Impact of anti‐tumor necrosis factor‐α agents on serum levels of KL‐6 and surfactant protein‐D in patients with psoriasis

We longitudinally examined the influence of anti‐tumor necrosis factor (TNF)‐α treatment on serum levels of KL‐6 and surfactant protein‐D (SP‐D). The study group comprised 22 patients with psoriasis treated with infliximab or adalimumab and with no history of interstitial lung disease (ILD). KL‐6 and SP‐D levels were measured in serum samples. Twelve of the 22 patients (55%) showed at least a 20% increase in KL‐6 levels compared with baseline. Of these 12 patients, none exhibited any signs of ILD on chest computed tomography and nine who showed an increase in KL‐6 levels (75%) showed at least a 20% increase in SP‐D levels. Some patients showed simultaneous increases in KL‐6 and SP‐D levels after treatment with anti‐TNF‐α agents. Although these patients may have undetectable or subtle alveolar damage, careful observation is needed.     

Section Review: Cardiovascular & Renal: Calcium sensitisers and heart failure

To date, the use of positive inotropic agents for the treatment of heart failure has not been a success. Not only have these drugs had little documentable beneficial effect on survival, but in some instances, most notably with the phosphodiesterase inhibitors, they have-caused an unacceptable increase in early mortality due to arrhythmias [1]. This has led to a body of opinion in some quarters that positive inotropic therapy for heart failure is a doomed approach and that all efforts should be concentrated on preventing or reversing atheroma, enhancing blood flow to the myocardium and dealing with the effects of secondary compensatory mechanisms. Although everyone agrees that prevention is better than cure, it seems inevitable that there will always be substantial numbers of patients with heart failure of various degrees of severity. Thus, it is important to be very sure of the facts before abandoning any hope of pharmacological contractile support for these patients. This article briefly reviews current evidence on the potential utility of calcium sensitisers.     

亲属间活体肾移植免疫抑制剂的应用规律

目的:回顾分析150例亲属间活体肾移植的免疫抑制剂应用方案,以总结亲属间活体肾移植患者的免疫抑制剂的应用规律。方法:回顾在我院进行复查并且肾功能稳定的150例亲属间活体肾移植受者免疫抑制剂应用资料,并按照相同染色体倍数分组,同时与同期无关尸体供肾肾移植患者进行比较,并进行统计分析。结果:亲属间活体肾移植受者免疫抑制剂用量与相同染色体倍数相关,两条染色体相同者<一条染色体相同者<无染色体相同者<无关尸体供肾肾移植受者。结论:亲属间活体肾移植受者免疫抑制剂应用量较少,相应的免疫抑制剂相关的不良事件也较少,有利于受者的长期存活。     

Effect of clenbuterol on peripheral airway obstruction in bronchial asthma

Summary

A study was carried out in 6 patients with bronchial asthma to investigate the effects of clenbuterol, a β₂-sympathomimetic bronchodilator, on peripheral airway obstruction. The basal lung functions of the patients were almost within normal range in both vital capacity (VC) and forced expiratory volume in 1 second (FEV₁), but their maximal flow rates were lower in effort-independent phase of both maximal expiratory flow volume (MEFV) curve and partial expiratory flow volume (PEFV) curve. Furthermore, they demonstrated marked basal frequency dependence of dynamic compliance [C_Ddyn]. Oral administration of clenbuterol (40 μg) produced a significant increase in the maximal flow in effort-independent phase of both MEFV and PEFV curves, and markedly decreased frequency dependence of C_Ddyn in comparison with the baseline values, while it improved both VC and FEV₁ to a lesser extent. These results suggest that clenbuterol preferentially reduced the peripheral airway obstruction in bronchial asthma.     

Section 3 The activity and tolerance of ibuprofen in patients with rheumatism and associated conditions

Summary

Ibuprofen, in a daily dosage range of 600?mg. to 1200?mg., was given to 100 patients suffering from a variety of rheumatic conditions for periods ranging from 1 to 3 months. The drug was found to be effective and well-tolerated by the majority of patients, even by those with associated conditions such as gastro-intestinal disorders which often make treatment difficult with other antirheumatic agents. Side-effects were reported in only 4 patients.     

Microbubble Destruction During Intravenous Administration: A Preliminary Study

The concentration and size distribution of microbubble suspensions are important parameters for both diagnostic and therapeutic applications. The aim of this preliminary study was to investigate the relationship between changes in the microbubble population and the administration process variables, specifically syringe inner diameter, needle inner diameter, volume flow rate and the liquid in which the microbubbles are suspended. It was found that reducing either the syringe or needle inner diameter produced large reductions in microbubble concentration during administration, as much as 99.9% for needle inner diameters <0.24 mm. Increasing the volume flow rate up to 3 mL/min and changing the suspending fluid from distilled water to glycerol, however, were both found to reduce the degree of microbubble destruction. Further work is needed to fully explain these observations. However, investigation of the response of microbubbles to changes in hydrostatic pressure only, indicated that this was unlikely to be the main mechanism of destruction and hence that shear stress was a more important factor. Comparison with findings from another recent study of microbubble stability indicated that microbubble size, concentration and composition were also important parameters and should be taken into account in designing administration procedures for microbubble agents. It was concluded that current procedures should be reviewed, particularly for therapeutic applications, and that the results should also be taken into account when assessing the accuracy of microbubble size distribution measurements obtained using automatic particle sizing equipment in which microbubbles are made to flow under pressure. (E-mail: e_stride@meng.ucl.ac.uk)