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Biomedical subjects

S L Green

Publications and source records attributed to S L Green.

At least 55 records · Page 3Linked to original sources

Effects of hypoxia and azotaemia on the pharmacokinetics of amikacin in neonatal foals.

The effects of hypoxia and azotaemia on the pharmacokinetics of amikacin were evaluated in 20 full-term neonatal critically ill foals which required 24-h supportive care, antibiotics and dextrose-supplemented polyionic fluids given intravenously, nasal insufflation with oxygen and nutritional supplementation. There was no association between sepsis score or survival and pharmacokinetic parameters. Concurrent hypoxia and azotaemia were associated with significantly decreased clearance and increased peak and trough serum concentrations of amikacin; however, peaks or troughs did not exceed toxic values. Derangements in serum peak, trough and clearance values, which were present on admission, persisted over the 6-day duration of this study. Daily monitoring of serum amikacin concentration revealed a tendency to underdose (particularly in foals receiving aggressive fluid therapy), which necessitated increasing the dose/kg body weight (9-12 mg/kg) and increasing the dose interval (10-12 h) in 40% (8/20) of the cases, so that blood concentrations of amikacin could be maintained within the target range of 3-15 micrograms/ml. Amikacin-induced nephrotoxicity was not indicated by conventional laboratory testing, nor was it strongly suspected after examination of post mortem lesions.

Amikacin↗

Community-based plan for treating human immunodeficiency virus-infected individuals sponsored by local medical societies and an acquired immunodeficiency syndrome service organization.

Individuals infected with human immunodeficiency virus frequently experience difficulty finding medical care from private physicians. Fear of occupational exposure, prejudice, lack of knowledge, and financial loss have all been cited as reasons for the reluctance of primary care physicians to accept patients with acquired immunodeficiency syndrome into their practices. To meet the medical needs of all patients infected with human immunodeficiency virus, this Virginia community adopted a voluntary rotational referral plan to provide primary care for all such individuals. The program required the cooperation of a voluntary pool of internists and family practitioners and an acquired immunodeficiency syndrome service organization with a volunteer physician advisor to coordinate referrals of unassigned patients. No physician received more than three referrals per year. During the 2 years of operation, 118 referrals were made to 30 physicians. Regular educational seminars were provided with medical updates and consultation support was provided. This locally based program appears to be meeting the acquired immunodeficiency syndrome challenge in this community and may have applicability to other communities as well.

Attitude of Health Personnel↗

Concepts of designing new delivery models.

The need for health-care organizations to deliver high-quality care that is affordable, while maintaining high morale and productivity among employees, has become a central concern for hospital executives. This article addresses the internal and external pressures that are resulting in hospitals wanting to and having to do things in dramatically different ways. The assumptions, success factors, and approaches to redesign are discussed in relation to the decision to redesign, with attention to factors that should be taken into account in the redesign process, and issues and processes of putting the redesign in place. An example of patient-care redesign with case management is included.

Hospital Bed Capacity, 500 and over↗

A mouse endothelial cell-specific monoclonal antibody: its reactivity with LTMC endothelium.

The binding of a marrow cell-related monoclonal antibody (H513E3 MAb) has been investigated in long-term marrow cultures (LTMC) and in vivo. Immunogold labeling and electron microscopy revealed that this antibody labeled an endothelial-like cell. Cross-reaction of anti-human Factor VIII confirmed endothelial specificity of the H513E3 MAb. In addition, vessel endothelium (vena cava, aorta, and marrow) exhibited binding of the antibody. This antibody provides a unique tool to study the cellular architecture of LTMC and implicates endothelium as an important component of LTMC. The function of the endothelial cell-specific surface antigen is unknown, although preferential labeling of the upper surface of endothelial cells suggests that it may play a role in cell communication, particularly with the floating population. The H513E3 MAb reacts with an external membrane antigen, a property that makes this antibody particularly useful for fluorescences-activated sorting of endothelial cells.

Animals↗

Use of bone marrow somatic cell hybrid lines to generate monoclonal antibodies specifically reactive with rare marrow cells.

The technique of somatic cell hybridization has been applied to obtain new sources of immunogen for monoclonal antibody production. A marrow population enriched for rare and undifferentiated cells was hybridized with A9 cells. Mature cells were depleted by using mice at 8 days following 5-fluorouracil treatment and by using a sorting procedure. Selection of hybrids was in medium containing hypoxanthine, aminopterin, and thymidine (HAT). Chromosome analysis was used to verify that clones contained hybrid cells. An example of an antibody (H513E3) obtained by immunizing with a hybrid cell line (H5Scl1.4.4) is presented. The H513E3 antibody showed low reactivity with normal marrow (0%-3%), and hemopoietic cell lines of various types exhibited no cross-reaction. However, about 10% of cells from the adherent stromal layer of long-term marrow cultures reacted with the H513E3 antibody. A specific cell type was labeled that appeared to have endothelial-like morphology when observed with immunogold labeling and electron microscopy. The hybridization technique allows a cell of a particular differentiation lineage to be conserved, wholly or partially, in a cloned form, thus overcoming the heterogeneity of a normal marrow population.

Animals↗

Concentrations of trimethoprim and sulfamethoxazole in cerebrospinal fluid and serum in mares with and without a dimethyl sulfoxide pretreatment.

Each of seven mares was given an intravenous (IV) injection of 40% dimethyl sulfoxide (DMSO) at a dosage of 1 g/kg, over 35 min, immediately followed by a single IV injection of a trimethoprim (TMP) and sulfamethoxazole (SMZ) combination (SMZ 83%, TMP 17%) at a combined dosage of 44 mg/kg (7.48 mg/kg TMP; 36.52 mg/kg SMZ). Each horse served as its own control and was alternately treated with an identical dose of TMP-SMZ treatment alone at least seven days following or preceding the DMSO and TMP-SMZ treatment. Serum and cerebrospinal fluid (CSF) concentrations of TMP and SMZ were measured over a six hour period. Dimethyl sulfoxide treatment caused no significant difference in the mean serum concentration of SMZ or in the mean CSF concentrations of TMP or SMZ. The mean serum concentration of TMP was significantly (p less than 0.05) increased at the two, four and six hour sampling time in the mares receiving pretreatment with DMSO. The clearance of TMP was also significantly (p less than 0.05) decreased from 675 mL/h/kg to 327 mL/h/kg by DMSO administration. Concentrations of TMP and SMZ in the CSF in both treatment groups exceeded the minimum inhibitory concentrations for many common bacterial pathogens of equine origin. In addition, CSF concentration of TMP exceeded the serum concentrations required for 50% inhibition of dihydrofolate reductases of protozoan origin. Serum TMP and SMZ concentration were similar to those reported to be effective against Toxoplasma gondii in in vitro studies on the killing or inhibition of the organism.

Animals↗

Avian mycobacteriosis in three horses.

The clinical, bacteriologic and pathologic findings of three adult horses suffering from avian tuberculosis are presented. Chronic weight loss and hypoproteinemia were pertinent clinical abnormalities in all three horses. Gross pathologic lesions were characterized by chronic enterocolitis with mesenteric lymphadenopathy in two horses and hepatic granulomas in the third horse. The microscopic diagnoses were chronic, non-caseating granulomatous enterocolitis, and necrotizing, non-mineralizing granulomatous hepatitis, respectively. All three horses had granulomatous lymphadenitis of mesenteric lymph nodes with varying degrees of non-mineralizing, coagulation necrosis. Various serotypes of the Mycobacterium avium-intracellulare complex were isolated from selected tissues and feces.

Animals↗

The response of megakaryocytes with processes to thrombin.

The response of megakaryocytes to thrombin (1-10 U/ml) has been examined by time-lapse cinemicrography and electron microscopy. The study was confined to mature megakaryocytes which had developed processes following incubation in vitro. The initial response of all cells was to undergo retraction of processes, behaviour thought to be linked with the depolymerization of microtubules which extend longitudinally through the processes. The majority of cells completely withdrew their processes, but about 30% responded differently and underwent only limited retraction, followed by secretion. Analysis of time-lapse film showed that processes from the latter group of cells had formed attachments with the coverslip prior to exposure to thrombin. Within the partially retracted processes of these cells, secretory granules were found to be clustered centripetally and enveloped by a microfilamentous structure in the form of a cylinder. Vacuoles appeared, some of which were located outside the microfilamentous structure. Microtubules were present, but many appeared disorientated. The shape of the microfilamentous structure suggests that the cytoplasm is not organized into putative platelets at the time of process formation.

Actin Cytoskeleton↗

Ultrastructure and innervation of the swimbladder of Tetractenos glaber (Tetraodontidae).

The general structure, ultrastructure and innervation of the swimbladder of the smooth toadfish, Tetractenos glaber, were examined with light-microscopic, fluorescence-histochemical, and transmission electron-microscopic techniques. The structure of the swimbladder is similar to that of other euphysoclists. Fluorescence histochemistry showed adrenergic fibres in both the secretory and resorptive areas of the swimbladder. Transmission electron microscopy revealed two morphologically distinct axon profiles: type-I profiles containing many small, flattened vesicles; type-II profiles containing both large, granular vesicles and rounded, small clear vesicles in varying proportions. The gas-gland cells and surrounding muscularis mucosae are innervated by both type-I and type-II fibres. Type-I fibres also innervate pre-rete arteries. The rete- and gas-gland capillaries do not appear to be innervated. Arteries running to the resorptive area are innervated by type-I fibres. Both type-I and type-II profiles make contact with the muscularis mucosae in the resorptive area. Only type-I fibres innervate the radial dilator muscle in the oval sphincter region, whereas only type II fibres innervate the circular muscle of the oval sphincter. Type-I fibres took up alpha-methyl-noradrenaline, and could not be found after pre-treatment with 6-hydroxydopamine. They are, therefore, assumed to be adrenergic. Type-II fibres were tentatively identified, by exclusion, as cholinergic.

Air Sacs↗

Evidence for postpartum toxic-shock syndrome in a mother-infant pair.

Toxic-shock syndrome occurred in a mother and possibly in her infant in the immediate postpartum period. Staphylococcus aureus of identical phage type and antibiogram was recovered from mucous membranes in both patients. Staphylococci were transmitted from mother to infant during parturition. These cases represent the first postpartum clinical description and possible vertical transmission of this disease.

Adult↗

Factitious polymicrobial bacteremia: a case report.

A 23-year-old student nurse presented with polymicrobial bacteremia and symptoms suggestive of a renal abscess. After extensive evaluation, including an exploratory laparotomy, failed to reveal the source of sepsis, factitious illness owing to self-inoculation was suspected. In the absence of urologic, biliary or gastrointestinal obstruction self-inoculation must be considered in all patients with polymicrobial bacteremia.

Adult↗