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Biomedical subjects

H Turndorf

Publications and source records attributed to H Turndorf.

At least 127 records · Page 7Linked to original sources

Meperidine-promethazine combination and learning function of mice and of their progeny.

Twenty mice aged three to four months and trained to find food in a six compartment maze after a 24 hour fast, were divided into two equal groups. For just over one month the group which had received intraperitoneal meperidine 3 microgram.g-1 and promethazine 1.66 microgram.g-1 performed significantly slower than the group which had received intraperitoneal physiological saline. Because of this marked effect, it was decided to investigate the action of the drug combination on brain development and to assess whether it produced permanent retardation in learning function. The dams of a second group of 12 mice were, therefore, given either the same dose of drug combination or saline. At the age of seven weeks, the six pups born to dams which had received intramuscular saline and the six born to dams which were given intramuscular promethazine with meperidine performed equally well in a series of tests conducted in a T maze and in the six compartment maze after a 24 hour fast. In the T maze they had to distinguish between the presence of food provided in diminishing amounts or no food. In the six compartment maze they were tested with multiple maze pattern sequences. Meperidine and promethazine given during early labor does not permanently affect the learning function of the progeny of mice.

Aging↗

Continuous and simultaneous on-line measurements of VO2 and VCO2 during endotracheal anesthesia.

A single method was developed for the continuous measurement of oxygen consumption (VO2) and carbon dioxide production (VCO2) during endotracheal anesthesia. The total vented flow from a Bain circuit was measured during anesthesia in 28 adult patients and was found to attain at least 97% of a 6-L/min fresh gas inflow (FGI). Therefore, the circuit overflow was assumed to approximate the FGI. Total volume of vented oxygen was calculated by multiplying FGI by oxygen concentration in the vented (mixed expired) gas. VO2 was assessed as the difference between the oxygen volumes entering and leaving the circuit. VCO2 was derived from the product of FGI and mixed expired CO2 concentration. VO2 measured on the Bain circuit correlated with measurements made on a non-breathing circuit (n = 60 pairs, r = 0.99). A good correlation was also found between VCO2 obtained on both circuits (n = 60 pairs, r = 0.99).

Adolescent↗

Cuffed tracheal tubes--physical and behavioral characteristics.

This study compares physical and behavioral characteristics of currently used cuffed tracheal tubes. Variability in physical and behavioral characteristics between size 8 tracheal tubes and cuffs exists: radius of tube curvature varies from 12.1 to 15.8 cm, bevel angle 39 to 56 degrees, bevel direction 73 to 107 degrees, distance from proximal end of bevel to cuff 15.4 to 24.4 mm, internal tube diameter 7.5 to 8.8 mm, wall thickness 1.14 to 2.37 mm, force to collapse 1020 to 3103 g, angle to kink 52 to 96 degrees, and indentation hardness 65.4 to 83.1. Cuff lengths vary from 29.7 to 45.3 mm, thickness 0.03 to 0.54 mm, diameter 14.5 to 32 mm, and cuff resting volume 0.15 to 19.9 ml. We recommend use of a soft, thermolabile, kink- and collapse-resistant tracheal tube fitted with a soft, thin-walled, tough, compliant, moderately long cuff, with a moderately large resting volume and diameter larger than tracheal diameter. Argyle, National Catheter, Ohio, Portex, Rusch "safety," and Shiley tracheal tubes resist collapse and kinking. Argyle, Lanz, National Catheter "hi-lo," National Catheter "intermediate hi-lo," Ohio, and Portex "profile" cuffs are thin and have diameters larger than the average male tracheal diameter.

Hardness↗

Uterine contractions and the spread of local anesthetics in the epidural space.

Local anesthetics injected into the epidural space during a uterine contraction are commonly believed to produce a higher than usual level of anesthesia. This was evaluated in 34 parturients undergoing continuous lumbar epidural labor analgesia. The patients were divided into two equal groups. In group A, the inducing dose (2% chloroprocaine, 8 ml) was injected during an active uterine contraction and the top-up dose was injected between contractions. In group B, the injection sequence was reversed. Irrespective of the time of injection, in relation to uterine contractions, approximately 16 dermatomal segments were blocked in both groups. It is concluded that uterine contractions do not affect spread of local anesthetic solution in the epidural space.

Adult↗

Oxygen transfer from mother to fetus during cesarean section under epidural anesthesia.

The correlation between maternal PaO2 levels and umbilical vein (UV) and umbilical artery (UA)PO2 levels was studied in 40 healthy patients undergoing elective cesarean sections under lumbar epidural anesthesia. Patients were divided into four equal groups. Each group inhaled oxygen at a FIO2 of 0.21, 0.47, 0.74 (in nitrogen), or 1.0. Maternal arterial samples and fetal UV and UA samples were collected at the time of delivery. Maternal PaO2 levels increased from 96 +/- 4 (1 SE) torr during exposure to to a FIO2 of 0.21 to 232 +/- 6, 312 +/- 16, and 423 +/- 6 torr while breathing FIO2 of 0.47, 0.74 and 1.0, respectively. UV PO2 levels increased from 28 +/- 1 to 36 +/- 1.5, 41 +/- 1.3 and 47 +/- 1.2 torr in the hyperoxic groups. UA PO2 levels increased from 15 +/- 0.7 to 19 +/- 0.8, 21 +/- 0.3, and 25 +/- 1.8 torr, respectively. Oxygen saturation and blood O2 contents increased in maternal and fetal blood. Maternal arterial, UV, and UA base excess values in the hyperoxic groups were significantly higher than in the normoxic groups. There was no difference in 1- or 5-minute Apgar scores between the normoxic and hyperoxic groups. It is concluded that maternal hyperoxia improves fetal oxygen stores and acid-base status during cesarean section under epidural anesthesia.

Adult↗

Coaxial catheter for humidification during jet ventilation.

A coaxial jet ventilation catheter capable of entraining liquid water by Venturi effect was assembled by inserting an epidural catheter (water injector tube) into a 69-cm-long, 3-mm-i.d., outer jet delivery tube. Gas jet flow in the outer tube produced a negative pressure in the inner injector tube. The entrainment pressure could be varied by increasing or decreasing the distance between the injector and jet portals. The quantity of entrained water could thus be regulated between 8 +/- 1 to 44 +/- 2 mg/L of gas by decreasing this distance from 3.5 to 0.5 cm. The catheter was used to deliver low- or high-frequency jet ventilation for 4 hours in dogs (five dogs per mode of ventilation) and for 2 hours in patients (12 patients per mode). Patients receiving either mode of ventilation were divided into two equal groups. One group was ventilated with dry gases and the other with humidified gases containing 44 mg H2O/L. Ciliated epithelial cells were obtained by bronchial lavage at the onset and termination of each study. Damage to ciliated cells was assessed numerically by a point scoring system. The coaxial catheter produced adequate pulmonary ventilation both in dogs and humans during both modes of ventilation. The human tracheobronchial cellular score decreased approximately 21% after unhumidified low- and high-frequency ventilation. However, the score did not change significantly in patients who received humidified gases, indicating efficient humidification by the coaxial catheter.

Adult↗

Cerebrospinal fluid cyanide after nitroprusside infusion in man.

Sodium nitroprusside (SNP) is frequently used as an hypotensive agent for clipping of intracranial aneurysms, repair of arteriovenous malformations and resection of vascular tumours. Cyanide (CN), which is its main metabolic product, has been recovered from the cerebrospinal fluid (CSF) of the rat after intravenous administration of CN, but recovery of CN from CSF after SNP has not been reported in man. Seven consenting adults were studied. Adequate premedication was provided with pentobarbitone 2 mg x kg-1 and atropine 0.4 mg one hour before operation. Anaesthesia was induced with thiopentone 8 mg x kg-1 and maintained with nitrous oxide 60 per cent with oxygen and supplemental fentanyl 0.05 mg and pancuronium 0.5-1 mg as needed. Lumbar subarachnoid, radial artery, central venous, and Foley urinary catheters were inserted. Arterial carbon dioxide tension (PaCO2) was maintained between 4.6-5.32 kPa (35-40 torr) with an Air Shields ventilator. Red cell, plasma and CSF cyanide were measured using a digital ionanalyzer before and at 30 minutes interval after infusing SNP at a rate sufficient to maintain the blood pressure at two thirds of the pre-operative level. Average total dose of SNP was 0.51 mg x kg-1. CN concentration in the red blood cells increased from 9.5 +/- 2.05 to 75.12 +/- 17.12. Plasma CN increased from 0.54 +/- 0.05 to 1.09 +/- 0.14 micrograms per cent. CSF CN increased from 0.11 +/- 0.04 to 0.72 +/- 0.07 micrograms per cent. Significant increase in red cell, plasma and CSF CN occurred five minutes after the start of SNP and returned to the preoperative level 19 hours later. Conclusion CN crosses the blood-brain barrier. Large doses of SNP in patients with neurovascular brain disorders warrants caution because cytotoxic cerebral oedema and CN encephalopathy have been described in rats after intravenous injection of sodium cyanide or exposure to hydrogen cyanide.

Adult↗

A circle system with a rotating wick vaporizer.

The humidity output of a circle system was raised to 28 mg H2O/l by the use of a modified rotating wick vaporizer placed in the center of the soda lime canister and coaxial inspiratory and expiratory limbs. Both the fresh gas inflow and the expired gases passed through the lime and reached a compartment below it. The bag/ventilator connector, bearing a pressure relief valve, opened on the lateral wall of that compartment. Gases returning to the inspiratory valve passed: (1) through a tube in the canister connecting the inferior compartment to the vaporizer above water level, (2) through the upper portion of the vaporizer and around the rotating wick, and (3) through a tube emerging from the top of the vaporizer to reach the inspiratory valve. Thus inspired gases were humidified by the rotating wick constantly replenishing its water content warmed by the reaction of neutralization. The use of coaxial inspiratory and expiratory limbs reduced water condensation outside the canister.

Anesthesiology↗

Decreases in electric thoracic impedance during transurethral resection of the prostate: an index of early water intoxication.

Thoracic impedance of 18 patients undergoing transurethral resection of the prostate was measured 15 minutes preoperatively, and 30 and 60 minutes after the start of the operation. Impedance variations were compared to variation in 1) cardiac output, 2) serum sodium osmolality and 3) alveolar-arterial oxygen tension difference. Thoracic impedance, initially 24.6 plus or minus 0.3, decreased to 23.8 plus or minus 0.5, 30 minutes after the onset of the operation (p less than 0.0005) and 22.9 plus or minus 0.5, 30 minutes later (p less than 0.01 from previous reading and 0.0005 from control). Patients in whom impedance had decreased 10 per cent or more from control values received 10 mg. furosemide intravenously 60 minutes after the onset of the operation. This therapy permitted the restoration of impedance values, cardiac output, alveolar-arterial oxygen tension difference and serum sodium osmolality to values statistically similar to those found in the 10 patients who had not sustained such precipitous decreases in impedance within 60 minutes. We believe that the measurement of thoracic impedance during transurethral prostatic surgery offers the most sensitive index of early water intoxication. Measurements can be obtained without delay in the operating room and, thus, permit immediate correction of the condition.

Aged↗

A percolator vaporizer heated by reaction of neutralization of lime by carbon dioxide.

To improve the humidification of anesthetic gases without use of electricity and its associated dangers the principle of the coffee percolator has been applied to a new vaporizer. Coffee percolators work by introducing steam-driven spurts of boiling water into a perforated coffee container. A water vaporizer, which functions on this principle, was used substituting the fresh gas inflow of an anesthesia machine as the driving gas. The vaporizer was placed in the center of the lime canister of a circle system with coaxial-valved respiratory limbs. The gas-water mixture percolated through a multiple wire mesh gauze filter that prevented the introduction of water droplets into respiratory channels. All gases emerging from the bottom of the canister and reaching the inspiratory valve passed through the vaporizer above water level. The circuit delivered gases containing 4 to 9 mg of H2O/L above saturated values at ambient temperature (20.5 mg of H2O/L) within 15 minutes, if the fresh gas inflow was set at 2.5 L/min.

Anesthesiology↗

Routine cytodiagnosis of pulmonary malignancies.

Anesthesiologists normally discard the material routinely suctioned from the tracheal tube of patients under general endotracheal anesthesia. We preserved, and later examined microscopically, specimens from 10,621 patients. We found 11 cytologically abnormal smears from subjects with unsuspected pulmonary involvement, an incidence slightly more than 1:1,000. The accuracy of our method was assessed by calculation of the percent of abnormal smears obtained from patients with prediagnosed bronchogenic carcinomas: 40% when suctioned material was immediately spread on slides, and 67% when cellular concentration was achieved by mucolysis followed by filtration or centrifugation. Secretions normally discarded can reveal much information that would otherwise be missed. Our method may be useful if applied to patients at risk (heavy smokers, workers with asbestos, nitrosamine, or benzopyrine, miners of radioactive material, etc) who undergo general anesthesia for incidental surgery.

Adolescent↗

Exposure to halothane and enflurane affects learning function of murine progeny.

This study was conducted to assess the learning function of murine progeny born of mothers that had received either 1% or 2% halothane or 2% or 4% enflurane, on days 6 and 10 or days 14 and 17 or gestation. Their timed performance at the age of 6 to 7 weeks was compared in a maze with that of control mice of similar ages that had not been exposed to anesthetics prenatally. All mice exposed to halothane in utero performed poorly at first, especially the group with mothers exposed to 2% halothane on days 14 and 17 of pregnancy. By the 10th training period, the performance of all mice improved but remained significantly slower than control mice. The offsprings of mice exposed to enflurane also performed poorly on the first training period, but between the fifth and seventh training periods, made statistically significant progress. However, they too remained slower in maze performance than control mice. Although blood pressure and arterial blood gas studies were only performed on two pregnant mice, data obtained suggest that the anesthetics did not have sufficient effect on respiration to affect our results. Second generation offspring, born to dams exposed to 2% halothane in utero late in pregnancy and sired by normal unexposed males, were also consistently slower than control mice, indicating a possible genetic effect induced by the anesthetic.

Animals↗

Urine and serum potassium levels after potassium cardioplegia.

Potassium cardioplegia for myocardial preservation is being used extensively in heart operations. This study was designed to determine the effect of potassium cardioplegia on serum and urine potassium levels. A control group of 11 patients was compared to a study group of 24 patients. Myocardial preservation in the control group was achieved by whole body cooling to 20 degrees to 30 degrees C and in the study group, by repeated injections every 30 minutes of 500 to 700 ml of cold pump blood, containing potassium chloride 30 mEq/L, into the aortic root after aortic clamping. Total potassium dose in the study group was 46 +/- 21 mEq (mean +/- SD). Mean serum potassium level was significantly higher during and after bypass in the study group (after bypass: control 3.65 +/- 0.11 mEq/L, study 4.24 +/- 0.10 mEq/L [mean +/- SE], p less than 0.005), but was within normal limits in both groups. Urine potassium levels and excretion rates were significantly higher in the study group (potassium excretion rate after bypass: control 6.1 +/- 0.7 mEq/hr, study 11.3 +/- 0.9 mEq/hr [mean +/- SE], p less than 0.0025). We conclude that no special measures are required to facilitate potassium excretion when total potassium cardioplegia dose is not greater than 50 mEq.

Adult↗

A microprocessor computer program. An aid to the International System of Units.

The transition from the scientific system of measurements used in the United States to the Système International creates difficulties for Americans who consult European or Canadian journals. Similar difficulties occur when they want to publish abroad. We have developed a program for the portable microcalculator, which may be coupled selectively to a recorder. Two types of programs are used on 7.5 X 1.5-cm electromagnetic cards. Program P1 is used with the recorder and program P2 with the calculator only.

Abbreviations as Topic↗

Rebound hypertension after sodium nitroprusside-induced hypotension.

Patients undergoing surgical procedures using sodium nitroprusside-induced hypotension were studied to determine the role of the renin-angiotensin system in the pathogenesis of rebound hypertension (RH) after discontinuing sodium nitroprusside (SNP) infusion. Retrospective observations documented RH in 9 of 12 patients (group I) with a systolic blood pressure (SBP) increase from 112 +/- 3.92 before SNP to 144 +/- 5.60 torr 10 min after SNP (p less than 0.001). In 12 patients (group II), plasma renin activity (PRA) rose from 950 +/- 432 to 3,611 +/- 1.874 pg/ml/hr (p less than 0.0005) during SNP and remained elevated (2,504 +/- 792 pg/ml/hr) 30 min after cessation of SNP. SBP rose from a control (pre-SNP) value of 112 +/- 5.24 to 129 +/- 8.52 torr after discontinuation of SNP (p less than 0.05). Significant PRA and SBP changes did not occur in a matched group of patients (group III) who did not receive SNP. That RH after cessation of SNP infusion was associated with persistent elevation of PRA leads us to suggest that RH may be attributable to the unopposed effects of the renin-angiotensin system after the rapid plasma disappearance of SNP.

Anesthesia, General↗