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Biomedical subjects

R W Hoskin

Publications and source records attributed to R W Hoskin.

9 recordsLinked to original sources
PubMed2001

Intraoperative decrease in pulse oximeter readings following injection of isosulfan blue.

PURPOSE: Sentinel lymph node mapping, involving injection of isosulfan blue dye around a tumour, is beginning to be used in patients with carcinoma of the breast. Absorption of the dye into the circulation may interfere with pulse oximetry, causing falsely low readings. This report describes changes in pulse oximeter readings following injection of isosulfan blue for sentinel lymph node mapping in a patient with carcinoma of the breast. CLINICAL FEATURES: An 83-yr-old female patient underwent sentinel node biopsy of the axilla followed by partial mastectomy for carcinoma of the left breast. Isosulfan blue was injected in the area of the tumour in the left breast. The SpO2 began to decrease 15 min after dye injection, reaching a nadir of 89-90% 30 min after injection. Arterial blood gas analysis showed normal arterial partial pressure of oxygen. Pulse oximeter readings did not return to normal until more than six hours after dye injection. CONCLUSION: Review of the literature reveals a small number of case reports of similar occurrences of low pulse oximeter readings following injection of isosulfan blue or patent blue dye for lymphatic mapping. Data from these reports and the case described here suggest that the latency, magnitude and duration of effect on pulse oximeter readings following injection of these dyes is highly variable. It is important to rule out other causes of low pulse oximeter readings when this effect occurs; normal oxygenation can be verified with arterial blood gas analysis. Co-oximetry can be done to rule out methemoglobinemia as a cause of decreased SpO2.

Adenocarcinoma↗
PubMed1994

Reevaluation of the balloon in gastrointestinal manometry.

Although the flow-through catheter (FTC) system has been useful and satisfactorily accurate for gastrointestinal manometry, we hypothesized that a cylindrical, liquid-filled balloon would also accurately reflect stress imposed by a sphincter. Latex balloons were fitted over the side ports of a closed-end catheter. The responses of the balloon and FTC system were compared in a cylindrical chamber commonly identified as a Starling resistor. Independent, constant-pressure sources were used to control both the inwardly directed "contact pressure" of the Starling resistor (Ps) and the intraluminal fluid pressure (P(lum)). The balloon transducers responded linearly and accurately (slope = 1) to changes in both Ps and P(lum) within the test range (0-200 mmHg, 0-26.7 kPa). When either P(lum) or Ps was held constant and the other changed, the balloon transducers always accurately measured the higher of the two pressures. Although the performance of the FTC system was improved after the Starling resistor was lubricated, the FTC system sometimes responded inaccurately to changes in Ps. The ability of the balloon transducers to measure the contractions of the lower esophageal sphincter and of the esophagus was demonstrated. We conclude that the balloon transducer can measure sphincter pressure accurately and suggest that, in certain circumstances, it might be advantageous relative to the FTC system.

Digestive System Physiological Phenomena↗
PubMed1989

Projections from inspiratory neurons of the nucleus retroambigualis to phrenic motoneurons in the cat.

The connection between the inspiratory neurons of the nucleus retroambigualis and the phrenic motoneurons was examined using the techniques of antidromic mapping to discover collaterals and spike-triggered averaging to detect postsynaptic potentials. Axon collaterals within the region of the C5 phrenic nucleus were found for 17 of 26 (65%) inspiratory neurons and 6 of these 17 (35%) were shown to generate excitatory postsynaptic potentials in at least one phrenic motoneuron. It was concluded that these results demonstrate a strong connection for those inspiratory neurons of the nucleus retroambigualis with a collateral within the phrenic nucleus.

Animals↗
PubMed1988

Projections from upper cervical inspiratory neurons to thoracic and lumbar expiratory motor nuclei in the cat.

Previous studies have demonstrated the existence of axonal projections from propriospinal respiratory neurons in the rostral cervical cord of the cat (upper cervical inspiratory neurons) to the vicinity of the phrenic and rostral thoracic inspiratory (external) intercostal motoneurons. However, no synaptic targets of the upper cervical inspiratory neurons have been identified. This study investigated the axonal projections to the caudal thoracic and upper lumbar cord and the possible existence of inhibitory connections to the expiratory intercostal and abdominal motoneurons. The connections from upper cervical inspiratory neurons to expiratory motoneurons in the lower thoracic cord were examined using the methods of antidromic mapping and the spike-triggered averaging of intracellular potentials. Of the 70 upper cervical inspiratory neurons examined, only four (5.7%) could not be antidromically activated from the T9 segment of the spinal cord. The axons of 66 upper cervical inspiratory antidromic activation at less than 5 microV, and the presence of collaterals was confirmed by antidromic mapping in 30 cases (49.2%). Of 21 axons tested for lumbar projections, 13 (61.9%) projected as far as T12, seven (33.3%) as far as L1, three (14.3%) as far as L2, and one (4.8%) was antidromically activated from L3. Spike-triggered averaging of the synaptic potentials recorded intracellularly from expiratory intercostal motoneurons in T9 and T10 spinal segments was done for 27 upper cervical inspiratory neurons, 17 of these with 4 or more motoneurons, for a total of 111 expiratory motoneurons. In 16 cases the motoneurons were injected with Cl- to reverse IPSPs and the spike-triggered averaging was repeated. No monosynaptic or disynaptic post-synaptic potentials were seen in any of the spike-triggered averages. We concluded that the upper cervical inspiratory neurons may provide inspiratory inhibition to expiratory motoneurons via a di- or oligosynaptic pathway involving segmental inhibitory interneurons and that either the spike-triggered averaging technique was not sensitive enough to detect the ipsilateral connections or the interneuron pathway was to the contralateral side of the spinal cord.

Animals↗
PubMed1988

Temperature and metabolic responses to inhalation and bath rewarming protocols.

Rewarming of mildly hypothermic subjects was compared using three different techniques that have been suggested for use in field situations. Eight subjects were cooled for up to 1 h, on four occasions, in a filled whole-body water calorimeter controlled at 22 degrees C. Following cooling, rewarming was initiated by one of four procedures: inhalation of warmed and humidified air at 40 degrees C or 45 degrees C, immersion in 40 degrees C water, or spontaneously by shivering. Deep body temperature was recorded simultaneously at three different sites: rectal, esophageal, and auditory canal. Skin temperatures were recorded from four sites: chest, forearm, thigh, and calf. Results showed that rapid external rewarming in 40 degrees C water produced the quickest rate of rewarming and smallest magnitude and duration of afterdrop. Regardless of which rewarming protocol was followed, the esophageal site always showed the smallest afterdrop. Although there were no differences in the rewarming rates calculated for each of the three core temperature sites during inhalation and spontaneous rewarming, both auditory canal and esophageal sites rose significantly quicker than rectal during the rapid rewarming in 40 degrees C water. Inhalation rewarming led to a depressed metabolic rate, compared to spontaneous rewarming, which was not compensated by heat provided through the respiratory tract. It was concluded that for mildly hypothermic subjects, rapid rewarming in 40 degree C water was the most efficient procedure and that esophageal temperature--the closest approximation of aortic blood or cardiac temperature--is the most sensitive to change during rewarming by any procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Intracellular recordings from upper cervical inspiratory neurons in the cat.

Intracellular recordings were made from propriospinal, inspiratory neurons, at the lateral edge of lamina VII in the upper cervical cord of the cat. The membrane potentials were found to fluctuate with the central respiratory rhythm, as determined from a recording of the phrenic nerve discharge. Excitatory postsynaptic potentials occurred during the inspiratory phase, and inhibitory postsynaptic potentials were shown to occur in the expiratory phase by injecting chloride to reverse them. These recordings are the first demonstration that the upper cervical inspiratory neurons receive both excitation during inspiration and inhibition during expiration.

Animals↗
PubMed1987

Excitation of upper cervical inspiratory neurons by inspiratory neurons of the nucleus retroambigualis in the cat.

The experiments reported here examined inputs from inspiratory neurons of the nucleus retroambigualis to upper cervical inspiratory neurons. Antidromic mapping in contralateral C1 demonstrated the existence of axon collaterals for 9 of 19 nucleus retroambigualis axons tested (47%). Forty nucleus retroambigualis neurons were tested with antidromic mapping for a projection to the ipsilateral C1 segment; 9/40 (22%) had an ipsilateral axon (8 of these also projected contralaterally), and 2/40 (5%) had an axon collateral in ipsilateral C1. Cross-correlation histograms suggested monosynaptic excitation of an upper cervical inspiratory neuron by a contralateral nucleus retroambigualis neuron in 4/69 cases (6%) and common input to the pair in 2/69 cases (3%). Six of the 69 cross-correlograms were computed during antidromic activation of the nucleus retroambigualis neuron, and one of these six demonstrated direct excitation of the upper cervical inspiratory neuron by the retroambigualis neuron. We concluded that at least some upper cervical inspiratory neurons receive monosynaptic excitation from the contralateral, and possibly the ipsilateral, nucleus retroambigualis inspiratory neurons. These results, together with those published elsewhere for inputs from inspiratory neurons in the contralateral ventrolateral nucleus tractus solitarius, suggest that the rhythmic, inspiratory firing pattern of the upper cervical inspiratory neurons is due to excitatory inputs from these two inspiratory bulbospinal neuron populations.

Animals↗
PubMed1986

Bath rewarming from immersion hypothermia.

Trunk-only bath rewarming has often been recommended over whole-body bath rewarming as a method for the treatment of immersion hypothermia. At present, no report of a direct comparison of the relative merits of these techniques has been made. Authorities in favor of trunk-only bath rewarming base their proposal on the assumption that core temperature afterdrop would be minimized by preventing peripheral vasodilation when the subject's limbs are not immersed in the rewarming bath. In the present study, trunk-only and whole-body bath rewarming are compared by rewarming eight mildly hypothermic male subjects twice, once via each technique. It was concluded that trunk-only rewarming is not superior to whole-body bath rewarming as a therapy for mild immersion hypothermia, based on the findings that no significant differences existed between the two techniques, either in size or duration of core temperature afterdrop, or in rate of rewarming.

Adult↗