Biomedical subjects
Publications and source records attributed to R A Braun.
A patient was treated for lobar pneumonia due to coccidioidomycosis. When the pneumonia recurred, the patient was found to have an arteriovenous malformation, which had become infected. Complete resolution was achieved with resection and postoperative amphotericin B therapy.
A patient underwent resection of a superior sulcus tumor after an extensive workup was nondiagnostic. Postoperatively, primary pulmonary cryptococcosis was diagnosed. Management of this patient is presented along with a review of the literature.
Methods are described for studying the effects of drugs on increases in tracheobronchial microvascular permeability (leakage) induced by inflammatory mediators. A model in conscious guinea pigs (in which the leakage effects resulted from circulating mediator) and a model in anesthetized rats (in which the leakage effects resulted from application of the mediator to the airway lumen) are described. Inhibitor drugs were given i.v. 2 min before the mediator. In guinea pigs either histamine or leukotriene D4 (LTD4) and colloidal carbon (C, the tracer molecule for leakage) were administered together iv.; in rats 5-hydroxytryptamine (5-HT, 100 micrograms) was injected intratracheally followed by i.v. colloidal carbon. Tracheal and bronchial tissues were removed 15 min later from the killed animals and prepared for histology, and the number of C-labeled microvessels in the mucosal/submucosal region of 7-micron sections was counted. In guinea pigs, leakage produced by LTD4 or histamine was related to the dose administered and the relative potency of LTD4:histamine was approximately 123:1, on a molar basis. Leakage caused by histamine, but not by LTD4, was prevented by mepyramine (1 mg/kg) and LTD4-induced leakage was prevented by FPL 55712 (1 mg/kg). Terbutaline (1 mg/kg) attenuated leakage to both mediators but never abolished it. In rats, leakage was also seen to 5-HT, which was prevented by methysergide (1 mg/kg) and markedly attenuated by ketanserin (1 mg/kg) or by terbutaline (1 mg/kg). It is suggested that the colloidal carbon tracer technique has application to pharmacological studies designed to examine the effects of drugs on mediator-induced permeability to macromolecules in the tracheobronchial microcirculation.
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A retrospective study was made of 230 consecutive unselected mediastinoscopies done during the years 1969 through 1975 in an attempt to identify guidelines for selective use of mediastinoscopy. Findings at mediastinoscopy were correlated with pathologic diagnosis, location and size of the lesion, presence or absence of enlarged lymph nodes on chest x-ray film, and findings at subsequent thoractomy when performed. On the basis of this review, the following lesions seem amenable to diagnosis at mediastinoscopy: bilateral hilar adenopathy (24 of 25 in this study); central lesions (30 of 45); peripheral lesions with adenopathy seen on x-ray film (nine of 22); and infiltrates (eight of 24). Mediastinoscopy is not recommended for peripheral lesions without adenopathy seen on x-ray film.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.