Phase II clinical and pharmacological study of pirarubicin in combination with 5-fluorouracil and cyclophosphamide in metastatic breast cancer

Doxorubicin containing combination chemotherapy regimens are widely used for treatment of breast and other cancers. However, these regimens are associated with significant toxicities including myocardial dysfunction and alopecia. Analogues of doxorubicin are being developed to reduce these side effects. We conducted a Phase II trial of an anthracycline analogue, pirarubicin, administered in combination with 5-fluorouracil and cyclophosphamide every 3 weeks, as front-line chemotherapy in women with metastatic breast cancer. Patients who had received prior anthracycline therapy were excluded. The chemotherapy doses were as follows: 5-fluorouracil (500 mg/m2 on days 1 and 8), pirarubicin (50 mg/m2 on day 1), and cyclophosphamide (500 mg/m2 on day 1). Among 40 evaluable patients treated on this protocol, a major response (partial or complete remission) was observed in 26 patients (response rate, 62%; 95% confidence interval, 46-77). The median response duration was 8 months, and median survival was 16 months. Grade III/IV myelosuppression occurred in 81% of the courses. The median cumulative pirarubicin dose was 410 (range, 90-870) mg/m2. A significant decrease in left ventricular ejection fraction occurred in 12 patients (at a median cumulative pirarubicin dose of 460 mg/m2) and led to congestive heart failure in 4 of these patients (cumulative pirarubicin doses of 500, 520, 590, and 730 mg/m2, respectively). Eleven patients underwent endomyocardial biopsy, either because they experienced a drop in left ventricular ejection fraction or because they had received a cumulative pirarubicin dose of 600 mg/m2 and were still responding to the treatment. Of these, only one biopsy was found to be more than grade 1.0 (in an individual who had received a cumulative dose of 705 mg/m2). Severe alopecia occurred in two-thirds of the patients. Pharmacokinetic studies revealed a triphasic elimination of pirarubicin with alpha, beta and gamma half-lives of 0.12, 1.44, and 33.9 h, respectively. Total clearance of drug was 4.2 liters.1 h/kg while the cumulative 24-h urinary excretion was less than 10% of the administered dose. The activity of the combination appears to be similar to doxorubicin-containing regimens, while the incidence of alopecia appears to be lower than the historical experience with doxorubicin. However, cardiotoxicity remains a significant problem.     

Progress in the diagnosis of hypovitaminosis A: clinical and biochemical correlations

Hypovitaminosis A is a widespread problem, especially among preschool children in many parts of the world. According to the World Health Organization (WHO) estimates, about 100,000 children become blind every year, and many are dying due to vitamin A deficiency while millions of others are suffering from other consequences of vitamin A deficiency such as growth retardation and increased susceptibility to infection. It is, therefore, very important that not only the severe cases of hypovitaminosis A be diagnosed for immediate treatment, but also the marginal cases of vitamin A deficiency in vulnerable populations be diagnosed as early as possible so that appropriate preventive measures be implemented. Available methods for the diagnosis of vitamin A deficiency can be classified into four categories: clinical, biochemical, functional, and dietary. Clinical diagnosis is based on examining ocular and extraocular signs of hypovitaminosis A, and is only useful for the detection of severe cases. Biochemical methods are based on the plasma concentrations of retinol and retinol-binding protein (RBP), and liver reserve of vitamin A whenever possible. Two other commonly used diagnostic tests are: functional testing for nightblindness using dark adaptation time, and pathological testing for ocular signs of conjunctival xerosis, with or without the use of Rose Bengal or lissamine green dye. Dietary method for the diagnosis of vitamin A deficiency is based on the estimation of dietary intake of vitamin A and carotenoids. In addition, there are newer methods such as isotope dilution and relative dose response (RDR) techniques which have been recently proposed for the diagnosis of vitamin A deficiency. RDR appears to be a reliable and sensitive indicator of marginal vitamin A. However, the most desirable approach to diagnosis may be one based on multiple indicators for the accurate assessment of vitamin A status in the community. The purpose of this paper is to draw attention to the problems of diagnosis, to recent advances and to our Brazilian experience in this important area of vitamin A research with significant global implications.     

Formulation,in vitro evaluation and study of variables on tri-layered gastro-retentive delivery system of diltiazem HCl

Context: Tri-layered floating tablets using only one grade of polyethylene oxide (PEO) would enable easy manufacturing, reproducibility and controlled release for highly soluble drugs.

Objective: To evaluate the potential of PEO as a sole polymer for the controlled release and to study the effect of formulation variables on release and gastric retention of highly soluble Diltiazem hydrochloride (DTZ).

Methods: Tablets were compressed with middle layer consisting of drug and polymer while outer layers consisted of polymer with sodium bicarbonate. Design of formulation to obtain 12?h, zero-order release and rapid floatation was done by varying the grades, quantity of PEO and sodium bicarbonate. Dissolution data were fitted in drug release models and swelling/erosion studies were undertaken to verify the drug release mechanism. Effect of formulation variables and tablet surface morphology using scanning electron microscopy were studied.

Results and discussion: The optimized formula passed the criteria of USP dissolution test I and exhibited floating lag-time of 3–4?min. Drug release was faster from low molecular weight (MW) PEO as compared to high MW. With an increase in the amount of sodium bicarbonate, faster buoyancy was achieved due to the increased CO₂ gas formation. Drug release followed zero-order and gave a good fit to the Korsmeyer–Peppas model, which suggested that drug release was due to diffusion through polymer swelling.

Conclusion: Zero-order, controlled release profile with the desired buoyancy can be achieved by using optimum formula quantities of sodium bicarbonate and polymer. The tri-layered system shows promising delivery of DTZ, and possibly other water-soluble drugs.     

A Multifunctional Nanoplatform for Imaging,Radiotherapy, and the Prediction of Therapeutic Response

Gold nanoparticles have garnered interest as both radiosensitzers and computed tomography (CT) contrast agents. However, the extremely high concentrations of gold required to generate CT contrast is far beyond that needed for meaningful radiosensitization, which limits their use as combined therapeutic–diagnostic (theranostic) agents. To establish a theranostic nanoplatform with well‐aligned radiotherapeutic and diagnostic properties for better integration into standard radiation therapy practice, a gold‐ and superparamagnetic iron oxide nanoparticle (SPION)‐loaded micelle (GSM) is developed. Intravenous injection of GSMs into tumor‐bearing mice led to selective tumoral accumulation, enabling magnetic resonance (MR) imaging of tumor margins. Subsequent irradiation leads to a 90‐day survival of 71% in GSM‐treated mice, compared with 25% for irradiation‐only mice. Furthermore, measurements of the GSM‐enhanced MR contrast are highly predictive of tumor response. Therefore, GSMs may not only guide and enhance the efficacy of radiation therapy, but may allow patients to be managed more effectively.     

Ag and O ion irradiation induced improvement in dielectric properties of the Ba(Co1/3Nb2/3)O3 thin films

We present the preliminary results of temperature and frequency dependent dielectric measurements on Ba(Co_1/3Nb_2/3)O₃ (BCN) thin films. These films were prepared on indium tin oxide (ITO) coated glass substrates by the pulse laser deposition (PLD) technique. It exhibits single-phase hexagonal symmetry. These films were irradiated with Ag¹⁵⁺ (200 MeV) and O⁷⁺ (100 MeV) beams at the fluence 1 × 10¹¹, 1 × 10¹², and 1 × 10¹³ ions/cm². On irradiating these films, its dielectric constant (?′) and dielectric loss (tan δ) parameters improve compared to un-irradiated film. Compared to O⁷⁺ irradiation induced point/cluster defects Ag¹⁵⁺ induced columnar defects are more effective in reducing/pinning trapped charges within grains. The present paper highlights the role of swift heavy ion irradiation in engineering the dielectric properties of conductive samples to enable them to be useful for microwave device applications.     

Multimodal image/video fusion rule using generalized pixel significance based on statistical properties of the neighborhood

Image fusion has been receiving increasing attention in the research community with the aim of investigating general formal solutions to a wide spectrum of applications such as multifocus, multiexposure, multispectral ( $IR$ -visible) and multimodal medical (CT and MRI) image and video fusion. While there exist many fusion techniques for each of these applications, it is difficult to formulate a common fusion technique that works equally well for all these applications. This is mainly because of the different characteristics of the images involved in various applications and the correspondingly different requirements on the fused image. In this work, we propose a common generalized fusion framework for all these classes, based on the statistical properties of local neighborhood of a pixel. As the eigenvalue of the unbiased estimate of the covariance matrix of an image block depends on the strength of edges in that block, we propose to employ it to compute a quantity we call as the significance of a pixel. This generalized pixel significance in turn can be used as a measure of the useful information content in that block, and hence can be used in the fusion process. Several data sets were fused to compare the results with various recently published methods. The analysis shows that for all the image types into consideration, the proposed methods improve the quality of the fused image, both visually and quantitatively, by preserving all the relevant information.     

Automated information system for controlling the sociopsychological adaptation of junior grade schoolchildren during learning activities

Acute graft rejection and delayed function are considered to be the major risk factors of short-term as well as long-term graft survival. We studied the impact of these factors on graft outcome among 109 renal transplant recipients. All recipients were treated with triple drug protocol. The recipients were divided into two groups: I group included 57 patients with delayed graft function (DGF), II group included 52 patients with immediate graft function (IGF). We studied graft survival, incidence of acute rejection, serum creatinine levels and the cause of graft loss for patients in both groups. Acute rejection episodes occurred in 49% of patients from DGF group and 45% of patients from IGF group. Graft survival in IGF group was better than in DGF group. Actuarial graft survival at 1, 2, 3 and 4 years in examined groups was 84%, 82%, 72%, 65% vs. 92%, 86%, 84%, 84%, respectively. One-year graft survival in patients with acute rejection from DGF group and IGF group was significantly lower than in patients who remained rejection free (69%, 74% vs. 94%, 96%). We concluded that delayed graft function decreases long-term graft survival, while immediate graft function has an excellent impact on graft outcome. Acute graft rejection is the strongest risk factor of graft loss.