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Biomedical subjects

L M Shaw

Publications and source records attributed to L M Shaw.

At least 109 records · Page 6Linked to original sources
PubMed1992

Acute aspirin overdose: mechanisms of toxicity.

The case history described herein illustrates many of the salient clinical and laboratory features of acute salicylate overdose. Aspirin overdose remains a commonly used means of attempting suicide in young adults. This case demonstrates the role of the laboratory in the management of salicylate overdose. Medical treatment of several critical concurrent metabolic responses was dependent on frequent evaluations of serum electrolytes, blood and urine pH, blood PO2, blood PCO2, and blood HCO3- concentrations. In addition, essential to her excellent medical care was the ongoing close interaction between the clinical toxicology laboratory and the clinical staff.

Adult↗
PubMed1991

Laminin binding proteins.

Cells express many proteins that bind to laminin, the major adhesive component of basement membranes. Some of these, specifically integrins, function as transmembrane receptors that 'signal' the presence of laminin on the cell surface to the cytoplasm. Lectins constitute a second class of laminin binding proteins that may augment integrin function by interacting with laminin carbohydrate. Caution must be used in ascribing functions to other laminin binding proteins, especially cytosolic proteins.

Animals↗
PubMed1991

FACIT collagens: diverse molecular bridges in extracellular matrices.

The collagens form a large family of proteins. Collagen fibrils, composed of staggered arrays of fibrillar collagen molecules (types I, II, III, V and XI), provide a supporting scaffold for extracellular matrices of connective tissues. The non-fibrillar collagens are less abundant than the fibrillar collagens, but it is becoming clear that they have important functions in the matrix. Recently, a group with unique structural characteristics has been defined and named the FACIT (Fibril-Associated Collagens with Interrupted Triple-helices) group. There is evidence that these collagens may serve as molecular bridges that are important for the organization and stability of extracellular matrices.

Animals↗
PubMed1991

Making digoxin therapeutic drug monitoring more effective.

Digoxin is an important drug in the treatment of patients with either congestive heart failure or atrial arrhythmia. Because of its narrow therapeutic range, digoxin serum concentrations are commonly monitored in both inpatients and outpatients. However, with the costs of health care skyrocketing, there is debate whether such therapeutic drug monitoring (TDM) is cost-effective. To reduce the number of samples drawn too soon after a previous dose and in an effort to improve digoxin TDM at this teaching hospital, a new dosing and monitoring policy was initiated. This policy involved uniform digoxin dosing at 5 p.m. (1700 h) for all inpatients and serum drug measurements at 7 a.m. (0700 h) the next day. By coordinating the time of dosing to be greater than 12 h prior to serum digoxin analysis, the number of inappropriate digoxin serum determinations have been reduced. This new protocol has increased the effectiveness of the toxicology laboratory and enhanced the efficiency of the house staff. Other issues concerning digoxin TDM are also addressed. These findings can be generalized to all drugs that are monitored at any hospital and can result in a significant cost savings and decrease the time spent analyzing inappropriate data.

Adult↗
PubMed1991

Ultrasensitive measurement of delta-9-tetrahydrocannabinol with a high energy dynode detector and electron-capture negative chemical-ionization mass spectrometry.

Plasma concentrations of delta-9-tetrahydrocannabinol, the principal psychoactive cannabinoid in marijuana, decline to values substantially less than 1 microgram/L within a few hours after a subject has smoked a marijuana cigarette. Using a single-quadrupole gas chromatograph-mass spectrometer (GC/MS) operated in the negative chemical-ionization mode and retrofitted with a High Energy Dynode detector system, we measured delta-9-tetrahydrocannabinol and a primary metabolite, 11-nor-delta-9-tetrahydrocannabinol-9-COOH. Using a trifluoroacetic anhydride derivatization procedure and the High Energy Dynode detector system, we improved by 6.25-fold the limit of detection for delta-9-tetrahydrocannabinol in plasma over that obtained with the same GC/MS system without the new detector (80 vs 500 ng/L). The new detector system will thus permit further investigation of the post-distribution pharmacokinetics of delta-9-tetrahydrocannabinol and detection of delta-9-tetrahydrocannabinol in plasma for a longer time after ingestion of the drug in forensic cases. The High Energy Dynode detector system should be applicable to a wide variety of other GC/MS analyses that require significantly improved sensitivity.

Dronabinol↗
PubMed1990

The major non-integrin laminin binding protein of macrophages is identical to carbohydrate binding protein 35 (Mac-2).

Current data indicate that cell adhesion to laminin, the major basement membrane glycoprotein, is mediated by specific integrins, a family of adhesion receptors. In addition, most cell types express a complement of high affinity non-integrin laminin binding proteins (LBPs). Despite considerable effort, the function of these LBPs has not been elucidated. We report here that the major non-integrin LBP of murine macrophages exhibits an Mr of 35,000 and is expressed on the cell surface. Protein microsequencing data revealed that this protein is identical to carbohydrate binding protein 35. This murine galactose-specific lectin is the macrophage antigen Mac-2. Thus, these data suggest that the non-integrin LBPs may contribute to laminin adhesion by a mechanism involving protein-carbohydrate interactions.

Amino Acid Sequence↗
PubMed1990

The activation dependent adhesion of macrophages to laminin involves cytoskeletal anchoring and phosphorylation of the alpha 6 beta 1 integrin.

Macrophages require activation with either PMA (Mercurio, A. M., and L. M. Shaw. 1988. J. Cell Biol. 107:1873-1880) or interferon-gamma (Shaw, L. M., and A. M. Mercurio. 1989. J. Exp. Med. 169:303-308) to adhere to a laminin substratum. In the present study, we identified an integrin laminin receptor on macrophages and characterized cellular changes that occur in response to PMA activation that facilitate laminin adhesion. A monoclonal antibody (GoH3) that recognizes the integrin alpha 6 subunit (Sonnenberg, A., H. Janssen, F. Hogervorst, J. Calafat, and J. Hilgers. 1987. J. Biol. Chem. 262:10376-10383) specifically inhibited adhesion to laminin-coated surfaces. This antibody precipitated an alpha 6 beta 1 heterodimer (Mr 130/110 kD) from 125I surface-labeled macrophages. The amount of radiolabeled receptor on the cell surface did not increase after PMA activation. Thus, the induction of laminin adhesion cannot be attributed to de novo or increased surface expression of alpha 6 beta 1. By initially removing the Triton X-100-soluble fraction of macrophages and then disrupting the remaining cytoskeletal framework, we observed that 75% of the alpha 6 beta 1 heterodimer on the cell surface is anchored to the cytoskeleton in macrophages that had adhered to a laminin substratum in response to PMA. Significant cytoskeletal anchoring of this receptor was not observed in macrophages that had adhered to fibronectin or tissue culture plastic, nor was it seen in nonadherent cells. PMA also induced phosphorylation of the cytoplasmic domain of the alpha 6 subunit, but not the beta 1 subunit. Phosphorylated alpha 6 was localized to the cytoskeletal fraction only in macrophages plated on a laminin substratum. In summary, our results support a mechanism for the regulation of macrophage adhesion to laminin that involves specific and dynamic matrix integrin-cytoskeletal interactions that may be facilitated by integrin phosphorylation.

Animals↗
PubMed1990

Consensus document: Hawk's Cay meeting on therapeutic drug monitoring of cyclosporine.

The optimal measurement method and clinical application of the therapeutic drug monitoring of cyclosporine remain uncertain. At a workshop held at Hawk's Cay, FL, from January 14 to January 17, 1990, 57 scientists presented their latest research findings, either in formal papers or as discussants. Lively debate and discussion followed presentation of extant and new methodologies for drug measurements as well as multicenter validation studies: applications of trough-concentration monitoring in renal, hepatic, and bone-marrow transplants as well as in autoimmune disease; and alternative pharmacokinetic approaches to guide cyclosporine therapy. The process of inducing and maintaining optimal immunosuppression to facilitate graft success is a complex and often challenging task, requiring the combined expertise of multiple disciplines. Thus, the assembly of four of the groups essential to the transplant process--clinicians, laboratory scientists, the pharmaceutical company, and the manufacturers of cyclosporine measurement kits--provided a unique opportunity to evaluate therapeutic drug monitoring issues facing the transplant field. Here we present the major conclusions reached at the meeting, brief discussions of the study data on which they are based, and a summary of unresolved problems that will require further rigorous investigations. The Consensus Document was reviewed by all the workshop participants before we submitted this final manuscript.

Chromatography, High Pressure Liquid↗
PubMed1990

Massive theophylline overdose with atypical metabolic abnormalities.

We report a case of fatal theophylline overdose in a 16-year-old asthmatic boy who presented with seizures, respiratory arrest, and a theophylline concentration of 117 mg/L in serum. His hospital course was complicated by refractory hypotension and severe ischemic necrosis of skeletal muscle, bowel, and liver. The metabolic abnormalities observed early in his hospital course included severe hyperkalemia, hyperphosphatemia, hypermagnesemia, hypocalcemia, and profound metabolic acidosis. These metabolic abnormalities differ from those previously reported in cases of massive theophylline overdose. The metabolic abnormalities observed in this patient probably reflected his extensive ischemic tissue damage with release of intracellular ions and associated acidemia. Markedly increased catalytic activities of creatine kinase, aspartate aminotransferase, and alanine aminotransferase in serum were also noted.

Adolescent↗
PubMed1989

Interferon gamma and lipopolysaccharide promote macrophage adherence to basement membrane glycoproteins.

The ability of thioglycollate (TG)-elicited peritoneal macrophages, a population of recently recruited monocytes, to adhere to the basement membrane glycoproteins laminin and type IV collagen is not a constitutive function of these cells. Adherence can be induced, however, by treatment with IFN-gamma and LPS. In general, IFN-gamma is more potent than LPS in promoting this adherence. Maximal adherence, however, is observed when IFN-gamma (greater than or equal to 5 U/ml) is used together with LPS (2.0 ng/ml). These requirements parallel the conditions needed to obtain tumoricidal activation of TG-elicited macrophages. Adherence to laminin, in the presence of these stimuli, is transient, being maximal at 8 h after their addition and diminishing with longer periods of incubation. In contrast, adherence to type IV collagen does not appear to be transient and IFN-gamma and LPS induce a more prolonged association of macrophages with this substratum.

Animals↗
PubMed1989

Advances in cyclosporine pharmacology, measurement, and therapeutic monitoring.

This review will focus on our current state of understanding of the cellular and molecular mechanisms by which CsA exerts immunosuppression and will present new information on: pharmacokinetic variability of CsA, selection of specimen and method for measuring CsA concentration, identity of CsA metabolites and their immunosuppressive and toxic activity, and the relationship between steady-state pre-dose concentrations of CsA in blood and response to treatment in transplant patients.

Cyclosporins↗