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R Mehta

Publications and source records attributed to R Mehta.

At least 145 records · Page 8Linked to original sources
PubMed1984

Altered tissue distribution of amphotericin B by liposomal encapsulation: comparison of normal mice to mice infected with Candida albicans.

Recently, it has been observed that encapsulation of Amphotericin B (Amp-B) into multilamellar vesicles (liposomes) decreases the toxicity associated with the administration of Amp-B, while maintaining its antifungal efficacy. In this study, the tissue concentrations of Amp-B in normal mice and in mice infected with Candida albicans were examined. Amp-B concentrations in various tissues were quantitated by high-performance liquid chromatography. Liposomal encapsulation improved the delivery of Amp-B to the liver, spleen, lung, and kidney in both normal and infected mice. Furthermore, after injection of the encapsulated drug, Amp-B was demonstrable in brain tissue of infected animals at potentially therapeutic concentrations. None was demonstrable in the brains of normal animals or animals injected with free Amp-B. The results suggest that capillary endothelial damage and phagocytic cell uptake may contribute to an enhanced liposome delivery of Amp-B to those organs most frequently infected with fungi.

Amphotericin B↗
PubMed1984

Liposome-encapsulated amphotericin B for treatment of disseminated candidiasis in neutropenic mice.

The relative efficacies of free amphotericin B (Amp B) and liposome-encapsulated Amp B (L-AmpB) in the treatment of established Candida albicans infection in mice rendered neutropenic with cyclophosphamide were studied. AmpB was entrapped in multilamellar liposomes composed of dimyristoyl phosphatidylcholine and dimyristoyl phosphatidylglycerol in a molar ratio of 7:3. Infected mice treated with single doses of 3 mg L-AmpB/kg of body weight had an increased survival time compared with those injected with either single (dose, 0.8 mg/kg) or multiple doses (dose, 0.8 mg/kg daily for five days) of free AmpB. When treatment was delayed beyond three days postinfection, neither single nor multiple doses of free AmpB resulted in increased survival, whereas treatment with single-dose L-AmpB (dose, 4 mg/kg) showed efficacy when delayed as much as four days postinfection. Five days postinfection only higher doses (dose, 5.6 mg-11.2 mg/kg) of L-AmpB improved survival time and the renal impairment present in the infected animals. These data provided a rational basis for using high-dose L-AmpB to treat fungal diseases in humans, particularly in neutropenic patients.

Agranulocytosis↗
PubMed1984

Prophylaxis of Candida albicans infection in neutropenic mice with liposome-encapsulated amphotericin B.

The efficacy of liposome-encapsulated amphotericin B in the prophylaxis of disseminated Candida albicans infections in neutropenic mice was studied. The administration of liposome-encapsulated amphotericin B was associated with protection against infection with C. albicans when used at doses of greater than or equal to 2 mg of amphotericin B per kg of body weight. Neither empty liposomes nor free amphotericin B showed prophylactic efficacy.

Agranulocytosis↗
PubMed1984

In vitro antifungal activities of amphotericin B and liposome-encapsulated amphotericin B.

The in vitro activities of liposome-encapsulated amphotericin B and free amphotericin B against Candida albicans 336 were comparable. Amphotericin B concentrations 12-fold and greater than 50-fold higher were required to kill the same organism when cholesterol and ergosterol were incorporated into the liposomes. The addition of cholesterol to liposomes caused a significant increase in the minimal fungicidal concentration of amphotericin B in 7 of 19 other yeast strains tested, whereas ergosterol caused an increase in 18 of the 19 strains.

Amphotericin B↗
PubMed1984

Clinical pharmacology of 99mTc-labeled liposomes in patients with cancer.

The pharmacokinetics, organ distribution, and 24-hr urinary excretion of negatively charged 99mTc-labeled multilamellar liposomes, composed of dimyristoylphosphatidylcholine and dimyristoylphosphatidylglycerol in a 7:3 molar ratio, were studied in seven patients with cancer. The radiolabeled liposomes were administered i.v. in three doses: 150 mg/sq m of body surface area; 300 mg/sq m; and 450 mg/sq m of lipid. The dose of 99mTc was 4.8 to 7.6 mCi per patient. The plasma disappearance curve was biphasic (half-life alpha = 5.53 min, half-life beta = 289 min), suggesting a two-compartmental model of distribution. The calculated volume of distribution indicated considerable tissue retention of liposomes. This was confirmed by body imaging. Twenty-four hr after injection, liposomes were localized in organs rich in reticuloendothelial cells, i.e., liver [44.5 +/- 9.1% (S.E.)], spleen [25.5 +/- 7.7%], lung [14.5 +/- 4.9%], and bone marrow. Although the hepatic uptake accounted for more than 40% of the total uptake, the spleen retained liposomes at a higher density. Cumulative urinary excretion of radioactivity was 13.4 +/- 1.5% over 24 hr. Liposome administration was safe and devoid of any adverse side effects. The results provide a basis for the use of liposomes as potential target-specific and safe drug carriers in the treatment of pathological conditions that involve organs rich in reticuloendothelial cells.

Adult↗
PubMed1984

The use of colonoscopy in the treatment of colonic volvulus: three cases and review of the literature.

Four to 10% of cases of large bowel obstruction are caused by volvulus. Nonoperative therapy is the preferred initial treatment of patients with colonic volvulus who do not have signs of bowel strangulation because of the high mortality associated with emergency surgery. We report our experience with three cases and review the literature on the use of the colonoscope to treat colonic volvulus.

Aged↗
PubMed1984

Tissue and species specificity of the microsomal metabolism of N-nitrosomethylbenzylamine.

The microsomal activation of N-nitrosomethylbenzylamine (NMBzA) by oxidation at the methylene carbon atom was examined in various organs of a number of species to determine the role of metabolism in the organ-specificity of tumour induction by NMBzA. In Sprague-Dawley rats, NMBzA was metabolized by microsomes from liver, lung and oesophageal mucosa. In Fischer F-344 rats and in rabbits, metabolic activity was present in both liver and oesophageal mucosa, the only tissues studied in those species. In contrast, in Syrian hamsters and in BALB/cBYJ mice, no NMBzA metabolism was detectable in the oesophagus, but it occurred at relatively high rates in liver, lung and kidney. The forestomach mucosa exhibited undetectable levels of activity in all species except the hamster in which it was present at a very low level. In human oesophageal mucosal microsomes from six patients, rates of metabolism of NMBzA were either undetectable or approximately 70 times lower than those in the Sprague-Dawley rats. A comparison of NMBzA metabolism in the different species with the known carcinogenicity of the nitrosamine in rats and rabbits, and our preliminary data on the acute toxicity of NMBzA in hamsters and mice suggests that, in the oesophagus at least, metabolic activation of NMBzA is necessary to elicit its toxic and/or carcinogenic effect. However, in the liver, which in all species has high metabolic activity but which is also resistant to the toxic and carcinogenic effects of NMBzA, other factors besides metabolic activation must be involved.

Animals↗
PubMed1984

Organ specificity in the microsomal activation and toxicity of N-nitrosomethylbenzylamine in various species.

The microsomal metabolism of the rat esophageal carcinogen N-nitrosomethylbenzylamine (NMBZA) at the methylene carbon atom to yield benzaldehyde was studied in various organs of a number of species to determine the role of metabolic activation in the carcinogenicity or toxicity of the nitrosamine. In the Sprague-Dawley rat, NMBZA was metabolized by microsomes from liver, lung, and esophageal mucosa. In the F344 rat and rabbit, metabolic activity was present in both liver and esophageal mucosa, the only tissues studied in these species. In contrast, in the Syrian hamster and BALB/cByJ mouse, NMBZA debenzylation was undetectable in the esophagus but occurred at relatively high rates in liver, lung, and kidney. The forestomach mucosa exhibited undetectable levels of activity in the Sprague-Dawley rat and BALB/cByJ mouse, although in the hamster, it was present at a very low level. Administration of a dose of NMBZA acutely toxic to the rat (18 mg/kg i.p.) resulted in significant cellular damage only to the rat esophageal mucosa, no other tissues examined in the rat, hamster, or mouse being affected. These observations, together with the available data on carcinogenicity of the nitrosamine in the rat and rabbit, suggest that in the esophagus, at least, metabolic activation of NMBZA is necessary to elicit its toxic and/or carcinogenic effect. However, NMBZA is also metabolized at a high rate in the liver of all species but is not toxic or carcinogenic in this tissue, suggesting that other factors besides metabolic activation must be involved in the resistance of hepatocytes to the effects of the nitrosamine. Microsomes prepared from human esophageal mucosa from six patients metabolized NMBZA at rates that were either undetectable or approximately 70 times lower than in the Sprague-Dawley rat.

Animals↗
PubMed1984

Induction and suppression of N-nitrosomethylbenzylamine activation by microsomes from rat liver and esophagus.

Male Sprague-Dawley rats were pretreated with various chemicals to determine their effects on the microsomal activation of the esophageal carcinogen N-nitrosomethylbenzylamine [( NMBzA ) CAS: 937-40-6; N-methyl-N- nitrosobenzylamine ] in the rat esophagus and, for comparative purposes, in the rat liver. When rats were pretreated with NMBzA , little change in hepatic NMBzA - debenzylase activity was observed. In contrast, NMBzA metabolism in the esophagus was significantly (60-65%) reduced. Similarly, pretreatment of rats with disulfiram [CAS: 97-77-8; bis( diethylthiocarbamoyl )disulfide] caused a 40% decrease in esophageal metabolism, but it had no significant effect in the liver. Pretreatments with the methylenedioxybenzenes safrole [CAS: 94-59-7; 4-allyl-1,2-(methylenedioxy)benzene], isosafrole [CAS: 120-58-1; 1,2-(methylenedioxy)-4-propenylbenzene], and dihydrosafrole (CAS: 94-58-6; 1,2-(methylenedioxy)-4- propylbenzene ) caused a marked induction (twofold to fivefold) of the hepatic metabolism of NMBzA , but again esophageal metabolism was suppressed. The results indicate that esophageal metabolism of NMBzA is either unchanged or suppressed by the various chemical pretreatments, but hepatic metabolism of the nitrosamine is induced by the methylenedioxybenzenes .

Animals↗
PubMed1983

Disseminated Mycobacterium chelonei infection following cadaveric renal transplantation: favorable response to cefoxitin.

This article describes a case of disseminated Mycobacterium chelonei infection in a renal transplant recipient. This patient, who underwent thoracic duct drainage prior to cadaveric renal transplantation, developed M chelonei bacteremia and numerous subcutaneous nodules a few weeks after transplantation. The M chelonei initially responded to amikacin and tetracycline. Because of side effects and bacterial resistance, however, these drugs had to be discontinued. Subsequent treatment with cefoxitin led to reduction in size of subcutaneous nodules, but control of the infection was not achieved until an intravascular nidus of infection at the anastomotic site of an arteriovenous fistula was removed.

Adult↗
PubMed1983

Effects of sterols on the therapeutic efficacy of liposomal amphotericin B in murine candidiasis.

Incorporation of amphotericin B (AMP-B) into phospholipid vesicles (liposomes) has been shown previously to decrease AMP-B toxicity while retaining the antifungal efficacy of the drug. In this report, the role of sterols in the formulation of liposomes as well as in their effectiveness in the treatment of murine candidiasis have been investigated. The presence of ergosterol or cholesterol at different lipid ratios did not augment the encapsulation efficiency of AMP-B as compared with vesicles containing phospholipids alone. There was no significant difference in the survival time of mice infected with Candida albicans treated with sterol-containing vesicles compared with those treated with sterol-free vesicles. These findings suggest that the sterol-free liposomes might be of advantage for delivering AMP-B because of its simple formulation, lack of toxicity, and ease of preparation.

Amphotericin B↗
PubMed1983

Treatment and prophylaxis of disseminated infection due to Candida albicans in mice with liposome-encapsulated amphotericin B.

The toxicology of liposome-encapsulated amphotericin B in mice and its efficacy in the treatment and prophylaxis of systemic candidiasis in these animals were studied. The toxicology studies indicated that the maximal tolerated dose of free amphotericin B was 0.8 mg/kg of body weight and the 50% lethal dose (LD50) was reached at 1.2 mg/kg, while neither the maximal tolerated dose nor the LD50 for the liposomal amphotericin B was reached at a dose of 12 mg/kg. No abnormalities in blood chemistry or histology were observed in the animals injected with encapsulated amphotericin B, while the administration of free amphotericin B was associated with nephrocalcinosis and renal parenchymal edema. The encapsulated drug was as effective as the free drug when used in similar concentrations, while the animals treated with higher concentrations of liposomal amphotericin B (4 mg/kg) had a longer survival time. Thus, an improved therapeutic index resulted by encapsulating amphotericin B in liposomes.

Amphotericin B↗
PubMed1982

Familial Hibernian fever.

An Irish family with an unusual periodic syndrome is described. Attacks consist of fever with localized myalgia and painful erythema. Other features include abdominal pain and pleurisy, with leucocytosis and a high ESR. The syndrome resembles classical familial Mediterranean fever (FMF) but differs from it in its prompt response to steroids and its autosomal dominant pattern of inheritance. The disease appears to have a benign course and no patient has developed amyloid.

Adult↗