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Biomedical subjects

R H Epstein

Publications and source records attributed to R H Epstein.

At least 37 records · Page 2Linked to original sources
PubMed1990

Relationship between train-of-four ratio and first-twitch depression during neuromuscular blockade: a pharmacokinetic/dynamic explanation.

Fade, as measured by train-of-four, lags behind twitch depression during the initial phase of nondepolarizing neuromuscular blockade, i.e., the ratio of the fourth to first twitch height in a train (T4/T1) is greater at the onset of the block than during spontaneous recovery for the same level of first twitch depression. We believe that these data can be explained by picturing the muscle as having localized regions that respond much more slowly than the rest, leading to a delay in drug effect in that area, especially when the drug concentration rises rapidly as during bolus administration. This was modeled by computer as a muscle of 15 compartments distributed in a log-normal fashion according to equilibration rate. Experimental data consisting of the time course of first twitch and train-of-four ratio were fitted by nonlinear regression to the model. A good fit was obtained with a median equilibration time t1/2 of 3.3 min and a standard deviation of 2.1. The difference between train-of-four during onset and regression of block at the same level of first twitch depression was reproduced.

Computer Simulation↗
PubMed1990

Incendiary potential of the flash-lamp pumped 585-nm tunable dye laser.

The recently introduced pulsed flash-lamp pumped tunable dye laser is used to treat cutaneous port-wine stains. In our practice, infants and children receive general anesthesia for these brief, yet painful, treatments. Because the flammability of this laser has not been reported and because we administer supplemental oxygen and nitrous oxide, we analyzed the incendiary potential of this laser by measuring the flammability of gauze and Telfa strips, hair, clear plastic face masks and tracheal tubes, and green nasal cannulae in 21%-100% oxygen and in nitrous oxide at laser energies between 6.0 and 10.0 J/cm2. (Our clinical range is 6.0-7.0 J/cm2.) In room air, gauze, Telfa, masks, and tubes did not ignite; only gauze ignited at high energy in 100% oxygen. Hair ignited in room air only when struck repeatedly at high energy, but easily ignited in 100% oxygen. Wetting hair with saline prevented ignition in room air and decreased flammability in supplemental oxygen. Green nasal cannulae prongs were extremely flammable in oxygen. Caution should be taken when using supplemental oxygen/nitrous oxide during treatment with the tunable dye laser.

Facial Neoplasms↗
PubMed1989

Evaluation of a continuous noninvasive blood pressure monitor in obstetric patients undergoing spinal anesthesia.

A noninvasive blood pressure monitor (Finapres) that continuously displays the arterial waveform using the Penaz methodology has recently been introduced into clinical practice. We compared this device with an automated oscillometric blood pressure monitor (Dinamap 1846SX) in 20 patients during spinal anesthesia for nonemergency cesarean section according to a procedure suggested by the Association for the Advancement of Medical Instrumentation. After administration of the spinal anesthetic, the Finapres monitor produced systolic, mean, and diastolic pressure measurements greater than those of the Dinamap monitor (6.6 +/- 12.5, 3.3 +/- 10.4, and 7.2 +/- 9.8 mm Hg, respectively). In most patients, the Finapres measurements were similar to those determined by the Dinamap; however, in 4 patients, mean systolic differences were greater than 20 mm Hg. These patients did not differ from the others in age, height, weight, or baseline blood pressure, and the pressure values recorded by the Finapres monitor were substantially higher than those measured by auscultation in the labor room. In 30% of the patients, the offset between Dinamap and Finapres blood pressure measurements changed markedly over the course of the surgical procedure. The Finapres monitor occasionally stopped working and had to be restarted. In 1 patient (not included in this analysis), the Dinamap monitor was unable to determine the blood pressure due to patient shivering; this did not appear to interfere with the Finapres. We conclude that the Finapres monitor does not consistently provide blood pressure information equivalent to that of the Dinamap in obstetric patients undergoing spinal anesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

Functional capacities of lungs and thorax in beagles after prolonged residence at 3,100 m.

Functional capacities of the lungs and thorax in beagles taken to high altitude as adults for 33 mo or in beagles raised from puppies at high altitude were compared with functional capacities in corresponding sets of beagles kept simultaneously at sea level. Comparisons were made after reacclimatization to sea level. Lung volumes, airway pressures, esophageal pressures, CO diffusing capacities (DLCO), pulmonary blood flow, and lung tissue volume (Vt) were measured by a rebreathing technique at inspired volumes ranging from 15 to 90 ml/kg. In beagles raised from puppies we measured anatomical distribution of intrathoracic air and tissue using X-ray computed tomography at transpulmonary pressures of 20 cm H2O. Lung and thoracic distensibility, DLCO, and Vt were not different between beagles that had been kept at high altitude for 33 mo as adults and control subjects kept simultaneously at sea level. Lung distensibility, DLCO, and Vt were significantly greater in beagles raised at high altitude than control subjects raised simultaneously at sea level. Thoracic distensibility was not increased in beagles raised at high altitude; the larger lung volume was accommodated by a lower diaphragm, not a larger rib cage.

Altitude↗
PubMed1984

Intracellular morphogenesis of bacteriophage T4. I. Gene dosage effects on early functions and tail fiber assembly.

Mixed infection of nonpermissive bacteria by amber mutant and wild-type T4 phage reduces the burst size in a manner that depends on the nature of the gene product eliminated by the mutation. While the genotypic proportions produced by such mixedly infected cells were directly proportional to those in the starting mixtures, the fraction of the burst size compared to wild-type-infected cells was dependent on the kind of mutant used. For example, mutants in genes 56, 42, and 43, which control catalytic functions for DNA synthesis, produced normal burst sizes even at ratios of four mutant to one wild-type phage. The multiplicity of infection in these experiments was near 20, and most cells received one wild-type phage. By contrast, infection with mutants in tail fiber structural genes gave a normal burst size with 1:1 mixtures of wild-type phage, but showed a decrease in burst size below this ratio. The conclusions drawn are that enzymes of DNA replication are present in large excess over the amount needed for phage DNA synthesis, and that tail fiber structural proteins are made in a three- to fourfold excess over the amount needed for phage maturation under normal laboratory conditions.

DNA Replication↗
PubMed1984

Intracellular morphogenesis of bacteriophage T4. II. Head morphogenesis.

The relative phage yields of cells of Escherichia coli infected with both wild-type and amber mutant phages deficient in head morphogenesis were determined. The decrease in burst size as a function of the ratio of mutant:wild-type-infecting phage was linear and proportional for mutants in genes 20, 22, and 23, while for mutants in genes 21, 31, and 24 the results suggest an excess of intracellular gene product. The initiation of assembly of phage particles was not delayed at reduced gene product levels; only a reduction in the rate of phage assembly was observed. The effects on burst size of pairs of mutations in genes 20 and 23, 22 and 23, and 22 and 24, in both cis and trans arrangements, were identical. Experiments using the mutant E920g in gene 23 show that varying the kind and intracellular amounts of the major capsid protein (gp23) with respect to the major core or scaffold protein (gp22) had a profound effect on the length of the T4 head. Head length determination must therefore depend on the proper intracellular balance between these two proteins.

Escherichia coli↗
PubMed1982

Use of 100-Hertz tetanus as an index of recovery from pancuronium-induced non-depolarizing neuromuscular blockade.

During recovery from non-depolarizing neuromuscular blockade the evoked response to train-of-four (TOF), 100-HZ tetanus (T100) and 50-HZ tetanus (T50) was measured in 10 patients. When the TOF fade ratio exceeded 0.70, tetanic tension to T50 was well sustained. However, even at TOF ratios as high as 0.88 a 2-second tetanic response to T100 showed marked fade. T100 stimulation appears to be too sensitive a test to residual curarization for routine clinical use. Fade on T100 may be quite apparent at a time when the use of additional neuromuscular antagonists are not indicated and may be counterproductive.

Electric Stimulation↗
PubMed1980

Isolation and characterization of context mutations affecting the suppressibility of nonsense mutations.

Secondary mutations which increase the efficiency of suppression of nonsense mutations in the rIIB cistron of bacteriophage T4 have been isolated. These secondary mutations, called context mutations, map at sites very close to the nonsense codon, possibly on the promotor distal side. In context-nonsense double mutants, the amount of suppressed gene product is increased approximately 10-fold. The context mutations examined can act on the UAA (ochre) nonsense allele as well as on the UAG (amber) nonsense allele at a given site. These context mutations affect all suppression mechanisms analyzed (genetic suppressors, 5-fluorouracil suppression and spontaneous suppression). We suggest that context mutations affect information which is significant to the termination of polypeptide chains. According to our view, context mutations change the immediate neighborhood of nonsense mutations and so reduce the degree of resemblance to the sequences normally used for the termination of translation.

Chromosome Mapping↗
PubMed1979

Temperature-sensitive mutation in the initiation codon of the rIIB gene of bacteriophage T4.

We have determined the sequence of a ribosome-protected region of T4 rIIB mRNA labeled in vivo. The rIIB mutant HD263, which is temperature sensitive for translation, has an altered initiation codon (AUA instead of AUG). Because wild-type and HD263 proteins have the same fMet peptide, this AUA is used to initiate translation in the mutant rIIB mRNA. We have also identified a six-base sequence which is complementary to the 3" end of the 16S rRNA.

Base Sequence↗