口服Carvedilol治疗心力衰竭多中心研究(MOCHA)

标题　Ｃａｒｖｅｄｉｌｏｌ对慢性心力衰竭患者左心室功能的改善和存活的提高呈剂量相关性作者　ＢｒｉｓｔｏｗＭＲ，ＧｉｌｂｅｒｔＥＭ，ＡｂｒａｈａｍＷＴ，等　　Ｃｉｒｃｕｌａｔｉｏｎ１９９６，９４：２８０７～２８１６　　研究疾病：充血性心力衰竭。目的：对Ｃａｒｖｅｄｉｌｏｌ治疗慢性心力衰竭患者剂量－疗效特征进行评价。　　设计：随机、双盲、安慰剂对照的多中心研究，剂量效应关系研究。病人资料：共３４５名心力衰竭患者，年龄１８～８５岁，左室射血分数≤０－３５，心力衰竭症状时间≥３月，研究前所有患者必须用利…     

Folgeerscheinungen der Narkose am Zentralnervensystem

Ohne ZusammenfassungDer histologische Teil dieser Arbeit erscheint in der Z. Neur.     

Association of achalasia and pulmonary Mycobacterium fortuitum infection

A case of achalasia complicated by Mycobacterium fortuitum pulmonary infection and empyema is reported. This association has been documented in the medical literature. Possible mechanisms explaining this association are discussed.     

Pharmacodynamic profile of verapamil in relation to absolute bioavailability: investigations with a conventional and a controlled-release formulation.

The absolute bioavailability F and response (prolongation of the PR interval) of verapamil after single doses of the same oral formulation administered on two different days were investigated in 16 male subjects with an 80 mg fast dissolving and a 240 mg controlled-release preparation and compared with a bolus injection of 5 mg of verapamil. The absolute bioavailability was 23% in both investigations for the 80 mg preparation and 32% in both investigations for the 240 mg dosage form. The individual values obtained for tmax, cmax, F, and AUC0-alpha showed a wide intersubject variability; therefore, no significant differences could be observed between the two trials for each dosage, but significant differences existed between the investigations of the two preparations. After intravenous administration, concentration-effect curves were about twofold left shifted when compared with the 80 mg tablet and about threefold left shifted when compared with the 240 mg tablet. Estimation of the drug input rate showed significantly (p less than 0.05) smaller values when the controlled-release tablet was given (80 mg tablet: 95.1 and 107.7 mg/h; 240 mg tablet; 55.8 and 46.3 mg/h). Thus, the effect and bioavailability of verapamil show sufficient intersubject reproducibility if the same formulation is given. The differences between the responses and the bioavailability after administration of different preparations may be related as well to the drug absorption rate and the stereoselective first pass of verapamil as to saturation of first-pass metabolism.     

Congestive cardiomyopathy in association with AIDS

During a 10-month period in 1985 and 1986, three cases of acquired immunodeficiency syndrome (AIDS) and a rapidly progressive fatal cardiomyopathy were encountered. All three patients originally presented with common opportunistic infections and later experienced marked congestive heart failure associated with echocardiographic and radiologic findings consistent with four-chamber cardiomyopathy. Diffuse cardiomyopathy was confirmed postmortem, but in each case a specific cause was not found.     

Independent component analysis of subdurally recorded occipital seizures

OBJECTIVE: To study the components of occipital seizures using independent component analysis (ICA) of subdurally recorded electroencephalogram (EEG) data. METHODS: Twenty-seven subdurally recorded occipital seizures from eight patients were studied. ICA was performed, and the resulting independent components (ICs) were compared with respect to their power, frequency, degree of spread within the epileptogenic zone, and propagation patterns. The ictal ICs were further subdivided into propagating and non-propagating types. RESULTS: ICA provided information over and above that supplied by standard visual EEG analysis, confirming that all the seizures originated in the occipital lobe, and affording additional knowledge regarding the nature of the seizure onset zone. Each seizure was composed of multiple ICs, some of which propagated while others remained within the epileptogenic zone. There was no statistical difference between the propagating and non-propagating ICs with respect to power or frequency. However, propagating ICs involved a significantly greater number of recording electrodes at their onset when compared to the non-propagating ICs. CONCLUSIONS: The propagation likelihood of ICs in occipital seizures is independent of their power or frequency, but it is dependent on the volume of brain giving rise to that signal; ICs that are generated by a greater volume of brain within the epileptogenic zone are more likely to propagate. SIGNIFICANCE: This study shows that ICA has the potential to be used to redefine the epileptogenic zone and guide the extent of cortisectomy for the treatment of patients with medically intractable occipital epilepsy.     

Über den pharmakologischen Nachweis kleiner Substanzmengen durch intrazerebrale Injektion an der Maus

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