Functions of endothelium.
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Biomedical subjects
Publications and source records attributed to E L Lee.
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The combination of continuous intravenous infusion of diazepam (20--40 mg/kg per day) and intragastric phenobarbitone (10--15 mg/kg per day in 4 divided doses) was used to treat 19 cases of neonatal tetanus. Mortality was 2/19 (11%). This regimen was considered to have reduced the mortality and the need for artificial ventilation. The main side effects encountered were severe drowsiness, coma, and apnoeic episodes which were reversible when the level of diazepam was reduced.
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All of 16 infants with neonatal meningitis treated during a 30-month period were found to have accompanying ventriculitis at the time of the initial ventricular puncture. Fifteen of these infants were caused by gramm-negative organisms. All infants received antibiotics systemically and intraventricularly via an implanted ventriculostomy reservoir or by direct ventricular injection. Antibiotic concentrations within the ventricular fluid were monitored during chemotherapy; the complications encountered during treatment are discussed. Fifteen infants survived the infection; of these, seven infants were normal at follow-up examinations. In our experience intraventricular chemotherapy as an adjunct to systemic administration of antibiotics has greatly reduced the mortality rate in neonatal meningitis.
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Three newborn infants with meningitis due to Flavobacterium meningosepticum were treated with rifamycin administered parenterally and directly into the cerebral ventricles. Antibiotic concentrations of blood and cerebrospinal fluid (CSF) were monitored during treatment. There was rapid sterilization of the CSF after this antibiotic. Jaundice was the only toxicity noted. All 3 infants developed hydrocephalus and are shunt dependent. Two of them are otherwise free of neurological complications and are developing normally. Rifamycin is a safe and effective antibiotic in this form of neonatal meningitis.
The efficacy of oxantel pamoate (1, 4, 5, 6-tetrahydro-2-[trans-3-hydroxystyryl]-1-methyl pyrimidine pamoate) was evaluated in 25 children with severe Trichuris infection. The presence of chronic dysentery and sigmoidoscopic demonstration of whipworms in the intestinal mucosa were the criteria for inclusion in the trial. Most of these patients had severe anemia, rectal prolapse, digital clubbing, hypoproteinemia, and growth retardation. There were a high incidence of concomitant parasitism with other intestinal helminths and with Entamoeba histolytica and Giardia lamblia. Sigmoidoscopic grading of Trichuris load and egg count in the feces were carried out prior to treatment and 2 days after each course of oxantel therapy. Oxantel was administered at a dose of 10 mg/kg body weight twice daily for a 3-day course. Satisfactory response, as judged by relief of dysentery and absence of whipworms from the mucosa at sigmoidoscopy, was achieved in 17 patients after the first course and in the remaining 8 patients after a second course of oxantel. The drug was well tolerated and no side effects were noted during or after treatment. It is concluded that oxantel is a safe and effective anthelmintic for severe clinical trichuriasis.
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Platelets processed for transfusion are routinely subjected to centrifugation, mechanical agitation and storage at either room temperature or 4 C. To evaluate morphologic changes associated with standard blood bank conditions, platelet units were grouped into four categories: linear agitation at room temperature, agitation at a 90 degrees arc with a Hemolater at room temperature, agitation at a 360 degrees arc with a commercial platelet agitator, and refirgeration at 4 C without agitation. Cold (4 C) preservation resulted in a surprisingly good preservation of platelet ultrastructure, even at 72 hours of storage. By contrast, harsh linear agitation at room temperature brought about marked alterations in platelet ultrastructure beginning at 24 hours. The Hemolator agitator with 90 degrees arc was associated with good preservation of platelet organelles even at 72 hours, whereas marked degenerative changes were observed at this time in platelets processed with a commercial agitator with a 360 degrees arc. These results indicate that platelets stored at 4 C or processed at room temperature with an agitator with 90 degrees arc show the best preservation of ultrastructure.
An example of anti-Cob which caused an acute hemolytic transfusion reaction is reported. Immunohematologic studies showed this antibody to be an IgG immunoglobulin that weakly bound complement and reacted in the antiglobulin phase of the crossmatch. The unit of whole blood implicated in the hemolytic transfusion reaction was from a donor who was phenotyped as Co(a+b+). The patient gave no history of previous transfusions; however, anti-E and anti-c were also present.