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Biomedical subjects

H Frankel

Publications and source records attributed to H Frankel.

35 records · Page 2Linked to original sources

Selection of a reference lot of Mueller-Hinton agar.

A collaborative study was undertaken to evaluate the performance of currently marketed Mueller-Hinton agars from seven manufacturers by replicate disk diffusion tests with standard quality control strains. Identification of the manufacturers was concealed, and the resulting data were evaluated for the selection of a physical reagent standard against which the performance of future production lots would be tested and made to conform. A medium was selected which was sufficiently close to existing National Committee for Clinical Laboratory Standards quality control limits that current interpretive criteria would require minimum modification. Two of the seven lots were eliminated from further consideration because the final pHs were outside acceptable limits. The remaining four lots had 96% of mean zone diameters less than or equal to 2 mm from those of the chosen lot and 65% of the means were less than or equal to 1 mm from those of the chosen lot for all 28 antimicrobial agent-organism combinations. Manufacturers then attempted to produce new lots of Mueller-Hinton agar which performed within the prescribed limits of the chosen lot. One lot performed in close conformity with the selected standard, but the overall performance of the media was essentially the same as that of the randomly chosen lots in the initial study. It was concluded that one of the original seven lots demonstrated properties which made it a tentative candidate for a physical reagent standard and that the use of a physical reagent standard in evaluating production lots might aid in stabilizing the performance of Mueller-Hinton agar.

Agar↗

The role of spinal cord transmission in the ventilatory response to exercise in man.

The ventilatory response to electrically induced exercise was studied in thirteen patients with traumatic spinal cord transection at or about the level of T6. The steady-state and on-transient responses to this exercise were compared with those obtained in eighteen normal subjects (Adams, Garlick, Guz, Murphy & Semple, 1984). Exercise was produced by surface electrode stimulation of the quadriceps and hamstring muscles so as to produce a pushing movement at 1 HZ against a spring load. At rest there was no significant difference between normals and patients, except that the patients had a lower CO2 elimination (VCO2) and end-tidal PCO2 (PET,CO2) and a higher heart rate. On exercise the mean rise in VCO2 for the patients was 172 ml min-1 (S.D. 72), and for the normals was 287 ml min-1 (S.D. 143). The corresponding mean changes in ventilation (VI) were 4.4 l min-1 (S.D. 2.2) and 7.6 l min-1 (S.D. 3.2). However, the ventilatory equivalent for CO2 (delta VI/delta VCO2) in the steady state was not significantly different between patients (26.0, S.D. 5.9) and normals (28.5, S.D. 7.4). In the steady state there was a mean rise in PET,CO2 of 0.9 mmHg (S.D. 1.4) in the normals, and 3.2 mmHg (S.D. 2.7) in the patients, but there was overlap between the two groups. In many experimental runs in both groups, PET,CO2 did not rise, and sometimes fell. Where PCO2 did rise, the ventilatory response to exercise could not be accounted for on the basis of the ventilatory sensitivity to CO2 inhalation. From arterial sampling in three of the patients it was found that when PET,CO2 rose, the corresponding change in Pa,CO2 was less. During the on transient, there was a significant rise in both VCO2 and VI by the second breath in both groups. At the end of the on transient the normal subjects had achieved 84% (S.D. 40) of the steady-state increase in VCO2 and 88% (S.D. 24) of the increase in VI. The corresponding values for the patients were 67% (S.D. 17) and 77% (S.D. 16) respectively; these differences between normals and patients are significant. The increase of VI during the on transient in the patients was achieved almost entirely by an increase in tidal volume whereas in normals, an increase in respiratory rate was a more important component. We conclude therefore that in man, spinal cord transection with a presumed loss of muscle afferents allows a ventilatory response to electrically induced exercise that cannot be explained by classical chemoreception.(ABSTRACT TRUNCATED AT 400 WORDS)

Carbon Dioxide↗

Regulation of CSF composition--blocking chloride-bicarbonate exchange.

The possibility that the increase in cerebrospinal fluid (CSF) [HCO-3] observed during respiratory acidosis could be the result of a decrease in CSF [Cl-] was studied by blocking a putative Cl--HCO-3 exchange transport system. Anesthetized dogs (pentobarbital 30 mg, iv) were given either 4,4'-diisothiocyano-2,2'-disulfonate stilbene (DIDS, 0.02 mumol/kg) or pyridoxal 5-phosphate (P-5-P, 4 mumol/kg) in the lateral cerebral ventricles and maintained either normocapnic (RA) or hypercapnic (5% CO2). CSF and arterial Pco2, pH, [Na+], [K+], [Ca2+], [Cl-], and [lactate] were determined. [HCO-3] was calculated. Samples were drawn before and 4 h after the drug was administered. In control dogs on RA no significant change was observed in any measured parameter after 4 h. Dogs receiving either DIDS or P-5-P and on RA had decreased CSF [Na+] of 2-4 meq/l and CSF [Cl-] of 6 meq/l. CSF [HCO-3] in DIDS dogs decreased approximately 5 meq/l. There was no significant change in CSF [HCO-3] in P dogs. After 4 h of 5% CO2, control dogs had decreased CSF [Cl-] of 3 meq/l and CSF [HCO-3] increased approximately 4 meq/l. Dogs receiving DIDS or P-5-P and breathing 5% CO2 for 4 h had decreased CSF [Cl-] of 6-9 meq/l and [HCO-3] increased of 7-9 meq/l. CSF [Na+] did not change during respiratory acidosis in any group. It was concluded the Cl- transport in CSF can be interfered with by use of blocking agents which inhibit Cl--HCO-3 exchange channels.

4,4'-Diisothiocyanostilbene-2,2'-Disulfonic Acid↗

Spinal cord potentials in traumatic paraplegia and quadriplegia.

Cortical, cervical and lumbar somatosensory evoked potentials were recorded following median and tibial nerve stimulation in patients with traumatic paraplegia and quadriplegia. The isolated cord was able to produce normal potentials even during spinal shock if the vertical extent of the lesion did not involve the generator mechanisms. The cervical potentials showed subtle changes in paraplegia at Th5 levels and below. In high cervical lesions the early cervical potentials may still be present but the later potentials were absent or, in partial lesions, delayed.

Adult↗

Fibrinous uremic pleuritis: a surgical entity.

Fibrosing uremic pleuritis is a newly recognized late complication of uremia. Extreme incarceration of the lining and chest wall can occur with disabling restriction of pulmonary function. Decortication of the chest wall and the lung can be carried out safely with minimal bleeding and restoration of pulmonary function.

Adult↗

In vitro activity of cefoperazone/sulbactam and other antimicrobials against anaerobic bacteria.

Sulbactam inhibits the hydrolytic activity of several, clinically important beta-lactamases including those produced by anaerobic bacteria. This study was undertaken to determine the effect of sulbactam on the activity of cefoperazone against 250 anaerobic bacteria including 174 isolates belonging to the Bacteroides fragilis group and to compare the activity of cefoperazone/sulbactam with other antimicrobial agents. beta-lactamase activity was detected in 98% of the isolates of the Bacteroides fragilis group but not in the other species evaluated. Antagonistic activity between cefoperazone and sulbactam was not observed with any of the species. Forty-two percent of the isolates belonging to the B. fragilis group were resistant to cefoperazone. Ninety-four percent of these were converted to either the susceptible or moderately susceptible range upon the addition of sulbactam. Sixty-seven percent were susceptible to the combination cefoperazone/sulbactam and 27% were moderately susceptible. Overall, metronidazole and chloramphenicol were the most active antimicrobials. Significant differences in the antimicrobial susceptibility patterns of members of the B. fragilis group were observed. Sulbactam demonstrated some intrinsic activity against all of the species tested.

Anti-Bacterial Agents↗