Maternal complications from tocolytic treatment with beta-mimetics. Three cases of pulmonary edema

We report three cases of pulmonary edema associated with prolonged intravenous tocolytic therapy with beta 2-adrenergic agonists among patients with multiple pregnancies. Although beta 2-adrenergic agonists may have direct myocardial side-effects, the underlying pathophysiologic mechanisms are mainly noncardiogenic. The most important one appears to be the fluid overload, related to amounts of fluids given intravenously and to direct result of beta-sympathomimetic therapy on renal excretion of sodium and water. Neonatal benefit of prolonged tocolytic therapy remains hypothetical. If this strategy is used, the prevention of cardiovascular adverse effects requires an intensive maternal supervision, especially in case of multiple pregnancy, the use of beta 2-adrenergic agonists in concentrated solution in order to reduce the amounts of fluids given intravenously, and the association with progesterone therapy which can reduce the infusion rate and the duration of tocolytic therapy.     

Delivery of cefotaxime to the brain via intranasal administration

The purpose of this study was to investigate the plausibility of delivery of cefotaxime to the brain via intranasal administration. In vitro permeation studies were carried out using Franz diffusion cells, and the effect of different concentrations of chitosan (0.1% w/v and 0.25% w/v) on drug permeation across the bovine olfactory mucosa was determined. Samples were collected from the receiver compartment at different time points and analyzed using HPLC. The amount of cefotaxime that permeated across the olfactory mucosa when 0.25% w/v of chitosan was used as a permeation enhancer was ~1.5- and ~2-fold higher at the end of the first hour and second hour, respectively, over control (29.56 ± 6.18 μg/cm(2)). There was no significant enhancement in drug permeation when 0.1% w/v chitosan was used as the permeation enhancer. Pharmacokinetic studies were carried out using Sprague-Dawley rats. Cefotaxime solution with 0.25% w/v chitosan (40 mg/kg) was administered intravenously (i.v.) to rats in groups 1 and 3 and intranasally to those in group 2 and 4. The time course of drug in the brain was investigated by performing microdialysis in rats of groups 1 and 2. Blood samples were withdrawn from rats in groups 3 and 4, and cefotaxime in plasma was analyzed using HPLC after extraction with a hydrochloric acid-chloroform:1-pentanol (3:1) and phosphate buffer solvent system. Pharmacokinetic parameters were calculated using the trapezoidal rule. The results imply that the drug levels attained in the brain following i.v. and intranasal administrations were comparable. These results suggest that intranasal administration of cefotaxime could be a potential method of delivering antibacterial agents because of it being noninvasive and patient compliant.     

Blast resistance and energy absorption of foam-core cylindrical sandwich shells under external blast

The early time, through-thickness stress wave response of a foam-core, composite sandwich cylindrical shell under external blast is examined in this paper. Solutions for the transient response of the facesheets were derived as stress waves propagated through an elastic–plastic, crushable foam core. These solutions were found to be in good agreement with results from finite element analysis. The blast response of the composite sandwich cylindrical shell was shown to be affected by the magnitude and duration of the pressure pulse. High amplitude, low duration (impulsive) pressure pulses induced the greatest energy absorption. Low amplitude, long duration pressure pulses caused minimal energy absorption. The amount of energy absorbed increased and the failure load decreased with increasing core thickness. Sandwich shells with foams of varying density, compressive modulus and crushing resistance were also examined. The sandwich shells with the foam of the highest density, compressive modulus and crushing resistance (Divinycell HCP100) were found to be the most blast resistant to failure even though no energy was absorbed by them. Per unit weight, however, the shells with a lighter, less stiff and strong, Divinycell H200 foam core were more blast resistant to failure than shells with a Divinycell HCP100 foam core.     

Delayed deliveries in multiple pregnancies: is this reasonable?

A gene polymorphism of the angiotensin II (AII) type 1 receptor has been described previously (A to C transversion at position 1166). Besides the epidemiological studies needed to determine a possible relationship between the polymorphism and some cardiovascular diseases, no study has been conducted to determine the impact of the polymorphism on vascular functions. At subthreshold concentrations, within the physiological range, AII potentiates alpha-adrenergic-dependent vascular tone. We investigated phenylephrine-induced tone and its amplification by AII (10 pmol/l) in human internal mammary artery rings mounted in organ baths. We performed concentration-response curves to phenylephrine (0.1-100 micromol/l) before and after pretreatment with AII (10 pmol/l). Patients had the genotype AA (n = 20) or the A to C transversion (AC/CC, n = 30). Contractions to phenylephrine (0.1-100 micromol/l) were significantly higher in rings from AC/CC than from AA patients (maximum response: 1.47+/-0.07 vs. 1.22+/-0.06 mN/mg, p < 0.001). AII (10 pmol/l) induced a significant potentiation of phenylephrine-induced contraction (e.g. 58.9% increase in tone with 1 micromol/l phenylephrine, p < 0.001) which was significantly lower in the AC/CC than in the AA group (46+/-9 vs. 66+/-7% with 1 micromol/l phenylephrine, p < 0.01). Contractions to AII (1 or 100 nmol/l) were not significantly affected by the genotype. Although the study was performed in arteries from patients with a coronary artery disease, these changes in vascular reactivity might be of interest in the understanding of the relationship between a possible higher probability of cardiovascular disorder and the genetic polymorphism of the AII type 1 receptor.     

The effect of bulk-fill flowable composites on the fracture resistance and cuspal deflection of endodontically treated premolars

The aim of this study was to evaluate the effect of bulk-fill flowable composites on cuspal deflection and fracture resistance of endodontically treated teeth. Forty-two maxillary premolars were subjected to endodontic treatment followed by the preparation of mesioocclusodistal cavities. Teeth were divided into six groups according to restorative materials as follows: Group 1: Clearfil Majesty Flow and Clearfil Majesty Posterior; Group 2: Venus Bulk Fill and Clearfil Majesty Posterior; Group 3: Clearfil Majesty Posterior; Group 4: Vertise Flow and Clearfil Majesty Posterior; Group 5: SDR and Clearfil Majesty Posterior; and Group 6: x-tra base and Clearfil Majesty Posterior. A single-step self-etch adhesive (OptiBond All-in-One) was applied to all groups, except Group 4. The cavities were restored with a centripetal incremental insertion technique and flowable composites using a 2-mm-thick base material, except for Group 3. The distance between cusp tips was measured before and after the cavity preparations, after the restorations, and after thermal cyclus with a digital micrometer. After measuring, each tooth was subjected to compressive loading with a stainless steel ball (4 mm diameter) perpendicular to the occlusal surface with a crosshead speed of 1 mm/min, and mean loads necessary to fracture were recorded in Newtons. The data were statistically analyzed by Kruskal–Wallis test. No statistically significant differences were found between groups in fracture strength or cuspal deflections (p > 0.05). Bulk-fill flowable composite bases did not change the cuspal deflection or fracture resistance of endodontically treated teeth, compared with that of a conventional flowable base and conventional resin composite.     

Comparison of vehicle types at an automated container terminal

At automated container terminals, containers are transshipped from one mode of transportation to another. Automated vehicles transport containers from the stack to the ship and vice versa. Two different types of automated vehicles are studied in this paper, namely automated lifting vehicles and automated guided vehicles. An automated lifting vehicle is capable of lifting a container from the ground by itself. An automated guided vehicles needs a crane to receive and deliver a container.In designing automated container terminals one have to consider the choice for a certain type of equipment. The choice for a certain type of equipment should be made by performing a feasibility and economic analysis on various types of equipment. In this paper, we examine effects of using automated guided vehicles and automated lifting vehicles on unloading times of a ship, with simulation studies. In choosing a certain type of equipment we have considered criteria such as unloading times of a ship, occupancy degrees and the number of vehicles required. 38% more AGVs need to be used than ALVs. From this specific study, we conclude that, by observing only purchasing costs of equipment, ALVs are a cheaper option than AGVs.To obtain an accurate analysis we have performed a sensitivity analysis. It can be concluded that the design of the terminal and technical aspects of quay cranes impact the number of vehicles required and as a result the choice for a certain type of equipment. Correspondence to: Iris F. A. Vis     

Tungsten disulfide nanoparticle-containing PCL and PLGA-coated bioactive glass composite scaffolds for bone tissue engineering applications

Journal of Materials Science - In the study, tungsten disulfide (WS2) nanoparticle-containing polymer-coated bioactive glass composite scaffolds were prepared for bone tissue engineering...     

Macromolecular intravenous contrast agent for MR lymphography: characterization and efficacy studies

PURPOSE: To determine the pharmacokinetic and magnetic resonance (MR) imaging properties of diethylenetriaminepentaacetic acid (DTPA) conjugated with a polyglucose-associated macrocomplex (PGM), which accumulates in lymph nodes. MATERIALS AND METHODS: In 124 normal and 20 tumor-bearing rats, Gd-DTPA PGM was administered intravenously in doses of 2, 10, 20 mumol gadolinium per kilogram of tissue. RESULTS: Mean blood half-life was 2 hours. Maximum accumulation in peripheral (33.0% injected dose [ID]/g +/- 16.2 [standard deviation]) and central lymph nodes (63.2% ID/g +/- 16.5) was observed within 24 hours after administration. The optimum dose range was 10-20 mumol Gd/kg in rats. At 24 hours after administration of 20 mumol Gd/kg, the signal-to-noise ratio increased from 30.9 +/- 0.4 to 83.2 +/- 5.2 in normal lymph nodes (P < .001). Differentiation between normal and metastatic lymph nodes was improved. CONCLUSION: When labeled with Gd-DTPA, the PGM-based graft copolymer significantly increases signal intensity at MR imaging of normal but not metastatic lymph nodes without causing distortion artifacts.     

5-Fluorouracil-loaded PLA/PLGA PEG–PPG–PEG polymeric nanoparticles: formulation,in vitro characterization and cell culture studies

In this study, 5-FU, a potent anticancer drug, is planned to be delivered via a new and promising drug delivery system, nanoparticles formed with hydrophobic core polymer and triblock copolymers; Poly(DL-lactic acid), Poly(ethylene glycol)-block-poly(propylene glycol)-block-poly(ethylene glycol) copolymer (PLA/PEG-PPG-PEG) and Poly(D,L-lactide–co-glycolide)/Poly(ethylene glycol)-block-poly(propylene glycol)-block-poly(ethylene glycol) copolymer (PLGA/PEG-PPG-PEG) nanoparticles. Particle size range of nanoparticles was found to be between 145 and 198?nm, which would promote the passive targeting of the nanoparticles to tumor cells based on the enhanced permeability and retention (EPR) effect. SEM images revealed all nanoparticles formulations to be spherical and without pores. Zeta potential, yield value and encapsulation efficiencies of 5-FU-loaded nanoparticles were within the range of ?11.1 and ?13.7?mV, 72.7–87.7% and 83.6–93.9%, respectively. Cumulative release of 5-FU was observed between 90% and 94.4% in all nanoparticle formulations by the end of 72?h, and fitness of release profiles to Higuchi model indicated matrix-controlled diffusion of the 5-FU from polymeric nanoparticles. Cell viability values of the cells treated with 5-FU-loaded nanoparticles were obtained as low as 47% and 52% with tetrazolium dye assay, suggesting that delivery of 5-FU via amphiphilic triblock copolymer nanoparticles would be a promising delivery system because of the EPR effect.