Treatment of uterine fibroids with a slow-release formulation of the gonadotrophin releasing hormone antagonist Cetrorelix

A depot preparation of the third-generation gonadotrophin-releasing hormone (GnRH) antagonist Cetrorelix (SB-75) was used for preoperative treatment in twenty premenopausal patients with symptomatic uterine fibroids who were to undergo surgery. In a prospective, open, randomized setting 60 mg of Cetrorelix pamoate salt was administered i.m. on cycle day 2. Patients were randomized for a second dose of 30 or 60 mg of Cetrorelix depot, which was administered according to the degree of oestradiol suppression (<50 pg/ml) on treatment day 21 or 28. Surgery was done after 6 or 8 weeks of treatment, depending on second dosage administration. Weekly transvaginal sonography (TVS) and magnetic resonance imaging (MRI) before and after treatment was performed, for fibroid volume assessment. Sixteen patients showed satisfactory suppression of gonadotrophins and sex steroid secretion, avoiding any initial flare-up effect. In these patients a mean shrinkage rate of largest fibroid volume of 33.5% at the end of treatment could be observed according to TVS, while the mean shrinkage rate obtained after 14 days of treatment was 31.3%. In good responders (shrinkage >20%) largest fibroid volume at day 14 was approximately 56.7% of basic assessment. Although MRI showed minor mean shrinkage rates of only 25.4% of the initial volume, these differences in comparison to TVS assessment were not statistically significant. The avoidance of any initial flare-up in gonadotrophin secretion may explain this extremely fast reduction in fibroid size. The advantages of GnRH antagonist treatment in this indication consist in the short treatment time with a fast restoration of the ovarian function. The rate of poor responders may be reduced by using an improved slow release preparation.     

Cyclic diamides with (CH2) x segments: Phase transitions in the solid state

Summary Cyclic diamides with various CH₂ segment lengths were synthesized. Cyclo-(octamethylene sebacamide) I, x=8, was investigated as a model system by means of calorimetry, X-ray diffraction and Raman spectroscopy with special emphasis on its phase behaviour. In the low temperature phase the molecules exist as collapsed rings where the amide groups are located in the folds and the straight stems consist of nondisordered CH₂ segments. During the solid phase transition at about 84°C a strong increase of conformational disorder (4 additional gauche defects per molecule) occurs which does not change significantly during subsequent melting. It is shown that the conformation of the molecules in the high temperature phase is similar to that in the melt (liquid-like). In spite of conformational disorder the linewidth of the X-ray reflection peaks is smaller in the high temperature phase compared to that in the solution crystallized phase.     

Severe, accidental hypothermia: active rewarming with a simple extracorporeal veno-venous warming-circuit

We report the case of a 35-year-old male who was admitted to the intensive care unit because of somnolence due to accidental hypothermia. Initial examination showed a Glasgow coma score of 10 and a rectal temperature of 27.4 degrees C. Because of stable circulatory conditions, there was no mandatory indication for rewarming by means of cardiopulmonary bypass. We rewarmed the patient with an extracorporeal veno-venous haemofiltration device combined with a countercurrent fluid warmer. An average increase in body temperature of 1.34 degrees Ch-1 could be obtained. We conclude that the described technique represents an effective and well-controllable method for treatment of hypothermia in patients with stable haemodynamic conditions. Because of the availability of the required equipment, this method can also be practised in hospitals without cardiac surgical departments and cardiopulmonary bypass facilities.     

Optimal codes,n-arcs and Laguerre geometry

Summary In this paper we give sharp bounds for the block-length n of optimal linear (n, k)-codes over GF(q).     

8-channel optical demultiplexer realized as SiO2/Siflat-field spectrograph

The operation of a flat-field spectrograph in silica on silicon (SiO₂/Si) for 2-nm channel spacing is demonstrated. Crosstalk attenuations of >20 dB and significantly reduced fiber-to-fiber insertion losses of 5 dB could be obtained     

Comparison of the compositional, microbiological, biochemical and volatile profile characteristics of three Italian PDO fermented sausages

Three Italian PDO fermented sausages, Varzi, Brianza and Piacentino, were compared for compositional, microbiological, biochemical and volatile profile characteristics. Mean values for the gross composition varied especially due to moisture, fat, total protein and nitrate concentration which reflected differences in the ingredients and some technological parameters. Cell numbers of the major microbial groups were almost similar among sausages. The major differences were found for Brochothrix thermosphacta, enterococci and moulds. Apart from their use as starters, Lactobacillus sakei and Lactobacillus curvatus were the dominant lactic acid bacteria and, as well as Staphylococcus xylosus, dominated the population of coagulase-negative staphylococci. Sausages differed for the hydrolysis of myofibrillar proteins and secondary proteolysis. Varzi, the sausage subjected to prolonged fermentation at 23–25 °C for 10 days before ripening, showed the highest degree of secondary proteolysis. Varzi and Brianza, the two fermented sausages manufactured by using microbial starters, showed the highest concentration and similar profiles of free amino acids. The peptidase activities contained in the aqueous extracts agreed with the above findings. A total of 52 volatile components, mainly alcohols, aldehydes and terpenes, were identified by solid-phase micro-extraction coupled with gas chromatography–mass spectrometry analysis. The volatile profiles of the three Italian PDO fermented sausages differed in part and, except for terpenes, the highest levels of the other chemical classes were found in Varzi and Brianza sausages. The composition of free fatty acids of the three Italian PDO sausages was rather similar. Monounsaturated fatty acids (MUFA) were found at the highest relative percentage followed by saturated (SFA) and polyunsaturated (PUFA) fatty acids. Oleic, palmitic, linoleic and stearic were the main free fatty acids found in all fermented sausages.     

Infrared transmission spectrometry for the determination of urea in microliter sample volumes of blood plasma dialysates

Application of mid-infrared spectroscopy for the determination of urea in blood plasma dialysates of microliter sample volumes using a transmission microcell was investigated. Infrared spectra of the dialysates of plasma samples collected from 75 different patients using CMA 60 microdialysis catheters were evaluated with multivariate partial least squares regression. Using the absorbance spectral data from 1520-1420 cm(-1) and 1220-1120 cm(-1), a minimum standard error of prediction (SEP) of 0.88 mg/dL (0.14 mM) was achieved with spectral variable selection. Our findings suggest the feasibility of developing a mid-infrared sensor in combination with micro-fluidics for on-line monitoring of urea in patients undergoing dialysis treatment.