26
|
Shin B, Ledford D, Lockey R. Abdominal pain, Nausea, and Vomiting as the Initial Presenting Symptoms of Systemic Lupus Erythematosus. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.11.098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
27
|
Jamieson B, Bayes R, Davydov YI, Depommier P, Doornbos J, Faszer W, Fujiwara MC, Gagliardi CA, Gaponenko A, Gill DR, Gumplinger P, Hasinoff MD, Henderson RS, Hu J, Kitching P, Koetke DD, Macdonald JA, MacDonald RP, Marshall GM, Mathie EL, Mischke RE, Musser JR, Nozar M, Olchanski K, Olin A, Openshaw R, Porcelli TA, Poutissou JM, Poutissou R, Quraan MA, Rodning NL, Selivanov V, Sheffer G, Shin B, Stanislaus TDS, Tacik R, Torokhov VD, Tribble RE, Vasiliev MA. Measurement ofPμξin polarized muon decay. Int J Clin Exp Med 2006. [DOI: 10.1103/physrevd.74.072007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
28
|
Musser JR, Bayes R, Davydov YI, Depommier P, Doornbos J, Faszer W, Gagliardi CA, Gaponenko A, Gill DR, Green P, Gumplinger P, Hasinoff MD, Henderson RS, Hu J, Jamieson B, Kitching P, Koetke DD, Krushinsky AA, Lachin YY, Macdonald JA, MacDonald RP, Marshall GM, Mathie EL, Miasoedov LV, Mischke RE, Nord PM, Olchanski K, Olin A, Openshaw R, Porcelli TA, Poutissou JM, Poutissou R, Quraan MA, Rodning NL, Selivanov V, Sheffer G, Shin B, Sobratee F, Stanislaus TDS, Tacik R, Torokhov VD, Tribble RE, Vasiliev MA, Wright DH. Measurement of the Michel parameter rho in muon decay. PHYSICAL REVIEW LETTERS 2005; 94:101805. [PMID: 15783475 DOI: 10.1103/physrevlett.94.101805] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2004] [Indexed: 05/24/2023]
Abstract
The TWIST Collaboration has measured the Michel parameter rho in normal muon decay, mu(+)--> e(+)nu(e)nu (mu). In the standard model, rho = 3/4. Deviations from this value imply mixing of left- and right-handed muon and electron couplings. We find rho=0.750 80+/-0.000 32(stat) +/- 0.000 97(syst) +/- 0.000 23, where the last uncertainty represents the dependence of rho on the Michel parameter eta. This result sets new limits on the W(L)-W(R) mixing angle in left-right symmetric models.
Collapse
|
29
|
Cho M, Shin B, Choi S, Lee Y, Song K. Gel polymer electrolyte nanocomposites PEGDA with Mg–Al layered double hydroxides. Electrochim Acta 2004. [DOI: 10.1016/j.electacta.2004.03.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
30
|
Kalinichenko VV, Lim L, Stolz DB, Shin B, Rausa FM, Clark J, Whitsett JA, Watkins SC, Costa RH. Defects in pulmonary vasculature and perinatal lung hemorrhage in mice heterozygous null for the Forkhead Box f1 transcription factor. Dev Biol 2001; 235:489-506. [PMID: 11437453 DOI: 10.1006/dbio.2001.0322] [Citation(s) in RCA: 153] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Decreased pulmonary expression of Forkhead Box f1 (Foxf1) transcription factor was associated with lethal alveolar hemorrhage in 55% of the Foxf1 +/- newborn mice. The severity of the pulmonary abnormalities correlates with the levels of Foxf1 mRNA. Defects in alveolarization and vasculogenesis were observed in subsets of the Foxf1 +/- mice with relatively low levels of expression from the normal Foxf1 allele. Lung hemorrhage was coincident with disruption of the mesenchymal-epithelial cell interfaces in the alveolar and bronchiolar regions of the lung parenchyma and was associated with increased apoptosis and reduced surfactant protein B (SP-B) expression. Finally, the lung defect associated with the Foxf1 +/- mutation was accompanied by reduced expression of vascular endothelial growth factor (VEGF), the VEGF receptor 2 (Flk-1), bone morphogenetic protein 4 (Bmp-4), and the transcription factors of the Brachyury T-Box family (Tbx2-Tbx5) and Lung Kruppel-like Factor. Reduction in the level of Foxf1 caused neonatal pulmonary hemorrhage and abnormalities in alveologenesis, implicating this transcription factor in the regulation of mesenchyme-epithelial interaction critical for lung morphogenesis.
Collapse
|
31
|
Rodning N, Andersson W, Davydov Y, Depommier P, Doornbos J, Faszer W, Gagliardi C, Gaponenko A, Gill D, Green P, Gumplinger P, Hardy J, Hasinoff M, Helmer R, Henderson R, Kitching P, Koetke D, Korkmaz E, Khruchinsky A, Maas D, Macdonald J, MacDonald R, Manweiler R, Marshall G, Mathie T, Musser J, Nord P, Olin A, Openshaw R, Ottewell D, Porcelli T, Poutissou JM, Poutissou R, Price G, Quraan M, Schaapman J, Selivanov V, Sheffer G, Shin B, Sobratee F, Soukup J, Stanislaus T, Stinson G, Tacik R, Torokhov V, Tribble R, Vasiliev M, Walter HC, Wang SC, Wright D. TWIST- The TRIUMF weak interaction symmetry test the Michel parameters from μ+ decay. ACTA ACUST UNITED AC 2001. [DOI: 10.1016/s0920-5632(01)01232-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
32
|
Kalinichenko VV, Lim L, Shin B, Costa RH. Differential expression of forkhead box transcription factors following butylated hydroxytoluene lung injury. Am J Physiol Lung Cell Mol Physiol 2001; 280:L695-704. [PMID: 11238010 DOI: 10.1152/ajplung.2001.280.4.l695] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The forkhead box (Fox) proteins are a growing family of transcription factors that have important roles in cellular proliferation and differentiation and in organ morphogenesis. The Fox family members hepatocyte nuclear factor (HNF)-3beta (Foxa2) and HNF-3/forkhead homolog (HFH)-8 (FREAC-1, Foxf1) are expressed in adult pulmonary epithelial and mesenchymal cells, respectively, but these cells display only low expression levels of the proliferation-specific HFH-11B gene (Trident, Foxm1b). The regulation of these Fox transcription factors in response to acute lung injury, however, has yet to be determined. We report here on the use of butylated hydroxytoluene (BHT)-mediated lung injury to demonstrate that HFH-11 protein and RNA levels were markedly increased throughout the period of lung repair. The maximum levels of HFH-11 were observed by day 2 following BHT injury when both bronchiolar and alveolar epithelial cells were undergoing extensive proliferation. Although BHT lung injury did not alter epithelial cell expression of HNF-3beta, a 65% reduction in HFH-8 mRNA levels was observed during the period of mesenchymal cell proliferation. HFH-8-expressing cells were colocalized with platelet endothelial cell adhesion molecule-1-positive alveolar endothelial cells and with alpha-smooth muscle actin-positive peribronchiolar smooth muscle cells.
Collapse
|
33
|
Johnson ET, Ryu S, Yi H, Shin B, Cheong H, Choi G. Alteration of a single amino acid changes the substrate specificity of dihydroflavonol 4-reductase. THE PLANT JOURNAL : FOR CELL AND MOLECULAR BIOLOGY 2001; 25:325-33. [PMID: 11208024 DOI: 10.1046/j.1365-313x.2001.00962.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Many plant species exhibit a reduced range of flower colors due to the lack of an essential gene or to the substrate specificity of a biosynthetic enzyme. Petunia does not produce orange flowers because dihydroflavonol 4-reductase (DFR) from this species, an enzyme involved in anthocyanin biosynthesis, inefficiently reduces dihydrokaempferol, the precursor to orange pelargonidin-type anthocyanins. The substrate specificity of DFR, however, has not been investigated at the molecular level. By analyzing chimeric DFRs of Petunia and Gerbera, we identified a region that determines the substrate specificity of DFR. Furthermore, by changing a single amino acid in this presumed substrate-binding region, we developed a DFR enzyme that preferentially reduces dihydrokaempferol. Our results imply that the substrate specificity of DFR can be altered by minor changes in DFR.
Collapse
|
34
|
Lee J, Koh J, Shin B, Ahn K, Roh J, Kim Y, Kim K. Comparative study of angiostatic and anti-invasive gene expressions as prognostic factors in gastric cancer. Int J Oncol 2001. [DOI: 10.3892/ijo.18.2.355] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
|
35
|
Yagi M, Kanzaki S, Kawamoto K, Shin B, Shah PP, Magal E, Sheng J, Raphael Y. Spiral ganglion neurons are protected from degeneration by GDNF gene therapy. J Assoc Res Otolaryngol 2000; 1:315-25. [PMID: 11547811 PMCID: PMC2957193 DOI: 10.1007/s101620010011] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022] Open
Abstract
Perceptual benefits from the cochlear prosthesis are related to the quantity and quality of the patient's auditory nerve population. Multiple neurotrophic factors, such as glial cell line-derived neurotrophic factor (GDNF), have been shown to have important roles in the survival of inner ear auditory neurons, including protection of deafferented spiral ganglion cells (SGCs). In this study, GDNF gene therapy was tested for its ability to enhance survival of SGCs after aminoglycoside/diuretic-induced insult that eliminated the inner hair cells. The GDNF transgene was delivered by adenoviral vectors. Similar vectors with a reporter gene (lacZ) insert served as controls. Four or seven days after bilateral deafening, 5 microl of an adenoviral suspension (Ad-GDNF or Ad-lacZ) or an artificial perilymph was injected into the left scala tympani of guinea pigs. Animals were sacrificed 28 days after deafening and their inner ears prepared for SGC counts. Adenoviral-mediated GDNF transgene expression enhanced SGC survival in the left (viral-treated) deafened ears. This observation suggests that GDNF is one of the survival factors in the inner ear and may help maintain the auditory neurons after insult. Application of GDNF and other survival factors via gene therapy has great potential for inducing survival of auditory neurons following hair cell loss.
Collapse
|
36
|
Choi G, Yi H, Lee J, Kwon YK, Soh MS, Shin B, Luka Z, Hahn TR, Song PS. Phytochrome signalling is mediated through nucleoside diphosphate kinase 2. Nature 1999; 401:610-3. [PMID: 10524631 DOI: 10.1038/44176] [Citation(s) in RCA: 194] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Because plants are sessile, they have developed intricate strategies to adapt to changing environmental variables, including light. Their growth and development, from germination to flowering, is critically influenced by light, particularly at red (660 nm) and far-red (730 nm) wavelengths. Higher plants perceive red and far-red light by means of specific light sensors called phytochromes(A-E). However, very little is known about how light signals are transduced to elicit responses in plants. Here we report that nucleoside diphosphate kinase 2 (NDPK2) is an upstream component in the phytochrome signalling pathway in the plant Arabidopsis thaliana. In animal and human cells, NDPK acts as a tumour suppressor. We show that recombinant NDPK2 in Arabidopsis preferentially binds to the red-light-activated form of phytochrome in vitro and that this interaction increases the activity of recombinant NDPK2. Furthermore, a mutant lacking NDPK2 showed a partial defect in responses to both red and farred light, including cotyledon opening and greening. These results indicate that NDPK2 is a positive signalling component of the phytochrome-mediated light-signal-transduction pathway in Arabidopsis.
Collapse
|
37
|
Oh BJ, Ko MK, Kostenyuk I, Shin B, Kim KS. Coexpression of a defensin gene and a thionin-like via different signal transduction pathways in pepper and Colletotrichum gloeosporioides interactions. PLANT MOLECULAR BIOLOGY 1999; 41:313-9. [PMID: 10598099 DOI: 10.1023/a:1006336203621] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
The anthracnose fungus, Colletotrichum gloeosporioides, interacts incompatibly with the ripe fruit of pepper (Capsicum annuum). It interacts compatibly with the unripe-mature fruit. We isolated a defensin gene, jl-l, and a thionin-like gene, PepThi, expressed in the incompatible interaction by using an mRNA differential display method. Both genes were developmentally regulated during fruit ripening, organ-specifically regulated, and differentially induced during the compatible and incompatible interactions. Expression of the PepThi gene was rapidly induced in the incompatible-ripe fruit upon fungal infection. The fungus-inducible PepThi gene is highly inducible only in the unripe fruit by salicylic acid. In both ripe and unripe fruit, it was induced by wounding, but not by jasmonic acid. Expression of the jl-l gene is enhanced by jasmonic acid in the unripe fruit but suppressed in the ripe fruit. These results suggest that both small and cysteine-rich protein genes are induced via different signal transduction pathways during fruit ripening to protect the reproductive organs against biotic and abiotic stresses.
Collapse
|
38
|
Johnson ET, Yi H, Shin B, Oh BJ, Cheong H, Choi G. Cymbidium hybrida dihydroflavonol 4-reductase does not efficiently reduce dihydrokaempferol to produce orange pelargonidin-type anthocyanins. THE PLANT JOURNAL : FOR CELL AND MOLECULAR BIOLOGY 1999; 19:81-5. [PMID: 10417729 DOI: 10.1046/j.1365-313x.1999.00502.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Some angiosperms are limited to a range of possible flower colors. This limitation can be due to the lack of an anthocyanin biosynthetic gene or to the substrate specificity of a key anthocyanin biosynthetic enzyme, dihydroflavonol 4-reductase (DFR). Cymbidium hybrida orchid flowers primarily produce cyanidin-type (pink to red) anthocyanins and lack the pelargonidin-type (orange to brick-red) anthocyanins. To investigate the underlying molecular mechanism of this flower color range, we cloned a Cymbidium DFR gene and transformed it into a DFR- petunia line. We found that the Cymbidium DFR did not efficiently reduce dihydrokaempferol (DHK), which is an essential step for pelargonidin production. Phylogenetic analysis of a number of DFR sequences indicate that the inability to catalyze DHK reduction has occurred at least twice during angiosperm evolution. Our results indicate that developing a pelargonidin-type orange flower color in Cymbidium may require the transformation of a DFR gene that can efficiently catalyze DHK reduction.
Collapse
|
39
|
Shin B, Higa K, Sheng O, Ide T. Analyzing the media usage behavior of telework groups: a contingency approach. ACTA ACUST UNITED AC 1999. [DOI: 10.1109/5326.740675] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
40
|
Kim J, Yang Y, Shin B, Cho C. Visualization and flow of platelets and leukocytes in vivo in rat retinal and choroidal vessels. Ophthalmic Res 1997; 29:374-80. [PMID: 9380339 DOI: 10.1159/000268038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE To directly visualize the flow of leukocytes in choroidal vessels and the flow of platelets in retinal vessels in a rat without incision by fluorescein leukocyte angiography (FLA) using a scanning laser ophthalmoscope (SLO). METHODS Blood was withdrawn from a tail vein of a Sprague-Dawley rat with a tuberculin syringe traced with sodium heparin and mixed with sodium fluorescein. The fluorescent plasma layer was diluted with saline solution, centrifuged and then the overlying plasma discarded. The remaining cell suspension was diluted with saline to create the original hematocrit, then infused into the vein of the same rat while performing fluorescein angiography with an SLO. The angiographic image was recorded on a videotape using time-lapsed photography. RESULTS Fluorescent platelets were detected and the flow within the retinal vessels traced over time. Fluorescent leukocytes in the choroidal vessels were also detected and the flow of a leukocyte was traced and its relative velocities were plotted against the time sequence. The relative size and fluorescence intensities of the platelets and leukocytes in the angiographic image corresponded well with the smear of the blood preparation. CONCLUSIONS FLA using an SLO can be used to detect the flow of platelets in the retinal vessels and the flow of leukocytes in the choroidal vessels in the experimental rat eye model.
Collapse
|
41
|
Rosen GH, Boullata JI, O'Rangers EA, Enow NB, Shin B. Intravenous phosphate repletion regimen for critically ill patients with moderate hypophosphatemia. Crit Care Med 1995; 23:1204-10. [PMID: 7600828 DOI: 10.1097/00003246-199507000-00009] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To document the safety and efficacy of an intravenous phosphate repletion regimen that is more aggressive than recommended by previously published guidelines, in intensive care unit (ICU) patients with hypophosphatemia. DESIGN Prospective evaluation of rapid, intravenous phosphate repletion in eligible patients. SETTING Surgical ICU in a teaching hospital. PATIENTS Patients with a serum phosphorus concentration of < 2 mg/dL (< 0.65 mmol/L) while in the ICU. INTERVENTIONS Enrolled patients received 15 mmol of sodium phosphate in 100 mL of 0.9% sodium chloride, infused intravenously over a period of 2 hrs. Patients with a serum potassium concentration of < 3.5 mmol/L received potassium phosphate, if no other potassium supplementation was ordered. The same dose could be repeated to a maximum of 45 mmol in a 24-hr period if either the 6-hr or follow-up (18- to 24-hr) postinfusion serum phosphorus remained < 2 mg/dL (< 0.65 mmol). Serum electrolytes, renal function, vital signs, and reflexes were closely monitored. MEASUREMENTS AND MAIN RESULTS Eleven patients enrolled had baseline serum phosphorus values of 1.6 to 1.9 mg/dL (0.51 to 0.61 mmol/L). The serum phosphorus value immediately postinfusion was 2.3 to 5.3 mg/dL (0.74 to 1.7 mmol/L). Only one patient had a 6-hr postinfusion serum phosphorus of < 2 mg/dL (< 0.65 mmol/L), requiring two additional doses. Two other patients each required a second dose. Serum phosphorus was corrected in other patients with a single dose. No significant changes were noted in serum calcium, magnesium, or potassium concentrations, urine output, vital signs, or reflexes throughout the repletion period. CONCLUSIONS All patients were successfully repleted using the described protocol without any significant adverse effects. This repletion regimen may have widespread applicability in the ICU setting.
Collapse
|
42
|
Grace GT, Badder E, Shin B, Wehburg K, Brunner M, Sutter B, Stone HH. Acute postoperative hypokalemia. CURRENT SURGERY 1990; 47:435-8. [PMID: 2279402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
43
|
Grace GT, Shin B, Levin P, Stone HH. Immediate post-traumatic hypokalemia. CURRENT SURGERY 1988; 45:463-4. [PMID: 3234020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
|
44
|
|
45
|
Shin B, Mackenzie CF, Helrich M. Creatinine clearance of early detection of posttraumatic renal dysfunction. Anesthesiology 1986; 64:605-9. [PMID: 3963478 DOI: 10.1097/00000542-198605000-00010] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Acute renal failure develops insidiously in the presence of normal urine output and vital signs. A prospective study was carried out to find whether renal impairment can be detected in the immediate postoperative period and to determine the renal function test best predicting the development of renal dysfunction. Forty patients with multiple trauma who required more than 10 units of blood and had a systolic blood pressure less than 80 mmHg on admission were studied. Creatinine clearance (Ccr), free-water clearance (CH2O), fractional excretion of Na+, blood urea nitrogen (BUN), urine flow rate, and vital signs were measured and compared in seven patients who developed renal dysfunction within a week of trauma (Group 1) and 33 patients who maintained normal renal function (Group 2). In all Group 1 patients Ccr remained less than 25 ml/min and CH2O greater than -15 ml/h for 6 h following surgery. None of the Group 2 patients had Ccr less than 25 ml/min for longer than 4 h following surgery. However, CH2O values were greater than -15 ml/h in 15 of the 33 Group 2 patients during the first 24 postoperative hours. Ccr values less than 25 ml/min were present, despite normal urine flow rate and blood pressure, in patients who subsequently developed renal dysfunction. Patients who have Ccr values less than 25 ml/min within 6 h following trauma and surgery may develop renal dysfunction, and some of them may proceed to acute renal failure. CH2O was not as good a predictor of development of renal dysfunction as Ccr.
Collapse
|
46
|
Mackenzie CF, Shin B, Krishnaprasad D, McCormack F, Illingworth W. Assessment of cardiac and respiratory function during surgery on patients with acute quadriplegia. J Neurosurg 1985; 62:843-9. [PMID: 3998833 DOI: 10.3171/jns.1985.62.6.0843] [Citation(s) in RCA: 36] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Cardiorespiratory function was assessed in 22 mechanically ventilated patients who underwent surgery within an average of 4.8 days following traumatic spinal cord injury at C3-7. A fluid challenge technique was used to derive right and left ventricular function curves and to assist in choice of therapy from four possible outcome responses. Both right and left ventricular stroke work increased but left ventricular stroke work was still lower than normal in six (27%) of 22 patients despite elevation of cardiac filling pressures. Pulmonary vascular resistance fell, but systemic vascular resistance was unchanged following fluid challenge. Respiratory function, including intrapulmonary shunt, lung/thorax compliance, dead space, and arterial pO2 and pCO2, were unchanged by fluid administration averaging 520 ml of plasma protein fraction in 12 minutes. The Bainbridge reflex was inoperative. There was no correlation between anesthetic agent, level or type of neurological deficit, and cardiorespiratory function. Left ventricular function was impaired so the use of peripheral vasoconstrictors that elevate systemic vascular resistance should be avoided in the management of spinal shock. Instead, myocardial depressants should be reduced and fluid replacement used to optimize cardiac function. Elevation of central venous or pulmonary capillary wedge pressures to 18 mm Hg should be used to reverse hypotension, acidosis, low venous pO2, or oliguria before institution of centrally acting inotropic therapy in the management of acute spinal cord injury.
Collapse
|
47
|
Mackenzie CF, Shin B. Cardiorespiratory function before and after chest physiotherapy in mechanically ventilated patients with post-traumatic respiratory failure. Crit Care Med 1985; 13:483-6. [PMID: 3888530 DOI: 10.1097/00003246-198506000-00009] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Chest physiotherapy (CPT) is used frequently in the ICU, but there is little available information that quantitates its effect on cardiac or respiratory function. Nineteen mechanically ventilated patients with post-traumatic respiratory failure were studied before, immediately after, and 2 h after CPT was used to manage secretion retention. Cardiac index was unchanged, but there was an immediate decrease in intrapulmonary shunt, followed 2 h later by an increase in lung/thorax compliance. We did not find the reduced cardiac output reported by others. The reasons for this may include use of different CPT techniques, a young patient population (mean age 32.4 yr), and mechanical ventilation with positive end-expiratory pressure. CPT did not produce the deleterious cardiopulmonary changes associated with bronchoscopy, and it reduced retained lung secretions without producing hypoxemia. Intrapulmonary shunt and lung/thorax compliance were significantly improved, but the long-term clinical effect of these changes is unknown.
Collapse
|
48
|
Richards WO, Schnaper LA, Shin B. Creatinine clearance and intra-abdominal infection. CURRENT SURGERY 1985; 42:111-2. [PMID: 3996023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
49
|
Abstract
Polyuria, peaking at 2000 ml/h, was seen in a patient after resuscitation of hemorrhagic shock and a brief period of oliguria. This unusual polyuria appears to be a consequence of renal tubular dysfunction that persisted after glomerular filtration rate had returned to normal.
Collapse
|
50
|
Richards WO, Scovill WA, Shin B. Opsonic fibronectin deficiency in patients with intra-abdominal infection. Surgery 1983; 94:210-7. [PMID: 6879439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The reticuloendothelial system provides host defense functions by the intravascular phagocytosis of bacteria and nonbacterial particulates. Fibronectin is opsonic for reticuloendothelial phagocytosis. Plasma fibronectin was measured before and after operation in patients with intra-abdominal infection. Preoperatively opsonic fibronectin was reduced by 39% of normal control levels in 16 patients with intra-abdominal infection. There was an even greater reduction of opsonic fibronectin after operation that was first observed in the recovery room. This deficiency persisted for the first 4 days with a tendency toward recovery of normal circulating levels by the fifth postoperative day. In contrast, patients who underwent elective major abdominal operation without infection manifested a transient opsonic fibronectin deficiency with recovery by the second and third postoperative days. Eight of 16 patients with intra-abdominal infection developed multiple organ failure. The opsonic fibronectin levels in those patients were lower than the levels in eight patients who did not develop multiple organ failure. Furthermore, there was no tendency toward recovery of normal circulating opsonic fibronectin in those patients. On all days when multiple organ failure occurred there was a marked deficiency of circulating opsonic fibronectin. We conclude that transient opsonic fibronectin deficiency occurs after major elective abdominal operation. Patients with intra-abdominal infection manifest opsonic fibronectin deficiency before operation, and further depletion of opsonic fibronectin occurs after operation. Postoperative multiple organ failure occurs only in association with severe opsonic fibronectin deficiency.
Collapse
|