Biomedical subjects
Publications and source records attributed to C M Martin.
A term pregnancy occurred in the presence of a significant uterine septum. The changes in the anatomic appearance of the septum were documented sonographically throughout the gestation. A complete workup for other causes of pregnancy loss and attention to obstetric detail are central to the management of such patients.
A case occurred of Rh isoimmunization complicating a triplet gestation. Management of that extremely rare situation required careful attention to the problems inherent in both multiple pregnancy and isoimmunization. Amniocentesis and frequent antepartum fetal monitoring were the cornerstones of therapy.
Thirty-four patients believed to have ectopic pregnancies were examined by transabdominal and transvaginal ultrasonography. Twenty-five patients had tubal pregnancy confirmed operatively within 24 hours after ultrasonographic examination. In these cases adnexal findings highly suspicious for ectopic pregnancy were found in 68% of cases by transabdominal ultrasonography and in 84% by transvaginal ultrasonography. A distinct adnexal gestational sac was apparent in 32% of cases by transabdominal ultrasonography and in 64% of cases by transvaginal ultrasonography. Transvaginal ultrasonography was significantly more accurate (p less than 0.01) in identifying an adnexal gestational sac and allows more detailed adnexal imaging.
Six male and six female subjects were given 112 trials on each of two tasks requiring a yes-no comparison of pairs of letters presented to the right and left hemispheres. One task was predominantly visual (detection of curved letter segments) and the other was predominantly verbal (detection of rhyming "ee" sounds). It was found that for "yes" decisions, females were faster in the right hemisphere than in the left, while the reverse was the case for males. Also for females "no" decisions were faster than "yes" decisions in the left hemisphere but "yes" decisions were faster than "no" decisions in the right hemiphere.
Explore the source record for details and available documents.
The use of lidocaine HCL solution at concentrations of 0.5 and 1.0% to reconstitute sodium cefoxitin relieves the pain associated with intramuscular injections of the antibiotic. Cefoxitin absorption by the intramuscular route is initially rapid and is virtually complete. Peak serum concentrations, corresponding to about one-half those of a comparable intravenous infusion, are achieved in 30 min. Continuing absorption tends to maintain higher serum concentrations for longer times. Renal clearance and serum half-life of cefoxitin do not appear to be affected by lidocaine at its effective anaesthetic concentrations.
Explore the source record for details and available documents.
Microelectrodes with 2-micronm-tip diameters arranged to record differentially between this ascending limbs (ALH) and ascending vasa recta (AVR), gave values of 1.95 +/- 0.17 mV, ALH positive, in hydropenia with mineral oil bathing the kidney. Average values remained in the range of 1-2 mV when the ALH and AVR values were obtained sequentially, when the kidney was bathed in Ringer solution, when 5-8 Momega Ling-Gerard microelectrodes were used in the ALH, or when the hamsters were in saline diuresis. These results contradict reports of earlier studies with high impedance Ling-Gerard electrodes that the PD was -9 mV, ALH negative. Perfusion of ALH in saline diuresis with solutions of various compositions provided estimates of ionic transport numbers: tNa+ = 0.33 +/- 0.01, tK+ = 0.00 +/- 0.02, tC1- = 0.67 +/- 0.02. When the perfusion solution was designed to have the same Na+, K+, and C1- concentrations as AVR plasma, the PD was 1.36 +/- .20 mV; when ouabain or furosemide were included (10(-5) M), the PD declined 1.35 +/- 0.21 mV and 1.41 +/- 0.28 mV, respectively. The results suggest that active C1- transport is mainly responsible for the PD, but that diffusion potentials can contribute.
Explore the source record for details and available documents.
Intravenous doses of 0.5, 1, and 2 g cephalothin and cefoxitin, a semi-synthetic cephamycin antibiotic highly resistant to bacterial cephalosporinase, were infused over a period of 3 minutes into 18 normal adult males by a randomized, crossover design. Serum and urine data on cefoxitin best fit a two-compartment open model. Serum concentrations following cefoxitin were higher and more prolonged and urine recoveries higher than those following equal doses of cephalothin. The terminal serum half-life of cefoxitin was longer at all dose levels. Renal clearance of cephalothin-like activity exceeded that of cefoxitin, which may possess dose-dependent kinetics. Whereas cephalothin has been reported to metabolize by greater than 35% to the less active desacetyl form, cefoxitin was metabolized by 0.1 to 6% to the descarbamyl form in individual subjects.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The possible presence of epsilon-(gamma-glutamyl) lysine covalent bonds in human epidermal proteins prompted a study of transamidase activity in human hair-free epidermis. Callus contains an enzyme which catalyzes the incorporation of radioactive putrescine into alpha-casein. The enzyme is active without prior treatment with exogenous proteolytic enzymes. The putrescine incorporation is calcium dependent and inhibited by iodoacetamide. The enzyme was partially purified (50-fold over starting material), and has an apparent molecular weight between 50,000 daltons and 55,000 daltons by agarose 0.5m gel filtration. The apparent molecular weight is unaltered by chromatography in the presence of 11 mMCaCl2, a condition known to dissociate plasma transglutaminase (Factor XIII) into its ultimate subunits. The enzyme is active over a wide pH range up to pH 10.4 The Km for putrescine varies by 1-fold over the pH range 6.0 to 10.2, although enzyme activity increases at least 20-fold over the same pH range. The human epidermal transamidase is similar to the guinea-pig hair follicle transglutaminase and cow snout transamidase in its ability to cross-link fibrin.
Hydrostatic pressures were measured in cortical tubules, long loops of Henle, terminal collecting ducts, and in vasa recta in hamsters. In hydropenia, the loops of Henle and terminal collecting ducts provided the major fluid flow resistances, as judged by the location of hydrostatic pressure drops. In mannitol or saline diuresis, hydrostatic pressures in all tubular segments increased, but pressure drops in loops of Henle disappeared, indicating dilatation of loops. The major pressure drop was in terminal collecting ducts, especially in ducts of Bellini, even though these tubular segments also dilated. At highest urine flows, cortical tubule pressures were higher with the ureter and renal pelvis intact than when they were excised, suggesting laminar flow in the ureter adds a flow resistance at high flows. The pressure drop across the medullary capillary bed was 1-2 mmHg. The summation of medullary capillary hydrostatic and colloid osmotic pressures favored fluid uptake from the interstitium, a relationship enhanced by vasa recta geometry which ensures that descending vasa recta offer 4 times the flow resistance of ascending vessels.
Explore the source record for details and available documents.
The safety of cefoxitin, in terms of values obtained in laboratory tests during and after therapy, was estimated by three methods for analysis of data derived from controlled clinical comparisons of cephalothin and cefoxitin. Both antibiotics were found to be safe with respect to hematologic, renal, and hepatic function and did not differ significantly from each other. Laboratory data confirmed by tests performed serially and by paired related tests were analyzed by a novel method of comparison.
Features of the distribution, metabolism, elimination, and pharmacokinetics of the cephalosporins and cefoxitin must be considered when concentrations of these drugs in biological fluids are interpreted. The extensive (approximately 86%) binding of cefazolin to plasma protein may account for the smaller volume of distribution and slower rate of renal clearance than are observed for cefoxitin, which is less extensively (73%) bound to protein. Results of microbiological assays of drug in urine may be influenced by the extent of metabolism of the drugs, which is 33% for cephalothin but less than 2% for cefoxitin. Elimination of cephalosporins and cefoxitin occurs by both glomerular filtration and tubular secretion and can be inhibited by the concurrent administration of probenecid. The pharmacokinetics of cefoxitin may be described by a linear, two-compartment, open model that has been used to predict levels of drug achieved in serum and urine after various dose regimens, including administration by intravenous bolus or infusion. The bioavailability of intramuscularly administered cefoxitin is equivalent to that of intravenously administered cefoxitin and is 90% complete within 3-4 hr after the dose is given.