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Biomedical subjects

F L Glauser

Publications and source records attributed to F L Glauser.

At least 109 records · Page 6Linked to original sources
PubMed1976

Ethchlorvynol (Placidyl)-induced pulmonary edema.

Two patients experienced severe nonhemodynamic pulmonary edema following the intravenous injection of 25 and 40 mg/kg of body weight of ethchlorvynol (Placidyl). The pulmonary edema cleared rapidly. Injection of Placidyl (12 to 80 mg/kg of body weight) intravenously into dogs caused acute, severe, nonhemodynamic pulmonary edema (as evidenced by markedly elevated lung weights and microscopic evidence of intra-alveolar edema), hypotension with a relative bradycardia, and a decreased cardiac output. Injection of polyethylene glycol, the vehicle in which ethchlorvynol is diluted, did not reproduce the syndrome.

Adult↗
PubMed1976

Paraquat poisoning: new aspects of therapy.

Clinical, laboratory, and pulmonary physiologic features of three fatal cases of paraquat poisoning are presented. Experimental investigations and clinical experience would suggest several possible means of modifying paraquat toxicity. The following specific therapeutic interventions, several of which had previously been applied only in experimental circumstances, were used: (1) inhibition of absorption of paraquat with Fuller's Earth and catharsis by magnesium sulfate, (2) elimination of absorbed paraquat by hemodialysis with ultrafiltration and forced diuresis, (3) competition by d-propranolol for tissue binding sites, (4) modification of direct pulmonary tissue effects of paraquat by hypoxic breathing mixtures, superoxide dismutase, and corticosteroids. Treatment was unsuccessful. However, our clinical experience and data concerning paraquat concentration in body and dialysis fluids suggest a therapeutic approach aimed at preventing early and progressive tissue damage. A combination of Fuller's Earth and magnesium sulphate should be used immediately and in frequently repeated doses to prevent absorption. Diuresis and haemodialysis should be instituted as soon as possible to increase excretion. Hypoxic atomspheres should be created urgently to produce a PaO2 of 40-45 mmHg, and the use of superoxide dismutase be further investigated. It is hoped that the high mortality of paraquat poisoning will be modified by this combined approach of early and intensive treatment.

Adolescent↗
PubMed1976

Hyperamylasemia in heroin addicts. Characterization by isoamylase analysis.

Hyperamylasemia was noted in 17 (19%) of a group of 91 hospitalized heroin addicts. Thirteen of the 17 were in acute respiratory distress (12 with so-called "heroin lung" syndrome and one with status asthmaticus). Isoamylase analysis in the hyperamylasemic patients demonstrated S-type isoamylase dominance in 15, P-type isoamylase dominance in one and essentially equivalent P- and S-type isoamylase elevations in one. It would appear from these data that the hyperamylasemia after heroin in most persons addicted to the use of this drug arises from the sources other than the pancreas. Changes in the lungs occurring in association with heroin addiction seem to have an important role among the possible contributory factors.

Adolescent↗
PubMed1975

High incidence of precipitins in sera of heroin addicts.

We analyzed sera of 50 consecutively hospitalized heroin-abuse patients for precipitins against several antigens. Forty-seven addicts had precipitins against extracts from moldy hay, and 34 against extracts from bagasse. Thirty-six showed precipitin bands against extracts from one or more of the following: Aspergillus, Micropolyspora faeni, and Thermoactinomyces vulgaris. These findings were significantly different from those of a control population (P less than .0001 for all antigens tested). The recent culture identification of bacteria and fungi from street heroin suggests that the addicted population may be injecting antigenic material intravenously, with subsequent antibody formation.

Adult↗
PubMed1975

Minimal increases in pulmonary wedge pressure associated with improved PaO2s in dogs.

To determine the relationship between minimal increases in pulmonary wedge pressure (PWP), arterial PO2s, single breath diffusing capacity (DLCO), and lung perfusion pattern (as determined by semiupright lung scans), we elevated PWP by 61.8+/-4.1% from baseline values of 5.5+/-0.4 mm Hg. At the end of 30 min PaO2 increased by 13.2+/-1.4% (p less than 0.001) from baseline values of 81.7+/-3.1 mm Hg; DLCO decreased by 15.5+/-1.2% (p less than 0.01) to 0.98+/-0.10 ml/min/mm Hg/kg. Lung perfusion changes in the right lung apical zone increased by 28.0+/-4.2% (p less than 0.001) and decreased in the basal zone by 6.2+/-0.8% (NS). In the left lung the apical perfusion increased by 14.9+/-1.1% (p less than 0.01) and basal perfusion decreased by 8.6/+-1.4% (NS). We conclude that minimal elevation of PWP in dogs leads to improvement in PaO2s through alterations in the lungs perfusion pattern.

Animals↗
PubMed1975

Pulmonary parenchymal tissue volume measurements in graded degrees of pulmonary edema in dogs.

We investigated the accuracy and the sensitivity of a modification of the acetylene inhalation technique for the determination of lung tissue volume (Vt) during various grades of hemodynamic pulmonary edema in 23 dogs. After base-line acetylene measurements were obtained, intravascular driving force (pulmonary wedge pressure minus intravascular colloid osmotic pressure) was varied between -8 and +71 mm Hg by the inflation of an intra-aortic ballon and the infusion of isotonic saline. After 30 minutes at this new driving force, four timed acetylene samples were again collected. Vt (when factored by alveolar volume, VA) increased from base line to 0.23 plus or minus 0.07 ml/ml between a driving force of 0 and + 17 mm Hg. This same change in Vt/VA was accompanied by an increase in the lung wet weight-dry weight ratio from 3.84 plus or minus 0.31 to 5.2 plus or minus 0.25. Vt was 271 plus or minus ml compared with an actual lung wet weight of 288 plus or minus 57 g; Vt tended to overestimate lung wet weight in severe pulmonary edema. Alloxan-induced pulmonary edema (6 dogs) tended to parallel these data. We conclude that the acetylene method may ve a relatively accurate noninvasive method for the determination of increasing lung water in pulmonary edema.

Acetylcholine↗
PubMed1975

The effects of dehydration on the radiologic and pathologic appearance of experimental canine segmental pneumonia.

In an attempt to determine whether dehydration (intravascular fluid depletion) alters the radiologic or histologic picture of segmental Streptococcus pneumoniae pneumonia, we induced pneumonia in 2 groups of dogs, group 1 (normally hydrated) and group 2 (dehydrated). Five hours after the intrabronchial instillation of a brain-heart-Streptococcus pneumoniae mixture, all chest radiographs of dogs in group 1 and 2 were compatible with segmental alveolar pneumonia. Histologic lung sections obtained as early as 2.5 hours after infusion of the brain-heart-Streptococcus pneumoniae mixture revealed intra-alveolar edema with a minimum of leukocytes. By 24 hours after infusion, both groups showed marked intra-alveolar collections of edema fluid, fibrin, and leukocytes. We conclude that in a canine model, moderate dehydration has no effect on the radiologic or histologic features of Streptococcus pneumoniae pneumonia.

Animals↗
PubMed1975

In vitro pleural fluid clottability and fibrinogen content.

Twenty-three specimens of pleural fluid from 23 patients were examined for quantitative fibrinogen, total protein levels, and for clottability in vitro using the recalcification time. Of the 19 specimens of pleural fluid from patients without loculation, 11 (seven exudates) had no detectable fibrinogen; another 8 (six exudates) had a mean fibrinogen level of 55.0 +/- 10.2 mg percent, and a mean recalcification time of 19.4 +/- 2.6 minutes. The pleural fluids from the four patients with loculation had no detectable fibrinogen. The only fluids containing fibrinolytic activity were from the nonloculated non-fibrinogen-containing group. No correlation existed between pleural fluid/plasma total protein ratios and pleural fluid/plasma fibrinogen ratios. In vitro clottability in this study did not reflect the in vivo tendency for coagulation and loculation.

Adult↗
PubMed1975

Pulmonary interstitial fibrosis following near-drowning and exposure to short-term high oxygen concentrations.

Following near-drowning in fresh water, a 19-year-old man experienced severe adult respiratory distress syndrome, necessitating ventilatory support with positive end-expiratory pressure and high oxygen concentrations. Post-extubation, his course was highlighted by persistent hypoxemia and interrupted by a lung abscess which responded promptly to antibiotics. Pulmonary function tests were consistent with severe restrictive disease and chest radiograph revealed persistent bilateral alveolar and interstitial infiltrates. An open lung biopsy on the 26th hospital day showed interstitial fibrosis. Over the ensuing two months, the chest radiograph and pulmonary function tests returned towards normal. We attribute the pulmonary fibrosis to incomplete resolution of the alveolar interstitial pathology secondary to the near-drowning and exposure to high oxygen mixtures.

Adult↗
PubMed1975

Physiologic and biochemical abnormalities in self-induced drug overdosage.

The following abnormalities were observed during the first 24 hours of admission for 162 drug overdosage (OD) episodes in 152 patients: abnormal chest x-ray films; increased A-aO2 gradient; elevated white blood cell (WBC) counts; elevated serum enzyme levels; gross myoglobinuria; skin lesions suggestive of pressure necrosis; and abnormal electrocardiograms. Many sputum cultures were positive for single or multiple potentially pathogenic organisms. These correlations existed: all patients with OD duration of less than 12 hours were hyperthermic; as temperatures increased so did WBC counts; hyperthermic patients had higher creatine phosphokinase (CPK) values than those with hypothermia or normothermia; patients with skin lesions had higher temperatures and CPK values and longer OD duration; serum enzme levels increased with increasing OD duration; patients with CPK levels greater than 10,000 mU/ml had myoglobinuria; and patients with the most abnormal chest x-ray films had higher temperatures and larger A-aO2 gradients. Incidence of pneumonitis is low, even with abnormal chest radiograms, leukocytosis, hyperthermia, and positive sputum cultures. Abnormal temperatures and leukocytosis are probably secondary to stress, hypoxemia, acidosis, and specific drug ingestion rather than infection.

Adolescent↗