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Biomedical subjects

L L Snyder

Publications and source records attributed to L L Snyder.

10 recordsLinked to original sources
PubMed1993

Allotypic dependency of the specificity and avidity of human monoclonal IgM rheumatoid factors derived from rheumatoid synovial cells.

OBJECTIVE: To better understand the genetic derivation and pathogenicity of rheumatoid factor (RF) molecules in rheumatoid arthritis (RA), we have focused our studies on rheumatoid synovial cells (RSC). METHODS: Five monoclonal human IgM rheumatoid factor (mRF)-secreting hybridomas were produced from the RSC of an RA patient. Fine subclass specificities and avidities of these RSC mRFs were compared with several paraprotein monoclonal IgM RFs using direct binding (reactivity) and competitive inhibition (specificity and avidity) enzyme-linked immunosorbent assays. RESULTS: The following observations were made: 1) RSC mRF had greater avidity for IgG than did paraprotein mRF; 2) 4 of the 5 RSC RF were highly avid for IgG3; and, 3) the avidity of RSC RF binding for IgG3 was highest for IgG molecules expressing the G3m(5) allotype. CONCLUSION: We conclude that RSC RF have different specificities and avidities than do paraprotein RF. This may suggest an antigen-driven process in RA synovium, with the production of higher-avidity IgG3m(5)-specific RSC RF, which could have special pathogenetic importance.

Adult↗
PubMed1990

Antibiotic sensitivity and the prescribing information sheet: assisting the prescribing physician.

The concept conceived 5 years ago is now a reality. Physicians have information readily available for empiric prescribing from the home, office, or hospital. The other two hospitals in the city have implemented the systems. The reaction of physicians has been extremely favorable. In fact, two new publications for the outpatient/community and for the pediatric populations are now under way at the suggestion of physicians. Plans are in place to assess physician satisfaction and use of the information sheet within the coming year. Presently, too little time has passed to evaluate whether changes in prescribing have actually occurred. In fact, it may never be possible to identify how many instances of inadvisable prescribing are prevented with good initial information. However, for the relatively low cost involved, this has been an exciting new opportunity for education, as well as a method to promote cost-effective and appropriate antibiotic therapy.

Anti-Bacterial Agents↗
PubMed1984

Experimental hypervolemic hemodilution: physiological correlations of cortical blood flow, cardiac output, and intracranial pressure with fresh blood viscosity and plasma volume.

Rheological, cerebrovascular, and cardiovascular alterations induced by serial plasma volume (PV) expansion were evaluated in splenectomized dogs. Seven dogs received two infusions of autologous plasma within 120 minutes; each infusion equaled 20% of the respective dog's total blood volume (TBV). The PV increased 31% and then another 26% after the two respective infusions, and the hematocrit (Hct) was obligatorily decreased by 22% during the experiment. The fresh blood viscosity at the shear rate of 10 sec-1 varied inversely with the TBV and the PV and correlated directly with the Hct after these plasma infusions. Cardiac output (CO) increased 71% after the two infusions without significant alterations in mean arterial blood pressure. Additionally, CO was inversely related to both Hct and blood viscosity. Although the 15% rise in regional cortical blood flow (rCoBF) in the territory of the middle cerebral artery did not reach statistical significance, the rCoBF was related inversely to both Hct and blood viscosity and directly to TBV, PV, and CO after the plasma infusions. Cortical vascular resistance (CVR) decreased 18% after the two infusions. The CVR correlated inversely with PV and directly with Hct and blood viscosity. Our data suggest that hypervolemic hemodilution with expansion of PV increases CO more than cerebral blood flow in normal brain. Fresh blood viscosity seems to be a major factor determining CO and cerebral perfusion after IV expansion. This study adds support to the hypothesis that reductions of blood viscosity account for the direct relationship between cerebral blood flow and CO observed after intravascular volume expansion with hemodiluting agents. Hypervolemic hemodilution with plasma reduces CVR, possibly secondary to its effect on blood viscosity, and also raises intracranial pressure.

Animals↗
PubMed1982

Failure of intravascular volume expansion without hemodilution to elevate cortical blood flow in region of experimental focal ischemia.

Cerebrovascular and cardiac alterations evoked by intravascular volume expansion with whole blood, a popular adjunct in the clinical prevention or therapy of the focal ischemic deficits of cerebral vasospasm and acute stroke, were studied in splenectomized dogs. Clipping of the right distal internal carotid and proximal middle cerebral arteries in eight dogs reduced regional cortical blood flow (rCoBF) by 49% to 58% without altering cardiac output (CO), and produced about 10% hemispheric infarction. Eight dogs underwent similar cerebral arterial occlusion and eight dogs underwent arterial manipulation without clipping. Both latter groups received two autologous whole blood infusions within 2 hours, each equal to 20% of the respective dog's total blood volume. Despite significant CO elevations after the infusions, rCoBF in the middle cerebral arterial territory did not rise. These whole-blood infusions did not significantly alter mean arterial blood pressure, hematocrit, intracranial pressure, or, in dogs with clipped cerebral arteries, the relative size of infarction. These data suggest that nondilutional hypervolemia neither elevates collateral perfusion to ischemic regions of the brain nor reduces infarction. In addition, elevations in CO do not appear to augment blood flow in either ischemic or normal brain.

Animals↗
PubMedDate not supplied

Methicillin-resistant Staphylococcus aureus eradication in a burn center.

Methicillin-Resistant Staphylococcus aureus and its detection, virulence, and significance relative to morbidity, epidemics, and cost have been widely discussed in the literature. Although some experts recommend against attempting to eradicate the organism, our health center decided that under the circumstances this course should be pursued. This article describes the outbreak of Staphylococcus aureus, the rationale for pursuing its eradication, the measures successful in doing so, and the relative costs involved.

Burn Units↗