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Biomedical subjects

S C Body

Publications and source records attributed to S C Body.

33 records · Page 2Linked to original sources
PubMed1997

Manufacture and measurement of nitrogen oxides.

A decade of research has identified nitric oxide as a unique endogenous biologic mediator with functions as diverse as vasodilation, macrophage cytotoxicity, platelet adhesion, and memory formation. Measurement devices, previously used in research on atmospheric nitrogen oxides, are being adapted for and applied to clinical situations without approval, regulation, or rigorous testing, and with little understanding of how the devices work or their limitations. This article discusses the chemistry, manufacture, and measurement of nitrogen oxides.

Administration, Inhalation↗
PubMed1996

Laryngeal mask airway for therapeutic fiberoptic bronchoscopic procedures.

These cases illustrate the advantages of the laryngeal mask as compared with an endotracheal tube or oxygen face mask for selected patients undergoing therapeutic bronchoscopic procedures. The advantages include a larger internal diameter allowing easier passage of instruments, reduced work of breathing, lack of discomfort associated with insertion, access to the vocal cords and upper trachea unimpeded by the presence of an endotracheal tube, and capnographic and volume monitoring of respiration. The LMA is thus a valuable alternative for airway management in pulmonary compromised patients undergoing therapeutic bronchoscopic procedures.

Adult↗
PubMed1996

Pulmonary function changes during epidural anesthesia for cesarean delivery.

Although changes in pulmonary function in parturients are documented, little is known about effects of regional anesthesia on these changes. This study was undertaken to determine if two local anesthetics, often used for epidural anesthesia for cesarean delivery, have different effects on pulmonary function testing. Nineteen ASA physical status I parturients undergoing elective cesarean delivery with epidural anesthesia were randomly assigned in double-blind fashion to receive either 0.5% bupivacaine or 2% lidocaine with epinephrine (1/200,000). Pulmonary function tests were measured using a calibrated spirometer with computer-recorded flow volume loops. Peak inspiratory pressure and peak inspiratory flow rate, peak expiratory pressure (PEP) and peak expiratory flow rate, forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1) were measured. Measurements were taken prior to epidural placement and at T-10 and T-4 levels. Peak inspiratory pressure, FEV1/FVC, FEV1, FVC, peak expiratory flow rate, and peak inspiratory flow rate did not differ from baseline in either group. Patients receiving lidocaine showed a significantly greater decrease in PEP at both T-10 and T-4 levels. Pep is largely dependent on abdominal musculature. If a denser motor block is provided by 2% lidocaine with epinephrine than by 0.5% bupivacaine, these muscles would be more affected, resulting in a greater decrease in PEP. These results may have implications regarding choice of local anesthetic for epidural anesthesia in parturients with some degree of respiratory compromise undergoing cesarean delivery.

Adult↗
PubMed1996

Multicenter study of target-controlled infusion of propofol-sufentanil or sufentanil-midazolam for coronary artery bypass graft surgery. Multicenter Study of Perioperative Ischemia (McSPI) Research Group.

BACKGROUND: The use of target-controlled infusions of anesthetics for coronary artery bypass graft surgery has not been studied in detail. The effects of target-controlled infusions of propofol or sufentanil, supplemented by infusions of sufentanil or midazolam, respectively, were evaluated and compared. METHODS: At 14 clinical sites, 329 patients were given a target-controlled infusion of propofol (n = 165) to produce effect-site concentration (Ce) of > or = 3-micrograms/ml or a target-controlled infusion of sufentanil (n = 164). Sufentanil or midazolam, respectively, also were infused. Systolic hypertension, hypotension, tachycardia, and bradycardia were assessed by measuring heart rate and blood pressure every minute during operation. Myocardial ischemia was assessed perioperatively by monitoring ST segment deviation via continuous three-lead Holter electrocardiography, and it was evaluated during operation by monitoring left ventricular wall motion abnormality via transesophageal echocardiography. RESULTS: The measured cardiovascular parameters were satisfactory and usually similar for the patients receiving propofol-sufentanil or sufentanil-midazolam. The primary endpoint of the percentage of patients with intraoperative ST segment deviation (23 +/- 6% vs. 24 +/- 6%, P = 0.86) did not differ significantly between the two groups. The incidence of left ventricular wall motion abnormality shown on transesophageal echocardiography before (19 +/- 4% vs. 26 +/- 4%, P = 0.25) and after (23 +/- 4% vs. 31 +/- 5%, P = 0.32) cardiopulmonary bypass also did not differ significantly for the two groups. Changes in intraoperative target concentration were more frequent with propofol-sufentanil anesthetic than with sufentanil-midazolam (11.7 +/- 7.1 vs. 7.3 +/- 3.6, P < 0.001). The incidence of intraoperative hypotension (77% vs. 55%, P < 0.001), the use of inotropic/vasopressor medications (93% vs. 84%, P = 0.01), and the administration of crystalloids (2.8 +/- 1.4 L vs. 2.4 +/- 1.2 L, P < 0.001) were significantly greater in the propofol-sufentanil group. Conversely, the incidence of intraoperative hypertension (43% vs. 54%, P = 0.05) and the use of antihypertensive/vasodilator medications (70% vs. 90%, P < 0.001) were significantly less in the propofol-sufentanil group. CONCLUSIONS: Target-controlled infusions of propofol or sufentanil, supplemented by infusions of sufentanil or midazolam, respectively, were suitable to provide anesthesia for coronary artery bypass graft surgery. Continuous monitoring revealed a high prevalence of hemodynamic abnormalities. Despite greater hypotension in the propofol-sufentanil group and greater hypertension in the sufentanil-midazolam group, episodes of myocardial ischemia were similar for both groups and were not temporally related to episodes of hemodynamic abnormalities.

Aged↗
PubMed1996

Sevoflurane depresses myocardial contractility less than halothane during induction of anesthesia in children.

BACKGROUND: Cardiovascular stability is an important prerequisite for any new volatile anesthetic. We compared echocardiographically derived indices of myocardial contractility during inhalation induction with sevoflurane and halothane in children. METHODS: Twenty children were randomized to receive either halothane or sevoflurane for inhalation induction of anesthesia. No preoperative medications were given. Myocardial contractility was evaluated at baseline and at sevoflurane and halothane end-tidal concentrations of 1.0 minimum alveolar concentration (MAC) and 1.5 MAC. RESULTS: There were no differences between groups in patient age, sex, physical status, weight, or height. Equilibration times and MAC multiples of sevoflurane and halothane were comparable. Vital signs remained stable throughout the study. Left ventricular end-systolic meridional wall stress increased with halothane but remained unchanged with sevoflurane. Systemic vascular resistance decreased from baseline to 1 MAC and 1.5 MAC with sevoflurane. Halothane depressed contractility as assessed by the stress-velocity index and stress-shortening index, whereas contractility remained within normal limits with sevoflurane. Total minute stress and normalized total mechanical energy expenditure, measures of myocardial oxygen consumption, did not change with either agent. CONCLUSIONS: Myocardial contractility was decreased less during inhalation induction of anesthesia with sevoflurane compared with halothane in children. Although the induction of anesthesia with sevoflurane or halothane was equally well tolerated, the preservation of myocardial contractility with sevoflurane makes it an attractive alternative for inducing anesthesia in children.

Anesthesia, Inhalation↗
PubMed1996

Platelet activation and interactions with the microvasculature.

Platelet adherence to structurally or functionally damaged endothelium and its subsequent activation are multifaceted events. Regulation of the rate and extent of platelet adhesion is under local control by the platelets and endothelium. Even in the absence of platelet adhesion to endothelium or subendothelium, there is a complex hemostatic balance of coagulation and anticoagulation. This is mediated by the manufacture, release, and inactivation of various procoagulant and anticoagulant compounds, predominantly by the platelets and endothelium. The relationship between the two in maintaining the homeostasis of coagulation and other processes is complex. This review focuses on the structure, function, and interaction of endothelium, subendothelium, and platelets and on their vasoactive and pro-/anticoagulant functions.

Animals↗
PubMed1995

Shed whole blood autotransfusion during aortic aneurysm operation with a modified collection infusion system.

We describe a modified shed whole blood collection and autotransfusion system that allows several options for the processing and autotransfusion of shed blood: use of the Cell Saver (Haemonetics, Braintree, MA) or the ultrafiltration of collected blood, and the autotransfusion of unprocessed shed whole blood. The system has proved useful for transfusion in the setting of thoracic aortic operations, and we describe here our experience in 5 patients undergoing resection of a descending thoracic aortic aneurysm in whom this system was used.

Aged↗
PubMed1995

Nitric oxide: delivery, measurement, and clinical application.

The biologic and therapeutic roles of NO are rapidly being elucidated. Before inhalational NO administration is commonplace, there is a clear need for consensus regarding safe and accurate delivery and measurement systems. The potential for NO usage appears large and potentially life-saving; yet multicenter trials need to carefully evaluate efficacy and safety.

Humans↗
PubMed1994

Management of a term parturient with tracheal stenosis.

We describe the management of a 37-week parturient with a breech singleton pregnancy presenting with progressive dyspnoea caused by tracheal stenosis. The patient underwent bronchoscopy using a flexible fibreoptic bronchoscope and dilatation of a stenosis using a balloon-tipped catheter. Subsequently, the patient had a normal delivery.

Adult↗
PubMed1988

Gestational exposure to phencyclidine (PCP) in rats decreases PCP binding sites in term fetal brain.

Pregnant Sprague-Dawley rats were treated with 5 mg/kg body weight of phencyclidine (PCP) injected at 1 ml/kg subcutaneously on three consecutive days at four different stages of gestation. Within 10-30 min after treatment, dams showed some lack of motor coordination and became lethargic. On gestational day 21, all rats were killed by decapitation and brains were dissected and stored from mother and fetus for neurochemical analysis. PCP, dopamine and muscarinic cholinergic receptor binding was measured in membranes prepared from maternal and fetal whole brain. Neurotransmitter concentrations were also measured in the fetal brain homogenates. There was a significant decrease in PCP binding sites in fetal but not maternal brains after maternal PCP injection at gestational days 12-14, 15-17 and 18-20, but not at 9-11 days. Dopamine and muscarinic cholinergic receptor binding was not significantly altered in fetal or maternal brain when compared with vehicle control animals. The whole brain dopamine, 3,4-dihydroxyphenylacetic acid, serotonin, and 5-hydroxyindoleacetic acid concentrations did not show significant change in any group studied. These data indicate that gestational exposure to PCP decreases high affinity binding of PCP in term fetal brain at doses which do not alter maternal PCP receptor binding.

Animals↗
PubMed1979

High concentrations of glutathione in glandular stomach: possible implications for carcinogenesis.

In laboratory rodents, concentrations of reduced glutathione (GSH) are exceedingly high (up to 7 to 8 millimolar) in the glandular gastric tissue compared to concentrations in other portions of the gastrointestinal tract or to those of most other organs. Gastric GSH varies diurnally, with the highest levels occurring in the late afternoon or early evening. Starvation, treatment with diethyl maleate, or cold-restraint stress all caused marked decreases in stomach GSH, whereas treatment with cobaltous chloride caused an increase in the GSH concentrations. The physiological significance of the high gastric GSH is unknown, but because this endogenous compound may strongly modulate (decrease or increase) the macromolecular binding of certain chemicals capable of inducing stomach tumors, the possible role of glutathione in the pathogenesis of chemically induced gastric cancer should be considered.

Animals↗
PubMedDate not supplied

Effect of nitric oxide upon gas transfer and structural integrity of a polypropylene membrane oxygenator.

Gaseous nitric oxide (NO) may act as a membrane passivator during cardiopulmonary bypass by inhibition of platelet and leukocyte adhesion, activation, and aggregation. However, NO and its by-product nitrogen dioxide (NO2) are potently reactive and may be capable of degradation of membrane oxygenator constituents in an oxygen-rich environment. To test these concepts, nine polypropylene hollow fiber membrane oxygenators received 224 +/- 10 ppm NO and 6.7 +/- 1.7 ppm NO2 in 73% oxygen (O2), and six oxygenators received 73% O2, while being perfused with heparinized thrombocytopenic bovine blood for 6 hours. Oxygenators were used for measurement of O2 and carbon dioxide (CO2) transfer rates, structural integrity by pulsing with 22 psi water at 0.5 Hz for 6 hours, and scanning electron microscopic (SEM) examination of structural integrity. Transfer rates between groups at 0, 1, 3, and 6 hours revealed no differences in O2 or CO2. No oxygenator failed hydraulic tests of structural integrity or exhibited "wet-out" during bypass. No evidence of material degradation was shown in the SEM appearance of oxygenators. There were no differences in hematologic values. These data support the safety of gaseous NO in polypropylene membrane oxygenators for limited-term cardiopulmonary bypass.

Animals↗