Comparison of tissue pH monitor with a standard blood pH meter.
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Biomedical subjects
Publications and source records attributed to F Silverman.
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A woman with a 7-year history of herpes progenitalis was delivered by cesarean section after herpes simplex virus was isolated from the cervix 2 weeks prior to delivery. No overt signs of herpes progenitalis had been observed during this pregnancy. At amniocentesis done the day of delivery to assess fetal maturity, herpes simplex virus was isolated from the amniotic fluid. An unaffected infant was delivered; she remains healthy at 18 months of age. Immunoglobulin levels in fetal serum and amniotic fluid did not indicate fetal infection.
Eleven patients with moderate fetal bradycardia in labor were studied by fetal scalp blood pH, continuous tissue pH, and umbilical arterty pH at delivery. The neonatal outcomes and biochemical data demonstrated that moderate fetal brdycardia does not indicate fetal distress.
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We compared respiratory variables in 441 grain elevator workers with 180 civic outside laborers in Thunder Bay. The grain handlers had a lower frequency of both positive skin reactions to pollens and molds and a family history of asthma, which suggests that they may have been self-selected for a decreased tendency to develop allergic respiratory disease. There was a higher frequency of cough and rales and a small decrease in forced vital capacity and forced expiratory volume in one sec among the grain handlers, as compared to the civic workers matched for smoking. However, these differences between grain and nongrain workers were small in comparison to those between smokers and nonsmokers. There was no clear indication of a worsening of respiratory functions that could be attributed specifically to duration of employment as a grain elevator worker.
Asthmatics appear to be more susceptible to the effects of air pollutants than nonasthmatics. The present studies were undertaken to examine the effects of exposing asthmatics to ozone concentrations that occur in the environment. Seventeen well-documented male and female asthmatics have been exposed for 2 hr in an environmental chamber to 0.25 ppm of ozone on one occasion (ozone) and to air on another occasion (air). Effects were assessed by measurements of pulmonary function obtained prior to (0 hr), every half-hour during and at the end of all exposures (2 hr). Paired t-test analysis of lung volumes, forced expiratory volume in 1 sec (FEV1.0), and maximum expiratory flow rates at 50% of vital capacity (V50%VC) showed no significant changes (p greater than 0.05) when the following comparisons were made: 0 hr air vs 0 hr ozone, 0 hr air vs. 2 hr air, 0 hr ozone vs. 2 hr ozone, 2 hr air vs. 2 hr ozone. There was variability in severity of asthma and pulmonary function status; most subjects were taking some form of medication at the time of study. Some asthmatics showed no change or improvement with both air and ozone and others developed greater reductions in pulmonary function with ozone than with air. Approximately one-third of the asthmatics demonstrated greater changes in V50%VC with exposure to 0.25 ppm of ozone relative to air exposure. These studies indicate that acute exposures to ozone at realistic concentrations in the environment can produce adverse responses in some asthmatics.
The work of nasal breathing was determined in human subjects as a measure of impedance to respiratory airflow. The nasal cavities were examined separately and simultaneously with a split mask; flow and pressure signals were fed to a microprocessor for on-line computation and printout of respired volumes and work of nasal breathing. An alternating resistive nasal cycle of 3--4 hours' duration was demonstrated in the majority of normal, resting subjects. Reciprocity of the resistive changes in each nasal cavity maintained a constant total nasal respiratory work load of about 0.2 Joules/litre. Moderate changes in breathing rate and tidal volume had little influence on work. Inspiratory work was 1.6 times that of expiration. Increases in resistance of the dependent nostril were seen when the lateral decubitus position was adopted. Increase in cephalic venous pressure and pathological nasal obstruction increased the work of nasal breathing.
The historical development of nasal aerodynamic measurement is discussed. Attention is drawn to the absence of a consensus on adequate rhinometric techniques and standards, which hampers the elevation of rhinometry to the universal clinical status of audiometric, impedance, or nystagmus measurement. A computer-aided technique is described which overcomes some problems of rhinometry, by measurement of the amount of energy the body devotes to moving respiratory air through each separate nasal cavity. Although the approach is different, our preliminary results confirm previous work and suggest that assessment of the work of breathing is a promising technique in the investigation of nasal respiratory airflow.
We used a corneal microscope to measure the break up time of the tear film (BUT) in 14 young volunteers; four were men and all were non-smokers. Values under controlled conditions and after ten minutes of exposure to filtered air or to cigarette smoke in a room of 14.6 m3 were determined. Exposure to cigarette smoke was associated with a substantial (35--40%) and statistically significant (P less than 0.001) reduction of BUT. This may reflect an alteration in the relative proportions of the three constituents of the tear film. The chemical responsible, and the way in which it increases the flow of watery constituents and suppresses mucus and lipid secretion demand further research.
A bicycle ergometer was used to measure maximum exercise oxygen consumption following 2 h of intermittent exercise in an environmental chamber ventilated with air (FA test) or filtered air plus 0.75 ppm ozone (PO test). Thirteen adult males performed both tests according to a random sequence. The maximum attained VO2 declined 10% (P less than 0.01), maximum attained work load was reduced by 10% (P less than 0.01), maximum ventilation decreased 16% (P less than 0.01), and maximum heart rate dropped 6% (P less than 0.05) in the PO test. At the highest common work load, heart rate and oxygen consumption were similar and ventilation was slightly higher (P less than 0.05); however, frequency of respiration increased 45% (P less than 0.01) and tidal voluem fell by 29% (P less than 0.01) following ozone exposure. During maximum exercise, the respiratory frequency was similar in both tests, but tidal volume was 21% lower (P less than 0.01) in PO experiments. Decreases in vital capacity and FEV1.0 as well as cough and chest discomfort were also noted following ozone exposure. We conclude that the reduction of maximum attained VO2 is a consequence of ventilatory limitation of maximum effort, probably related to respiratory discomfort.
The efficacy of inhaled beclomethasone dipropionate has been examined in 44 steroid-dependent asthmatics observed for 9 months to 2 years. A 3-month double-blind trial found that subjects treated with beclomethasone had a significant diminution in symptoms, were able to reduce their use of medication, and had improved maximum expiratory flow rates. Approximately one half were able to discontinue the use of oral prednisone within 9 months after starting beclomethasone, and a further one third reduced their dose by at least 50%. No characteristics could be defined to predict responsiveness to beclomethasone. The effectiveness of beclomethasone was sustained for as long as 2 years and was not associated with any abnormal urine, blood, or serum values or chest X-ray findings. Candidiasis of the palate appeared in approximately one third of the subjects and was usually transient. The chronic use of beclomethasone did not result in endocrine suppression.
Bolus injection of T-1824-albumin, test indicator, and tritiated water into a jugular vein of the anesthetized dog and sequential sampling of blood from a carotid artery yielded multiple-indicator outflow patterns for the lung. Permeability-surface products of the test indicator for the lung endothelial barrier were obtained by comparison of test indicator with T-1824-albumin on the upslope of the test-indicator curve and correction for backdiffusion. The derived endothelial permeability coefficients, based on surface area/wet lung weight-500 cm2/g (mean +/- 2 SE, 10(-5) cm s(-1)), were: sodium ion, 2.9 +/- 0.8; ethylene glycol, 7.3 +/- 1.5; 1, 3-propranediol, 7.9 +/- 3.2; 1, 2-propanediol, 10 +/- 4; 1, 4-butanediol, 14 +/- 8; 1, 5-pentanediol, 21 +/- 6; 1, 6-hexanediol, 41 +/- 11; formamide, 16 +/- 9; acetamide, 13 +/- 4; propionamide, 31 +/- 12; butyramide, 42 +/- 24; valeramide, 79 +/- 12; tritiated water, 150 +/- 50. The backdiffusion correction varies from 8% for sodium to 75% for valeramide. A parallel-pathway model of blood-tissue passive exchange of small nonelectrolyte solutes is compatible with these results, with a lipid pathway through endothelial cells and an aqueous pathway possibly through interendothelial clefts.
A total of 28 healthy young subjects have been exposed for 2 h to ozone (0.37-0.75 ppm) under conditions of either rest or intermittent light exercise (sufficient to increase the respiratory minute volume by a factor of 2.5). All pulmonary function tests (vital capacity, forced expiratory volume, maximum expiratory flow-volume curve, slope of phase III of alveolar nitrogen plateau) showed a significant deterioration relative to parallel control experiments. Responses were related to the dose of ozone as calculated from the product of concentration, exposure time, and respiratory minute volume during exposure, changes at 1 h averaging approximately one-half those seen at 2 h.
We have tested the response of 28 subjects to a three-stage ergometer test, with loads adjusted to 45, 60, and 75% of maximum aerobic power following ozone exposure. The subjects were exposed to one of 0.37, 0.50, or 0.75 ppm O3 for 2 h either at rest (R) or while exercising intermittently (IE) (15 min rest alternated with 15 min exercise at approximately 50 W. sufficient to increase VE by a factor of 2.5). Also, all subjects completed a mock exposure VE, respiratory frequency (fR), mixed expired PO2 and PCO2, and electrocardiogram were monitored continuously during the exercise test. Neither submaximal exercise oxygen consumption nor minute ventilation was significantly altered following any level of ozone exposure. The major response noted was an increase in respiratory frequency during exercise following ozone exposure. The increase in fR was closely correlated with the total dose of ozone (r = 0.98) and was accompanied by a decrease in tidal volume (r = 0.91) so that minute volume was unchanged. It is concluded that through its irritant properties, ozone modifies the normal ventilatory response to exercise, and that this effect is dose dependent.
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