Taking aim at firearm injuries.
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Emergencies↗
Biomedical subjects
T L Cheng
Publications and source records attributed to T L Cheng.
Effect of bundling and high environmental temperature on neonatal body temperature.
OBJECTIVE: The effect of bundling and ambient heat on newborn body temperature has not been systematically studied. It was hypothesized that bundling and warm environments can elevate the newborn's temperatures to the range that would prompt clinical concern of neonatal sepsis. METHODS: Twenty well, term newborns more than 1 day old were assigned to the control group (one blanket; 24.0 degrees C room) or the experimental group (five blankets and hat; 26.6 degrees C room). Continuous rectal probe temperatures were monitored over a 2 1/2-hour period. RESULTS: There were 8 control and 12 experimental newborns. The mean change in rectal temperature after 2 1/2 hours was -0.04 degrees C (SD +/- 0.23) in control newborns and +0.56 degrees C (SD +/- 0.12) in the treatment group (P < .0001, t test). Temperatures in the treatment group rose, after an initial half-hour lag, at a linear rate of 0.27 degrees C per hour without a plateau. Two newborns reached 38.0 degrees C, a rectal temperature that may raise concern of infection. CONCLUSIONS: Bundling and warm environments can elevate newborn body temperature to the "febrile" range in this age group. Physicians treating neonates with elevated temperature should ask about bundling and environmental conditions to differentiate endogenous from exogenous "fevers."
Body Temperature↗
House staff work hours and moonlighting: what do residents want? A survey of pediatric residents in California.
In the autumn of 1988, pediatric residents were surveyed on attitudes toward work hours, moonlighting, and priorities in regulation of working conditions. Questionnaires for all 756 California residents in accredited pediatric programs were sent to chief residents. Of these, 676 questionnaires were distributed to residents and 319 (47%) were returned. Respondents indicated strong support for limits on house staff working hours, and most approved of the reduction regulations proposed in New York State. Most believed that individual departments, hospitals, or subspecialties should regulate hours. By a ratio of 4.3:1, however, respondents favored legislative intervention if such limits were not set by the profession. Moonlighting was generally considered to be an individual's choice and responsibility, but a majority were willing to restrict moonlighting if total house staff hours were also limited.
Attitude of Health Personnel↗
Superimposed infections following the use of antibiotics.
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Adolescent↗
Accelerated clearance of polyethylene glycol-modified proteins by anti-polyethylene glycol IgM.
Tumor therapy by the preferential activation of a prodrug at tumor cells targeted with an antibody-enzyme conjugate may allow improved treatment efficacy with reduced side effects. We examined antibody-mediated clearance of poly(ethylene glycol)-modified beta-glucuronidase (betaG-sPEG) as a method to reduce serum concentrations of enzyme and minimize systemic prodrug activation. Enzyme-linked immunosorbent assay and immunoblot analysis of two monoclonal antibodies generated by immunization of BALB/c mice with an antibody-betaG-sPEG conjugate showed that mAb 1E8 (IgG1) bound betaG and betaG-sPEG whereas mAb AGP3 (IgM) bound poly(ethylene glycol). Neither antibody affected the betaG activity. mAb 1E8 and AGP3 were modified with 36 and 208 galactose residues (1E8-36G and AGP3-208G) with retention of 72 and 48% antigen-binding activity, respectively, to target immune complexes to the asialoglycoprotein receptor on liver cells. mAb 1E8 and AGP3 cleared betaG-PEG from the circulation of mice as effectively as 1E8-36G and AGP3-208G, respectively. mAb AGP3, however, cleared betaG-sPEG more completely and rapidly than 1E8, reducing the serum concentration of betaG-sPEG by 38-fold in 8 h. AGP3 also reduced the concentration of an antibody-betaG-sPEG conjugate in blood by 280-fold in 2 h and 940-fold in 24 h. AGP3-mediated clearance did not produce obvious damage to liver, spleen, or kidney tissues. In addition, AGP3 clearance of betaG-sPEG before administration of BHAMG, a glucuronide prodrug of p-hydroxyaniline mustard, prevented toxicity associated with systemic activation of the prodrug based on mouse weight and blood cell numbers. AGP3 should be generally useful for accelerating the clearance of PEG-modified proteins as well as for improving the tumor/blood ratios of antibody-betaG-PEG conjugates for glucuronide prodrug therapy of cancer.
Aniline Mustard↗
Efficient clearance of poly(ethylene glycol)-modified immunoenzyme with anti-PEG monoclonal antibody for prodrug cancer therapy.
The F(ab')(2) fragment of the anti-TAG-72 antibody, B72.3, was covalently linked to Escherichia coli-derived beta-glucuronidase that was modified with methoxypoly(ethylene glycol). The conjugate (B72.3-betaG-PEG) localized to a peak concentration in LS174T xenografts within 48 h after injection, but enzyme activity persisted in plasma such that prodrug administration had to be delayed for at least 4 days to avoid systemic prodrug activation and associated toxicity. Conjugate levels in tumors decreased to 36% of peak levels at this time. Intravenous administration of AGP3, an IgM mAb against methoxypoly(ethylene glycol), accelerated clearance of conjugate from serum and increased the tumor/blood ratio of B72. 3-betaG-PEG from 3.9 to 29.6 without significantly decreasing the accumulation of conjugate in tumors. Treatment of nude mice bearing established human colon adenocarcinoma xenografts with B72. 3-betaG-PEG followed 48 h later with AGP3 and a glucuronide prodrug of p-hydroxyaniline mustard significantly (p< or =0.0005) delayed tumor growth with minimal toxicity compared to therapy with a control conjugate or conventional chemotherapy.
Aniline Mustard↗