Current pharmacologic testing for horner syndrome

First described in 1727, Horner syndrome occurs from injury to one of the three neurons in the oculo-sympathetic pathway. Its presence can be confirmed with pharmacologic testing, traditionally including cocaine testing with hydroxyamphetamine localization. More recently, apraclonidine testing has become a viable alternative in some practices. Concern has been raised regarding the possibility of false-negative results with apraclonidine testing as well as the safety of its use in young children.     

Idiopathic edema is associated with obstructive sleep apnea in women

BACKGROUND AND PURPOSE: This study was undertaken to clarify whether idiopathic edema is a marker for obstructive sleep apnea (OSA), independent of level of obesity, in patients with normal left ventricular function. PATIENTS AND METHODS: Seventy-eight ambulatory, obese, adults, 44 with bilateral, pitting pre-tibial edema, and 34 without edema, from an inner city family practice and a suburban family practice enrolled from July 1995 until March 2003. Edematous subjects, but not non-edematous subjects, underwent echocardiography, urinalysis, and blood test evaluations to ensure that cardiac, renal, hepatic, and thyroid functions were normal. All subjects underwent spirometry, pulse oximetry on room air, and polysomnography evaluations. RESULTS: Compared to the non-edematous subjects, the edematous subjects were more obese (body mass index=47.0+/-9.3 versus 36.5+/-4.6 kg/m2, P=0.002), had more severe OSA (apnea-hypopnea index (AHI)=34.1+/-27.7 versus 17.0+/-19.4, P=0.002), and had lower oxygen saturations (96.2+/-2.0 versus 97.1+/-1.5%, P=0.05). Using an AHI > or = 15 as the criteria for diagnosing OSA, there was an association between edema and OSA in women (P=0.02) but not men. CONCLUSIONS: In subjects with normal left ventricular function, idiopathic edema is associated with OSA in women.     

Doxorubicin loaded Polymeric Nanoparticulate Delivery System to overcome drug resistance in osteosarcoma

Background  

Drug resistance is a primary hindrance for the efficiency of chemotherapy against osteosarcoma. Although chemotherapy has improved the prognosis of osteosarcoma patients dramatically after introduction of neo-adjuvant therapy in the early 1980's, the outcome has since reached plateau at approximately 70% for 5 year survival. The remaining 30% of the patients eventually develop resistance to multiple types of chemotherapy. In order to overcome both the dose-limiting side effects of conventional chemotherapeutic agents and the therapeutic failure incurred from multidrug resistant (MDR) tumor cells, we explored the possibility of loading doxorubicin onto biocompatible, lipid-modified dextran-based polymeric nanoparticles and evaluated the efficacy.     

Adenocarcinoma in ileal duplication cyst: Case report and review of literature

Adenocarcinomas of Ileal Duplication Cysts are an extremely rare occurrence, this is a case report and review of current literature as to the best management of this condition.     

Intraocular Sustained-Release Delivery Systems for Triamcinolone Acetonide

Recently, the use of triamcinolone acetonide (TA) injection has increased dramatically in treatment for several ocular diseases. Among them, macular diseases such as macular edema due to diabetic retinopathy, venous occlusive diseases, ocular inflammation and age-related macular degeneration (AMD) are very common vision threatening disorders and are great challenges to treat. In these types of chronic retinal diseases, repeated intraocular injections of TA are often required which increases the likelihood of complications. In order to achieve sustained-release, maintain therapeutic levels of TA over longer times and reduce frequency of intravitreal injections, researchers are investigating different implantable devices or injectable systems. However, as of yet, there is no sustained-release product for TA available on the commercial market. This review discusses and compares different sustained-release devices or injectable systems that are currently being developed. Supported by the Discovery Eye Foundation, Henry L. Guenther Foundation, Iris and B. Gerald Cantor Foundation and the Research to Prevent Blindness Foundation.     

Cyp1b1 protein in the mouse eye during development: an immunohistochemical study.

We show, for the first time, the spatiotemporal appearance of Cyp1b1 protein during mouse eye ontogeny. The protein was unambiguously identified in the adult mouse eye and newborn (P0) whole mouse microsomes and was shown to be localized in inner ciliary epithelium, corneal epithelium, retinal inner nuclear cells, and ganglion cells. The enzyme protein was present in the lens epithelium adjacent to the developing ciliary body at 15.5 days postconception (E15.5) and was most strongly expressed during E17.5 to 7 days postnatally (P07). Subsequently, it declined to very low levels. The protein was also expressed in the corneal endothelial cells adjacent to the ciliary body at P07. Cyp1b1 was barely detectable in the inner ciliary epithelium before E17.5 but increased rapidly postnatally, reaching adult levels by P28. Levels of the enzyme protein in the corneal epithelium were seen from E15.5 onward, increasing sharply, and after a decrease at P07, were highest in the adult animal eye. The presence of Cyp1b1 protein in the inner nuclear layer of the retina was very low in the prenatal eye, increasing rapidly postnatally, and was highest in the adult animal eye. In the ganglion cell layer of the retina, it increased slowly from E15.5 to P07 and then rapidly reached adult levels. Interestingly, Cyp1b1 was not detected in the trabecular meshwork at any stage of development or in the adult eye. We conclude that the enzyme may play important roles in normal eye development and function in mice as in humans, and that the mouse may prove to be an excellent model for determination of the roles of CYP1B1 in human eye development and function.     

Biodegradable poly(epsilon -caprolactone) nanoparticles for tumor-targeted delivery of tamoxifen

To increase the local concentration of tamoxifen in estrogen receptor (ER) positive breast cancer, we have developed and characterized nanoparticle formulation using poly(epsilon -caprolactone) (PCL). The nanoparticles were prepared by solvent displacement method using acetone-water system. Particle size analysis, scanning electron microscopy, zeta potential measurements, and differential scanning calorimetry (DSC) were used for nanoparticle characterization. Biodegradation studies were performed in the presence and absence of Pseudomonas lipase in phosphate-buffered saline (PBS, pH 7.4) at 37 degrees C. Tamoxifen loading over different concentrations was analyzed by high-performance liquid chromatography (HPLC) and the optimum loading concentration was determined. In vitro release studies were performed in 0.5% (w/v) sodium lauryl sulfate (SLS) containing PBS at 37 degrees C. Cellular uptake and distribution of fluorescent-labeled nanoparticles was examined in MCF-7 breast cancer cells. SEM micrographs and Coulter analysis showed nanoparticles with spherical shape and uniform size distribution (250-300 nm), respectively. Zeta potential analysis revealed a positive surface charge of +25 mV on the tamoxifen-loaded formulation. Being hydrophobic crystalline polyester, PCL did not degrade in PBS alone, but the degradation was enhanced by the presence of lipase. The maximum tamoxifen loading efficiency was 64%. Initial burst release of tamoxifen was observed, probably due to significant surface presence of the drug on the nanoparticles. A large fraction of the administered nanoparticle dose was taken up by MCF-7 cells through non-specific endocytosis. The nanoparticles were found in the perinuclear region after 1 h. Results of the study suggest that nanoparticle formulations of selective ER modulators, like tamoxifen, would provide increased therapeutic benefit by delivering the drug in the vicinity of the ER.     

Preparation and in vitro characterization of a eutectic based semisolid self-nanoemulsified drug delivery system (SNEDDS) of ubiquinone: mechanism and progress of emulsion formation

The objectives of the present work were, first, to develop a self-nanoemulsified drug delivery system (SNEDDS) based on the eutectic properties of ubiquinone (CoQ10); and second, to study the progress of emulsion formation and drug release mechanisms by turbidimetry and droplet size analysis. Binary phase diagrams of CoQ10 with menthol and essential oils were constructed and used to develop the self-nanoemulsified formulation. Pseudo ternary phase diagram was constructed to identify the efficient self-emulsification region. Release mechanisms of the resultant formulas were quantified using turbidimetry in combination with dissolution studies. Turbidity time profiles revealed three distinctive regions: lag phase, plateau, and the pseudolinear phase. Lag phase was attributed to the liquid crystalline properties of the formula. Plateau turbidity was correlated with droplet size. Laser diffraction analysis revealed an average droplet diameter of 100 nm. Emulsification rate was obtained from the corrected slope of the pseudolinear phase of the profile. Stability of the formula was further evaluated using Fourier transform-infrared (FT-IR) attached to an attenuated total reflectance (ATR) accessory. The present study revealed a eutectic based semisolid self-emulsified delivery system that can overcome the drawbacks of the traditional emulsified systems such as low solubility and irreversible precipitation of the active drug in the vehicle with time.