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Biomedical subjects

D Honeybourne

Publications and source records attributed to D Honeybourne.

At least 73 records · Page 4Linked to original sources
PubMed1991

Microlavage: a technique for determining the volume of epithelial lining fluid.

A new technique ("microlavage") was used to determine the volume of epithelial lining fluid recovered by bronchoalveolar lavage. A standard bronchial brush tube is used to lavage a peripheral lung subsegment rapidly with 20 ml of normal saline and the concentrations of urea and total protein are measured in the aspirated fluid. Using a very short dwell time for fluid (less than 20 seconds), this technique allows the urea dilution method to be used to quantify the epithelial lining fluid protein concentration, which is then used as an endogenous marker of the epithelial lining fluid in conventional bronchoalveolar lavage fluid. The reproducibility of the calculation of the concentration of the lining fluid protein was assessed in 10 patients by performing the method in three separate lung subsegments. The mean coefficient of variation of the urea to protein ratio was 9.0%. A comparison of microlavage and conventional lavage was made in a further 28 patients. The differential cell counts were similar by the two methods, suggesting that similar epithelial lining fluid was sampled. The application of the microlavage technique to the calculation of epithelial lining fluid volume gave a lower value than the urea dilution method in association with conventional lavage. Microlavage should provide more accurate quantification of epithelial lining fluid volume and could be used in conjunction with conventional lavage, which is still required for an adequate harvest of alveolar cells.

Aged↗
PubMed1990

Concentrations of temafloxacin in serum and bronchial mucosa.

The bronchial mucosal concentrations of temafloxacin hydrochloride were determined in specimens obtained at fibreoptic bronchoscopy and compared with simultaneous serum concentrations. The 18 patients studied were given an oral dose of 400 mg b.i.d for three days to achieve steady state levels. The mean serum concentration was 6.9 mg/l (SD 2.5 mg/l) and the mean bronchial mucosal concentration 12.2 mg/kg (SD 4 mg/kg). The mucosal levels exceeded those required to inhibit most of the common respiratory pathogens, including Streptococcus pneumoniae and Pseudomonas aeruginosa. These data support the use of temafloxacin for therapy of bronchial infections.

4-Quinolones↗
PubMed1990

The effects of chronic obstructive airways disease on the ability to drive and to use a roadside alcolmeter.

Subjects with chronic obstructive airways disease may have difficulty with the roadside alcolmeter. Twenty-six subjects with a FEV1/FVC less than 60% were asked to use an alcolmeter simulator. Only ten were able to produce the necessary flow rate of 28 l min-1 for a minimum of 2.7 s, two could produce the same total volume (1.25 l) at 10 l min-1 for 7.5 s, five could only expel 10 l min-1 for 4.5 s, and nine were unable to trigger the alcolmeter at even these very low flow rates. Subjects with an FEV1 of less than 1.51 or FEV1% predicted less than 50% were very unlikely to be able to activate the alcolmeter. Ten healthy subjects were investigated to assess the accuracy of the roadside alcolmeter at a flow rate of 10 l min-1 compared to 40 l min-1. No significant difference was found in breath alcohol levels between the two flow rates. It is proposed that some modification could be made to the roadside alcolmeter, without affecting its accuracy, to allow some subjects with chronic obstructive lung disease to activate the device. A postal survey of 284 subjects with a FEV1/FVC less than 60% was carried out. Of those who were drivers or exdrivers, 24.7% had had to stop or reduce their driving because of their respiratory disease. This group had a significantly lower FEV1% predicted (P = 0.035) than those whose driving was unaffected.

Adult↗
PubMed1990

Cefepime concentrations in bronchial mucosa and serum following a single 2 gram intravenous dose.

The concentrations of cefepime in bronchial mucosa were measured after intravenous administration of a single 2 g dose in 20 patients undergoing diagnostic fibreoptic bronchoscopy. These concentrations were compared with simultaneous serum concentrations. The mean bronchial mucosal concentration was 24.1 mg/kg (s.d. 17.8 mg/kg) and the mean serum concentration was 40.4 mg/l (s.d. 28.1 mg/l). The mean percentage penetration was 59.8% (s.d. 12.5%). We conclude that a twice daily dosing of cefepime would be adequate for most respiratory infections although an 8-hourly dose may be necessary in pseudomonal infections.

Biological Assay↗
PubMed1990

Concentrations of oral lomefloxacin in serum and bronchial mucosa.

The bronchial mucosal concentrations of lomefloxacin were determined for specimens obtained by fiber-optic bronchoscopy and compared with simultaneous concentrations in serum. The 23 patients studied were given an oral dose of 400 mg once daily for 4 days to achieve steady-state levels. The median concentration in serum was 2.5 micrograms/ml (range, 1.0 to 5 micrograms/ml), and the median bronchial mucosal concentration was 5.0 micrograms/g (range, 0.7 to 18.6 micrograms/g). The median percent penetration was 177% (range, 69 to 541%). The concentrations in serum and mucosa exceeded the MIC for 90% of strains of organisms causing bronchial infections but not sufficiently to recommend lomefloxacin for the routine treatment of pneumococcal infections.

4-Quinolones↗
PubMed1990

Azithromycin concentrations at the sites of pulmonary infection.

Azithromycin is a new macrolide antimicrobial. The distribution to the potential sites of pulmonary infection was assessed after the administration of a single 500 mg oral dose to 22 patients undergoing fibreoptic bronchoscopy. Concentrations of azithromycin in sputum, bronchial mucosa, eptihelial lining fluid (ELF) and alveolar macrophages (AM) were determined at intervals up to 96 h after dosing. The mean serum concentration was low at 12 h (0.13 micrograms.ml-1, SEM 0.05) but was still detectable at 96 h (0.01 micrograms.ml-1). In contrast, peak sputum ELF, bronchial mucosal and AM levels were found at 48 h. Bronchial mucosal concentrations were significantly greater than ELF concentrations, which were in turn greater than sputum concentrations. Mean peak AM concentrations were sixfold greater than bronchial mucosal concentrations (23 micrograms.ml-1, SEM 5.1 and 3.89 micrograms.ml-1, SEM 1.2, respectively). The high intracellular concentrations indicate that azithromycin is likely to be effective for sensitive intracellular pathogens and the favourable penetration into sputum, ELF and bronchial mucosa suggest that it should be useful in pneumonia and bronchial infections.

Azithromycin↗
PubMed1988

The penetration of fleroxacin into bronchial mucosa.

Twenty patients undergoing fibreoptic endoscopy received 400 mg of fleroxacin once a day for four days. Bronchial biopsies were performed 2.7-5.9 h following the final dose of fleroxacin. A microbiological assay was used to determine the levels of fleroxacin in serum and biopsy material. The serum levels of fleroxacin ranged from 3.9-12.5 mg/l (mean 8.4, S.D. 2.4). In all but one patient the bronchial mucosa level exceeded that in serum, the range being 5.9-19 mg/l (mean 12.8, S.D. 3.3). The mean percentage penetration into bronchial mucosa over the period of the study was 158% (S.D. 41.2%). The therapeutic implications are discussed.

Biopsy↗
PubMed1988

Evaluation of the penetration of ciprofloxacin and amoxycillin into the bronchial mucosa.

The concentrations of two antibiotics, amoxycillin and ciprofloxacin, were measured by microbiological assay in serum and in bronchial mucosa obtained at fibreoptic bronchoscopy in 38 patients undergoing diagnostic bronchoscopy for a range of respiratory symptoms. Patients had taken one of the two drugs orally for four days before bronchoscopy. The percentage penetration of antibiotic from serum to bronchial mucosa was calculated as the ratio of drug concentration in bronchial tissue to that in serum x 100. Of the nine patients who took amoxycillin 500 mg thrice daily the mean (SD) percentage penetration was 75. This was significantly lower than the mean percentage penetration of 147 in 29 patients who took ciprofloxacin 500 mg twice daily. Ten patients were given a single intravenous dose of ciprofloxacin 200 mg one hour before bronchoscopy and the mean percentage penetration was 231. This study has shown that the quinolone antibiotic ciprofloxacin is concentrated in the bronchial mucosa.

Aged↗
PubMed1987

Amiodarone-induced pulmonary toxicity mimicking metastatic lung disease.

A 65 year old man developed atrial arrhythmias secondary to a congestive cardiomyopathy which were resistant to quinidine and disopyramide. Amiodarone controlled the paroxysmal atrial tachycardia but 4 months after starting the drug he developed increasing dyspnoea and radiological changes highly suggestive of metastatic lung disease. Lung biopsy showed change of drug-induced pneumonitis and 4 months after stopping amiodarone his symptoms resolved and the chest X-ray had cleared. Amiodarone may cause pulmonary toxicity mimicking metastatic lung disease.

Aged↗
PubMed1986

Physiological evidence that emphysema is not a feature of byssinosis.

A group of women with byssinosis of grades 2 and 3 were seen consecutively over three years in an occupational outpatient clinic. Detailed lung function tests were performed and the results for smokers and non-smokers compared. One hundred and fifty three patients were seen and 50 of these were life time non-smokers, 35 smoked one to nine cigarettes a day, and 68 smoked 10 or more cigarettes a day. After correction for age the mean FEV1 was found to be significantly lower (p less than 0.01) in heavy smokers than in non-smokers. In a subgroup of 89 subjects who were able to perform the carbon monoxide gas transfer test significantly lower values were obtained for the carbon monoxide transfer factor (TLCO), (p less than 0.001), TLCO % predicted (p less than 0.001), and the transfer coefficient (KCO) (p less than 0.001) in the heavy smokers than in the non-smokers, despite the fact that the non-smokers had worked longer in the cotton mills (p less than 0.02). The mean TLCO was significantly lower than predicted in the heavy smokers (p less than 0.001) but not in the non-smokers. A significant negative correlation was found between the number of cigarettes smoked per day and the TLCO (p less than 0.01), TLCO % predicted (p less than 0.001), and KCO (p = 0.005), but not with the number of years spent in the carding area. These results provide evidence supporting recent pathological observations that emphysema is probably due to concomitant cigarette smoking and is not itself a feature of byssinosis.

Aged↗
PubMed1985

A mesothelioma presenting with multicentric reticulohistiocytosis.

Multicentric reticulohistiocytosis is a rare disorder of the skin and joints, with characteristic histological features. An increasing number of reported cases have been associated with internal malignancy. We report a case of multicentric reticulohistiocytosis in an elderly man with mesothelioma.

Aged↗
PubMed1985

Treatment of malignant pleural effusions with intrapleural Corynebacterium parvum or tetracycline.

Thirty two patients with malignant pleural effusion were randomly allocated to treatment with intrapleural Corynebacterium parvum or tetracycline hydrochloride in an attempt to prevent symptomatic recurrence of pleural fluid. Success in preventing recurrence of fluid at one month, using up to 2 doses of each drug, was 14 of 16 cases for Corynebacterium parvum, 5 of 9 for tetracycline given via an intercostal needle, and 6 of 7 for tetracycline given through an intercostal tube. These difference were not statistically significant. Corynebacterium parvum was significantly more likely to produce pyrexia equal or greater than 38 degrees C (P less than 0.001) and pain requiring analgesia (P less than 0.05) than tetracycline hydrochloride. Corynebacterium parvum is a useful agent for the management of malignant pleural effusion, but is associated with more side effects than tetracycline.

Bacterial Vaccines↗