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L W Chosy

Publications and source records attributed to L W Chosy.

10 recordsLinked to original sources

Increased alveolar macrophage chemiluminescence and airspace cell superoxide production in active pulmonary sarcoidosis.

Alveolar macrophages (AMs) and lymphocytes are activated in pulmonary sarcoidosis. Mediators from these cells are potentially important in the pathophysiology and pathogenesis of this disease. To determine whether the enhanced release of reactive oxygen species (ROS) participates in inflammatory events in sarcoidosis, and to explore the relationship between ROS release and clinical parameters, we studied ROS metabolism of AMs and other airspace cells by luminol-enhanced chemiluminescence and by direct biochemical measurement of superoxide anion production. Ten of 17 patients with sarcoidosis were prospectively found to have active disease by objective radiographic, functional, and laboratory criteria. In these subjects, ROS metabolism by AMs was significantly enhanced compared either with healthy control subjects or with patients with inactive sarcoidosis. Abnormalities in ROS metabolism were not seen in peripheral blood monocytes, suggesting that this increased metabolic activity is compartmentalized to the lung. Enhanced ROS metabolism by AMs was associated with recent adverse chest radiographic changes, recent decline in forced vital capacity, and more advanced radiographic type. These data support the hypothesis that ROS generated by airspace cells can promote parenchymal inflammation in sarcoidosis, are associated with physiologic and radiologic changes, and may thereby contribute to the pathogenesis of sarcoidosis.

Adult↗

Role of cerebrospinal fluid [H+] in ventilatory deacclimatization from chronic hypoxia.

Once ventilatory acclimatization begins in sea level residents sojourning at high altitude, abrupt restoration of normal oxygen tensions will not restore ventilation to normal. We have investigated the role of cerebrospinal fluid (CSF) [H(+)] in this sustained hyperventilation by measuring CSF acid-base status in seven men (lumbar) and five ponies (cisternal) in normoxia, first at sea level and then periodically over 13-24 h of "deacclimatization" after 3-5 d in hypoxia (P(B) = 440 mm Hg). After 1 h deacclimatization, hyperventilation continued at a level only slightly less than that obtained in chronic hypoxia (+1-2 mm Hg Pa(CO2)), whereas CSF pH was either equal (in man) or alkaline (in pony, +0.02, P < 0.01) to sea level values. Between 1 and 12-13 h deacclimatization in all humans and ponies Va fell progressively (Pa(CO2) increased 4-7 mm Hg) and CSF pH became increasingly more acid (-0.02 to -0.05, P < 0.01). Between 12 and 24 h of normoxic deacclimatization in ponies, Pa(CO2) rose further toward normal, coincident with an increasing acidity in CSF (-0.02 pH). Similar negative correlations were found between changes in arterial pH and Va throughout normoxic deacclimatization. We conclude that [H(+)] in the lumbar or cisternal CSF is not the mediator of the continued hyperventilation and its gradual dissipation with time during normoxic deacclimatization from chronic hypoxia. These negative relationships of Va to CSF [H(+)] in normoxia are analogous to those previously shown during acclimatization to hypoxia.

Acclimatization↗

HbO2 dissociation in man during prolonged work in chronic hypoxia.

In healthy human sojourners to 3,100 m we studied exercise-induced shifts in HbO2 dissociation: their regulation in femoral venous blood and their net effect on estimated capillary PO2 (PC-O2) in working skeletal muscle. Prolonged heavy work effected an increase of 10.3 plus or minus 0.9 mmHg in in vivo P50 (7.30 PH-v, 41 degrees C-v, and 45 Pv-CO2); due entirely to the additive effects of increased venous temperature and [H+]. The rightward curve shift during work at 3,000 m, compared to that at 250 m, produced a similar increase in in vivo P50 but a reduced net effect on PC-O2, because Cv-02 at 3,100 m was reduced similar to 2 ml/100 ml to the lower converging portions of the curve. The lower Cv-O2 (and Pv-O2) at 3,100 M was attributable to a small decrease in total systemic blood flow. The net effect of the rightward curve shift during exercise on mean to end-capillary PO2 was positive in most cases (+1 to +8 mmHg PCO2). However, it was shown that the levels of mean to end-capillary PO2 (28-13 mmHg), which would have been obtained during exercise in the absence of any rightward curve shift, were more than adequate to sustain a steady state of aerobic energy production in working skeletal muscle. These data do not support the concept of a significant contribution to oxygen delivery to working skeletal muscle from in vivo shifts in HbO2 dissociation, during either acclimatization to high altitude or during prolonged muscular work.

Acclimatization↗

Incomplete compensation of CSF [H+] in man during acclimatization to high altitude (48300 M).

This study has assessed the regulation of arterial blood and cerebrospinal fluid acid-base status in seven healthy men, at 250 m altitude and after 5 and 10-11 days sojourn at 4,300 m altitude (PaO2 = 39 mmHg day 1 to 48 mmHg day 11). We assumed that observed changes in lumbar spinal fluid acid-base status paralleled those in cisternal CSF, under these relatively steady-state conditions. Ventilatory acclimatization during the sojourn (-14 mmHg PaCO2 at day 11) was accompanied by: 1) reductions in [HCO3-] (-5 to -7 meq/1) which were similar in arterial blood and CSF; 2) substantial, yet incomplete, compensation (70-75%) of both CSF and blood pH; and 3) a level of CSF pH which was maintained significantly alkaline (+0.05 +/- 0.01) to normoxic control values. These data at 4,300 m confirmed and extended our previous findings for more moderate conditions of chronic hypoxia. It was postulated that the magnitude and time course of pH compensation in the CSF during chronic hypoxia and/or hypocapnia are determined by corresponding changes in plasma [HCO2-].

Acclimatization↗

Respiratory tract disease from thermosetting resins. Study of an outbreak in rubber tire workers.

An outbreak of upper and lower respiratory tract inflammatory disease and conjunctivitis among synthetic rubber tire workers occurred. The outbreak began after the introduction of a new thermosetting resin, containing resorcinol and a trimere of methylene aminoacetronitrile, into the rubber tire carcass stock formulation. Two hundred ten workers were affected. Characteristically, symptoms improved during periods of sick leave or vacation, recurring upon the workers' return to the plant. Chest radiograms disclosed pneumonic infiltrates in about one fourth of the cases. Pulmonary function studies detected abnormal airways dynamics as well as abnormal diffusing capacity in more than one third of the workers tested. Lung biopsy showed evidence of focal interstitial fibrosis and peribronchiolar and perivascular chronic inflammatory reaction. The illness was ascribed to volatile products released during the manufacture of synthetic rubber tires. The exact chemical nature of these products is unknown.

Adult↗