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Biomedical subjects

C Hales

Publications and source records attributed to C Hales.

10 recordsLinked to original sources

Bronchoalveolar lavage fluid phospholipase A2 activities are increased in human adult respiratory distress syndrome.

The role of phospholipase A2 (PLA2) in lung injury in humans is unclear. Previous studies have failed to identify an increase in PLA2 activity in bronchoalveolar lavage fluids (BALF) of patients with the adult respiratory distress syndrome (ARDS). In this study, increased phospholipase A2 (PLA2) activity was detected in BALF from patients with ARDS. PLA2 levels in BALF correlated positively with lung injury score in patients with lung disease. BALF PLA2 activity in patients with ARDS was resolved into heparin binding and nonbinding activities. Both PLA2 activities were increased in BALF of ARDS patients. The PLA2 activity that bound to heparin was identified as a group II PLA2 by its chromatographic characteristics, its inhibition by dithiothreitol, its substrate specificity, and its approximate molecular mass of 14 kDa. The second PLA2 activity was further purified and found to require Ca2+ at a concentration > 2 x 10(-4) M for activity. This form of PLA2 exhibited a neutral and broad pH optimum (pH 6.0-8.0) and hydrolyzed both phosphatidylethanolamine and phosphatidylcholine effectively. Its apparent molecular mass was estimated to be 80-90 kDa. Neither anti-pancreatic PLA2 antiserum nor anti-pig spleen cytosolic 100-kDa PLA2 antiserum immunoprecipitated the enzymatic activity. Thus at least two forms of PLA2 are increased in activity in BALF of patients with ARDS, a group II PLA2 and a biochemically and immunochemically form distinct from group I, group II, and cytosolic PLA2. Increased lung PLA2 activity may be important for the pathophysiology of ARDS.

Adult

Pulmonary function of haplotype-matched and mismatched allografts in dogs treated with total-body irradiation, autologous marrow transplantation, methotrexate, and donor blood.

Seven beagle recipients surviving 2-11 years after allotransplantation of a left lung were available for study of pulmonary function. Significant reductions of ventilation and perfusion to the transplanted lung were documented by radionuclide scanning. These reductions in function were well-matched, however, and allowed relatively normal gas exchange, as measured by VD/VT, arterial PO2 and shunt fraction. The vasoconstrictor response of the transplanted lung to both hypoxia and stellate ganglion stimulation was comparable to that of the native lung. An abnormal rise in graft pulmonary vascular resistance and fall in PaO2 when the normal lung was made hypoxic suggest an inability of the transplanted lung to vasodilate and recruit blood vessels normally in response to increased blood flow. The animals were sacrificed at the conclusion of the pulmonary function testing. Pathologic study of the transplanted lungs showed minimal changes of rejection in spite of the fact that these recipient animals received no immunotherapy after the second posttransplant week.

Animals

Ibuprofen prevents synthetic smoke-induced pulmonary edema.

Multiple potentially injurious agents are present in smoke but the importance of each of these agents in producing lung injury as well as the mechanisms by which the lung injury is produced are unknown. In order to study smoke inhalation injury, we developed a synthetic smoke composed of a carrier of hot carbon particles of known size to which a single known common toxic agent in smoke, in this case HCI, could be added. We then exposed rats to the smoke, assayed their blood for the metabolites of thromboxane and prostacyclin, and intervened shortly after smoke with the cyclooxygenase inhibitors indomethacin or ibuprofen to see if the resulting lung injury could be prevented. Smoke exposure produced mild pulmonary edema after 6 h with a wet-to-dry weight ratio of 5.6 +/- 0.2 SEM (n = 11) compared with the non-smoke-exposed control animals with a wet-to-dry weight ratio of 4.3 +/- 0.2 (n = 12), p less than 0.001. Thromboxane B, and 6-keto-prostaglandin F1 alpha rose to 1,660 +/- 250 pg/ml (p less than 0.01) and to 600 +/- 100 pg/ml (p greater than 0.1), respectively, in the smoke-injured animals compared with 770 +/- 150 pg/ml and 400 +/- 100 pg/ml in the non-smoke-exposed control animals. Indomethacin (n = 11) blocked the increase in both thromboxane and prostacyclin metabolites but failed to prevent lung edema.(ABSTRACT TRUNCATED AT 250 WORDS)

6-Ketoprostaglandin F1 alpha

Regional lung function evaluation with nitrogen-13.

Regional ventilation and perfusion studies are routinely performed with molecular nitrogen-13 (a short-lived positron emitter), a multicrystal positron camera, and a computer. These studies have the advantage of viewing with equal sensitivity all sections of the lung simultaneously. Nitrogen-13 is less soluble than xenon in blood and therefore allows more accurate ventilation imaging. The short half-life of the radiopharmaceutical allows simultaneous ventilation and perfusion scintigraphy of the lung. Unlike other imaging techniques in which the residual radioactivity persists in the lung for hours, nitrogen-13 is rapidly cleared allowing repetitive imaging. Ventilation and perfusion studies are part of the routine preoperative evaluation for lung cancer resection or for bullectomy in patients with chronic obstructive pulmonary disease and for assessment of pulmonary emboli in the presence of chronic obstructive disease.

Adult

N13-N2(1).

13N when coupled with a positron camera allows excellent quantification and imaging of regional lung function. The studies can be readily repeated since the half-life of the 13N is uncer 10 min and the radiation dose to the patient with each study is low. The very low solubility of 13N not only enhances lung imaging but reduces total body radiation by remaining confined to the lung.

Adolescent

Three-dimensional reconstruction of lung perfusion image with positron detection.

Transverse section images of the distribution of pulmonary perfusion in a canine have been obtained using microspheres labeled with the positron-emitting isotope 68Ga and a three-dimensional reconstruction technique. The reconstruction method is more accurate than conventional tomographic procedures and is facilitated by the use of positron detection. The transverse sections presented demonstrate the capacity of the technique to delineate reduction in regional perfusion resulting from occlusion of the artery to the left lower lobe.

Animals

Venovenous bypass with a membrane lung to support bilateral lung lavage.

Partial venovenous cardiopulmonary bypass with a membrane oxygenator was used to exchange respiratory gases during and after bilateral lung lavage in a patient with severe hypoxemia caused by pulmonary alveolar proteinosis. The patient was unable to tolerate an attempt at lung lavage without bypass. Therefore, extracorporeal perfusion safely supported the patient's respiration for 32 hours, buying time to lavage each lung separately and to enable sufficient recovery of transpulmonary gas exchanging capacity.

Cardiopulmonary Bypass