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Biomedical subjects

R L Norris

Publications and source records attributed to R L Norris.

29 records · Page 2Linked to original sources

Apparent coral snake envenomation in a patient without visible fang marks.

Envenomation by the North American coral snake is an uncommon entity in the United States. In most cases fang marks will be present, although they may be quite small and difficult to see. The case of a young man who demonstrated evidence of envenomation following the bite of a Texas coral snake (Micrurus fulvius tenere), despite the absence of any apparent fang marks on close examination, is reported. The problems associated with coral snake envenomation in terms of diagnosis and management are reviewed.

Adult↗

Preliminary observations on the effects of hyperbaric oxygen therapy on western diamondback rattlesnake (Crotalus atrox) venom poisoning in the rabbit model.

Intermittent hyperbaric oxygen therapy has been shown to reduce skeletal muscle necrosis in a compartment syndrome animal model. To study whether intermittent exposure to hyperbaric oxygen augments antivenin therapy in reducing muscle necrosis, we injected sublethal doses of Western Diamondback rattlesnake (Crotalus atrox) venom intramuscularly into the hind legs of New Zealand White rabbits. In this pilot study, the animals were divided into three treatment groups. The first group received one vial of antivenin intravenously, the second group received one vial of antivenin intravenously plus three hyperbaric oxygen treatments, and the third group received no treatments. There were no statistically significant differences among the groups. These preliminary observations suggest that muscle necrosis secondary to Crotalus atrox venom poisoning is not significantly altered either by Antivenin [Crotalidae] Polyvalent at the dose level we used or in combination with intermittent hyperbaric oxygen treatments in this rabbit model.

Animals↗

Deep vein thrombosis in an adolescent.

We report an unusual case of deep vein thrombosis following minor trauma in an adolescent who presented with a swollen, tender, lower extremity. Work-up consisted of a venogram which demonstrated occlusion of the deep venous system in the proximal leg. The patient was hospitalized for intravenous heparin followed by oral anticoagulation therapy. The problem of deep venous thrombosis in adolescents and the approach to diagnosis are discussed.

Adolescent↗

A modified assay for cyclosporin in blood using solid-phase extraction with high-performance liquid chromatography.

A modified procedure for measuring cyclosporin in whole blood by high-performance liquid chromatography is described and evaluated for clinical use. Sample preparation uses solid-phase extraction cartridges that can be reused. Life of the reverse-phase analytical column exceeds 1,000 injections at 70 degrees C. Cyclosporins A and D (internal standard) elute after 5.6 and 7.6 min, respectively. Calibration plots are linear from 50 ng/ml to at least 2,000 ng/ml. Within-day and between-day imprecision is less than 9% (coefficient of variation). Minimum measurable concentration is 50 ng/ml.

Chromatography, High Pressure Liquid↗

Temelastine does not affect theophylline pharmacokinetics in normal subjects.

The pharmacokinetics of theophylline (i.v. aminophylline 250 mg) were studied in a balanced, double-blind crossover following the administration of oral temelastine (100 mg) or placebo, twice daily for 7 days, to 10 normal volunteers. Comparison of volumes of distribution, elimination rate constants, elimination half-lives and areas under the plasma concentration-time curve indicated that temelastine had no significant effect on theophylline pharmacokinetics.

Adult↗

Assessment of a two-step high-performance liquid chromatographic assay using dual-wavelength ultraviolet monitoring for 25-hydroxyergocalciferol and 25-hydroxycholecalciferol in human serum or plasma.

The technique of dual-wavelength monitoring was used to verify the purity of high-performance liquid chromatographic (HPLC) peaks quantified as 25-hydroxyergocalciferol and 25-hydroxycholecalciferol. The data obtained show the need for a second HPLC step prior to quantitation. Potential inaccuracy arising from inadvertent collection of radio-labelled decomposition products was assessed. Between-day coefficients of variation were 7.3, 5.0 and 3.6%, respectively for 11.3 (n = 12), 17.1 (n = 14), and 32.9 (n = 8) ng/ml of 25-hydroxycholecalciferol. For 25-hydroxyergocalciferol, these values were 6.4 and 3.8% for 11.1 (n = 12) and 20.1 (n = 8) ng/ml concentrations, respectively. Comparison of total 25-hydroxycalciferol with a competitive protein binding assay was made. The comparison produced a correlation coefficient (r) of 0.94 and a relationship of y = 1.03x + 3.3. Four of the samples contained more than 10 ng/ml of 25-hydroxyergocalciferol and the results are consistent with the reported 100% cross-reactivity of the competitive binding protein method for 25-hydroxyergocalciferol and 25-hydroxycholecalciferol. A simple regeneration procedure is also described which enables Sep-Pak C18 cartridges to be reused up to eighteen times. Samples may be stored at -18 degrees C for upto several months before assay and either serum or plasma may be used.

25-Hydroxyvitamin D 2↗

Binding of disopyramide to alpha 1-acid glycoprotein in plasma measured by competitive equilibrium dialysis.

A modification of equilibrium dialysis in which alpha 1-acid glycoprotein and plasma compete directly for disopyramide has been used in conjunction with binding curves to measure the extent of the alpha 1-acid glycoprotein-disopyramide interaction. At concentrations in the therapeutic range, 80-90% of disopyramide was bound to alpha 1-acid glycoprotein for plasma from each of six healthy adults. Also, equilibrium dialysis data are presented, indicating that pH does not influence the binding of disopyramide within the therapeutic range.

Dialysis↗

Determination of unbound fraction of disopyramide in plasma: a comparison of equilibrium dialysis, ultrafiltration through dialysis membranes and ultrafree anticonvulsant drug filters.

A simple, rapid ultrafiltration technique for determination of free drug concentration in plasma is described and compared with equilibrium dialysis and ultrafiltration through dialysis membranes. When used for disopyramide protein binding studies, this method requires only 1 ml of plasma and up to 20 samples may be filtered simultaneously in 20-40 min. Commercially available Ultrafree anticonvulsant drug filters are used, these are attached to 2 ml leur tip syringes, which provide the pressure gradient for filtration. Compared to equilibrium dialysis this technique is far quicker and permits protein binding to be measured at the drug concentration in the original plasma. Ultrafiltration through dialysis membranes was found to be more tedious and time-consuming than it was through Ultrafree filters. Adsorption of disopyramide from the plasma sample and protein leakage were also problems with this method. Leakage of protein did not occur with either Ultrafree filters or equilibrium dialysis. With the Ultrafree method, recovery of 14C-labeled disopyramide in buffer at 1.1 micrograms/ml and 8.4 micrograms/ml was 87% and 89% respectively. In carefully controlled experiments, a comparison of the Ultrafree method with equilibrium dialysis and ultrafiltration gave comparable values for the free fraction of the drug for total concentrations from 0.3-8 microgram/ml disopyramide.

Blood Proteins↗

Ovarian hyperstimulation syndrome in the emergency department: a case report.

The Ovarian Hyperstimulation Syndrome (OHSS) is a complication of ovulation enhancing technologies that is becoming more prevalent with increasing use of these techniques in infertile women. In this report, we describe a 36-year-old woman who presented to the Emergency Department with hemodynamic compromise secondary to OHSS. The OHSS is characterized by ovarian enlargement, ascites, electrolyte disturbances, hypotension, and thromboembolic events. This case illustrates a serious complication of techniques used to enhance fertility.

Adult↗

Effect of disopyramide on left ventricular performance: the relationship of free and total concentrations of the drug and of its mono-N-dealkylated metabolite to noninvasive indices of function.

We used M-mode echocardiography and recordings of systolic time intervals to follow changes in left ventricular systolic function of 10 normal subjects during administration of 200 mg oral disopyramide every 8 h. Left ventricular function was significantly depressed (peak rate of change of dimension - 17%, p less than 0.001; mean velocity of circumferential fiber shortening - 15%, p less than 0.01; percent fractional shortening - 16%, p less than 0.05) for as long as 7 h after a dose. These changes could be correlated with those in plasma concentrations of free and total disopyramide, and of its mono-N-dealkylated metabolite (change in peak rate of change of dimension versus levels of disopyramide plus metabolite, r = -0.41, p less than 0.03; changes in ratio preejection time/ejection time versus levels of disopyramide and metabolite, r = 0.62, p less than 0.002).

Adult↗