Care of the elderly: sound sleep.
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Biomedical subjects
Publications and source records attributed to B Towers.
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Self-reflective consciousness is distinguished from 'simple' awareness and from conscious awareness. Awareness is a fundamental property of living matter as it reacts to environmental stimuli. A hypothesis is advanced to account for the general phenomenon of decussation of nerve fibres in the central nervous system of vertebrates. This feature, the crossing over of nerve fibres to the opposite side of the brain, is interpreted as exemplifying the inherent caution of living forms. The evolution of increasing complexity of structure in spinal cord and brain is a prerequisite for increasing awareness of the environment and for increasing freedom from its constraints. Conscious awareness is manifested in living forms primarily when they are learning to respond either to new stimuli or to internal demands such as breathing and walking. The relegation of learnt activities to the realm of unconscious reflex allows for concentration on new and more complex responses, which leads to further freedom of action. The seeming simplicity of human thinking rests on the increasing complexity of the evolving brain and of appropriate responses learnt during phylogenetic development. The human brain and its thinking functions are basically trustworthy because they are rooted in biological evolution.
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Ten pairs of twin lambs 118--122 days of gestation were given either natural surfactant or diluent endotracheally before the first breath. By using the premature twin lamb model, we have been able to show that instillation of natural surfactant produced 100% survival for the duration of the study period (2 hr); stable blood gases on room air; lungs that became increasingly compliant while on the respirator; generally well aerated lungs at autopsy; good lung pressure-volume relationships; normal lung surface tension measurements; and histologic evidence of good alveolar expansion with large amounts of free intraluminal phospholipid, no epithelial damage, and no hyaline membranes. It is concluded that tracheal instillation of natural surfactant into the premature lamb protects the lungs from developing many features characteristic of the respiratory distress syndrome.
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