Congenital adrenocortical hyperplasia: the syndrome.
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Biomedical subjects
Publications and source records attributed to J Burnett.
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Scanning electron microscopic evaluation of two intraocular lenses removed at keratoplasty for pseudophakie bullous keratopathy demonstrated apparently viable endothelial cells adherent to their surfaces. These presumably adhered to the lens implants at the time of their insertion and confirm this as a mechanism for endothelial damage and subsequent corneal edema from intraocular lens implantation.
A comparison has been made of the urinary metabolites of volunteers who had taken therapeutic doses of paracetamol with those of persons who had taken an overdose in an attempt to highlight the metabolic changes associated with massive doses. The main technique for examining urine samples was two-dimensional thin layer chromatography. Other chromatographic techniques were used for the isolation and purification of metabolites. The urinary metabolites after a therapeutic dose of paracetamol were identified as free paracetamol, paracetamol sulphate, 3-hydroxy-paracetamol-3-sulphate, 3-methoxy-paracetamol sulphate, paracetamol glucuronide, 3-methoxy-paracetamol glucuronide, paracetamol 3-cysteine conjugate and paracetamol 3-mercapturate. The same metabolites were also present in urine following overdosage but the proportions were quite different. There was particularly a big increase in the relative amounts of cysteine and mercapturic acid conjugates excreted. No new metabolites were found. The significance of these findings is briefly discussed in relation to the metabolism and toxicology of paracetamol.
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The assay of carbenicillin in clinical specimens is complicated by the fact that carbenicillin also contains a small amount of benzylpenicillin, thereby precluding the use of conventional penicillin assay organisms. This report gives details of a microbiological assay method involving the use of a strain of Pseudomonas aeruginosa which is very sensitive to carbenicillin but insensitive to benzylpenicillin. The outline of a microassay method with this organism is presented, and a method for the assay of specimens containing mixtures of carbenicillin and other antibiotics is described.
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The techniques of continuous quality improvement have been applied to the problem of wrongly addressed clinical laboratory test reports. Over a 6-month period, flow charts of the process of producing test reports were created, the error rates of incorrectly addressed test reports were established, and the root causes of these errors were identified and progressively removed. A 17-fold sustained reduction in the rate of incorrectly addressed test reports was achieved with faster turnaround time, no significant expenditure of funds, and no changes in staff, equipment, or the laboratory information system.
Radiocontrast-induced nephropathy (RCIN), a leading cause of in-hospital acute renal failure, is an acute decrease in renal function related to intravascular administration of iodinated radiocontrast agents. Though RCIN is relatively uncommon in patients without predisposing factors, patients with preexisting renal dysfunction, diabetes mellitus and severe congestive heart failure are at increased risk for acute renal failure following radiocontrast. Three recently developed animal models have provided important insights into the pathophysiology of RCIN. Specifically, these studies have implicated transient renal ischemia, direct renal tubular toxicity and changes in glomerular capillary permeability as possible mediators of RCIN, and these pathophysiologic mechanisms are not mutually exclusive. There is currently no effective treatment for RCIN. Assuring adequate hydration may reduce the risk of RCIN. In addition, synthetic atrial natriuretic factor and/or mannitol are promising, but as yet unproven, approaches to the prophylaxis of RCIN.
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