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Biomedical subjects

K L Rice

Publications and source records attributed to K L Rice.

23 records · Page 2Linked to original sources
PubMed1987

Lysophosphatidylcholine augments elastase-induced alveolar epithelial permeability and emphysema in the hamster.

We administered low dose porcine pancreatic elastase (PPE) with and without lysophosphatidylcholine (lysoPC), a naturally occurring constituent of lung lipids with known membrane-perturbing properties, to test the hypothesis that alveolar epithelial solute permeability is a determinant of the severity of elastase-induced emphysema in experimental animals. Four age- and weight-matched groups of hamsters received intratracheal injections of one of the following in a total volume of 0.5 ml TRIS buffered saline: (1) no additions, (2) 4 units PPE, (3) 135 micrograms lysoPC, or (4) 4 units PPE plus 135 micrograms lysoPC. Thirty minutes later the permeability surface area products (PS) of the alveolar epithelium to 14C-sucrose and 125I-dextran 70 were measured in excised, perfused lungs from some animals from each group. The remaining animals were killed at 6 wk, at which time pressure-volume relationships were measured in excised lungs, and the mean linear intercept was determined from sections of fixed lung tissue. Neither PPE nor lysoPC alone caused statistically significant increases in PS for either tracer. The PPE plus lysoPC caused statistically insignificant increases in sucrose PS but approximate tenfold increases in dextran 70 PS, which were highly significant (p less than 0.001). Although focal air-space enlargement was observed in some lungs 6 wk after exposure to PPE, pressure-volume relationships and mean linear intercepts were not significantly different from control values. Lungs previously exposed to lysoPC were indistinguishable from control lungs for all measurements. Severe emphysema was uniformly observed in animals that received PPE in combination with lysoPC; lysoPC had no demonstrable effect upon PPE-induced hydrolysis of native elastin in vitro.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1987

Aminophylline for acute exacerbations of chronic obstructive pulmonary disease. A controlled trial.

STUDY OBJECTIVE: To determine the efficacy of intravenous aminophylline in the treatment of patients hospitalized for exacerbation of chronic obstructive pulmonary disease. DESIGN: Randomized, double-blind, placebo-controlled trial during the first 72 hours of hospitalization. PATIENTS: Thirty patients admitted from the emergency room or walk-in clinic with the primary diagnosis of an exacerbation of chronic obstructive pulmonary disease. Twenty-eight patients completed the study; 2 patients, 1 receiving placebo and 1 receiving aminophylline, were removed from the study because of respiratory failure requiring mechanical ventilation. INTERVENTIONS: PATIENTS received either intravenous aminophylline or placebo, in addition to nebulized, inhaled 0.3 mL of a 5% solution every 6 hours; methylprednisolone, 0.5 mg/kg body weight every 6 hours intravenously; ampicillin, 500 mg orally every 6 hours (tetracycline or trimethoprim-sulfamethoxazole were substituted in penicillin-allergic patients); and supplemental oxygen as needed. Aminophylline infusion rates were adjusted by an unblinded investigator to achieve theophylline levels of 72 to 83 mumol/L. Changes were also made in placebo infusion rates to maintain the double-blind design. MEASUREMENTS AND MAIN RESULTS: The forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) before and after metaproterenol inhalation were measured twice daily by a blinded investigator, who also administered a verbal dyspnea index with a scale of 1 to 10 and questioned patients regarding possible side effects of treatment (tremor, palpitations, nausea, or vomiting). Arterial blood gas measurements at 72 hours were compared with those obtained on admission. Significant improvements in FEV1 and FVC measured before and after metaproterenol treatment and in dyspnea occurred over time in both treatment groups (p less than 0.05 for all measurements). However, there were no significant differences between the placebo and aminophylline groups in any of the spirometric measurements or the dyspnea indices (p greater than 0.5 in all five analyses). The mean increases (+/- SE) in Po2 of 1.9 (+/- 0.5) kPa with placebo and 1.7 (+/- 0.7) kPa with aminophylline and the mean decreases in PCO2 of 0.5 (+/- 0.4) kPa with placebo and 1.2 (+/- 0.4) kPa with aminophylline were not significantly different (p greater than 0.6 for PO2, p greater than 0.2 for PCO2).(ABSTRACT TRUNCATED AT 400 WORDS)

Acute Disease↗
PubMedDate not supplied

Minimizing venous thromboembolic complications in the orthopaedic patient.

Venous thromboembolic events (VTE), which include deep venous thrombosis (DVT) and pulmonary embolus (PE), are the most common life-threatening complications associated with orthopaedic surgical procedures. DVT is particularly prevalent in patients undergoing total knee and hip arthroplasty, occurring at a rate of 50 to 60%. In addition, up to 2% of orthopaedic patients receiving pharmacologic prophylaxis still develop PE. Because the majority of candidates for these procedures are older adults with a multitude of comorbid conditions, standard prophylactic practices may not always result in optimal clinical outcomes. Thus, it is important for nurses to have a general understanding of appropriate thromboprophylaxis. This article will provide an overview of the current recommended guidelines and explore the risks and benefits of both pharmacologic agents and adjunctive treatment modalities.

Anticoagulants↗