Biomedical subjects
Publications and source records attributed to L Gram.
Eighteen controlled studies investigating the psychotropic effect of anti-epileptic drugs are critically reviewed. The neurochemical evidence for existence of psychotropic properties is still speculative. It seems questionable on the basis of this survey that there exist genuine psychotropic effects of antiepileptic drugs, which are not related to antiepileptic efficacy and/or differences in toxicity.
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In eight epileptic patients receiving chronic antiepileptic treatment, a study of the excretion in sweat of phenytoin, phenobarbitone and carbamazepine was performed. All three drugs were found to be present in sweat. Phenytoin sweat concentration was found to correspond to the free fraction in plasma and to be independent of sweat flow. Phenobarbitone sweat concentration was found to increase with increasing sweat flow. Regarding drug level monitoring it is proposed that under changing climatic conditions the phenomenon may be of clinical significance.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Valproate (VPA) and vigabatrin (gamma-vinyl GABA, GVG) are two novel antiepileptic drugs with a presumed GABAergic mechanism of action. However, for VPA, this aspect has been extensively debated. The aim of the present study was to investigate whether treatment of cultured neurons with clinically relevant concentrations of VPA and GVG might enhance release of endogenous GABA. In order to address the question of the fate of released GABA, studies involving exogenous, radiolabeled GABA were also undertaken. Exposure of neurons to GVG in a concentration range of 10-300 microM led to a significant increase in the cellular GABA content, whereas concentrations of VPA of 30-300 microM had no such effect. Treatment of the neurons with concentrations of GVG as low as 25 microM resulted in a pronounced increase in evoked release of endogenous GABA, compared to controls. Only high concentrations of VPA (300 microM) caused an increase in the synaptic GABA release, which reached statistical significance. Preincubating the neurons with exogenously labeled GABA in the presence of GVG or aminooxyacetic acid, both of which block GABA metabolism, caused a decrease in the specific radioactivity in the cellular GABA pool. This, together with the observation that the specific radioactivity of the releasable GABA pool always exceeded that of the cellular pool, indicates that exogenously supplied GABA preferentially labels the transmitter pool of GABA.
Juvenile myoclonic epilepsy is a well defined, age related epileptic syndrome. Case reports are presented, demonstrating the onset of this syndrome very early in life as well as in old age. Consequently, since the correct diagnosis is of decisive importance with regard to optimal treatment, the search for this syndrome should not be confined to juvenile patients.
A total of 227 marine isolates of ubiquitous fungi were cultivated on different media and the secondary metabolite content of the extracts (ethyl acetate/chloroform/methanol 3:2:1) characterized by HPLC. The fungi were secured from animals, plants and sediments of Venezuelan waters (0-10 m) including mangroves and lagoonal areas. The extracts were tested for antibacterial activity. A total of 7 were active towards Vibrio parahaemolyticus and 55 towards Staphylococcus aureus, representing 18 different fungal species from 8 ascomycetous genera. For 61 strains of Penicillium citrinum antibacterial activity correlated well with content of secondary metabolites as measured by HPLC. Thirteen isolates of Penicillium steckii produced very similar profiles of secondary metabolites and 6 of these had activity against either V. parahaemolyticus or S. aureus or both.
Therapeutic drug monitoring, an important aid in antiepileptic drug (AED) therapy, has a lag time before results are obtained from clinical laboratories. The AccuLevel test is an enzyme immunochromatographic method for quantitative measurement of AEDs including phenobarbital (PB), phenytoin (PHT), and carbamazepine (CBZ), with results available within 20 min. A comparison between AccuLevel and TDx, (fluorescence polarization immunoassay) was conducted in 233 paired blood samples from patients with AED therapy, including 12 Eskimo children receiving treatment in Greenland. Forty-five blood samples were analyzed for PB, 80 for PHT, and 108 for CBZ. Linear regression analysis showed good agreement between the two methods (r = 0.951, 0.958, and 0.945, respectively). The test is easy to perform, but care must be taken to follow the correct procedure, or inaccuracies will result. That happened in some of our results. A reduction in lag time, using on-site drug monitoring, was demonstrated. The AccuLevel is a rapid, accurate, and convenient method for use in AED monitoring.
The human definitions of epilepsy and seizure classification were applied rigidly to epileptic dogs to investigate whether the distribution of the seizure types and epilepsies of dogs is comparable to that of human beings. Sixty-three dogs were referred because of recurrent (> 2) epileptic seizures. Only dogs without previous or ongoing antiepileptic treatment were included. All dogs had a physical and neurologic examination and blood work that included a CBC and a biochemical profile. All owners were asked to complete a questionnaire, focusing on seizure development. In addition, video recordings of suspected seizure episodes were analyzed if available. In the majority of dogs where an intracranial lesion was suspected, a computerized tomography scan was performed. Sixty-five percent of the dogs experienced partial seizures with or without secondary generalization and 32% exhibited primary generalized seizures; in 3% of the dogs the seizures could not be classified. Twenty-five percent of these cases were classified as idiopathic, 16% as symptomatic, and 45% as cryptogenic epilepsy; in 14% of these a classification was not possible. Applying human definitions, the distribution of seizure types and epilepsy classifications in these dogs differed widely from those in previous reports of canine epilepsy, where generalized seizures and idiopathic epilepsy were most frequently reported. However, our findings are consistent with the results of several large studies of human epilepsy patients. In dogs with epilepsy, closer attention must be given to the detection of a partial onset of seizures. In this study, detailed questioning of the owners and when possible analysis of video recorded seizures, proved to be sufficient for diagnosing seizures with a partial onset in a significant number of dogs. Partial onset of seizures may be an indication of underlying cerebral pathology. Some adjustments of veterinary epilepsy terminology are suggested.