Biomedical subjects
Publications and source records attributed to D Quinn.
Lymphoid cells from bone marrow radiation chimeras do not produce normal levels of IL 2 but are capable of responding to IL 2 in mitogenic and cytotoxic assays in vitro. The administration of recombinant human IL 2 into host mice that have received allogeneic, H-2-compatible marrow did not enhance mortality.
The metabolism of cefmenoxime (SCE-1365) was studied in four healthy male volunteers after intramuscular administration of a single 500-mg dose of the 14C-labeled drug. Plasma levels of total radioactivity and cefmenoxime peaked at 0.5 and 1.0 h, corresponding to 16.5 micrograms eq/ml and 15.8 micrograms/ml, respectively. Thereafter, parent drug levels declined rapidly, with a terminal elimination half-life of ca. 1.5 h. No significant differences were noted between total radioactivity and parent drug levels up to 2 h after drug administration. After 3 h, low but persistent levels of radioactivity were significantly greater than parent drug levels, indicating metabolism or degradation of cefmenoxime. The terminal elimination half-life of total radioactivity was estimated to be ca. 40 h. The radioactive plasma metabolite(s) remaining at the end of the 5-day study represented only 1% of the administered dose. Urinary excretion was the major route of elimination of cefmenoxime, accounting for ca. 86% of the dose in 12 h. Analysis of cefmenoxime in urine by total radioactivity, high-pressure liquid chromatography, and a microbiological assay showed that 80 to 92% of the excreted dose was parent drug. Radioactivity was also excreted into the feces via the bile and represented ca. 11% of the dose after 5 days. Although extensive degradation of cefmenoxime was found in fecal samples, it was proposed that this may be due to the metabolic activity of the intestinal flora rather than in vivo biotransformation in the liver. This study supports the concept that cefmenoxime undergoes minimal metabolism in humans and is excreted largely as unchanged drug.
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In this study, we were concerned with the effect of probenecid on the pharmacokinetics of 1,000 mg of cefmenoxime administered over a 30-min period by intravenous infusion. Each of a total of 10 subjects received cefmenoxime twice, once with and once without adjunctive probenecid. The data were fit by iterative nonlinear regression procedures to a two-compartment open pharmacokinetic model, with elimination from the central compartment. The mean calculated peak concentration, area under the curve from zero to infinity, and half-life without probenecid were 78.1 micrograms/ml, 77.2 micrograms . h/ml, and 1.14 h, respectively. When cefmenoxime was administered with probenecid, these values were 86.7 micrograms/ml, 158.2 micrograms . h/ml, and 1.78 h, respectively. Averages of about 55 and 46% of the administered doses were recovered in urine samples collected at 0 through 24 h for doses administered without and with probenecid, respectively. The mean corrected renal drug clearance was 159 and 66 ml/min without and with probenecid, respectively. Statistical significance (P less than 0.05) was demonstrated for the differences in beta half-life, (K/net), calculated peak concentration, area under the curve from 0 to infinity, and renal clearance, but not for K21, K12, volume of distribution, or alpha-phase distribution rate constant. The results of this study indicate that tubular secretion is the predominant mechanism of clearance for cefmenoxime and that probenecid alters the pharmacokinetics of the compound by competitively inhibiting its tubular secretion without affecting either the rate or the extent of its distribution.
Acute respiratory failure is characterized by pulmonary vascular injury and increased endothelial permeability. Since endothelial cells synthesize or release factor VIII, we studied factor VIII:antigen, factor VIII:von Willebrand's factor, and factor VIII:coagulant activity in 100 patients with acute respiratory failure, in 29 critically ill patients without evidence of lung disease, and in 60 normal subjects. As a group, patients with respiratory failure had factor VIII:antigen levels that were five times normal, whereas their factor VIII:coagulant and von Willebrand's activities were normal or above normal. However, there was a remarkable disproportion between the levels of factor VIII:antigen and those of factor VIII:coagulant and von Willebrand's factor. In the other ill patients and in the normal group, these levels were in close proportion. In patients with respiratory failure, both slowly and rapidly migrating components of factor VIII:antigen had abnormal electrophoretic patterns; in moderate and severe cases, there was a marked increase in the fast component. Patients who recovered from acute respiratory failure had electrophoretic patterns that returned toward normal. Factor VIII:antigen may be a sensitive circulating indicator of pulmonary endothelial injury and repair.
Cells of colonic carcinoma line HT-29, cultured over more than 170 generations and extensively used in immunological studies of patients with colorectal tumours, still express several immunologically valuable characteristics presumably present since its inception. The cell line can induce a poorly differentiated adenocarcinoma in the nude mouse, it has human antigenic characteristics, it expresses blood group A antigen, and produces a colon-specific mucin and CEA, though not colon cancer-specific mucin (CCM). It remains useful as a target for in vitro testing of anti-tumour immunoreactivity in colorectal cancer patients.
The Capgras syndrome is reviewed and two case reports are described. While the Capgras syndrome is frequently considered to be a rather rare psychiatric syndrome is more common than previously thought. Original explanations of this syndrome usually involved dynamic interpretations, but recently there have been many reports to suggest an organic lesion as being the main contributing factor. The mechanism involved seems to be a generalized dysfunction of the non-dominant cerebral hemisphere. It is suggested that any patient presenting with this syndrome be thoroughly evaluated for an underlying organic lesion before dynamic interpretations are used to explain this syndrome. Brief mention is made of two other syndromes which also involve misidentification and are also considered to be organic in origin.
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Of 206 cases of serious child mistreatment brought before a metropolitan juvenile court on Care and Protection Petitions (C & P), 63 (31%) were dismissed (returning the child to the parent(s]. During a 2-year follow-up period, 18 (29%) of these dismissed cases had substantiated reports of further mistreatment, and 10 (16%) subsequently returned to court on another C & P. Families that had previously been to court for a C & P, and those in which the parent was diagnosed psychotic or character disordered, were significantly more likely to return to court. In addition, we were surprised to find that 8 (6%) of the 130 children ordered permanently removed from parental custody also returned to court. This study documents the continuing mistreatment of children, even after the state's most serious interventions. The study also highlights the necessity of incorporating clinical research in the form of ongoing follow-up of individual cases into the court process, and suggests that it may be possible to identify cases with a very high probability of reinjury and return to court.
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OBJECTIVE: To determine if less frequent bathing alters colony count or type of organism in skin flora of preterm infants. DESIGN: Descriptive, repeated measures study. SETTING: A regional neonatal intensive-care unit. PARTICIPANTS: Forty-five preterm infants, 31 weeks mean gestational age (SD +/- 1.6 weeks) and 17 days mean postnatal age (SD +/- 3.7 days). INTERVENTIONS: Before the study, all infants received a bath every other day. On Day 1 of the study, a routine sponge bath was given, then no further bathing was performed for 4 days. MAIN OUTCOME MEASURE: Serial axillary skin cultures to identify the number of colony forming units (CFU) and type of organism were obtained within 30 minutes of the bath on Day 1 and at the same time on Days 2, 3, and 4. RESULTS: Normal skin flora CFU count, predominantly coagulase-negative staphylococci, increased within 48 hours after bathing compared to values 30 minutes after bathing. There were no differences in normal skin flora CFU on Days 2, 3, and 4. Pathogens were identified in 12 infants for at least one time point during the study. Significantly fewer pathogens were found in the cultures over time, despite longer interval since bathing, and no infant developed symptoms of infection during the study period. CONCLUSION: Findings from this study suggest that the frequency of bathing of preterm infants can be reduced without increasing the risk of infection.