Search PubMed⌕ Search

Biomedical subjects

R W Walker

Publications and source records attributed to R W Walker.

135 records · Page 8Linked to original sources
PubMedDate not supplied

Antidepressant treatment of chronic tension-type headache: a comparison between fluoxetine and desipramine.

Amitriptyline, which is a noradrenaline reuptake and 5-HT reuptake inhibitor, has an established role in the management of chronic tension-type headaches. In a single-blind study, patients with chronic tension-type headache were randomized to either fluoxetine 20 mg (a selective 5-HT reuptake inhibitor) or desipramine 75 mg (a selective noradrenaline reuptake inhibitor) and followed for 12 weeks to compare the effectiveness of the two drugs in improving headache, and to assess whether pain control is related to changes in depression. Patients were evaluated at weekly intervals on an analog pain-rating scale and at 4-weekly intervals on the Montgomery and Asberg Depression Rating Scale (MADRS), the MOS general health status questionnaire (SF36), the Hospital Anxiety and Depression Scale (HADS), and a side effects checklist. Eighteen patients were randomized to take fluoxetine and 19 to take desipramine. Of the 25 patients who completed the trial, 12 were on fluoxetine and 13 were on desipramine. There was no significant difference between the two groups at baseline nor in change of pain; reduction in use of analgesic medication; nor change in the HADS, MADRS, or SF36 scores at 12 weeks, but 72% of patients who completed the study improved, and this improvement almost exactly mirrored the improvement on the MADRS. The results from this trial are compatible with the notion that the beneficial effect of antidepressants in chronic tension-type headache is indirect, mediated by an effect on depression, and not more,dependent on serotonin reuptake inhibition than noradrenaline reuptake inhibition.

Adolescent↗
PubMedDate not supplied

Oxidative and defluorinative metabolism of fludalanine, 2-2H-3-fluoro-D-alanine.

The antibacterial agent fludalanine [2-2H-3-fluoro-D-alanine (DFA)] is a potent inhibitor of bacterial alanine racemase, an enzyme required for the generation of D-alanine, an essential component of the bacterial cell wall. Primary metabolism of DFA involves its oxidation to fluoropyruvate (FP); this organic fluoride is then rapidly reduced to fluorolactate (FL) which is the major organic metabolite in laboratory animals. Gas-liquid chromatographic chemical ionization mass spectrometric assays were developed for these two metabolites. FL is the predominant organofluoride metabolite of DFA in the circulation. FP was detected in the urine although recovery was very low. The rapid conversion of FP to FL precludes assay of the former in serum. Maximum serum FL concentrations in the rat appear about 1 hr after the dose of DFA and are relatively constant for several hours thereafter. The peak FL concentration is proportional to the dose of DFA; repeated daily dosing of DFA appears to cause neither saturation nor induction of metabolic pathways. Comparison of FL concentrations determined using the GC/MS assay with those based on an enzymic method specific for L-(+)-FL demonstrated that only the latter isomer is found in the plasma of monkeys dosed with DFA. In vivo exchange studies involving the alpha-proton of FL indicate that a small FP pool exists and is in equilibrium with FL. A crude pyruvate dehydrogenase complex isolated from beef heart mitochondria was shown to produce equimolar quantities of acetate, CO2, and fluoride from FP.

Alanine↗
PubMedDate not supplied

MR imaging of brainstem tumors.

Eighteen patients aged 4-72 years old with brainstem tumors were studied using a 0.5 T magnetic resonance (MR) imager and a third- or fourth-generation computed tomographic (CT) scanner. MR imaging showed the brainstem to be enlarged on sagittal views in all cases; exophytic growth was seen in eight. Alterations of signal intensities were shown in most cases on spin-echo sequences using 30 and 90 msec echo times and inversion recovery techniques. It was not possible to distinguish primary from metastatic tumors. The configurations and margins of the areas with abnormal signal did not appear to correlate with the clinical behavior of the tumors. CT was able to recognize brainstem tumor in only 13 of 16 cases. In the two cases of metastases, plain CT scans were normal, but enhancement was seen after administration of contrast material in one. It appears that MR imaging is sensitive in detecting tumor enlargement and abnormal signals and is superior to CT in evaluating brainstem tumors.

Adolescent↗
PubMedDate not supplied

Physiological disposition and metabolism of 2-aminomethyl-4-(1,1-dimethylethyl)-6-iodophenol hydrochloride.

MK-447-(14)C [2-aminomethyl-4-(1,1-dimethylethyl)-6-iodophenol hydrochloride] was well absorbed and metabolized in man, rats, and dogs. Peak plasma levels of radioactivity were observed in these species 1-2 hr after oral administration of 2 mg/kg to rats and dogs and 25 mg to man. At the peak, parent drug represented about 15% of the radioactivity in human plasma and only approximately 5% in rat and dog plasma. The half-life of the parent drug in human plasma was approximately 4 h. Human subjects excreted 96% of the dose, with 76% in the urine and 20% in the feces, in 3 days. Rats excreted 80% of an oral and 82% of an intravenous 2-mg/kg dose in 72 hr, with 66% in the urine and 12-16% in the feces. In dogs given a 2-mg/kg dose intravenously, the recovery of radioactivity in 72 hr was approximately 99%, with 85% in the urine and 14% in the feces. The major metabolite in rat and dog urine, constituting approximately 90% of the urine radioactivity, was the O-sulfate conjugate of MK-447. In man, this metabolite accounted for 17% of the radioactivity in the urine. The major metabolite in human urine, constituting approximately 73% of the urine radioactivity, was tentatively identified as the N-glucuronide of MK-447. Less than 1% of the radioactivity in the urine of the three species was in intact MK-447.

Animals↗
PubMedDate not supplied

Identification of a glutathione conjugate of cambendazole formed in the presence of liver microsomes.

The incubation of multiply labeled (2H, 3H, 13C, 14C) cambendazole and glutathione with hepatic microsomes from phenobarbital-dosed hamsters results in the formation of polar metabolites. The major metabolite has been characterized by a variety of isotopic, spectrometric, chromatographic, and degradative/synthetic techniques as a glutathione conjugate of cambendazole in which substitution is on the 4-position of the benzimidazole nucleus. The same metabolite is produced by hepatic microsomes from the rat.

Animals↗
PubMedDate not supplied

Timolol metabolism in man and laboratory anamals.

The two major urinary metabolites of 14C-timolol in man, involving oxidation and hydrolytic cleavage of the morpholine ring, are also observed in both Sprague-Dawley rats and CRCD-1 mice. These are the N-T(4-[3-(1,1-dimethylethyl)amino]-2-hydroxypropoxy)-1,2,5-thiadiazol-3-ylT-N-(2-hydroxyethyl)glycine and 1-(1,1-dimethylethylamino-3-([4-(2-hydroxyethylamino)-1,2,5-thiadiazol-3-yl]oxy)-2-propanol. The former was previously identified erroneously as the isomeric compound 1-(1,1-dimethylethylamino)-3-([4-(N-2-hydroxyethylglycolamido)-1,2,5-thiadiazol-3-yl]oxy)-2-propanol. Rats and mice had two additional metabolites in common, 1-[(1,1-dimethylethyl)amino]-3-([4-(2-hydroxy-4-morpholinyl)-1,2,5-thiadiazol-3-yl]oxy)-2-propanol and a compound now proposed to be the corresponding morpholino lactone 1-[1,1-dimethylethyl)-amino]-3-([4-(2-oxo-4-morpholinyl)-1,2,5-thiadiazol-3-yl]oxy)-2-propanol but for which the corresponding isomeric morpholino lactam structure 1-[(1,1-dimethylenthyl)-amino]-3-([4-(3-oxo-4-morpholinyl)-1,2,5-thiadiazol-3-yl]oxy))-2-propanol was tentatively proposed in an earlier publication. A metabolite observed in the rat, but not in the other species studied, was 4-(4-morpholinyl)-1,2,5-thiadiazol-3-ol-1-oxide. The metabolic pattern in these rodents does not change significantly after repeated doses. A scheme summarizing the metabolic fate of timolol in man and laboratory animals is presented.

Animals↗
PubMedDate not supplied

The metabolism of avermectins B1a, H2B1a, and H2B1b by liver microsomes.

The avermectins area a new class of structurally related antiparasitic agents isolated from Streptomyces avermitilis. The major polar metabolites isolated from in vitro incubations of [3H]avermectins B1a, H2B1a, and H2B1b with either rat or steer liver microsomes have been isolated and identified as the C24-methyl alcohols of the parent compounds. A smaller quantity of a more polar metabolite has also been identified as the monosaccharide of the C24-methyl alcohols of avermectin H2H1b from rat liver microsomal incubation and avermectin H2B1a from steer liver microsomal incubation. The mass spectra and 300-MHz 1H-NMR spectra permitted assignment of structures to these metabolites. Together these two metabolites represent 50-80% of the total radioactivity more polar than the parent compounds. The metabolite profiles on reverse-phase HPLC demonstrate that the rat and steer are qualitatively similar in the production of these two polar metabolites.

Animals↗