Continuous twin screw extrusion for the wet granulation of lactose

The purpose of this study was to examine and compare the powder and mechanical properties of different batches of low crystallinity powdered cellulose (LCPC-S1 to LCPC-S5) with those of commercial microcrystalline celluloses (MCC) (Avicel PH-101, Avicel PH-102, Avicel PH-103, Avicel PH-301, Avicel PH-302, and Emcocel 90m) and powdered celluloses (PC) (Solka Floc BW-40 and Solka Floc BW-100). Both the LCPC and MCC products were aggregated powders, whereas, the PC materials showed a fibrous structure. The primary particles forming the LCPC aggregates, however, were smaller in size and showed a greater degree of coalescence between boundaries, than those forming the MCC aggregates. The LCPC materials had significantly higher bulk and tap densities and lower porosity values compared with the MCC materials. The yield pressure value calculated from the linear region of the Heckel curve for LCPC varied between 48 and 70 MPa, for Avicel and PC materials between, 80 and 106 MPa, and for Emcocel 90m was 48 MPa. These results suggest that the LCPC products and Emcocel 90m, compared with commercial MCC and PC excipients, undergo plastic deformation at relatively lower compression pressures. The total volume reduction (i.e. compressibility), determined by calculating the area under the Heckel curve (AUHC), however, was comparable for all materials, with the exception of the LCPC-S3, which owing to the low yield pressure value, showed the largest reduction in volume. With the exception of LCPC-S1 and Solka Floc BW-40, all the other materials formed compacts, whose strength ranged from about 522 to 799 MPa2. The strengths of LCPC-S1 and Solka Floc BW-40 compacts, in contrast, were 214 and 257 MPa2, respectively. Irrespective of the solid fraction levels, the LCPC compacts, in general, disintegrated much faster than the MCC and PC compacts. In conclusion, the results suggest that the new LCPC materials reported herein have powder properties that are quite different from the MCC and PC materials evaluated, and show clear potential as direct compression excipients.     

In vitro evaluation of the quality of essential drugs on the Tanzanian market

We evaluated the in vitro availability and its stability under simulated tropical conditions of various formulations of four essential drugs marketed in Tanzania. We obtained 22 formulations (containing paracetamol, acetylsalicylic acid, chloroquine or sulphadoxine/pyrimethamine) from wholesale pharmacies in Dar es Salaam and the Medical Stores Department (Tanzania). The drug content, in vitro availability (dissolution) and its stability under simulated tropical conditions were determined using methods specified in the United States Pharmacopoeia (USP) 24 monograph of the respective drugs. All formulations passed the pharmacopoeia requirements for the drug content. However, seven formulations (three acetylsalicylic acid, two sulphadoxine/pyrimethamine and two paracetamol) failed to meet the USP 24 tolerance limits for dissolution. Another five formulations (three paracetamol and two chloroquine) failed to meet the dissolution tolerance limits after being subjected to an accelerated stability test under simulated tropical conditions (75% RH/40 degrees C) for 6 months. The study has demonstrated the presence on the Tanzanian market of essential drug formulations that met potency requirements and yet had unsatisfactory in vitro availability as they were not robust enough to withstand storage under simulated tropical conditions.     

Slug species- and population-specific effects on the end points of the Slug Mucosal Irritation test.

The Slug Mucosal Irritation test seems to be a promising method for the evaluation of the local tolerance of products applied to the mucosa. Furthermore, the Slug Mucosal Irritation test is a reliable method to classify chemicals accurately into three eye irritation categories based on the mucus production and the score for tissue damage. Until now the slug Arion lusitanicus collected in Belgium was always used as test organism. The present study investigated the effects of the slug population and species on the end points of the test and on the eye irritation classification. For this purpose, the eye irritation/damage test procedure and eye reference chemicals were used. Comparison of the results of one Belgian and two Swiss A. lusitanicus populations indicated that the geographic and ecological origins of slug populations did neither influence the mucus production, nor the score for tissue damage. Slug species-specific effects on the test end points were investigated by comparing the data of Belgian Limax flavus with corresponding data of Belgian A. lusitanicus. L. flavus produced more mucus than A. lusitanicus, so that the mucus production cut-off values had to be increased. Therefore, the results indicated that the test procedure and prediction model have to be optimised and validated, if other slug species are used instead of A. lusitanicus.     

颅内动脉瘤栓塞后并发脑缺血的原因分析

1 临床资料我们总结2004-02/2004-06在第四军医大学唐都医院神经外科住院行栓塞治疗颅内动脉瘤患者27(男12,女15)例,年龄32～72岁.     

Plasma antioxidant vitamins, chronic hepatitis B virus infection and urinary aflatoxin B1-DNA adducts in healthy males

Epidemiological evidence indicates that aflatoxin B1 (AFB1) intake is associated with an increased risk of hepatocellular carcinoma (HCC). The hepatocarcinogenesis is initiated by covalent binding of AFB1 to cellular DNA. To determine whether nutritional factors and hormonal status may influence the binding of AFB1 to hepatic DNA, a cross- sectional study was performed on a total of 42 male asymptomatic hepatitis B surface antigen (HBsAg) carriers and 43 male non-carriers in a cohort study on the multistage development of HCC in Taiwan. The major AFB1-DNA adduct in vivo, AFB1-N7-guanine, was measured by high- performance liquid chromatography in urine. Urinary AFB1-N7-guanine was detectable in 40% of the subjects. HBsAg carriers had a higher detection rate of urinary AFB1-DNA adducts than non-carriers and the difference was statistically significant after multivariate adjustment. After taking into account the total AFB1 urinary metabolite level, chronic HBsAg carrier status, and other potential confounders, plasma levels of cholesterol, alpha-tocopherol, and alpha- and beta-carotene were positively associated with the detection rate of the AFB1-DNA adducts in a dose-dependent manner, whereas plasma lycopene level was inversely related to the presence of the adducts in urine. The association of urinary AFB1-DNA adducts with the plasma levels of cholesterol, alpha-tocopherol, lycopene, and alpha- and beta-carotene was observed at both low and high exposure levels of AFB1. There was a synergistic interaction of plasma alpha-tocopherol with alpha- and beta- carotene on the adduct levels. No association with the adducts was found for plasma levels of retinol and testosterone. This study demonstrated different associations of antioxidant vitamins with AFB1- DNA adduct formation. The data consistent with our previous finding in cultured woodchuck hepatocytes that alpha-tocopherol and beta-carotene enhanced AFB1-DNA adduct formation suggest that prospective investigation of the relationship between plasma micronutrients and risk of AFB1-related HCC is warranted.      

Logarithmic quantitation model using serum ferritin to estimate iron overload in secondary haemochromatosis

Nineteen children and adolescents receiving repeated transfusions and subcutaneous desferrioxamine treatment were investigated in an attempt to quantitate iron overload non-invasively. Before patients were started on desferrioxamine individual relationships were correlated for 12 to 36 months between transfused iron, absorbed iron estimated gastrointestinally, and increasing serum ferritin concentrations. Patients with inflammation, increased liver enzymes, or haemolysis were excluded from analysis. The relationship between the variables could be described by a logarithmic regression curve (y = transfused iron [plus eventually gastrointestinally absorbed iron] = iron overload = a+b log [x = serum ferritin]) for each individual patient. All patients showed close correlation (R2) between x and y (median R2 of 0.909, 0.98, and 0.92 in thalassaemia, aplastic anaemia, and sickle cell anaemia patients, respectively). When started on desferrioxamine, current serum ferritin concentrations were used to derive the iron overload from each individual regression curve. The derived estimated iron overload ranged from 0.6 g to 31 g. Left ventricular dilatation was observed in three patients with beta thalassaemia and in one patient with aplastic anaemia with median iron overload of 20.7 (14.1-31.3) g and 24.0 g respectively. Hypothyroidism was found in four patients with beta thalassaemia and one patient with aplastic anaemia with iron overload between 14.7 (6.8 and 26.1) g and 15.1 g respectively. Human growth hormone deficiency was detected in three patients with beta thalassaemia with an iron overload of 4.2 (3.5-6.8) g; all three patients had excellent desferrioxamine compliance.     

Aortic aneurysm complicating bacterial endocarditis in childhood

Bacterial endocarditis is an uncommon diagnosis in childhood with significant morbidity and mortality. Aortic aneurysm as a complication is well described in adults but there are few reports in the paediatric literature. Two children with bacterial endocarditis are described, whose illnesses were complicated by aortic aneurysm formation requiring surgical intervention.     

Cardiac rhabdomyomas and their association with tuberous sclerosis

A search for children presenting with signs or symptoms of cardiac rhabdomyomas was made through members of the paediatric section of the British Cardiac Society in order to establish their birth incidence, presenting features, clinical course, and the frequency of a concurrent diagnosis of tuberous sclerosis. Fifteen children were identified and 12 had tuberous sclerosis (80%). Heart failure was the presentation in six, five of whom died; six presented because of a murmur and three because of arrhythmias. The prevalence of echocardiographic evidence of cardiac rhabdomyomas in a population of patients with tuberous sclerosis was established. Twenty individuals had echocardiography and eight had echodensities consistent with cardiac rhabdomyomas. It is concluded that the minimum birth incidence for children presenting because of the effects of cardiac rhabdomyomas is 1/326,000 and a minimum of 80% have tuberous sclerosis. In a population of patients with tuberous sclerosis a minimum of 60% under 18 years have cardiac rhabdomyomas.     

Fructosamine and glycated haemoglobin in the assessment of long term glycaemic control in diabetes

Fructosamine and glycated haemoglobin were measured simultaneously in 147 children with diabetes. If glycated haemoglobin is considered as the 'gold standard' for long term glycaemic control, then fructosamine is a poor indicator of actual glycated haemoglobin values, with wide 95% confidence (fiducial) limits. This shows that it is impossible to accurately predict glycated haemoglobin concentrations and therefore, by implication, longer term glycaemic control, from measurements of fructosamine. As the major studies on the prevention of microvascular complications in diabetes have used glycated haemoglobin levels to assess glycaemic control, it is suggested that this measurement should be used in all children with diabetes in preference to the measurement of fructosamine.