Management of cancer pain with oral controlled-release morphine sulfate

Morphine sulfate Contin (MSC) is an investigational matrix delivery system for oral morphine sulfate that allows for prolonged blood levels of morphine. Twenty-six patients with inadequately controlled cancer-related pain were examined in an open but controlled study using MSC. Initially, all patients were converted from the prestudy analgesic regimen to an equianalgesic amount of immediate-release morphine sulfate (IRMS) on a q4h dose schedule that was in turn titrated to the level of adequate pain relief. Patients then were switched to MSC q8h and eventually to q12h, starting at doses representing the same total daily amount of morphine that was in the final IRMS dose. Of the 18 patients who completed the study, all achieved satisfactory levels of analgesia on MSC, seven at q8h and 11 at q12h dosing intervals. All patients reported better analgesia while taking MSC compared with their previous regimen. Side effects associated with MSC included sedation and constipation but not nausea or respiratory difficulty. Significant drug tolerance did not develop during a mean follow-up period of four weeks (range, 1-18 weeks). MSC is an effective oral opioid analgesic that allows an increased dose interval without increased side effects or decreased potency. It can improve the quality of life of cancer patients by allowing them to be maintained without frequent dosing or parenteral medication.     

咯利普兰逆转豚鼠离体气管对沙丁胺醇的耐受性

本研究目的旨在观察ＰＤＥＩＶ抑制剂咯利普兰对沙丁胺醇（ＳＢ）耐受性的影响。用豚鼠离体气管标本，预先接触ＳＢ１μｍｏｌ·Ｌ－１，１ｈ可使ＳＢ对抗乙酰甲胆碱气管收缩作用的剂量反应曲线右移５倍，最大松弛率下降３０％，形成ＳＢ气管松弛作用的耐受性。磷酸二酯酶（ＰＤＥ）ＩＶ抑制剂咯利普兰能翻转ＳＢ气管松弛作用的耐受性，但ＰＤＥＩＩ抑制剂氰胍哒嗪则不能。虽然蛋白合成抑制剂环己酰亚胺对ＳＢ耐受性无预防作用，但上述结果仍提示ＳＢ气管松弛作用的耐受性可能与ＰＤＥＩＶ活性的增高有关。     

Chemopreventive effect of squalene on colon cancer

Epidemiologic and laboratory studies suggest a cancer protective effect and/or lack of a tumor promoting effect by dietary olive oil as compared with other types of non-marine oils. Squalene, a constituent of olive oil, and a key intermediate in cholesterol synthesis may be regarded as partially responsible for the beneficial effects of olive oil, which include decreased mortality rates among populations with high olive oil consumption. Thus, in this study we have assessed the chemopreventive efficacy of squalene on azoxymethane (AOM)-induced colonic aberrant crypt foci (ACF). In addition, we measured the effect of squalene on serum cholesterol levels in the rats. Male F34 rats (5 weeks old) were fed the control diet (modified AIN-76A) or experimental diets containing 1% squalene or 320 p.p.m. sulindac. Two weeks later, all animals except those in vehicle (normal saline)-treated groups were s.c. injected with AOM (15 mg/kg body wt, once weekly for 2 weeks). At 16 weeks of age, all rats were killed, colons were evaluated for ACF and serum was assayed for the cholesterol levels. As expected, dietary administration of sulindac suppressed ACF development and reduced crypt multiplicity, i.e. number of aberrant crypts/focus. Administration of dietary squalene inhibited total ACF induction and crypt multiplicity by approximately >46% (P < 0.001). Further, squalene at a level of 1% did not show any significant effect on serum cholesterol levels. Our finding that squalene significantly suppresses colonic ACF formation and crypt multiplicity strengthens the hypothesis that squalene possesses chemopreventive activity against colon carcinogenesis.      

Zoonotic tuberculosis due to Mycobacterium bovis in developing countries.

The World Health Organization (WHO) estimates that human tuberculosis (TB) incidence and deaths for 1990 to 1999 will be 88 million and 30 million, respectively, with most cases in developing countries. Zoonotic TB (caused by Mycobacterium bovis) is present in animals in most developing countries where surveillance and control activities are often inadequate or unavailable; therefore, many epidemiologic and public health aspects of infection remain largely unknown. We review available information on zoonotic TB in developing countries, analyze risk factors that may play a role in the disease, review recent WHO activities, and recommend actions to assess the magnitude of the problem and control the disease in humans and animals.     

Experimental intracranial septic infarction: magnetic resonance enhancement

Intracranial brain abscess was produced in three monkeys by embolization of a small pledget of polyvinyl alcohol (PVA) soaked in a broth of Staphylococcus aureus. Imaging of the chronic stable abscess was performed on the General Electric 8800 CT unit (Milwaukee, Wis.) and a 1.4 T superconducting small bore imaging system. Magnetic resonance imaging included saturation recovery, inversion recovery, and spin echo techniques. MR imaging was also performed after paramagnetic enhancement using gadolinium-DPTA (Gd-DTPA). Our results show that paramagnetic enhancement with T1-weighted imaging adds specificity and enables rapid assessment of abnormalities of the blood-brain barrier. T2-weighted imaging without paramagnetic enhancement was very sensitive in defining areas of abnormality in the brain but in our experiment lacked specificity. T2-weighted imaging with Gd-DTPA demonstrated no obvious change in the appearance of the lesion. The combination of T1-weighted Gd-DTPA and T2-weighted imaging appeared complementary in our experiment, and these images correlated well with the pathologic findings.     

A MANAGEMENT INFORMATION SYSTEM FOR MEDICAL SERVICES AT COMMAND HEADQUARTERS

Management information system (MIS) is increasingly being used for information storage, handling, processing and retrieval of data for improving the services provided by any organisation. It allows quick decision making for overall functional improvement. Headquarters Central Command (Medical) Lucknow has developed software for data capturing in respect of six important functional areas. These include employability and availability of specialist officers, assessment of hospital services through functional update and monitoring team (FUMTs), patient satisfaction survey, user commanders opinion, state of critical items of hospital clothing and modernisation of hospitals. This automation has resulted in quick and scientific decision making for improving the medicare services to the clientele.KEY WORDS: Management information system, Software, Medical decision making, Medical staff     

De novo development and self-replenishment of B cells

Previous studies distinguished two murine B cell lineages: theconventional lineage, which comprises the majority of B cells,and the Ly-1 B lineag (B-1a), which represents a small percentageof total adult B cells. A third subset, B-1b cells, shares manyproperties with B-1a cells, including the characteristic abilityto self-replenish, but does not express Ly-1 (CD5). Reconstitutionstudies presented here show that (i) although the B220^–population in adult spleen and bone marrow contains very littleprogenitor activity for B-1a cells, it can reconstitute roughlyhalf the normal number of B-1b cells; (ii) B-1 progenitors presentin adult bone marrow and spleen function at low levels in adultanimals; (iii) peritoneal B-1 cells (principally B-1b) thatdevelop following bone marrow transfer, like B-1 cells fromnormal animals, are capable of substantial self-replenishment;and (iv) conventional B cells do not expand (self-replenish)in adoptive recipients, although they can persist for long periods.Collectively, these progenitor and self-replenishment characteristicsprovide a developmental base for distinguishing B-1a, B-1b andconventional B cells.