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Biomedical subjects

S Klein

Publications and source records attributed to S Klein.

466 records · Page 26Linked to original sources
PubMedDate not supplied

Capnographic monitoring of extubated postoperative patients.

Postoperative respiratory monitoring of surgical patients requires assessment of both oxygenation and ventilation. Arterial blood gas (ABG) measurements traditionally have been used to detect elevated arterial carbon dioxide (PaCO2) concentrations. The recent availability of a noninvasive technique for end-tidal CO2 measurements (EtCO2) may allow substitution of this real-time modality for the more cumbersome blood gas determinations. This study examines 41 extubated postoperative patients monitored with both modalities and evaluates whether capnography can replace routine blood gas determinations in selected patients. Paired ABG and EtCO2 measurements were obtained at 30 and 90 min after admission to the recovery room. A new nasopharyngeal catheter was employed to obtain exhaled gas samples for EtCO2 measurement. Overall, EtCO2 was lower than PaCO2 by 2.8 torr (p < .05), with a precision of +/- 2.6 torr. Correlation between EtCO2 and PaCO2 was excellent (r = 0.87, p < .01). We conclude that on-line EtCO2 measurements provide a useful substitute for routine ABG determinations of PaCO2 in selected patients. The nasopharyngeal catheter provides both a patent airway and undiluted gas for evaluation. This methodology can improve patient comfort and safety considerably while decreasing cost and discomfort.

Blood Gas Analysis↗
PubMedDate not supplied

GM-CSF secreted by murine adenocarcinoma cells modulates tumor progression and immune activity.

During tumor development, growth factors may act in autocrine manner stimulating cell proliferation, or in paracrine manner affecting the microenvironment of the tumor and modulating the immune system. Murine mammary adenocarcinoma M3 tumor bearers develop lung metastases and leukocytosis during its evolution. Previously we described that M3 conditioned media enhanced metastasis incidence, when it was inoculated in tumor-operated mice. In the present study we determine that spleen cells from M3 tumor operated mice treated with M3 conditioned media, were able to transfer the capacity to enhance metastasis to other tumor operated mice. Spleen cells have immune suppressor activity that could be reversed by cyclophosfamide treatment. M3 tumor cells secrete GM-CSF, which is able to promote in vitro proliferation of M3 cells as well as spleen cells. This proliferation could be abrogated by the addition of anti-GM-CSF. We report that the GM-CSF secreted by M3 tumor cells had stimulatory activity on M3 tumor cell and lymphocyte proliferation.

Adenocarcinoma↗
PubMedDate not supplied

Immune reactivity during the growth of a murine lung adenocarcinoma: evaluation of paraneoplastic syndrome development.

The purpose of this study was to investigate if specific immune responses were present in mice bearing a lung adenocarcinoma that presents paraneoplastic syndromes during tumor evolution. Leukocytosis, mainly due to polymorphonuclear leukocytes, was found from day 15 of tumor growth. Delayed type hypersensitivity response and increased interleukin-6 (IL-6) serum levels were observed along tumor growth. Concomitant immunity, specific rejection of a second inoculum and in vitro specific cytotoxicity occurred at 20 days of implant. In advanced stages of tumor evolution impaired cytotoxicity, accompanied by a great increase of IL-6 in serum, were observed. Role of polymorphonuclear leukocytes and IL-6 overproduction as responsible for immune dysregulation and paraneoplastic syndromes are discussed.

Adenocarcinoma↗
PubMedDate not supplied

Laparoscopic surgery with carbon dioxide insufflation causes respiratory acidosis.

This study analyzes the changes in cardiopulmonary parameters of patients undergoing laparoscopic cholecystectomy. Six healthy females with normal preoperative cardiopulmonary status were selected for laparoscopic surgery using the same criteria as for traditional cholecystectomy. Respiratory and cardiovascular parameters were collected and compared prior to peritoneal insufflation and just before desufflation. Patients experienced significant elevations of arterial and end-tidal CO2, accompanied by decreased pH. Bicarbonate concentration, blood pressure and pulse rate remained constant. Based on these results, and on our laboratory investigations, we have introduced helium as an alternate agent for insufflation, and present the data from the first two patients so managed. No change was observed in EtCO2, PaCO2 or pH in either of these two patients during the course of surgery. We conclude that hypercarbia occurs in those undergoing laparoscopic cholecystectomy with CO2 insufflation. This acidosis requires compensation by increased minute ventilation to prevent decline in pH. In our initial experience, helium did not produce these changes, and therefore merits further investigation as an alternate agent for abdominal insufflation.

Acidosis, Respiratory↗
PubMedDate not supplied

Correlation of foot radiographs with foot function as analyzed by plantar pressure distribution.

The goal of this study was to correlate radiographic measurements to the dynamic plantar pressure of the residual clubfoot. This was done by comparing radiographs and EMED plantar pressure results in 61 idiopathic clubfeet in 39 children at an average of 8 years after complete subtalar release. Radiographic measures were obtained using the standard method outlined by Simons, and pressure data were collected for eight regions of the foot. Pearson correlation analysis was performed and the most significant correlation was found between the calcaneal/first metatarsal angle in the lateral radiographic view (r = 0.72) and the midfoot contact area. In the anteroposterior view there was mild correlation between the talus/first metatarsal angle and both the peak pressure and plantar contact area. The results of this study indicate that radiographs used in concert with dynamic plantar pressure analysis will provide a more complete assessment of the corrected clubfoot.

Child↗
PubMedDate not supplied

The challenge of preparation for a chemical, biological, radiological or nuclear terrorist attack.

Terrorism is not a new phenomenon, but, in the contemporary scene, it has established itself in a manner which commands the most serious attention of the authorities. Until relatively recently, the major threat has been through the medium of conventional weaponry and explosives. Their obvious convenience of use and accessibility guarantees that such methods will continue to represent a serious threat. However, over the last few years, terrorists have displayed an enthusiasm for higher levels of carnage, destruction and publicity. This trend leads inexorably to the conclusion that chemical, biological, radiological and nuclear (CBRN) methods will be pursued by terrorist organisations, particularly those which are well organised, are based on immutable ideological principles, and have significant financial backing. Whilst it is important that the authorities and the general public do not risk over-reacting to such a threat (otherwise, they will do the work of the terrorists for them), it would be equally ill-advised to seek comfort in denial. The reality of a CBRN event has to be accepted and, as a consequence, the authorities need to consider (and take seriously) how individuals and the community are likely to react thereto and to identify (and rehearse in a realistic climate) what steps would need to be taken to ameliorate the effects of such an event.

Biological Warfare↗
PubMedDate not supplied

Alcoholism and associated malnutrition in the elderly.

Although most free-living people over age 55 yr use alcohol occasionally, both the fraction of people drinking and the magnitude of individual alcohol consumption decrease with every decade of age. Overall, approximately 5% of drinkers over age 55 yr use alcohol at excessive levels, i.e., sufficient to interfere with health or social functioning. As age increases, the fraction of drinkers with alcohol-caused central nervous system disease and cirrhosis increases, indicating increased sensitivity to alcohol injury. Beyond age 70 yr, new-onset alcoholism is more common than long-standing alcoholism. Malnutrition in the elderly alcoholic person is rare; it usually is caused by multiple factors, including alcohol displacing nutrient-rich diet factors, disease, limited availability of food, or altered metabolism increasing nutrient requirement. The recognition of alcohol and malnutrition problems in the elderly is more difficult than in younger people.

Aged↗
PubMedDate not supplied

Mitigating effects of dialysable leukocyte extract (DLE) on the experimental allergic uveitis (EAU) of the rabbit.

Experimental allergic uveitis (EAU) is an induced autoimmune disease by administering soluble retinal S antigen and complete Freund's adjuvant (CFA). In rabbits, the result is the occurrence of chorioretinitis in 90% of the cases. The first inflammation is followed by spontaneous relapses. The EAU of the rabbit was utilized to study the effects of the dialyzable leucocyte extract (DLE) on the course and the intensity of the disease in this autoimmune model. The DLE preparations examined differed with regard to their origin or the immunological stimulation of the initial material (DLE from humans (DLE Hu) and DLE from the normal rabbit (DLE RaO) or rabbits which had EAU (DLE RaEAU) and rabbits which had received CFA (DLE Ra (CFA). One unit of DLE corresponds to the extract from 10(9) cells. The administration of DLE starts with the onset of inflammation. 4 x 0.5 units were administered during the first week, 1 x 0.5 units per week from the 2nd to the 12th week. All preparations decrease the cumulative frequency of the days of illness significantly. The duration of the initial inflammation is reduced in all animals treated, but only in part significantly. There appears a graduation of efficacy: DLE RaEAU greater than DLE Ra CFA greater than DLE Hu greater than DLE RaO. Overall, it can be seen that, on the one hand, there is no specificity or restriction of the species for the efficacy and, on the other hand, the extent of the effects depends on the degree of the immunological stimulation. The maximum efficacy of DLE RaEAU is not exclusively due to the transmission of an antigen-specific sensitization.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

Tumor cells cultured in vivo in diffusion chambers induce hematological alterations.

We have studied in BALB/c mice the hematological alterations of the host induced by the growth of tumor cells in diffusion chambers (DC) In this model, host-tumor interactions are only mediated by soluble factors. Tumor cells proliferate and grow in DC up to 15 days after implant. Our results show a reversal of the granulocyte-lymphocyte ratio in peripheral blood, with lymphopenia and a relative increase of myeloid progenitors in the bone marrow of mice bearing DC with M3 tumor cells (M3TC).

Adenoma↗