Alterations in cellular enzymes and tissue metabolism in the oxygen toxic primate lung.
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Biomedical subjects
Publications and source records attributed to L A Robinson.
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In order to investigate the effects of high concentrations of oxygen on the lung, experiments were performed on 18 baboons exposed to a humidified environment of 95% oxygen for five days. Open lung biopsies for biochemical assay, histologic and electron microscopic analysis and measurement of tissue respiration were performed before and after oxygen exposure. Pulmonary function was evaluated by measurement of arterial blood gases, compliance, closing capacity (CC), functional residual capacity (FRC), total lung capacity (TLC), residual volume (RV) and vital capacity (VC) before and after exposure and then at seven and 14 days in the animals which recovered. Six baboons removed from the oxygen environment after 96--110 hours and exposed to room air died within three to 20 hours of profound hypoxemia (PaO2 40 +/- 6). The remaining 12 baboons were successfully weaned to room air over a three day period with a return of ABGs to control values (PaO2 89+/- 2). Electron microscopic analysis of alveolar membranes exposed to 120 hours of hyperoxia demonstrated endothelial cell swelling, interstitial alveolar membrane edema, and an increased predominance of Type II pneumocytes. Lung volume measurements showed significant decreases in TLC (25%), VC (34%), CC/TLC (28%) and dynamic compliance (47%). Biochemical studies indicated a shift toward anaerobic metabolism with a decrese in tissue oxygen consumption, reduced cytochrome oxidase activity, and increased lung lactic acid production. These changes were all found to be reversible in the 12 baboons slowly weaned back to room air.
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Various administrative techniques used to bring staff pharmacists in a decentralized, satellite pharmacy system into the managerial decision-making process are discussed. These techniques include a staff pharmacist on-call procedure to discourage absenteeism, and the concept of a head pharmacist to serve as a link with departmental administration. The head pharmacist works in the satelite pharmacy, is responsible for its daily operation and is the spokesman for the satellite. Active roles for the head pharmacist in the selection and evaluation of technicians are outlines. Management skills are developed in head pharmacists through a program of special classes and discussion groups. It is concluded that this program has improved the credibility of administrative decisions and has tapped an underused source of ideas and talent.
A pharmacy-based program for the procurement, allocation and maintenance of infusion pumps is presented. Policies and procedures for various facets of the program, job descriptions for personnel, and training programs for pharmacy and nursing personnel are discussed. A plan for quality assurance, including in-use accuracy testing, preventive maintenance, repairs, and complete record keeping and documentation is outlined. Various aspects of equipment selection, economic justification of equipment, and revenue generation potential are addressed. It is concluded that an infusion pump program can be operated successfully by the hospital pharmacy department.
Etiologic factors of the Stevens-Johnson syndrome, both drug-related and nondrug-related, are discussed. A description of the Stevens-Johnson syndrome as a symptom complex is presented. Available literature is reviewed and critiqued as to its contribution in helping to define the role of drugs as specific etiologic factors in the syndrome. A patient case history is presented to demonstrate the difficulty of determining the causative agent for the syndrome, and to emphasize the need for a complete drug history before specific agents are implicated. The need for caution and discretion in reporting and implicating agents without the availability of a complete patient history is discussed.
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The present investigation evaluated the relationship between smoking and body weight (body mass index [BMI]) in a large, biracial sample of seventh-grade students. Participants were 6751 (5,607 African American, 1,144 White) seventh-grade students participating in an evaluation of smoking determinants in adolescence. In addition to providing, in this survey design, information about their smoking status, participants self-reported both their height and weight, which was converted into a BMI. Contrary to predictions, smoking was positively related to BMI. That is, with increasing levels of smoking exposure, BMI significantly increased. Thus, it appears that smoking is not related to lowered BMI in adolescent populations. Implications and possible reasons for these findings are discussed.
The AIDS epidemic has resulted in an unprecedented death toll among young adults, many of whom are survived by siblings. Whereas the circumstances surrounding deaths from AIDS place survivors at risk for intense bereavement, no reported studies have examined the pattern or intensity of grief among adult siblings. One hundred and two adults who had experienced the death of a sibling from AIDS were recruited into this study in which grief reactions were measured using the Grief Experience Inventory. Time since the sibling's death ranged from 3 months to 11 years. Grief reactions were found to exceed those previously reported. A positive relationship was found between the level of closeness of the survivor to the deceased and the intensity of grief reactions. No relationship was found between time since the sibling's death and intensity of grief.