Biomedical subjects
Publications and source records attributed to M Skacel.
Using chromatographic analysis the authors studied glucose concentration in the brain of Swiss mice inoculated with CSF of four patients with amyotrophic lateral sclerosis. They found reduction in the levels of glucose, suggesting the existence of an exogenous factor transferred by CSF.
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Current methods for measurement of chest wall properties assume that resistance (R) and elastance (E) are independent of the volume breathed. In six healthy subjects relaxed at functional residual capacity, we measured total and regional R and E of the chest wall within the range of normal breathing frequencies (0.2 to 0.6 Hz) and tidal volumes (250 to 750 ml), using volume forcing at the mouth as previously described. With these methods, esophageal and gastric pressures are compared with surface displacements measured with inductance plethysmographic belts to calculate R and E of rib cage and diaphragm-abdomen "pathways." Rib cage R and E were 25 to 30% higher than that of the total chest wall at each frequency and volume, whereas diaphragm-abdomen R and E were at least five times higher. R of the chest wall and each of the pathways decreased by about 70% with increasing frequency and by about 30% with increasing tidal volume. E of the chest wall and each of the pathways also decreased by about 30% with increasing tidal volume but was independent of frequency in this range. These results are consistent with nonlinear, viscoplastic models presented elsewhere. We conclude that: (1) despite the great structural differences between the rib cage and diaphragm-abdomen, each exhibits nonlinear behavior similar to that of the total chest wall; (2) chest wall R and E depend importantly on frequency and tidal volume.
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Patients were randomly allocated to receive either vecuronium or atracurium as the sole muscle relaxant for day-case gynaecological laparoscopy to determine if either agent was superior with respect to post-operative morbidity during the 48 h after operation. Intubating conditions and cardiovascular stability were similar in both groups. Post-operative morbidity prior to discharge was also similar except for a significantly higher incidence of abdominal pain in the vecuronium group. There was no statistical difference in specific morbidity during the 48 h after laparoscopy, but a greater number of patients in the vecuronium group was able to resume normal activity 24 h after laparoscopy. Both agents are very suitable for day-case laparoscopies and other short surgical procedures.
Fentanyl or alfentanil, in doses approximating to those used in clinical practice, was added to the priming fluid of an extracorporeal circuit before the institution of cardiopulmonary bypass (CPB). The concentrations of both drugs in the priming fluid were measured over a 20-min period. The concentration of fentanyl decreased at neutral or high pH values, suggesting drug adsorption to the circuit. The concentration of alfentanil was unaffected. The administration of fentanyl to the priming fluid may produce lower anaesthetic concentrations than anticipated.
A comparison was made of postoperative morbidity following two anaesthetic techniques for day case laparoscopies. One group of patients was allowed to breathe spontaneously after intubation under suxamethonium. The second group received atracurium and their lungs were mechanically ventilated. Patients in the controlled ventilation group experienced significantly less severe sore throats and muscle pain in the first 24 hours postoperatively than the patients who breathed spontaneously. Both techniques proved to be safe and are suitable for day case laparoscopy. The safety of patients is discussed in relation to the choice of anaesthetic technique used.
The authors report a case of paraplegia caused by a lumbar intraspinal paracoccidioidomycosis (PCM) granuloma. Clinical neurological diagnosis of a compressive spinal cord lesion was confirmed by spinal magnetic resonance imaging (MRI). Patient was submitted to surgery with total excision of the lesion. Histopathological analysis confirmed the diagnosis of PCM. Patient is on sulfamethoxazole/trimethoprim combined with fluconazole and is experiencing positive neurological recovery.