Solution behavior of a graft copolymer in selective solvents for its backbone or grafts

Association of a graft copolymer polyisoprene-graft-polystyrene in solvent mixtures selective either for polyisoprene backbone (THF/heptane) or for polystyrene grafts (THF/ethanol; 1,4-dioxane/ethanol) was studied by static and dynamic light scattering and sedimentation velocity. Values of molar mass and dimensions of graft copolymer micelles were determined, and qualitative information on the dynamics of the unimer ? micelles equilibrium was obtained.     

Agreement between instruments for rating treatment decisional capacity.

OBJECTIVE: The objective of this study was to measure agreement between three treatment decisional capacity assessment instruments in mild to moderate dementia. METHOD: Subjects (N=79) were recruited from the community. Rating agreement was evaluated with kappa statistics. RESULTS: Three-way agreement was fair for overall capacity (kappa=0.451), very good for understanding (0.618), very poor for choice (0.158), and no better than chance for reasoning and appreciation. Pairwise agreement showed a similar pattern. CONCLUSIONS: With the exception of understanding, current treatment decisional capacity assessment instruments do not consistently agree with one another in assessing treatment decision abilities.     

Determination of free amino acids in beers: A comparison of Czech and foreign brands

The content of 16 free amino acids in 35 beers commercially available in Czech Republic was measured using high-performance liquid chromatography method with pre-column derivatization by AccQ·Tag agent and separation in reverse phase column followed by fluorescent detection. Content of proline, which was the amino acid most commonly found, varied in range from 40 to 250 mg/L. Czech beers were characterized by a significantly higher amino acid content in comparison to imported global brands (450.41±27.66 vs. 257.53±46.46 mg/L). Among individual amino acids, nine amino acids were significantly (p<0.01) more concentrated in the Czech beer brands than in the studied foreign brands, and those amino acids were from three distinctive taste groups: bitter tasting amino acid (isoleucine, leucine, lysine, phenylalanine and histidine), bitter sweet amino acids (valine and proline) and salty-umami amino acids (glutamic acid and aspartic acid).     

Caroli's disease: liver resection and liver transplantation. Experience in 33 patients

BACKGROUND: The aim of this study was to review and discuss our observations on 33 patients who underwent surgical treatment for Caroli's disease (CD), focusing on diagnosis, current surgical management, and long-term outcome. METHODS: Between May 1993 and June 2004, 642 liver resections and 286 liver transplantations in 252 patients were performed in our department of surgery. Thirty-three patients were referred to our center for diagnostic and therapeutic management of CD. Prior surgical interventions for hepatobiliary disorders, current diagnostic and surgical procedures, procedure-specific complications, duration of hospital stay, duration of follow-up, outpatient information, and long-term outcome were reviewed. RESULTS: Fifteen male and 18 female patients were treated in this study. Initial symptoms and signs of the disease noted in our patients included right upper quadrant pain, fever, and jaundice. In 2 of the 33 patients, we noted clinical evidence of cirrhosis followed by histologic confirmation. One patient suffered from variceal bleeding. In 26 patients, diagnoses were established by a combined endoscopic retrograde cholangiopancreatography, ultrasonography, and computed tomographic studies. The disease was localized in 25 and diffuse in 8 patients. Liver resection was carried out in 29 patients. Partial hepatectomies were performed in 27 of these 29 at our institution. Two female patients with the diffuse disease underwent orthotopic liver transplantation. Thirteen of the 31 patients who underwent surgery at our institution had an uneventful postoperative course. Fourteen patients had minor postoperative complications and responded well to medical management. Four patients had major complications that required further surgical treatment. Two patients died of complications related to postoperative hemorrhage and sepsis. Two patients with intrahepatic cholangiocarcinoma died because of primary tumor progress. One patient with cholangiocarcinoma died 1 year after a successful left hepatectomy because of metastatic disease recurrence. The long-term results of the 26 surviving patients were assessed during a mean follow-up of 3.7 years (range, 1-11 years). All 26 patients remained free of biliary symptoms or complications. In 25 patients, surgery including liver transplantation was curative. CONCLUSIONS: Partial hepatectomy for localized CD is potentially curative. In patients with diffuse CD, liver transplantation provides gratifying long-term results.     

Transdermal fentanyl for the treatment of pain caused by osteoarthritis of the knee or hip: an open,multicentre study

Background

This study was designed to evaluate the utility of transdermal fentanyl (TDF, Durogesic^®) for the treatment of pain due to osteoarthritis (OA) of the knee or hip, which was not adequately controlled by non-opioid analgesics or weak opioids. The second part of the trial, investigating TDF in patients with rheumatoid arthritis (RA) is reported separately.

Methods

Current analgesia was optimised during a 1-week run-in. Patients then received 28 days treatment with TDF starting at 25 μg/hr, with the option to increase the dose until adequate pain control was achieved. Metoclopramide was taken during the first week and then as needed.

Results

Of the 159 patients recruited, 75 with OA knee and 44 with OA hip completed the treatment phase, 30 knee and 18 hip patients entered the one-week taper-off phase. The most frequently used maximum dose of TDF was 25 μg/hr. The number of patients with adequate pain control increased during the run-in period from 4% to 27%, and further increased during TDF treatment to 88% on day 28. From baseline to endpoint, there were significant reductions in pain (p < 0.001) and improvements in functioning (p < 0.001) and physical (p < 0.001) and mental (p < 0.05) health. Scores for 'pain right now' decreased significantly within 24 hours of starting TDF treatment. TDF was assessed favourably and 84% of patients would recommend it for OA-related pain. Nausea and vomiting were the most common adverse events (reported by 32% and 26% of patients respectively), despite prophylaxis with metoclopramide, which showed limited efficacy in this setting.

Conclusion

TDF significantly increased pain control, and improved functioning and quality of life. Metoclopramide appeared to be of limited value in preventing nausea and vomiting; more effective anti-emetic treatment may enable more people to benefit from strong opioids such as TDF. This study suggests that four weeks is a reasonable period to test the benefit of adding TDF to improve pain control in OA patients and that discontinuing therapy in cases of limited benefit creates no major obstacles.

     

Exploratory study on the effects of treatment with two mistletoe preparations on chronic hepatitis C

Twenty-one patients with chronic hepatitis C were treated with a mistletoe preparation as monotherapy (either Iscador or Abnoba viscum) during one year. The treatment was well tolerated. Patients entering the study with elevated transaminases had a significant improvement, both for AST (aspartate aminotransferase) (p = 0.01) and for ALT (alanine aminotransferase) (p = 0.04). Quality of life significantly improved (p = 0.006) in patients with a low initial quality of life. Although one patient obtained a complete virological response, few effects on viral load were seen in the whole group. These results suggest an effect comparable to glycyrrhicin treatment: improvement of liver inflammation and thus possibly reduction of the long term complications, viz cirrhosis and liver cancer. Mistletoe preparations have the advantage of easy administration and low cost.