PubMed Health⌕ Search

Biomedical subjects

T S Ingrassia

Publications and source records attributed to T S Ingrassia.

3 recordsLinked to original sources

Oxygen-exacerbated bleomycin pulmonary toxicity.

Bleomycin is an antineoplastic agent with potential for producing pulmonary toxicity, attributed in part to its free radical-promoting ability. Clinical and research experiences have suggested that the risk of bleomycin-induced pulmonary injury is increased with the administration of oxygen. We report a case in which the intraoperative administration of oxygen in the setting of previous bleomycin therapy contributed to postoperative ventilatory failure. Our patient recovered with corticosteroid therapy. Physician awareness of a potential interaction between oxygen and bleomycin may help reduce the morbidity and mortality related to bleomycin therapy.

Acute Disease↗

Plastic bronchitis: an old disease revisited.

Expectoration of bronchial casts (plastic bronchitis) is an uncommon but ancient problem. Herein we describe a 40-year-old man, with no prior lung disease, who had dyspnea, cough, and expectoration of long branching bronchial casts. No specific cause was delineated, although special stains for eosinophilic granule major basic protein demonstrated occasional foci of eosinophils and small amounts of extracellular major basic protein in the bronchial casts. Various diseases, such as allergic bronchopulmonary aspergillosis, bronchiectasis, and cystic fibrosis, have been associated with the formation of bronchial casts and should be considered in the differential diagnosis. Although most previously reported cases have been associated with some type of pulmonary disease, our patient had no evidence of an underlying pulmonary disorder.

Acetylcysteine↗

Influence of sleep state on CO2 responsiveness. A study of the unloaded respiratory pump in humans.

We measured the ventilatory recruitment threshold for CO2 (RT) during wakefulness, nonrapid eye movement sleep (NREM), and rapid eye movement sleep (REM) in eight patients with respiratory failure. Because the lungs were mechanically ventilated during the RT measurements, we were able to define the effects of arousal state on the chemoresponsiveness of the unloaded respiratory system. Ventilator settings were held constant in each patient, assuring that mechanoreceptor input to the respiratory controller remained the same during all measurements. RT increased from 38 +/- 6 mm Hg during relaxed wakefulness to 42 +/- 8 mm Hg during NREM sleep (p less than or equal to 0.01), consistent with a blunting of chemoresponsiveness during sleep. In five subjects we were able to measure RT during REM sleep also. In four of them, REM RT exceeded the wakefulness measurement by at least 3 mm Hg. The remaining patient showed no demonstrable changes in RT during either sleep state. We conclude that the loss of a wakefulness stimulus contributes to sleep-induced hypercarbia in humans.

Adult↗