Biomedical subjects
Publications and source records attributed to M Kenny.
We critically review formulas for temperature correction of pH, pCO2, and pO2 measurements in whole blood and the clinical usefulness of these formulas. We discuss both the theoretical derivation and experimental verification of temperature-induced changes. We recommend when to use and when not to use these formulas, based upon the clinical interpretation of these assays.
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1 In a double-blind, placebo controlled study, the efficacy of Ro 15-1788, a new benzodiazepine antagonist, in blocking the cognitive, psychomotor and subjective effects of diazepam, was investigated in a group of six healthy male volunteers. 2 The central effects of orally administered diazepam (40 mg) were most pronounced 1 h after dosing and persisted for 9 h with decreasing severity. 3 Concurrent oral administration of Ro 15-1788 (200 mg) completely prevented the impairment in cognitive and psychomotor function observed after diazepam alone. 4 The duration of action of Ro 15-1788 was shorter than that of diazepam. 5 Plasma diazepam levels after administration of the diazepam/antagonist combination were very similar to those observed following diazepam alone.
Two preadolescent girls and their mother with the syndrome of central and peripheral resistance to thyroid hormones are reported. The sisters had goiters, high radioiodine uptakes, high plasma levels of thyroid hormones, normal TSH levels, and brisk increases in TSH after TRH administration, but had no clinical evidence of thyrotoxicosis. The mother, who had undergone partial thyroidectomy and radioiodine therapy, presented with mild hypothyroid symptoms, normal thyroid hormone levels, and a high TSH level. On T4 treatment, her TSH fell toward normal, and thyroid levels became elevated without thyrotoxic symptoms. Special studies were performed with cultured skin fibroblasts. T3 stimulated low density lipoprotein receptor activity in cells from normal subjects, but failed to do so in fibroblasts form the three patients, indicating that their fibroblasts had a defective response to T3. However, after incubation of fibroblasts with labeled T3, no abnormalities in the binding capacity or affinity of nuclei were observed. These findings suggest that in this family, the thyroid hormone resistance demonstrable in vivo and in vitro results from a cellular defect at a site other than at the nuclear binding site.
Transcutaneous pCO2 electrode response time was optimized by use of a new electrode filling solution composed of NaCl/NaHCO3 electrolyte buffer (100 and 20 mmol/L, respectively) in an equivolume mixture of glycerol and water. The 95% response time to a step change in pCO2 was 49.9 +/- 2.8 s (mean +/- SD) when there was no spacer between the membrane and glass of the electrode. Use of this filling solution during monitoring of severely ill premature infants with cardiopulmonary disease allowed identification of large, unpredictable transient changes in transcutaneous pCO2, and therefore presumably in arterial pCO2, that occurred during capillary blood gas sampling. The changes, which occurred in 19 of 20 samplings, ranged from -1.06 + 2.53 kPa (-8 to +19 Torr). The maximum relative change observed was +29%. These results indicate that the standard protocol for capillary blood collection induces significant transient fluctuations in blood gas tensions. We believe these fluctuations decrease the reliability of capillary pCO2 values for use in clinical management in patient populations similar to ours.
We describe a simple, practical method for routine clinical determination of long- and medium-chain stool lipids. Stool lipids were extracted into a hot mixture of benzene/ethanol/water (12/59/29, by vol), saponified in 30 min without formation of ethyl esters, and titrated in a clear, one-phase medium to a sharp color change. CVs for the titration were 2, 1, and 1% for 0.05, 0.25, and 0.5 mmol of fatty acids, respectively. Interference of stool short-chain acids other than fatty acids was not statistically significant. The precision of sampling of stool homogenate was improved by analysis of two aliquots, one from the top and one from the bottom of the suspension. This method of sampling is a practical alternative to the unpleasant homogenization with a blender or to the addition of large quantities of bile salts. The accuracy of the method may be increased, in special cases, by removing potential interferants.
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Ro 11-2465, a cyanide derivative of imipramine with serotonin uptake inhibitory properties, was investigated in six healthy volunteers for its effect on serotonin concentration in blood platelets. The initial dose was 1 mg daily, the maximum dose of 3 mg being reached on day 3 and maintained for 7 days. A significant decrease in the platelet serotonin concentration was not observed until 3 days after the start of drug administration, after which depletion was rapid. After 5 days of treatment, the reduction was about 80% compared to pre-drug level. Serotonin restoration after drug withdrawal was very slow, and 5 days after discontinuation, it was still 70% below its baseline level.
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Groups of male Wistar rats were injected with either apomorphine alone twice daily for one week or with apomorphine in combination with chlorpromazine or thioridazine. The neuroleptics were administered once daily so that it was possible to assess their duration of effect on the apomorphine responses. Other groups were injected with saline (controls) chlorpromazine or thioridazine. The nature and time of onset and duration of the stereotyped response following apomorphine injection was determined twice daily. In addition, the behaviour of the rats on the hole board apparatus was also assessed after seven days of drug treatment. Apomorphine was found to induce either a "sniffing/burrowing" or a "fighting" stereotypy. Chlorpromazine increased the latency and reduced the duration of both types of stereotypy. In contrast thioridazine only increased the latency and reduced the duration of response the "fighting" group. On the hole board apparatus, both neuroleptics reduced the ambulation and rearing scores of the "fighting groups alone. It is suggested that the different types of stereotypy induced by chronic apomorphine administration, and their sensitivity to the two neuroleptics, are mediated by different types of dopamine receptors.
Arteriovenous fistulas were constructed as an adjunct to femoral peroneal and tibial bypasses in 13 patients threatened by imminent limb amputation. Previous attempts at conventional vascular reconstructive procedures had failed in nine patients. Deficient or absent pedal arches were noted in all patients, as were poor quality or small crural arteries. Graft patency was achieved in 11 cases and limb salvage in 10. There was no mortality. A steal phenomenon occurred in one patient and was successfully treated by secondary popliteal vein ligation. These preliminary results clearly indicate that an adjunctive arteriovenous fistula can maintain patency in a femoral tibial or peroneal bypass graft while preserving flow into the markedly diseased distal circulation.
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Eleven patients with congenital esotropia were tested with the Bayley Scales of Infant Development (BSID) before surgery and at two and six months after surgery. Eight patients completed all three tests and no obvious changes were found between the first and last test. Of the eight patients, two were considered developmentally normal by the BSID; three had significantly delayed mental and motor scores; one showed significant mental delay; and one had motor delay. Medial rectus muscle recessions were done bilaterally on all patients. Four required a second operation. Orthophoria was obtained in six patients.