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Biomedical subjects

R Teoh

Publications and source records attributed to R Teoh.

45 records · Page 3Linked to original sources

The simultaneous determination of five anti-epileptic drugs in plasma by high performance liquid chromatography.

A high performance liquid chromatographic (HPLC) method is described for the simultaneous determination in plasma of carbamazepine, ethosuximide, phenobarbitone, phenytoin and primidone. The procedure involved the preliminary extraction of the drugs and the internal standard (hexobarbitone) into a mixture of organic solvents at pH 2. The dried extract was dissolved in methanol and 25 microliter of the concentrate was injected into a liquid chromatograph linked to a reverse-phase column. The drugs and internal standard were eluted from the column by a mixture of methanol and water, as the mobile phase, and detected with a UV spectrophotometer at 204 nm. This HPLC assay, which required 0.5 ml of plasma, was used to determine anti-epileptic drugs levels in 136 mentally-handicapped children suffering from epilepsy. Comparison between different batches of assays showed that recovery of the drugs from plasma varied from 60 to 98% and with a coefficient of variance between 3.8 to 9.8%. Detection limit of the method ranged from 2 micrograms ml-1 for primidone, to 1 microgram ml-1 for the remainder of the anti-epileptic drugs.

Anticonvulsants↗

Combined short-term immunotherapy for experimental autoimmune myasthenia gravis.

A therapeutic strategy was designed to eliminate the humoral immune response to acetylcholine receptor (AChR) in ongoing experimental autoimmune myasthenia gravis (EAMG). Rats with EAMG were treated with a protocol consisting of three components: (1) A single high dose of cyclophosphamide (200 mg/kg) was used to produce a rapid and sustained fall in the anti-AChR antibody levels by preferential destruction of antibody-producing B-lymphocytes. "Memory" lymphocytes were not eliminated by cyclophosphamide. (2) Irradiation (600 rads) was used to eliminate the "memory" cells. It eliminated the anamnestic response to a challenge with the antigen AChR. (3) Bone marrow transplantation was used to repopulate the hematopoietic system after the otherwise lethal dose of cyclophosphamide. We used bone marrow from syngeneic rats with active EAMG to simulate an autologous transplant. Rats with EAMG treated with this combined protocol showed a prompt and sustained fall in the anti-AChR antibody levels and had no anamnestic response to a challenge with AChR. Thus, an affected animal's own marrow could be stored and used later for repopulation after cyclophosphamide-irradiation treatment. This treatment eliminates the animal's ongoing immune responses and reconstitutes the immune system in its original state. The success of this approach suggests that, if their safety could be established, similar "curative" strategies might be developed for the treatment of patients with severe antibody-mediated autoimmune disorders, such as myasthenia gravis.

Animals↗

Polyneuritis cranialis as a presentation of malignant lymphoma.

Two cases of polyneuritis cranialis resulting from infiltration of nerve roots by malignant lymphoma are described, and 8 previously reported cases discussed. In these, cranial nerve involvement was the presenting feature of lymphoma, and lesions at other sites were inconspicuous until necropsy. In one patient infectious mononucleosis developed concurrently with the neurological deficit. The course of this condition is progressive and fatal.

Adult↗

Localised nodular myositis: a clinical and pathological variant of polymyositis.

Three cases of a painful, inflammatory, nodular myopathy in young and middle-aged adult males are described. In two of the cases the nodular process gradually evolved into a diffuse proximal myopathy accompanied by dysphagia, and manifesting the so-called "facioscapulohumeral syndrome". The electromyogram (EMG) in all three cases was "myopathic" in type and in two cases abnormalities consistent with an inflammatory muscle disorder were seen. Muscle biopsy revealed a consistent pattern of intense, predominantly interstitial, pleomorphic infiltration of muscle with scattered foci of muscle fibre destruction and regeneration, which resembled muscle infarcts. It is suggested that this syndrome, whilst readily recognizable from both the clinical and pathological standpoints, is not a nosological entity in its own right but rather an unusual presentation of polymyositis.

Adult↗