Non-stationary pharmacokinetics of bupivacaine during continuous interpleural infusion

The study presented here was undertaken to assess the time-associated changes in disposition of bupivacaine during continuous interpleural infusion. Seven female patients undergoing open cholecystectomy received a continuous interpleural infusion of bupivacaine (25 mg/hr) for 72 hours after an initial bolus dose of 50 mg. Blood concentrations of bupivacaine (determined by gas chromatography) at defined time intervals were then modelled using a two-compartment model. Peak blood concentrations of 1.68 μg/ml (range 0.97 to 2.49 μg/ml) were measured in all patients at 48 hours and then declined significantly over the subsequent 24 hours. This was paralleled by a significant apparent increase in clearance. Therefore, we could not confirm the widely postulated accumulation of bupivacaine over long-term infusion; on the contrary we found non-stationary kinetics with decreasing concentrations and increasing clearance over 72 hours, explicable either by changes in hepatic clearance or alteration in protein binding.     

Plasma exchange does not improve survival in a canine model of human septic shock

Whether plasma exchange would improve survival in antibiotic-treated canines with septic shock was investigated. Escherichia coli O86H8 (1.4 × 10(10)) was surgically implanted as an intraperitoneal clot in 18 two- year-old (10-12 kg) purpose-bred beagles. Beginning 4 hours after surgery, all animals received cefoxitin and gentamicin for 5 days. Three treatment groups were defined: 1) a no apheresis, or control group, (n = 6); 2) a sham apheresis group, whose whole blood plasma was removed, separated, and then transfused (n = 6); and 3) a plasma exchange group from whom blood and plasma were removed and separated, to whom the blood was returned, and in whom infected plasma was replaced with compatible fresh-frozen canine plasma (n = 6). For the sham apheresis and plasma exchange groups, a commercial blood cell processor was used to separate 1.5 blood volumes of plasma at 5 and 24 hours after surgery. Serial radionuclide left ventricular ejection fractions and femoral and pulmonary arterial catheter hemodynamics were measured simultaneously in awake animals. All six animals in the plasma exchange group died. In both the sham and control groups, only one of six animals survived. Survival times were ordered (median in hours) (control [372 h] > sham apheresis [48 h] > plasma exchange [24 h] [p < 0.038]). Decreases in mean cardiac index and mean arterial pressure (from before apheresis to after) at 5 to 7 hours after surgery were ordered (plasma exchange > sham apheresis > control; p < 0.03). Thus, plasma exchange in this controlled trial of septic shock was associated with decreased survival and worsened hemodynamics.(ABSTRACT TRUNCATED AT 250 WORDS)     

PAROTOID TUMOURS: A STUDY OF 65 CASES

Sixty five patients who had undergone surgery for parotid tumours over a period of nine years were studied retrospectively. There were 45 males and 20 females. There were 49 benign and 16 malignant tumours. Age ranged 35-69 years; mean 47 years. Pain (6%) and facial palsy (3%) were unusual features. Size of tumour at presentation varied from 1.5 to 12 cm. Superficial parotidectomy was the commonest operation performed and Total/Radical/Extended parotidectomy was done in selected cases. Postoperative radiotherapy was used in six cases. No recurrences were noted following surgery for benign tumours. However a local recurrence rate of 37% was found for malignancies (6/16 cases). This paper aims to review the experience of managing these tumours in the setting of service hospitals.KEY WORDS: Carcinoma parotid, Parotid tumour, Pleomorphic adenoma     

LIVER RESECTION FOR METASTASES FROM COLORECTAL CANCER

Five percent of patients with liver secondaries from colorectal carcinoma are potentially resectable and several studies have demonstrated significantly improved survival following resection. Two hundred and ten patients operated for colorectal carcinoma were followed up. Computed tomography confirmed potentially resectable metastasis to the liver in 38. On exploration 18 patients who had 4 or less hepatic metastases and no extrahepatic disease, underwent resection of their secondaries. Fourteen were males and 4 females with a mean age of 43.5 (SD 13.6, range 18-72) years. Ten patients presented with synchronous liver metastasis and 8 had metachronous disease. There was no post-operative mortality. All 18 have been followed up. for a median period of 23.5 (range 12-38) months. Seven patients are alive and well with no evidence of recurrence at a median period of 28 months (survival 39%). Four are alive with local recurrence in the liver. Median time to recurrence was 22 months. Seven patients have died of disseminated disease. The disease free survival at 28 months is 39% and the overall survival 61%. A close follow-up protocol for all patient undergoing curative surgery for colorectal cancer is essential, if such patients are to be selected early.KEY WORDS: Colorectal cancer, Liver resection, Metastases     

表面活性剂用于黄酮药物的薄层色谱分离鉴定的研究

The micellar thin layer chromatographic behaviours of rutin, quercetin and morin were studied. The methods of separation and identification were established: Polyamide thin coating was used as the stationary phase and 4% Zeph--acetylacetone--H2O (5:1.5:1.5) used as the mobile phase. The method was applied to the separation and identification of quercetin and rutin in samples of Sophorae flos and satisfactory result was obtained.     

促性腺激素释放多肽(GRP)对体外培养小鼠垂体分泌LH的影响

合成的促性腺激素释放多肽(GRP)及其类似物GRp～NH₂,[Glu^7.9.14Lys^6.10]GRP(6～14),[phe¹⁴]GRP(5～14)和[phe¹⁴]GRP浓度在0.05mmol·L^-1时,具有刺激体外培养的小鼠垂体分泌LH的作用。其活性依此相当对照垂体的115.4,114.2,140,160和179%。小鼠于妊振第7～9天或第1～5天,每只sc[phe¹⁴]GRP1mg·d^-1,或于妊娠第2～4天每只sc[phe¹⁴]GRP(5～14)1mg·d^-1,有40～60%的妊娠动物出现死胎。     

A1, a Bcl-2 family member, prolongs cell survival and permits myeloid differentiation

A1, a bcl-2 family member, has been identified as a hematopoietic- specific, early inducible gene. In this study it is shown that stable transfection of A1 into an interleukin-3 (IL-3)-dependent myeloid precursor cell line, 32D c13, leads to a retardation of IL-3 withdrawal- induced cell death similar to that observed with transfection of bcl-2. However, unlike bcl-2. A1 expression permits the accumulation of differentiated myeloid cells both before and after IL-3 withdrawal. Total cell accumulation, on the other hand, is considerably greater after IL-3 deprivation in the bcl-2 transfectant than in A1-expressing cells. Cells cotransfected with the two genes behave similarly to cells singly transfected with bcl-2, except that viability following IL-3 withdrawal is somewhat further enhanced. These results suggest that these two proteins have distinct roles that may be related to the divergent regulation of their expression during myeloid differentiation.