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Biomedical subjects

J M Milstein

Publications and source records attributed to J M Milstein.

63 records · Page 4Linked to original sources

Normocarbic hyperventilation fails to induce pulmonary vasodilation.

The pulmonary vasodilator effect of increased rate of mechanical ventilation, with and without respiratory alkalosis, was studied in chronically instrumented newborn lambs. Pulmonary hypertension was first induced by ventilating with a hypoxic gas mixture. Subsequent respiratory alkalosis caused significant decreases in pulmonary arterial pressure and pulmonary vascular resistance. When normocarbia was re-established by adding carbon dioxide to the inspired gas, with the ventilator rate being held constant, the pressure and resistance returned to the baseline hypertensive state. Therefore, mechanical factors, either direct or indirect, appear to be of minor importance in the mechanism of pulmonary vasodilation secondary to frequency-induced hyperventilation.

Alkalosis, Respiratory↗

Effect of pulmonary hypertension on lung compliance in newborn lambs.

We studied the effects of increased pulmonary arterial pressure and vascular resistance on lung compliance in 12 anesthetized newborn lambs. Lung compliance was unaffected by large changes in pulmonary artery pressure and pulmonary vascular resistance (80% increase) that were induced by either hypoxia or acidosis. We conclude that contraction of the pulmonary vascular smooth muscle in normal newborn lambs does not affect the stiffness of the lung in the parenchymal regions undergoing volume change during ventilation.

Animals↗

Ondine curse and neurocristopathy.

Two newborns, 1 male and 1 female, had both Ondine curse, also known as congenital, central hypoventilation syndrome, and Hirschsprung disease. Both infants demonstrated insufficient respiration while asleep and normal respiration when awake. The lesser affected child had an otherwise normal neurologic examination, but suffered from seizures. He died at 18 months of age; neuropathologic examination of the brain was unremarkable. The girl had a severe and ultimately fatal form of this disorder and manifested a variety of neurologic abnormalities indicative of developmental failure of the neural crest-derived tissues. These abnormalities included unreactive pupils and deafness. She died at 40 days of age; autopsy permission was denied. The etiology of sleep apnea is not known. Mechanisms of central integration may be abnormal but the association with neural crest maldevelopment implicates the peripheral nervous system.

Axons↗

Childhood polymyositis as a paraneoplastic phenomenon.

Childhood polymyositis and dermatomyositis are rare conditions that are not generally associated with malignancy even though an association between adult-onset and malignancy has been reported. A child is presented with typical polymyositis in whom an immunoblastic sarcoma subsequently became manifest; the literature also is reviewed concerning the association between malignancy and these childhood conditions.

Biopsy↗

Sclerema neonatorum: a sign of transient hyperammonemia of the newborn.

We cared for four neonates with transient hyperammonemia of the newborn (THAN), all of whom exhibited sclerema during their course. Sclerema is a hardening of the subcutaneous tissues, which gives the tissue a firm, rubber-like quality. This association has not been previously reported, and it may provide a clue to early diagnosis and intervention in THAN.

Ammonia↗