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Biomedical subjects

N Murray

Publications and source records attributed to N Murray.

At least 109 records · Page 6Linked to original sources
PubMed1987

Effects of captopril on renal function in patients with cirrhosis and ascites.

Blockade of angiotensin-converting enzyme has been variously reported to increase or to decrease sodium excretion in patients with cirrhosis and ascites. We administered captopril (50-150 mg) to 11 patients with cirrhosis and ascites to determine the effects on blood pressure, renal blood flow and sodium excretion. Plasma renin activity increased and mean blood pressure fell (by 14 mm Hg). Para-aminohippurate clearances increased from 321 +/- 53 to 559 +/- 83 ml/min (P less than 0.005), but inulin clearances were minimally altered (73 +/- 8 to 76 +/- 7 ml/min), suggesting preferential dilation of glomerular efferent arterioles. Despite unchanged glomerular delivery of sodium, urinary sodium excretion fell in all subjects (from 2.70 +/- 1.00 to 0.48 +/- 0.21 mEq/h), urinary volume was reduced (377 +/- 55 to 182 +/- 42 ml/h, P less than 0.005), and the natriuretic effect of furosemide was blunted. The antinatriuretic effect of captopril may be mediated by reduced angiotensin II-mediated sodium excretion, by decreased prostaglandin production, and/or by indirect effects of reduced blood pressure. Captopril impairs rather than promotes sodium excretion.

Adult↗
PubMed1987

Oligoclonal antibodies in CSF of patients with meningopolyneuritis Garin-Bujadoux-Bannwarth: Ig class, light chain type and specificity.

Detection of intrathecally produced antibodies in cerebrospinal fluid (CSF) of patients with meningopolyneuritis Garin-Bujadoux-Bannwarth (MPN-GBB) is well documented. Analysis of CSF has revealed the oligoclonal nature of these antibodies. We investigated oligoclonal antibodies (OA) in CSF and serum of MPN-GBB patients with regard to immunoglobulin class, light chain type and specificity and compared the findings with those in other neurological diseases (OND). For this purpose an immunofixation (IF) technique after agarosegel electrophoresis (AE) of concentrated CSF was used. 87% of patients with MPN-GBB demonstrated in the acute stage of their disease oligoclonal bands (OB) in their CSF which could not be detected in paired serum samples. IF revealed in most cases of MPN-GBB IgG banding. While IgM banding was a common finding in CSF of MPN-GBB patients, this was not the case in OND. Specificity of CSF OA against components of Borrelia burgdorferi could be demonstrated by agarose isoelectric focusing (AIEF), transfer to nitrocellulose paper and reaction with 125I labelled B. burgdorferi antigen.

Antibodies, Bacterial↗
PubMed1987

Accuracy of twelve methods for estimating the real ear gain of hearing aids.

The gain of a hearing aid was measured on each of eight subjects using a variety of functional (subjective) and insertion (objective) gain methods. Each measurement was repeated on subsequent days and the hearing aid gain was also determined in several couplers and on KEMAR. The multiple measurements enabled an accurate estimate of the "true" gain of the aid on each subject to be determined. The real ear gain measured by each of the individual methods was then compared with this true gain estimate and the relative accuracy of each method was quantified. Of the clinically feasible methods, probe microphone measurement of insertion gain proved to be the most accurate. Few significant differences were found between functional gain and insertion gain. Estimation of real ear gain on the basis of coupler gain appeared to be a reasonable, though not recommended approach.

Audiometry↗
PubMed1987

Phenytoin toxicity and hepatic encephalopathy: simulation or stimulation?

Two cases of phenytoin toxicity in patients with chronic liver disease who were taking 300 mg phenytoin daily are described. Each patient developed encephalopathy, characterized by confusion, disturbed conscious state, asterixis, and nystagmus, which was resistant to treatment with protein restriction, lactulose, and neomycin, but responsive to withdrawal of phenytoin. We suggest that the phenytoin did not precipitate hepatic encephalopathy, but caused an encephalopathy that mimicked it. We recommend that phenytoin be used cautiously in patients with liver disease, and that the drug's unbound serum level be measured if encephalopathy occurs.

Diagnostic Errors↗
PubMed1987

What proportion of patients with myocardial infarction are suitable for thrombolysis?

Four hundred and three patients were considered for entry into a trial of intravenous streptokinase in suspected myocardial infarction. Three hundred and sixty seven (91%) were excluded. Two hundred and sixty (65%) did not meet the inclusion criteria and 45 of the remaining 143 (35%) patients had contraindications to thrombolysis. This left 98 (24%) patients who were suitable for thrombolysis and 42 of them were over 70 years, the upper age limit. Thus according to this trial protocol 56 (14%) patients were eligible for recruitment; 36 (9%) patients were finally randomised. These data suggest that treatment with intravenous streptokinase may be applicable to only a small proportion of patients with myocardial infarction.

Adult↗
PubMed1987

Superiority of alternating non-cross-resistant chemotherapy in extensive small cell lung cancer. A multicenter, randomized clinical trial by the National Cancer Institute of Canada.

The National Cancer Institute of Canada Clinical Trials Group conducted a prospective randomized study comparing standard chemotherapy with alternating chemotherapy in patients with extensive small cell lung cancer. "Standard" treatment consisted of cyclophosphamide (1000 mg/m2 body surface area); doxorubicin (50 mg/m2), and vincristine (2 mg) every 3 weeks for six courses. Alternating chemotherapy was cyclophosphamide, doxorubicin, and vincristine alternating with etoposide (100 mg/m2 on days 1 to 3) and cisplatin (25 mg/m2 on days 1 to 3) every 3 weeks for six treatment cycles. Two hundred eighty-nine patients were eligible and evaluable for response to therapy and survival. Best response was higher in patients on alternating chemotherapy (complete plus partial response, 80% compared with 63.2%; p less than 0.002). Progression-free survival for patients on alternating chemotherapy was superior (p less than 0.0001) as was overall survival (p = 0.03). Major toxicities were equally frequent in both treatment groups. These results show a modest superiority of alternating chemotherapy over standard therapy in extensive small cell lung cancer.

Adult↗
PubMed1987

The importance of dose and dose intensity in lung cancer chemotherapy.

The concepts of dose-response and intensity-response are distinguished via analysis of chemotherapeutic regimens for small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC) with methodology previously described. Using the data base for CAV (cyclophosphamide, doxorubicin, vincristine), and CAE (cyclophosphamide, doxorubicin, etoposide) chemotherapy, there was no consistent correlation between cyclophosphamide dose intensity and outcome; however, doxorubicin dose intensity in extensive stage disease was highly significantly associated with response rates for both regimens and median survival time for the CAE combination. Analysis of cyclophosphamide results for NSCLC do not support its use at any dose. While waiting for the development of new and more active drugs for lung cancer chemotherapy, the innovative investigation of the best drugs currently available provides the best chance for improved results.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Phase II study of lonidamine in patients with small cell carcinoma of the lung.

Lonidamine, a substituted indazole carboxylic acid that inhibits cellular respiration, was given in an escalating oral schedule to 20 evaluable patients with measurable extensive small cell carcinoma of the lung. Two partial responses occurred. Reversible acceptable toxicity included myalgia, nausea, hyperesthesia, photophobia, somnolence, and testicular pain. The drug was not myelosuppressive. Lonidamine has modest activity in small cell lung cancer and further studies are warranted.

Adult↗
PubMed1986

The human anti-myelin-associated glycoprotein IgM system.

Two mouse monoclonal antiidiotypic antibodies that react with human monoclonal IgM antibodies with specificity for myelin-associated glycoprotein (MAG) have been used to study the immunological specificity of the reported cross-reactions involving the anti-MAG IgM. Both of the antiidiotypic antibodies are shown to react with the combining site of their respective idiotypic IgM and to inhibit the reaction between IgM and MAG. Using these antiidiotypic antibodies as "surrogate" antigen, we have demonstrated immune cross-reactivity between MAG, a human peripheral nerve glycolipid, and a low-molecular-weight protein of human peripheral nerve myelin. In addition, we have used the two antiidiotypic antibodies to conduct a search for evidence of shared idiotypy among 34 different neuropathy-associated paraproteins. Our results provide no evidence for a neuropathy-associated idiotype, suggesting a degree of polymorphism in the human anti-MAG IgM system.

Animals↗
PubMed1986

Specificity of CSF antibodies against components of Borrelia burgdorferi in patients with meningopolyneuritis Garin-Bujadoux-Bannwarth.

The specificity of immunoglobulin (Ig) for components of Borrelia burgdorferi was investigated in cerebrospinal fluid (CSF), serum and in CSF oligoclonal bands from nine patients with meningopolyneuritis Garin-Bujadoux-Bannwarth (MPN-GBB). All patients showed specific IgG and IgM antibodies in serum and CSF when incubated with a lysate of B. burgdorferi strain B 31. Specific antibody was detected in CSF but not in paired serum samples, indicating intrathecal synthesis. Investigation of the specificity of oligoclonal Ig in the CSF revealed oligoclonal bands with specificity for B. burgdorferi in one of the nine patients.

Antibody Formation↗
PubMed1986

Predictability of the required frequency response characteristic of a hearing aid from the pure-tone audiogram.

This paper examines the predictability of the optimal frequency response characteristic of a hearing aid from the shape of the pure-tone audiogram. The main data were derived from two studies, using 14 and 16 sensorineurally hearing-impaired ears, representing a wide variety of audiometric configurations. Optimal (required) frequency response slopes were estimated from most comfortable loudness levels for speech bands after finding that such responses were superior to ones derived from other procedures. The low (0.4 or 0.5 to 1.25 kHz), high (1.25 to 3 kHz), and total (0.4 or 0.5 or 3 kHz) slopes of the optimal responses were analyzed relative to the corresponding audiogram slopes. A moderately strong relationship was found between audiogram slopes and required response slopes (correlations averaged almost 0.6) and different studies agreed substantially regarding the formula describing that relationship. We conclude that it is justifiable to select the frequency response of a hearing aid from the pure-tone audiogram and that an appropriate formula would be more effective than providing a standard frequency response for all clients.

Adult↗
PubMed1986

Activation of myelin protein kinase by diacylglycerol and 4 beta-phorbol 12-myristate 13-acetate.

In an effort to gain a more complete understanding of the regulation of myelin basic protein phosphorylation, we have been interested in defining further the mode of regulation of the myelin protein kinase involved in this posttranslational modification. Here we report the partial purification of a protein kinase from rat brain myelin. By gel filtration, it was determined that the molecular weight of this enzyme was in the range of 70-80 X 10(3) daltons Furthermore, it was established that at low calcium concentrations, this enzyme was markedly activated by phosphatidylserine in combination with either 4 beta-phorbol 12-myristate 13-acetate or diolein. The enzyme was not affected by cyclic AMP or by calcium, alone or in combination with calmodulin. On the basis of these findings this enzyme can be identified as a protein kinase C-like enzyme.

Animals↗