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Biomedical subjects

H A Saltzman

Publications and source records attributed to H A Saltzman.

At least 37 records · Page 2Linked to original sources
PubMed1981

In vivo comparison of cerebral tissue PO2 and cytochrome aa3 reduction-oxidation state in cats during hemorrhagic shock.

To assess the adequacy of oxygen availability and utilization within the cerebral cortex in vivo, we have measured the partial pressure of oxygen in tissue (PtO2), as well as the reduction oxidation state of cytochrome c oxidase (cyt aa3) during shock induced by slow or rapid hemorrhage in anesthetized cats. PtO2 was measured with pyrenebutyric acid-generated fluorescence in cerebral cortical cells. Cyt aa3 redox state was measured by the absorption of monochromatic light at 605 nm absorption peak of the enzyme reflected from the same cortical field. The PtO2 remained within the normal range until either 30 +/- 1.5 ml blood/kg was removed or the mean arterial pressure fell by 70 +/- 5% of base line. Beyond either point, the PtO2 fell rapidly to a low value approximating zero. By contrast, the reduction of cyt aa3 began early when as little as 5 ml blood/kg was removed. Thereafter, the shift toward reduction was progressive and continuous with a slow rate at first and a rapid rate later. This accelerated rate of cyt aa3 reduction preceded the rapid fall of PtO2. We concluded that, under these experimental conditions, cyt aa3 reduction is a much earlier and more sensitive indicator of perturbed intracellular aerobic metabolism due to hemorrhage that is PtO2.

Animals↗
PubMed1980

Right ventricular obstruction secondary to intracardiac metastatic osteosarcoma.

A 30-year-old female with a history of surgically treated osteosarcoma 2 years prior to admission presented with progressive dyspnea and cyanosis. Physical examination was otherwise negative. Cardiac catheterization demonstrated a right ventricular mass lesion. At surgery, a metastatic osteosarcoma filling the entire right ventricle and extending from the pulmonary valve across the tricuspid valve and into the right atrial cavity was partially excised. Despite marked improvement postoperatively, she did 33 d after surgery. Postmortem findings were unusual in that the heart represented the sole site of metastasis. The diagnostic approach to cardiac symptoms from malignancy is discussed in relation to this patient.

Adult↗
PubMed1980

Redox transitions in mitochondria of cat cerebral cortex with seizures and hemorrhagic hypotension.

Fluorometry and dual-wave-length spectrophotometry were used to detect transitory shifts in the redox state of mitochondrial NADH and cytochrome aa3 in the exposed cerebral cortex of anesthetized paralyzed cats as seizures were induced with pentylenetetrazol. In normotensive animals, NADH and cytochrome aa3 oxidation accompany the seizures, but when the mean arterial pressure (MAP) is reduced to 40.2 +/- 1.1% of the base line by hemorrhaging, the NADH fluorescence response converts to a biphasic oxidation-reduction sequence. In extreme hypotension (MAP lowered to an average of 28%), only NAD reduction transients are observed with seizures, and cytochrome aa3 is oxidized irrespective of the low MAP. Our data show that a reversible perfusion impairment, perhaps inhomogeneous in its distribution, appears in the cortex at the 40% MAP level and modifies electron flux in the respiratory chain between NADH and cytochrome aa3, and uniform oxygen insufficiency is an unlikely cause for the reversal of NADH oxidation toward reduction during seizures under hypovolemic conditions.

Animals↗
PubMed1977

Oxidation of cerebral cytochrome aa3 by oxygen plus carbon dioxide at hyperbaric pressures.

The reduction-oxidation level of cytochrome aa3 in the intact cerebral cortex of cerveau isolé or pentobarbital-anesthetized cats was monitored by means of dual-beam reflectance spectrophotometry. Respiratory gases containing varying fractions of carbon dioxide and oxygen were administered at increased pressures, allowing titration of the cytochrome redox state from maximum reduction during nitrogen ventilation to the completely oxidized state. We show that the fully oxidized state could be reached with about 5% CO2-95% O2 inspired at 4 ATA. Maximum oxidation was achieved only through the relaxation of oxygen-induced vasoconstriction of the cerebral vessels, as our data indicated that large blood volume responses accompanied the increases in inspired carbon dioxide. With out technique, we have established that under resting air-breathing conditions cytochrome aa3 is about 85% reduced in the cat cerebral cortex, and that the absorption peak for cytochrome aa3 in situ is located near 602 nm. A free energy change of an additional 8 kcal is calculated to occur with donation of an electron pair from 85% reduced cytochrome aa3 to oxygen as compared to a 1% reduction level.

Animals↗
PubMed1975

Volume-controlled lung lavage in a woman with cystic fibrosis.

A 22-year-old woman with cystic fibrosis was treated by volume-controlled lavage of each of her lungs on two occasions. Following the first lavages, the patient's vital capacity increased by 1.03 liters and her 1-sec forced expiratory volume increased by 0.70 liters/second. Similar improvements, although less pronounced, were noted after both lungs has been lavaged a second time. It is concluded that volume-controlled lung lavage can be of benefit as an adjunct in the treatment of patients with cystic fibrosis.

Adult↗
PubMed1975

"Early-peak" carbon monoxide production in certain erythropoietic disorders.

The "early-labeled" peak (ELP) of 14CO excretion following injection of glycine-2-14C was used to study erythropoiesis in a patient with sideroblastic anemia and in four subjects with myeloproliferative disorders. The ELP was greatly enlarged in all patients, as compared with a normal volunteer. The contour of the peaks from the hematologically abnormal subjects suggested the presence of increased erythroid heme degradation. In the patient with sideroblastic anemia, all hours of the early peak were significantly reduced after transfusion. This was interpreted to mean that even the earliest or "nonerythroid" phase of the peak is influenced by erythropoietic activity, at least under conditions of erythropoietic stress.

Anemia, Sideroblastic↗
PubMed1975

Experimental and clinical experience with hyperbaric oxygen in the treatment of clostridial myonecrosis.

At Duke University Medical Center, 49 patients with proved clostridial myonecrosis were treated with hyperbaric oxygen (HBO) during the past 10 years. Survival in patients with involvement confined to the extremities was 92.3 percent. Survival in patients with combined involvement of extremity and trunk was 53-3 percent, and with primary trunk involvement half of the patients survived. Survival for the entire series was 73.5 percent. Among the 28 patients receiving at least five HBO treatments, 24 survived. Extensive experimental studies were conducted during this same period including in vitro testing and in vivo experimental infections with C. perfringens. Data from the experimental models of gas gangrene indicate a therapeutic benefit with HBO by significantly decreasing both mortality and morbidity rates. The mechanism of action for this appears to be complex but probably includes a direct bactericidal action, bacteriostasis, inhibition of toxin production, and improvement in tissue oxygenation. In the absence of a controlled study, the therapeutic efficacy of HBO in the treatment of clostridial myonecrosis is not fully proved. Nevertheless HBO treatment can be recommended on the bases of sound experimental evidence and the results of favorable clinical experience. Mitigation of this severe but infrequent illness can best be accomplished through prevention, with strict adherence to the principles of wound care.

Adult↗