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Biomedical subjects

C M Kunin

Publications and source records attributed to C M Kunin.

At least 127 records · Page 7Linked to original sources

Binding of antibiotics to the human intracellular erythrocyte proteins hemoglobin and carbonic anhydase.

The interaction between human erythrocyte lysates and antibiotics was studied, and the effect of intracellular components on the activity and binding of the drugs was determined. Lysates inhibited antibacterial activity of penicillin G, dicloxacillin, tetracycline, and minocycline to about the same extent as did human plasma. Dicloxacillin activity was the most inhibited, followed by the activities of penicillin G, minocycline and tetracycline. All four antibiotics bound to human hemoglobin, as determined by gel filtration methods. Heme-free globin was also effective in binding the antibiotics. In addition, minocycline and tetracycline were bound to another erythrocytic protein, which, on the basis of electrophoretic mobility, molecular size, and localization, has been identified as carbonic anhydrase. Experiments with pure preparations of carbonic anhydrase revealed that the C isozyme is the major binder of the tetracyclines and that zinc is required for binding. Tetracyclines did not inhibit enzymatic activity of carbonic anhydrase.

Anti-Bacterial Agents↗

Effect of organic mercurials and sulfhydryl compounds on the urease activity of Proteus: inhibition by urine and ascorbic acid.

Meralluride, mercaptomerin, ethacrynic acid, and penicillamine inhibited urease activity of Proteus mirabilis. The activity of the organic mercurials and ethacrynic acid was markedly inhibited by human and dog urine. Antiurease activity could not be detected in the urine of a human and a dog given meralluride by injection. Urine from patients receiving penicillamine also failed to inhibit urease activity. Ascorbic acid inhibited, whereas dehydroascorbic acid enhanced, the activity of the mercurials, but neither agent altered the inhibitory effect of urine. The lethal effect of meralluride against Proteus occurred at the same concentration at which urease activity was inhibited, but penicillamine inhibited the enzymatic activity without affecting viability of the organism. The data suggest that these sulfhydryl-reactive compounds will not be useful against Proteus infections of the urinary tract.

Animals↗

Detection of urinary tract infections in 3- to 5-year-old girls by mothers using a nitrite indicator strip.

A program to detect urinary tract infections among 3- to 5-year-old girls was conducted in Madison-Dane County, Wisconsin using local pharmacies as the distribution site for test kits. Screening was conducted at home by mothers with a nitrite dip-strip on three consecutive first morning specimens. Twenty-one percent of the target population participated during a one-month study period. Eighteen cases were found among 1,573 participants (1.1%). In addition, 243 girls other than those in the target area or age group participated and yielded eight additional cases, for a total of 26 cases among 1,816 total participants. The rate of false-positive nitrite tests was 0.3%. Newspapers were the most effective means of alerting the public to the program. The only factors which were associated with less awareness or participation were low socioeconomic and rural residence. Past history of infection, minor urinary symptoms, and pyuria were common among the bacteriuric girls. Immunoglobulin-coated bacteria suggestive of tissue invasion were present in one third of the cases. Vesico-ureteral reflux was present in five and caliectasis in two of 23 girls studied. Despite the likelihood that some bacteriuric girls, particularly those infected with gram-positive organisms were not detected, screening at home appears to be a highly efficient method of detecting urinary tract infections in large populations of preschool children.

Bacteriuria↗

Self-screening for significant bacteriuria. Evaluation of dip-strip combination nitrite/culture test.

A self-administered dip-strip device was used to screen for urinary tract infection in female subjects. Fifty-two cases of significant persistent bacteriuria were detected among 2,250 subjects by simultaneous use of pourplate quantitative cultures. The dip-strip culture test had good reliability in detecting Gram-negative organisms. Repeated nitrite tests, performed on first-morning specimens and read by the patient, also had good reliability in detecting Gram-negative bacteria. No false-positive test occurred. The device is effective in screening out contaminants, thus decreasing the need for repeated testing.

Adolescent↗

Prediction of drug dosage in patients with renal failure using data derived from normal subjects.

A one-compartment model designed to predict alterations in persistence of drugs in uremic patients was constructed using information obtained from normal subjects. Data obtained from the literature in which the fraction of absorbed drug eliminated unchanged in the urine and the apparent elimination rate constants were compared in both normal control subjects and in severely uremic patients. Twenty-two drugs were examined. Despite changes in apparent volume of distribution and metabolism reported in uremia, the model was able to predict overall elimination rate constants in severe uremia with an error under 10% for 12 and under 20% for 7 additional drugs. The method appears to be most informative for drugs that tend to be retained in the presence of renal failure. Great error was observed with doxycycline and erythromycin. Studies with erythromycin lactobionate and a cupplate assay reduced the error for this drug from 56% for the glucoheptonate to 18%. Doxycycline is known to have a complex enterohepatic circulation. The model is offered as a useful approach to predict dosage adjustment in uremic patients with drugs for which data are not available.

Cephalosporins↗

Needle aspiration in the diagnosis of soft tissue infections.

Diagnosis of soft tissue infections is often delayed or made incorrectly because of reliance on indirect means to determine the etiologic agent. A rapid, speific method is the needle aspiration of these lesions combined with Gram-stain and culture studies. More frequent use of this direct method should facilitate diagnosis and improve treatment. Seven case studies are present to illustrate the usefulness of this technique.

Abscess↗