Pharmacokinetics of vindesine bolus and infusion

Summary The pharmacokinetics of vindesine were investigated during treatment of 15 patients with progressive malignancies refractory to conventional treatment. Patients were administered one of three IV dose schedules: 3.0 mg/m² bolus injection, 1.2 mg/m²/day infusion for 5 days, or 2.0 mg/m²/day infusion for 2 days. Concentrations of the drug in the serum and urine were determined by radioimmunoassay. Serum concentrations were highest (5×10^-7 M) in patients receiving a bolus injection, but fell to nondetectable levels by 48 h in four of five patients (terminal t_1/2 15.0±9.4 h). Compared with bolus injection, 1.2-to 1.4-fold greater areas under the blood concentration curve were observed during infusions of 2.0 mg/m² and 1.2 mg/m². Whereas steady-state concentrations (1×10^-8 M) were maintained throughout the infusion of 1.2 mg/m²/day progressively increasing serum levels were observed during the infusion of 2.0 mg/m²/day. Serum concentrations fell rapidly following discontinuation of the 2.0-mg/m² infusion, but were somewhat more sustained in the 1.2-mg/m² infusion group. The average urinary excretion was similar for each dose-schedule (8%–11% of the total dose). The pharmacokinetics of vindesine are influenced by variations in dose schedule.     

Safety and efficacy of thulium laser resection of bladder tumors versus transurethral resection of bladder tumors: a systematic review and meta-analysis

Lasers in Medical Science - The thulium laser resection of bladder tumor (TmLRBT) is widely used in the treatment of non-muscle-invasive bladder cancer (NMIBC), and we conduct this study to compare...     

Enzyme activities associated with the demyelinating phase of canine distemper

Summary Canine distemper, a naturally occurring viral disease of dogs which often terminates in parainfectious demyelination, was used as a model to study the role of acid proteinase, neutral proteinase and beta-glucuronidase in demyelination. These enzymes were higher in cerebella of dogs with distemper-associated demyelination than in age-matched controls. The highest elevations corresponded with the most severely demyelinated cerebella. The source of the increased enzymes activities was apparently unrelated to the lymphocytes present in areas of demyelination.The direct effect of distemper virus and serum on these enzymes was tested in canine glial monolayers. Virus infection resulted in lower enzyme activities in cells concomitant with the appearance of cellular lesions. There was a relative increase of beta glucuronidase activity in the media suggesting that distemper virus released pre-formed lysosomal enzymes. Serum which was obtained from dogs with distemper-associated demyelination and had previously demyelinated cerebellar explants, also decreased activities of all 3 enzymesin vitro.The 3 enzymes were measured in gerbil brains at various time intervals following unilateral cerebral infarction to determine if processes other than demyelination also caused these enzymes to be increased. Uncomplicated ischemic necrosis (24 h post infarction) did not alter the activities of these enzymes. Invasion of macrophages to ingest and digest necrotic tissue 10 days after infarction resulted in greatly increased acid proteinase and beta-glucuronidase, but unchanged neutral proteinase, activities.It was concluded that the increased activities of acid proteinase and beta-glucuronidase in demyelinated tissue probably are derived from macrophages ingesting damaged tissue. Neutral proteinase may be more specifically involved in the demyelinating process since this is partially located within myelin and can degrade the basic protein of myelin.Supported in part by Research grant Nos. GM 1052 and Al-09022 from National Institutes of Health Service, U.S. Public Health Service.     

The optical characteristics of aiming scopes in archery

Technical advancements in target archery have been extended to widespread use of "scopes" which magnify the target. In fact, these optical devices are simple converging lenses used at an arm's length from the eye. They produce a magnified image, but it is an image that suffers from significant dioptric blur, diminished somewhat by use of a peep sight in the bowstring which functions as an aperture stop. Visual acuities were taken with these scopes and, as might be expected, it was found that subjects saw no better with them. With the highest power scopes, acuity actually decreased. Experienced archers did slightly better with these aids than those with no archery experience.     

重度蒸汽吸入性损伤犬伤后肿瘤坏死因子水平的改变及其意义

目的研究蒸汽吸人性损伤犬伤后血浆肿瘤坏死因子水平的改变及其与吸入性损伤呼吸循环功能受损程度的关系.方法取犬15条,以蒸汽致重度吸入性损伤,分别于伤前、伤后1h、2h、3h、4h观察有呼气相气道阻力(RE)、心率(HR)、心输出量(CO)、动脉血氧分压(PaO2)、血浆TNF水平;伤后4h致死动物,取肺做病理检查.结果伤后1hTNF、RE升高,HR、CO、PaO2下降;TNF与RE正相关(r=O.965,P<O.01),与CO负相关(r=-0.824,P<O.05).结论严重蒸汽吸入性损伤激发TNF分泌,这是诱发肺损伤及循环系统甚至全身器官功能障碍的重要原因.     

Considerations for inter-hospital extracorporeal cardiopulmonary support resuscitation and transport

The availability of commercial, pre-packaged extracorporeal cardiopulmonary support (ECPS) circuits, which are simplified for rapid set-up and priming, has made the intra-hospital resuscitation of moribund patients routine. The successful utilization of this technology in the emergent setting requires planning and the coordination of personnel familiar with the technology. Many issues must be addressed when a patient requiring life-sustaining support utilizing this technology at an outlying hospital, must be transported while on ECPS. After reducing the size and weight of the ECPS cart and obtaining Federal Aviation Administration approval for use during aeromedical transport, the Emanuel Hospital Mobile Surgical Transport Team (MSTT) was able to extend the use of emergency cardiopulmonary bypass to outlying medical facilities. The patients selected for transport, using ECPS, are a group of patients with a potentially survivable pathology unlikely to survive inter-hospital transport without such measures. This report describes our experience with inter-hospital transport of patients on ECPS with special emphasis on transport considerations.     

CLINICO-EPIDEMIOLOGICAL ALGORITHM FOR PREDICTING SYSTEMIC ARTERIAL HYPERTENSION AT HIGH ALTITUDE THROUGH MATHEMATICAL MODELLING

A population based hybrid design combining element of cohort and cross-sectional approach was used to develop a simple clinical algorithm to predict individual probability of developing hypertension (systolic BP > 140 mm Hg and/or diastolic BP > 90 mmHg). 3615 soldiers initially normotensive at the time of induction into high altitude, were studied by systematic random sampling. Multiple logistic regression analysis showed a high significant association between hypertension and age, body mass index (BMI), tobacco smoking and alcohol consumption. Using the constant/coefficient values obtained from the logistic model and the receiver operating characteristics (ROC) curve analysis, the following predictive rule was developed – To the age in years, add (BMIx 3.86); also add 5.53 if he is a smoker; and add 19.81 if he consumes alcohol. If the total exceeds 142, the individual is at high risk of developing hypertension. This algorithm carries a sensitivity of 68.2% and specificity of 78.5%.KEY WORDS: Hypertension, High altitude