of this oral medication. We established a canine model and measured the right lymph duct flow, mean pulmonary arterial pressures, and pulmonary vascular resistance to determine the short-term effects on hemodynamics and the flow of lymph after intravenous administration of crushed pentazocine tablets (3 to 4 mg/kg of body weight) or pure talc (2.5 to 3 mg/kg). A typical response to both agents consisted of short-term elevations of mean pulmonary arterial pressure and pulmonary vascular resistance to approximately twice baseline values, with a slow decrement over 30 to 45 minutes. The average flow of lymph tripled, peaking at approximately two hours after injection. The lymph contained high levels of albumin. We concluded that the talc filler in oral tablets of pentazocine induces the pulmonary hypertension, probably by mechanical obstruction of the pulmonary vasculature. Association with this transient pulmonary hypertension is an increase in the permeability of the pulmonary microvasculature.

Adult↗
PubMed1981

Cardiac arrhythmias and ECG abnormalities in tricyclic antidepressant overdose.

Tricyclic antidepressant overdose is widely felt to be associated with cardiac arrhythmias which may occur without warning, sometimes late in the clinical course. For this reason, many institutions routinely monitor cardiac rhythm in such patients for up to 72 h. A retrospective study was carried out to analyze the clinical course of such patients with emphasis on cardiac complications. Thirty-eight cases of TCA overdose were reviewed. Fourteen patients (36.9%) were classified as lethargic or stuporous on admission while 23 (60.5%) were either comatose or semicomatose, nine requiring endotracheal intubation. Patients were continuously monitored an average of 60 h after admission. Admission ECG's were abnormal in a high number of cases, most common abnormalities being sinus tachycardia (43%) and intraventricular conduction defects (24%). Ventricular ectopy was less common (7.8%). ECG abnormalities, with the exception of sinus tachycardia and infrequent PVC's were associated with a severely depressed sensorium and disappeared with neurological improvement, usually in 24 h. No arrhythmias were noted after the patient had become alert. Overall mortality was 2.6%, with no deaths in the adult populations. After a search of the literature, we conclude that intensive care unit monitoring is not indicated for prolonged periods once the patient has otherwise recovered from his acute complications of drug overdose.

Adolescent↗
PubMed1980

Gallium scans and serum angiotensin converting enzyme levels in talc granulomatosis and lymphocytic interstitial pneumonitis.

We have described two patients who had positive gallium lung scans with simultaneous elevation in serum angiotensin converting enzyme (SACE) levels. One patient had talc granulomatosis secondary to the intravenous injection of pentazocine, while the other patient had lymphocytic interstitial pneumonitis. We believe these are the first cases in which a positive gallium scan and elevated SACE levels were associated with these entities.

Adult↗
PubMed1980

Physiological effects of controlled concussive brain trauma.

Utilizing a fluid percussion device, we measured the physiological effects of brain trauma in cats exposed to controlled levels of injury. Concussive brain injury at 3-4 atm of intensity led to profound elevations of the mean systemic arterial blood pressure from 128 +/- 26 to 229 +/- 33 mmHg, left ventricular end-diastolic pressure from 4 +/- 2 to 24 +/- 15 mmHg, and pulmonary wedge pressures (PWP) from 5 +/- 3 to 27 +/- 17 mmHg and a relatively moderate increase in intracranial pressure (ICP) from 6 +/- 3 to 38 +/- 31 mmHg (all P < 0.001). Pulmonary edema was evidenced by a significant increase in lung tissue wet-to-dry weight ratios to 3.74 +/- 0.81 as compared with a control group of 2.29 +/- 0.23 (P < 0.001). There was poor correlation between wet-to-dry weight ratios and PWP. Approximately 60% of all spontaneously breathing animals become permanently apneic within 6 min after injury, while the remaining 40% developed transient apnea. Arterial O2 or CO2 pressure alterations, in contrast to pretreatment with phentolamine did not affect the hemodynamic or edemogenic response to trauma. Phentolamine did not block the apneic response or increase in ICP. Comparative studies using intravenous levarterenol without trauma produced responses similar to trauma. Concussive brain injury of 3-4 atm results in pulmonary edema, apnea, sympathetically mediated peripheral vasoconstriction and left ventricular failure effect.

Animals↗
PubMed1980

Pulmonary alveolar epithelial permeability in surgically induced hemorrhagic pancreatitis in dogs.

The adult respiratory distress syndrome has been associated with acute pancreatitis in 5-8% of patients. to determine, in a quantitative manner, the effects of acute, hemorrhagic pancreatitis on alveolar epithelial permeability, we studied two groups of dogs (group 1 - sham-operated, 7 dogs; group 2 - surgically induced pancreatitis, 7 dogs) and measured the flux of 10,000-20,000 molecular weight dextran and albumin (69,000 molecular weight), from the blood to the saline-filled lung. Following the surgical procedure (day 1), serum amylase levels increased significantly (397 +/- 70-1,268 +/- 95 dye units) in group 2 but not in group 1. Alveolar epithelial permeability (expressed as T1/2 time in minutes to 50% equilibration between blood and lung liquid) did not increase in either group for dextrans or albumin. We conclude that experimental acute pancreatitis does not cause an increase in alveolar epithelial permeability for molecular weight substances up to 69,000 daltons.

Acute Disease↗
PubMed1980

Histamine receptor and prostaglandin synthetase blockers in ethchlorvynol-induced pulmonary edema in canines.

The injection of ethchlorvynol intravenously in humans and animals causes an increased permeability form of pulmonary edema. The proximate cause for this increased alveolar capillary membrane permeability is unknown but humoral mediators such as histamine and prostaglandins could play a role. To determine whether these agents were a factor in the altered permeability, we employed the saline-filled dog lung model and measured the flux of albumin across the alveolar capillary membrane. Following the intravenous injection of ethchlorvynol, there was a marked increase in permeability which was not altered by treatment with H1 and H2 receptor blockers or a prostaglandin synthetase inhibitor. We conclude that histamine and prostaglandins play no role in the increased permeability associated with ethchlorvynol injection.

Albumins↗
PubMed1980

Cardiopulmonary dynamics in a severe case of Rocky Mountain spotted fever.

A 19-year-old man had multisystem organ failure secondary to Rocky Mountain spotted fever. In addition to renal, cerebral, liver, and gastrointestinal tract involvement he manifested noncardiogenic pulmonary edema and, later, myocardial dysfunction. Aggressive surgical, medical, and monitoring procedures led to recovery. Previously suggested myocardial dysfunction was documented for the first time.

Animals↗
PubMed1980

Pathophysiologic alterations in endotoxemia. Similarities to an animal model.

The validity of animal models of human sepsis has been questioned. We describe a patient who experienced a short episode of endotoxemia (? bacteremia) with resultant pulmonary hypertension, pulmonary edema from increased alveolar capillary membrane permeability, hypoxemia, hypotension, and relative leukopenia, which mimics the pathophysiologic changes noted following infusion of Pseudomonas bacteria into awake sheep. The similarity of abnormalities and their resolution suggests that Pseudomonas infusion in sheep is a valid experimental model of human septic shock.

Adolescent↗
PubMed1980

Sleep apnea syndrome: clinical features and treatment.

The sleep apnea syndrome is a relatively unappreciated but by no means rare cause of nocturnal hypercapnia and hypoxemia that sometimes persist into the waking hours. The authors describe their experience in diagnosing and treating this disease in seven patients who were characteristically overweight, tended to snore, and had daytime somnolence, intellectual deterioration and elevated hematocrits.

Humans↗
PubMed1979

P pulmonale in status asthmaticus.

We studied 129 patients during acute, severe asthmatic attacks. Electrocardiograms showed P pulmonale in 49% of patients who had an arterial carbon dioxide tension (PaCo2) greater than or equal to 45 mm Hg and an arterial pH less than or equal to 7.37, whereas P pulmonale was present in only 2.5% of asthmatics who had a PaCO2 less than or equal to 44 mm Hg and a pH greater than or equal to 7.38 (p less than 0.001). P wave and QRS axes were 79 +/- 8 degrees and 80 +/- 20 degrees, respectively, in the presence of P pulmonale. When P pulmonale disappeared, the P wave and QRS axes shifted significantly to the left (p less than 0.001). Electrocardiographic P pulmonale persisted 12 to 60 hr after correction of hypoxemia, hypercapnia, and acidosis. In 7 patients with P pulmonale and respiratory acidosis, cardiac catheterization demonstrated normal artery pressures (PAPs) measured relative to atmospheric pressure. In 12 of these peak inspiratory pulmonary artery transmural pressures (PATPs) were increased. Since increased right heart transumural pressures could result in chamber distention, these data are consistent with the hypothesis that reversible P pulmonale in status asthmaticus is explainable on the basis of markedly negative tidal pleural pressures and increased right heart transmural pressures.

Adolescent↗
PubMed1979

Increased alveolar epithelial permeability with acid aspiration: the effects of high-dose steroids.

Using the in vivo, liquid-filled dog lung model, we found that aspriation of acid with a pH of 2.5 or less led to increased alveolar epithelial permeability for albumin (molecular weight, 69,000 daltons; molecular radius, 35 a) and exogenously administered, polydispersed dextrans (molecular weight, 150,000 to 170,000 daltons: approximately molecular radius, 100 a). This increased permeability occurred with a large-volume (3 to 5 ml/kg) or small-volume (1 to 1.5 ml/kg) aspirate and with acid nebulization (1 to 1.5 ml/kg). When animals were either pretreated (30 min before aspiration) or post-treated (30 min after aspiration) with 30 mg of methylprednisolone/kg of body weight, there was no improvement in the increased permeability associated with acid aspiration. We conclude that, acutely, steroids have no effect on the increased alveolar epithelial permeability associated with acid aspiration.

Albumins↗