Stephen M Koch

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N-acetylcysteine (NAC) is a nonspecific antioxidant that selectively inhibits acute fatigue of rodent skeletal muscle stimulated at low (but not high) tetanic frequencies and that decreases contractile function of unfatigued muscle in a dose-dependent manner. The present experiments test the hypothesis that NAC pretreatment can inhibit acute muscular(More)
Forty-six patients with severe nonpenetrating brain injury [Glasgow Coma Scale (GCS) 4-7] were randomized to standard management at 37 degrees C (n = 22) and to standard management with systemic hypothermia to 32 to 33 degrees C (n = 24). The two groups were balanced in terms of age (Wilcoxon's rank sum test, p > 0.95), randomizing GCS (chi-square test, p =(More)
The lack of easily measurable, objective physiologic indices of muscle fatigue in humans has hampered the evaluation of interventions that putatively inhibit muscle fatigue. In 6 healthy subjects, isometric fatigue of right and left tibialis anterior (TA) was produced using 180 s of intermittent electrical stimulation to the motor point (40 Hz, 650-ms or(More)
An extensive literature suggests that there are minimal complications of systemic hypothermia in humans at and above 30 degrees C for periods of several days. Intracranial hemorrhage has been found to complicate profound hypothermia (10-15 degrees C), and ventricular arrhythmias occur at temperatures below 30 degrees C. Our initial clinical studies were(More)
PURPOSE To present the first photographed bronchoscopic findings associated with negative pressure pulmonary oedema (NPPE). CLINICAL FEATURES A previously healthy patient underwent anterior C3-C4 disc removal and arthrodesis. Following tracheal extubation he developed acute respiratory distress manifested as stridor, tachypnoea, restlessness, and(More)
PURPOSE A prospective patient study was done to evaluate the effect of passive range of motion (PROM) on intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in neurosurgical patients. MATERIALS AND METHODS Twelve adult patients admitted to the neurological-neurosurgical intensive care unit of a community teaching hospital were enrolled in(More)
OBJECTIVE To review the physiology of the chloride ion and its relationship to various disease states encountered in the ICU. Special emphasis was paid to the renal handling of chloride and its role in the evaluation of the urine and serum anion gaps. Metabolic acidosis and alkalosis are discussed. DATA SOURCES English-language articles were identified(More)
PURPOSE This study was undertaken to determine the relationship between total magnesium and ionized magnesium in critically ill and injured patients. METHODS Eighty consecutive intensive care unit (ICU) admissions were evaluated and 34 patients were enrolled in the study. Patients were enrolled who had indwelling arterial catheters and were within 4 days(More)