Effects of RSR13, a synthetic allosteric modifier of hemoglobin, alone and in combination with dizocilpine, on outcome from transient focal cerebral ischemia in the rat

This study examined the effect of a pharmacologically induced rightward shift in the partial pressure of oxygen at which 50% of hemoglobin is saturated (P50) on outcome from transient focal cerebral ischemia in the rat. Halothane anesthetized rats (n=20 per group) were given saline or a single 15-min infusion of 150 mg/kg RSR13 (2-[4-[[3,5-dimethylanilino) carbonyl]methyl]phenoxy]-2-methylproprionic acid) intravenously before or 30 min after onset of 75 min of middle cerebral artery filament occlusion (MCAO). Seven days later, severity of hemiparesis and cerebral infarct size were examined. RSR13 alone did not significantly improve outcome. Conscious normothermic rats (n=12 per group) were also given RSR13 (150 mg/kg) or 0.9% NaCl intravenously and subjected to 75 min of MCAO with 7 days of recovery. Again, RSR13 alone did not significantly reduce infarct size or improve neurologic score. A dose-response curve for dizocilpine (MK-801) was then constructed in conscious normothermic rats subjected to 75 min of MCAO. Dizocilpine (0.5 mg/kg i.v.) caused a 90% reduction in mean infarct size while 0.25 mg/kg reduced infarct size by 48%. Other rats were then subjected to 75 min of MCAO after being given dizocilpine (0.25 mg/kg i.v.; n=18) or RSR13 (150 mg/kg i.v. )+dizocilpine (0.25 mg/kg i.v.; n=15). RSR13+dizocilpine resulted in smaller cortical infarct volume (8+/-14 mm3 vs. 34+/-37 mm3, p<0.02) and total cerebral infarct volume (46+/-28 mm3 vs. 81+/-60 mm3, p<0. 05) compared to dizocilpine alone, respectively. We conclude that a pre-ischemic peak increase in P50 of approximately 25 mmHg alone is insufficient to reduce focal ischemic injury, but may be advantageous when used in conjunction with other neuroprotective agents.     

Lung cancer risk in male workers occupationally exposed to diesel motor emissions in Germany.

BACKGROUND: Although in several epidemiological studies exposure to diesel motor emissions (DME) shows an elevated lung cancer risk, it is still controversial whether DME is a human carcinogen. METHODS: In a pooled analysis of two case-control studies on lung cancer in Germany a total of 3498 male cases with histologically or cytologically ascertained lung cancer and 3541 male population controls were included. Information about lifelong occupational and smoking history was obtained by questionnaire. Drivers of lorries, buses, taxies, diesel locomotives and forklift trucks, bulldozers, graders, excavators, and tractors, were considered as exposed to DME and their cumulative exposure was estimated. All odds ratios were adjusted for smoking and asbestos exposure. RESULTS: The evaluation of lung cancer risk for all jobs with DME-exposure combined showed an odds ratio of OR=1.43 (95%-CI: 1.23-1.67). Most pronounced was the increase in lung cancer risk in heavy equipment operators (OR=2. 31 95%-CI: 1.44-3.70). The risk of tractor drivers increased with length of employment and reached statistical significance for exposures longer than 30 years (OR=6.81, 95%-CI: 1.17-39.51). The group of professional drivers (e.g., trucks, buses, and taxies), showed an increased risk only in West Germany (OR=1.44, 95%-CI: 1. 18-1.76), but not in East Germany (OR=0.83, 95%-CI: 0.60-1.14). DME-exposure in other traffic related jobs (e.g., diesel engine locomotive drivers, switchmen, forklift operators) was associated with an odds ratio of OR=1.53 (95%-CI: 1.04-2.24). CONCLUSIONS: The study provides further evidence that occupational exposure to diesel motor emissions is associated with an increased lung cancer risk.     

Primary vitrectomy without scleral buckling for rhegmatogenous retinal detachment

Background: Pars planta vitrectomy has evolved as an alternative method in the treatment of more complicated rhegmatogenous retinal detachments. We report a series of patients who underwent primary vitrectomy with gas tamponade without the use of additional scleral buckling. Methods: A retrospective study of 53 patients with a follow-up of 6–45 months (mean 17.8 months) was carried out. Preoperative findings included unusual, multiple or large breaks, vitreous haemorrhage, proliferative vitreoretinopathy and bullous retinal detachment. Preoperative visual acuity was between light perception and 1.0, with 30% (16/53) of patients with 0.4 or better. Results: Retinal reattachment was achieved in 64% of cases (34/53) with one and in 92% (49/53) with one or more operations. Final visual acuity was between light perception and 1.0, with 41% (22/53) of patients with 0.4 or better. Cataract formation occurred in 86% (37/43) of all patients with a clear lens preoperatively. Macular pucker was noted in 11 % (6/53) and postoperative proliferative vitreoretinopathy causing redetachment in 6% (3/53). Conclusion: With primary vitrectomy, a high final anatomical success rate with few intraoperative complications can be achieved in more complicated forms of rhegmatogenous retinal detachment. The major drawback of the procedure is the high incidence of post-operative cataract formation.     

Satisfaction with nursing homes. The design of employees' jobs can ultimately influence family members' perspectives

Organizational commitment on the part of nursing home employees can be a determinant of service quality. Proper design of health care jobs and clarity of roles make employees feel more dedicated to their jobs, enable them to do their jobs well, and enhance family members' evaluations of nursing home care. When management develops a dynamic, interactive, high-quality environment, nursing home employees feel encouraged to report shortcomings without fear because they are involved in the process.     

Small artery reconstruction with a new vascular prosthesis

In the Surgical Department of the University of Erlangen, 307 reconstructions in all areas of the arterial tree were performed with PTFE (GORE-TEX^®) grafts, of which 188 were performed in the femoral-popliteal and femoral-crural areas. Femoral-popliteal bypass grafts above the knee joint remained patent in 93% of the patients during an average follow-up time of 6.7 months. Below the knee joint, the patency rate was 85% during an average follow-up time of 5.6 months. In the proximal aorta, aorta-renal, and aorta-femoral areas, long-term results with the PTFE graft have been excellent.     

Influence of the concentration of metipranolol eye drops on the drug concentration in human aqueous humour

The concentration of the metabolite of the beta-blocker metipranolol was determined in the aqueous humour of 89 cataract patients. At 1, 2 or 5 h before surgery, they received one drop (30 l) of a 0.1 % or 0.3% solution of the drug. At 1, 2 or 5 h after the application of 0.1 % metipranolol eye drops, desacetylmetipranolol concentrations of 624.55, 235.29 and 88.02 ng/ ml, respectively, were measured. At the same intervals after the instillation of 0.3% metipranolol eye drops, the respective values of 1289.20, 1120.88 and 327.36 ng/ ml were found. The metabolite concentration in the eye drops and the values measured show no consistent correlation.Offprint requests to: H. Bleckmann     

Effect of photocorrosion on cadmium sulfide suspensions applied in animal inhalation studies with CdS particles

Cadmium sulfide aerosol (90 g Cd/m³) was generated from an aqueous suspension for 12 weeks and the ratio of Cd⁺⁺/Cd_total in the suspension and the resulting aerosol was determined. After 4 weeks the concentration of Cd⁺⁺ in the suspension and the aerosol leveled off at 43.5±11.4% and 35.8±6.8%, respectively. Therefore, lung tumors in rats observed after inhalation exposure to such CdS aerosols (Glaser et al. 1990) may have been caused not only by the effect of CdS but also by the influence of inhaled Cd⁺⁺ or CdSO₄. The contribution of CdS particles to the observed lung tumor rate depends on the bioavailability of CdS retained in the lungs. The photochemical decay of CdS in aqueous suspensions only occurred when exposed to light and adjusting the suspension up to pH 3 did not increase the decomposition rate of CdS. Ethanolic suspensions of CdS are much more stable than aqueous ones and experiments with suspensions kept under shield gases showed that the decay of CdS is not dependent on oxygen.     

Stoff und Applikationsart beim Drogenkonsum Jugendlicher

Zusammenfassung In einer Stichprobe von 382 schweren Drogenkonsumenten wurden Art und Ausmass des Drogenkonsums unter Berücksichtigung der Applikationsart der Stoffe erfragt und die Angaben einer Faktorenanalyse unterworfen. Es bildeten sich drei Faktoren mit den Kurzbezeichnungen «intravenös applizierte illegale Drogen», «oral applizierte illegale Drogen» und «oral applizierte Medikamente». Dies weist darauf hin, dass sich «intravenös spritzen» von den übrigen Applikationsarten eindeutig unterscheidet und dass die Definitionen des Betäubungsmittelgesetzes ein starkes Kriterium für die Einstellung der Drogenkonsumenten den Stoffen gegenüber ist. Pharmakologische Gesichtspunkte und solche der subjektiven Wirkung der Stoffe erlangen daneben kaum sichtbare Bedeutung.

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Drugs and their modes of application — a factor analytic inquiry of drug abuse

Summary In a sample of 382 heavy users mode and extent of drug abuse were inquired. Factor analysis of the data gave three factors named i.v. applicated illegal drugs, oral applicated illegal drugs and oral applicated medicaments for short. Results show that attitudes of the drug users towards their drugs are strongly influenced by the mode of application and the definitions of the drug laws, whereas pharmacological aspects and subjective effects have hardly any demonstrable importance.

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Drogues et leurs modes d'application — une enquête concernant la consommation abusive de drogues utilisant l'analyse factorielle

Résumé Une enquête sur mode et quantité de l'abus de drogues a été faite dans un échantillon de 382 graves consommateurs de drogues. L'analyse factorielle des données mène à trois facteurs abbréviés: «drogues illégales appliquées i.v.», «drogues illégales appliquées per os» et «médicaments appliqués per os». En regardant ces résultats on peut dire que les attitudes des consommateurs envers les drogues sont tout d'abord influencées par la mode d'application et les définitions des lois concernant les narcotiques, pendant que des points de vue pharmacologiques et les effects subjectifs n'ont peu d'importance.

     

Effect of implant design and endplate preparation on the compressive strength of interbody fusion constructs

STUDY DESIGN: A human cadaveric study on the compressive strength of different lumbar interbody fusion implants and endplate preparation techniques was performed. OBJECTIVES: To assess the axial compressive strength of an implant with peripheral endplate contact as opposed to full surface contact, and to assess whether removal of the central bony endplate affects the axial compressive strength. SUMMARY OF BACKGROUND DATA: The compressive strength of interbody fusion constructs has been compared between implants and bone grafts. Neither implant design nor endplate preparation has been shown to affect strength. Removal of the central bony endplate for bone grafts was noted to improve graft incorporation but also to facilitate subsidence. METHODS: A total of 44 vertebrae were tested in four experimental groups by combining two interbody implants (full-surface vs peripheral surface support) with two endplate preparation techniques (intact bony endplate vs removal of the central bony endplate). Specimens were tested to ultimate compressive failure using a 50 N/second ramped load. Yield strength and ultimate compressive strength were compared between groups using two-factor analysis of covariance. A P value less than 0.05 was considered significant. Stepwise linear regressions assessed the predictive power of age, bone mineral content, and the implant's normalized endplate coverage on yield strength and ultimate compressive strength. RESULTS: Neither implant design nor endplate preparation technique affected yield strength or ultimate compressive strength. Age, bone mineral content, and the normalized endplate coverage were strong predictors of yield strength (P < 0. 0001; r2 = 0.459) and ultimate compressive strength (P < 0.0001; r2 = 0.510). CONCLUSIONS: An implant with only peripheral support resting on the apophyseal ring offers axial mechanical strength similar to that of an implant with full support. Neither supplementary struts nor a solid implant face has any additional mechanical advantage, but reduces graft-host contact area. Removal of the central bony endplate is recommended because it does not affect the compressive strength and promotes graft incorporation.     

Local anaesthetic injection with and without corticosteroids for subacromial impingement syndrome

Fifty patients with impingement syndrome refractory to long-term conservative treatment were randomized to three treatment groups. All patients received an injection of 10 ml 0.5% bupivacaine, in group 1 without corticosteroid, in group 2 with crystalline corticosteroid and in group 3 with lipoid corticosteroid. Treatment in group 1 had to be stopped because of inefficacy. In groups 2 and 3 favorable results were achieved in 19 out of 40 patients.

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Résumé  50 patients avec conflit sous-aeromial, qui ne montraient pas d’amélioration après un long traitement conservatif récevaient une injection dans la bourse subacromiale. Le premier groupe récevait une injection contenant un anaesthétique local pur, groupe 2 une mixture d’anaesthétique avec des corticostéroides cristalins et groupe 3 avec des corticostéroides lipoides. Le traitement du groupe 1 devait être arrété cause d’inificacité. 19 de 40 patients du groupe 2 et 3 montraient une amélioration après 6 mois.

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Accepted: 6 January 2000