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Biomedical subjects

G S Moss

Publications and source records attributed to G S Moss.

At least 91 records · Page 5Linked to original sources
PubMed1979

Changes in lung ultrastructure following heterologous and homologous serum albumin infusion in the treatment of hemorrhagic shock.

The object of this study was to compare the ultrastructure pulmonary effects of the infusion of homologous and heterologous serum albumin solution in the treatment of hemorrhagic shock in baboons. Adult baboons subjected to hemorrhagic shock were resuscitated with either baboon serum albumin, human serum albumin, or Ringer's lactate solution. The lungs were fixed in vivo with potassium pyroantimony, a solution which produces electron dense interstitial precipitation of sodium. The lungs from animals resuscitated with baboon serum albumin showed evidence of interstitial edema, including dispersion of collagen fibers, interstitial smudging and increased interstital sodium concentrations. Similar changes were seen following human serum albumin infusions. Lung tissue from animals treated with Ringer's lactate solution showed minimal changes from normal. These results suggest that interstitial pulmonary edema develops after either homologous or heterologous serum albumin infusion in the treatment of hemorrhagic shock in baboons.

Animals↗
PubMed1979

Cardiac output response to extreme hemodilution with hemoglobin solutions of various P50 values.

Cardiovascular responses have been studied in baboons, after total exchange transfusion with hemoglobin solutions having various P50 values. At the end of the exchange transfusion, the hematocrit was 1.5%, the mean hemoglobin concentration was 4.4 g/dl, and the P50 varied between 12 and 26 mm Hg. Cardiac output did not change during the study, although heart rate increased, and stroke volume and MAP decreased. Hemoglobin concentration, per se, does not appear to be the critical stimulus for an increase in cardiac output with hemoglobin solution. In addition, the position of the hemoglobin-oxygen dissociation curve does not appear to influence these hemodynamic responses. The physiological response to anemia in the presence of hemoglobin solution appears different from that observed in the absence of plasma O2 carriers.

Anemia↗
PubMed1979

Blood and blood substitutes: current practice.

We have seen that the vast majority of previously healthy patients can tolerate a significant reduction in red cell mass without adverse effect on oxygen consumption. For these patients, volume replenishment with electrolyte solutions will adequately restore blood volume and cardiac output. Colloid solutions offer no advantage over electrolyte solutions, certainly are more expensive and may even be harmful. For patients who need restoration of oxygen-carrying capacity, washed, packed red cell administration is the therapy of choice, and frozen, thawed red cells represent optimal utilization of a scarce commodity. Other components, such as fresh frozen plasma, factor VIII or IX concentrates and platelets, are not indicated unless a specific deficiency exists. Autologous blood, using one of the techniques described above, is a safe and effective means of replacing lost red cells in special circumstances. The use of these techniques, combined with realistic ordering of homologous blood for elective surgical procedures, should act in concert to relieve shortages of blood.

Albumins↗
PubMed1979

Influence of sympathetic nervous system on surfactant production. An ultrastructural study.

The influence of the sympathetic nervous sytem on pulmonary surfactant was investigated in an ultrastructural study of normal and chemically sympathectomized rat lungs. Chemical sympathectomy was accomplished by administration of 6- hydroxydopamine (6-OHDA). The 6-OHDA did not have any systemic influence on the experimental animals. These animals grew normally and were killed at intervals of three, four, six, and seven weeks. The mean weight of the controls at three weeks was 41.75 +/- 3.12; at four weeks, 77.00 +/- 2.68; at six weeks, 169.25 +/- 11.29; and at seven weeks, 182.25 +/- 4.94. The mean weight of the 6-OHDA treated group at three weeks was 48.50 +/- 1.04; at four weeks, 76.25 +/- 1.93; at six weeks, 171.75 +/- 3.40; and at seven weeks, 180.25 +/- 2.36. The body/ lung weight ratio was about the same in both groups. In the control animals, the alveolar capillary membranes were intact, the alveoli were well expanded, and epithelial cells appeared normal. The cytoplasm of the granular II pneumocytes contained their characteristic osmiophilic lamellated bodies as well as multiple transition forms between the multivesicular and lamellated bodies. It is these lamellated bodies that are the suspected site of surfactant production in the lung and they appear to migrate towards the alveolar lumen. In addition to the lamellated bodies, multiple lattice-like tubular myelin figures were abundant in the alveoli of the normal rat lung. Following sympathectomy, structural alterations occurred within the cytoplasm of the granular II pneumocytes, involving mainly the lamellated bodies. There was a decrease of osmiophilic content as well as loss of organization of the bodies. This change was quantitated by scoring the degree of osmiophilia in the control and sympathectomized animals. The mean score in the control animals was 4.43 +/- 0.03 S.E., whereas in the sympathectomized group it was 3.77 +/- 0.16 S.E. It was concluded that the lamellated bodies, the site of phospholipid synthesis in the granular II pneumocyte, arise from the multivesicular bodies and are extruded into the alveolus. They then participate in the formation of the alveolar acellular lining layer. Sympathectomy alters the structure of the lamellated bodies, thereby influencing the development of the surfactant system.

Animals↗
PubMed1977

Pancreatoduodenectomy for penetrating pancreatic trauma.

Six cases of pancreatoduodenectomy performed for combined injuries of the pancreas, duodenum, and/or distal common duct are reported. Pancreatoduodenectomy is indicated when there is extensive destruction of the pancreatic head in conjunction with major injuries of the duodenum, distal common duct, and/or retropancreatic portal vein, necessitating complete division of the pancreatic head. Reconstruction is best achieved by end-to-end pancreatiocieiunostomy, end-to-side choledochojejunostomy, antrectomy, and vagotomy.

Adolescent↗
PubMed1977

Crystalloid vs colloid in the etiology of pulmonary failure after trauma: a randomized trial in man.

One possible cause of pulmonary failure after trauma is the type of asanguinous fluid used for resuscitation, i.e., crystalloid or colloid. To investigate this issue, patients having a laparotomy for trauma randomly received either Ringer's lactate (RLS) alone or Ringer's lactate with albumin (ALB). Both groups received washed red cells. Test fluids and red cells were given before and during operation to restore vital signs and hematocrit to normal. Pulmonary function tests were performed for 5 days after operation. One hundred and forty-one cases were studied (84 RLS, 57 ALB). The volume of asanguinous resuscitation fluid infused was 5.37 +/- 3.38 liters (-x +/- SD) for RLS and 5.87 +/- 3.05 liters for ALB. ALB cases received 213 +/- 130 gm of albumin. Red cell transfusions were 1.5 +/- 2.9 units for RLS and 2.0 +/- 3.1 for ALB. Six patients died (three RLS, there ALB). Three RLS and six ALB patients received intermittent mandatory ventilation or continous positive air pressure after operation. Pulmonary function results were not significantly different between the two groups for any parameter on any day after operation. Results of a randomized trial in human subjects of resuscitation with crystalloid and colloid solutions for acute trauma requiring laparotomy did not reveal significant differences in (1) survival rate, (2) incidence of pulmonary failure, or (3) postoperative pulmonary function.

Adult↗
PubMed1976

Penetrating trauma of the neck.

Two hundred forty-six patients admitted to the Trauma Unit of Cook County Hospital with penetrating neck wounds have been reviewed. A policy of mandatory neck exploration combined with a systematic approach to resuscitation and a diagnostic evaluation including neck and chest X-rays, endoscopy, and arteriography has been employed. The study has revealed a high incidence of negative neck explorations (63%) but minimal morbidity (less than 1%), no mortality, and a brief duration of hospitalization in the negative exploration group. Patients with positive explorations had an 8% morbidity and a 9% mortality rate. In addition, 13 of the patients with positive explorations had clinically negative wounds which might have been overlooked if selective management had been utilized in this series. We conclude that a policy of mandatory neck exploration is justified and advisable for patients sustaining penetrating neck injuries.

Adolescent↗