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Biomedical subjects

G N Olsen

Publications and source records attributed to G N Olsen.

At least 37 records · Page 2Linked to original sources
PubMed1985

Phagocytic activity of alveolar macrophages in patients with bronchogenic carcinoma.

Human bronchoalveolar cells were obtained by lavage during diagnostic fiberoptic bronchoscopy of 21 patients suspected of having lung malignancies. Of these patients 11 were diagnosed as having primary lung cancer (Group I) and included individuals with squamous cell carcinoma, adenocarcinoma, undifferentiated large and oat cell carcinoma at varying locations and TNM stages, 4 patients demonstrated nonprimary metastatic carcinoma (Group II), and 6 patients did not reveal detectable tumors by bronchoscopy or follow-up (Group III) and were included as study controls. We examined the ability of pulmonary alveolar macrophages (PAMs) lavaged from patients in each of the three study groups to phagocytose opsonized sheep red blood cells. Phagocytic activity varied among patients in the same and different study groups; however, no significant differences were observed in the phagocytic or tumoristatic activities of PAMs recovered from tumor-bearing and nontumor-bearing lung regions of the same patient. Moreover, lavage fluids collected from tumor-bearing regions did not suppress the phagocytic activity of PAMs collected from control lungs nor lung regions contralateral to the tumor-bearing lung. The data do not support the view that bronchial neoplasms or their secreted products suppress phagocytic functions of alveolar macrophages.

Adult↗
PubMed1985

Bronchoalveolar lavage and the immunology of primary lung cancer.

Bronchoalveolar lavage (BAL) is a powerful tool with which the immunology of the lung in health and disease can be studied. This technique has been successfully used to characterize localized humoral and cell-mediated responses in sarcoidosis and a number of other interstitial pneumonitides. In contrast, BAL in patients with lung cancer has resulted in some confusion regarding the extent and type of local and systemic immunity in these patients. This review summarizes some of the data obtained from these patients via BAL, but does not attempt to explain the reported discrepancies. The objective of this review is rather to identify gaps which exist in our knowledge of the environmental factors influencing pulmonary immunity in primary lung cancer.

Antibodies, Neoplasm↗
PubMed1984

Endotracheal granular cell myoblastoma. A failure of laser therapy.

A patient had multicentric endobronchial granular cell myoblastoma. Progression with worsening tracheal obstruction following carbon dioxide laser therapy led to surgical resection. Flow volume loops documented progressive relief of airway obstruction after laser and resectional surgery. Our experience with failure of laser therapy supports previous recommendations for surgical therapy for large (greater than 8 mm) lesions of the trachea.

Adult↗
PubMed1984

Lateral position test and quantitative lung scan in the preoperative evaluation for lung resection.

The postpneumonectomy FEV1 was predicted in 24 patients with severe chronic obstructive pulmonary disease (FEV1 less than or equal to 2.0 L) and a lung mass using the quantitative lung scan (QLS) and lateral position test (LPT). Although a good correlation (r = .72, p = 0.0006) was found between the FEV1 predicted by QLS and LPT, there was more than 10 percent difference between the result in 59 percent of the subjects. A subgroup of these patients performed multiple (two to five) LPTs, and the results were calculated blindly to assess variability. The variation seen was 14 times greater than in previously reported normal subjects. Calculations suggest that as many as 37 tracings would be needed on each patient to obtain an acceptably low measurement error. Whereas there was a good overall correlation between the predicted postpneumonectomy FEV1 using both methods, the variability found with LPT would suggest extreme caution in its use.

Aged↗
PubMed1983

Recovery of embolized albumin microspheres from the pulmonary microvasculature using a wedged balloon-tipped catheter.

This study was performed to determine if particulate material within the pulmonary vascular bed could be sampled by aspirating blood from a wedged pulmonary artery catheter. 99mTechnetium-labeled albumin microspheres (20 micrometers) were injected and embolized into the precapillary pulmonary vasculature of 6 critically ill and 4 routine diagnostic catheterization patients. Recovery of the particulates was demonstrated by comparing the gamma radioactivity of the wedge blood sample obtained to that of mixed venous blood. The degree of success in the recovery corresponded to the height of the oxygen tension of the wedge blood sample (PWO2). This suggests that the PWO2 may be a useful marker of successful sampling of the pulmonary microvascular bed during wedge aspiration. In wedge samples obtained serially, peak yield of the microspheres was obtained within the first 10 ml whereas peak oxygen tension was obtained at 20 ml of total aspiration volume. Wedge aspiration has promise as a sampling method for microembolized particulates in the investigation of acute pulmonary microvascular diseases.

Adult↗
PubMed1982

Use of blood gas values to estimate the source of blood withdrawn from a wedged flow-directed catheter in critically ill patients.

A technique for sampling blood from the damaged pulmonary microvasculature in patients with acute respiratory failure is described. Blood was aspirated through the distal lumen of wedged pulmonary arterial catheters in 28 critically ill patients. Successful aspiration was achieved in 88% of the attempts and 20 ml of blood drawn before sampling was optimal for clearing mixed venous precapillary blood. The blood gas values obtained were classified as "capillary" when the wedge (w) PO2 greater than PaO2 and PwCO2 less than PaCO2 (17 patients, 61%); "mixed venous" when PwO2 and PwCO2 were equal to values obtained from the main pulmonary artery (5 patients, 18%); and "mixed source" when intermediate PwO2 and PwCO2 were noted, i.e., PaO2 greater than PwO2 greater than PVO2 and PwCO2 variably greater than or less than PaCO2 (6 patients, 21%). When mixed venous samples are eliminated, microvascular sampling can be assumed in 82% of the successful aspirations.

Adult↗
PubMed1981

Prospective evaluation for pneumonectomy using perfusion scanning: follow-up beyond one year.

Thirty-eight high-risk patients (forced expiratory volume in one second [FEV1] less than 2.0L or maximum voluntary ventilation [MVV] less than 50 per cent of predicted) were observed for a minimum of one year after pneumonectomy for carcinoma of the lung. Operability was assessed by calculating a predicted postoperative FEV1 (based on the right-left fractional perfusion estimated by a perfusion lung scan) and requiring this predicted postoperative value to exceed 800 ml. No other invasive physiologic studies were performed before surgery. At one year, 23 of 38 patients were still alive, and 13 of 38 patients survived to the end of the second year. At five years, two of 15 patients were alive with no evidence of metastatic disease. This simple physiologic approach involves widely available techniques and, in patients with lung cancer who have compromised pulmonary function, appears to result in acceptable survival over a longer period.

Carcinoma↗
PubMed1979

Segmental pulmonary angiography in the critically-ill patient using a flow-directed catheter.

Selective pulmonary angiography was performed using a flow-directed, balloon-tipped catheter in 20 consecutive intensive care unit patients requiring heart catheterizations on the right side for hemodynamic monitoring. No morbidity was encountered from this procedure. Adequate quality balloon-occlusion angiographs were obtained with a portable chest roentgenogram in 17 (85 percent) but appeared normal in only 12 (60 percent), seriously limiting the usefulness of this technique in the diagnosis of occult pulmonary embolisms. With this technique, the catheter tip was found to be in a segmental pulmonary artery anterior to the left atrium (zone I) in 30 percent of the patients. From these findings, we conclude that not infrequently the catheter tip was situated in zone I anterior to the left atriums. Slective pulmonary angiography using a flow-directed, balloon-tipped catheter proved useful in demonstrating the precise location of the catheter tip. When this is the case, the catheter tip should be relocated to a segment below the left atrium (zone III) in patients requiring positive end-expiratory pressure because the "wedge" pressure measured in zone I may not accurately reflect left atrial pressure.

Blood Pressure↗