William R. Barclay

Consumption Coagulopathy in Miliary Tuberculosis

Abstract A 56-year-old woman required hospitalization and endotracheal intubation because of progressive respiratory distress associated with bilateral diffuse pulmonary infiltrates. Within 12 hr s...

Effects of Drugs on the Pulmonary Circulation and Ventilation as Reflected by Changes in the Arterial Oxygen Saturation

The effect of: l-epinephrine, acetylcholine, histamine, aminophylline, and serotonin on Ihe pulmonary circulation and ventilation was studied in anesthetized dogs. The following observations were noted: Serotonin produced an increase in arterial oxygen saturation, the other drugs a decrease. Although reduced, the effect was not eliminated by controlling the volume of ventilation or by the inhalation of 25 or 30 percent oxygen. The administration of 100 percent oxygen eliminated the response in all dogs studied. The effect was not abolished by controlling blood flow in addition to ventilation. Changes in the over-all ventilation/perfusion ratio appeared of major importance. In addition, these drugs apparently produced local changes in ventilation/perfusion ratios (physiologic shunting) and/or in the degree of anatomic intrapulmonary shunting of blood. The effects of changes in pulmonary blood flow on peripheral arterial oxygen saturation were also investigated. With the volume of ventilation constant, the following was observed: Increasing pulmonary blood flow by whatever means decreased SaO2; decreasing blood flow resulted in an increase in SaO2.

NON-UNIFORM PULMONARY DIFFUSION AS DEMONSTRATED BY THE CARBON MONOXIDE EQUILIBRATION TECHNIQUE: EXPERIMENTAL RESULTS IN MAN

Available evidence indicates that pulmonary diffusion is distributed in a non-uniform manner throughout the lung; the pertinent literature was reviewed briefly in the preceding paper of this series (1). Conventional methods for measuring the pulmonary diffusing capacity do not allow a quantitative assessment of this non-uniformity, and, in the presence of uneven diffusion, may yield erroneous values for total DL.1 This prob-

NON-UNIFORM PULMONARY DIFFUSION AS DEMONSTRATED BY THE CARBON MONOXIDE EQUILIBRATION TECHNIQUE: MATHEMATICAL CONSIDERATIONS*

It is now well established that both ventilation and perfusion are distributed unevenly throughout the lung. Inert gas washout curves have consistently revealed non-uniformity of ventilation/lung volume (VA/VA) ratios (1-3); study of the respiratory exchange ratios in different parts of the lung has provided evidence of uneven ventilation/perfusion (VA/Qc) ratios (4, 5), and both bronchospirometric studies (6) and measurements of physiological dead space (7) have supported these findings.1 Analysis of single

Goiter and myxedema due to iodide administration.

Excerpt The syndrome of goiter and/or myxedema due to administration of iodide preparations has been reported in more than 30 cases since 1945.1-14Despite these observations, most of them single ca...

THE EFFECT OF CORTISONE ON THE VASCULAR REACTIONS TO SERUM SICKNESS AND TUBERCULOSIS

The rabbit-ear chamber provides a convenient method for studying small blood vessels at high magnifications and for long periods of time. This technique had been employed to study the course of tuberculous infection,l the focal reaction, and serum sickness.2 This technique has also revealed, a t least in part, the manner in which cortisone modifies the inflammatory response of tissues to infection3 and to hypersensitivity states:, The technique and the tissue changes described here were illustrated by a Kodachrome motion picture The first portion of the film illustrates the mechanical construction of the chamber and the method of making observations. The chamber itself is made of lucite6 and consists of a base plate with a raised central observation table, a mica cover slip, and a lucite cover-slip-retaining ring. The chamber is inserted into the pinna of the rabbit with a strictly aseptic technique. At the time the chamber is inserted, a clot is formed on the central observation table and, in the ensuing three to four weeks, blood vessels grow into this clot and transform it into a thin vascularized layer of connective tissue. The normal vascular pattern in such a chamber is composed of arterioles, venules, and capillaries supported by an undifferentiated layer of connective tissue. The arterioles have a well-developed muscular wall, a highly refractile endothelium, and a narrow uniform bore. The muscular wall is actively contractile, and arterioles periodically show complete constriction for short periods of time. The venules are wide channels, not of uniform diameter, and tend to be somewhat tortuous. The capillaries have only a thin endothelial wall, a narrow diameter, and are intermittently closed off by precapillary sphincters.