Biomedical subjects
R G Carroll
Publications and source records attributed to R G Carroll.
The relationship of head and neck irradiation to the subsequent development of thyroid neoplasms.
Individuals who have received head and neck radiation for benign conditions have a markedly increased risk of developing thyroid, salivary, and perhaps breast cancer as compared to the general population. Although the relative risk is very high, the absolute risk that any one individual who has had head or neck irradiation will develop a subsequent malignancy is low. Identification of these patients through some type of screening procedure may be beneficial in terms of prevention of subsequent morbidity and perhaps mortality from cancer, especially thyroid and salivary cancer. The risks of any detection or prophylaxis program must be carefully weighed against the probable, but unproved benefits of early detection. A major unresolved question is the natural history of microscopic thyroid carcinoma in the 25 yr-40 yr old radiation exposed population.
Functioning thyroid masses in childhood and adolescence. Clinical, surgical, and pathologic correlations.
Six girls, aged 5 to 15 years, presented with thyroid masses in otherwise nonpalpable thyroid glands and with normal serum thyroxine levels. Scintiscanning before and after TSH stimulation confirmed the presence of autonomous nodules in the four adolescents, of whom two had elevated T3 levels. Surgical exploration revealed adenomatous thyroid hyperplasia in three of the girls and papillary adenocarcinoma in the fourth. Scans in the other two girls revealed absence of the left lobe. One of them proved to have agenesis of the left lobe with enlargement of the right lobe because of lymphocytic thyroiditis. The other girl had an ectopic thyroid with chronic inflammation. A thorough diagnostic evaluation of single or multiple functioning thyroid masses in children and adolescents is essential in establishing the correct diagnosis. The possibility that carcinoma can occur in autonomous nodules as well as in hemiagenesis and ectopic thyroid tissue is discussed. An approach to the management of functioning thyroid masses in the pediatric age group is proposed.
Patients exposed to therapeutic irradiation for benign conditions in childhood.
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Hazard with Portex tracheostomy tubes.
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Performance characteristics of tracheal cuffs.
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Interferon administered in the cerebrospinal space and its effect on rabies in rabbits.
Because combined administration of intramuscular and intravenous interferon has been partially successful in the incubationary treatment of rabies, the effect of direct interferon administration into the cerebrospinal fluid space was tested. After injecting 1,800 U of interferon into the cisterna magna or the lateral ventricle, periodic samples, obtained by cisternal taps, showed that 1 to 5% remained after 24 h, as opposed to the known clearance of interferon from the bloodstream to this level within minutes. The distributions of interferon and (131)I-labeled albumin were similar as demonstrated by kinetics of clearance monitored over 24 h. Beginning with and after experimental infection of rabbits, daily intraventricular injections of one million units of interferon were given for as long as 3 weeks. Interferon was prepared from cell culture fluids after pressure dialysis and chromatography on Sephadex G-100. This intensive treatment did not prevent encephalitis, but prolonged the length of the incubation period by one- to two-thirds. The outcome after intraventricular administration was not as favorable as when one million units equally divided between intramuscular and intravenous injections were given at the time of challenge. Interferon administered in the subarachnoid space in this fashion is apparently inadequate to protect the rabbit against rabies. Its role as an adjunct measure, or other methods of administration in the nervous system, remains to be examined.
A multiple-dose 133Xe solution "generator": the disposable glass ampule equilibration chamber.
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Myocardial perfusion scintigraphy after intracoronary injection of 99m Tc-labeled human albumin microspheres. Toxicity and efficacy for detecting myocardial infarction in dogs; preliminary results in man.
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Ethanol-clonidine hemodynamic interaction in normotensive rats is modified by anesthesia.
Our previous findings have shown that ethanol attenuates the decreases in plasma norepinephrine (NE) levels, and blood pressure elicited by centrally acting antihypertensive drugs in spontaneously hypertensive rats (SHRs). The present study investigated whether this interaction can be influenced by baseline blood pressure (BP) and sought direct evidence to support the involvement of the SNS by recording the sympathetic neural activity (SNA) of the splanchnic nerve. The conscious aortic barodenvervated (ABD) rat model was utilized because it exhibits greater hypotensive responses to clonidine compared with sham-operated (SO) rats. Although ABD and SO rats (332 + 33 vs. 227 + 18 pg/ml). Clonidine (30 micrograms/kg, i.v.) elicited significantly greater decreases in mean arterial pressure (MAP; -20.0 + 2.1 vs. -10.4 + 0.8 mm Hg) and plasma NE (-194 + 26 vs. -50 + 11 pg/ml) in conscious ABD vs. SO rats. Ethanol (1 g/kg, i.v.) reversed clonidine-evoked decreases in BP and plasma NE levels, but the interaction was more prominent in ABD rats. To support the hypothesis that the interaction occurs within the CNS, the effect of ethanol was studied on clonidine-evoked decreases in preganglionic SNA and BP in anesthetized rats. In contrast to its effects in conscious rats, ethanol augmented both the hypotensive and sympathoinhibitory responses to clonidine in anesthetized rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Evaluation of tracheal tube cuff designs.
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Proper use of large diameter, large residual volume cuffs.
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Recommended performance specifications for cuffed endotracheal and tracheostomy tubes: a joint statement of investigators, inventors, and manufacturers.
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Evaluation of tube deformation pressure in vitro.
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Blood pressure normalization in carotid barodenervated rats: role of cardiac output.
This study evaluated the role of sympathetic nervous system (SNS) activity, peripheral hemodynamic changes, and pressure diuresis in blood pressure (BP) normalization in carotid barodenervated rats. The acute and short-term effects of carotid barodenervation or sham operation on blood pressure, heart rate, cardiac output, stroke volume, total peripheral resistance, and plasma catecholamine levels were determined. Changes in plasma volume, urine output, and water and food intakes were also measured. Surgical denervation of the carotid baroreceptors resulted in rapid rises in blood pressure and heart rate in anesthetized rats. These changes were associated with significant increases in plasma catecholamine levels and total peripheral resistance whereas the cardiac index and stroke volume remained unchanged. After recovery from the anesthesia, the blood pressure of carotid barodenervated rats was still significantly higher than that of sham-operated rats at 3 and 24 h after denervation and returned to sham-operated levels by 48 h. Plasma catecholamine levels and total peripheral resistance were higher in carotid barodenervated than in sham-operated rats on the 2 days following surgery. On the other hand, cardiac index (32 +/- 1 vs. 40 +/- 2 mL.min-1 x 100 g-1 body mass) and stroke volume (205 +/- 13 vs. 283 +/- 4 microL/beat) were significantly lower on day 2 in carotid barodenervated than in sham-operated rats, which suggests a compensatory role for carotid output in blood pressure normalization after carotid barodenervation. Both carotid barodenervation and sham operation caused a reduction in water and food intakes but the responses were greater in carotid barodenervated rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Malignant hypertensive crisis induced by chronic intrarenal norepinephrine infusion.
The purpose of the present study was to develop a controllable experimental model in the dog that would consistently and predictably produce a malignant hypertensive crisis, and to determine the sequential changes in renal function, salt and water balance, and hormones that are involved in the transition from benign to accelerated hypertension. Norepinephrine (NE) was infused continuously into the renal artery of unilaterally nephrectomized dogs that were maintained on 50 mEq sodium/day. The infusion rate of NE was increased each day according to the following schedule: 0.05, 0.1, 0.2, 0.3, 0.4, and 0.5 microgram/kg/min. During the first 4 to 5 days of intrarenal NE infusion, there was a progressive decrease in glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), and increases in plasma renin activity (PRA), mean arterial pressure (MAP), and filtration fraction. At the end of this period of benign hypertension, MAP had risen from a control value of 91 +/- 4 to 132 +/- 8 mm Hg, in association with approximately a 10-fold increase in PRA and a 40% reduction in renal function. Then, suddenly, during the subsequent 24-hour infusion period, the MAP increased abruptly in all animals (MAP = 156 +/- 8 mm Hg), and a hypertensive crisis occurred. This crisis was associated with the following: salt and water depletion, hyponatremia, hypovolemia and hemoconcentration, polydipsia, marked activation of the renin-angiotensin-aldosterone system, increased plasma cortisol concentration, hemolysis, marked impairment in renal function, lethargy, and vomiting.(ABSTRACT TRUNCATED AT 250 WORDS)
Role of the renal nerves in one-kidney, one clip hypertension in rats.
The effects of renal denervation on the onset and maintenance of one-kidney, one clip Goldblatt (1K1C) hypertension were determined. Renal denervation was performed at the time of 1K1C surgery, and was repeated at 3-week intervals to prevent renal nerve regeneration. Denervation delayed the onset of 1K1C hypertension by about 5 weeks, but the final hypertensive state was unaltered. Mean arterial pressure (MAP) averaged 196 +/- 11.4 mm Hg in six rats at 9 weeks after 1K1C surgery and 194 +/- 11.3 mm Hg in eight renal-denervated rats at this time. The delay in the development of 1K1C hypertension following renal denervation could not be explained by interference with renin release. This delay in the development of hypertension could be prevented, however, in renal-denervated 1K1C rats by substituting saline for the drinking water. Two weeks after 1K1C surgery and a high sodium diet, MAP averaged 164 +/- 6.4 mm Hg in eight rats rats with intact renal nerves and 173 +/- 4.8 mm Hg in nine renal-denervated rats. Intact renal nerves are not necessary for the development or maintenance of 1K1C hypertension. Renal denervation delays development of 1K1C hypertension, possibly by delaying the ability of these rats to retain sodium.