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Biomedical subjects

D L Wagner

Publications and source records attributed to D L Wagner.

At least 19 recordsLinked to original sources

Comparative oral bioavailability of azimilide dihydrochloride in the fed and fasted states.

AIMS: This study investigated the relative oral bioavailability of azimilide dihydrochloride following administration in the fed (high-fat meal) and fasted states. METHODS: This was a single-dose, randomized, two-way crossover study in 30 healthy, Caucasian, male subjects. Following oral administration, blood samples were collected over 27 days and analysed for azimilide using h.p.l.c. with u.v. detection. Pharmacokinetic parameters were determined using 'noncompartmental' analysis and compared using an ANOVA and 90% or 95% confidence intervals. RESULTS: The extent of absorption was equivalent in the fed and fasted states (ratio = 96.2%; 90% CI=90.5% -102.4%). However, Cmax was decreased 19% following a high-fat meal (ratio=81.4%; 90% CI= 76.2% -87.0%). No difference in tmax or t(1/2),z was observed. CONCLUSIONS: Azimilide dihydrochloride may be orally administered to patients without regard to the prandial state.

Administration, Oral↗

Azimilide pharmacokinetics following intravenous and oral administration of a solution and capsule formulation.

Azimilide dihydrochloride (NE-10064) is a novel class III anti-arrhythmic agent that blocks both the slowly and rapidly acting components of the delayed rectifier potassium current of human atrial and ventricular myocytes. In clinical studies, azimilide reduced the frequency of symptomatic episodes of atrial fibrillation, atrial flutter, and paroxysmal supraventricular tachycardia. This study was conducted to characterize azimilide pharmacokinetics following single-dose administration of a 1 mg/kg intravenous infusion (18 min), 2 mg/kg oral solution, and a 150 mg orally administered capsule. This was a three-period, randomized, crossover study in 27 healthy, drug-free (including caffeine and alcohol), non-smoking male volunteers (mean [SD]; age, 25.9 [1.0] years; weight 74.3 [0.7] kg; 23 Caucasians and 4 Hispanics). Blood and urine samples were collected for 27 days and analyzed for azimilide using HPLC with UV detection. Subjects were monitored for adverse events and abnormalities in clinical laboratory tests, vital signs, and electrocardiography (including Holter monitoring). Mean (%CV) azimilide parameters were total clearance = 0.143 L/h/kg (38%), renal clearance = 0.014 L/h/kg (35%), steady-state volume of distribution = 13.2 L/kg (23%), and terminal exponential half-life = 78.8 h (44%). Similar parameter estimates were obtained following oral administration. Both the oral solution and capsule formulations were completely absorbed. In addition, the rate (Cmax) and extent of absorption (AUC) following oral administration of the capsule dosage form were bioequivalent to the oral solution with means for times of maximum blood concentration of 7.08 and 7.18 hours for the oral solution and capsule, respectively. Azimilide dihydrochloride was generally well tolerated in all subjects.

Administration, Oral↗

Enhancing consumer independence through delegation.

Many forces are influencing the development of delegation options, and states are approaching the issue differently. In 1997 Oregon, Texas, New York, and Washington participated in a national symposium on delegation convened by The National Institute of Consumer-Directed Long-Term Services. These states do not necessarily represent four different approaches; however, each illustrates some of the issues involved and the ways that competing forces continue to work together to improve the policies and regulations governing delegation.

Activities of Daily Living↗

A nuclear gene for higher level phylogenetics: phosphoenolpyruvate carboxykinase tracks mesozoic-age divergences within Lepidoptera (Insecta).

The sequence of phosphoenolpyruvate carboxykinase (PEPCK) has been previously identified as a promising candidate for reconstructing Mesozoic-age divergences (Friedlander, Regier, and Mitter 1992, 1994). To test this hypothesis more rigorously, 597 nucleotides of aligned PEPCK coding sequence (approximately 30% of the coding region) were generated from 18 species representing Mesozoic-age lineages of moths (Insecta: Lepidoptera) and outgroup taxa. Relationships among basal Lepidoptera are well established by morphological analysis, providing a strong test for the utility of a gene which has not previously been used in systematics. Parsimony and other phylogenetic analyses were conducted on nucleotides by codon positions (nt1, nt2, nt3) separately and in combination, and on amino acids, for comparison to the test phylogeny. The highest concordance was achieved with nt1 + nt2, for which one of two most-parsimonious trees was identical to the test phylogeny, and with all nucleotides when nt3 was down-weighted sevenfold or higher, for which a single most-parsimonious tree identical to the test phylogeny resulted. Substitutions in nt3 approached saturation in many, but not all, pairwise comparisons and their exclusion or severe downweighting greatly increased the degree of concordance with the test phylogeny. Neighbor-joining analysis confirms this finding. The utility of PEPCK for phylogenetics is demonstrated over a time span for which few other suitable genes are currently available.

Amino Acid Sequence↗

Ninety-seven million years of angiosperm-insect association: paleobiological insights into the meaning of coevolution.

From well preserved leaf damage of the mid-Cretaceous Dakota Flora (97 million years ago), three distinctive, insect-mediated feeding traces have been identified and assigned to two extant genera and one subfamily. These taxa are the leaf miners Stigmella and Ectoedemia of the Nepticulidae and Phyllocnistinae of the Gracillariidae. These fossils indicate that within 25 million years of early angiosperm radiation, the organs of woody dicots already were exploited in intricate and modern ways by insect herbivores. For Ectoedemia and its platanoid host, we document 97 million years of continuity for a plant-insect interaction. The early occurrence during the mid-Cretaceous of diverse and extensive herbivory on woody angiosperms may be associated with the innovation of deciduousness, in which a broadleafed angiosperm provided an efficient, but disposable, photosynthetic organ that with-stood the increased cost of additional insect herbivory. Moreover, the group represented in this study, the leaf-mining Lepidoptera, exhibits a wide range of subordinal taxonomic differentiation and includes the Gracillariidae, a member of the most derived lepidopteran suborder, the Ditrysia. Ditrysian presence during the mid-Cretaceous, in addition to lepidopteran body-fossil evidence from Early Cretaceous and Late Jurassic deposits, suggests that the radiation of major lepidopteran lineages probably occurred during the Late Jurassic on a gymnosperm-dominated flora.

Journal Article↗

Platelet MAO in subtypes of alcoholism.

A number of investigators have observed low platelet monoamine oxidase (MAO) activity in alcoholism. There is also preliminary evidence suggesting that low enzyme activity is principally associated with one of two putative subtypes of alcohol dependence, i.e., type II (male limited). The results of this study are consistent with two previous reports of reduced platelet MAO activity in type II male alcoholics as compared with type I male alcoholics and normal, healthy male controls. Type I (milieu-limited) alcoholics showed a smaller reduction in enzyme activity. The observed differences do not appear to be related to concurrent use of other psychoactive substances, characteristic differences in age between type I alcoholics and type II alcoholics, antisocial personality disorder, or variation in platelet size. Low platelet MAO activity in alcoholics is possibly related to both state and trait factors and may be a useful biochemical measure to assist with subtyping.

Adult↗

Shock in the operating room.

Many factors may contribute to producing a shock state within the surgical environment. The classic causes of shock--hypovolemia, cardiac failure, and sepsis--occur commonly in the operating room. Additionally, concurrent surgery and anesthesia may contribute to produce clinical shock. Surgery may produce hypovolemia from "third space" loss and/or from blood loss. Some anesthetic drugs, by inhibiting the autonomic nervous system, impair the body's ability to compensate for hypovolemia, cardiac failure, or sepsis. Other entities such as tension pneumothorax, drug allergy, or mechanical factors produced by surgical exposure may contribute to hemodynamic compromise of the patient. Shock that occurs outside the surgical suite may also be produced by a variety of insults. One or more factors may contribute to inadequate tissue perfusion, thus making diagnosis of the cause(s) of shock a clinical challenge. Presented in this review is an anesthesiologist's approach to shock on a macrocirculatory level. Two important concepts are vital to this approach. First, one must act immediately to restore adequate perfusion to the brain and heart when confronted with a patient in shock. This is possible without knowing the specific cause(s) of the poor perfusion. Second, a rapid, accurate diagnosis of the cause(s) must be made if the patient is slow to respond to the initial therapy. Through the use of pulmonary artery catheterization, the factors producing any given shock state may be identified, and appropriate therapy may be instituted and monitored.

Anesthesia, General↗

Factors affecting production of catalase by Bacteroides.

Several variables affected the production of catalase by members of the "Bacteroides fragilis group" of anaerobic bacteria. Both media yielded higher catalase levels than the respective agar media. Addition of hemin to media after autoclave sterilization, rather than before, significantly increased production of catalase. Both of these variables could be related to the available hemin concentration present in the medium being tested. Significantly higher amounts of hemin were required for catalase production than were required for growth. For catalase production by B. fragilis ATCC 25285, 1 microgram of hemin per ml was required. Of the various media tested, the use of chopped meat broth resulted in the highest levels of catalase production (up to 50 to 60 U of catalase per mg of protein). Of the various species and DNA homology groups tested, strains of B. fragilis and Bacteroides distasonis were catalase positive. Strains of Bacteroides thetaiotaomicron, Bacteroides ovatus, and Bacteroides eggerthi possessed variable catalase activity. Bacteroides vulgatus, Bacteroides uniformis, and DNA homology groups "3452A" and "subsp. a" were catalase negative. A catalase well test, in which equal volumes of 3% H2O2 and chopped meat culture are mixed, is described and recommended for routine catalase tests.

Anaerobiosis↗

Carbohydrate repression of catalase synthesis in Bacteroides fragilis.

Catalase formation by Bacteroides fragilis was immediately stopped upon addition of glucose to a culture growing in peptone medium. Each of eight other carbohydrates fermented by the organism also repressed catalase formation. Without added carbohydrate, the strains produced relatively large amounts of catalase (25 to 50 U/mg of protein).

Bacteroides fragilis↗