Radiography for ankle injuries.
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Biomedical subjects
Publications and source records attributed to J F Waller.
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An alternative approach to anaesthesia of the forefoot is described whereby injections were performed at the midtarsal level rather than above the ankle joint as previously advocated. The technique provided complete forefoot anaesthesia, and was considered easier and less cumbersome to perform. Ankle tourniquet pain was not observed.
The effects on heart rate, blood pressure and pulmonary function of single oral doses of prizidilol hydrochloride (400 mg SK&F 92657) and propranolol (40 mg) were compared with placebo in nine healthy volunteers, in a double blind crossover study. Prizidilol had no effect on heart rate while propranolol caused a significant reduction compared with placebo. Diastolic blood pressure was lowered to the same extent by both prizidilol and propranolol. Propranolol significantly reduced the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and the maximal expiratory flow at 50% vital capacity (MEF 50). Prizidilol had no effect on flow-volume loop parameters. Effective pulmonary blood flow was not altered by propranolol, but it was significantly increased by prizidilol. Oral prizidilol exerts its hypotensive effect by vasodilatation without reflex tachycardia. It does not cause airways obstruction in healthy subjects.
In an effect to determine how far inspired air could penetrate into the respiratory tract before being brought to body conditions, we measured the temperature in the airways of the anterior basilar segment of the right lower lobe in five normal subjects while they breathed air at subfreezing and ambient conditions. During quiet breathing, most of the heating of the incoming gas took place in the upper airways as expected. However, as the thermal burden was increased by rapid inspirations, frigid air, and hyperventilation, the temperature of the distal airways progressively fell and the point at which the incoming air reached body conditions moved deep into the periphery of the lung. These findings demonstrate that heat and water transfer is not localized to one region, but rather is a continuous process that begins the moment the air enters the body and involves as much of the respiratory tract as necessary to complete the task.
The effect of inhaled or oral terbutaline on the subsequent response to inhaled terbutaline was studied using a double-blind cross-over technique in 12 asthmatic patients. 12 indices of respiratory function were obtained from the maximal flow-volume loop and a single-breath inert gas technique. These were used to evaluate the effect and to attempt to distinguish the site of action of the drug. Although the initial dose of inhaled terbutaline had a greater immediate effect than its oral counterpart there were no significant differences in the response to subsequently inhaled terbutaline. These findings do not support recent suggestions that oral administration has a greater effect on distal airways or promotes the effects of inhaled bronchodilators.
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