Experience with once daily dosing of gentamicin: considerations regarding dosing and monitoring

Plasma concentrations of gentamicin following a fixed dose of 240 mg once daily to patients with normal renal function were measured. The purpose was to establish guidelines to achieve a sufficiently high peak concentration with an appropriately low risk of accumulation. In 40 patients, 1-hour concentrations of plasma gentamicin had a median of 9.3 mg/l (range: 4.5-19.0 mg/l) and 9.7 mg/l (range: 3.6-14.6 mg/l) on days 1 and 3 of gentamicin treatment, respectively. Thirty-nine patients had 1-hour concentrations > 5 mg/l. The 1-hour concentrations varied considerably intra- and interindividually but showed a significant inverse correlation with body weight, surface area and the estimated endogenous creatinine clearance. The plasma gentamicin elimination half-life correlated significantly with age and inversely with body weight and creatinine clearance. There was no increase in the mean plasma creatinine from day 0 to day 4. No patients showed signs of nephrotoxicity, although 2 patients, both elderly and with low body weight, showed signs of beginning gentamicin accumulation. In conclusion, gentamicin treatment with the dose of 240 mg once daily in 3 days to adults with normal kidney function generally does not require adjustment or monitoring. However, the dose should be increased in young patients with an excessive body weight, and decreased doses are needed for old and underweight patients. Monitoring of trough plasma gentamicin concentration is not necessary with treatment duration of 3 days or less.     

In the beginning [junction transistor]

The junction transistor, technologically the most important solid-state device, invented theoretically by W.B. Shockley on January 23, 1948, brought about the semiconductor revolution. That invention was triggered by the experimental discovery of the point-contact transistor by W. Brattain and J. Bardeen 38 days earlier. Bardeen's notebook entries at Bell Telephone Laboratories for the crucial 100-day period November 21, 1947-February 29, 1948 have been examined to ascertain why this winner of two Nobel Prizes in physics could not invent the junction transistor. It was found that the boundary between the thin p-type inversion layer and the n-type bulk germanium semiconductor in their original point-contact transistor discovery was characterized as a “high resistance boundary” in macroscopic electrical engineering terms by Bardeen, the electrical engineer turned mathematical physicist. Pages from Shockley's notebook are reproduced in full to show what exactly he was thinking on December 16, 1947, the day the point-contact transistor was experimentally discovered by Brattain and Bardeen. The origin of U.S. Patent 2524035 has been traced to the Bell Telephone Laboratories notebook pages of its inventors and examined. It is shown that this patent could not be considered as the first patent describing Shockley's revolutionary theoretical invention of the minority carrier injection concept underlying bipolar transistor action     

Noninvasive assessment of hepatobiliary and renal elimination of cysteinyl leukotrienes by positron emission tomography

N-Acetyl-leukotriene E4 has been identified as an endogenous, biologically less active cysteinyl leukotriene metabolite in rodents and humans. To evaluate the ratio of hepatobiliary to renal elimination of leukotrienes noninvasively by positron emission tomography (PET), we synthesized N-[11C]acetyl-leukotriene E4 by chemical N-acetylation of leukotriene E4. After the intravenous injection of N-[11C]acetyl-leukotriene E4 in normal rats and monkey, uptake by the liver and subsequent excretion into bile were largely responsible for its rapid elimination from blood. In the Cynomolgus monkey, renal excretion of the leukotriene into urine was of additional quantitative importance. Kinetic modeling indicated a mean transit time through the liver of 17 minutes and 34 minutes in rat and monkey, respectively; the corresponding hepatic excretion half-times amounted to 8.5 minutes and 16 minutes. In a mutant rat strain deficient in the hepatobiliary excretion of cysteinyl leukotrienes across the canalicular membrane, the apparent mean liver transit time was 54 minutes, and the hepatic excretion half-time was 29 minutes, indicating prolonged organ storage and metabolism. After transport from the liver back into the circulating blood of omega-oxidized and beta-oxidized metabolites of N-[11C]acetyl-leukotriene E4, renal excretion compensated for the impairment of hepatobiliary elimination in the transport mutant. Metabolite analyses in urine after intravenous injection of N-[3H]acetyl-leukotriene E4 indicated the extensive inactivation of N-acetyl-leukotriene E4 by beta-oxidation from the omega-end in the mutants. A similar shift from hepatobiliary to renal cysteinyl leukotriene elimination was monitored in rats with cholestasis due to bile duct obstruction.(ABSTRACT TRUNCATED AT 250 WORDS)     

An image processing IC for backprojection and spatial histogrammingin a pipelined array

The first VLSI digital signal processor that performs both high-precision image backprojection and spatial histogram calculations at raster-scan rates as high as 30 MHz is described. Realized in 1 μm CMOS technology, this 13.3 mm×13.3 mm chip is designed to handle images as large as 1024×1024 12 b pixels. Loadable coefficients and a unified architecture allow this IC to be used with a variety of computed-tomography scanners for image reconstructions, including fan- and parallel-beam reconstruction. This chip also computes the forward Radon transform, which is a spatial histogram, permitting it to be used for iterative reconstruction algorithms. The bit lengths in the fixed-point architecture assure 12 b reconstruction accuracy     

Analysis of proliferative activity using anti-proliferating cell nuclear antigen antibody in gastric cancer tissue specimens obtained by endoscopic biopsy

BACKGROUND: Proliferative activities of tumors are thought to be prognostic features of malignant tumors, but their value as measured by proliferating cell nuclear antigen (PCNA) labeling remains unclear in gastric cancer. METHODS: PCNA labeling rates (LR) were quantified in 121 paraffin-embedded biopsy specimens from primary tumors by immunocytochemistry. RESULTS: Immunohistochemical analyses have demonstrated that PCNA presents an intense staining in the nuclei of tumor cells and mucous neck cells of gastric glands. The PCNA LR ranged from 12% to 79% (mean +/- standard deviation), and a significant correlation was found between bromodeoxyuridine labeling indices and PCNA LR: PCNA LR were closely associated with tumor size, serosal invasion, and nodal involvement. The patients with tumors with high PCNA LR (greater than 40%) were dead significantly earlier than were those with tumors with low PCNA LR: When the PCNA LR and all the clinicopathologic parameters were entered into a Cox regression model, PCNA LR emerged as an independent prognostic factor. CONCLUSION: These results indicate that PCNA LR may be a potentially useful prognostic factor for gastric cancer.     

Alcohol in Munich secondary school students--a study for dissemination of experiences, knowledge, attitude and behavior

The Munich Community Health Service (Medical School-Service Department) conducted an alcohol prevention project in ten public secondary schools. The 423 pupils (11-17 years of age) filled in a questionnaire on alcohol and discussed it afterwards under the guidance of a school physician and a teacher using guideline information. The results of the survey are presented in this paper. Additionally, suggestions for transferring the results to conceptualize and carry out preventive measures are made. The results indicate that the first experience with alcohol occurred early in life. One-fifth of the sample had already tried alcohol at the age of six. Immediate effects of alcohol (e.g. state of drunkenness) were experienced by 35.7 percent of the sample group. Kiosks, shops, and beverage stores were named most frequently as sources for alcohol. The sources of social support varied with respect to sex and age. With increasing age of the children, parents were contacted less frequently whereas the role of peers increased. The present results supply possible paths of action for the development of successful prevention strategies, e.g. by pointing out the early age of onset as well as specific sources of alcohol acquisition.     

Gentamicin treatment in peripheral vestibular disorders other than Ménière''s disease

Two cases of congenital trabecular hypoplasia of the right ventricle are reported. In the first, the neonatal diagnosis was missed and the child did well until the 13th month of life when a modified Blalock-Taussig shunt was done because of increasing cyanosis. Outcome was good until the 4th year of life when symptomatic atrioventricular block was detected in an emergency situation. A bidirectional Glenn anastomosis and pacemaker implantation were successfully carried out after clinical establization and the child is doing well up to now. The second case presents the disease with its worst features: severe cyanosis and acidosis in the first day of life. A modified Blalock-Taussig shunt was performed and death occurred soon after the operation.     

A circular reflector interferometer for the far infrared

The construction of a Fourier transform spectrometer to study magnetic resonances in solids is described. The spectrometer operates in the Far Infrared (maximum frequency of 500 cm^?1) and is based on a wavefront dividing interferometer with circular geometry. To illustrate the performance, a water vapour spectrum is given.