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Biomedical subjects

J Lim

Publications and source records attributed to J Lim.

At least 217 records · Page 12Linked to original sources
PubMed1989

The optimal dose of hyperbaric tetracaine spinal anesthesia for cesarean section.

Seventy-five term parturients undergoing cesarean section were anesthetized with 9 mg, 12 mg, 15 mg and 18 mg of tetracaine in 1.5 cc of 10% using a standardized spinal anesthetic technique. The four groups were compared for their maximal spread of anesthesia, quality of analgesia, incidence of hypotension, mgs of ephedrine used to correct hypotension, and the Apgar scores of the infant. It was found that maximal segmental spread of analgesia for 9 mg. 12 mg and 15 mg groups were not different significant regardless of height or weight. But with the 18 mg-group there was significant excessive spread of analgesia. While there was no difference in maximal spread of analgesia, there was a progressive increase in good quality of analgesia with increasing dosages. There were 67%, 81%, 96%, 100% of the patients had good analgesia for their operation in the four respective group. The percentages of hypotension were significanly more in the 15 mg and 18 mg groups. However, we did not find the hypotension in the 15 mg and 18 mg group need more ephedrine to correct than the lower dosages. In addition, all babies had good Apgar scores and there was no statistical difference among the four groups.

Adult↗
PubMed1987

Treatment of unstable trochanteric fractures with Dimon-Hughston osteotomy displacement fixation and acrylic cement.

For the management of unstable trochanteric fractures, a new method consisting of Dimon-Hughston medial displacement osteotomy, fixation with a sliding screw sleeve-plate device, with augmentation of the posterior and medial upper femoral cortical defect with acrylic cement, was performed in 84 patients. All patients were allowed full weight bearing on the affected extremity within 1 week of operation. Sixty-five patients were available for follow-up more than 12 months after operation. Complication rates were low and 77 per cent of the patients achieved excellent and good functional results.

Aged↗
PubMed1987

Treatment of unstable intertrochanteric fractures with Sarmiento valgus osteotomy and acrylic cement augmentation.

Seventy unstable intertrochanteric fractures (Kyle III) were treated by Sarmiento valgus osteotomy, fixation with a sliding hip-screw and plate, and augmentation of the posteromedial upper femoral defect with acrylic cement. Immediate full weight bearing walking was started after the operation. Forty-two patients were followed up for more than 1 year (average 21.4 months). Excellent or good results were obtained in 71.4 per cent. However, there was mechanical failure in which the hip screw cut out of the femoral head superolaterally in 8.6 per cent. Comparison was made between the results of the present technique and our previously reported technique which consisted of Dimon-Hughston medial displacement osteotomy, fixation with sliding hip screw and acrylic cement augmentation to the upper posteromedial femoral defect. It was found that the result of the latter technique is slightly better, probably because of the more rigid reduction.

Aged↗
PubMed1987

Activity of (+)-cyclaradine (Sch 31172) against herpes simplex virus in vitro and in vivo.

(+)-Cyclaradine (Sch 31172) is the carbocyclic derivative of adenosine arabinoside (9-beta-D-arabinofuranosyladenine). Because it is not deaminated by deaminase in serum, as is adenosine arabinoside, (+)-cyclaradine is about 2 to 5 times more active in vitro against herpes simplex virus. (+)-Cyclaradine has in vitro activity nearly equivalent to that of phosphonoformate but is significantly less active than acycloguanosine (acyclovir; ACV), trifluorothymidine, or 9-(1,3-dihydroxy-2-propoxymethyl)guanine. The absolute ratios of in vitro activities are difficult to determine because of variability among virus strains, inoculum size, and dependence on the tissue culture cell line in which the comparative test is carried out. (+)-Cyclaradine is active against TK-, ACV-resistant mutants. In the guinea pig model of vaginal herpes simplex virus infection, (+)-cyclaradine is only slightly less active than ACV when both molecules are nearly equivalently bioavailable; thus, the large difference in activity seen in vitro is not reflected in this in vivo model system.

Acyclovir↗
PubMed1987

Pharmacokinetics and metabolism of an intravenously administered penem (Sch 34343) in humans.

The pharmacokinetics of Sch 34343, a new broad-spectrum penem antibiotic, was studied in subjects receiving 1 g of 14C-labeled drug by intravenous administration. At the end of a 30-min intravenous infusion, the mean maximum concentration of drug in serum was 39 micrograms/ml for unchanged Sch 34343 and 49 mu eq/ml for total radioactivity. The mean serum half-lives of Sch 34343 were 0.16 h for the distribution phase and 0.80 h for the elimination phase. The total body clearance of Sch 34343 was 7.52 ml/min per kg, and the mean apparent volume of distribution was 525 ml/kg. Over a 4-day period, mean urinary excretion of radioactivity accounted for 87.9% of the dose, and mean urinary excretion of unchanged Sch 34343 accounted for 23.6% of the dose. The total radioactivity in feces on days 0 to 6 accounted for only 0.8% of the dose. In serum from 0.5 and 1 h, unchanged Sch 34343 represented the major radioactive peak, with negligible amounts of several metabolites. In urine, there were at least six metabolites in addition to Sch 34343. The amount of unchanged Sch 34343 accounted for 33% of radioactivity in samples of urine from 0 to 2 h, 22% in urine from 2 to 4 h, 15% in urine from 4 to 8 h, and 0% in urine from 8 to 12 h.

Adult↗
PubMed1987

Evaluation of (+)-cyclaradine-5'-esters as prodrugs for (+)-cyclaradine in animals.

Both (+)-cyclaradine-5'-methoxyacetate (CM) and (+)-cyclaradine-5'-ethoxypropionate (CE) were converted to (+)-cyclaradine (C) in squirrel monkey and human sera at 37 degrees C. CE was more stable than CM. After oral administration (20 mg base equivalent per kg) of either CM or CE, no unchanged esters were observed in serum of squirrel monkeys, rabbits, or rats. Instead, C was detected, indicating conversions of CM and CE to C in vivo. In squirrel monkeys, the areas under the curve (AUCs) of C obtained from oral dosing with CM were 61% higher than those obtained from dosing with C, indicating that CM may be a good prodrug for C. In squirrel monkeys, rabbits, and rats, CE resulted in a 20 to 90% higher AUC of C than did CM, indicating that CE was better absorbed than CM.

Administration, Oral↗
PubMed1986

Ictal catatonia as a manifestation of nonconvulsive status epilepticus.

Three patients with EEG documented ictal catatonia, a nonconvulsive status epilepticus, who responded dramatically to intravenous phenytoin are described. The EEG showed continuous bilateral pseudoperiodic sharp waves and spike discharges in one patient, spike and wave complexes were seen prominently in the right fronto-central region in another, and the EEG of the third patient showed periodic lateralising epileptiform discharges during the catatonic state. We postulate that such catatonia was due to involvement of the limbic system by seizure activity.

Aged↗
PubMed1985

Symptomatic coronary artery disease in patients aged 21 to 30 years.

One hundred one young people (88 men, 13 women) aged 30 years or younger with arteriographically proved obstructive coronary artery disease (CAD) were identified and reviewed for risk factor prevalence. The men were compared with an age and date-of-catheterization matched control group who were arteriographically normal. Significant risk factors were cigarette smoking (p = 0.001), familial CAD (p = 0.002) and familial CAD manifested by age 50 years or younger (p = 0.005). Serum cholesterol values were significantly higher in the CAD group (p = 0.0001), but in most (54%) were still less than 250 mg/dl. Arteriography showed a spectrum of CAD: 1-vessel in 57, 2-vessel in 21 and 3-vessel in 22. One patient had significant left main CAD. Follow-up was obtained for all of the 94 American subjects. One-year mortality was 3% and 5-year mortality was 20%. The causes of death were predominantly cardiac: myocardial infarction in 10 patients, congestive heart failure in 2 and sudden death in 6; 3 patients died of noncardiac causes.

Actuarial Analysis↗
PubMed1985

Steady-state bioavailability of dexbrompheniramine and pseudoephedrine from a repeat-action combination tablet.

The steady-state bioavailabilities of dexbrompheniramine and pseudoephedrine were evaluated following multiple-dose administrations of a repeat-action combination tablet containing 6 mg of dexbrompheniramine maleate with 120 mg of pseudoephedrine sulfate every 12 h for 7 d compared with reference standards. The reference standards used in this study were concomitant administration of conventional 2-mg dexbrompheniramine maleate tablets every 4 h and 120-mg pseudoephedrine sulfate repeat-action tablets every 12 h, each for 7 d. Twelve healthy adult male volunteers completed this randomized two-way crossover study. Blood samples for subsequent assay were obtained at frequent time intervals throughout each 7-d dosing phase. Sensitive and specific gas-liquid chromatographic methods were used for the determination of dexbrompheniramine and pseudoephedrine in plasma. Based on the plasma levels, the times to reach steady state were determined. In addition, the major bioavailability parameters (Cmin, Cmax, tmax, and AUC) for days 6 and 7 of dosing were determined and statistically evaluated. The results of this study demonstrate that, at steady state, the repeat-action combination tablet and concomitant administration of the reference standards are bioequivalent.

Biological Availability↗
PubMed1985

Pharmacokinetics of Sch 34343 in rats and dogs.

The pharmacokinetics of 14C-Sch 34343 were studied in rats and dogs following intravenous and intramuscular dosing. In both species, it was rapidly absorbed after intramuscular dosing. The serum AUC for total radioactivity and for intact drug after intramuscular dosing were similar to those obtained after intravenous dosing. Following both routes of drug administration, the elimination of half-life (T 1/2 beta) was 7 min in rats and 25-32 min in dogs. Following intravenous dosing of 14C-Sch 34343 to rats, radioactivity in tissues disappeared rapidly with time indicating no tissue accumulation. Highest concentrations of radioactivity were seen in the kidney. Liver, lung, skin and heart appeared to have concentrations of radioactivity similar to those of blood. Sch 34343 was excreted rapidly and primarily into the urine in both rats and dogs. After either route of dosing, urinary excretion of total radioactivity ranged from 84 to 93% and that of intact Sch 34343 from 41 to 51% of the dose, respectively. In addition, the effect of pretreatment with probenecid on the pharmacokinetics in rats and dogs and in anephric rats were also evaluated. Pretreatment with probenecid prolonged the elimination half-life in both rats and dogs. Anephric rats had a longer half-life than normal rats.

Animals↗
PubMed1985

A test of a linear discriminant for identifying low-risk abdominal pain.

This study tests a previously published decision rule for identifying nonspecific abdominal pain (NSAP). The rule, developed for ambulatory male patients in two Veterans Administration (VA) facilities and a prepaid group practice, was studied in an additional 110 VA patients and in 77 patients (predominantly female) from a solo private practice. The group of 58 patients (33%) classified as "low-risk" rarely had abnormal laboratory tests or radiographs, except for upper gastrointestinal series; 15 of these patients had potentially serious disease. Peptic ulcer was the specific diagnosis most often misclassified as NSAP. The accuracy of the rule in our population is similar to the accuracy of the judgment of experienced clinicians.

Abdomen↗
PubMed1984

Management of childhood urinary tract infection in family practice.

To find out to what extent doctors appreciate the potential damage that bacteriuria may cause, we sent questionnaires to 195 family practitioners and trainees in one health board in Northern Ireland. The results of the survey showed that, though doctors seemed to be aware of the risk of renal disease, this was not reflected in practice.

Bacteriuria↗