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Biomedical subjects

J Michael

Publications and source records attributed to J Michael.

At least 127 records · Page 7Linked to original sources

Chloroacryloyl amides and alpha-methylenelactones from naltrexone, oxymorphone and fentanyl.

A series of chloroacryloyl amides and alpha-methylenelactones were prepared from naltrexone and oxymorphone and some chloroacryloyl amides from fentanyl were prepared as potential Michael acceptors and irreversible ligands. The relative rates of Michael additions of p-methoxybenzenethiol to the double bonds were measured in an NMR spectrometer. The IC50's in rat brain homogenates and the irreversible binding to rat brain membranes were determined. In the methylene-lactone series, it was found that both the alpha and beta isomers derived from naltrexone and oxymorphone were excellent Michael acceptors, but only the beta isomers were more active in the opioid binding assays. The beta isomer derived from naltrexone was an irreversible ligand whereas the oxymorphone analogue was active only in the presence of 100 mM NaCl. In the chloroacryloyl series, only the alpha-chloroacryloyl amide derived from beta naltrexamine proved to be an irreversible binding ligand in the absence of NaCl. It was an excellent Michael acceptor. Under the conditions of our experiments, beta-FNA was a poor Michael acceptor and did not behave as an irreversible ligand in rat membranes.

Acrylates↗

Hybromet: a ligand for purifying opioid receptors.

Condensation of the Grignard reagent derive from 2-[4-(allyloxy)phenyl]ethyl bromide (4b) with 7 alpha-acetyl-6,14-endo-ethenotetrahydrothebaine (5) furnished the (R) tertiary carbinol, 7, which upon methoxymercuration followed by treatment with the KBr gave the bromomercurio compound 10 (Hybromet). The corresponding N-cyclopropylmethyl analogue, 11, was prepared also. The bromomercurio compound, 1, and the mercaptobenzothiazole derivative, 3, gave allyl phenyl ether when treated with BAL at room temperature. Similar treatment of 10 with BAL gave 7 in high yield. Binding studies using rat brain homogenates indicated that 7, 13, and 14 have moderately high affinities for mu rather than delta binding sites. Although much weaker, 10 showed preferential mu binding also. These results along with the fact that 10 reacted smoothly with sulfhydryl groups suggest that Hybromet would be a suitable ligand for use in affinity chromatography.

Animals↗

Purification and characterization of the mu opiate receptor from rat brain using affinity chromatography.

Opiate receptors have been solubilized from rat neural membranes and purified 500-fold (relative to the crude solubilized extract) by affinity chromatography. Active receptors were solubilized by using 3-[( 3-cholamidopropyl)-dimethylammonio]-1-propanesulfonate (CHAPS), a zwitterionic derivative of cholic acid. Affinity chromatography was carried out using Affi-Gel 401, a sulfhydryl derivative of agarose to which "hybromet," a newly synthesized opioid ligand with high affinity for the mu receptor, had been attached. Scatchard analysis of [3H]etorphine binding to the purified receptor revealed a single class of high-affinity sites (Kd = 1.4 nM; Bmax = 2800 fmol/mg of protein). Half-maximal binding was achieved at approximately equal to 1 nM. Activity was markedly inhibited by protein modifying reagents, findings which suggest that the sites are proteinaceous. Opiate binding activity was also inhibited by the guanyl nucleotide GTP. Electrophoresis of the purified material under denaturing conditions revealed three subunits of molecular weights 94,000, 44,000, and 35,000. The inhibitory guanyl nucleotide binding protein (Ni) implicated in opiate action has been shown to be comprised of two subunits of molecular weights 42,000 and 35,000. Thus, the opiate receptor may be an aggregate of multiple protein components that may include a guanyl nucleotide binding protein.

Animals↗

Vancomycin and tobramycin in the treatment of CAPD peritonitis.

Seventy-five episodes of continuous ambulatory peritoneal dialysis (CAPD) peritonitis were studied during a 1 year period at the Queen Elizabeth Hospital, Birmingham. When two simple culture methods were used in parallel, the causative organisms were identified in 97% of cases. Nearly two thirds of episodes of peritonitis were caused by coagulase-negative staphylococci (C-NS), many of which were multiply antibiotic-resistant. On the basis of detailed antibiotic sensitivities, intraperitoneal vancomycin and tobramycin were chosen for the initial treatment of CAPD peritonitis. With this regime, a cure was achieved in 32 of 38 episodes, compared with 15 of 27 episodes when cefuroxime was used. All but 1 of 24 episodes caused by C-NS were cured by vancomycin.

Adolescent↗

Topical use of PVP-I (Betadine) preparations in patients with spinal cord injury.

Povidone-iodine (PVP-I) has a wide range of activity against bacteria. The author's clinical experience has indicated that it can be used successfully as a topical agent in the treatment of decubital ulcer in patients with spinal cord injury. To date, 110 patients have been treated with Betadine solution and ointment, topically applied at daily intervals. Of these, 70 patients had decubitus ulcers involving the sacral and trochanter region; 20 were chronic ulcers which cleared up well. Another 20 required rotation grafting procedure. Primary healing was achieved in all patients (1-4).

Administration, Topical↗

Does cyclosporine inhibit renal prostaglandin synthesis?

Urinary PGE2 excretion was measured in female renal allograft recipients being treated either with prednisolone and cyclosporine (Cys) or with prednisolone and azathioprine. The mean urinary PGE2 excretion in patients on Cys of 940 pmol/4 hr was lower than in patients on prednisolone and azathioprine (2033 pmol/4 hr) although the difference did not achieve statistical significance. These data are consistent with the hypothesis that Cys inhibits renal prostaglandin synthesis.

Cyclosporins↗

Conversion from cyclosporine to prednisolone and azathioprine. Safe or unsafe?

Out of 58 consecutive cadaveric renal allograft recipients whose initial immunosuppression was cyclosporine (Cys) and prednisolone, 18 were converted to prednisolone and azathioprine. Of these all four patients converted because of rejection lost their grafts. Renal function improved in seven patients converted because of nephrotoxicity and in six out of seven patients converted for miscellaneous reasons. Out of five patients converted electively at three months, one died of infection and three developed acute rejection episodes.

Azathioprine↗

Disinfection of hands and tubing of CAPD patients.

During a 3 month study the effectiveness of two methods of handwashing was assessed in a group of 31 patients undergoing continuous ambulatory peritoneal dialysis. A defined, double rinse with alcohol, prior to bag exchange, was found to be more convenient and significantly more effective than povidone-iodine alone or povidone-iodine followed by alcohol. Spraying the tubing around the bag connector with 70 per cent ethanol reduced the numbers of adherent skin organisms so reducing the likelihood of bacteria being drawn into the dialysate. Although there was no difference in the overall incidence of peritonitis in the two groups of patients studied, there was an unexpected drop in the incidence of peritonitis caused by coagulase-negative skin staphylococci. This was attributed to an overall awareness of the importance of handwashing and aseptic procedures during bag exchange. Monitoring the bacteriology of the catheter exit site may give some prior indication as to the likelihood of subsequent peritonitis especially with Staphylococcus aureus and Gram-negative bacilli.

Catheters, Indwelling↗

Verbal behavior.

THE RECENT HISTORY AND CURRENT STATUS OF THE AREA OF VERBAL BEHAVIOR ARE CONSIDERED IN TERMS OF THREE MAJOR THEMATIC LINES: the operant conditioning of adult verbal behavior, learning to be an effective speaker and listener, and developments directly related to Skinner's Verbal Behavior. Other topics not directly related to the main themes are also considered: the work of Kurt Salzinger, ape-language research, and human operant research related to rule-governed behavior.

Journal Article↗

Surgical treatment of hydrothorax complicating continuous ambulatory peritoneal dialysis.

Acute hydrothorax is a well recognized complication of continuous ambulatory peritoneal dialysis (CAPD) and is usually regarded as a contra-indication to the further use of this form of dialysis. We report the first case of treatment by surgical closure of a communication between the peritoneal and the right pleural cavity enabling CAPD to continue successfully. The development of an acute hydrothorax on CAPD is therefore not a reason to abandon this form of dialysis and can be treated by a simple thoracic surgical procedure.

Aged↗

Hyperkalaemia in cyclosporin-treated renal allograft recipients.

Mean serum potassium levels were significantly higher for 9 months in renal allograft recipients receiving cyclosporin than in those receiving prednisolone and azathioprine. Sustained hyperkalaemia (serum potassium 6.0-7.1 mmol/l) inappropriate for their renal function (glomerular filtration rate 21-36 ml/min) developed in seven of forty-three cyclosporin-treated patients. All seven patients had hyperchloraemic acidosis; four were able to acidify their urine to pH less than or equal to 5.4. Six of the seven patients were hypertensive and receiving beta-blockers; one had had bilateral nephrectomy. Despite hyperkalaemia, plasma aldosterone levels were within the normal range in five patients and raised in two. During moderate sodium restriction, plasma renin activity was low or low-normal in five of the seven patients. In these patients a combination of hypoaldosteronism and renal tubular damage leading to a tubular defect of potassium and hydrogen ion secretion is the apparent cause of the hyperkalaemia and hyperchloraemic acidosis. Hyporeninaemia caused by beta-blockade probably blunts the aldosterone response to hyperkalaemia, thereby worsening it.

Acidosis↗

Rapid diagnosis of obscure pneumonia in immunosuppressed renal patients by cytology of alveolar lavage fluid.

16 episodes of pneumonia of obscure origin in 15 immunosuppressed renal patients were investigated without complication by fibreoptic bronchoscopy with alveolar lavage under local anaesthesia. Cytological examination and culture of lavage fluid produced a rapid definitive diagnosis in 15 episodes of pneumonia caused by infections with Pneumocystis, fungi, tuberculosis and staphylococci, or by pulmonary haemorrhage. This led to successful treatment of 10 of the 13 infective episodes.

Adult↗