溶剂系统对18-甲基炔诺酮渗透皮肤的影响

本文对乙醇、水、油酸等溶剂系统对左旋18-甲基炔诺酮(简称LNG)及消旋18-甲基炔酮(简称NG)渗透皮肤的影响进行了研究。实验采用Vaila-Chien双室扩散池及成人离体皮肤。结果表明,在80%乙醇水溶液中,LNG与NG的皮肤渗透速率比用生理盐水提高5～6倍,其中NG的皮肤渗透速率比LNG高1～2倍.含水乙醇与油酸复合使用时,对LNG通透皮肤具有明显的协同促进作用。当油酸—80%乙醇(0.75:9.25v/v)作为复合溶剂时。所获得的LNG皮肤渗透速率为0.53μg/cm²·h,分别比油酸或80%乙醇单独使用时提高29倍和3倍。提示正确地采用复合溶剂系统,能有效地提高LNG或NG透皮速率。     

Similar response rates and superior early progression-free survival with gemcitabine, dexamethasone, and cisplatin salvage therapy compared with carmustine, etoposide, cytarabine, and melphalan salvage therapy prior to autologous stem cell transplantation for recurrent or refractory Hodgkin lymphoma

BACKGROUND: The objective of this study was to compare the response rates, ability to mobilize autologous hematopoietic (peripheral blood) stem cells (PBSCs), and progression-free survival (PFS) after second-line chemotherapy with either gemcitabine, dexamethasone, and cisplatin (GDP) or carmustine, etoposide, cytarabine, and melphalan (mini-BEAM) followed by high-dose therapy and hematopoietic stem cell transplantation (ASCT) for patients with recurrent or refractory Hodgkin lymphoma. METHODS: The outcomes of 68 consecutive patients who were referred for salvage therapy (34 patients received mini-BEAM, and 34 patients received GDP) were compared retrospectively. Patients received mini-BEAM as inpatient treatment every 3-4 weeks, whereas GDP was administered on an outpatient basis every 3 weeks. Responding patients proceeded to stem cell mobilization, followed by high dose etoposide and melphalan, and ASCT. Patients who had disease bulk at recurrence that measured > 5 cm received involved-field radiation post-ASCT. RESULTS: The response rate to GDP prior to ASCT (complete responses, unconfirmed complete responses, and partial responses) was 62% (95% confidence interval [95% CI], 45-78%) compared with 68% (95% CI, 52-83%) for mini-BEAM (P = 0.61). After mobilizing chemotherapy, the proportion of patients for whom the target PBSC number of > or = 5 x 10(6) CD34-positive cells/kg was obtained was 97% after GDP and 57% after MB (P = 0.0003). More patients completed collection with a single apheresis procedure after GDP than after mini-BEAM (73% vs. 36%; P = 0.004), and fewer patients in the GDP group required bone marrow harvesting to proceed to ASCT. After a median follow-up of 1.8 years after ASCT, PFS was significantly better for patients who received GDP compared with patients who received mini-BEAM (74% vs. 35% at 1.5 yrs, respectively; P = 0.005). Overall survival at 1.5 years was 91% after GDP and 82% after mini-BEAM (P = 0.23). CONCLUSIONS: Although this was a retrospective analysis, response to GDP and early PFS after ASCT compared favorably with mini-BEAM salvage chemotherapy. Based on these data, the authors believe that a Phase III trial comparing GDP with mini-BEAM or other platinum-containing regimens is warranted.     

Attention and mental processing speed in hemodialysis patients

It has remained unclear whether well-dialyzed patients with end-stage renal disease (ESRD) show persisting neurocognitive deficits, especially in tasks that depend on sustained attention or psychomotor speed. We administered a battery of six attentional measures to 10 stable hemodialysis (HD) patients (age, 61+/-16 years; education, 12.4+/-3.8 years; Kt/V, 1.35+/-0.07) and 10 matched controls with normal renal function (age, 62+/-10 years; education, 11.6+/-1.0 years; estimated creatinine clearance, 92+/-25 mL/min). Results of the Trailmaking Test, Paced Auditory Serial Addition Test, Stroop Test, Digit Span, Continuous Performance Test (CPT), and Gordon Diagnostic System did not differ between groups. We conclude it is unlikely that well-dialyzed patients with ESRD manifest significant uremic neurocognitive deficits in the functional spheres related to sustained attention or mental processing speed.     

'Wine Glass' appearance: a unique MRI observation in a case of primary lateral sclerosis

Magnetic resonance images (MRI) in a patient with primary lateral sclerosis is described. T2WI, MRI of brain showed characteristic hyperintensities of the corticospinal tracts bilaterally, extending from the internal capsule to the brain stem - producing a 'wine glass' appearance on coronal sections, which has not been described so far to the best of our knowledge. Differential diagnosis of this interesting 'wine glass' appearance on MRI along with a review of the MR-signal abnormalities in motor neuron disease is discussed.