PubMed Health⌕ Search

Biomedical subjects

J B Karlinsky

Publications and source records attributed to J B Karlinsky.

22 records · Page 2Linked to original sources
PubMed1976

In vitro effects of elastase and collagenase on mechanical properties of hamster lungs.

A previous study of hamsters, 21 days after intratracheal treatment with pancreatic elastase, showed development of emphysema, shift of the volume-pressure curve up an to the left, with both air and saline filling, and increase in quasistatic lung compliance. There was also a striking increase in vital capacity and lung volume at transpulmonary pressure of 25 cm H2O (TLC25); however, 21 days after collagenase treatment, there was only a slight increase in TLC25. The lung volume changes were not consistent with the theory that the collagen fiber network is responsible for limiting distension of the lung. This report considers saline-filled volume-pressure curves studied in excised hamster lungs after incubation with endotracheally instilled pancreatic elastase or clostridial collagenase solutions. Fluid retained in the lungs after the first infusion-withdrawal cycle was significantly greater in lungs treated with elastase than in lungs treated with collagenase or in control lungs. Total fluid volume at full inflation was similar in the 3 groups. Chord compliance of lungs treated with collagenase was greater at high volume range than that in lungs treated with elastase or control lungs; chord compliance of elastase-treated lungs was higher at mid-volume range than that of collagenase-treated or control lungs. The results of these in vitro studies are consistent with the theory of independently functioning elastic and collagen fiber networks, with the latter limiting lung distensibility at high volumes, and the former providing great extensibility at low volumes. Events that are part of the repair process after elastase injury may result in a change in the orientation of collagen in alveolar tissue and appear to account for the differing effects of in vivo and in vitro elastase treatment on the static mechanical properties of the lungs.

Animals↗
PubMedDate not supplied

Differences in outpatient corticosteroid prescribing patterns between attending and house staff physicians as an indicator of the quality of supervision.

Computerized information systems have become an indispensable source of quality improvement data in the healthcare field. The degree to which we are successful in using these systems is limited only by our ability to ask the right questions. In this study, computerized patient records were used to evaluate the uniformity in the prescribing patterns for oral corticosteroids among house staff and attending physicians as a measure of the adequacy of resident supervision in the outpatient setting. Retrospective analysis of the records of 771 outpatients receiving prescriptions for oral corticosteroid preparations over 1 year in a large tertiary-care university-affiliated Department of Veterans Affairs Medical Center indicated different prescribing patterns for attending physicians and house staff. Additionally, it was noted that house staff tended to manage more complex patients than did attending physicians. We further evaluated the clinical outcomes of these patients to assess the quality, appropriateness, and comparability of care within cohorts of patients and to determine the degree to which resident supervision may have affected outcomes. The study results suggest that there is an opportunity to improve the management of patients treated with oral corticosteroid therapy by increasing staff physician involvement either through direct care of the most complex cases or through enhanced resident supervision.

Administration, Oral↗