Breathlessness and blood oxygen tension in patients with chronic bronchitis and emphysema

A method is described whereby about 100 litres of plasma containing 10-50 IU/ml tetanus antitixin was obtained, from which were prepared 5000 X 250 IU doses of human antitetanus immunoglobulin. Of 40 blood donors who received a booster injection of tetanus vaccine BP, 33 were plasmapheresed each week over a 10-12 week period starting three weeks after the injection. Twenty-two of these donors provided 90% of the total plasma, the antitoxin content of which averaged 23.6 IU/ml over the 10-12 week period.     

Changes in paO2 and of acid-base equilibrium of the arterial blood of hypoxemic polyglobulic patients subjected to acute blood depletion

Partial respiratory gas tension and acid-base equilibrium patterns were examined in polyglobulic patients subjected to acute blood depletion. The increase in oxyhaemoglobin concentration and fall in haematocrit value already described were confirmed. It was also noted that: 1) pH increased significantly in all subjects; 2) urinary osmolarity increased in all subjects; 3) blood sodium and potassium concentration increased significantly in 14 patients (1st group), but fell in the 2nd group (8 subjects). It is suggested, therefore, that acute blood depletion changes renal reabsorption of the main electrolytes, i.e. increased values in cases where a fall in glomerular arteriolar pressure leads to increased renal medullary osmolarity, and decreased values where a fall in circulation leads to increased arteriolar pressure, hyperosmolarity of the medulla, and retainment of liquids as opposed to electrolytes.     

Protein electrolyte spectrum of the blood in patients with chronic suppurative inflammatory diseases of the lungs and pleura

A second case of malfunction of a Harken disk valve due to undue disk wear is reported. Two and one-half years after aortic and mitral valvular replacement, the patient had paraprosthetic aortic insufficiency and physical findings suggesting intermittent dysfunction of his prosthetic mitral valve. Catheterization showed intermittent hemodynamic abnormalities; fluoroscopic and cineangiographic findings indicated intermittent mitral regurgitation secondary to undue mitral disk wear. At operation, the excised valve showed normal struts and sewing ring but severe disk wear. There was loss of disk substance and rim notching.     

Relationships between blood oxygen parameters in patients with chronic obstructive lung disease

The hemoglobin-oxygen dissociation curve and the relationships between the parameters of tension, saturation, capacity, affinity and concentration of oxygen in the course of respiratory failure in chronic obstructive lung diseases (COLD) were studied. The study included 141 patients divided into four basic groups according to the value of pO2 (a): patients with normoxia, mild, moderate and severe arterial hypoxia. The blood-gas status was determined using the ABL-330 and OSM-3 analyzers (Radiometer A/S, Denmark). It is concluded that: 1. Presence of normoxia (pO2 and sO2 in norm) in COLD patients does not exclude abnormalities in their arterial blood oxygen transport and increased risk of tissue hypoxia. 2. Total oxygen concentration in respiratory failure is relatively stable and "independent" from the stepwise decrease of the arterial pO2, which results from the compensatory increase of the total and effective hemoglobin. 3. There are phase fluctuations of the ctO2/pO2 dissociation curve in the reference interval, expressed in the "lowering" of P50 and p90 in mild hypoxia and the "centering" or "raising" of their values in severe hypoxia. Such fluctuations are more pronounced in the p90 than in the p50. 4. The oxygen extraction tension lowers progressively (without reaching the anaerobic threshold) and the oxygen compensation factor elevates with the pO2 (a) reduction and the arising of hypercapnia and acidemia. 5. The calculated 2,3-diphosphoglycerate (2,3-DPG) concentration values are significantly higher in hypercapnics with COHb > 1% than in those with COHb < 1%. The relationships between hypoxia, oxygen affinity, hemoglobinemia and oxygen affinity as well as the dissociation curve properties in chronic respiratory failure are discussed.     

Central venous pressure and blood circulation in orthostatic by changes of the total blood volume in postoperative patients (author's transl)

In 13 postoperative patients (1st to 9th day) of both sexes, aged 32 to 74, we studied whether an additional volume of 500 ml Haemaccel might demonstrate-as in earlier test series--a correlation between CVP measured in the horizontal position and changes of CVP and Pa measured at atrial level in a partly upright position (tilting angle 45 degrees and 60 degrees of the revolving bed). After volume administration (average: 8.13 ml/kg body weight) and raising of CVP in the horizontal by 3.42 cm H2O corresponding to an E'-value of 0.42 cm H2O/ml/kg body weight, we noticed a significant reduction of the decrease due to orthostasis as well of Pa at heart level as of the "shock index"; at the same time, however, the extent of the CVP decrease registered for all patients increased significantly regardless of tilting angle. Therefore, a correlation between the intravasal filling state and the reaction of orthostatic CVP and Pa may be assumed. In conclusion, the explanation for these results and the relation between the venous filling volume and some pathophysiological functions at the right heart are discussed.     

Changes in the electrolyte and acid-base equilibrium during the first days of life]

The concentrations of potassium, sodium and magnesium in plasma, red corpuscels and acid-base status were measured during the first five days of life. Significant differences were observed during this period of life, these values also differ markedly from those of adults. The causes of the particular conditions of the neonates are complex and not all known at present.     

Changes of venous blood flow velocity waveforms in fetuses with supraventricular tachycardia

Studies in the fetal lamb have shown that atrial pacing beyond a rate of 300-320 beats/min may be associated with dramatic changes of venous blood velocity waveforms, an increase of venous pressure by up to 75%, hydrops, polyhydramnios and placental edema. The aim of our study was to determine the 'critical' heart rate frequency in the human fetus. In 11 fetuses (five with and six without hydrops) with supraventricular tachycardia, pulsed wave Doppler analysis of flow velocity waveforms of the inferior vena cava, the ductus venosus and the left hepatic vein were performed before and after drug treatment. In ten cases cardioversion was achieved by in utero antiarrhythmic drug therapy; in one case treated with digoxin and flecainide the supraventricular tachycardia was decreased to 160-190 beats/min with disappearance of hydrops. Before intrauterine treatment of supraventricular tachycardia, pulsatile reversal of blood flow in the inferior vena cava, ductus venosus and left hepatic vein was visible, with monophasic forward flow during systole and reversed flow during diastole in ten of 11 fetuses. One fetus with supraventricular tachycardia of 195 beats/min showed a normal biphasic forward flow pattern. During drug-induced sinus rhythm, a normal biphasic forward venous blood flow pattern was shown in all ten cases. In five cases pulsatile reversal was demonstrated during a drug-induced reduction of the heart rate from 280 to 210 beats/min and a normal biphasic forward flow velocity waveform appeared during supraventricular tachycardia below 210 beats/min.(ABSTRACT TRUNCATED AT 250 WORDS)     

The erythrocyte lipids of the peripheral blood and myocardial dystrophy in patients with iron-deficiency anemia

Lipids of peripheral blood red cells (total lipids and phospholipids, triglycerides, free fatty acids, cholesterol, cholesterol ethers, lysophospholipids, sphingomyelins, phosphatidylserins, phosphatidylethanolamines, phosphatidylcholines, cardiolipins, phosphatid acids) were assessed in correlation with wave T height on resting ECG. It is shown that iron deficiency anemia patients develop shifts in red blood cell lipid composition contributing to the onset of myocardiodystrophy. The correction of the lipid composition defects is an additional factor decreasing dystrophic processes in the myocardium.     

The 4 rights of compression therapy for patients with chronic venous insufficiency and venous ulceration

Compression therapy has become an ever increasing component in the care of patients with Chronic Venous Insufficiency (CVI) and venous ulcerations. Although compression therapy is of great benefit to many of these patients, this treatment option does not come without risks. The increased use of compression therapy has coincided with an increase in its improper application. This article simplifies the principles of compression and highlights the common pitfalls of its use, with an emphasis on the home healthcare setting.     

Calcitonin and calcium content of the blood of patients with thyroid pathology

The blood calcitonin and calcium content was studied in 38 patients with thyrotoxicosis, 20 subjects with endemic euthyroid goiter and 7 persons with primary hypothyrosis. The blood calcium and calcitorim levels were not changed in males and females with endemic euthyroid goiter in comparison with those of 19 healthy controls. Calcitonin content was markedly decreased in patients with hypothyrosis. Calcium level was significantly increased in males, remaining practically unchanged in females. Calcium and calcitonin levels were dependent on thyrotoxicosis severity. Calcitonin content remained unchanged in moderate thyrotoxicosis and lowered in the severe stage of the disease. The blood calcium level remained unchanged both in males and females suffering from severe thyrotoxicosis and in males with the moderate form of the disease. Calcium content diminished in the blood serum of females with moderate thyrotoxicosis.     

Plasma and erythrocyte magnesium levels are correlated with oxygen uptake in patients with non-insulin dependent diabetes mellitus

The excavation of a 23 year-old aircraft crash site in the Socialist Republic of Vietnam and the transformational processes preceding its excavation in 1995-1996 are detailed. The history of the site involved an initial catastrophic event, with subsequent reclamation and disturbances. Ultimately, a recovery effort by a joint U.S. team from the Central Identification Laboratory, Hawaii (CILHI). Joint Task Force-Full Accounting (JTF-FA) and a Socialist Republic of Vietnam contingent yielded numerous human remains, personal effects, and life-support items from the crash site. This case study should be of interest to the increasing number of forensic anthropologists who carry out work in international contexts. The application of forensic anthropology in human rights abuse cases, for example in Rwanda, Argentina, and Bosnia, provide examples of such cross-cultural endeavors. Cultural factors act in the development of a site and should not be overlooked as significant taphonomic agents. The approach that an indigenous person takes to a crash site or mass grave may be quite different from our own approach, involving Western science. Holland, Anderson, and Mann (I) describe the postmortem alternation of exhumed and/or curated bone caused by indigenous South-east Asian peoples; the examples provided by these authors demonstrate how culture affects the treatment of what we would call "evidence." The international nature of an incident can add complicating "filters" to the reconstruction of events, since reclamation responses by indigenous people vary according to their interpretations of the scene. An investigating forensic anthropologist needs to understand the emic viewpoint (the insider's view), as cultural anthropologists do, when attempting to recover and reconstruct such an incident. In response to the cultural (and natural) taphonomic agents at work on such a site, the use of dual forensic recovery methods--simultaneously treating the investigation scene like an aircraft crash and a clandestine burial site--is advised. Employing a flexible set of methods will allow for maximal recovery of evidence.