经皮椎体成形术治疗椎体血管瘤

目的:探讨经皮椎体成形术(PVP)的方法及其对椎体血管瘤治疗的临床效果。方法:4例患者,6个椎体(胸椎2个,腰椎4个),X线透视全程监视下行侧椎弓根穿刺。穿刺针到位后,先造影了解椎旁静脉丛位置、引流静脉以及针尖是否位于粗大血管内,后注射骨水泥至椎体填充满意。结果:技术操作全部成功,椎体填充达1/2椎体以上或病灶大部填充。临床症状:疼痛完全缓解3例,明显缓解1例。无严重并发症发生。结论:PVP可以解除或缓解椎体血管瘤引起的剧痛,增加椎体稳定性;规范操作是技术成功、并发症减少的关键。     

Intracavernous application of diazepam: An alternative route of the seizure treatment − an experimental study in rabbits

BACKGROUND: There is a general need to terminate seizures as soon as possible using anticonvulsant drugs via an intravenous (i.v.) route, but it is often difficult to achieve a secure i.v. line during the seizure, especially in children. However, it has been demonstrated that high volumes of fluid can be injected into the corpora cavernosa. The purpose of this study was to evaluate the absorption properties of diazepam (DZ) after intracavernous (i.c.) administration and whether therapeutically significant plasma concentrations can be obtained or not. METHODS: Diazepam was administered to rabbits using both the i.v. and i.c route with a dose of 1 mg/kg. Blood samples were collected from the saphenous vein for a time period of 30 min. The levels of DZ in the blood were analyzed by high performance liquid chromatography and their blood profiles were obtained and compared. RESULTS: The insertions of the needle using this method were successful in all cases. The average time of inserting the needle was less than 5 s. There was no statistically significant difference between the i.v. and i.c. administration with regard of the blood DZ levels. Within 48 h after the experiment, none of the animals demonstrated any evidence of infection or disability. CONCLUSION: Our results demonstrated that commercially available parenteral DZ can be absorbed rapidly by the i.c. route in rabbits. Further studies are needed on the feasibility of this method before it is evaluated in humans.     

Effect of route of administration and distribution on drug action

The extent and time course of drug action can be markedly affected by the route of drug administration into the patient as well as the pattern of drug distribution within the patient. Drugs which are rapidly cleared by hepatic processes will show a decreased extent of availability following oral administration due to metabolism of drug on its first pass through the liver. The magnitude of this first pass will depend on the blood flow to the liver and the intrinsic clearing ability of the liver (i.e., the ability of the organ to eliminate the drug independent of the rate at which drug is brought to the organ). Drug distribution in the patient will depend on the blood flow to various sites in the body as well as the partition coefficient of the drug between the blood and the distributive organs. Protein binding both in the plasma and in the tissues will markedly affect this distribution. However, free drug concentrations are generally believed to be the effective determinant in drug therapy. Often a redistribution due to changes in protein binding will have little effect on the therapeutic efficacy since, although total drug distribution changes, free concentrations in the plasma remain essentially similar.This article is extracted from the forthcoming bookModern Pharmaceutics: Drug Product Design and Evaluation, edited by Gilbert S. Banker and Christopher T. Rhodes, copyright 1978, Marcel Dekker, Inc. Published with permission.     

Animal studies and prediction of human tumors can be aided by graphical sorting of animal data: neoplastic risk from B(a)P, benzene, benzidine, and chromium

This work is a graphical study of all known dose-response data for neoplasia induced by B(a)P, benzene, benzidine, and chromium administered to test animals. Doses are put in units of lifetime intake given in micromoles of chemical per kilogram body weight, and responses are in percent increased effect per unit dose. Space limitations do not permit experiment-by-experiment critiques; however, computer graphics have been used to compare the relationship of any individual dose-response point estimate to other such point estimates for the chemical of interest. Graphics are also used to study variability resulting from different experimental parameters such as species, route of intake, number of treatments, pathological classification of neoplasia, etc. Graphical sorting, according to various physical and biological classification parameters, permits one to judge, from visual inspection, such questions as whether mice as a species are more sensitive than rats as a species, whether intravenous injection is generally more effective than inhalation, whether a single well-defined dose-response function, which ignores these classification parameters, can be evaluated numerically from the composite data base deriving from all oncogenic studies with a given chemical, etc.     

股静脉的应用解剖

观测100例成人尸体股静脉长度、外径、瓣膜形态、位置、数目和方位;股静脉主要属支外径,距腹股沟韧带距离,注入方位及入口附近瓣膜,为临床提供了形态学依据;对股静脉穿刺、插管,瓣膜修复术、移植术及静脉逆行造影进行了讨论。     

Prediction and improvement of protected peptide solubility in organic solvents*

A predictive method of solubility for protected peptide fragments of globular proteins was described. The solubility prediction was performed on the basis of both the randomness of peptide structures in a solid state and the existence of tertiary peptide bonds such as X-Pro and X-(Z)Y bonds, in which X and Y are arbitrary amino acid residues and Z is a suitable protecting group for the X-Y peptide bond. In order to predict the randomness, the coil conformational parameter, P_e, was utilized. Solubility prediction by this method was success fully applied to the two classes of protected peptides composed solely of hydrophobic and of various amino acid residues. The solubility test results also indicate that the protection of peptide bonds at suitable intervals is effective in achieving a remarkable improvement in the solubility of extraordinarily insoluble peptides. Lastly, the strategy for the selection of the coupling routes in the protein syntheses was proposed.     

Comparative study and evaluation of side effects of low-dose contraceptive pills administered by the oral and vaginal route

This was a comparative study of side effects and acceptability of low-dose pills administered by the oral and vaginal rout. In an experimental clinical trial study, undesirable side effects of nausea, dysmenorrhea, breast tenderness, gastrointestinal disorders, vertigo, headache, and breakthrough bleeding (BTB) were studied. The participants of the case and the control groups were the same women. The side effects were compared in 143 women using contraceptive pill containing 150 microg levonorgestrel and 30 microg ethinyl estradiol by vaginal and oral route. The efficacy and acceptability were evaluated. The side effects among the patients who used the contraceptive pills orally were significantly higher than among those who used the vaginal route (p < 0.0001). BTB occurred more often with the oral route, but there was no significant difference between their incidences (p = 0.267). Most participants in this study expressed a high level of acceptability with the vaginal route. There was only one unwanted pregnancy, which occurred when the participant used the contraceptive pill vaginally, but used it incorrectly. Using the contraceptive pill administered by vaginal route is a safe method with fewer side effects and more acceptability when compared with the oral route.     

Enhancing Immunogenicity and Reducing Dose of Microparticulated Synthetic Vaccines: Single Intradermal Administration

PURPOSE: Our purpose was to evaluate the ability of a polymeric vehicle to release a model synthetic vaccine to the skin in order to reach a potent activation of the specific immune response. METHODS: The peptide-loaded poly-D,L-lactide-co-glycolide acid (PLGA) microparticles were prepared by a double emulsion technique and administered to Balb/c mice. The immune response (antibody and T cell activation) obtained by the intradermal (i.d.) and the subcutaneous (s.c.) routes was tested. RESULTS: When similar doses of peptide-loaded microparticles were injected s.c. or i.d. in mice, the antipeptide IgG antibody immune response was found to be significantly higher after i.d. injection into the skin. We could also reduce the dose of antigen 10 times by the i.d. route and find a similar antibody response to that obtained by the s.c. immunization. At the lowest i.d. dose level, the IgG2a/IgG1 ratio was also incremented and the IgE production decreased. The i.d. microparticles induced, at both dose levels, a marked IFN-gamma secretion by peptide-stimulated splenocytes and lymph node cells and a significant T cell proliferation in spleen cell cultures. CONCLUSIONS: The results demonstrate that peptide-loaded microparticles were efficiently administered by the i.d. route because lower doses were required and powerful antibody and T cell responses were obtained compared to the conventional s.c. administration.     

椎体血管瘤的CT导引治疗

目的:探讨椎体血管瘤的CT导引治疗效果。方法:10例患者,12个椎体(胸椎4个,腰椎8个)CT导引下行侧椎弓根穿刺。穿刺针到位后,先造影了解椎旁静脉丛位置、引流静脉以及针尖是否位于粗大血管内,后注射骨水泥至椎体填充满意。结果:穿刺技术操作全部成功,椎体填充达1/2椎体以上或病灶大部填充。临床症状:疼痛完全缓解7例,明显缓解3例。无严重并发症发生。结论:CT引导下外科介入治疗不仅可以解除或缓解椎体血管瘤引起的剧痛,增加椎体稳定性;而且避免因椎体开窗术造成创伤的缺点。