9 results on '"Komadina K"'
Search Results
2. Protection from hyperbaric oxidant stress by administration of buthionine sulfoximine
- Author
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Komadina, K. H., primary, Duncan, C. A., additional, Bryan, C. L., additional, and Jenkinson, S. G., additional
- Published
- 1991
- Full Text
- View/download PDF
3. Comparison of the Wang 19-gauge and 22-gauge needles in the mediastinal staging of lung cancer.
- Author
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Schenk DA, Chambers SL, Derdak S, Komadina KH, Pickard JS, Strollo PJ, Lewis RE, Patefield AJ, Henderson JH, and Tomski SM
- Subjects
- Aged, Bronchoscopy, Carcinoma, Bronchogenic diagnostic imaging, Humans, Lung Neoplasms diagnostic imaging, Lymphatic Metastasis diagnostic imaging, Male, Neoplasm Staging, Prospective Studies, Radiography, Sensitivity and Specificity, Biopsy, Needle, Carcinoma, Bronchogenic pathology, Lung Neoplasms pathology, Lymphatic Metastasis diagnosis, Mediastinum diagnostic imaging, Needles
- Abstract
Transbronchial needle aspiration (TBNA) offers the unique opportunity to pathologically stage patients with lung cancer at the time of diagnostic bronchoscopy. The purpose of this study was to compare the staging sensitivities of the Wang 22-gauge and 19-gauge needles. We studied 64 patients with bronchogenic carcinoma and mediastinal adenopathy. Before bronchoscopy each patient underwent chest CT. Three to four aspirates were obtained with each needle from endotracheal sites adjacent to paratracheal lymphadenopathy. In 47 patients malignant mediastinal adenopathy was confirmed by the 19-gauge needle. A total of 29 patients had malignant 22-gauge needle aspirates. Of the 64 patients, 9 had benign, reactive mediastinal lymph nodes. There were 20 patients in whom only the 19-gauge needle demonstrated malignancy and 2 patients with malignant 22-gauge needle aspirates as the sole identifier of paratracheal malignancy. As a staging tool, the 19-gauge needle was significantly more sensitive than the 22-gauge needle, 85.5 versus 52.7% (p = 0.0001). Overall, in 49 of 55 patients (89.1%) with malignant mediastinal lymphadenopathy paratracheal tumor was confirmed by TBNA. The 19-gauge TBNA staging of the mediastinum is an effective, safe, and cost-saving alternative to surgical mediastinal exploration that can be performed during initial diagnostic bronchoscopy.
- Published
- 1993
- Full Text
- View/download PDF
4. Electrophysiologic study of the effects of aminophylline and metaproterenol on canine myocardium.
- Author
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Komadina KH, Carlson TA, Strollo PJ, and Navratil DL
- Subjects
- Administration, Inhalation, Adrenergic beta-Antagonists pharmacology, Aminophylline administration & dosage, Animals, Cardiac Pacing, Artificial, Dogs, Electrophysiology, Heart physiology, Infusions, Intravenous, Metaproterenol administration & dosage, Propanolamines pharmacology, Aminophylline pharmacology, Heart drug effects, Metaproterenol pharmacology
- Abstract
Aminophylline and beta-adrenergic agonists are widely used in the treatment of obstructive lung diseases. It has been suggested that combined aminophylline and beta-agonist therapy may promote the development of atrial and ventricular arrhythmias. The effects of these agents in combination on myocardial conduction and tissue refractoriness have not been documented. We evaluated the electrophysiologic effects of intravenous aminophylline and inhaled metaproterenol on canine myocardium. Aminophylline produced significant decreases from baseline in the AH interval (85 +/- 6.5 [SD] to 63 +/- 4.1 ms [p less than 0.02]), Wenckebach cycle length (WCL) (226 +/- 8.7 to 182 +/- 5.8 ms [p less than 0.02]), and ventricular effective refractory period (VERP) (166 +/- 6.0 to 148 +/- 4.9 ms [p less than 0.01]). Metaproterenol produced similar results, except metaproterenol significantly decreased the atrial effective refractory period (AERP) from 152 +/- 6.6 to 130 +/- 3.2 ms (p less than 0.02), an effect not seen with aminophylline alone. Metaproterenol also produced significantly greater reductions in AH interval and WCL, as well as a greater increase in heart rate than aminophylline did. When compared with aminophylline alone, combined metaproterenol and aminophylline therapy produced significantly greater reductions in the AH interval (63 +/- 4.1 versus 48 +/- 1.2 ms for combined therapy [p less than 0.01]), HV interval (32 +/- 1.2 versus 28 +/- 2.0 ms for combined therapy [p less than 0.02]), WCL (182 +/- 5.8 versus 150 +/- 7.1 ms for combined therapy [p less than 0.02]), and VERP (148 +/- 4.9 versus 132 +/- 2.0 ms for combined therapy [p less than 0.02]). We conclude that both aminophylline and metaproterenol significantly enhance AV nodal and His-Purkinje conduction. Metaproterenol produced significant changes in both atrial and ventricular tissue refractoriness. Metaproterenol produced significantly greater changes than aminophylline alone, and inhaled metaproterenol combined with intravenous aminophylline produced greater changes in AV nodal and His-Purkinje conduction and ventricular refractoriness than did aminophylline alone in a canine model.
- Published
- 1992
- Full Text
- View/download PDF
5. Interobserver variability in the interpretation of pulmonary artery catheter pressure tracings.
- Author
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Komadina KH, Schenk DA, LaVeau P, Duncan CA, and Chambers SL
- Subjects
- Adult, Aged, Female, Humans, Intensive Care Units, Male, Middle Aged, Observer Variation, Pulmonary Artery, Catheterization, Swan-Ganz, Pulmonary Wedge Pressure
- Abstract
Study Objective: We evaluated the ability of three independent reviewers (R1, R2, R3) using waveform analysis to accurately identify confirmed valid PCWP tracings, and their ability to consistently report the PCWP numerical value., Design: Sixty PA and PCWP tracings were prospectively obtained and blindly reviewed by three independent critical care physicians., Setting: The medical ICU of Wilford Hall USAF Medical Center., Patients or Participants: Twenty mechanically ventilated patients with PA catheters inserted for hemodynamic assessment., Interventions: Sixty PA and PCWP tracings were reviewed blindly and independently for acceptability using waveform criteria by three critical care physicians. While recording all 60 tracings, blood was aspirated from the distal port of the PA catheter with the balloon "wedged" and blood gas analysis was done. Each reviewer analyzed the PCWP tracings for validity using waveform criteria, and reported a numerical PCWP reading for those tracings judged valid by waveform criteria. Reviewer sensitivity, specificity and accuracy in performing waveform analysis were assessed by comparing their predictions with those tracings that were confirmed their predictions with those tracings that were confirmed valid by the aspiration of pulmonary capillary blood. Inter-reviewer agreement upon which validity of PCWP tracings was based and reviewer agreement on the numerical PCWP reading were also assessed. All tracings were blindly reviewed by each physician, first without and then with an AP tracing to define end-expiration., Measurement and Results: Thirty-eight of 60 PCWP tracings were confirmed valid by the aspiration of pulmonary capillary blood. In the remaining 22 tracings, mixed venous blood was aspirated with the balloon wedged, and tracing validity was unconfirmed. Reviewer accuracy in identifying was 50 percent for R1, 65 percent for R2 and 57 percent for R3. No reviewer's accuracy was significantly different from a random guess which would yield an accuracy of 50 percent. Agreement by all three reviewers in identifying valid PCWP tracings using waveform analysis varied from 37 percent in the absence of an AP tracing to 66 percent when an AP tracing was available to identify end-expiration (p less than 0.003). Agreement by all three reviewers on the PCWP numerical reading (within 4 mm Hg) was 79 percent without an AP tracing and 96 percent with an AP tracing (p = NS). The numerical reading reported by the ICU nurses and house staff correlated closely with the reviewers' readings. Agreement with the reported PCWP reading was improved only for R2 by the addition of an AP tracing., Conclusion: We conclude that the validation of PCWP tracings by waveform analysis is subject to interobserver variability, and reviewer accuracy in identifying confirmed valid tracings was no better than a random guess. Agreement on the numerical PCWP reading was high among the reviewers as was agreement by each individual reviewer with the reported PCWP. Finally, the presence of an AP tracing, to define end-expiration, adds little to the interpretation of the PCWP numerical reading by experienced physicians.
- Published
- 1991
- Full Text
- View/download PDF
6. Vegetable peroxidase is denatured by gastric acid: fresh vegetables do not cause false-positive stool Hemoccults in normal subjects.
- Author
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Meyer GW, Komadina K, and Perucca P
- Subjects
- Adult, False Positive Reactions, Gastric Acid metabolism, Humans, Occult Blood, Peroxidase, Vegetables
- Published
- 1991
- Full Text
- View/download PDF
7. Polyarteritis nodosa presenting as recurrent pneumonia following splenectomy for hairy-cell leukemia.
- Author
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Komadina KH and Houk RW
- Subjects
- Aneurysm complications, Diagnosis, Differential, Extremities blood supply, Female, Humans, Middle Aged, Polyarteritis Nodosa diagnostic imaging, Polyarteritis Nodosa etiology, Radiography, Recurrence, Temporal Arteries, Leukemia, Hairy Cell surgery, Pneumonia diagnosis, Polyarteritis Nodosa diagnosis, Postoperative Complications, Splenectomy
- Published
- 1989
- Full Text
- View/download PDF
8. Utility of the Wang 18-gauge transbronchial histology needle in the staging of bronchogenic carcinoma.
- Author
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Schenk DA, Strollo PJ, Pickard JS, Santiago RM, Weber CA, Jackson CV, Burress RS, Dew JA, Komadina KH, and Segarra J
- Subjects
- Bronchoscopy, Humans, Mediastinal Neoplasms pathology, Neoplasm Staging, Prospective Studies, Biopsy, Needle instrumentation, Carcinoma, Bronchogenic pathology, Lung pathology, Lung Neoplasms pathology, Mediastinal Neoplasms secondary, Needles
- Abstract
Use of the Wang 18-gauge histology needle in TBNA was employed as a staging procedure in 29 patients with bronchogenic carcinoma and mediastinal adenopathy demonstrated on chest CT. Twenty patients had malignant aspirates; 12 had both histologic and cytologic specimens demonstrating malignancy; six patients had malignant histologic specimens; two had cancerous cytologic specimens as their only evidence of mediastinal disease. Of the nine negative aspirates, four were true negative at surgery. Five patients had false-negative aspirates. Overall sensitivity of the Wang 18-gauge histology needle in the mediastinal staging of patients with bronchogenic carcinoma was 80 percent. When patients with small cell carcinoma were excluded, sensitivity was 82 percent. The enhanced yield of the 18-gauge histology needle warrants its use in mediastinal staging of bronchogenic carcinoma. We conclude that all patients with bronchogenic carcinoma and mediastinal adenopathy demonstrated on chest CT accessible via TBNA should undergo histology needle aspiration as an initial staging procedure.
- Published
- 1989
- Full Text
- View/download PDF
9. Goodpasture's syndrome associated with pulmonary eosinophilic vasculitis.
- Author
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Komadina KH, Houk RW, Vicks SL, Desrosier KF, Ridley DJ, and Boswell RN
- Subjects
- Adult, Anti-Glomerular Basement Membrane Disease pathology, Biopsy, Eosinophilia pathology, Female, Humans, Kidney pathology, Lung pathology, Skin blood supply, Skin pathology, Vasculitis pathology, Anti-Glomerular Basement Membrane Disease complications, Eosinophilia complications, Pulmonary Circulation, Vasculitis complications
- Abstract
Lung hemorrhage and antiglomerular basement membrane (anti-GBM) antibody mediated nephritis define Goodpasture's syndrome. We present the case of a 19-year-old Caucasian woman with unique clinical findings of Goodpasture's syndrome. Our patient initially presented with leukocytoclastic vasculitis of the skin followed by the development of nephritis and lung hemorrhage. An open lung biopsy done prior to diagnosing anti-GBM antibody disease demonstrated an intense eosinophilic vasculitis. Skin vasculitis has only been rarely reported, and to our knowledge this is the first reported case of pulmonary eosinophilic vasculitis associated with Goodpasture's syndrome.
- Published
- 1988
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