PubMed Health⌕ Search

Biomedical subjects

N G Waterman

Publications and source records attributed to N G Waterman.

At least 19 recordsLinked to original sources

Control of cancer pain by epidural infusion of morphine.

Pain that cannot be controlled by traditional oral and parenteral methods in those patients with advanced cancer can be alleviated by spinal administration of narcotics. Epidural and intrathecal infusion with morphine causes analgesia by blocking spinal receptors without significant long-term central nervous, gastrointestinal, and genitourinary system effects. Of the total of 33 patients, epidural catheters inserted in 20 patients then connected by a subcutaneous tunnel to a continuous infusion system. Implanted pumps were used in each of these patients. Because of the cost and limitations of the implanted pumps, epidural catheters were connected, either directly or by subcutaneous reservoirs, to external ambulatory infusion pumps in the remaining 13 patients. Patient assessment by a linear analogue scale to measure pain levels determined that 23 of the 33 total patients (70%) had excellent or good relief of pain. The delivery of spinal administration of narcotics to treat intractable cancer pain in patients is safe. Most importantly, this method of delivery can be used in community hospitals, in outpatient settings, and in home health care programs.

Adult↗

Familial male breast carcinoma.

Breast cancer in men is a rare disease, accounting for approximately 1% of all breast cancers. In a recent review of the literature, only 12 reports of breast cancer in related men have been recorded. A case of familial breast cancer is reported involving two men and two women. The role of hereditary factors and associated etiologic factors in male breast cancer are reviewed. The overall prognosis of male patients with breast cancer is poor compared with female patients with breast cancer, possibly related to a delay in diagnosis and difference in regional spread of the tumor. Increased surveillance of families with a history of male breast cancer and the presence of associated etiologic factors appears advisable.

Adenocarcinoma↗

Concentration relationships of cefaclor in serum, interstitial fluid, bile, and urine of dogs.

The concentrations of cefaclor in the serum, urine, bile, and tissue fluids of the abdominal wall, kidney, and liver of dogs were compared over a 4-h period after oral administration of a single dose of this drug. The concentration of cefaclor in the soft-tissue interstitial fluid peaked 2 h after administration, thereby demonstrating a diffusion rate similar to those of other cephalosporins. Both urine and bile concentrations greatly exceeded the serum levels, whereas none of the tissue fluid concentrations were greater than the serum concentrations at the times of measurement.

Animals↗

Cefazolin in the treatment of pneumonia.

Cefazolin is a semi-synthetic derivative of cephalosporin C that has a lower cross-immunogenicity with penicillins than do the other cephalosporins. This agent was evaluated as an alternative to penicillin in the therapy of patients with pneumococcal pneumonia. Thirty patient were treated with cefazolin, most receiving 125 or 250 mg IM every 12 hours for 5-10 days. Satisfactory clinical responses were obtained in 29 of these 30 patients, and none complained of pain following IM injections. Three patients developed eosinophilia while receiving cefazolin, and one of these also had a maculopapular eruption that may have been an allergic reaction to cefazolin. Serum levels of cefazolin were measured at 1, 6, and 12 hours after administration. Susceptibilities of 100 isolates of Streptococcus pneumoniae, including these patients' organisms, were determined by broth dilution. Both cefazolin and cephalothin were bactericidal for all 100 isolates at concentrations of 2 microgram/ml or less. Cefazolin appears to be an entirely adequate alternative to penicillin for the therapy of pneumococcalpneumonia. This agent is effective in low dosages, and adequate serum levels are maintained for long periods of time, permitting twice-daily administration.

Adult↗

A community-wide experience with jejunoileal bypass for obesity.

The records of seventy-nine patients who had jejunoileal bypass operations for morbid obesity were reviewed. The data represent the entire experience of surgeons in the Louisville, Kentucky metropolitan area for the period studied. Retrospective evaluations of criteria for selecting patients for bypass operation, type of shunt done, and clinical results were recorded. Sixty-eight patients (86 per cent) weighed more than 100 pounds over ideal weight. Operative mortality was 5 per cent. Only 31 patients (47 per cent) were judged as having satisfactory results. Two patients died of hepatic failure and five required restoration of intestinal continuity. Comparison of this community experience with published data supports the concept that these operations are best confined to those institutions where there is special interest in the full range of medical and surgical care of obese patients.

Adolescent↗

Effects of serum lipid content on the binding of minocycline.

Minocycline was added to normal and hyperlipemic serum samples in concentrations of 1 approximately 10 mcg/ml. These specimens had similar protein contents. Chemically extractable minocycline was quantitated fluorometrically. Hyperlipemic serum (cholesterol 480 mg/100 ml; triglycerides 321 mg/100 ml) yielded an average of 50% less minocycline than did normal serum (cholesterol 170 mg/100 ml; triglycerides 114 mg/100 ml). When ultrafiltrates of serum containing 6, 12 and 20 mcg/ml minocycline were assayed microbiologically, it was evident that variations in serum triglyceride and cholesterol levels did not alter the ratio of bound to free drug. Minocycline appears to be reversibly associated with, and/or soluble in, triglyceride-cholesterol components of serum.

Bacillus subtilis↗

Clinical evaluation of intravenous minocycline.

24 patients with severe infections were treated with intravenous minocycline 100 mg every 12 hours. Average blood levels were within therapeutic ranges during the first 12 hours after the initial dose. Determination of efficacy of therapy in 23 of the patients who were evaluable showed that clinical and bacteriological results were satisfactory in 20 patients, unsatisfactory in 2, and questionable in 1. One patient developed a fatal secondary infection which may have been related to prior therapy with minocycline. No toxicities or side-effects were observed.

Adolescent↗

Demonstration in vitro of postmortem bacterial transmigration.

The kinetics of the migration of intestinal bacterial flora to the peritoneal cavity upon death of the host was studied. A laboratory experiment that excluded any source of contamination was used. Samples of sterile saline solution in which a loop of the intestine was submerged were streaked onto blood agar at given intervals. Recovery of bacteria began after about 15 hours, with Staphylococcus aureus being the predominant organism. This organism showed a gradual decrease through a 36-hour period and at 48 hours was almost absent. In the same manner, other organisms such as gram-negative bacilli and spore-forming gram-positive bacilli gradually increased in numbers.

Animals↗

Protein binding and concentrations of cephaloridine and cefazolin in serum and interstitial fluid of dogs.

Percentages of free and protein-bound cefazolin and cephaloridine in serum and interstitial fluid of dogs were determined by ultrafiltration and microbiologic assay. The percentages of cephaloridine and cefazolin bound to protein in serum were 10% and 80%, respectively. In interstitial fluid accumulating within tissue-embedded polypropylene capsules, 29% of cefazolin was bound to protein, and cephaloridine was unbound. Both antibiotics rapidly penetrated the interstitial fluid and attained measurable levels 5 min after intravenous administration. Levels of total cefazolin in the interstitial fluid were generally higher than those of cephaloridine; however, concentrations of free cephaloridine in the fluid exceeded the levels of free cefazolin after the first 15 min. Binding of anitbiotics by serum proteins does not restrict such agents to the intravascular space, since a highly protein-bound compound has been shown to penetrate interstitial fluid as readily as one that is minimally bound. It should be noted, however, that this penetration may be due primarily to the slow rate of binding of cefazolin to serum proteins.

Animals↗

Concentration of cefamandole in serum interstitial fluid, bile, and urine.

Cefamandole readily diffuses from the serum into soft tissue interstitial fluid. The rate of diffusion differs little from that of cephalothin. The concentrations of antibiotic were greater in bile and urine during the entire period of study than is necessary to kill susceptible pathogenic bacteria present in these fluids.

Animals↗

Antibiotic concentrations in hepatic interstitial and wound fluid.

This study in dogs using tissue-implanted capsules indicates that cephalothin, cefazolin, ampicillin and tetracycline are excreted in the bile, appearing in this fluid at concentrations greater than the concomitant serum levels. Hepatic interstitial fluid concentrations of these agents differed little from levels achieved in soft tissues elsewhere in the body, indicating that compounds which are concentrated in bile do not necessarily achieve high levels in the hepatic parenchyma. The selection of an antimicrobial agent for the therapy of hepatic parenchymal infection or obstructive cholecystitis should, therefore, be based on susceptibilities of the suspected organism rather than on the relative tendencies of various agents to be concentrated in bile.

Ampicillin↗

Regional antibiotic infusion of the heart.

Regional arterial infusion of the heart and lung with an antibiotic did not increase the drug in the aortic serum to concentrations that would be clinically significant when compared with concentrations which can be attained by the intravenous method in a near normal functioning heart.

Animals↗

Concentration of antibiotics in renal interstitial fluid: an experimental model.

In a new canine experimental model the time concentration relationship of cephalothin in serum, urine, soft tissue interstitial fluid (STIF) and renal interstitial fluid (RIF) were compared simultaneously. Antibiotic concentration in RIF was less than urinary levels but exceeded the serum concentration. Urinary antibiotic concentration does not necessarily reflect concentration in the renal interstitium. This model helps to understand the basic pharmacokinetics of antibiotics in the renal interstitium where pyelonephritis occurs.

Animals↗