High-frequency positive-pressure ventilation in management of a patient with bronchopleural fistula.
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Biomedical subjects
Publications and source records attributed to C Ray.
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A technique is described to perform multiple determinations of cardiac output; two 150 ml bottles of 5% dextrose in water, stored in identical conditions, are immersed in an ice slush, contained in a styrofoam cooler. Comparison of cardiac output determinations obtained with this technique and with multiple syringes indicates very close duplication of results. The technique is very inexpensive and allows one to follow patients for up to four hours with as many as 30 consecutive determinations of cardiac output.
Interference observed in the Stroop color-word task is influenced by various characteristics of the words employed. 38 students in their final year, approaching examinations, were asked to name the colors of words associated with this theme. These words produced greater delay than a control set, and those students who were most anxious about the examinations experienced most interference. This effect might be more generally employed in stress research, providing a performance-based index of reaction to issues or situations which are potential sources of anxiety.
The diffusional water permeability of collecting ducts in vitro and the cyclic A.M.P. content of isolated papillae were measured after exposure to different concentrations of antidiuretic hormone, isoproterenol and noradrenalin. Antidiuretic hormone 25 mu units/ml. caused a 25% increase in diffusional water permeability. This response was not affected by isoproterenol (10(-6) M) or noradrenalin (2 x 10(-6) M). Antidiuretic hormone 100 mu unit ml-1 caused a 50% increase in diffusional water permeability which likewise was not altered by isoproterenol or noradrenalin. Isoproterenol (10(-6) M) and noradrenalin (2 x 10(-6) M) had no significant effect on basal levels of diffusional water permeability. Isoproterenol had no significant effect on the tissue concentration of cyclic A.M.P. concentration induced by antidiuretic hormone. Noradrenalin (2 x 10(-6) and 10(-4)) had no significant effect on basal cyclic A.M.P. concentration. However, noradrenalin inhibited the stimulation of cyclic A.M.P. induced by antidiuretic hormone. This effect was inhibited by phentolamine. This study suggests that catecholamines do not alter water handling by a direct action on the water permeability of the kidney but probably exert their action through an effect of A.D.H. release.
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Respiratory failure of different origins often requires therapy with mechanical ventilation and positive end-expiratory pressure (PEEP). These supports are occasionally inadequate if the damage to one lung is significantly more pronounced than that to the other lung. Technical means exist to ventilate each lung independently or to provide a different PEEP to each lung. The findings from nine patients in whom one of these techniques was applied are presented, and advantages and disadvantages are discussed.
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The adjustment of a group of mastectomy patients to their operation was assessed at an interval of between 18 months and 5 years after surgery. They were found to be significantly more depressed and anxious than a control group of cholecystectomy patients; they tended to have lower self-esteem; and they described themselves as being more introverted in their behaviour. These differences were attributed to concern about both the loss of the breast and the possibility of recurrence of the cancer.
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The effect of the antifungal drugs amphotericin B, fluocytosine, miconazole, griseofulvin, and nystatin on the chemotactic responsiveness of human neutrophils was studied. Amphotericin B in a concentration of 2 mug/ml inhibited chemotatic responsiveness, and in a concentration of 5 mug/ml it also inhibited chemiluminescence. The inhibition of chemotaxis could be reversed by washing the cells. The other antifungal drugs did not inhibit chemotaxis even in concentrations much higher than those obtained in human serum during treatment.
Fifteen patients with chronic renal failure had depressed neutrophil chemotactic responsiveness following several hemodialysis treatments. The chemotactic index (C.I.) of these patients was 12.7+/-6.4 as compared with 72.8+/-22.7 for controls (p less than 0.001). Patients with chronic renal failure, not on hemodialysis, had only mildly depressed neutrophil chemotactic responsiveness (42.3+/-15;p less than 0.01). Thus, hemodialysis impairs neutrophil function and may contribute to the increased risk of infection in uremic patients. Chemotactic responsiveness returned to normal in three patients following renal transplantation.
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