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Biomedical subjects

R Swarm

Publications and source records attributed to R Swarm.

6 recordsLinked to original sources
PubMed2005

Postoperative pain management following bilateral lung volume reduction surgery for severe emphysema.

This study was conducted to audit the clinical management of a continuous local anaesthetic infusion delivered by a fluoroscopically placed thoracic epidural catheter in conjunction with supplemental intravenous opioid patient controlled analgesia for postoperative pain control following bilateral lung volume reduction surgery for severe emphysema. This retrospective case series involved a random sample of 43 patients from a possible 65 patients. The mean dose of epidural bupivacaine 0.15% was 6.7 ml/h (SD 1.5), while the mean daily dose of morphine or hydromorphone was 22.5 mg/day (SD 17.9) and 4.3 mg/day (SD 3.1), respectively. Inadequate analgesia was reported by 19 (44%) patients during the first two postoperative days, but was successfully treated by individual titration of these medications. The incidence of atrial fibrillation (n = 6), premature epidural catheter dislodgement (n=6) or respiratory failure (n=3) appeared to be greater among patients who had inadequate analgesia at some stage. One patient developed excessive sedation; otherwise, there were no major complications. The use of an epidural bupivacaine infusion in conjunction with intravenous opioid patient controlled analgesia proved to be a safe and effective pain medication regimen when accompanied by individual titration of these agents in response to acute exacerbations of postoperative pain.

Aged↗
PubMed1977

A murine tumor producing a matrix of basement membrane.

We have studied a murine tumor previously classified as a poorly differentiated chondrosarcoma. Although the cells in this tumor are surrounded by large quantities of extracellular matrix material, the matrix fails to react with stains specific for the sulfated glycosaminoglycans present in normal cartilage. Here we show at the ultrastructural level that the tumor matrix is a homogeneous, nonfibrillar material, resembling basement membrane. Neither the proteoglycan matrix granules nor collagen fibrils characteristic of cartilage are present in the tumor matrix. Amino acid analyses of whole tumor tissue, enzyme-solubilized tumor components, and the protein extracted from lathyritic tumors confirmed that the tumor matrix is a basement membrane collagen. The collagenous protein extracted from the tumor by nonenzymatic means contains three unique polypeptides larger than the alpha-chain components of the other types of collagen. These studies indicate that the tumor is not a type of chondrosarcoma but a basement membrane producing tumor.

Amino Acids↗
PubMed1971

Mucopolysaccharide and protein--polysaccharide of a transplantable rat chondrosarcoma.

Two mucopolysaccharides, chondroitin 4-sulfate (97.8%) and hyaluronic acid (1.2%), were isolated after exhaustive proteolysis of a transplantable chondrosarcoma of the rat. The chondroitin 4-sulfate was fractionated into three fractions of varying degrees of sulfation and chain length. Keratan sulfate and chondroitin 6-sulfate were absent. Extraction of the fresh tumor gave two protein-polysaccharides of similar carbohydrate composition, one soluble in 0.5 M NaCl, the other insoluble. The latter was solubilized in 4 M guanidine.HCl. A dialyzable fraction from the 4 M guanidine solution may be responsible for the insolubility. Both protein-polysaccharides were antigenic and cross-reacted with similar fractions of bovine and human cartilage.

Animals↗
PubMedDate not supplied

Pseudo-spinal headache.

BACKGROUND AND OBJECTIVES: Myofascial trigger points are often not considered in the differential diagnosis of headaches. METHODS: A patient who presented with severe bifrontal headaches was treated by injections of the sternocleidomastoid muscle trigger points with local anesthetics. RESULTS: The patient experienced complete resolution of all symptoms, which had not reappeared after 14 months. CONCLUSIONS: Myofascial pain may mimic other disorders, and myofascial headaches can be easily treated once properly diagnosed.

Adult↗