Actions of Kavain and Dihydromethysticin on Ipsapirone-Induced Field Potential Changes in the Hippocampus

The kava-pyrones kavain and dihydromethysticin are constituents of Piper methysticum which possess muscle relaxant, anticonvulsant, analgesic and anxiolytic properties. In the present study the effect of both kava-pyrones were tested on field potential changes induced by the serotonin-1A agonist ipsapirone in the area CA1 and CA3 of the hippocampal slice preparation of guinea pigs. Ipsapirone induced positive field potential changes which were decreased in amplitude by the serotonin-1A antagonist NAN. The ipsapirone response was reduced by extracellular administration of kavain and dihydromethysticin in a dose-dependent manner down to 22·2 and 33·6%, respectively. It is suggested that kavain and dihydromethysticin modulate serotonin-1A receptor activity which may be of importance in the anti-anxiety action of kava-pyrones. © 1997 John Wiley & Sons, Ltd.     

OCULAR COMPLICATIONS IN HAEMODIALYSIS AND RENAL TRANSPLANT PATIENTS

Abstract
115 patients on haemodialysis and 160 renal transplant patients were examined over an eight year period. A high percentage in both groups were found to have ocular complications. These included disorders of the cornea, lens, retina, choroid, and optic nerve. In contrast to other studies on renal transplant patients a relatively large number had symptoms and even required surgery for cataract removal. 65 (40. 7%) had posterior sub-capsular cataracts. It is likely that nearly all were caused by the use of prednisone for immunosuppression. Of this number 25 (38.5%) had symptoms and 12 (18.5%) required cataract extraction. Pigmentary disturbances of the retinal pigment epithelium, together with vascular changes in the choroid were found in some. The implication of these relatively unknown complications, together with their possible aetiology, is discussed. The study emphasises the fact that all haemodialysis ana renal transplant patients should be monitored for ocular complications.     

A highly unusual cluster of acute promyelocytic leukaemia: an environmental aetiology?

We report three consecutive cases of acute promyelocytic leukaemia (APML) that were diagnosed within a 4‐month period. This unexpected sequence of events was made all the more notable following our discovery of co‐incidental geographic, social, and occupational factors that linked them together. Our data strongly suggests that environmental agents may play a greater role in the aetiology of APML than is commonly perceived.     

A novel approach to monitoring adherence to preventive therapy for tuberculosis in adolescence

OBJECTIVES: To evaluate the usefulness of a microelectronic tablet-dispenser for monitoring adherence to preventive therapy for tuberculosis infection in adolescents. METHODOLOGY: Twenty-one patients with positive Mantoux tests were treated with isoniazid (INH), dispensed in a microelectronic tablet-dispenser that recorded the date, time and duration that the container was opened. Other measures of adherence included attendance at clinic, patient self-report, tablet count, and measurement of urinary INH metabolites. RESULTS: The mean adherence rates were: 83% using attendance at clinic, 91% using tablet counts, 79% using urine assays, and 66% using the electronic tablet-dispenser. Self-reporting appeared to over-estimate adherence. CONCLUSION: Adherence to 6 months of INH calculated using different measures is higher in this study than in previous reports. Microelectronic tablet-dispensers are an effective method to objectively measure adherence on a daily basis. Other measures are less helpful.     

TUMOR LOCALIZATION AND SYSTEMIC ABSORPTION OF INTRAVESICAL INSTILLATION OF RADIO-IODINATED IODODEOXYURIDINE IN PATIENTS WITH BLADDER CANCER

PURPOSE: We evaluated tumor uptake and systemic distribution of intravesically instilled iododeoxyuridine (IUdR) in patients with superficial bladder cancer. MATERIALS AND METHODS: We performed 24 intravesical instillation studies in 11 patients with a mean age of 71 years. Radio-iodinated IUdR was administered through a Foley catheter. Gamma camera imaging was done after instillation and after 5 to 7 bladder irrigations. Tumor uptake was estimated by region of interest analysis. Bladder biopsy samples and surgical tumor specimens were tested for acid insoluble (deoxyribonucleic acid incorporated) radioactivity. Blood samples were obtained and analyzed for systemic absorption. RESULTS: Imaging was positive in all patients with bladder cancer. Average tumor uptake plus or minus standard deviation was 0.185+/-0.120% of the instilled dose. Preferential uptake of IUdR in the tumor was observed in all 6 patients undergoing tissue analysis. The tumor-to-normal bladder ratio ranged from 3.2 to 74,000 (median 202). Systemic absorption of IUdR was minimal. Blood sample analysis performed after intravesical instillation in all 11 cases revealed an average uptake of 3.2x10(-5)% instilled dose per ml. (range 0.69x10(-5) to 6.7x10(-5)) in the systemic circulation. Instillation within 24 hours after transurethral bladder tumor resection in 5 cases resulted in a higher but not dangerous average systemic uptake of 7.3x10(-4)% instilled dose per ml. (range 1.3x10(-5) to 2.6x10(-3)). Instillation 1 to 4 weeks after transurethral surgery in 8 cases resulted in no increased systemic absorption with an average blood level of 3.4+/-1.8x10(-5)% instilled dose per ml. There was no detectable distribution of radioactivity into other organs, including the thyroid. We noted no evidence of systemic toxicity in the study. CONCLUSIONS: Intravesical instillation of radio-iodinated IUdR achieves selective localization in the bladder tumor with minimal uptake by the normal bladder and minimal systemic absorption. The use of intravesical IUdR therapy for bladder cancer appears to be promising and requires further study.     

Comparison of the efficacy of blood and polyethylene glycol-hemoglobin in recovery of newborn piglets from hemorrhagic hypotension: effect on blood pressure, cortical oxygen, and extracellular dopamine in the brain

BACKGROUND: Successful blood substitutes, when infused in place of an equal volume of whole blood, provide similar delivery of oxygen to the tissues without introducing abnormalities in cellular metabolism. STUDY DESIGN AND METHODS: Equal volumes of whole blood (control), polyethylene glycol-hemoglobin solution at 6 g per dL, dextran solution, and physiologic saline were compared for their ability to reverse the effects of hemorrhagic hypotension on oxygenation and dopamine metabolism in the brain of newborn piglets. The decrease in mean arterial blood pressure was used as a measure of the hemorrhagic insult. Cerebral oxygen pressure was determined optically by the oxygen- dependent quenching of phosphorescence, and the extracellular level of dopamine in the corpus striatum was determined by in vivo microdialysis. RESULTS: Following a 2-hour stabilization after implantation of the microdialysis probe in the corpus striatum, the mean arterial blood pressure was decreased from 88 +/? 7 torr (control) to 42 +/? 5 torr by the removal of blood in a stepwise manner, over a period of 60 minutes. Decrease in mean arterial blood pressure caused a progressive stepwise decrease in cortical oxygen pressure from 48 +/? 5 torr to 16 +/? 4 torr at the end of bleeding. As a consequence of the decrease in oxygen pressure, extracellular dopamine increased progressively to about 2300 percent of the control value. When a volume of blood equal to that removed was returned and bicarbonate was injected to help correct arterial pH, blood pressure, cortical oxygen pressure, and extracellular dopamine all returned within the 20- to 30- minute recovery period to values not significantly different from control values. An equal volume of polyethylene glycol-hemoglobin solution, even with significantly lower hemoglobin content than whole blood, gave results comparable to those with whole blood. CONCLUSION: Polyethylene glycol-hemoglobin solution, like whole blood but in contrast to physiologic saline or dextran solution, was capable of returning the mean arterial blood pressure, cortical oxygen pressures, and extracellular dopamine nearly to control levels after acute blood loss in newborn piglets.