Doxorubicin cellular pharmacokinetics plays no role in chemosensitizing effect of verapamil on Swiss-3T3 cells

AIM: To find whether or not the doxorubicin (Dox) cellular pharmacokinetics plays a role in chemosensitizing effect of verapamil (Ver) on drug sensitive cells. METHODS: Cytotoxicity and cellular Dox contents (during accumulation and retention periods) were measured in the absence and presence of verapamil in Swiss-3T3 cells and compared with those in multidrug resistant (MDR) MCF-7Adr cells and drug sensitive MCF-7WT cells. mdr-1 mRNA expression in Swiss-3T3 cells was analyzed. RESULT: Dox cytotoxicity was enhanced 2.0-fold in Swiss-3T3 cells by Ver (3 mumol.L-1) and 3.6-fold in MCF-7Adr cells by Ver (6 mumol.L-1), but not in MCF-7WT cells (Ver 6 mumol.L-1). Cellular accumulation of equi-effective concentrations of Dox increased at 6-h incubation in the presence of Ver in Swiss-3T3 (1.5-fold)i and MCF-7WT cells (2.1-fold) but decreased rapidly in MCF-7Adr cells by 20% to 50% compared to that in the absence of Ver. Cellular retention of Dox decreased after 10-min increase in the presence of Ver in Swiss-3T3 cells compared to that in the absence of Ver, that was similar to that in MCF-7WT cells, while the retention was augmented by Ver in MCF-7Adr cells. Slot blot analysis of RNA revealed no mdr-1 gene expression in Swiss-3T3 cells. CONCLUSION: Changes in cellular accumulation and retention of Dox did not account for the chemosensitizing effect of Ver on Swiss-3T3 cells.     

Total-body skeletal muscle mass: evaluation of 24-h urinary creatinine excretion by computerized axial tomography

We retrospectively reviewed the results of operative decompression for peroneal nerve palsy in thirty-one patients who had been managed between 1980 and 1990. All patients had been managed non-operatively for at least two months after they had initially been seen. Intraoperatively, we found epineurial fibrosis and bands of fibrous tissue constricting the peroneal nerve at the level of the fibular head and at the proximal origin of the peroneus longus muscle. At a mean of thirty-six months (range, twelve to seventy-two months) postoperatively, thirty (97 per cent) of the thirty-one patients reported subjective and functional improvement and were able to discontinue the use of the ankle-foot orthosis. In contrast, only three of nine patients who had been managed non-operatively reported subjective and functional improvement (p < 0.01). Peroneal nerve palsy does not always resolve spontaneously; if it is left untreated, the loss of dorsiflexion of the ankle and persistent paresthesias can result in severe functional disability. Therefore, if non-operative measures do not lead to improvement within two months, we believe that operative decompression should be considered.     

Urinary incontinence and bacteriuria in women

We analyzed the urodynamic data and their relationship with significant bacteriuria in 103 consecutive female patients (mean age = 55.7 yrs) with urinary incontinence. Significant bacteriuria was observed in 25.2% of the cases. E. coli was the pathogen most frequently isolated (70.3%). Significant bacteriuria was demonstrated in 29.3% of the patients with urge-incontinence. The most frequent type of incontinence in patients with bacteriuria was no urodynamic reproduction of urinary incontinence (42.8%). Bladder instability was not associated with significant bacteriuria (27.2%). Significant bacteriuria was observed in 75% of the patients with lower urinary tract obstruction, 66.6% of the patients who voided by abdominal straining and 26.3% of those with postvoiding residual urine. These findings indicate that urine culture should be done in patients with no urodynamic reproduction of urinary incontinence. There was no statistically significant correlation between urge-incontinence/bladder instability and significant bacteriuria. Consequently, antibiotics should not be used routinely in female urinary incontinence.     

A critical review of research related to family physician-assisted smoking cessation interventions

A review of family physician-assisted smoking cessation research indicates that the family practice setting affords an excellent opportunity to intervene with a large proportion of smokers, at a time when they are receptive to health promotion messages. Outcome data at 6- and 12-month follow-up intervals indicate the value of combining 3 key strategies in achieving optimal results: physician advice and support, nicotine replacement therapy, and cognitive-behavioural counselling. The authors' review identifies questions that need to be addressed in future research: How can barriers to program delivery be overcome in the family practice setting? What is the best way to ensure optimal integration of the 3 key strategies? Which follow-up intervals are appropriate (e.g., 6 months, 12 months, 18 months) given the finding that relapse is common and that most smokers make several quit attempts before stopping for good?     

Anatomy of the internal mammary veins and their use in free TRAM flap breast reconstruction

The anatomy of 61 internal mammary veins (IMV) in the 3rd, 4th and 5th intercostal spaces was studied in 34 fresh human cadavers by injection and corrosion methods and surgical dissection. The IMV was present in all 34 cadavers. Four different patterns of venous anatomy were identified: Types 1 (69%) and 2 (26%) were common, Types 3 (3%) and 4(2%) were rare. The most common arrangement (Type 1) consists of the internal mammary vein running medial and parallel to the artery to the 4th intercostal space where it divides into the medial and the lateral IMV, the lateral crossing the internal mammary artery (IMA) anterior to it in direction from medial to lateral. Both veins are connected by interconnecting branches. The mean diameter of internal mammary veins is 2.7 mm (range 1.1-4.8 mm) for the medial and 1.8 mm (range 0.5-3.5 mm) for the lateral one. The mean distance from the lateral bordoffof the sternum of the medial vein is 9 mm (range 2-18 mm) and 14 mm (range 9-24 mm) for the lateral vepfpff. We present a review of 7 patients in whom internal mammary vessels were used as recipient vessels for breast reconstruction with free TRAM flaps with no complications, as well as the advantages and disadvantages of such a procedure.     

A nonstationary model of newborn EEG

The detection of seizure in the newborn is a critical aspect of neurological research. Current automatic detection techniques are difficult to assess due to the problems associated with acquiring and labelling newborn electroencephalogram (EEG) data. A realistic model for newborn EEG would allow confident development, assessment and comparison of these detection techniques. This paper presents a model for newborn EEG that accounts for its self-similar and nonstationary nature. The model consists of background and seizure submodels. The newborn EEG background model is based on the short-time power spectrum with a time-varying power law. The relationship between the fractal dimension and the power law of a power spectrum is utilized for accurate estimation of the short-time power law exponent. The newborn EEG seizure model is based on a well-known time-frequency signal model. This model addresses all significant time-frequency characteristics of newborn EEG seizure which include; multiple components or harmonics, piecewise linear instantaneous frequency laws and harmonic amplitude modulation. Estimates of the parameters of both models are shown to be random and are modelled using the data from a total of 500 background epochs and 204 seizure epochs. The newborn EEG background and seizure models are validated against real newborn EEG data using the correlation coefficient. The results show that the output of the proposed models have a higher correlation with real newborn EEG than currently accepted models (a 10% and 38% improvement for background and seizure models, respectively).