Biomedical subjects
C Lee
Publications and source records attributed to C Lee.
Necrotizing fasciitis of perineum.
Twenty-eight patients with necrotizing fasciitis of the perineum were treated at the Mount Sinai Medical Center from 1971 to 1979. Ten of the 28 died of the disease, for a mortality rate of 36%. The mortality rate was even higher when the lesion was located in the perianal area and associated with diabetes mellitus and delayed surgical intervention. Necrotizing fasciitis is a rare disease that involves both superficial and deep fascia. It begins with fascial necrosis at onset and rapidly progresses to surrounding fascial planes, eventually involving overlying skin and underlying muscle. Evidence proves that it is not the result of abscess, but primarily originates from fascia and is devoid of frank pus in the well-formed pyogenic abscess cavity. If one observes dark brown necrotic turbid fluid and fails to see frank pus, the disease should be treated as necrotizing fasciitis by complete surgical removal of all necrotic tissue until the normal plane is reached.
Neuromuscular blocking effects of tobramycin, gentamicin, and cefazolin.
Forty patients (A.S.A. class I or II), 18 to 75 years of age, who were undergoing elective surgery were studied to determine the clinical and subclinical neuromuscular blocking effects of two antibiotics, tobramycin and gentamicin and to compare these effects with those produced by cefazolin, an aminoglycoside not known to produce paralysis. Patients were prospectively and randomly assigned in approximately equal numbers to one of four groups: group A received 1 mg/kg of tobramycin; group B, 1 mg/kg of gentamicin; group C, 500 mg of cefazolin; or group D, control (no antibiotic). Antibiotics were administered intravenously 45 minutes immediately preceding the study. The ulnar nerve was stimulated supramaximally and neuromuscular function was measured electromyographically. Anesthesia was induced with thiopental, 4 mg/kg IV, and maintained with endotracheal enflurane 1.0% to 1.5% (inspired) and N2O-O2 (2 L:1 L) after intubation. Succinylcholine (1 mg/kg) was administered after induction of anesthesia and the magnitude and duration of neuromuscular block monitored. d-Tubocurarine (0.1 mg/kg) was given 5 to 10 minutes after full recovery from succinylcholine and repeated as required. At the end of the operation, atropine, 0.02 mg/kg, and neostigmine, 0.4 mg/kg, were used to reverse the block. Base line neuromuscular data, duration of block of succinylcholine, and potency, duration of block, recovery rate, train-of-four fade, tetanic trend, response to double stimuli, post-tetanic effect, and reversibility of the subsequent d--tubocurarine-induced neuromuscular block were not significantly different (p less than 0.01) between any two groups. Tobramycin, gentamicin, and cefazolin, in recommended single doses, lack clinical neuromuscular blocking and subclinical relaxant-potentiating effects.
High-performance liquid chromatographic measurement of cloprednol in human plasma.
A rapid and specific high-performance liquid chromatographic method for the quantitative determination of cloprednol in human plasma is described. Samples were extracted using methylene chloride-ether (40:60) and then purified further by solvent and pH partitioning techniques. Cloprednol was analyzed using normal-phase chromatography and UV detection at 254 nm. The final recovery after losses during the cleanup procedure for cloprednol from human plasma was 80.8%. The lowest concentration that could be measured with confidence was 8 ng/ml.
Pharmacokinetics of sulfisoxazole compared in humans and two monogastric animal species.
The pharmacokinetic profile of sulfisoxazole was studied and compared in dogs, swine, and humans. The trial was conducted over a 72-hr period after intravenous administration and a 96-hr period after oral administration in dogs and swine. In humans, the trial was conducted over an 8-hr period after oral administration. A two-compartment model system was used to define the pharmacokinetic profile. The mean half-lives for the distribution phase were 4.08, 1.30, and 0.56 hr in dogs, swine, and humans, respectively. For the elimination phase, the mean half-lives were 33.74, 46.39, and 7.40 hr in dogs, swine, and humans, respectively. The mean volume of the central compartment was approximately the same in dogs and swine, 10.6 and 10.5 liters, respectively. Humans had a smaller volume of distribution, 7.7 liters. The steady-state volumes of distribution were 17.2, 30.3, and 16.2 liters in dogs, swine, and humans, respectively. Dogs and swine excreted 42.2 and 30.7%, respectively, of the intravenous dose and 29.4 and 18.3%, respectively, of the oral dose. The bioavailability was 69.8% in dogs and 100.0% in swine. The fraction of drug bound ranged from 30 to 50% in dogs, 40 to 60% in swine, and 25 to 40% in humans.
Effect of ovariectomy on serially transplanted rat mammary tumors induced by 7,12-dimethylbenz[a]anthracene.
Explore the source record for details and available documents.
Cumulation of neomycin and its residual potentiation of tubocurarine in the cat.
Cumulation and interaction of neuromuscular blocking effects of neomycin and tubocurarine were determined on responses of the tibialis anterior muscle of the anaesthetized cat to indirect stimulation. Neuromuscular block produced by neomycin was cumulative despite rapid and apparent full recovery of twitch tension and an interval of 3 h between dose-response studies. Ed50 of neomycin on twitch tension decreased (P less than 0.05) from 22 +/- 4 mg kg-1 to 12 +/- 3 mg kg-1 after 3 h; marked post-tetanic exhaustion was observed after the antibiotic. Neuromuscular block (80-90%) with neomycin 25-30 mg kg-1 followed by full recovery and 3-h interval decreased (P less than 0.05) the ED50 of tubocurarine on twitch tension from 0.2 +/- 0.02 mg kg-1 to 0.13 +/- 0.03 mg kg-1. Tubocurarine exhibited no cumulative effects at intervals of 2 h and did not significantly affect the response of twitch and tetanic tension to neomycin after an interval of 2 h. It is concluded that neomycin increases the sensitivity of neuromuscular transmission to tubocurarine despite apparently normal responses to indirect stimulation and that the post-tetanic exhaustion observed with neomycin alone may explain apnoea reported in patients with the antibiotic.
Reversal of dantrolene sodium-induced depression of skeletal muscle in the cat.
Dantrolene sodium, a muscle relaxant, does not have a clinically useful antagonist. The present study was undertaken to test the efficacies of germine monoacetate, 4-aminopyridine, neostigmine, and calcium chloride as possible agents for the reversal of the direct skeletal muscle depression produced by dantrolene sodium in the cat anesthetized with alpha-chloralose. Depression of the indirectly elicited twitch responses (0.1 Hz) of the tibialis anterior muscle by 25, 50, 75 and 84 per cent was produced by dantrolene, 0.16, 0.36, 0.88 and 1.13 mg/kg respectively; spontaneous recovery of twitch tension during the subsequent 30 min was negligible. After the 30-min observation period had elapsed, one of the reversal agents under study was given (iv) in divided doses at intervals of 10 min (five cats for each agent). Germine monoacetate (2 X 0.5 mg/kg) immediately reversed the dantrolene-induced twitch depression, with an over-shoot that persisted for an hour. 4-Aminopyridine (4 X 0.5 mg/kg) caused a steady but incomplete reversal to 17 per cent depression, 30 min after the last dose. Neostigmine (4 X 0.04 mg/kg) caused an immediate, but transient, reversal of the twitch depression, with overshoot. Calcium chloride (4 X 10 mg/kg) was without effect. It is concluded that germine monoacetate is the drug of choice for reversal of the muscle depression produced by dantrolene sodium in the cat.
Maybe it will go away: the five most dangerous words in the English language.
Explore the source record for details and available documents.
Physiology of castration-induced regression in rat prostate.
Explore the source record for details and available documents.
Evaluation of prostatic fluid in prostatic pathology.
Explore the source record for details and available documents.
Cancer of the male breast. A review of 17 cases.
Explore the source record for details and available documents.
Clinical study of estrogen receptor in Chinese patients with breast cancer.
Explore the source record for details and available documents.
Heterogeneity of human thymocytes and a malignant T-lymphoblast cell line, MOLT-3.
The purpose of this paper was to study the heterogeneity of human thymocytes and leukemic cells of the T-cell line MOLT-3 by velocity sedimentation. Analysis of the subpopulations of thymocytes demonstrated that they represent a heterogeneous population of cells with respect to their size, proliferative activity, and presence and quantities of terminal deoxynucleotidyl transferase and human thymus leukemia-associated antigen, a thymic isozyme of adenosine deaminase (HThy-L/ADA). Only a minor subpopulation of thymocytes (large cells) was in active cycle. The highest level of HThy-L/ADA was associated with the main subpopulation of thymocytes sedimenting at 3 to 4 mm/hr while low amounts of the HThy-L/ADA antigen (enzyme) were found in the minor fractions of the small and large cells. The distribution of terminal deoxynucleotidyl transferase-positive cells indicated that most, but not all, thymocytes contain the enzyme. Analysis of the T-cell line MOLT-3 showed that these cells could be separated into subpopulations with different biochemical and biological properties. More than one subpopulation of cells was capable of DNA synthesis. In contrast to the thymocytes, all fractions of MOLT-3 cells contained high amounts of HThy-L/ADA. The proportion of terminal deoxynucleotidyl transferase-positive cells as a function of sedimentation velocity was also quite constant although there was a slight but reproducible drop in the percentage of these cells in the slowly sedimenting fractions. The percentage of cells with receptors for sheep erythrocytes also remained high in fractions separated on the basis of size, although a consistently higher percentage was found in smaller cells. These studies indicated that thymus cells as well as the malignant T-cell line MOLT-3 can be separated on the basis of sedimentation velocity into subpopulations with different biological and biochemical properties. The data also indicated that the heterogeneity of MOLT-3 line cannot be explained solely on the basis of volume changes due to cell cycle, suggesting that they may represent heterogeneous populations of cells.
Rapid infusion of phenytoin sodium loading doses.
The use of rapid intravenous infusions of phenytoin sodium to achieve prompt plasma therapeutic concentrations of phenytoin was studied in adult epileptic patients. Six adult patients who experienced recent tonic-clonic seizures were selected for study. Four of them had not been treated with phenytoin before the study; two were on chronic phenytoin therapy but had subtherapeutic serum levels. A leading dose of phenytoin sodium (15 mg/kg in 100 ml of 0.9% sodium chloride injection) was infused at 30-50 mg/min. Blood samples were drawn before phenytoin administration, every five minutes during the infusion, and at 1, 2, 4, 8, 12, 18, and 24 hours after completion of the infusion. Adverse effects were monitored during the infusion. Pharmacokinetic variables were calculated. Patients received from 750 to 1500 mg phenytoin sodium (mean +/- S.D. = 1040.8 +/- 297.3 mg). From 5 to 30 minutes were required to reach therapeutic (10-20 micrograms/ml) serum phenytoin concentrations; concentrations peaked at 31.1 +/- 10.0 micrograms/ml. Four of the six patients had therapeutic serum concentrations at 18 hours after completion of the infusion. Adverse effects were minimal and not severe; no cardiotoxicities were noted. Phenytoin half-life was 31.2 +/- 8.4 hours, total plasma clearance was 47.2 +/- 10.7 ml/kg/hr, and volume of distribution was 1.96 +/- 0.46 liters/kg. It is concluded that rapid intravenous infusion of phenytoin appears to be a reasonably safe and effective method of rapidly reaching therapeutic phenytoin concentrations.
Depression of myocardial function during acute pancreatitis.
The left ventricular function of 24 patients with acute pancreatitis was studied noninvasively using systolic time intervals. Seven of the 24 patients were reevaluated 4-40 days following the onset of acute symptoms. During the acute phase the PEP/LVET ratio was significantly prolonged to 0.470 +/- 0.031 and later declined to 0.376 +/- 0.017 (P less than 0.01). The convalescent value is similar to the low grade abnormality found in noncardiac alcoholics without pancreatitis (0.381 vs 0.312 in age-matched normals). Since serum electrolytes were normal, serum cardiac isoenzymes were not elevated and there was no evidence of volume depletion in the initial stages, the transient cardiac depression produced by acute pancreatitis may be mediated by the postulated myocardial depressant factor from the pancreas.
Incorporation and release of tritiated leucine in rat prostate during castration induced involution.
Rates of 3H-leucine incorporation into and release from the ventral prostate during castration induced involution were studied in adult male rats. We measured the rate of 3H-leucine incorporation by incubating the prostatic tissue in medium 199 containing 3H-leucine at 37 C for 1 hour. The rate of radioactivity incorporated into the protein fraction was expressed as cpm mg of protein. This rate reduced linearly from Day 0 to Day 6 post castration. Subcutaneous implantation of a silastic capsule containing crystalline testosterone to castrated rats restored the rate of incorporation to that of sham operated rats. To study the rate of 3H-leucine release, 3H-leucine prepared in 0.9 per cent Na C1 solution was injected intravenously into rats 1 day before castration. The amount of radioactivity remaining in the protein fraction of the prostate, expressed as cpm per prostate, was measured at different intervals after castration or after sham operation. Radioactivity disappeared at a significantly faster rate in the prostate of castrated rats than in sham operated controls. Testosterone replacement to castrated rats delayed the rate of loss of radioactivity to a degree similar to that of sham operated rats. These findings indicate that the rapid rate of protein loss in the regressing prostate is the result of a combined action of an accelerated rate of protein degradation and a rate of protein synthesis. Testosterone administration reversed these patterns of protein metabolism.
An inhibitor against factor V occurring postoperatively in a case of pancreatic cancer.
Explore the source record for details and available documents.