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Biomedical subjects

S Braude

Publications and source records attributed to S Braude.

29 records · Page 2Linked to original sources
PubMed1986

Increased pulmonary transvascular protein flux after canine cardiopulmonary bypass. Association with lung neutrophil sequestration and tissue peroxidation.

We examined the hypothesis that increased pulmonary transvascular protein flux after cardiopulmonary bypass (CPB) is mediated in part by neutrophil-derived, oxygen-free radicals. Measurements of transvascular lung 113mIn-transferrin flux, transpulmonary neutrophil counts, and plasma concentrations of thiobarbituric acid (TBA) reactive substances were made in 8 dogs after CPB and in 6 dogs who underwent thoracotomy alone. The TBA reactivity is indicative of lipid peroxidation and was used as an index of oxygen-free radical release. All 14 dogs had a baseline measurement of lung protein flux 1 wk prior to thoracotomy. In the bypass dogs, lung protein flux was -0.2 +/- 0.3 protein flux units (mean +/- SEM) at baseline and increased significantly after bypass to 3.3 +/- 1.0 (p less than 0.01). The control thoracotomy group had baseline values similar to the baseline studies in the CPB dogs (0.2 +/- 0.3 units), but no significant difference was noted after thoracotomy. The CPB dogs showed initial significant parallel falls in left atrial (LA) and central venous (CV) neutrophil counts during bypass (baseline, 5.3 +/- 0.7 X 10(9) cells/L in both sample sites, falling to 3.0 +/- 0.5 and 2.9 +/- 0.5, respectively, p less than 0.001), but a significant CV-LA transpulmonary gradient existed only when pulmonary perfusion recommenced after a period of total asystole. Concentration of TBA reactive substances increased significantly during the course of bypass (baseline LA, 6.4 +/- 0.5 nmol/L, baseline CV, 6.4 +/- 0.5, increasing to 9.8 +/- 1.0 and 9.4 +/- 1.6 at the end of bypass, respectively, p less than 0.01), but likewise, there was a significant transpulmonary gradient only after reversal of asystole.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1985

Adult respiratory distress syndrome after allogeneic bone-marrow transplantation: evidence for a neutrophil-independent mechanism.

5 patients in whom the adult respiratory distress syndrome (ARDS) developed after bone-marrow transplantation (BMT) for chronic myeloid leukaemia are described. Donors in all cases were siblings who were matched for all major-histocompatibility-complex determinants. All patients were neutropenic to varying degrees at the onset of respiratory symptoms. Histological evaluation in all patients at necropsy showed diffuse alveolar damage with no evidence of intrapulmonary neutrophil sequestration. No patient had detectable levels of plasma peroxidation products, which were measured as an index of neutrophil oxidant function. Significantly increased clearance of inhaled 99mTc-diethylene-triamine-pentacetate was a uniform finding, suggesting impaired alveolar-capillary barrier function in keeping with ARDS. An increase in an index of lung epithelial permeability leading to ARDS may develop in neutropenic patients who have evidence of neither intrapulmonary neutrophil sequestration not tissue oxidant injury. ARDS after BMT is probably multifactorial in aetiology, but neutrophil-derived oxidant products play no part in its genesis.

Adult↗
PubMed1984

Histamine increases lung permeability by an H2-receptor mechanism.

The effect of specific H1 and H2 receptor antagonists on bronchial reactivity and increase in lung epithelial permeability in response to inhaled histamine was measured in 5 non-smoking men (age range 24-36 years). Inhaled histamine produced a short-lived but consistent increase in permeability to 99Tc-diethylenetriamine penta-acetate. An H1-receptor antagonist, terfenadine (60 mg), protected against the bronchoconstrictor effect but had no significant influence on the increase in permeability. The H2-receptor antagonist ranitidine (150 mg) significantly reduced the permeability response without having an effect on bronchial reactivity. These results demonstrate that the bronchoconstrictor effect of histamine is mediated by H1 receptors and permeability increase is mediated by H2 receptors. H2-receptor mediated increase in lung epithelial permeability may be important clinically.

Adult↗
PubMed1984

Hypertrophic osteoarthropathy in cystic fibrosis.

Seven adult patients with cystic fibrosis who had radiological evidence of hypertrophic osteoarthropathy were reviewed. In five of the patients symptoms were particularly pronounced at times of acute infective exacerbations; appropriate treatment of the infective episodes resulted in reduction or resolution of the bone pain and joint effusions. Despite this symptomatic relief periosteal changes persisted radiologically and their chronic nature was indicated by changes in the midshafts of long bones. Four of the seven patients had transient gynaecomastia or mastalgia related to infective exacerbations. It is hypothesised that a neuroendocrine mechanism--namely, release of vasoactive intestinal polypeptide--might account for the osteoarthropathy.

Acute Disease↗
PubMed1982

Earlier charcoal haemoperfusion in fulminant hepatic failure.

Charcoal haemoperfusion with a prostacyclin infusion for platelet protection was carried out daily in the treatment of 76 patients with fulminant hepatic failure. in the 31 patients who had been referred early and in whom the serial haemoperfusion was started while signs of grade III encephalopathy were still evident remarkable survival rates were obtained-70% for patients with paracetamol poisoning and 65% for the group overall. Cerebral oedema developed significantly less frequently in this group than in those patients in whom haemoperfusion was started later in the course of the disease, when signs of grade IV encephalopathy were already apparent (49% and 78% respectively, p less than 0.05), and this was likely to have been a major factor in their improved survival. Biocompatibility of the system was excellent, and both platelet and white-cell counts at the end of perfusion periods were the same as pre-perfusion values.

Adult↗
PubMedDate not supplied

Positive end-expiratory pressure increases pulmonary clearance of inhaled 99mTc-DTPA in nonsmokers but not in healthy smokers.

Positive end-expiratory pressure (PEEP) is widely used in the treatment of severe pulmonary oedema, although its effects on the clearance of water and small solutes from alveolus to blood are not well characterized. We studied the effect of the application of 10 cmH2O of PEEP on the flux of inhaled 99mTc-diethylene-triamine-penta-acetic acid (DTPA) from lung to blood in six healthy smoking and six nonsmoking subjects. The rate of flux was corrected for possible changes in pulmonary blood volume during PEEP by use of an intravenous injection of 99mTc-DTPA. The baseline clearance rate (K, % X min-1) for nonsmokers was 1.48 +/- 0.12 (mean +/- SE) and increased to 2.40 +/- 0.29 during PEEP (p less than 0.05). In contrast, the mean clearance rate for smokers was 3.26 +/- 0.82 at baseline and 3.03 +/- 0.82 during PEEP (p = NS). The application of positive end-expiratory pressure appears to increase alveolar solute flux in nonsmokers but not in smokers, suggesting that the pathway for solute clearance in smokers is governed by different rate-limiting steps to those of nonsmokers.

Administration, Inhalation↗