[Lymphopenia and bacterial infections. A biological sign of major prognostic significance in geriatrics].
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Biomedical subjects
Publications and source records attributed to J Nafziger.
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The treatment of HeLa and HL-60 cells with various concentrations of pentakis(arizidino)thiatriazadiphosphorine oxide results in inhibition of growth and modification of cell cycle distribution. These phenomena were observed at 10(-4) M and 5 X 10(-5) M for HeLa cells and 10(-5) M and 5 X 10(-6) M for HL-60 cells. The estimation of DNA content by flow cytometry showed an important shift in the distribution of cycling cells with a striking arrest in G2 for both cell lines with a concomitant late S-phase accumulation for HeLa cells. Incubation of cells in drug-free medium 3 days after treatment did not show any change in DNA distribution, suggesting the irreversibility of drug action.
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To assess the effects of i.v. injection of morphine, 0.5 mg/kg, hemodynamic studies were performed on 24 critically ill patients under controlled ventilation. An esophageal balloon was used to estimate intrapleural pressure and transmural cardiac filling pressures were calculated. After injection of morphine, there were significant decreases in heart rate (13%), cardiac index (18%), stroke index (17%) and arterial pressure (15%) and there was a nonsignificant increase in esophageal pressure (15%). Transmural cardiac filling pressures decreased significantly (21% for the pulmonary wedge pressure); intravascular filling pressures were unchanged. Oxygen consumption decreased significantly, by 21%, in 10 patients with initially elevated oxygen consumption and by 9% in 14 patients with initially normal oxygen consumption. The oxygen extraction ratio was unchanged, suggesting that the decrease in oxygen consumption was caused by decreased oxygen demand rather than by inadequate oxygen delivery. These results indicate that the hemodynamic effects of morphine (0.5 mg/kg) administered to critically ill patients were associated with a significant decrease in oxygen consumption, which probably reflected sedation and analgesia.
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Hemodynamic and oxygen consumption changes following general anesthesia were studied in 11 patients who did and in 11 patients who did not received droperidol at the end of operation. Both group were similar with respect to age, duration of anesthesia, doses of anesthetic drugs, and hemodynamic and oxygen consumption values immediately at the end of operation. The highest oxygen consumption measurements which were selected as representative of the maximal metabolism of the recovery period showed that the following parameters were lower in the droperidol group than in the non-droperidol group: oxygen consumption (162 +/- 12 and 238 +/- 19 ml/min/m2 respectively), cardiac index (3.0 +/- 0.2 and 4.4 +/- 0.4 l/min/m2), mean arterial pressure (11 +/- 6 and 129 +/- 5 torr), stroke index (27 +/- 3 and 46 +/- 4 ml/m2) left ventricular stroke work index (38 +/- 5 and 77 +/- 8 gm/m2) and PaCO2 (39 +/- 2 and 49 +/- 2 torr). The measurements performed after extubation were similar in both groups. These data show a metabolic and hemodynamic stabilizing effect of droperidol during recovery which may be useful in high-risk patients.
It seemed to us interesting to study the results supplied by a new apparatus designed for gasometric estimation of total CO2 in biological fluids according to a technique derived from that of Van Slyke. The main qualities observed are: linearity (10 to 40 mM/l); rapidly (20 estimations in 35 minutes), reliability (coefficient of variation 1.6% over 15 estimations), daily reproducibility (2 standard deviations = 2 mM/l), satisfactory correlation with a colorimetric method using orthocresolphtalein adapted to SMA 6/60 (r = 0.90) and with an indirect method leading to total CO2 levels by calculation from pH and pCO2 (r = 0.92). However, this technique is difficult to use in pediatrics for the samples of plasma cannot be less than 0.5 ml.
A study on eleven dogs of the effects of increasing doses of dopamine on the left ventricular function. A description of the method which consists of a venous shunt connected to an extra-corporeal circuit and which allows modification simply and rapidly of the state of vascular refilling of the animal. The results differ according to the pressure-level of the refilling of the left ventricule. At low pressure, the dopamine increases the arterial pressure, the cardiac output and the systolic activity of the left ventricle for a reduced tachycardic effect. At higher pressure, the average aortic pressure is only slightly increased and the systolic activity is elevated without increase in cardiac output. These facts indicate dopamine in states of shock with a low pressure of refilling.
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