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Two commonly used designs of swivel walker are the Consort 800 and the ORLAU 1000. This paper examines how the footplate rocking edge spacing varies between these two designs and then considers how lateral stability might be influenced if reduced separation is introduced to facilitate ambulation for less able users. In general it is shown that there should be no obstacles to such variation on the part of an orthotist thereby improving access to these devices and function for disabled individuals.

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MENTHOR is a database system for the storage and retrieval of three-dimensional coordinate and charge information on molecules as well as of traditional biological and physical properties. Our molecular graphics system retrieves from MENTHOR structural information in individual molecules and receptor map/macromolecular binding site hypotheses. Substructural searches of MENTHOR are used to find starting coordinates for molecular modeling and traditional database searches of MENTHOR identify compounds for which modeling is needed. It also forms the data to be searched with ALLADDIN, our substructure/geometric search program. MENTHOR expedites molecular modeling by organizing previous work and facilitating transmission of information between individuals. Examples from modeling of D-2 receptor agonists are shown.

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1 Ketotifen (HC 20-511 Sandoz) 1 mg twice daily for 12 weeks was found to be equivalent to sodium cromoglycate (SCG) 20 mg four times daily for 12 weeks in 35 skin test positive asthmatic patients in a randomised double-blind cross-over study. 2 No statistically significant difference between the two drugs in mean values for daily peak flow rates, diary card scores and spirometry at monthly visits was demonstrated. 3 Treatment failures as judged by severe asthma requiring withdrawal from the trial or addition of short courses of prednisone occurred in three patients on each drug. 4 Sedation was noted by 10 patients onHC 20-511 and 5 on SCG. 5 Weight loss was noted in those patients on SCG, but not those on HC 20-511.

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Prednisolone serum levels have been measured by radio-immunoassay in 12 steroid-dependent asthmatic patients. Differences in prednisolone pharmacokinetics did not account for the variation in dose of prednisolone required to control asthma.

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A dose-response study of terbutaline nebulizer solution has been performed in nine convalescent asthmatic patients. Both 5-mg and 10-mg doses administered as a wet aerosol resulted in effective bronchodilatation, but the higher dose caused a mild tachycardia.

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A case of bronchial infection with Syngamus laryngeus (Gapeworm) in a 42-year-old woman is described. Following presentation with chronic cough, haemoptysis and weight loss, a pair of worms was removed at bronchoscopy, with resolution of symptoms.

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1 Prednisolone plasma levels were measured in seven patients by a competitive protein binding method after administration of prednisolone (20 mg) by mouth as plain or enteric-coated tablets. 2 The mean peak plasma prednisolone concentration after the enteric-coated preparation, 199 ng ml-1, was significantly lower than after the plain tablet, 268 ng ml-1, and occurred later, at 4.69 h compared with 1.72 h. The bioavailability of the two preparations was similar. 3 It is concluded that, although the plasma concentration versus time profiles are different, the absorption of prednisolone from plain and enteric-coated preparations is equal.

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1 The pharmacokinetics of ICI 74,917 were studied in both asthmatic patients and normal volunteers. 2 The tritiated compound was administered to the lungs by inhalation from an aerosol and a bronchoscope, and by intravenous, oral and buccal routes. Radioactivity was measured in plasma, urine, faeces, sputum and exhaled air. 3 After bronchoscopic administration 63% of the available dose was absorbed; after aerosol administration 8% was absorbed from the lung and more than 50% swallowed. 5 Intravenous studies indicated that the drug is excreted in the bile and urine in the ratio 2:1. 5 Minimal oral and no buccal absorption occurred. 6 There was no evidence of tritium exchange or drug metabolism. 7 The mean terminal half-life following administration by all route was 16.1 hours. However, the majority of the dose was rapidly excreted. 8 Aerosol administration is the method of choice for the clinical use of ICI 74,917.

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The effects of intravenous salbutamol (4 mug/kg) were compared with those of aerosol salbutamol (200 mug) in 10 asthmatic patients in a double-blind placebo-controlled study. Both methods of administration produced equal bronchodilatation. Intravenous salbutamol caused significant increases in plasma insulin and glucose levels and a fall in serum potassium concentration in addition to tachycardia and tremor, whereas aerosol salbutamol produced only a small transient increase in the plasma glucose level. The initially raised non-esterified fatty acid levels decreased significantly after aerosol and placebo but not after intravenous salbutamol.

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1 Ephedrine plasma levels have been measured in ten asthmatic patients given a singel dose of ephedrine hydrochloride (22 mg) along and in combination with theophylline and a barbiturate. 2 Pharmacokinetic assessment of the data indicated no significant intra-subject changes in kinetic parameters before or after chronic treatment with ephedrine HCl (11 mg three times a day) alone or in combination. 3 Tolerance to these therapeutic doses, if it occurs, is therefore not disposition-related but rather to pharmacodynamic changes.

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A competitive protein-binding assay was used to measure plasma prednisolone levels after administration of prednisolone-21-phosphate retention enemas to seven patients with colitis. Prednisolone appeared in the plasma of all patients after the enema, and concentrations rose to a peak within three hours. In five of the patients plasma prednisolone levels were also measured after the same dose of prednisolone by mouth. Although in individual patients the plasma levels achieved by enema were often quite different from those achieved by mouth, overall the levels achieved by each mode of administration were of a similar order. These findings suggest that 20 mg prednisolone given by retention enema may well exert a systemic effect.

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The effect of i.v. salbutamol was compared with aerosol salbutamol in ten asthmatic patients. 2 A cumulative dose of salbutamol (300 mug) given in three separate injections over 45 min resulted in a mean increase in peak expiratory flow rate (PEFR) of 38.3% and FEV1 of 36%. 3 There was no significant difference in degree of bronchodilatation to the same dose of salbutamol administered intravenously or by aerosol. 4 Palpitations, tremor, and postural hypotension were common when the drug was injected intravenously over one minute, but did not occur after aerosol administration. 5 It is suggested that sulbutamol by intravenous injection is a useful addition to the treatment of acute asthma.

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In eight asthmatic patients, there was no change in the bronchodilator response to a single dose of ephedrine (22 mg) given alone or in a compound tablet, after treatment with ephedrine (11 mg three times a day) or one tablet three times a day for 2 weeks. 2 There was no deterioration in lung function during the 2 week treatment period with either ephedrine or the compound tablet. 3 An inter-patient variation was noted in the plasma ephedrine concentraition required for bronchodilatation. 4 The half-life of theophylline did not change after chronic treatment with the tablets, one three times a day for 2 weeks.

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1. A modification of the competitive protein binding assay for prednisolone described by English, Chakraborty & Marks (1974) is presented. 2. Addition of pg quantities of [3H]-prednisolone following oral dosage with prednisone or prednisolone. 3. Mean plasma half-life and peak plasma concentrations in patients with respiratory disease seen following prednisolone administration agree well with previous studies in healthy volunteers performed by other workers using competitive protein binding and radioimmunoassay techniques. 4. A considerable inter-patient variation in bioavailability after a standard dose of prednisolone (20 mg) was noted.

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