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Biomedical subjects

N Peterson

Publications and source records attributed to N Peterson.

At least 19 recordsLinked to original sources
PubMed2000

o-raffinose cross-linked hemoglobin improves the hemostatic defect associated with anemia and thrombocytopenia in rabbits.

Several different preparations of cross-linked hemoglobin (CLHb) are being evaluated for their efficacy and safety as red cell substitutes in a variety of preclinical and clinical settings. Because CLHb is known to sequester nitric oxide (NO) and inhibit NO-mediated processes, we hypothesized that CLHb would have a hemostatic effect by enhancing platelet reactivity, inducing vasoconstriction, or both. Infusion of o-raffinose CLHb shortened the prolonged microvascular bleeding time and decreased blood loss from ear incisions in rabbits rendered anemic and thrombocytopenic. Moreover, this hemostatic effect persisted for at least 24 hours after infusion. Phenylephrine induced a degree of vasoconstriction similar to that induced by CLHb but did not shorten the bleeding time or decrease blood loss, suggesting that vasoconstriction alone cannot account for the hemostatic effect of CLHb. There was no evidence of CLHb-induced activation of coagulation in vivo, since infusion of CLHb did not increase circulating levels of thrombin-antithrombin complex. In vitro, CLHb abolished the inhibitory effect of the NO donor 3-morpholinosydnonimine on platelet aggregation and enhanced the aggregation of stimulated but not resting platelets. This potentiating effect was not attenuated by the addition of superoxide dismutase or catalase. To evaluate the potential arterial thrombogenicity of CLHb, a model of carotid artery thrombosis was developed in rabbits without thrombocytopenia or anemia. Compared with albumin infusion, CLHb infusion shortened the time to complete carotid occlusion. These data suggest that CLHb may shift the thromboregulatory balance toward clot formation, resulting in decreased bleeding in anemic and thrombocytopenic rabbits and possibly increasing arterial thrombogenicity in normal rabbits.

Adrenergic alpha-Agonists↗
PubMed1997

A comprehensive pediatric bereavement program: the patterns of your life.

The death of a child is one of the most painful experiences a parent can endure. Communicating and meeting the needs of parents during this time of crisis is a challenge for nurses. Pediatric intensive care unit and emergency department nurses who may feel overwhelmed and inadequate when working with grieving families, especially with a sudden and unexpected death, are assisted by "The Patterns of Your Life: A Comprehensive Pediatric Bereavement Program." The program is a blending of critical pathways (an element of managed care), educational resources, and family follow-up for 1 year. Preliminary evaluations indicate that the comprehensive bereavement program appears to have many benefits for families and health care staff alike.

Bereavement↗
PubMed1995

Crystal structure of a cross-reaction complex between Fab F9.13.7 and guinea fowl lysozyme.

The crystal structure of the complex between the cross-reacting antigen Guinea fowl lysozyme and the Fab from monoclonal antibody F9.13.7, raised against hen egg lysozyme, has been determined by x-ray diffraction to 3-A resolution. The antibody interacts with exposed residues of an alpha-helix and surrounding loops adjacent to the lysozyme active site cleft. The epitope of lysozyme bound by antibody F9.13.7 overlaps almost completely with that bound by antibody HyHEL10; the same 12 residues of the antigen interact with the two antibodies. The antibodies, however, have different combining sites with no sequence homology at any of their complementarity-determining regions and show a dissimilar pattern of cross-reactivity with heterologous antigens. Side chain mobility of epitope residues contributes to confer steric and electrostatic complementarity to differently shaped combining sites, allowing functional mimicry to occur. The capacity of two antibodies that have different fine specificities to bind the same area of the antigen emphasizes the operational character of the definition of an antigenic determinant. This example demonstrates that degenerate binding of the same structural motif does not require the existence of sequence homology or other chemical similarities between the different binding sites.

Amino Acid Sequence↗
PubMed1992

Desflurane does not produce hepatic or renal injury in human volunteers.

We examined the potential toxicity of desflurane in 13 young 25.0 +/- 2.3 (mean +/- SD) yr-old men, given 7.35 +/- 0.81 MAC-hours of desflurane anesthesia. Hepatic and renal function tests, serum electrolytes, and standard urine and hematologic tests were performed before, during, and after anesthesia. No toxicity was found. There were no changes in tests of hepatocellular integrity (plasma alanine transferase activity), synthetic function (serum albumin, prothrombin time, partial thromboplastin time), or renal function (serum creatinine concentration, blood urea nitrogen concentration). Decreases in red blood cell count, hematocrit, and blood hemoglobin concentration during and immediately after anesthesia were attributed to blood sampling and infusion of intravenous electrolyte solution. These values returned by 4 days after anesthesia to values not different from those before anesthesia. Increased white blood cell counts and blood glucose concentrations noted during anesthesia with other inhaled anesthetics were also seen in these volunteers. Desflurane appears to have no greater toxicity than currently used inhaled anesthetics and, because of its lesser metabolism, may have lesser or not toxicity.

Adult↗
PubMed1992

Isoflurane anesthesia prevents unconscious learning.

We investigated whether greater than or equal to 0.6 minimum alveolar concentration (MAC) of isoflurane suppresses learning of information presented verbally. Preoperatively, we asked 45 healthy patients (aged 23-58 yr) undergoing elective surgery 15 general knowledge questions designed to arouse their curiosity. They were told that they would be given the answers during anesthesia. Anesthesia was induced with isoflurane and nitrous oxide (25 subjects also received 1.1 +/- 0.6 mg/kg of propofol). The trachea was intubated with the aid of vecuronium (0.07 mg/kg IV). Isoflurane in oxygen was given to provide 0.6 MAC before and 1.0 and 1.4 MAC during surgery. After 10 min at each of two of the three MAC levels, the answers were given to five of the questions. At the remaining concentration, patients received a message to either touch an ear (n = 30) or keep their arms still (n = 15) during the postoperative interview. Twenty-four hours later, patients were asked whether they recalled intraoperative events. They were then asked to answer the 15 questions, choosing from five possible answers to each, one of which was correct. The number of times each patient touched an ear during this interview was noted. No patient consciously recalled events during anesthesia. The number of questions answered correctly postoperatively did not differ according to whether the answers had been provided during anesthesia (at any isoflurane concentration) or had not been provided (control questions). The number of ear-touches postoperatively did not differ between those who had and had not received the intraoperative message encouraging ear-touching.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Clinical characteristics of desflurane in surgical patients: minimum alveolar concentration.

Desflurane (formerly I-653) is a new inhalaticnal anesthetic with a promising pharmacokinetic profile that includes low solubility in blood and tissue, including fat. Since its lipid solubility is less than that of other volatile agents, it may have lower potency. Low solubility would be expected to increase the rate at which alveolar concentration approaches inspired concentration during induction as well as to increase the rate of elimination of desflurane from blood at emergence. We determined the minimum alveolar concentration (MAC) of desflurane in 44 unpremedicated ASA physical status 1 or 2 patients undergoing elective surgery. We prospectively studied four patient groups distinguished by age and anesthetic regimen: 18-30 versus 31-65 yr and desflurane in 60% N2O/40% O2 versus desflurane in O2. Anesthesia was induced with desflurane or desflurane in 60% N2O/40% O2. MAC was determined by a modification of Dixon's up-and-down method with increments of 0.5% desflurane. The MAC of desflurane in O2 was 7.25 +/- 0.0 (mean +/- SD) in the 18-30-yr age group, and 6.0 +/- 0.29 in the 31-65-yr group; the addition of 60% N2O reduced the MAC to 4.0 +/- 0.29 and 2.83 +/- 0.58, respectively. The median time from discontinuation of desflurane to an appropriate response to commands was 5.25 min. Desflurane appears to be a mild airway irritant but was well tolerated by all patients.

Adult↗
PubMed1991

Comparison of percutaneous losses of sevoflurane and isoflurane in humans.

We studied the percutaneous losses of sevoflurane and isoflurane during administration and elimination in seven healthy male volunteers. Anesthesia was induced and maintained with fentanyl, midazolam, and/or thiopental, and nitrous oxide for 30 min, after which 1% sevoflurane and 0.4% isoflurane in 65% nitrous oxide were administered for 30 min. Inspired, end-tidal, and mixed-expired gas samples were collected during administration and for 5-7 days of elimination. To measure percutaneous loss, each subject's arm was enclosed in a glass cylinder sealed at both ends and with two ports, one for flushing with nitrogen and one for obtaining gas samples during the 30 min of administration and the first 150 min of elimination. Anesthetic concentrations in all samples were determined using gas chromatography. The surface area of the arm was measured and the total surface area was calculated. During administration and elimination, percutaneous loss of isoflurane was significantly greater than that of sevoflurane (P less than 0.05). For both volatile agents, losses during elimination were greater than during administration (P less than 0.05), but even when combined, these losses were too small to affect kinetic or metabolic studies based on mass balance.

Adult↗
PubMed1991

Cardiovascular actions of desflurane with and without nitrous oxide during spontaneous ventilation in humans.

We investigated the cardiovascular actions of desflurane (formerly I-653) during spontaneous ventilation. We gave 0.8-0.9, 1.2-1.3, and 1.6-1.7 MAC desflurane in oxygen (n = 6) and in 60% nitrous oxide, balance oxygen (n = 6) to unmedicated healthy male volunteers. Both anesthetic regimens decreased ventilation, increased partial pressure of arterial carbon dioxide, and produced similar cardiovascular changes. In comparison with values obtained when the volunteers were conscious, desflurane anesthesia with spontaneous ventilation decreased systemic vascular resistance and mean arterial blood pressure. Cardiac index, heart rate, stroke volume index, and central venous blood pressure increased. Left ventricular ejection fraction increased at 0.83 MAC desflurane in oxygen, and otherwise did not differ from the conscious value. The velocity of ventricular circumferential fiber shortening, estimated by echocardiography, increased with desflurane in oxygen but did not change with desflurane in nitrous oxide. Oxygen consumption increased during desflurane and oxygen anesthesia, but not when nitrous oxide plus oxygen was the background gas. Desflurane increased oxygen transport, the ratio of oxygen transport to oxygen consumption, mixed venous partial pressure of oxygen, and oxyhemoglobin saturation. The cardiovascular changes with desflurane during spontaneous ventilation differ from those during controlled ventilation. With both background gases, spontaneous ventilation, in comparison with controlled ventilation, increased cardiac index, stroke volume, central venous pressure, left ventricular ejection fraction, velocity of circumferential fiber shortening, oxygen transport, and the ratio of oxygen transport to oxygen consumption but did not change mean arterial blood pressure except at 1.66 MAC desflurane in oxygen (when it was higher with spontaneous than with controlled ventilation).

Administration, Inhalation↗
PubMed1988

Pure primary testicular carcinoid: a case report and discussion.

We report a case of pure primary testicular carcinoid tumor and review the literature. Distinctions are emphasized among the 3 subgroups of testicular carcinoids and their clinical significance. Criteria to establish the diagnosis of pure primary testicular carcinoid are offered.

Adult↗
PubMed1988

Encephalitozoon cuniculi: quantitation of parasites and evaluation of viability.

Two methods (manual and automated) for quantitation of viable versus dead Encephalitozoon cuniculi are reported. The manual method uses ethidium bromide and acridine orange to stain dead and viable organisms, respectively. The stained organisms are visually differentiated with the aid of a fluorescence microscope. The automated method uses propidium iodide to stain dead parasites, which are differentiated from viable unstained parasites with the aid of a flow cytometer. An automated cell counter (Coulter Counter) was used to count rapidly large numbers of samples and to improve the sensitivity of counting low concentrations of parasites. These methods will enhance investigators' abilities to conduct quantitative experiments on host defense mechanisms against E. cuniculi.

Acridine Orange↗
PubMed1988

Dot enzyme-linked immunosorbent assay (dot ELISA) for antibodies to Encephalitozoon cuniculi.

A dot-ELISA procedure was developed to detect antibodies against Encephalitozoon cuniculi. Sera from 84 rabbits, 22 dogs, 18 squirrel monkeys and 200 mice were tested by dot-ELISA and most also were tested by immunofluorescence. Comparison of the two tests showed that there was excellent agreement of the results (Kappa values greater than or equal to 0.74) in all four species. Dot-ELISA is a simple, quantitative, rapid alternative to immunofluorescence when large numbers of serum samples must be evaluated.

Animals↗
PubMed1985

Preoperative laparoscopic localization of the nonpalpable testis.

Laparoscopic examination was performed successfully on 14 patients with 17 nonpalpable testes. The procedure was successful in determining the location in 16 of 17 nonpalpable testes, and this information was beneficial for selecting the subsequent operative approach. Laparoscopy was safe in the younger child (10 patients were 3 years old or less and 7 patients were less than 2 years old), and it added an insignificant increase in operative time.

Child, Preschool↗
PubMed1982

Diagnosis and treatment of retroperitoneal perforation complicating the double-contrast barium-enema examination.

A case of retroperitoneal air caused by rectal perforation during a double-contrast barium-enema examination is reported. In 9 similar reported cases, radiographic signs included perirectal, mediastinal, and cervical emphysema. Because of the frequent absence of clinical signs, radiographic recognition may be crucial for prompt management. Reported experience suggests that asymptomatic patients with these radiographic findings may be managed with hospitalization and close observation rather than immediate laparotomy.

Aged↗