Interaction Between Erythromycin and Theophylline

PEDIATRICS ◽  
1978 ◽  
Vol 61 (2) ◽  
pp. 324-325
Author(s):  
Miles Weinberger
Keyword(s):  
Macrolide Antibiotic ◽  
Clinical Importance ◽  
Hepatic Metabolism ◽  
Free Base ◽  
Theophylline Clearance ◽  
Additional Information ◽  
Erythromycin Estolate

The report of Cummins et al. (Pediatrics 59:144, January 1977) is of potential clinical importance. Additional information, however, would make their data easier to interpret. Erythromycin is marketed as the free base and as various salts. Only erythromycin estolate has been demonstrated to have hepatotoxic potential. Since troleandomycin, another macrolide antibiotic with even greater hepatotoxic potential, has a profound effect on theophylline clearance, probably by decreasing hepatic metabolism,1 the highest index of suspicion for a similar interaction with an erythromycin would be directed at the potentially hepatotoxic estolate salt (Ilosone).

Bilateral Renal Metastases of Nasal Chondrosarcoma in a Dog

1997 ◽  
Vol 34 (4) ◽  
pp. 352-355 ◽  
Author(s):  
K. A. Hahn ◽  
M. D. McGavin ◽  
W. H. Adams
Keyword(s):  
Clinical Importance ◽  
Whole Body ◽  
Tumor Type ◽  
Thoracic Radiography ◽  
Old Irish ◽  
Renal Metastasis ◽  
Additional Information ◽  
Histologic Evaluation ◽  
Renal Enlargement ◽  
Renal Metastases

Chondrosarcoma is the most common nonepithelial sinonasal neoplasm in the dog, and metastasis is considered rare. A 7-year-old Irish Setter had bilateral renal enlargement 17 months following surgery and radiotherapy for a primary nasal chondrosarcoma. Histologic evaluation revealed chondrosarcoma metastases in both kidneys. A diagnosis of nasal chondrosarcoma with bilateral renal metastasis was made. The clinical importance of this report is that routine recommendations for the evaluation of regional and/or distant metatasis in a dog with a dignosis of nasal chondrosarcoma, namely routine whole body physical examination and thoracic radiography, failed to demonstrate the presence of abdominal metatases, which ultimately led to the demise of this dog. The biologically aggressive nature of this chondrosarcoma of the nasal cavity indicates that additional information is needed before a prognosis can be reliably established for dogs with this tumor type.

Incremental benefit of a novel signal recording system during mapping and ablation

EP Europace ◽  
2020 ◽  
Author(s):  
Deepak Padmanabhan ◽  
Alan Sugrue ◽  
Vaibhav Vaidya ◽  
Chance Witt ◽  
Omar Yasin ◽  
...  
Keyword(s):  
Signal Processing ◽  
Los Angeles ◽  
Dynamic Range ◽  
Current System ◽  
Clinical Importance ◽  
Rf Ablation ◽  
Additional Information ◽  
Cardiac Signals ◽  
Processing Platform ◽  
Signal Recording

Abstract Aims Current electrophysiology signal recording and mapping systems have limited dynamic range (DR) and bandwidth, which causes loss of valuable information during acquisition of cardiac signals. We evaluated a novel advanced signal processing platform with the objective to obtain and assess additional information of clinical importance. Methods and results Over 10 canines, we compared intracardiac recordings within all cardiac chambers, in various rhythms, in pacing and during radiofrequency (RF) ablation across two platforms; a conventional system and the PURE EP™ [(PEP); Bio Sig Technologies, Inc., Los Angeles, CA, USA]. Recording cardiac signals with varying amplitudes were consistently and reproducibly observed, without loss of detail or introduction of artefact. Further the amplitude of current of injury (COI) on the unipolar signals correlated with the instantaneous contact force (CF) recorded on the sensing catheter in all the animals (r2 = 0.94 in ventricle). The maximum change in the unipolar COI correlated with the change in local electrogram amplitude during non-irrigated RF ablation (r2 = 0.61 in atrium). Reduction in artefact attributable to pacing (20 sites) and noise during ablation (48 sites) was present on the PEP system. Within the PEP system, simultaneous display of identical signals, filtered differently, aided the visualization of discrete conduction tissue signals. Conclusion Compared to current system, the PEP system provided incremental information including identifying conduction tissue signals, estimates of CF and a surrogate for lesion formation. This novel signal processing platform with increased DR and minimal front-end filtering may be useful in clinical practice.

Fulminant Liver Failure Associated with Clarithromycin

2003 ◽  
Vol 37 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Andreas Tietz ◽  
Markus H Heim ◽  
Urs Eriksson ◽  
Stephan Marsch ◽  
Luigi Terracciano ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Transplantation ◽  
Liver Failure ◽  
White Woman ◽  
Macrolide Antibiotic ◽  
Hepatic Metabolism ◽  
Hepatic Toxicity ◽  
Fulminant Liver Failure ◽  
Hepatocellular Injury ◽  
Case Summary

OBJECTIVE To report a patient developing fulminant liver failure while being treated with clarithromycin for pneumonia. CASE SUMMARY A 58-year-old white woman developed fulminant liver failure while being treated with the macrolide antibiotic clarithromycin for pneumonia. Comedication included N-acetylcysteine, atenolol, and isradipine. Other causes of liver failure, such as viral hepatitis, autoimmune hepatitis, toxins, and heart failure, were excluded by appropriate diagnostic means. All drugs were stopped, and the patient was transferred to another hospital for liver transplantation. She recovered spontaneously within several days, making transplantation unnecessary. A liver biopsy obtained 10 days after the initial presentation revealed centroacinar necrosis and beginning fibrous reorganization, compatible with recent centroacinar damage. DISCUSSION Since no other cause could be identified, liver injury was considered to be drug related. Fulminant liver failure has not previously been described with concomitant use of atenolol and N-acetylcysteine. Although isradipine has been associated with hepatocellular injury, there are no reports of fulminant liver failure with this agent, and our patient had been treated for >2 years without signs of toxicity. The most likely cause of liver failure in this patient was, therefore, clarithromycin, which undergoes hepatic metabolism and has been reported to cause fulminant hepatic failure. A second possibility is an interaction between clarithromycin and isradipine, potentially increasing the hepatic toxicity of isradipine. CONCLUSIONS Clarithromycin may be a cause of fulminant liver failure either alone or by inhibiting the metabolism of other drugs.

Production of New and Revised A.A.V.S.O. Charts

1979 ◽  
Vol 46 ◽  
pp. 368
Author(s):  
Clinton B. Ford
Keyword(s):  
Variable Star ◽  
Standard Form ◽  
Original Data ◽  
University Of Pennsylvania ◽  
Standard Format ◽  
Additional Information ◽  
The Gift ◽  
The University

A “new charts program” for the Americal Association of Variable Star Observers was instigated in 1966 via the gift to the Association of the complete variable star observing records, charts, photographs, etc. of the late Prof. Charles P. Olivier of the University of Pennsylvania (USA). Adequate material covering about 60 variables, not previously charted by the AAVSO, was included in this original data, and was suitably charted in reproducible standard format.Since 1966, much additional information has been assembled from other sources, three Catalogs have been issued which list the new or revised charts produced, and which specify how copies of same may be obtained. The latest such Catalog is dated June 1978, and lists 670 different charts covering a total of 611 variables none of which was charted in reproducible standard form previous to 1966.

Convergent Beam Electron Diffraction

1978 ◽  
Vol 36 (3) ◽  
pp. 304-315
Author(s):  
G. Lehmpfuhl
Keyword(s):  
Electron Diffraction ◽  
Diffraction Pattern ◽  
Crystal Surface ◽  
Diffraction Spot ◽  
Crystal Thickness ◽  
Large Area ◽  
Electron Microscopic ◽  
Additional Information ◽  
Microscopic Investigations

Introduction In electron microscopic investigations of crystalline specimens the direct observation of the electron diffraction pattern gives additional information about the specimen. The quality of this information depends on the quality of the crystals or the crystal area contributing to the diffraction pattern. By selected area diffraction in a conventional electron microscope, specimen areas as small as 1 µ in diameter can be investigated. It is well known that crystal areas of that size which must be thin enough (in the order of 1000 Å) for electron microscopic investigations are normally somewhat distorted by bending, or they are not homogeneous. Furthermore, the crystal surface is not well defined over such a large area. These are facts which cause reduction of information in the diffraction pattern. The intensity of a diffraction spot, for example, depends on the crystal thickness. If the thickness is not uniform over the investigated area, one observes an averaged intensity, so that the intensity distribution in the diffraction pattern cannot be used for an analysis unless additional information is available.

Microtubule nucleation sequence studied by time-resolved x-ray scattering and electron microscopy

1983 ◽  
Vol 41 ◽  
pp. 766-767
Author(s):  
Eva-Maria Mandelkow ◽  
Eckhard Mandelkow ◽  
Joan Bordas
Keyword(s):  
Electron Microscopy ◽  
Dynamic Equilibrium ◽  
Time Resolved ◽  
X Ray ◽  
Additional Information ◽  
X Ray Scattering ◽  
Low Concentrations ◽  
Microtubule Growth ◽  
Ray Patterns ◽  
Ray Scattering

When a solution of microtubule protein is changed from non-polymerising to polymerising conditions (e.g. by temperature jump or mixing with GTP) there is a series of structural transitions preceding microtubule growth. These have been detected by time-resolved X-ray scattering using synchrotron radiation, and they may be classified into pre-nucleation and nucleation events. X-ray patterns are good indicators for the average behavior of the particles in solution, but they are difficult to interpret unless additional information on their structure is available. We therefore studied the assembly process by electron microscopy under conditions approaching those of the X-ray experiment. There are two difficulties in the EM approach: One is that the particles important for assembly are usually small and not very regular and therefore tend to be overlooked. Secondly EM specimens require low concentrations which favor disassembly of the particles one wants to observe since there is a dynamic equilibrium between polymers and subunits.

The Structure and Development of Microbodies in the Fat Body and other Tissues of an Insect (Calpodes Ethlius)

1970 ◽  
Vol 28 ◽  
pp. 148-149
Author(s):  
M. Locke ◽  
J. T. McMahon
Keyword(s):  
Electron Microscopy ◽  
Liquid Crystals ◽  
Fat Body ◽  
Competitive Inhibitor ◽  
Dense Core ◽  
Urate Oxidase ◽  
Blood Proteins ◽  
Free Base ◽  
The Core ◽  
The Matrix

The fat body of insects has always been compared functionally to the liver of vertebrates. Both synthesize and store glycogen and lipid and are concerned with the formation of blood proteins. The comparison becomes even more apt with the discovery of microbodies and the localization of urate oxidase and catalase in insect fat body.The microbodies are oval to spherical bodies about 1μ across with a depression and dense core on one side. The core is made of coiled tubules together with dense material close to the depressed membrane. The tubules may appear loose or densely packed but always intertwined like liquid crystals, never straight as in solid crystals (Fig. 1). When fat body is reacted with diaminobenzidine free base and H2O2 at pH 9.0 to determine the distribution of catalase, electron microscopy shows the enzyme in the matrix of the microbodies (Fig. 2). The reaction is abolished by 3-amino-1, 2, 4-triazole, a competitive inhibitor of catalase. The fat body is the only tissue which consistantly reacts positively for urate oxidase. The reaction product is sharply localized in granules of about the same size and distribution as the microbodies. The reaction is inhibited by 2, 6, 8-trichloropurine, a competitive inhibitor of urate oxidase.

Edge Penetration Effects in the Low-Loss Electron Image in the SEM

1988 ◽  
Vol 46 ◽  
pp. 202-203
Author(s):  
Oliver C. Wells
Keyword(s):  
Electron Microscope ◽  
Scanning Electron Microscope ◽  
Beam Energy ◽  
Secondary Electron ◽  
Sharp Edge ◽  
Beam Diameter ◽  
Low Loss ◽  
Additional Information ◽  
Electron Image ◽  
Scanning Electron

The low-loss electron (LLE) image in the scanning electron microscope (SEM) is useful for the study of uncoated photoresist and some other poorly conducting specimens because it is less sensitive to specimen charging than is the secondary electron (SE) image. A second advantage can arise from a significant reduction in the width of the “penetration fringe” close to a sharp edge. Although both of these problems can also be solved by operating with a beam energy of about 1 keV, the LLE image has the advantage that it permits the use of a higher beam energy and therefore (for a given SEM) a smaller beam diameter. It is an additional attraction of the LLE image that it can be obtained simultaneously with the SE image, and this gives additional information in many cases. This paper shows the reduction in penetration effects given by the use of the LLE image.

Ultrastructural autoradiography of L6 skeletal-muscle cells exposed to a tritiated macrolide antibiotic (LY237216) in vitro

1992 ◽  
Vol 50 (1) ◽  
pp. 612-613
Author(s):  
S.L. White ◽  
C.B. Jensen ◽  
D.D. Giera ◽  
D.A. Laska ◽  
M.N. Novilla ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Quantitative Analysis ◽  
Macrolide Antibiotic ◽  
Circle Method ◽  
Apical Surface ◽  
Polycarbonate Membrane ◽  
L6 Cells ◽  
Low Viscosity ◽  
Erythromycin A

In vitro exposure to LY237216 (9-Deoxo-11-deoxy-9,11-{imino[2-(2-methoxyethoxy)ethylidene]-oxy}-(9S)-erythromycin), a macrolide antibiotic, was found to induce cytoplasmic vacuolation in L6 skeletal muscle myoblast cultures (White, S.L., unpubl). The present study was done to determine, by autoradiographic quantitative analysis, the subcellular distribution of 3H-LY237216 in L6 cells.L6 cells (ATCC, CRL 1458) were cultured to confluency on polycarbonate membrane filters (Millipore Corp., Bedford, MA) in M-199 medium (GIBCO® Labs) with 10% fetal bovine serum. The cells were exposed from the apical surface for 1-hour to unlabelled-compound (0 μCi/ml) or 50 (μCi/ml of 3H-LY237216 at a compound concentration of 0.25 mg/ml. Following a rapid rinse in compound-free growth medium, the cells were slam-frozen against a liquid nitrogen cooled, polished copper block in a CF-100 cryofixation unit (LifeCell Corp., The Woodlands, TX). Specimens were dried in the MDD-C Molecular Distillation Drier (LifeCell Corp.), vapor osmicated and embedded in Spurrs low viscosity resin. Ultrathin sections collected on formvar coated stainless steel grids were counter-stained, then individually mounted on corks. A monolayer of Ilford L4 nuclear emulsion (Polysciences, Inc., Warrington, PA) was placed on the sections, utilizing a modified “loop method”. The emulsions were exposed for 7-weeks in a light-tight box at 4°C. Autoradiographs were developed in Microdol-X developer and examined on a Philips EM410LS transmission electron microscope. Quantitative analysis of compound localization employed the point and circle approach of Williams; incorporating the probability circle method of Salpeter and McHenry.

Research Consumerism 101: Evaluating External Evidence of Treatment Effectiveness

2008 ◽  
Vol 17 (2) ◽  
pp. 43-49
Author(s):  
James L. Coyle
Keyword(s):  
Treatment Effectiveness ◽  
Code Of Ethics ◽  
Oropharyngeal Dysphagia ◽  
Clinical Importance ◽  
Professional Services ◽  
Adverse Outcomes ◽  
Professional Judgment ◽  
Evidence Based ◽  
Intervention Selection ◽  
Published Research

Abstract The modern clinician is a research consumer. Rehabilitation of oropharyngeal impairments, and prevention of the adverse outcomes of dysphagia, requires the clinician to select interventions for which evidence of a reasonable likelihood of a successful, important outcome exists. The purpose of this paper is to provide strategies for evaluation of published research regarding treatment of oropharyngeal dysphagia. This article utilizes tutorial and examples to inform and educate practitioners in methods of appraising published research. It provides and encourages the use of methods of efficiently evaluating the validity and clinical importance of published research. Additionally, it discusses the importance of the ethical obligation we, as practitioners, have to use evidence-based treatment selection methods and measurement of patient performance during therapy. The reader is provided with tactics for evaluating treatment studies to establish a study's validity and, thereby, objectively select interventions. The importance of avoiding subjective or unsubstantiated claims and using objective methods of generating empirical clinical evidence is emphasized. The ability to evaluate the quality of research provides clinicians with objective intervention selection as an important, essential component of evidence-based clinical practice. ASHA Code of Ethics (2003): Principle I, Rule F: “Individuals shall fully inform the persons they serve of the nature and possible effects of services rendered and products dispensed…” (p. 2) Principle I, Rule G: “Individuals shall evaluate the effectiveness of services rendered and of products dispensed and shall provide services or dispense products only when benefit can reasonably be expected.” (p. 2) Principle IV, Rule G: “Individuals shall not provide professional services without exercising independent professional judgment, regardless of referral source or prescription.” (p. 4)

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