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Biomedical subjects

M S Kramer

Publications and source records attributed to M S Kramer.

At least 217 records · Page 12Linked to original sources
PubMed1978

Hemoperfusion with uncoated amberlite XE-336 resin in normal and uremic dogs.

Amberlite XE-336 is a pyrolized polystyrene resin with an adsorptive spectrum similar to activated charcoal. 5 normal (group I) and 5 uremic (group II) dogs had 6 h of hemoperfusion with a 400-gram column of Amberlite XE-336 resin with a blood flow rate of 300 ml/min. In group II during 0, 0.5, 1, 3, and 6 h of hemoperfusion the mean column clearances of creatinine were 273 +/- 10, 224 +/- 7, 177 +/- 8, 125 +/- 30, and 64 +/- 17 ml/min and the serum creatinine concentration decreased from 10.4 +/- 1.3 to 3.2 +/- 0.9 mg/dl. In one of the uremic dogs the column clearance of middle molecules measured at 0, 0,5, 1, 3, and 6 h of hemoperfusion was 273,258,101,109, and 23 ml/min. The side reactions in group I and II hemoperfusion studies included transient hypotension, hypocalcemia, leukopenia and a reduction in platelet count.

Adsorption↗
PubMed1978

Long-term short hemodialysis-implications to dialysis index.

From this data, we conclude: 1) that dialysis therapy should be individualized to achieve optimal patient well-being; 2) that long-term hemodialysis for 8--12 hr/wk with 1.0--1.5 M2 coil dialyzers and 1.3--2.5 M2 Dow Cordis hollow fiber kidney is feasible and safe; 3) that most patients do well on hemodialysis, when DI is maintained at 0.9 to 1.1 with coil dialyzers and 0.75 to 0.85 with Dow Cordis hollow fiber; 4) that patients with creatinine clearance greater than or equal to 1.0 ml/min or with excessive interdialytic weight gain (greater than 3.0 kg) may acquire maintenance of a DI greater than 1.2 when utilizing coil dialyzers.

Adult↗
PubMed1978

High density lipoproteins--correlation with cardiovascular disease in hemodialysis patients.

1) HDL levels are low in hemodialysis patients. 2) Lipid abnormalities do not correlate with the presence of CVD in hemodialysis patients. 3) Smoking may not effect blood lipid levels in hemodialysis patients. 4) Nandrolone decanoate may not play a role in CVD in hemodialysis patients. 5) Longer time on hemodialysis does not result in a decrease in triglyceride or increase in HDL levels.

Adult↗
PubMed1977

Menstrual epileptoid psychosis in an adolescent girl.

An adolescent girl with a previous history of trance-like states and a strong family history of epilepsy developed a pattern of recurrent brief psychotic episodes. These episodes seemed to coincide with her monthly menstrual periods, and after four to seven days of bizzare, catatonic behavior, she would return to a normal state. These episodes have been virtually eliminated by maintenance of a therapeutic blood level of phenytoin. The case is discussed in the light of the complex interrelationship of seizures, menstrual hormonal changes, and behavior.

Adolescent↗
PubMed1977

Effect of hemoperfusion of clearance of gentamicin, cephalothin, and clindamycon from plasma of normal dogs.

Nine normal dogs were divided into three groups of three. Group 1 was given an overdose of gentamicin; group 2, cephalothin; and group 3, clindamycin. Group 1 had hemoperfusion with Amberlite XE-336, and groups 2 and 3 with Amberlite XAD-4 resin adsorbents, for 6 hr with a blood flow rate of 300 ml/min. The plasma clearance and removal rates of antibiotics by the hemoperfusion columns were high. The clearance rate of gentamicin from plasma (mean +/- standard deviation) ranged from 59 +/- 30 to 199 +/- 6 ml/min, of cephalothin from 66 +/- 14 to 157 +/- 8 ml/min, and of clindamycin from 55 +/- 9 to 125 +/- 16 ml/min. Of the total dose of antibiotic administered, the hemoperfusion columns removed 67% from theplasma in group 1, 41% in group 2, and 18% in group 3. The fact that antibiotics may be rapidly removed from the blood during hemoperfusion should be considered in calculation of the therapeutic dose of antibiotic required for patients who receive this preocedure. Also, hemoperfusion can effectively and rapidly remove certain antibiotics from the blood of patients who have had a potentially toxic overdose.

Animals↗
PubMed1977

Prolonged continuous monitoring of intracranial pressure in severe Reye's syndrome.

Evidence from both clinical and pathological investigations suggests that increased intracranial pressure (ICP) is a significant factor in the mortality of patients with Reye's syndrome. This, coupled with a critical review of our previous 22 patients, which failed to document the efficacy of exchange transfusion, led us to include continous ventricular pressure monitoring in the supportive care of children with Reye's syndrome. To date, three children, ages 3 to 5 years, have been managed with continuous ICP monitoring. All had stage IV coma by both clinical and electroencephalographic criteria. Peak blood ammonia concentrations were 1,036, 316, and 56micronug/100 ml; all had elevations of serum glutamic oxaloacetic transaminase level, prothrombin time, and creatine phosphokinase level as well. Rapid, unprediatble increases in ICP occurred for many days in all children. Therapeutic measures most successful in controlling ICP were the intravenous administration of mannitol and hyperventilation. Elevations in ICP occurred despite serum osmolality as high as 418 mOsm and following oral administration of glycerol. Rapid increases in ICP also resulted from routine manipulation of the patients (e.g., postural drainage). Exchange transfusion, used in two of the three patients, increased ICP in one child and had no effect in the other. All three children have achieved complete recovery and are doing well 6 months after their illness. Our experience with these children suggests that vigorous supportive therapy, including careful monitoring of ICP, should be used as a basis of comparison when evaluating claims of specific treatment in Reye's syndrome.

Ammonia↗
PubMed1977

Miosis and fluctuation in the rabbit pupil: effects of morphine and naloxone.

In the unanesthetized rabbit, morphine (12-16 mg/kg i.v.) produced a miosis that was not sustained. The response to the narcotic was a pupillary constriction that became maximal within 2 minutes following i.v. administration, after which time the pupil size fluctuated appreciably. The magnitude of the fluctuation, typically as high as 40% of control diameter, was much larger than can be attributed to "noise." The fluctuations occurred within a frequency of approximately 0.5 to 2/min. The miosis and subsequent fluctuation seen with 12 and 16 mg/kg of morphine was blocked by naloxone (0.5 mg/kg i.v.), but 128 mg/kg of morphine overcame the block. Cumulative dose-response curves for morphine and for morphine after naloxone yielded the value pA2=6.8 which is in agreement with the values obtained using other effects and species. Administration of morphine after exposure to high intensity light produced less miosis than that seen under normal illumination.

Animals↗
PubMed1976

Neutralization of sensory-input modification of seizure thresholds in rats.

In this series of experiments it was demonstrated that the result of exposing rats to various parameters of either intermittent sound or intermittent light stimulation significantly decreased the threshold to chemically induced generalized seizures. Furthermore, simultaneous presentation of intermittent light with intermittent sound resulted in a mutual intersensory inhibition (cancellation, neutralization) of the preexisting seizurogenic potential of each stimulus. In these cases, the seizure thresholds did not differ from control values. Several working hypotheses are extended to probe the mechanism of the above results. The probable significance of these observations are (a) that the corroboration of results of other experiments on bimodal inhibitory interactions in normal animals suggests that intersensory inhibition is a property of the nervous system presented simultaneously with certain inputs and (b) that if generalizable to humans, the principle of intersensory inhibition may find an application in the abortion of sensory-precipitated seizures.

Acoustic Stimulation↗
PubMed1976

Recirculation peritoneal dialysis with sorbent Redy cartridge.

Sorbent regeneration of peritoneal dialysate and use of small volume of dialysate for intermittent peritoneal dialysis (IPD) has been shown to be feasible. The present study compares the solute clearance (C) for urea (U) and creatinine (Cr) at varying flow rates in IPD and in recirculation peritoneal dialysis (RPD) utilizing Redy cartridge in ten dogs. Two silastic peritoneal catheters and one Sarns roller pump were used for RPD. CU was 12 +/- 2 ml/min (mean +/- 1SD),18 +/- 2 with IPD and 15 +/- 2,21 +/- 4 with RPD at flow rate of 66 and 100 ml/min, respectively, while CCr was 9 +/- 2,12 +/- 2 with IPD and 10 +/- 2, 13 +/- 3 with RPD. At increasing flow rates of 150,200 and 250 ml/min, CU was 27 +/- 3,31 +/- 4 and 32 +/- 6, and CCr was 17 +/- 2,20 +/- 3 and 22 +/- 3 with RPD. U and Cr were completely removed by the Redy. Glucose was not removed by the cartridge after initial saturation. Serum sodium concentration increased 2-3 mEq/l after 6 h of RPD. The data suggest that at comparable flow rates, RPD is relatively more efficient than IPD (p greater than 0.01). This may be due to continuous exchange across the peritoneal membrane in RPD. At high flow rate in RPD, solute removal is 2-3 times higher than the currently used IPD. RPD with Redy cartridge is mechanically simple, efficient, and may help reduce total peritoneal dialysis time.

Animals↗
PubMed1976

Solute transport in comparable surface area dialyzers.

The present study compared clearance (K) for urea (U), uric acid (Ua), and BSP in relatively equal surface area dialyzers, EX-29 to dual EX-21 in parallel (DEX-21) at QB and QD 300 ml/min, and hollow fiber kidney model 5 (HFK-5) to dual HFK model 4 in series (DHFK-4) at QB 200, QD 500 ml/min. KU was 158 +/- 20 ml/min, 129 +/- 22; KUa was 106 +/- 10, 96 +/- 5, and KBSP was 80 +/- 11 and 67 +/- 12 (p less than 0.01) for EX-29 and DEX-21, respectively. KU was 173 +/- 8 ml/min, 159 +/- 6; KUa was 131 +/- 6, 117 +/- 8, and KBSP was 65 +/- 9 and 56 +/- 7 (p less than 0.01) for HFK-5 and DHFK-4, respectively. Comparable changes in outlet pressure had a varied effect on ultrafiltration and solute transport. 3-hour hemodialysis in the same patients showed that EX-29 was better tolerated than DEX-21. The data suggest that dialyzer designs with the same membrane of equal surface area may significant affect K for both small and middle molecular weight solutes. Comparable changes in outlet pressure may have a varied effect on K in different designs. Due to these variations, comparison of dialysis schedules with different dialyzers on the basis of the square meter hour dialysis to prove validity of middle molecule hypothesis should be interpreted cautiously.

Kidneys, Artificial↗
PubMed1976

Resin hemoperfusion for acute drug intoxication.

Eight patients with drug intoxication were hemoperfused on ten occasions at a blood-flow rate of 300 ml/min with a 650gm column of Amberlite XAD-4 resin, which is a macroreticular resin with a specific adsorptive attraction for lipid-soluble organic molecules. Column clearances of glutethimide and a variety of barbiturates ranged from 207 to 300 ml/min for treatment sessions extending from 2 1/2 to ten hours. After ingestion of 75 gm of glutethimide, one patient received hemoperfusion on three successive days for nine, ten, and eight hours, respectively. She recovered after the column removed over 30 gm of drug. The patients demonstrated dramatic clinical responses with no evidence of meaningful toxic reactions. Column hemoperfusion with Amberlite XAD-4 resin was simpler and more effective than any known method of removing barbiturates and glutethimide from the blood of patients with drug overdoses.

Adult↗