Physiologic and pathologic responses of dogs were studied to assess the effect on the lungs of aspiration of gastric contents at a pH value greater than 2.5. Experimental solutions were administered ...into the lungs at a dose of 2 ml/kg. Animals were divided into 5 groups: group 1 (n = 13) received saline at a pH of 5.9; group 2 (n = 8) received hydrochloric acid (HCl) at a pH of 1.8; group 3 (n = 6) received gastric contents containing small food particles at a pH of 5.9; group 4 (n = 6) received gastric contents containing food particles at a pH of 1.8; group 5 (n = 6) received gastric contents at a pH of 5.9 from which food particles had been filtered. Arterial blood gas tension, fractional intrapulmonary shunt, and blood pressure were measured at intervals for 48 h. Animals that received gastric contents at a pH of 5.9 and severe hypoxia and increased intrapulmonary shunting that were significantly greater than those of animals receiving saline and were as severe as those of animals receiving HCl at a pH of 1.8. If food particles were in the aspirate, hypercapnia and acidosis were noted. There was pneumonitis in lung sections taken from animals in groups 2, 3, and 4, but not groups 1 and 5. These findings contradict the common belief that aspiration of gastric contents at a pH greater than 2.5 is benign.
Aspiration and obstetrical anesthesia Kruse, J C; Gibbs, C P
Journal of the Florida Medical Association (1974),
10/1978, Letnik:
65, Številka:
10
Magazine Article
Giant cell tumor of bone Mendenhall, William M; Zlotecki, Robert A; Scarborough, Mark T ...
American journal of clinical oncology
29, Številka:
1
Journal Article
Recenzirano
To discuss the treatment and outcomes for giant cell tumor (GCT) of bone.
Review of the pertinent literature.
GCT is a rare benign bone lesion most often found in the extremities of women in the ...third and fourth decades of life. Surgery is the mainstay of treatment and usually consists of intralesional curettage; local control rates range from 80% to 90% after this procedure. Patients with extensive, recurrent, and/or biologically more aggressive tumors may require wide excision. A small subset of patients with incompletely resectable GCTs or with lesions that are surgically inaccessible may be treated with moderate-dose radiotherapy (45-50 Gy) and have a 65% to 80% likelihood of being locally controlled.
The majority of patients with GCTs are effectively treated with intralesional curettage. Wide excision or radiotherapy is necessary to cure a relatively limited subset of patients with extensive, aggressive, and/or incompletely resectable GCTs.
Metabolic factors have been proposed to explain strength deficits observed in skeletal muscle with immobilization that are not completely accounted for by changes in muscle cross-sectional area (CSA) ...and neural adaptations. The aim of this study was to quantify changes in the resting inorganic phosphate (Pi) concentration from the medial gastrocnemius muscle during immobilization, reloading and rehabilitation. Additionally, we assessed the contributions of CSA, muscle activation and Pi concentration to plantar flexor torque during rehabilitation following immobilization. Eight persons with a surgically stabilized ankle fracture participated. Subjects were immobilized for 6-8 weeks and subsequently participated in 10 weeks of rehabilitation. Localized (31)P-Magnetic resonance spectroscopy, magnetic resonance imaging, isometric torque and activation testing were performed on the immobilized and uninvolved limbs. At 6 weeks of immobilization, significant differences were noted between the immobilized and uninvolved limbs for the Pi concentration and the Pi/PCr ratio (P < 0.05). From 6 weeks of immobilization to 3-5 days of reloading, the increase in Pi concentration (15%, P = 0.26) and Pi/PCr (20%, P = 0.29) was not significant. During rehabilitation, the relative contributions of CSA, muscle activation and Pi concentration to plantarflexor torque were 32, 44 and 40%, respectively. Together, CSA, muscle activation and Pi concentration accounted for 76% of the variance in torque (P < 0.01). In summary, our findings suggest that immobilization, independent of reloading, leads to a significant increase in the resting Pi concentration of human skeletal muscle. Additionally, alterations in resting Pi concentration may contribute to strength deficits with immobilization not accounted for by changes in muscle CSA or neural adaptations.
Uterine arteries from pregnant and nonpregnant patients were studied to define their responses to lidocaine. Although local anesthetics usually are considered vasodilators, these data indicate that ...the human uterine artery constricts when exposed to 1,000 mug of lidocaine in vitro. Furthermore, those arteries from pregnant patients exhibited significantly greater responses than did those from nonpregnant patients.
