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Biomedical subjects

P B Kane

Publications and source records attributed to P B Kane.

15 recordsLinked to original sources
PubMed1991

Fatty infiltration: another restrictive cardiomyopathic pattern.

Restrictive cardiomyopathies have been shown to occur as result of infiltrative processes from a variety of sources. The current report describes an obese male, who was found to have hemodynamic evidence of a restrictive cardiac process. His pericardium was proven to be normal and an incisional biopsy obtained of the myocardium during coronary artery bypass surgery demonstrated histologic evidence of fatty infiltration of myocardium. Review of the restrictive and pathology literature is discussed and indicates that this is the first report to demonstrate the association between fatty infiltration and hemodynamic findings consistent with a restrictive cardiomyopathy.

Adipose Tissue↗
PubMed1991

Electrocautery-induced pacemaker malfunction during surgery.

We report a case of electrocautery-induced pacemaker failure that resulted in asystole in a 15-year-old girl scheduled for cardiac surgery. Her pacemaker was converted to the asynchronous mode the night before surgery. Electromagnetic interference from the unipolar electrocautery caused a reduction in the battery voltage, which allowed the digital circuitry, but not the voltage control oscillator (VCO), to work properly. Eventually the battery current drain caused VCO "lock-out," and pacemaker and battery failure. This report demonstrates that electrocautery-induced pacemaker failure can occur, even after conversion to asynchronous mode.

Adolescent↗
PubMed1991

High-performance liquid chromatography as a diagnostic tool in prolonged neuromuscular blockade.

We report the use of high-performance liquid chromatography (HPLC) to identify the cause of prolonged neuromuscular blockade in a child who had received 2 mg.kg-1 of succinylcholine. Upon analysis by HPLC the syringe was found to contain succinylcholine (10 mg.ml-1) and also atracurium (5 mg.ml-1), so that a diagnosis was established. In situations where medication errors are suspected, we recommend saving syringe contents for analysis for confirmation of the agent.

Anesthesia, Intravenous↗
PubMed1978

Effects of DDT on stable laboratory mouse populations.

Four stable laboratory mouse populations were established; each contained approximately 400 mice of both sexes and all ages postweaning living in a single cage, as well as neonates caged in separate nesting boxes with their dams. Two were used to determine the effects of continuous exposure to a dietary level of 100 ppm DDT while the other two served as controls. The results indicated a significant decrease (p less than or equal to 0.05) in neonatal survival (lactation index) within 20 wk after the beginning of exposure to the toxicant in one of the exposed populations and by 30 wk in the other. This deleterious effect of the DDT continued through each succeeding generation. On the other hand, improved postweaning survival in DDT-fed mice was noted. Histological examination showed no tumors in test or control animals; other pathology was seen more frequently in control than in test animals.

Animals↗
PubMed1978

Prevention of pulmonary insufficiency through prophylactic use of PEEP and rapid respiratory rates.

This study evaluated the effectiveness of prophylactic positive end-expiratory pressure (PEEP) rapid respiratory rates (RRR), and high tidal volume (HTV) in prevention of congestive atelectasis. Measurements of pulmonary hemodynamics, mechanics, gas exchange, functional residual capacity (FRC), pathology, and cinemicroscopy were performed in 45 anesthetized dogs subjected to hemorrhagic hypotension. Randomly, the animals received control ventilation, HTV (20 ml. per kilogram), RRR (32 breaths per minute), or PEEP (5 cm. of water). Carbon dioxide was added as needed to maintain normocapnia. Control and HTV animals showed characteristic changes of congestive atelectasis (capillary congestion, stasis, interstitial edema, periarterial hemorrhage, alveolar edema, and hemorrhage). These microscopic and cinemicroscopic changes were prevented by PEEP and RRR and correlated with decreased physiological shunting (PEEP 10 percent, RRR 13 percent, HTV 22 percent; p less than 0.01) in the postshock phase. PEEP increased FRC by 40 percent (p less than 0.02) and reduced the pulmonary artery--small pulmonary vein gradient (PA-SPV), suggesting a direct effect on the capillary bed. RRR did not affect FRC but minimized the SPV-LA gradient. This effect on the pulmonary venules theoretically could be mediated by stimulating lymphatic flow, thereby decreasing interstitial edema. Thus PEEP and RRR are beneficial when used prophylactically but may work by widely differing mechanisms.

Animals↗
PubMed1978

Ultrastructure of the proliferating cells in pulmonary lymphangiomyomatosis.

Pulmonary lymphangiomyomatosis occurs almost exclusively in women and is characterized by a widespread proliferation of spindle-shaped cells within the lung. Although these cells have been considered to be vessel-associated smooth muscle cells, their origin remains undefined. In this case of pulmonary lymphangiomyomatosis studied by electron microscopy, the proliferating cells were found to vary morphologically and to differ from typical smooth muscle cells. The ultrastructure suggests that the cell of origin might be the pulmonary interstitial cell rather than vascular smooth muscle. It is also possible that the cells are derived from pericytes. Accumulations of glycogen were seen in the proliferating cells and are suggested to be a reflection of an estrogenic hormonal dominance.

Female↗
PubMed1977

Diagnosis of asbestosis by transbronchial biopsy. A method to facilitate demonstration of ferruginous bodies.

The diagnosis of asbestos-associated pulmonary fibrosis was established in 3 patients by finding ferruginous bodies in transbronchial lung biopsies. Ferruginous bodies may be difficult to identify in histologic preparations when they are not oriented parallel to the plane of tissue section or when camouflaged by anthracotic pigment. We describe a simple method to enhance diagnostic sensitivity by digesting biopsy tissue and examining the filtered residue for ferruginous bodies.

Adult↗
PubMed1977

The role of carbon dioxide in the development of pulmonary insufficiency.

The effects of carbon dioxide (PCO2 = 40 versus PCO2 = 20) on pulmonary function changes during 2 hours of hemorrhagic hypotension followed by resuscitation are evaluated in 21 dogs. Pulmonary hemodynamics, mechanics, gas exchange, functional residual capacity, and morphology are studied. In the preshock period, hypocapnia is associated with a decreased cardiac output, increased dead space, and increased alveolar-arterial (A-a) gradiant (room air). During the period of hypotension, all parameters in both groups changed similarly. After resuscitation, the A-a gradients in the two groups further widened. Following the return to control levels of normocapnia in all animals, the group which had been hypocapnic during the hypotensive episode continued to show increased shunting (20 versus 13 percent, p less than 0.05). These results correlated well with cinemicroscopic findings, which showed the normocapnic group to have less interstitial edema and better capillary flow.

Animals↗
PubMed1976

Comparison of patients with coronary artery or valve disease: intraoperative differences in blood volume and observations of vasomotor response.

A review of 296 patients undergoing cardiac operations has shown that those with coronary artery disease have a blood volume deficit. The 148 patients with valve disease had a normal blood volume of 78 ml/kg (normal range, 68--88 ml/kg), while the 148 coronary artery disease had a blood volume of 69 ml/kg (p less than 0.001). Infusion of plasma prior to cardiopulmonary bypass as well as the total transfusion required afterward to maintain blood pressure indicated an important clinical difference in these two groups. Another finding was that the requirement for a drug to control blood pressure prior to use of cardiopulmonary bypass was greater in the coronary patients (p less than 0.01). Comparison of the requirement for a hypotensive agent before and after bypass showed a greater predictability in the valve group. This experience leads us to conclude that patients with coronary artery disease and angina not only have a low blood volume, but they also have a marked vasoactive lability which shows up in their hemodynamic response to the conduct of an operation and to anesthesia.

Blood Pressure↗
PubMedDate not supplied

Artifacts in the measurement of pulmonary artery wedge pressure.

Pulmonary artery wedge pressure (PAWP) will only reflect left atrial pressure (LAP) if continuity of fluid exists from the catheter tip to the left atrium. Either increased airway pressure or decreased hydrostatic pressure may lead to discontinuity of the fluid column and midinterpretation of PAWP. Simultaneous measurements of PAWP and LAP were made in 19 anesthetized dogs. Placement of the pulmonary artery wedge catheter above the left atrium (West Zone I) in combination with the incremental addition of 5 cm H2O of PEEP caused a 5 mm Hg gradient between PAWP and LAP in the normovolemic animal. Augmenting PEEP further or hypovolemia (i.e., decrease in LAP) increased the gradient. Hypervolemia (increase in LAP) diminished the gradient. Fluid continuity between the PAW catheter and LA is a prerequisite for monitoring LAP with the Swan-Ganz catheter. Increases in PEEP, placement of the catheter above the left atrium and hypovolemia may occlude the fluid column and cause artifacts in the PAWP obtained.

Blood Pressure↗
PubMedDate not supplied

A PSRO record-keeping system for anesthesiologist.

To meet the requirements for Professional Standards Review Organization (PSRO) auditing, a new anesthesia record-keeping system was designed. The forms are also well adapted for use in an anesthesia teaching department.

Anesthesia↗