Formulation,Bioavailability, and Pharmacokinetics of Sustained-Release Potassium Chloride Tablets

The release of potassium chloride incorporated into hydrogenated vegetable oil and hydroxypropyl methylcellulose matrix tablets was studied in vitro. The formulations containing 20% hydrogenated vegetable oil and hydroxypropyl methylcellulose showed a sustained-release profile comparable to that of a standard commercially available sustained-release preparation, containing 8 mEq potassium chloride embedded in a wax material. The formulated and standard sustained-release potassium chloride tablets were compared to a conventional enteric-coated potassium chloride tablet in 10 healthy subjects. Mean recoveries in 24-hr urine potassium levels from four dosage forms (after subtracting normal urine potassium excretion levels) were 76 ± 32% from hydroxypropyl methylcellulose, 95 ± 22% from hydrogenated vegetable oil-incorporated matrix tablets, 91 ± 29% from commercially available sustained-release tablets, and 97 ± 13% from enteric-coated tablets. There was no significant difference (P > 0.05) in the time to reach maximum excretion rates among the three sustained-release tablets. No significant adverse effect was experienced with any of the preparations.     

Nutrition, lifestyle, and breast cancer risk among Turkish women

Breast cancer is the most common malignancy in women, with more than 1 million cases occurring worldwide annually. Cancer is one of the leading causes of mortality in Turkey; deaths due to breast cancer constitute 24.1% of all carcinoma cases reported among women. We conducted a case-control study of Turkish women with and without breast cancer to investigate the relationships of selected lifestyle and nutritional risk factors with breast cancer risk. Factors were chosen based upon published associations with breast cancer. Subjects were women in Izmir, Turkey. Cases were 123 women with breast cancer registered with the Department of Oncology, Ege University Hospital, in February through July 2004. The control group included 120 randomly selected women without a breast cancer diagnosis, registered with the Evka-4 Health Care Center and having similar sociodemographic characteristics. Inclusion criteria for participation consisted of 40 yr of age and over and willingness to participate. Chi2 tests and t-tests were used to determine statistical differences between cases and controls based on selected variables. Logistic regression was used to find the association between selected risk factors and breast cancer occurrence. Cases had smoked for more years, their age of first pregnancy was higher, and breast cancer occurrence was more common in first-degree relatives such as mothers and sisters of cases compared with controls. Cases were found to have consumed higher amounts of vegetable oil in contrast to controls. These findings are consistent with similar studies conducted in both developed and developing countries.     

RESPONSE TO RITUXIMAB AND PREDNISOLONE FOR OPSOCLONUS-MYOCLONUS-ATAXIA SYNDROME IN A CHILD WITH GANGLIONEUROBLASTOMA

Opsoclonus-myoclonus-ataxia (OMA) syndrome is a rare neurobehavioral paraneoplastic disorder in children with neuroblastic tumors. The neurologic symptoms are generally treated with a number of immunosupressive and immunomodulating agents. A 4-year-old previously healthy male patient was admitted to the authors’ center with progressive ataxia, gait disturbance, diffuculty of speech, and opsoclonus. He had a diagnosis of ganglionueroblastoma at the thoracal paraspinal region. Following surgey, the patient received IVIG and prednisolone but his cerebellar symptoms progressed. Rituximab therapy was started and continued for total 8 weeks without any side effect. The authors observed excellent neurologic response in the patient at the 4th week of treatment. Rituximab is a new, promising, and safe therapy for OMA syndrome in children with neuroblastoma.     

Fatal giant pediatric intracranial cavernous angioma

Cavernous angioma is a benign vascular lesion that may occur in the central nervous system. The symptoms of raised intracranial pressure or consciousness alteration are usually related to acute hemorrhage. A previously healthy four-year-old girl was admitted with sudden loss of consciousness, vomiting and clonic seizures. Her Glasgow coma score (GCS) was 7 at presentation (5 m 1v 1e). Anisocoria and mydriasis were present on the right. Computerized tomography revealed a giant spherical, hyperdense intraaxial left frontoparietal lesion. The findings of surrounding vasogenic edema and compression of the adjacent lateral ventricle were seen on computerized tomography (CT). She was taken to operation and the mass was grossly excised. The GCS remained unchanged. A diagnosis of brain death was made. A cavernous hemangioma was diagnosed with pathologic examination. In conclusion, a cavernous angioma may occasionally follow a rapid and fatal course by causing gross hemorrhage in the pediatric age group. Early recognition by CT or magnetic resonance imaging (MRI) and prompt surgical evacuation are necessary.     

Differentiation of Two Subtypes of Adult Hydrocephalus by Mixture of Experts

This paper illustrates the use of mixture of experts (ME) network structure to guide model selection for diagnosis of two subtypes of adult hydrocephalus (normal-pressure hydrocephalus–NPH and aqueductal stenosis–AS). The ME is a modular neural network architecture for supervised learning. Expectation-Maximization (EM) algorithm was used for training the ME so that the learning process is decoupled in a manner that fits well with the modular structure. To improve classification accuracy, the outputs of expert networks were combined by a gating network simultaneously trained in order to stochastically select the expert that is performing the best at solving the problem. The classifiers were trained on the defining features of NPH and AS (velocity and flux). Three types of records (normal, NPH and AS) were classified with the accuracy of 95.83% by the ME network structure. The ME network structure achieved accuracy rates which were higher than that of the stand-alone neural network models.