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Biomedical subjects

K Goodman

Publications and source records attributed to K Goodman.

10 recordsLinked to original sources

Hemodynamic changes after nafcillin administration during coronary artery bypass surgery.

The hemodynamic response to nafcillin administration was studied in 45 patients with good left ventricular function and no known history of hypersensitivity to penicillin during coronary artery bypass grafting (CABG). Group I (15 patients) received 1 gram of nafcillin in 10 mL of saline as an intravenous (IV) bolus, group II (15 patients) received 1 gram of nafcillin in 50 mL of saline as a slow IV infusion over 15 minutes, and group III (15 patients) did not receive nafcillin. Hemodynamic variables and plasma histamine and catecholamine levels were measured before and after nafcillin administration, after 500 mg of CaCl2, and after 0.1 mg of phenylephrine. Bolus nafcillin administration produced profound hypotension secondary to vasodilatation with significant increases in cardiac index and decreases in systemic and pulmonary vascular resistances. Cardiac index increased from 3.15 +/- 0.3 L/min/m2 to 5.75 +/- 0.25 L/min/m2 (P less than 0.005) one minute after nafcillin administration, and remained at 5.1 +/- 0.35 L/min/m2 after administration of CaCl2 (P less than 0.005). All hemodynamic parameters returned toward control values after administration of 0.1 mg of phenylephrine, IV. Plasma epinephrine, norepinephrine, and histamine levels increased more than 100%. In group II, cardiac index increased, while systemic and pulmonary vascular resistances and mean arterial pressure decreased. However, these changes were less significant than those found in group I.(ABSTRACT TRUNCATED AT 250 WORDS)

Blood Pressure

Radiographic measures of hyperinflation in clinical emphysema. Discrimination of patients from controls and relationship to physiologic and mechanical lung function.

In a retrospective study we investigated the accuracy of radiographic measurements of hyperinflation in distinguishing a sample of patients with a clinical diagnosis of pulmonary emphysema (n = 44) from a sample of age- and sex-matched control subjects (n = 39). The relationship of the hyperinflation parameters to pulmonary function test results (PFTs) and arterial blood gas measurements (ABGs) in the emphysema patients was also examined. The radiographic measurements were diaphragmatic angle of depression, lung height, lung width, heart size, diaphragm level, radiographic total lung capacity (TLC), and size of the retrosternal air space. By discriminant function analysis, the best contributors to the function were lung height and diaphragmatic angle of depression, followed by radiographic TLC and heart size. The derived classification rule had a diagnostic accuracy of 88 percent. The radiographic measures, largely independent of one another, showed moderate correlations with percentage PFTs, ABGs, portable percentage spirometric studies, height, and weight. High correlations were found between several of the radiographic measurements and the PFTs that represent actual static lung volumes. The correlation between radiographically measured TLC and PFT TLC measured by the helium dilution technique was .90.

Female

Hemodynamic changes after the administration of protamine.

Hemodynamic changes associated with the administration of protamine were studied in 30 dogs divided into three equal groups. Protamine (1 mg X kg-1 X min-1 for 4 min) was administered 10 min after 4 mg X hg-1 heparin was given via a left atrial (LA) line in group A, via a central vein in group B, and via a peripheral vein in group C. Protamine given through the central venous pressure (CVP) line resulted in an immediate and significant decrease in mean arterial pressure (MAP) to 60 +/- 4.5 mm Hg (P less than 0.025) from 72 +/- 7 mm Hg immediately after the protamine and to 58 +/- 5 mm Hg (P less than 0.025) 5 min later and with an increase in cardiac index (CI) to 3.7 +/- 0.3 L X min-1 X m-2 from 2.8 +/- .25 L X min-1 X m-2 immediately after the protamine (P less than 0.005), followed by a decrease back to 2.7 +/- 0.3 L X min-1 X m-2 5 min later. Mean arterial pressure and CI remained unchanged after administration of protamine via the peripheral vein or the left atrium. Systemic vascular resistance (SVR) decreased significantly only after administration of protamine via the CVP and was statistically unchanged when administered via the peripheral and LA line. Plasma histamine levels increased significantly after administration of protamine through the central line but remained unchanged after administration via a peripheral vein or the left atrium.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Neurosonographic recognition of subependymal cysts in high-risk neonates.

Serial neurosonography was performed in 210 high-risk, preterm neonates. Eleven (5.8%) demonstrated small cystic formations in the subependymal lining of the lateral ventricles. These subependymal cysts were unilateral and were detected at the exact site of a previous subependymal hemorrhage in two cases. These 11 infants were not significantly different in maturity, size, or clinical parameters from our main high-risk newborn population. Ten survivors had marked motor retardation at follow-up ages of 9-13 months, and one died from neonatal sepsis.

Brain Diseases

Pneumatosis intestinalis.

Pneumatosis intestinalis is a usually benign condition which may affect any segment of the gastrointestinal tract from the stomach to rectum. Occasionally, however, it may be a grave prognostic sign. This article presents the spectrum of diagnostic radiographic features of the entity with emphasis on differentiation of the underlying etiologic factors. Representative examples of pneumatosis intestinalis complicating various gastrointestinal disorders are illustrated.

Adult