Treatment of the Breast’s Lateral Pole: Adjuvant Maneuver to Pitanguy’s Technique

Surgical procedures for the mammary region currently are assuming an important role in body-contouring surgery. Enhancement of results is a constant challenge to the plastic surgeon. A simple and efficient maneuver for resection of the breast’s lateral pole based on the mammoplasty technique of Professor Ivo Pitanguy is described. This study realized at the Private Clinic Sérgio Carreir?o, Rio de Janeiro, RJ, Brazil.     

Effects of L-DOPA and L-5-HTP on the visual evoked response

Small doses (10 and 20 mg/kg) of L-DOPA inhibited the amplitude of the visual evoked response (VER), while large doses (40 and 80 mg/kg) enhanced it. Though low doses (12.5 and 25 mg/kg) of L-5-HTP caused a slight increase in amplitude of the VER, the simultaneous administration of 12.5 mg/kg of L-5-HTP and 10 mg/kg of L-DOPA produced a marked enhancement. The peak latency was prolonged after the injection of any doses of L-DOPA, L-5-HTP, or both.     

Combined repeated-dose and reproductive/developmental toxicity screening test of benzene, 1,1′-oxybis-, tetrapropylene derivs. in rats

We have conducted animal toxicity tests of chemicals for a chemical safety program implemented by the Ministry of Economy, Trade and Industry of Japan. Here we conducted a combined repeated-dose and reproductive/developmental toxicity screening test of benzene, 1,1′-oxybis-, tetrapropylene derivs. (BOTD). BOTD was administered to 9-week-old Crl:CD(SD) male and female rats by gavage at 0, 40, 200, or 1000?mg/kg/day. Males were treated for 42 days including mating period. Females were treated for 42–53 days through the premating, mating, pregnancy, and until Day 4 of lactation periods. Increases in prothrombin time and activated partial thromboplastin time values were observed only in males at 200 and 1000?mg/kg/day. Hypertrophy of centrilobular hepatocytes was observed with increased liver weight in both sexes at 200 and 1000?mg/kg/day, but there was no histologic evidence of hepatotoxicity. Diffuse hypertrophy of follicular cells in thyroid glands was observed in females at 200?mg/kg/day and in both sexes at 1000?mg/kg/day, with an increased blood cholesterol level in females at 1000?mg/kg/day. The conception index was decreased for females at 1000?mg/kg/day; and no abnormalities were detected in the reproductive indices of implantation, delivery, or pups’ condition, although a slight increase in the pups’ body weight was noted at birth. Our data indicate a no-observed-adverse-effect level of 40?mg/kg/day for repeated-dose toxicity on the basis of the prolongation of blood coagulating time, and of 200?mg/kg/day for reproductive/developmental toxicity on the basis of the decreased conception index.     

Effect of sertindole on QTc interval in patients with schizophrenia

Sertindole has been marketed and offered daily clinical practice only for 9 months in our country, so no data has been its QTc prolongation potential. In the present study, we performed a clinical trial to investigate the effects of sertindole on QTc in patients with schizophrenia. The study comprised 21 patients with schizophrenia. Sertindole was administered in the following dosing regime: treatment was initiated with 4 mg/day sertindole. From day 3 to day 6, the dose was increased to 8 mg/day, and up to day 9, it was raised to 12 mg/day. The protocol allowed up to dose of 20 mg/day according to effectiveness and tolerability. QTc values were determined at beginning, months 3 and 6. In addition, Positive and Negative Syndrome Scale (PANSS) were scored concomitantly. At the beginning of 6-month period, the mean QTc interval of patients was 391.7 ± 19.2 ms. At the end of this period, it was 402.8 ± 23.8 ms. Although the mean QTc interval changing was significant throughout 6-month period, of the patients, at any evaluation point, only 1 female (451 ms) and 1 male (433 ms) had borderline prolongation at month 3 for both, without any exceeding the dangerous limits. In summary, our results suggest that sertindole is tolerable and despite dose-related QT prolongation, sertindole had not the proarrhythmic profile. Future studies with larger sample evaluating the effects of treatment are required.     

Duration of Twice-Daily Thoracic Radiotherapy and Time From the Start of Any Treatment to the End of Chest Irradiation as Significant Predictors of Outcomes in Limited-Disease Small-Cell Lung Cancer

Background

The hypothesis of this retrospective study was that the duration of twice-daily (BID) thoracic radiotherapy (TRT) and time from the start of any treatment to the end of chest irradiation (SER) would predict outcomes in limited-disease small-cell lung cancer.

Effects of prolongation of overall treatment time due to unplanned interruptions during radiotherapy of different tumor sites and practical methods for compensation

The prescribed total radiation dose should be administered within a specific time. In daily clinical practice, however, unplanned treatment interruptions resulting in prolongation of the overall treatment time are predictable. The present review evaluated the existing published data regarding the affect of the prolongation of the overall treatment time on the tumor control rate and outcome of patients with head-and-neck, lung, and uterine cervical cancer and other treatment sites. In most studies, including the planned interruption (split-course) schedules, as well as the retrospective studies analyzing the role of overall treatment time, a detrimental effect from the treatment break on the outcome was evident. This is suggestive of the deleterious effect of accelerated repopulation of tumor clonogens. In particular for the cancers of the head and neck for which the evidence is the strongest for such a consequence, even a 1-day interruption resulted in a decrease in the local control rate by 1.4%. Although the increased number of gaps was associated with a negative outcome, the data are contradictory concerning the effect of the number of gaps. The main recommendation is to exert all efforts to retain the planned irradiation schedule; however, existing data have shown that interruptions that effect the programmed time-course for irradiation need to be compensated for. This is to ensure biologic equivalence in treatment efficacy compared with uninterrupted regimens with respect to cancer site and stage. Practical methods for compensation using radiobiologic modeling and their limitations are also discussed.     

痉挛型脑瘫下肢矫形治疗

目的：探讨手术治疗痉挛型脑瘫下肢畸形的疗效。方法：Ａ组采用下肢肌或肌腱切断和运动神经支切除术,Ｂ组采用肌腱／肌切开延长术和运动神经支切除术治疗痉挛型脑瘫下肢畸形。结果;临床评估分优、良、改善,Ａ组分别为２１．４３％、５１．４３％、２７．１４％,Ｂ组分别为２４．６２％、５７．６９％、７．６９％。结论：手术治疗痉挛型脑瘫下肢畸形疗效较好,并以Ｂ组方式更优。     

Effects of 4-Aminopyridine on Cloned hERG Channels Expressed in Mammalian Cells

Introduction.  Non-clinical evaluation of a medication's potential to induce cardiac toxicity is recommended by regulatory agencies. 4-Aminopyridine (fampridine) is a potassium channel blocker with the demonstrated ability to improve walking ability in patients with multiple sclerosis. We evaluated the in vitro effects of 4-aminopyridine on the human ether-à-go-go -related gene (hERG) channel current, since hERG current inhibition is associated with QT interval prolongation—a precursor to torsade de pointes (TdP).
Methods.  4-Aminopyridine was evaluated in concentrations ranging from 0.1 mM to 30 mM in human embryonic kidney 293 cells stably transfected with the hERG gene; terfenadine 60 nM was used as a positive control.
Results and Discussion.  We observed concentration-dependent inhibition of hERG current with 4-aminopyridine doses between 0.3 and 30 mM. The concentration of 3.8 mM resulting in 50% inhibition (IC₅₀) is approximately three orders of magnitude higher than expected therapeutic plasma concentrations, suggesting 4-aminopyridine has low potential for prolonging QT interval or inducing TdP.     

The role of spatial interactions in creating the dispersion of transmembrane potential by premature electric shocks

Strong electric shocks applied during the refractory period can initiate or terminate cardiac arrhythmias. To elucidate the underlying mechanism, Knisleyet al. used rabbit papillary musclein vitro to scan the refractory period of an action potential with shocks of different strengths. The resulting map of the shock-induced changes in the transmembrane potential (Vm) illustrates the substrate for the creation of rotors. Our study uses computer simulations to reproduce this experimental map. Three models (a space-clamped membrane, a single cell, and a onedimensional fiber) were used to determine whether the observed map was caused by (i) the intrinsic dynamics of the membrane, (ii) the simultaneous depolarization and hyperpolarization of the opposite ends of each cell, or (iii) spatial interactions involving the whole muscle strand. The results show that the membrane and single cell models cannot reproduce the experimental map. The fiber model reproduces the shock-induced changes inVm and demonstrates that they are caused by a propagating disturbance, which, depending on the coupling interval and the shock strength, can be a new action potential or an electrotonus and can arrive from the depolarized end or from both depolarized and hyperpolarized ends of the fiber. These results indicate that the induction of rotors in the heart may not be a direct effect of the electric field.     

Modification of sensory-terminal responses and membrane structure of frog muscle spindle by collagenase

A preparation of decapsulated muscle spindles with intact sensory innervation has been developed to allow direct access to the sensory terminal for the application of drugs or to alter the extracellular ionic composition. Muscle spindles were isolated from semitendinosus muscles of the frog Rana catesbeiana, and were incubated in a calcium-free Ringer's solution containing 0.2% collagenase. Following optimal incubation at 34 degrees C for 30 min the response pattern of the spindles during stretch could not be distinguished from that of intact spindles, although the duration of individual afferent spikes was prolonged about 4 times normal. The spikes disappeared immediately after the Ringer's solution was replaced with an isotonic choline chloride solution, in contrast to those of intact spindles which remained for 30 min after the replacement. Electron microscopy showed that the outer and inner capsules were partially disrupted. No significant change was observed in the size or packing density of intramembrane particles in freeze-fracture replicas of spindles decapsulated under optimum conditions. More prolonged treatment with the enzyme resulted in abolition of the static component of the response during stretch, and also in an aggregation of the particles, whose size decreased and packing density increased.