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Biomedical subjects

R Linton

Publications and source records attributed to R Linton.

6 recordsLinked to original sources
PubMed1998

In vitro evaluation of a new lithium dilution method of measuring cardiac output and shunt fraction in patients undergoing venovenous extracorporeal membrane oxygenation.

OBJECTIVE: To evaluate, in vitro, a method of measuring cardiac output and shunt fraction during venovenous extracorporeal membrane oxygenation (ECMO). DESIGN: Experimental study using an in vitro model. SETTING: A teaching hospital. MODEL: An ECMO circuit was set up in parallel with a patient circuit consisting of tubing through which saline was circulated from a 50-L reservoir by a pump which was set at 3 L/min to represent cardiac output. A second pump in the ECMO circuit drew saline from the patient circuit and passed it through a membrane oxygenator. The flow from the membrane oxygenator either returned directly to the patient circuit or was diverted, via a third pump, back into the ECMO circuit, thereby producing a shunt. INTERVENTIONS: By adjusting the flow rates of the second (ECMO) and third (shunt) pumps, three shunt fractions of 12%, 25%, and 50% were produced at three different ECMO flow rates. Lithium chloride (0.15 mmol) was injected just downstream of the membrane oxygenator; the lithium ion concentration-time curves were recorded simultaneously in the flow returning to the saline reservoir and in the flow just upstream of the membrane oxygenator using lithium selective electrodes. MEASUREMENTS AND MAIN RESULTS: Nine pairs of curves were recorded, one pair for each combination of ECMO and shunt flow rates. Analysis of these curves allowed shunt flow and "cardiac output" to be calculated and compared with the flow rates delivered by the pumps. Mean "cardiac output" derived from the lithium dilution curves was 2.98 +/- 0.18 (SD) L/min, compared with a delivered pump flow of 3 L/min. Measured shunt flow = 0.008 + 1.09 x actual shunt flow (R = 0.997). CONCLUSIONS: This method would allow cardiac output and shunt flow to be measured in patients undergoing venovenous ECMO. It could result in better patient management and improved cannula design.

Blood Flow Velocity↗
PubMed1997

Lithium dilution cardiac output measurement: a comparison with thermodilution.

OBJECTIVE: To compare the results of cardiac output measurements obtained by lithium dilution and thermodilution. DESIGN: Case series, observational study. SETTING: High-dependency postoperative unit and intensive care unit of a teaching hospital. PATIENTS: Forty patients were studied. Thirty-four patients had undergoing heart surgery requiring cardiopulmonary bypass within the previous 2 days; the diagnoses in the other patients were myocardial infarct (n = 2), septicemia (n = 2), adult respiratory distress syndrome, and pericardectomy. INTERVENTIONS: Cardiac output was measured five times in each patient, using lithium dilution (single measurement) and bolus thermodilution (series of three to six measurements according to standard clinical practice, taking the average of the closest three). In a subgroup of 14 patients, cardiac output was also measured using "continuous thermodilution." MEASUREMENTS AND MAIN RESULTS: Comparing lithium dilution with bolus thermodilution, the mean of the differences (lithium dilution-thermodilution) was -0.25 +/- 0.46 [SD] L/min. Linear regression analysis gave y = 0.31 + 0.89x (r2 = .94) for lithium dilution vs. thermodilution. CONCLUSIONS: The overall agreement between the two methods was good. The variability of the thermodilution measurements was greater than that of the lithium dilution measurements. The lithium dilution method is at least as accurate as bolus thermodilution and, since pulmonary artery catheterization is not needed, it has the advantages of being safe and quick to perform.

Adult↗
PubMed1993

Posterior rotator cuff strengthening using theraband(r) in a functional diagonal pattern in collegiate baseball pitchers.

The deceleration phase of the pitching mechanism requires forceful eccentric contraction of the posterior rotator cuff. Because traditional isotonic strengthening may not be specific to this eccentric pattern, a more effective and functional means of strengthening the posterior rotator cuff is needed. Twelve collegiate baseball pitchers performed a moderate intensity isotonic dumbbell strengthening routine for 6 weeks. Six of the 12 subjects were randomly assigned to an experimental group and placed on a Theraband(R) Elastic Band strengthening routine in a functional-diagonal pattern to emphasize the eccentric contraction of the posterior rotator cuff, in addition to the isotonic routine. The control group (n = 6) performed only the isotonic exercises. Both groups were evaluated on a KIN-COM(R) isokinetic dynamometer in a functional diagonal pattern. Pretest and posttest average eccentric force production of the posterior rotator cuff was compared at two speeds, 60 and 180 degrees /s. Data were analyzed with an analysis of covariance at the .05 level with significance at 60 degrees /s. Values at 180 degrees /s, however, were not significant. Eccentric force production at 60 degrees /s increased more during training in the experimental group (+19.8%) than in the control group (-1.6%). There was no difference in the two groups at 180 degrees /s; both decreased (8 to 15%). Theraband was effective at 60 degrees /s in functional eccentric strengthening of the posterior rotator cuff in the pitching shoulder.

Journal Article↗
PubMed1991

Inactivation of a sperm motility gene by insertion of an epidermal growth factor receptor transgene whose product is overexpressed and compartmentalized during spermatogenesis.

Transgenic mice were generated with a human epidermal growth factor (EGF) receptor cDNA driven by the chicken beta-actin gene promoter. One line (AE24) that exhibited a unique expression pattern in which dramatically elevated levels of EGF receptor RNA were found only in the testis was established, suggesting that the beta-actin promoter was being influenced by an adjacent testis-specific enhancer. EGF receptor RNA was detected in primary spermatocytes, whereas the synthesis of receptor protein was restricted to elongate spermatids, indicating that transgene expression was under translational control. At spermiation, the EGF receptor was sequestered in residual bodies and excluded from mature sperm by a compartmentalization mechanism. About half of AE24 homozygous males were sterile because of sperm paralysis, whereas heterozygous males and females of either genotype were completely fertile. Electron microscopic analysis of sperm flagella from sterile AE24 homozygotes revealed an aberrant axonemal structure in which outer doublet microtubules were missing from the middle piece, resembling changes observed in the sperm of some infertile humans. Flagellar axonemal disassembly was observed in the vas deferens and epididymis but not in the testis, suggesting that outer doublets were assembled in a grossly normal manner but possessed a latent instability. These results demonstrate that in the AE24 mouse line the EGF receptor transgene was integrated into and inactivated an endogenous autosomal gene, causing sperm flagellar axonemal disruption and male sterility.

Actins↗
PubMed1986

Conceptualization for planning and evaluation.

Conceptualization is a central task in planning and evaluation. There is a need to develop conceptualization methods which can help multiple constituency groups collaborate on the development of conceptual frameworks which can guide the planning and evaluation effort. A general model for conceptualization methods is presented along with considerations for implementation. This model is illustrated in two planning and evaluation studies which involved a broad range of constituent groups within the organizations in the development of "concept maps" which could guide subsequent work. Some general implications of conceptualization methods for planning and evaluation are discussed.

Community-Institutional Relations↗