Bioavailability of labetalol in patients with end-stage renal disease.

The pharmacokinetics and pharmacodynamics of labetalol were assessed after a single oral and intravenous dose in eight patients with end-stage renal disease (ESRD) maintained on chronic hemodialysis, and in eight age-and sex-matched normal volunteers. The mean area under the serum concentration-time curve, volume of distribution, clearance, and terminal elimination half-life values after a single intravenous dose of 0.5 mg/kg of labetalol were not significantly different between ESRD patients and normal volunteers.

Operation for cavitating invasive pulmonary aspergillosis in immunocompromised patients.

Invasive pulmonary aspergillosis is a specific form of pulmonary Aspergillus infection that occurs almost exclusively in immunocompromised patients. It differs both histologically and in its clinical course from classic aspergillomas. During a 5-year period (1986-1990), 8 patients underwent resection for cavitating invasive pulmonary aspergillosis that developed as a consequence of neutropenia during chemotherapy for malignancy.

The structure and functions of the dentogingival junction and periodontal ligament.

The dentogingival junction and periodontal ligament perform unique functions. The former makes a seal where a tooth punctures the integument; the latter, nominally a ligament, cushions the tooth during mastication, while sheltering the delicate cells which remodel the bony socket. A special feature of both tissues is the rapid turnover of their major components.

Pharmacokinetics of cyclosporine in bone marrow transplantation: longitudinal characterization of drug in lipoprotein fractions.

The pharmacokinetics of cyclosporine (CSA; 2 mg/kg given iv over a period of 2 h every 12 h) in whole blood, plasma, high-density lipoproteins (HDL), and low-density lipoproteins (LDL) were studied after single (n = 10) and multiple (31 days; n = 6) doses in patients receiving allogeneic bone marrow transplants. Whereas HDL-cholesterol levels decreased significantly, LDL-cholesterol levels increased from day 1 to day 31 of CSA dosing. The mean area under the concentration-time curve and half-life values of CSA in whole blood or total plasma did not differ after single or multiple doses.

Fractures after Wagner limb lengthening.

A retrospective review of our experience with fractures after 27 Wagner limb lengthenings (23 patients) was undertaken. Ten fractures occurred after lengthening in eight patients (six spontaneous, four traumatic). Seven patients fractured despite a "staged" removal of the fixation plate.

Effects of suprofen on the isolated perfused rat kidney.

Although suprofen has been associated with the development of acute renal failure in greater than 100 subjects, the mechanism of damage remains unclear. The direct nephrotoxic effects of a single dose of 15 mg of suprofen were compared in the recirculating isolated rat kidney perfused with cell-free buffer with or without the addition of 5 mg/dL of uric acid. There were no significant differences in renal sodium excretion, oxygen consumption, or urinary flow rates in kidneys perfused with suprofen compared with the drug-free control groups.

Role of vascular congestion in cisplatin-induced acute renal failure in the rat.

The significance of vascular congestion in the pathogenesis of cisplatin acute renal failure (ARF) was studied in rats given pentoxifylline. Rats were administered single intraperitoneal doses of 1.0, 2.

Tissue distribution and in vivo immunosuppressive activity of liposomal cyclosporine.

The distribution and immunosuppressive activity of liposomal cyclosporine (L-CSA) when administered iv as single- and multiple-doses were compared with the commercially available cyclosporine (C-CSA) in rats. CSA concentrations in the spleen and liver were significantly greater 1 hr after dosing in rats given L-CSA compared with C-CSA. The apparent tissue to blood partition coefficient at 1 hr after dosing was significantly greater for the liver and spleen of rats treated with L-CSA compared with C-CSA.

Charting uncharted terrain: a behavioral observation system for mutual help groups.

Describes the development of a behavioral observation system for mutual help meetings and presents evidence supporting its reliability, validity, and utility. The MHOS-BIC (Mutual Help Observation System-Behavioral Interaction Codes) was used by 10 observers to record the sequential flow of group interaction in 527 meetings. Psychometric analyses indicate that the system performed consistently with measurement objectives.

Antifungal activity of HWA-138 and amphotericin B in experimental systemic candidiasis.

HWA-138, a pentoxifylline analog, has been shown to increase yeast urinary clearance and to reduce yeast counts in the kidneys of rats infected with Candida albicans. Furthermore, HWA-138 has also been shown to prevent amphotericin B-induced acute renal failure in rats. We report here on the effects of HWA-138 alone and in combination with amphotericin B in the treatment of systemic candidiasis in mice.

Reduced immunogenicity and improved pharmacokinetics of humanized anti-Tac in cynomolgus monkeys.

The anti-Tac mAb has been shown to bind to the p55 chain of the IL-2R, block IL-2 binding and inhibit T cell proliferation. A humanized form of anti-Tac (HAT) has been constructed that retains the binding properties of murine anti-Tac (MAT). These two mAb were evaluated in cynomolgus monkeys to compare relative immunogenicity and pharmacokinetic properties.

Reassessment of dapsone as a marker of acetylator phenotypes.

The ratio of metabolite to parent dapsone concentrations at 3 hours after dosing has been used as a marker of acetylator phenotypes. The absorption of dapsone is somewhat erratic with peak concentrations often found after the 3-hour determination. The present study done in 30 healthy, male volunteers compared ratios of metabolite to parent dapsone concentrations 3 hours after dosing with AUC values calculated during a 24-hour period as well as extrapolated to infinity.

Influence of pentoxifylline and related analogues in endotoxemic renal failure.

Acute kidney dysfunction, manifested by reductions in renal blood flow and glomerular filtration rate with increased renal vascular resistance, is a common finding in septic shock. In an attempt to halt the progressive renal dysfunction, the hemorheologic methylxanthines, pentoxifylline (1, 5, or 10 mg/kg of PTX) and 2 structurally-related analogues, 5 mg/kg of HWA-138 and 5 mg/kg of HWA-448, or saline wee given 7.5 hr after endotoxin infusion in the rat.

Effects of the immune system on cyclosporine absorption.

1. The pharmacokinetics and toxicodynamics of single and multiple doses of cyclosporine were studied in the immunized rat model and compared with non-immunized rats. 2.

Prophylactic minitracheotomy in lung resections. A randomized controlled study.

Thirty consecutive patients undergoing lung resections were randomized into two groups: Group A (n = 15) received minitracheotomy postoperatively and group B (n = 15) were control patients. Postoperative respiratory course was monitored by serial clinical assessments, chest x-ray examination, arterial blood gases, sputa bacterial cultures, and the patient's requirement and response to chest physiotherpy. The two groups were similarly matched in age (mean 58.

Broncho-oesophageal fistula of infectious origin.

A case of end stage pulmonary destruction secondary to adult onset broncho-oesophageal fistula of infectious aetiology is presented. Advanced bronchiectatic damage to the pulmonary parenchyma may be avoided by the maintenance of a high index of suspicion and a systematic approach to the diagnosis of recurrent lower respiratory tract infections.

Setting phenotypes in a mutual help organization: expanding behavior setting theory.

Expands Barker's theory of behavior settings by proposing an additional method of classifying settings based on their functional/behavioral aspects--the setting phenotype. Although behavior setting theory has been widely hailed as a revolutionary contribution to behavioral science, it has had limited impact on general psychology. This may be due in part to a reliance on a purely structural method of classifying behavior settings--the setting genotype.

Benefit of vascular decongestion in glycerol-induced acute renal failure.

The post insult administration of vascular decongestants has resulted in attenuation of experimental acute renal failure (ARF) following the introduction of various nephrotoxins including drugs, heavy metals, and endotoxin. In the present study, the dose-dependent effects of a novel methylxanthine, HWA-138, were studied in the glycerol-induced murine model of ARF. Renal function, assessed by serial inulin clearances at 24 and 48 h after glycerol injection, urinary electrolyte excretion rates, and renal morphology, was compared between controls and those given glycerol and single i.

Attenuation of amphotericin-B nephrotoxicity in the candidiasis rat model.

Dose-limiting nephrotoxicity has hampered the clinical usefulness of amphotericin-B (AmpB). Recently, vascular decongestants, such as pentoxifylline, have shown benefit in reducing drug-associated renal damage of AmpB in rats. The present study investigated a dose-dependent protection of a structurally similar methylxanthine, HWA-448, in the candidiasis rat model given a single dose of AmpB.

Therapeutic drug monitoring of cyclosporine-lipoprotein levels.

Cyclosporine therapy is complicated by nephrotoxicity that is not predicted by drug levels. In this study serial trough blood samples were obtained from 11 allogeneic marrow transplant recipients after initiation of intravenous cyclosporine 2 mg/kg every 12 hours for a period extending 4 weeks after transplantation. Renal dysfunction, assessed by an increase in serum creatinine levels to twice baseline values or when greater than 175 mumol/L, was found in four patients.

Circadian variation in renal function of the obese rat.

The influence of food and water intake on renal function was assessed by comparisons between the hyperphagic Zucker obese rat and its lean littermate, which demonstrates nocturnal dominance in activity. Serum creatinine and cortisol levels, creatine kinase activities, creatinine and urine clearances, and sodium and potassium excretion rates were measured over a 24-hour period in both lean and obese rats (n = 24 each). Six rats in each group were studied every 8 h to permit characterization over a 12-hour light/dark cycle at 2-hour intervals.

Validity of creatinine clearance estimates in the assessment of renal function.

In clinical practice, estimations of renal function are commonly used to calculate the appropriate dose for drugs that are renally cleared. Continuous-infusion inulin clearance (CLIN), 4-hour creatinine clearance (CLCR,m), and 24-hour creatinine clearance (CLCR,a) were measured in 109 subjects (86 men and 23 women) with varying degrees of stable renal function (CLIN, 6 to 209 ml/min) and compared with CLCR values as predicted by five equations on the basis of plasma creatinine concentrations, age, weight, and/or height. The CLCR,m was positively correlated with CLIN (r = 0.

Evaluation of amphotericin B-cyclosporine interaction in the rat.

Although a significant interaction between cyclosporine and amphotericin-B (AmpB) has been observed clinically, these findings have not been duplicated in animal studies. A total of 64 male albino rats were used in single- and multiple-dose experiments with AmpB and CsA in the absence or presence of systemic Candida infection. No significant differences in glomerular filtration rate were found in rats given single i.

Imaging rounds #103. Myositis ossificans in association with congenital radioulnar synostosis and congenital anterior radial head dislocation.

Although the initial trauma was minimal in this unusual case of bilateral congenital radioulnar synostosis and anterior radial head dislocation associated with myositis ossificans, a progressive decrease in elbow ROM ensued. Manipulation under general anesthesia was performed to improve flexion and extension of the involved elbow. This manipulation most likely initiated or enhanced the process of myositis ossificans in the elbow.