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Biomedical subjects

G A Graham

Publications and source records attributed to G A Graham.

14 recordsLinked to original sources

Autonomic physiological data associated with simulator discomfort.

A physiological monitoring capability was developed for the Army's Crew Station Research and Development Facility (CSRDF), a research simulator for advanced rotorcraft. Preliminary physiological data are reported from studies of simulator-induced sickness. Our objective was to demonstrate sensitivity of physiological measures relative to self-reports of simulator sickness severity. The data suggested that heart period, tachygastria, and skin conductance level were more sensitive to simulator sickness than were vagal tone and normal myoelectrical gastric activity.

Aerospace Medicine↗

The clinical chemistry and immunology of long-duration space missions.

Clinical laboratory diagnostic capabilities are needed to guide health and medical care of astronauts during long-duration space missions. Clinical laboratory diagnostics, as defined for medical care on Earth, offers a model for space capabilities. Interpretation of laboratory results for health and medical care of humans in space requires knowledge of specific physiological adaptations that occur, primarily because of the absence of gravity, and how these adaptations affect reference values. Limited data from American and Russian missions have indicated shifts of intra- and extracellular fluids and electrolytes, changes in hormone concentrations related to fluid shifts and stresses of the missions, reductions in bone and muscle mass, and a blunting of the cellular immune response. These changes could increase susceptibility to space-related illness or injury during a mission and after return to Earth. We review physiological adaptations and the risk of medical problems that occur during space missions. We describe the need for laboratory diagnostics as a part of health and medical care in space, and how this capability might be delivered.

Aerospace Medicine↗

Preliminary evaluation of an experimental clinical chemistry analyzer developed for space medicine.

An experimental clinical chemistry analyzer system was designed and built to demonstrate the feasibility of clinical chemistry as part of a medical-care system at NASA's planned space station Freedom. We report the performance of the experimental analyzer, called a medical development unit (MDU), for selected analytes in a laboratory setting in preparation for a preliminary clinical trial at patients' bedsides in an intensive-care unit. Within-run CVs ranged from 0.7% for sodium to 7.1% for phosphorus; day-to-day CVs ranged from 1.0% for chloride to 23.4% for calcium. Correlation of patients' blood sample analyses compared well with those by Ektachem E700 and other high-volume central laboratory analyzers (r ranged from 0.933 for creatine kinase MB isoenzyme to 0.997 for potassium), except for hemoglobin (r = 0.901) and calcium (r = 0.823). Although several CVs obtained in this study exceeded theoretical desired precision limits based on biological variations, performance was adequate for clinical laboratory diagnosis. We examined the effect of potentially interfering concentrations of hemoglobin, bilirubin, and lipids: the only effect was negative interference with calcium analyses by high concentrations of bilirubin. We also examined the effects of preanalytical variables and the performance of experimental sample-transfer cups designed to retain sample and reference liquid in microgravity. Continued development of the MDU system is recommended, especially automation of sample processing.

Aerospace Medicine↗

Systemic and regional hemodynamic effects of 1,25-dihydroxyvitamin D3 administration.

OBJECTIVE: To evaluate the cardiovascular effects of 1,25-dihydroxyvitamin D3 (1,25-D). DESIGN: Recent studies suggest that Ca-regulating hormones may contribute to the genesis of hypertension. We determined systemic and regional hemodynamics 24 h after administration of 1,25-D or vehicle to normal conscious Sprague-Dawley rats. In addition, to dissociate the vascular effects of 1,25-D from changes in serum ionized Ca2+, 1,25-D and vehicle were administered to rats maintained for 3 days on a low-Ca diet. To evaluate the effect of the slight rise in serum ionized Ca2+ with 1,25-D administration, we infused CaCl or vehicle over 1 h into normal rats to raise the serum Ca2+ to near that of rats treated with 1,25-D. METHODS: The radioactive microsphere technique was used. RESULTS: Systemic hemodynamics (blood pressure, heart rate, cardiac output, total peripheral resistance and stroke volume) did not differ between the two groups receiving a normal-Ca diet. In these rats 1,25-D significantly decreased renal blood flow (RBF), increased renal vascular resistance (RVR) and slightly increased serum ionized Ca2+. Similarly, in rats receiving a low-Ca diet, 1,25-D administration decreased renal blood flow, increased renal vascular resistance and caused only a minimal increase in serum ionized Ca2+. A low-Ca diet also increased heart rate, cardiac blood flow and renal blood flow. Although CaCl infusion raised serum ionized Ca2+, blood pressure, renal blood flow and renal vascular resistance did not change significantly. CONCLUSION: 1,25-D may constrict the renal vasculature directly or indirectly by enhancing the vascular sensitivity to circulating vasoconstrictors.

Animals↗

Effects of calcium channel blockade on calcium homeostasis in mild to moderate essential hypertension.

Calcium channel blockers may alter parathyroid hormone secretion in vitro, which would alter calcium homeostasis. To determine the chronic effect of calcium channel blockade in vivo, we conducted a randomized, double blind, 16 week study comparing the effects of two pharmacologic antihypertensive agents, the calcium channel blocker diltiazem and the angiotensin-converting enzyme inhibitor captopril on parameters of calcium homeostasis. Both diltiazem and captopril lowered blood pressure to a similar degree. Neither drug produced any significant change in blood levels of total and ionized calcium, magnesium, or phosphorus, which affect the regulation of parathyroid hormone and vitamin D. In addition, at eight or 16 weeks following initiation, neither drug altered the serum levels of parathyroid hormone (PTH) or 1,25-(OH)2-vitamin D3 (1,25-D). Chronic calcium channel blockade with diltiazem does not alter serum parameters of calcium homeostasis and, thus, should not affect bone mineralization.

Adult↗

Effect of dietary calcium supplementation on blood pressure and calciotropic hormones in mineralocorticoid-salt hypertension.

In order to determine the effect of dietary calcium supplementation on blood pressure and calciotropic hormones, we studied two groups (n = 12 each) of mineralocorticoid [deoxycorticosterone (DOC)]-salt hypertensive rats, one receiving a normal-calcium diet (0.6% calcium, as calcium carbonate) and the other a high-calcium diet (2.5% calcium), over an 8-week period. Dietary calcium supplementation significantly attenuated the rise in blood pressure. Serum ionized calcium concentrations were significantly decreased from baseline levels in both groups but tended to be higher among the calcium-supplemented rats. Serum concentrations of parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D3 (1,25-D) were significantly higher in the DOC-salt rats than in normotensive rats fed normal rat chow [PTH: 49 +/- 4 versus 15 +/- 0.9 pg/ml (means +/- s.e.m.); 1,25-D: 108 +/- 7 versus 73 +/- 13 pg/ml, in DOC-salt and normotensive rats, respectively]. In the DOC-salt rats, dietary calcium supplementation did not significantly lower the elevated serum concentration of PTH (from 49 +/- 4 to 40 +/- 4 pg/ml; NS), but did significantly reduce that of 1,25-D (from 108 +/- 7 to 66 +/- 8 pg/ml; P less than 0.01). Since 1,25-D may increase vascular smooth muscle calcium uptake, dietary calcium supplementation may lower blood pressure in DOC-salt hypertension, in part, by suppressing 1,25-D.

Animals↗

Clinically useful limits (CUL) criteria as a basis for quality control including minimal and optimal goals for quality control.

Quality control goals for quantitative clinical chemistry assays are reviewed. Recommendations for clinically useful limits (CUL) criteria as minimally acceptable +/- 2 SD for run-to-run and/or day-to-day technical reliability are presented in terms of biologic variations for different levels and clinical applications. A review of the literature and the questionnaire response of a medical school staff presented in this study reveal striking agreement of acceptable analytic goals based on physicians' opinions, biologic variation, and practical analytic feasibility. The current state-of-the-art in clinical laboratories can approach excellence because actual within-laboratory 2-SD variability estimates are somewhere between acceptable CUL criteria and twice as good. Assessing the reliability of laboratory reports based on accuracy and precision or total analytic error is also discussed.

Blood Chemical Analysis↗

Systemic and regional hemodynamic effects of dietary calcium supplementation in mineralocorticoid hypertension.

This study was undertaken to determine the systemic and regional hemodynamic effects of long-term dietary calcium supplementation in mineralocorticoid (DOC)-salt hypertension. Systemic and regional hemodynamic measurements were determined by the radioactive microsphere technique in conscious and unrestrained rats (kidneys intact) with DOC-salt-induced hypertension that were pair-fed either a normal calcium (0.6% by weight, n = 12) or a calcium-supplemented (high-calcium) diet (2.5% by weight, n = 12). After 7 to 8 weeks, there were no differences in weight, heart rate, or cardiac output between the two groups. In contrast, the high-calcium rats had a significantly lower mean blood pressure (125 +/- 4 mm Hg, mean +/- SEM) than the normal calcium rats (143 +/- 5 mm Hg); this finding appeared to result predominantly from a reduction in total peripheral resistance. The high-calcium rats had a higher renal blood flow (7.8 +/- 0.5% vs. 6.2 +/- 0.4% cardiac output; p less than 0.05) and lower renal (14.3 +/- 1 vs. 19.3 +/- 2 mm Hg/min/ml/g tissue; p less than 0.05) and jejunal vascular resistance than did the normal calcium rats. Two additional identical groups of normal calcium-and high-calcium-DOC-salt rats (n = 12 each) were also studied. In these rats, serum-ionized calcium decreased significantly (p less than 0.05) from baseline in both groups. Urinary sodium increased in both groups but did not differ significantly. In conclusion, dietary calcium supplementation attenuates the rise in peripheral vascular resistance that accompanies DOC-salt hypertension. This attenuated resistance appears to be relatively selective and is noted particularly in the renal vasculature.

Animals↗

Applicability of the Ektachem 400 analyzer for assaying analytes in miscellaneous body fluids.

The Ektachem analyzer, a slide-film chemistry technology, demonstrated applicability to non-serum, non-urine stimulated and actual clinical specimens having a wide range of protein concentration and pH. The simulated specimens studied had pH and protein that ranged from 2 to 9 and 0 to 88 g/L, respectively. Actual patients' specimens studied, which had protein concentrations ranging from 0.1 to 60 g/L, included peritoneal fluid, vitreous fluid, synovial fluid, pericardial fluid, and cerebrospinal fluid. The analytes studied included glucose, urea nitrogen, uric acid, creatinine, calcium, phosphorus, sodium, potassium, chloride, and carbon dioxide.

Autoanalysis↗

Interference by IgG paraproteins in the Jaffe method for creatinine determination.

A large (60-100%) negative interference in serum creatinine value of some (3 of 18 myeloma patients, all with monoclonal gammopathy of IgG type, was observed on several instruments that determine creatinine by the Jaffe reaction. No interference was observed in an enzymatic method. Serum electrophoresis showed a monoclonal band in all three samples. The interferent could be removed by acid precipitation or dithiothreitol preincubation, and partially isolated in the high molecular weight dialyzate from the serum. It was demonstrated that the interferent is not albumin or normal gammaglobulin. Kinetic analysis of the Jaffe reaction showed large initial decreases in absorbance, in agreement with the corresponding creatinine results. It is suggested that some monoclonal IgGs may react with the Jaffe picrate reagent, resulting in a false lowering of serum creatinine values.

Blood Protein Electrophoresis↗

Hyperbaric oxygen treatment of mandibular osteomyelitis in osteopetrosis.

A patient was successfully treated with hyperbaric oxygen for chronic osteomyelitis of the mandible associated with osteopetrosis. This mode of therapy appears to have a definite place in the management of such patients. There was no clinical, radiographic, or laboratory evidence that the osteopetrosis was made worse by the hyperbaric oxygen.

Female↗