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Biomedical subjects

R L Murphy

Publications and source records attributed to R L Murphy.

At least 91 records · Page 5Linked to original sources
PubMed1984

Pleural ascites without abdominal fluid: surgical considerations.

The presence of ascitic fluid in the pleural cavity in the absence of peritoneal fluid is rare. We have recently encountered two patients who presented with red-sided pleural effusions and no abdominal ascites. Both patients had diaphragmatic defects: One was an old traumatic diaphragmatic tear and the other a pinpoint spontaneous perforation. These cases are unique because the diagnosis of total ascitic fluid movement across the diaphragm was made during life, and the condition was surgically corrected. The literature concerning transdiaphragmatic movement of fluid is reviewed, and an operative approach is outlined.

Adult↗
PubMed1982

The prevalence and character of crackles (rales) in young women without significant lung disease.

Although some investigators have reported that crackles are present only in persons with lung disease, others say they also occur in normal persons. In order to clarify this difference of opinion, we determined the prevalence of crackles in 56 women without significant lung disease. The subjects ranged from 19 to 33 yr of age (mean, 21.3). They all had a FVC greater than 80% predicted and a FEV1/FVC ratio greater than 75%. None had a history of acute or chronic lung disease. During slow inspirations from residual volume, midinspiratory fine crackles were heard at the anterior bases in 35 of 56 subjects by a physician using an acoustic stethoscope, whereas a bioengineer using an 800 Hertz high pass filtered stethoscope heard crackles in 53 subjects. Crackles during tidal breathing were heard in 2 subjects. It is postulated that the crackles noted after expiration to residual volume are nonpathologic, and occur when basilar airways, which close at the end of a forced expiration, suddenly open during inspiration. Examination of the quality, timing, and anatomic distribution of the crackles in apparently normal subjects suggests that they can often be distinguished from those resulting from diseases such as bronchitis, interstitial fibrosis, and congestive heart failure.

Adult↗
PubMed1982

Absence of respiratory effects in subjects exposed to low concentrations of TDI and MDI.

One hundred seven subjects from a polyurethane plastic manufacturing plant have been followed over a five-year period with measurements of forced expiratory volume in 1 s (FEV1), and questionnaires on respiratory symptoms and smoking habits. Environmental concentrations of toluene diisocyanate and diphenyl methyl diisocyanate were extensively monitored to provide accurate estimates of the upper-limits of exposure of the subjects. Current mean levels of FEV1 in this population were higher than those predicted for healthy subjects. The five-year change in FEV1 did not exceed that expected from aging. No acute change in FEV1 could be demonstrated over the course of a Monday either before or after a two-week vacation. No improvement in ventilatory function was observed over the vacation period. The presence of cough or sputum was related to smoking but was not related to isocyanate exposure. The results indicate that exposure of workers to extremely low levels of isocyanates (time-weighted average concentrations of the order of 0.001 parts per million [ppm]) is not associated with chronic respiratory symptoms or effects on ventilatory capacity. The results suggest that isocyanates can be controlled to the point of eliminating effects as measured by these techniques.

Air Pollutants↗
PubMed1981

Auscultation of the lung: past lessons, future possibilities.

Review of the history of auscultation of the lung reveals few scientific investigations. The majority of these have led to inconclusive results. The mechanism of production of normal breath sounds remains uncertain. Hypotheses for the generation of adventitious sounds are unproven. Advances in instrumentation for lung sound recording and analysis have provided little of clinical value. There has been a recent resurgence of interest in lung sounds. Space-age technology has improved methodology for sonic analysis significantly. Lung sounds are complex signals that probably reflect regional lung pathophysiology. If they were understood more clearly important non-invasive diagnostic tools could be devised and the value of clinical auscultation could be improved. A multidisciplinary effort will be required to achieve this.

Animals↗
PubMed1977

Visual lung-sound characterization by time-expanded wave-form analysis.

To characterize lung sounds objectively, we examined, by means of time-amplitude plots, selected tape recordings of auscultatory phenomena considered by six observers to be typical of those in a standard classification. Normal lung sounds could not consistently be visually distinguished from adventitious sounds at conventional chart recorder speeds of 100 mm per second or less, but the differentiation was easily achieved when the time scale of the plots was raised to 800 mm per second. When discontinuous sounds (rales, crackles or crepitations) were heard clinically, the time-expanded wave forms showed intermittent "discontinuous" deflections usually less than 10 msec in duration. When continuous sounds (rhonchi or wheezes) were heard, the deflections were usually more than 250 msec. Time-expanded wave form analysis provides reproducible visual displays that allow documentation of the differentiating features of lung sounds and enhances the diagnostic utility of the sounds.

Auscultation↗
PubMed1976

Chronic nonspecific respiratory disease in Berlin, New Hampshire, 1967 to 1973. A further follow-up study.

The 1967 sample of Berlin, New Hampshire was resurveyed in 1973 by means of a standard questionnaire on respiratory symptoms and by simple tests of pulmonary function. Measurements of the levels of air pollution showed a decrease in the number of suspended particulates and an increase in the concentration of sulfation. These values were close to the Federal Primary Standard. No differences in respiratory symptoms, prevalences of chronic, nonspecific respiratory disease, or pulmonary function were detected. Within the limitations of this study, we concluded that the Federal Primary Standards for sulfur dioxide and total suspended particulates are probably adequate to protect the public.

Adult↗
PubMed1975

The NLRB decisions on appropriate bargaining units.

It appears that the NLRB's lack of familiarity with the health care industry and particularly with the day-to-day functioning of a hospital led it to search for touchstones such as the status of an RN or the certification of technicians that would enable it to make easy but illogical distinctions. As the cases are reviewed in the judicial system, the separate units for RNs, technical employes, and business office clerical employes will be closely scrutinized. Finally, the bargaining units as outlined and the placement of particular groups of employes based on their formal status will necessarily have an impact on the functional integration of hospital activities.

California↗