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Biomedical subjects

K L Brown

Publications and source records attributed to K L Brown.

112 records · Page 7Linked to original sources

Canine jugular vein endothelial cell monolayers in vitro: vasomediator-activated diffusive albumin pathway.

Cultured canine jugular vein endothelial cells were seeded on polycarbonate filters to create an in vitro permeability assay. The calculated diffusive permeability coefficient for FITC-BSA across untreated monolayers was 1.1 +/- 0.4 x 10(-6) cm/s. After 15-min incubations with either histamine or bradykinin, the resistance to albumin flux across the monolayers was reduced significantly. Diffusive albumin permeability coefficients were 3.4 +/- 1.8 x 10(-6) and 4.1 +/- 2.0 x 10(-6) cm/s, respectively. Ultrastructural morphometric analyses of the endothelial cell monolayers served to define uniform dimensions of intercellular clefts and similar plasmalemmal vesicle densities in the untreated and the vasomediator-activated monolayers. These results are consistent with the interpretation that the vasomediator-activated pathway across the venous endothelial monolayers is not dependent on sustained intercellular gap formation or sustained expansion of the plasmalemmal vesicle population for the 15-min observation periods. Whether the increased albumin flux is dependent on transient gap formation or on physical changes within the venous endothelial cell glycocalyx remains to be tested.

Animals↗

Role of the nurse in treating trauma patients.

Nurses, as the initial advanced life support providers at the scene of a disaster, can have great impact on the trauma patient's outcome. Below, their role at a disaster scene, with special emphasis on successful management of traumatized patients.

Disasters↗

Compartment syndrome associated with bupivacaine and fentanyl epidural analgesia in pediatric orthopaedics.

Two patients had a compartment syndrome after surgery at a remote site performed under a continuous lumbar infusion of a mixture of narcotic (fentanyl) and local anesthetic (bupivacaine 0.1%). Each patient had inadvertent excessive pressure applied to the limb distally and had no perception of pain in the presence of this analgesic combination. After the relief of this pressure from a sling or traction apparatus, each child had signs of a compartment syndrome, and this sensation of pathologic pain was not masked by the epidural infusion. A discussion of the literature questions the benefits of bupivacaine local anesthetic as a routine addition to epidural analgesia for orthopaedic surgery.

Adolescent↗

Extremity lawn-mower injuries in children: report by the Research Committee of the Pediatric Orthopaedic Society of North America.

In a multicenter study of pediatric lawn-mower injuries (push or riding gas-powered machines), we reviewed 144 children at an average age of injury of 7.0 years; 77% were boys. Most injuries (92 of 104) occurred in the afternoon. The child was the machine operator in 36 cases, a bystander in 84, and a passenger in 21. The average hospital stay was 13.3 days with 2.6 surgeries per child. Amputations occurred in 67 children; 63 were unilateral and four bilateral; the most common level was the toes (63%). Blood transfusions were given to 35 children. Children injured by riding lawn mowers, when compared with those by push lawn mowers, were younger (5.4 vs. 11.0 years), less frequently the operator (15 vs. 60%), had longer hospitalizations (15.0 vs. 8.9 days), and required more surgeries (3.0 vs. 1.6) and blood transfusions (41 vs. 3%). Children with free flaps needed more transfusions (78 vs. 26%), and transfused children were younger (4.6 vs. 8.1 years), more likely to be bystanders (91 vs. 63%), required more surgeries (4.1 vs. 2.0), and were hospitalized longer (21.6 vs. 9.7 days). Soft-tissue infections occurred in eight of 118 and osteomyelitis occurred in six of 117 children. At an average follow-up of 1.9 years, there were 43 satisfactory and 84 unsatisfactory results. When excluding those children with amputations of digits, there were 42 satisfactory and 47 unsatisfactory results. If children younger than 14 years had not been permitted around lawn mowers, approximately 85% of the injuries in this report would have been prevented. Further public dissemination of the following information is needed: (a) children younger than 14 years should not operate lawn mowers, (b) children younger than 14 years should not be in the yard while the lawn is being mowed, and (c) no passengers, regardless of age, should be allowed on riding mowers.

Accidents, Home↗