PubMed Health⌕ Search

Biomedical subjects

M Kraayenbrink

Publications and source records attributed to M Kraayenbrink.

4 recordsLinked to original sources
PubMed1997

Incidence and predictors of bulbar palsy after surgery for acoustic neuroma.

We present a retrospective review of the perioperative management and complications of 102 cases of acoustic neuroma operated on at an English teaching hospital over the last 9 years. Nine patients had a bulbar palsy postoperatively; five of those patients developed pulmonary complications. A bulbar palsy was more likely to occur in those with tumours > or = 3 cm. The occurrence of intraoperative bradycardias, present in nearly half of the bulbar palsy cases, did not help predict who would sustain this injury postoperatively. However, episodes of intraoperative hypotension served to better predict a bulbar palsy complication in conjunction with the presence of a large tumour. Post-operative airway management is an area of possible conflict of interest: the desire for early extubation to avoid the possibility of coughing and bucking on the endotracheal tube and the need to protect the airway of the patient with a lower cranial nerve deficit. Almost 10% of our patients did have such a deficit after surgery; and over half of them developed respiratory complications making this an important cause of postoperative morbidity. We recommend that the timing of extubation be judged on an individual basis for each patient. Those with tumours > or = 3 cm warrant particular concern. All patients should receive careful observation in a high dependency area for at least the first postoperative day.

Adult↗
PubMed1990

Mucus glycoproteins from 'normal' human tracheobronchial secretion.

Mucous secretions were collected from tracheas of patients undergoing minor surgery under general anaesthesia with tracheal intubation, and mucus glycoproteins were isolated by using isopycnic density-gradient centrifugation in CsCl/guanidinium chloride. 'Whole' mucins were excluded from a Sepharose CL-2B gel, whereas subunits obtained after reduction were included. Trypsin digestion of subunits afforded high-Mr glycopeptides (T-domains), which were further included in the gel. The latter fragments are heterogeneous and comprise two or three populations, as indicated by gel chromatography and ion-exchange h.p.l.c. Rate-zonal centrifugation showed that the 'whole' mucins are polydisperse in size, with a weight-average Mr of (14-16) x 10(6). The macromolecules were observed by electron microscopy, as linear and apparently flexible thread-like structures. Subunits and T-domains had weight-average contour lengths of 490 nm and 160 nm respectively. It is concluded that mucus glycoproteins are present in secretions from the healthy lower respiratory tract. The 'whole' tracheal mucins are assembled from subunits, which in turn can be fragmented into high-Mr glycopeptides corresponding to the oligosaccharide domains typically found in mucus glycoproteins. The size and macromolecular architecture of the tracheal mucins is thus similar to that observed for mucins from human cervical mucus, chronic bronchitic sputum and pig stomach, providing yet another example of this general design of these macromolecules, i.e. subunits assembled end-to-end into very large linear and flexible macromolecules.

Bronchi↗