Biomedical subjects
G Perkins
Publications and source records attributed to G Perkins.
Blood pressure changes and pulmonary edema in the rat associated with hyperbaric oxygen.
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Electrolyte disturbances in foals with severe rhabdomyolysis.
Marked electrolyte abnormalities characterized by profound hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia were noted in 4 neonatal foals with acute rhabdomyolysis and pigmenturia. In 2 foals, rhabdomyolysis developed 4-6 days after admission for dysmaturity, and in 2 foals, rhabdomyolysis was evident on presentation. Rhabdomyolysis was a consequence of selenium deficiency with or without vitamin E deficiency, possibly combined with increased oxidant stress due to sepsis or hypoxia and reperfusion injury after parturition. Foals gained from 7 to 15% of their initial body weight within 48 hours of developing rhabdomyolysis. Three of the foals developed cardiac arrhythmias characterized by spiked T waves and decreased-amplitude P waves. Postmortem examination of 2 foals revealed extensive myodegeneration and renal tubular nephrosis; renal cortical necrosis with myocardial necrosis was noted in 1 foal. Destruction of the major intracellular compartment (intracellular fluid [ICF]) through extensive myonecrosis combined, in some cases, with myoglobinuric renal insufficiency produced major fluid shifts and life-threatening electrolyte derangements. With the major ICF compartment disrupted, hyperkalemia was most effectively treated using mineralocorticoids, loop diuretics, and ion exchange resins to enhance elimination. In addition, i.v. calcium, glucose, insulin, and sodium bicarbonate were administered, which helped redistribute potassium to the ICF. Severe rhabdomyolysis should be included in the differential diagnoses of hyperkalemia, hyponatremia, hypocalcemia, and hyperphosphatemia in neonatal foals.
Purposeful activity as an indicator of quality in the care of elderly patients.
Standards of physical care on continuing care wards have improved but psychosocial care remains generally poor. Purposeful activity is central to the quality of care of patients on respite and continuing care wards and nurses must take greater responsibility for its provision.
Hemothorax in 2 horses.
This report documents the successful conservative medical management of hemothorax in 2 horses. Hemothorax occurred after a lung biopsy procedure (horse 1) and strenuous exercise on a treadmill (horse 2). The horses had tachypnea, tachycardia, nostril flaring, hemoptysis, and pawing. Hemothorax was suspected based upon absence of auscultable ventral lung sounds; development of cool extremities and pale, tacky mucous membranes; the ultrasonographic appearance of moderate to severe amounts of pleural fluid; and a concurrent decrease in hematocrit and total plasma protein. Both horses were treated successfully by intranasal administration of oxygen, intravenous administration of balanced polyionic solutions, and treatment with antibiotics, nonsteroidal anti-inflammatory drugs, and analgesics. In neither case was pleural blood removed. The hemothorax resolved in both horses without lasting abnormalities. Hemothorax does not require drainage for successful resolution.
Reliability of criteria for ultrastructural identification of neuroendocrine granules.
For full diagnostic use to be made of the neurosecretory granule, the range of sizes, forms, and staining qualities for this cytoplasmic organelle, along with the extent of its expression in various neoplasms, must be established. Neurosecretory type granules occasionally occur in nonneuroendocrine tumors. A series of carcinoids of the lung provides a model for assessing the morphologic types of cytoplasmic granules identified by antibodies to chromogranin A and immunogold labeling. The results show that granule structure in tumors is pleomorphic. Despite having sizes within the expected range, many labeled and, indeed, unlabeled secretory granules are atypical, particularly in structural form. Cell-to-cell variation in the proportion of even typical neurosecretory granules labeling for chromogranin A is the rule. Studies correlating biochemical, immunohistochemical, electron microscopic, and perhaps in situ hybridization characteristics are required to define better the criteria for unequivocal identification of neurosecretory granules in tumors.
Cardiopulmonary resuscitation training.
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