Influence of acute renal failure on FPIA rapid serum assay of midazolam and its main metabolite.

We recently developed a simple and fast assay technique, providing the possibility of monitoring of midazolam (M) during sedation. We compared HPLC vs FPIA for the measurement of the sum M plus alpha 1-hydroxymidazolam (OM), its main and pharmacologically active metabolite, in the serum of sedated ICU patients; this activity referred to as M-like. We identified certain patients in whom M-like activity appeared abnormally high in comparison with HPLC assays.

ELT-1, a GATA-like transcription factor, is required for epidermal cell fates in Caenorhabditis elegans embryos.

Epidermal cells are generated during Caenorhabditis elegans embryogenesis by several distinct lineage patterns. These patterns are controlled by maternal genes that determine the identities of early embryonic blastomeres. We show that the embryonically expressed gene elt-1, which was shown previously to encode a GATA-like transcription factor, is required for the production of epidermal cells by each of these lineages.

[Measles with respiratory involvement in adults. 2 cases].

Background: Measles is usually considered to be a childhood disease. Recent epidemiology data suggest that it is in progress amongst the adult population despite generalized vaccination.

Case Report: Within a 3-week period, two brothers, aged 19 and 21 years, developed fever and interstitial pneumonia.

Opercular jetting during fast-starts by flatfishes.

When attacked by predators, flatfishes perform fast-starts that result in a rapid take-off from the ocean bottom on which they lie. High-speed video recordings of the blind side of flatfishes indicate that they expel a coherent jet of water from the blind-side opercular valve during take-off. Buccal pressure recordings in winter flounder (Pseudopleuronectes americanus) show that a buccal pressure pulse begins 0­20 ms before the beginning of the fast-start and has a range of mean magnitudes for three individuals of 1.

Effects of four years' treatment with biosynthetic human growth hormone (GH) on body composition in GH-deficient hypopituitary adults.

Short-term trials of growth hormone (GH) substitution in hypopituitary adults have shown beneficial effects on body composition. To evaluate the long-term effects on body composition, we followed thirteen GH-deficient adults (GH < 6 mU/l following standard provocative tests) for 4 years of GH replacement. At yearly intervals, serum insulin-like growth factor I (IGF-I), body weight, body mass index (BMI), waist, waist-to-hip circumference ratio (WHR) and resting systolic (SBP) and diastolic blood pressure (DBP) were determined, and body composition was assessed using three independent methods: total body potassium (TBK), bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA).

Comparison of high-performance liquid chromatography and polyclonal fluorescence polarization immunoassay for the monitoring of midazolam in the plasma of intensive care unit patients.

Midazolam (M) is used as an induction agent for anesthesia. The main metabolite is alpha-hydroxymidazolam (OM), which is pharmacologically active. Use of M for sedation is a recent application, rapidly gaining favor.

Metoclopramide in trauma CT scanning: preventing emesis of oral radiographic contrast.

Vomiting of gastric contents is common among multisystem trauma patients and may cause significant morbidity. A study was conducted to examine whether metoclopramide (Reglan), an antiemetic and promotility agent, could decrease vomiting after administration of oral radiographic contrast in stable multisystem trauma patients undergoing computed tomography (CT) of the abdomen ("trauma CT patients"). The charts of 193 patients listed in the Duke Trauma Registry who underwent abdominal CT scanning from January, 1992 until February, 1993 were reviewed.

AIDS and prehospital personnel: knowledge and prevention of occupational exposure.

Objectives: Prehospital personnel, including law enforcement officers, paramedics, and fire-fighters, may be exposed to the human immunodeficiency virus (HIV) while working. This study of prehospital personnel sought to determine: 1) their knowledge of the acquired immune syndrome (AIDS) and HIV transmission; 2) the extent of AIDS training received; 3) self-assessment of risk for HIV infection; and 4) precautions adopted to reduce occupational risk of exposure to HIV.

Methods: A survey was administered to pre-hospital personnel in a large Southern California jurisdiction.

On-line steam distillation/purge and trap analysis of halogenated, nonpolar, volatile contaminants in foods.

An on-line, steam distillation/purge and trap gas chromatographic procedure is described for determination of halogenated analytes in foods and beverages. Recoveries were generally >80% (versus aqueous standards) from vegetable oil, flour, root beer, cream (10% butter fat), and milk spiked at 1-3 micrograms/kg for each of the 32 analytes studied. Analytes ranged in volatility from vinyl chloride to 1,2,3,4-tetrachlorobenzene.

Disposition of inhaled 1,1,1,2-tetrafluoroethane (HFA134A) in healthy subjects and in patients with chronic airflow limitation. Measurement by 18F-labeling and whole-body gamma-counting.

HFA134a (1,1,1,2-tetrafluoroethane) is a nonozone-depleting candidate to replace the chlorofluorocarbons used as propellants in metered-dose inhalers (MDIs) for pharmaceuticals that are widely used in the treatment of respiratory tract disease. As a means for ensuring the safety of such a compound for human use, it is necessary to establish that there is no excessive or unexpected accumulation in the body and in selected regions. A sensitive whole-body gamma-counting technique has been used with 18F-labeled HFA134a to measure the whole-body and regional absorption, distribution, and retention of HFA134a after administration in humans by single-breath inhalation.

Outbreak of Pneumocystis carinii pneumonia in a renal transplant unit.

The charts for seven renal transplant recipients who developed Pneumocystis carinii pneumonia were reviewed. They included six men and one woman transplanted a mean of 150 days before the diagnosis of this infection. Six presented at least one episode of acute graft rejection.

Abnormal body composition and reduced bone mass in growth hormone deficient hypopituitary adults.

Objectives: The role of growth hormone in maintaining normal body composition and bone strength in adults has attracted much interest recently. We have assessed body composition and bone mass in GH deficient hypopituitary adults on conventional replacement therapy and compared them with matched controls.

Design And Subjects: A cross-sectional study of 64 growth hormone deficient hypopituitary adults (29 males and 35 females) on conventional replacement therapy and a large number of healthy control subjects matched for age, sex and body mass index (BMI).

Immunoglobulin E levels in relationship to HIV-1 disease, route of infection, and vitamin E status.

Our recent studies have demonstrated that in early HIV-1 infection, elevation of plasma immunoglobulin E (IgE) levels precedes the decline of CD4 cell count and is influenced by vitamin E status. In order to further investigate the role of IgE elevation in HIV-1 infection, we determined IgE levels in HIV-1-seropositive and -seronegative intravenous drug users (IDUs) (n = 38), in relationship to cellular and humoral immune function, liver enzymes, and vitamin E status. To examine the possible impact of the route of HIV-1 infection on IgE levels, comparisons between the cohorts of the HIV-1-seropositive and -seronegative IDUs and homosexual men (n = 45) were also conducted.

Sensitive colorimetric cytotoxicity measurement using alarmar blue.

Cytotoxicity testing of anticancer drugs requires techniques which are sensitive, reproductible and applicable to large scale testing using automated instruments. End point staining of cells or viability stains are reliable but they are often not sensitive enough or not suitable for automation. We have already described a fluorometric cytotoxicity assay using a non fluorescent substrate, Alarmar Blue, which upon reduction in living cells, yields a fluorescent product.

The occurrence of phthalate ester and di-2-ethylhexyl adipate plasticizers in Canadian packaging and food sampled in 1985-1989: a survey.

Selected foods (260 samples) packaged in materials with the potential to contribute plasticizers to the food, and available food composites (98 samples) obtained from the Canadian Health Protection Branch Total Diet Program, were analysed for phthalate plasticizers and di-2-ethylhexyl adipate (DEHA). The available contacting packaging was also analysed for plasticizers. The results show DEHA in food-contacting film and as a migrant in store-wrapped meat, poultry, fish, cheese and ready-to-eat foods at levels as high as 310 micrograms/g (cheese).

A critical analysis of the HIV-T4-cell-AIDS hypothesis.

The data generally accepted as proving the HIV theory of AIDS, HIV cytopathy, destruction of T4 lymphocytes, and the relationship between T4 cells, HIV and the acquired immune deficiency clinical syndrome are critically evaluated. It is concluded these data do not prove that HIV preferentially destroys T4 cells or has any cytopathic effects, nor do they demonstrate that T4 cells are preferentially destroyed in AIDS patients, or that T4 cell destruction and HIV are either necessary or sufficient prerequisites for the development of the clinical syndrome.

Bipolar hemiarthroplasty for primary osteoarthritis of the hip.

One hundred twenty-five bipolar hemiarthroplasties of the hip were performed at the authors' hospital. Although the procedure was performed for acute femoral neck fractures, rheumatoid arthritis, revision hemiarthroplasty, and primary osteoarthritis, only the latter is the subject of this review. A modified Harris hip score (HHS) was used to evaluate the patients both preoperatively and postoperatively.