RESUMEN
Two main factors that affect the pharmacokinetics of cyclosporin A (CsA) during 24-h durable intravenous (DIV) administration have been reported, namely physiological changes after bone marrow transplantation, and blood sampling through indwelling lines. In addition, it has been found that infusion sets made of polyvinyl chloride (PVC) markedly adsorb CsA. We conducted in vitro adsorption studies of CsA on infusion sets, and the administration routes that are used in the treatment of patients with bone marrow transplantation. We also examined the effects of administration route on CsA pharmacokinetics in clinical practice. The in vitro adsorption study using 30-mm segments of lumen from commercially available infusion sets showed that the degree of CsA adsorption per area of lumen made of PVC was significantly higher than that in those made of polyethylene (PE) or polybutadiene (PB), which showed no adsorption of CsA. Due to its adsorption, use of infusion sets made of PVC resulted in about a 40-50% loss of CsA dose, which affected the pharmacokinetic parameters during 24-h DIV, while those made of PE and PB did not. The use of non-PVC infusion sets should allow for accurate monitoring of CsA results, and provide cost benefit in the treatment of bone marrow transplantation.
Asunto(s)
Trasplante de Médula Ósea , Ciclosporina/administración & dosificación , Ciclosporina/farmacocinética , Infusiones Intravenosas/instrumentación , Adsorción/efectos de los fármacos , Adulto , Materiales Biocompatibles/química , Materiales Biocompatibles/metabolismo , Materiales Biocompatibles/farmacología , Butadienos/metabolismo , Butadienos/farmacología , Ciclosporina/sangre , Elastómeros , Diseño de Equipo , Enfermedades Hematológicas/terapia , Humanos , Infusiones Intravenosas/normas , Masculino , Persona de Mediana Edad , Polietileno/metabolismo , Polietileno/farmacología , Polímeros/metabolismo , Polímeros/farmacología , Cloruro de Polivinilo/metabolismo , Cloruro de Polivinilo/farmacologíaRESUMEN
In the course of screening for novel naturally occurring insecticides from Chinese crude drugs, a dichloromethane extract of Podophyllum hexandrum was found to give an insecticidal activity against larvae of Drosophila melanogaster Meigen. From the extract, an insecticidal compound was isolated by bioassay-guided fractionation. The compound was identified as podophyllotoxin (1) by comparison of its spectroscopic characteristics with literature data. In bioassays for insecticidal activity, 1 showed a LC(50) value of 0.24 micromol/mL diet against larvae of D. melanogaster and a LD(50) value of 22 microg/adult against adults. Acetylpodophyllotoxin (1A), however showed slight insecticidal activity in both assays, indicating that the 4-hydroxyl group was an important function for enhanced activity of 1.
Asunto(s)
Drosophila , Insecticidas/aislamiento & purificación , Plantas Medicinales , Plantas Tóxicas , Podofilotoxina/aislamiento & purificación , Podophyllum/química , Animales , Cromatografía de Gases y Espectrometría de Masas , Larva , Extractos Vegetales/química , Relación Estructura-ActividadRESUMEN
A case of infective endocarditis caused by methicillin-resistant Staphylococcus aureus (MRSA) was successfully treated with a combination therapy with cefmetazole (CMZ) and fosfomycin (FOM). A 55 year old man was admitted to the Keio Hospital because of fever of unknown origin. Physical examination revealed blood pressure of 132/62 mmHg, heart rate of 118/min and body temperature of 39.8 degrees C. Diastolic regurgitant murmur (Levine II/VI) was heard at the left sternal border on the third intercostal space. Chest X-ray showed mild cardiomegaly. Two dimensional echocardiography and color flow mapping demonstrated mildly dilated and hyperkinetic left ventricle, redundant aortic valve, giant vegetation from the aortic valve and severe aortic regurgitation. MRSA was isolated from the blood of this patient. Bacteriostatic synergism between CMZ and FOM against S. aureus isolated from the blood of this patient was detected both by the Kirby-Bauer method and by the checker-board method. The combination therapy with CMZ and FOM cleared the clinical symptoms and normalized the inflammatory reactions. No relapse was observed for at least 10 months. We concluded that the combination therapy with CMZ and FOM was invaluable for the treatment of infections endocarditis by MRSA.
Asunto(s)
Cefmetazol/administración & dosificación , Endocarditis Bacteriana/tratamiento farmacológico , Fosfomicina/administración & dosificación , Infecciones Estafilocócicas/tratamiento farmacológico , Cefmetazol/uso terapéutico , Evaluación de Medicamentos , Quimioterapia Combinada/uso terapéutico , Fosfomicina/uso terapéutico , Humanos , Masculino , Meticilina/farmacología , Persona de Mediana Edad , Resistencia a las PenicilinasRESUMEN
Adjustments of urinary ALA concentrations as to urinary specific gravity and creatinine were examined for workers exposed to lead and heat. Judging from our findings, we suggested that it was preferable to adopt the specific gravity (UG) at 1.020 as the adjustment value to obtain the correct urinary ALA concentration. Though corrected values thus obtained were found adequate for urine in the normal range of specific gravity, they failed to be adequate for concentrated urine samples higher than UG 1.025. Urinary volume adjustment was found to be necessary for these concentrated urine in stead of urinary specific gravity adjustment. For the practical purposes, we postulated urinary volume coefficients, which were estimated to be 0.5 for samples ranging from UG 1.026 to 1.030, 0.4 for samples from UG 1.031 to 1.035 and 0.3 for samples from UG 1.036 to 1.040, respectively.
Asunto(s)
Ácido Aminolevulínico/orina , Calor/efectos adversos , Plomo/toxicidad , Ácidos Levulínicos/orina , Creatinina/orina , Electrólitos/metabolismo , Exposición a Riesgos Ambientales , Humanos , Enfermedades Profesionales/diagnóstico , Gravedad EspecíficaRESUMEN
Endoscopic Nd:YAG laser treatment was used to eradicate 14 broad-based protruded borderline lesions of the stomach in which snare excision might be difficult and hazardous. Multiple pulse irradiations of Nd:YAG laser with a power of 40 to 50 W ablated all the lesions. During and after laser treatments, no complications were recognized. The laser-induced ulcers healed within 4 to 7 weeks after the last procedure, and the biopsy material taken from the sites of the scars showed regenerative epithelium without evidence of atypical cells. These encouraging results suggest that endoscopic laser treatment is the method of choice for therapy of the gastric borderline lesions where snare excision is not feasible.