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Biomedical subjects

J T Good

Publications and source records attributed to J T Good.

At least 37 records · Page 2Linked to original sources
PubMed1980

Rheumatoid pleurisy. observations on the development of low pleural fluid pH and glucose level.

A patient with rheumatoid pleurisy provided the opportunity to observe the time course of development of the low glucose level and low pH characteristic of these pleural effusions. During six days, the effusion evolved from one with a normal glucose value and pH to one with a glucose value of 20 mg/dL and a pH of 6.78. The mechanisms responsible for these phenomena probably are (1) a selective block to glucose transport from blood to pleural fluid, (2) enhanced glucose use by rheumatoid pleura, and (3) an efflux block to the end products of pleural space glucose metabolism. Once the low glucose value-low pH rheumatoid effusion develops, it seems not to revert to an effusion with a normal glucose level and pH.

Arthritis, Rheumatoid↗
PubMed1980

The diagnostic value of pleural fluid pH.

One hundred eighty-three patients had simultaneous blood and pleural fluid pH determinations. Thirty-six effusions were transudates, and 147 were exudates. In 46 effusions, the pleural fluid pH was less than 7.30; all 46 were exudates. A pleural fluid pH less than 7.30 was associated with the following six diagnoses: (1) empyema; (2) malignancy; (3) collagen vascular disease; (4) tuberculosis; (5) esophageal rupture; and (6) hemothorax. The results of pleural fluid pH determination are immediately available, narrow the differential diagnosis of the exudate, and may expedite patient management. The pH of pleural fluid should be measured whenever a diagnostic thoracocentesis is performed.

Aged↗
PubMed1980

A model of immune complex-mediated pleuropulmonary injury; evidence of deposition of circulating immune complexes in the lung.

Severe acute, diffuse lung inflammation was induced in rabbits immunized to bovine serum albumin (BSA) and subsequently challenged with BSA intrapleurally. Evidence suggesting involvement of circulating immune complexes in the pathogenesis of lung injury in these rabbits include 1) positive lung immunofluorescence, 2) a fall in serum hemolytic complement, 3) diffuse bilateral involvement despite unilateral antigen challenge, and 4) absence of these findings in control rabbits. Further investigation with this model may provide insight into the processes involved in the deposition of immune complexes in the lung and the mechanisms of lung injury provoked by immune complex deposition.

Animals↗
PubMed1980

Office spirometry.

The practicality of the office spirometer as an effective, inexpensive diagnostic device is well established. It can be used in a matter of seconds by minimally trained office personnel. Two basic parameters can be quickly and accurately measured: forced vital capacity (FVC), a test of volume indicative of restrictive lung disease, and forced expiratory volume in one second (FEV1), a test of flow rate indicative of obstructive lung disease. The FEV1/FVC ratio is a valuable screening measurement that indicates the likelihood of progressive deterioration of pulmonary function.

Adult↗
PubMed1979

Emergency room intubations--complications and survival.

Forty-three consecutive patients requiring endotracheal intubation in an emergency room were studied prospectively to define the complications associated with intubation and the survival of these patients, and to evaluate emergency room policies. The indications for intubation were acute respiratory failure (ARF) in 22 patients and cardiopulmonary arrest (CPA) in 21 patients. Thirty-eight complications occurred in 24 of the 43 patients. The department or level of training of the intubator did not affect the rate of complications. Furthermore, specific complications did not influence survival. Seventeen patients survived, all in the ARF group. Age less than 40 years and admission PaO2 greater than 40 mm Hg also were associated with increased survival. We conclude that the complication rate of emergency room intubations is high and would not appear to be lowered by limiting intubations to physicians from specific departments or with certain levels of training. The underlying diagnosis and condition on admission to the emergency room appear to be more important factors relating to survival than complications during intubation.

Acute Disease↗
PubMed1979

The pH of sclerosing agents: a determinant of pleural symphysis.

The rate of success in producing pleural symphysis with intrapleural instillation of sclerosing agents has been variable. Differences in the designs of studies probably account for some of the variability, but the reasons for the remainder are not clear. Since a low pH of the pleural fluid is associated with pleural adhesions and loculations, the pH of the commonly used solutions of sclerosing agents was determined, both in their usual concentrations and when diluted with large quantities of exudative pleural fluid. The buffered solution of tetracycline hydrochloride had the most acidic pH (2.0) and showed little change when diluted by pleural fluid. A 0.5 percent solution of sodium hydroxide had the highest pH (13.0). The remainder of the sclerosing solutions showed a range of pH from 4.3 to 8.7. Experimental and clinical experience suggests that tetracycline consistently has the highest rate of success in producing pleural symphysis. It appears that when proper technique is employed, the pH of the solution of the sclerosing agent is an important determinant of the production of pleural symphysis.

Animals↗
PubMed1979

The routine use of positive end-expiratory pressure after open heart surgery.

Because atelectasis of the left lower lobe is a frequent complication of open heart surgery, we evaluated the efficacy of routine therapy with positive end-expiratory pressure (PEEP) to prevent this complication. Twenty-four patients were randomly assigned to either a group receiving therapy with PEEP (ten patients) or to a group with no PEEP (14 patients). The two groups could not be distinguished by age, weight, the forced expiratory volume in one second (FEV1), the ratio of FEV1 over the forced vital capacity, the time on the pump, the units of blood transfused, the tidal volume, or the hours of mechanical ventilation. There was no significant roentgenographic difference between the two groups in either the degree or frequency of left lower lobe atelectasis. While the arterial-alveolar ratios tended to improve over time in those patients receiving therapy with PEEP, this improvement was not clinically significant. No complications were encountered with the use of PEEP. We conclude that the routine use of PEEP following open heart surgery is safe but offers no advantage over standard ventilatory techniques.

Cardiac Surgical Procedures↗