Search PubMed⌕ Search

Biomedical subjects

J Tarkkanen

Publications and source records attributed to J Tarkkanen.

At least 55 records · Page 3Linked to original sources

Comparison of laryngotracheal and ultrasonic nebulizer administration of lidocaine in local anaesthesia for bronchoscopy.

Inhalation of nebulized minute lidocaine droplets has been suggested to be a very safe and pleasant method to produce topical anaesthesia for bronchoscopy. We produced topical anaesthesia of the respiratory tract either by laryngotracheal spraying (LS) of lidocaine (439 +/- 85mg) or ultrasonic nebulizer administration (UNA) of lidocaine (462 +/- 81 mg) in 40 patients undergoing bronchoscopy. All patients also received an average of 15 mg of diazepam intravenously. Both modes of lidocaine administration produced adequate anaesthesia and were safe, but when rated on the visual analogue scale, both the efficacy of local anaesthesia and the cooperation of patients during bronchoscopy were better (P less than 0.05) after LS than those after UNA. The peak plasma concentrations of lidocaine (means +/- s.d.) were lower and occurred earlier after UNA (0.53 +/- 0.34 micrograms/ml at 5-15 min after administration) than those after LS (0.89 +/- 0.63 micrograms/ml at 15-25 min after spraying). The highest individual values measured (2.54 micrograms/ml after LS and 1.17 micrograms/ml after UNA) were much less than those reported toxic lidocaine plasma concentrations. It is concluded that bronchoscopy can be conducted under local anaesthesia as successfully and safely using inhalation of lidocaine droplets from an ultrasonic nebulizer as when using laryngotracheal spraying of lidocaine.

Aerosols↗

Induction of autologous reactivity of human NK cells.

'Mature' human natural killer cell activity could be enriched by adsorption-elution with fetal fibroblast as adsorbents against normal allogeneic skin fibroblasts, but not against autologous targets. However, when the natural killer activity was augmented by contact with tumour cells (HeLa), autologous and allogeneic skin fibroblast targets were killed without preference. Adsorption-elution with augmenting target cells as adsorbents resulted in an efficient enrichment of NK activity showing non-discriminate cytotoxicity. Morphologically, this was associated with an enrichment of large granular lymphocytes previously shown to be responsible for human NK activity. We conclude that the NK activity of human 'mature' NK cells shows a relative autologous exemption, whereas 'pre-NK' cells augmented to full activity in vitro are non-discriminative.

Adsorption↗

Effect of age on amnesia and sedation induced by flunitrazepam during local anaesthesia for bronchoscopy.

Bronchoscopy was undertaken in 79 outpatients using local anaesthesia plus an i.v. injection of flunitrazepam 0.01 mg kg-1. The co-operation of the patients and the ease of bronchoscopy were good regardless of the age of the patient. There was an increase in amnesia for the bronchoscopy with increasing age, but the most distinct difference between different age groups was that the amnesic action of flunitrazepam was evident earlier and persisted longer in patients of more than 60 yr. Eye co-ordination and ability to stand steadily and walk on a line returned to normal more slowly in patients more than 60 than in those less than 60 yr, but no differences in recovery were noted between patients less than 40 and those of 40--59 yr, or between those 60--69 and those more than 70 yr.

Adult↗

Comparison of diazepam and flunitrazepam for sedation during local anaesthesia for bronchoscopy.

Diazepam and flunitrazepam were compared as amnesic and sedative adjuncts to local anaesthesia for diagnostic bronchoscopy in 92 patients. After local anaesthesia of the pharynx, larynx and trachea with lignocaine, atropine plus diazepam of flunitrazepam was injected i.v. The co-operation of the patients and the technical circumstances under which the bronchoscopy was performed were good in each group. None of the treatments significantly modified arterial pressure or heart rate. Two hours after the injection, flunitrazepam 0.01 mg kg-1 more frequently caused amnesia for pictures shown to the patients during the first 15 min after injection (failure to recall 42--75%, and for bronchoscopy 67%), than did diazepam 0.125 mg kg-1 (failure to recall 21--67%; bronchoscopy 38%). Double doses of the drugs caused amnesic actions similar to those of flunitrazepam 0.01 mg kg-1. When failure to recall was assessed on the following day, 29% and 5% of the patients remembered bronchoscopy after flunitrazepam 0.01 and 0.02 mg kg-1 respectively; after diazepam 0.125 and 0.25 mg kg-1 the corresponding percentages was 59% and 30% (P less than 0.05% v. fluintrazepam). The ability to stand and walk on a stright line was similar after the smaller doses of both drugs, but after the larger doses recovery was slower after flunitrazepam. Psychomotor performance was still distinctly impaired 2 h after the injection of the larger doses.

Adult↗

Influence of Caldwell-Luc operation on developing permanent teeth.

The influence of Caldwell-Luc operation on the permanent teeth of school children was studied in a material of 21 six to 14-year-old children, who had undergone, altogether, 30 Caldwell-Luc operations. Ten of the children had also undergone 23 endonasal antrostomies. The control material consisted of a class of 27 healthy school children, their mean age being 10.2 years. Total anesthesia was found in five teeth on the operated side and in one tooth on the non-operated side. Additionally, the operation had caused slight hypesthesia in part of the teeth, mostly in the first incisors. All sensory disturbances were caused by nerve lesion only, and no tooth had died as a result of the operation. The operation could not be shown to be conducive to caries. Correctly performed, Caldwell-Luc operation does not cause serious dental injuries in school children, and is indicated especially in chronic sinobronchitis when conservative methods of treatment fail.

Adolescent↗