Biomedical subjects
Publications and source records attributed to J R Raymond.
Nephrotoxicity becomes apparent days to months after the institution of amphotericin B therapy. It is characterized by azotemia, decreased renal plasma flow, decreased glomerular filtration rate, tubular defects, nephrocalcinosis, and diffuse, nonspecific histologic changes. Management consists of minimizing exposure to other nephrotoxins and ensuring adequate hydration.
Headache following a lumbar puncture is a common and often debilitating syndrome. Continued leakage of cerebrospinal fluid from a puncture site decreases intracranial pressure, which leads to traction on pain-sensitive intracranial structures. The headache is characteristically postural, often associated with nausea and optic, vestibular, or otic symptoms. Although usually self-limited after a few days, severe postural pain can incapacitate the patient. Management is mainly symptomatic, but definitive treatment with the epidural blood patching technique is safe and effective when done by an expert operator.
The clinical and/or autopsy records of 83 consecutive adults presenting with nontraumatic prehospital sudden death (NPSD) in a single county were reviewed. Coronary artery disease (CAD) was the primary cause of death in individuals 36 to 45 years old. Non-CAD cardiac disease was the second most common cause of NPSD in this age group. Between the ages of 18 and 35 years, non-CAD cardiac disease was the primary cause and toxic ingestions were the second most common. Patients with rhythms other than ventricular fibrillation/tachycardia, asystole, or electromechanical dissociation on presentation to the emergency room (ER) were more likely to survive. Patients with asystole in the ER were more likely to die in the ER than were patients with other rhythms. Patients with toxic ingestions tended to have a better prognosis for successful resuscitation and for ultimate survival. Age, sex, bystander cardiopulmonary resuscitation, and time in the field were not significant prognostic variables. Patients with abdominal hemorrhage (eight of 83) as the cause of NPSD may represent a subgroup for whom a special approach is warranted. None of these patients survived. Early detection by culdocentesis or paracentesis in female patients of reproductive age and nasogastric lavage or stool occult blood testing could lead to more vigorous fluid resuscitation and early surgical intervention in abdominal hemorrhage.
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A newly developed alpha 2-adrenergic photoaffinity ligand, 3-methyl-6-chloro-9-azido-1H-2,3,4,5-tetrahydro-3-benzazepine (SKF 102229), has been radiolabeled with tritium to a specific activity of approximately 80 Ci/mmol. Using membranes prepared from human platelets and from rabbit kidney, alpha 2-adrenoceptors have been covalently labeled following photolysis in the presence of [3H]SKF 102229. As determined by SDS-PAGE, the apparent molecular weight of alpha 2-adrenoceptors from both of these tissues was 64,000. The yield of covalent insertion of [3H]SKF 102229 into the alpha 2-adrenoceptor was very good. Thus, following photolysis up to 90% of the alpha 2-adrenoceptors could be irreversibly labeled with [3H]SKF 102229.
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The serotonin (5-hydroxytryptamine, 5-HT) receptors have been divided into 7 subfamilies by convention, 6 of which include 13 different genes for G-protein-coupled receptors. Those subfamilies have been characterized by overlapping pharmacological properties, amino acid sequences, gene organization, and second messenger coupling pathways. Post-genomic modifications, such as alternative mRNA splicing or mRNA editing, creates at least 20 more G-protein-coupled 5-HT receptors, such that there are at least 30 distinct 5-HT receptors that signal through G-proteins. This review will focus on what is known about the signaling linkages of the G-protein-linked 5-HT receptors, and will highlight some fascinating new insights into 5-HT receptor signaling.
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