B. V. R. Sastry
Vanderbilt University Medical Center
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Anesthesia & Analgesia | 1989
J. Reddy Kambam; B. Horton; Winston C. V. Parris; S. A. Hyman; M. L. Berman; B. V. R. Sastry
Pseudocholinesterase (PCHE) activity and dibucaine numbers (DN) in the cerebrospinal fluid (CSF) and plasma of 10 ASA physical status 1 and 2 patients were measured using a kinetic method. CSF had a mean PCHE activity of 0.018 +/- 0.013 unit/ml with a DN of 59 +/- 4. Whereas, PCHE activity and DN in the plasma were 0.960 +/- 0.12 units/ml and 84 +/- 3, respectively. We also measured PCHE activity and DN in the CSF and plasma of 4 patients in whom there was a recent history of intraventricular bleeding. These patients had a CSF PCHE activity of 0.340 +/- 0.07 units/ml (DN = 78 +/- 3) and a plasma PCHE activity of 0.950 +/- 0.10 units/ml (DN = 82 +/- 2). Our data show that there is a low activity of PCHE in CSF, 1/20-1/100th that of plasma. Our data also show that PCHE activity increased to 1/4 to 1/2 that of plasma in CSF of patients with bleeding into CSF.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie | 1987
J. Reddy Kambam; Stephanie Mouton; Steve Entman; B. V. R. Sastry; Bradley E. Smith
RésuméOn a déterminé ľactivité de la cholinestérase plasmatique chez 11 femmes en santé, 11 femmes en santé étant au terme de leur grossesse, et 11 femmes prééclamptiques étant au terme de leur grossesse, en utilisant une méthod colorimétrlque. Ľactivité moyenne de la cholinestérase plasmatique pour les femmes en samé, les femmes enceintes en santé et les femmes enceintes préédamptiques élait de438 ± 81,257 ± 25 et 173 ± 18 unites par ml, respectivement. Nos données laissent entendre que ľactivité de la cholinestérase plasmatique est réduite de façon significative chez les femmes enceintes préédamptiques en comparaison à celle des femmes en santé (p < 0.001) et à celle des femmes enceintes en santé (p < 0.001).
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie | 1987
J. Reddy Kambam; Rebecca J. Naukam; B. V. R. Sastry
The in vitro effect of procainamide on plasma cholinesterase (PCHE) activity in the plasma often normal ASA physical status I patients was studied using a kinetic method. The mean plasma cholinesterase activity without procainamide (control) was 0.90 ± 0.09 units.ml-1 The dibucaine numbers of all the samples were in the normal range of 78 to 86, indicating normal genotypes. The mean plasma cholinesterase activity, in the presence of procainamide in concentrations of 5.0, 10.0, 20.0 and 40.0 µ.ml-1, was reduced to 0.73 ± 0.04. 0.61 ± 0.03, 0.45 ± 0.02, and 0.36 ± 0.01 units.mt-1, respectively. At therapeutic concentrations of 4 to 12 µg.ml-1, procainamide inhibited cholinesterase activity 15 to 30 per cent. The authors also showed that the concentration of procainamide required to inhibit 50 per cent of plasma cholinesterase activity was 20 µg.mt-1 (Iso). The authors conclude that procainamide when tested in vitro had a statistically significant depressant effect on plasma cholinesterase activity at all the concentrations studied.RésuméOn a étudié ľeffet in vitro de la procaïnamide sur ľactivité de la cholinestérase plasmatique (PCHE) dans le plasma de dix patients normaux de statut physique ASA I, à ľaide ďune méthode cynétique. Ľactivité de la cholinestérase plasmatique moyenne sans procainamide (groupe témoin) était de 0.90 ± 0.09 unités.ml-1. Les nombres de dibucaine, pour tous les échantillons, se situaient dans ľéchelle normale de 78 à 86 dénotant, de ce fait, des génotypes normaux. La présence de procainamide dans des concentrations de 5.0, 10.0, 20.0 et 40.0 µg.ml-1, réduisait ľactivité de la cholinestérase plasmatique moyenne à 0.73 ± 0.04, 0.61 ± 0.03, 0.45 ± 0.02, et 0.36 ± 0.01 unités.ml-1, respectivement. Des concentrations thérapeutiques de 4 à 12 µg.ml-1 de procaïnamide inhibaient ľactivité de la cholinestérase de 15 à 30 pour cent. Les auteurs ont aussi démontré que la concentration de procaïnamide requise pour inhiber 50 pour cent de ľactivité de la cholinestérase plasmatique était de 20 µg.ml-1 (I50). Les auteurs concluent que la procaïnamide testée in vitro a un effet dépressif statistiquement significatif sur ľactivité de la cholinestérase plasmatique à toutes les concentrations étudiées.
Obstetric Anesthesia Digest | 1990
J. R. Kambam; B. Horton; Winston C. V. Parris; S. A. Hyman; L. Berman; B. V. R. Sastry; Gertie F. Marx
Pseudocholinesterase (PCHE) activity and dibucaine numbers (DN) in the cerebrospinal fluid (CSF) and plasma of 10 ASA physical status 1 and 2 patients were measured using a kinetic method. CSF had a mean PCHE activity of 0.018 ± 0.013 unit/ml with a DN of 59 ± 4. Whereas, PCHE activity and DN in the plasma were 0.960 ± 0.12 units/ml and 84 ± 3, respectively.We also measured PCHE activity and DN in the CSF and plasma of 4 patients in whom there was a recent history of intraventricular bleeding. These patients had a CSF PCHE activity of 0.340 ± 0.07 units/ml (DN = 78 ± 3) and a plasma PCHE activity of 0.950 ± 0.10 units/ml (DN = 82 ± 2).Our data show that there is a low activity of PCHE in CSF, 1/20–1/100th that of plasma. Our data also show that PCHE activity increased to 1/4 to 1/2 that of plasma in CSF of patients with bleeding into CSF.
Canadian Journal of Anaesthesia-journal Canadien D Anesthesie | 1990
J. Reddy Kambam; V. E. Janson; Paula Day; B. V. R. Sastry
The effects of the nondepolarizing muscle relaxants (NDMR), pancuronium, vecuronium, and d-tubocurarine and a depolarizing muscle relaxant, succinylcholine, were studied on choline acetyltransferase (ChAT) activity. A radiochemical assay was used in the determination of ChAT activity using purified placental enzyme. Pancuronium at concentrations of 10−7 M, 10−6 M, 10−5 M, 10−4 M, and 10−3 M inhibited CliAT activity by 3, 10, 15, 40 and 85 per cent, respectively; vecuronium at concentrations of 10−6 M, 10−5 M, 10−4 M, and 10−3 M inhibited ChAT activity by 5, 10, 26 and 57 per cent, respectively; d-tubocurarine at concentrations of 10−6 M, 10−3 M, 10−4 M, and 10−3 M inhibited ChAT activity by 0, 4, 12.5 and 29 per cent, respectively; whereas succinylcholine at concentrations of 10−7 M, 10−6 M, 10−5 M, and 10−4 M activated ChAT activity by 8, 10, 1, and 2 percent, respectively.Even though our present data demonstrated a significant dose-dependent inhibitory effect on ChAT activity by pancuronium, vecuronium and d-tubocurarine, it is unlikely that this inhibitory effect will contribute to the meclianism of action of NDMR. Our data, however, may suggest an additional mechanism for the phenomena of tetanic and train-of-four fades that are seen following the administration of nondepolarizing muscle relaxants.RésuméNous avons mesuré les effets de trois myorelaxants à action non-dépolarisante : le pancuronium, le vécuronium et la d-tubocurarine et de la succinylcholine (action dépolarisante) sur l’activité de la choline acétyltransférase (ChAT). Nous avons utilisé une mesure radiochimique de l’activité de la CliAT à partir d’enzyme purifie d’origine placentaire. Le pancuronium en concentration de 10−7 M, 10−5 M, 10−5 M, 10−4 M et 10−3 M diminuait l’activite de la ChAT de 3, 10, 15, 40 et 85 pour cent respectivement alors que le vécuronium à 10−6 M, 10−5 M, 10−4 Met 10−3 M la diminuait de 5, 10, 26 et 57 pour cent et la d-tubocurarine à 10−6 M, 10−5 M, 10−4 M et 10−3 M la réduisait de 0, 4, 12,5 et 29 pour cent. Par contre, la succinylcholine en concentration de 10−7 M, 10−6 M, 10−5 M et 10−4 M, augmentait l’activité de la ChAT de 8, 10, 1 et 2 pour cent respectivement. Il est toutefois peu probable que cette inhibition significative de la ChAT proportionnelle às la dose de pancuronium, de vécuronium et de d-tubocurarine soil à la base du mécanisme d’action des myorelaxants de type non-dépolarisant. Elle pourrait cependant contribuer à l’épuisement de la réponse à la stimulation tétanique ou en train-de-quatre qu’on observe avec ces agents.
Anesthesiology | 1987
J. Reddy Kambam; John J. Franks; Rebecca J. Naukam; B. V. R. Sastry
Anesthesiology | 1989
J. R. Kambara; Rebecca J. Naukam; Winston C. V. Parris; John J. Franks; S. M. Perry; B. V. R. Sastry; Bradley E. Smith
Anesthesia & Analgesia | 1988
J. R. Kambam; Winston C. V. Parris; John J. Franks; B. V. R. Sastry
Anesthesia & Analgesia | 1990
J. R. Kambam; Winston C. V. Parris; V. E. Janson; B. V. R. Sastry
Obstetric Anesthesia Digest | 1989
J. R. Kambam; Winston C. V. Parris; John J. Franks; B. V. R. Sastry; R. Nankam; Bradley E. Smith