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Biomedical subjects

F B Westervelt

Publications and source records attributed to F B Westervelt.

At least 37 records · Page 2Linked to original sources
PubMed1977

Use of hemodialysis in meprobamate overdosage.

A case of meprobamate overdosage successfully treated with hemodialysis is described. The patient was admitted 4 hours after an overdosage of meprobamate (30-40 g) deeply unconscious, hypotensive, in respiratory failure and with a serum meprobamate level of 50 mg/100 ml. Hemodialysis was instituted using a Gambro parallel flow dialyzer and a portable re-circulating dialyzate delivery system (Redy, CCi Life Systems). Meprobamate removal with hemodialysis was 672+/-167 mg/hr with a corresponding clearance of 61.97+/-9.9 ml/min. Drug removal with forced diuresis was 177+/-23.4 mg/hr. Metabolic degradation of the drug was approximately 482 mg/hr with a plasma disappearance rate of 5.2%/hr. No drug could be detected in the dialyzate fluid after its passage through the Redy re-circulating dialyzate system. Because of the rapidity of metabolic degradation of meprobamate, we feel that hemodialysis should be reserved for severe clinical intoxication and either compromised normal excretory routes or progressive clinical deterioration.

Female↗
PubMed1975

Ventriculojugular shunt nephritis with Corynebacterium bovis. Successful therapy with antibiotics.

A patient with hydrocephalus and a ventriculojugular shunt presented with acute nephritis, nephrotic syndrome (proteinuria 10 g/24 hours), decreased complement levels, circulating immune complexes and diminished creatinine clearance (41 ml/min). Seven blood cultures grew Corynebacterium bovis. A renal biopsy specimen revealed mesangiocapillary glomerulonephritis by light microscopy, and thickened glomerular basement membranes with areas of increased granular density by electron microscopy. Immunofluorescent examination of the biopsy specimen demonstrated 2+ granular glomerular basement membrane deposits of immunoglobulin M (IgM), with trace third component of complement (C-3), fourth component of complement (C-4) and immunoglobulin G (IgG). Rabbits immunized with C. bovis produced a line of partial identity in agar with patient serum against a sonicate of C. bovis. Indirect fluorescein staining of the biopsy specimen with the rabbit antiserum demonstrated 1+ granular glomerular basement membrane deposits. Potassium thiocyanate microelution of sections prior to examination markedly diminished staining with antihuman antiserum, but did not affect staining with rabbit antiserum. Following initial therapy with intravenous penicillin for six weeks the bacteremia cleared, serum complement levels returned to normal, proteinuria decreased and creatinine clearance increased. A relapse occured four weeks later with decreased complement levels, increased proteinuria and decreased creatinine clearance. Blood cultures were again positive for C. bovis. Following therapy with erythromycin and rifampin, the bacteremia cleared and there was a sustained improvement of all parameters. To our knowledge, this is the first time an association has been noted between C. bovis ventriculojugular shunt infection and glomerulonephritis. These findings support the potential role of C. bovis as an etiologic agent in human renal disease and further define the immune complex nature of shunt nephritis.

Adult↗
PubMed1975

Renal function after release of chronic unilateral hydronephrosis in man.

Differential renal function studies performed on ten patients after release of unilateral hydronephrosis revealed that the previously obstructed kidney exhibits abnormalities in a number of physiological indexes. Many of the obstructed kidneys had an impairment of glomerular filtration rate, concentrating ability, acidification, sodium reabsorption and tubular maximal secretion of para-aminohippurate with normal urinary dilution. Despite impairment of sodium and water reabsorption, none of these patients, nor 20 additional patients, had a significant postobstructive diuresis from the previously obstructed kidney. All of the patients had normal total renal function. Thus, the changes observed were a result of the obstructive injury and were not related to azotemia or aberrations in water or sodium metabolism.

Adolescent↗
PubMed1975

Identification of two populations of immunoglobulin-bearing lymphocytes in man.

Human peripheral blood lymphocytes bearing easily detectable surface immunoglobulin were quantitated with routine immunofluorescence procedures. The mean value in 17 healthy adults were 18% (range 9 to 30%). When the cells were preincubated at 37 degrees C and washed at the same temperature before staining, the mean value decreased to 9% (range 4.5 to 18%) (p less than 0.001). The mean value increased to 32% (range 15 to 49%) when the cells were prepared and washed at 4 degrees C, and this value was also significantly different from values at room temperature (p less than 0.01). These temperature-related effects were explained by IgG that remained bound to the cell membrane at 4 degrees C, but eluted at 37 degrees C in serum-free medium. The total number of Ig-bearing lymphocytes and T lymphocytes determined by rosette formation with sheep erythrocytes approached 100%. These studies indicate two populations of Ig-bearing lymphocytes in healthy subjects: one with surface-stable Ig determinants, and another that lacks these markers, but has receptors capable of binding IgG.

Adult↗
PubMed1973

Pharmacodynamics of cefazolin in the presence of normal and impaired renal function.

The excretion of cefazolin, a new cephalosporin antibiotic, was studied in subjects with normal and impaired renal function. Twelve subjects with creatinine clearances ranging from 0 to 144 ml per min per 1.73 m(2) were given a single 500-mg intramuscular dose of cefazolin. Serum and urine levels were determined at intervals by agar diffusion. Peak serum levels in normals ranged from 44 to 70 mug/ml and occurred 30 to 60 min after injection. The mean serum half-life in normals was 1.6 h, and this was prolonged from 20 to 40% by simultaneous administration of probenecid. The total elimination constant varied linearly with the creatinine clearance in patients with renal impairment. The serum half-life in anephric patients was about 42 h. The fractional clearance of the drug varied directly with the serum level. Peak urine levels ranged from 60 to over 2,000 mug/ml, and more than 90% of the dose was recovered in the urine of normals during the first 24 h. The data suggest that cefazolin is cleared primarily by the glomerulus, with tubular and biliary secretion playing a secondary role.

Cephalosporins↗