A very rare localization of metastatic lung carcinoma to the interosseous membrane

INTRODUCTION

Soft tissue is a rare localization of carcinoma metastasis. Skeletal muscle is considered the most frequent site. The aim of this paper is to report a very rare localization of soft-tissue metastasis of lung adenocarcinoma in the lower leg interosseous membrane, surgically treated at our department.

MATERIALS AND METHODS

A 66-year-old man with a history of lung adenocarcinoma was admitted to our department because he complained of a pain resistant to drugs that had persisted for 1 month. Imaging showed that the lesion was unique, localized in the interosseous membrane, with a distal margin more than 2 cm above the ankle platform. A distal fibula resection, including the tumour and a reconstruction according to Capanna type A2 was performed.

RESULTS

At the 6 months follow-up, the patient was walking without external support.

CONCLUSION

Surgery is not the treatment of choice for soft-tissue metastases, but it may be recommended when the lesion is unique and inducing a pain resistant to anti-inflammatory drugs.

Acrylic cement added with antiblastics in the treatment of bone metastases. Ultrastructural and in vitro analysis

An increased long-term survival of patients with alignant tumours also increases the possibility of the development of skeletal metastases and pathological fractures. The management of bone metastases includes the removal of gross disease and the administration of local adjuvants. We have investigated the possibility of adding antiblastic drugs to acrylic cement. Cylinders of acrylic cement were manufactured containing three different antiblastic drugs, methotrexate, cisplatin and doxorubicin. We performed in vitro analysis on MCF-7 human breast cancer cells in order to evaluate the biological effect of the mixtures and surface analysis of the acrylic cement-cisplatin cylinders using energy-dispersive x-ray analysis (EDAX). All drugs were released in an active form from the cement. Each drug had a different effect on cell viability. Doxorubicin had the greatest effect on breast cancer cells. Surface analysis showed that antiblastic drugs were present in the form of granules. These results confirm the potential of antiblastic-loaded cement as a possible adjuvant in the local treatment of bone metastases. Further studies should be undertaken to determine whether the release of antiblastic drugs from cement is elution or if they are only released from the surface.

Acrylic cement added with antiblastics in the treatment of bone metastases

An increased long-term survival of patients with malignant tumours also increases the possibility of the development of skeletal metastases and pathological fractures. The management of bone metastases includes the removal of gross disease and the administration of local adjuvants. We have investigated the possibility of adding antiblastic drugs to acrylic cement.

Cylinders of acrylic cement were manufactured containing three different antiblastic drugs, methotrexate, cisplatin and doxorubicin.

We performed in vitro analysis on MCF-7 human breast cancer cells in order to evaluate the biological effect of the mixtures and surface analysis of the acrylic cement-cisplatin cylinders using energy-dispersive x-ray analysis (EDAX). All drugs were released in an active form from the cement. Each drug had a different effect on cell viability. Doxorubicin had the greatest effect on breast cancer cells. Surface analysis showed that antiblastic drugs were present in the form of granules.

These results confirm the potential of antiblastic-loaded cement as a possible adjuvant in the local treatment of bone metastases.

Further studies should be undertaken to determine whether the release of antiblastic drugs from cement is elution or if they are only released from the surface.

Osseointegration in hip prostheses: experimental study in sheep

Sixteen 2- to 3-year-old sheep were submitted to a hemiarthroplasty of the hip joint with a specially designed femoral component. The proximal two thirds of the stem had a circumferential, plasma-sprayed, porous coating with hydroxyapatite. The animals where killed a 15, 30, 60, 90, 120, 180, 200, 270, 360, and 540 days after surgery. Femurs were submitted to plain radiographs, computerised tomography (CT) scan, and dual energy X-ray absorptiometry (DEXA). Cross-sections were obtained at four different levels and studied using scanning electron microscopy. In the coated portion of the stem, apposition of woven immature bone was evident at 15-30 days and mature lamellar bone by 30 days. With time, the gap between the endosteum and the coated surface was filled by bridges of lamellar bone with a marked trabecular orientation. In the distal uncoated portion of the stem, the implant was initially surrounded by fibrous tissue that, with time, transformed into lamellar bone.

Multiphase Flow Metering: Current Trends and Future Developments

Distinguished Author Series articles are general, descriptive representations that summarize the state of the art in an area of technology by describing recent developments for readers who are not specialists in the topics discussed. Written by individuals recognized as experts in the area, these articles provide key references to more definitive work and present specific details only to illustrate the technology. Purpose: to inform the general readership of recent advances in various areas of petroleum engineering.

Abstract

Over the last decade, the development, evaluation, and use of multiphase-flow-metering (MFM) systems have been a major focus for the oil and gas industry worldwide. Many alternative metering systems have been developed, but none can be referred to as generally applicable or universally accurate. Both established and novel technologies suitable to measure the flow rates of gas, oil, and water in three-phase flow are reviewed and assessed within this framework. Technologies already implemented in various commercial meters then are evaluated in terms of operational and economical advantages or shortcomings from an operator's point of view. The lessons learned about the practical reliability, accuracy, and use of available technology are discussed. As operators now realize, use of MFM systems (MFMSs) is essential in exploiting marginal fields. A new approach to flow assurance, deepwater developments, downhole/seabed separation systems, and wet-gas fields is foreseen. The authors suggest where additional research to develop the next generation MFM devices will be focused to meet the as yet unsolved problems.

Brief History

The first commercial MFMSs appeared approximately 10 years ago, as a result of several multiphase metering research projects in the early 1980s. The driving force to develop MFM technology was the forecast decline of production from the major North Sea fields, accompanied by the necessity to tie backfuture smaller discoveries to existing infrastructure. Increasing gas and waterfractions, inherent in a mature producing province, would create more-unstable flow conditions in existing production facilities and require more-flexible multiphase solutions.

In less than a decade, MFM has become accepted in the field and is beginning to be considered as a primary metering solution for new field developments.

MFM Applications

Within the oil and gas industry, it is generally recognized that MFM could lead to great benefits in terms of the following.1,2,3

Layout of Production Facilities.

The use of MFMs reduces the hardware needed for onshore, offshore topside, and offshore subsea applications. Of primary importance is the removal of a dedicated test separator for well-testing applications. Use of MFM (with its smaller footprint) for topside applications minimizes platform space and load requirements for well-testing operations. Finally, costly well-testing lines can be stripped from the production facilities, which may be of vital importance for unmanned locations, deepwater developments, and satellite fields.

Well Testing.

Conventional test separators are expensive and require much time to monitor each well's performance because of the time required to reach stabilized flow conditions. It is particularly important in deepwater developments, because of the exceptional length of the flowlines. In such cases, production from individual wells connected to the same manifold may be monitored by use of a dedicated test line to avoid shutting down all the wells, then testing them one by one (with considerable production loss). However, the expense of a separate flowline may be prohibitive, hence the advantages of MFM installed in the subsea manifold. Test separators have an accuracy between approximately 5 and10% (currently achievable with MFMSs) but require regular intervention by trained personnel and cannot provide continuous well monitoring. Another disadvantage of conventional well testing with conventional separators is that well performance suffers after shutdown cycles related to well testing. Often, wells tested on a regular basis require more-frequent workovers to maintain their production rates.

Use of MFMSs for exploration-well testing4 provides satisfactory flow measurements without separation of the phases. It is claimed that they can be used to monitor the well during its cleanup flow (traditionally, this flow information is lost because the well stream is not directed through the test separator). Added value is represented by improved control of the drawdown applied to the formation, the pressure transient, and shortened flow periods.

Reservoir Management.

MFMSs provide real-time, continuous data to enable operators to characterize field and reservoir performance better and react faster. Changes in gas/oil ratio or water cut can be detected and quantified immediately, where as traditional test separators provide information about only cumulative volumes at discrete points in time.

Synthesis and pharmacological activity of 1,2,4-triazolo[4,3-a]quinolines

The synthesis of a series of 1,2,4-triazolo[4,3-a]quinoline derivatives is described; their structures were assigned by 1H NMR and analytical data. The new compounds were tested in vivo for their antiinflammatory and analgesic activities, as well as for their ulcerogenic action. Some of the tested triazoles showed an analgesic activity in the acetic acid writhing test and antiinflammatory properties on carrageenan paw edema assay.

N-Acyl-N-phenyl ureas of piperidine and substituted piperidines endowed with anti-inflammatory and anti-proliferative activities

Six series of N-acyl-N-phenyl ureas 1-6 of piperidine (1), and 2-ethyl- (2), 3-methyl- (3), 4-methyl- (4), 4-phenyl- (5), cis-2,6-dimethyl- (6) piperidine were synthesised and evaluated for their anti-inflammatory, anaesthetic, anti-pyretic properties. Some derivatives of series 1 and 5 were also assayed for anti-proliferative activity. Several compounds showed an anti-inflammatory activity comparable or slighty inferior to that of indomethacin in rats (1c,d, 2a,b,g,h, 3b, 4h, 5d,e). Moreover, an appreciable anti-inflammatory activity was also found in 2c,e, 3e,f,g, 4g, 5a,b,c,f,h, and 6a,b,d. All the compounds were devoid of anti-pyretic activity and only a few of them exhibited a low level of infiltration anaesthesia in mice. Compound 5a showed a broad spectrum anti-cancer activity (at low micromolar concentrations), particulary significant against leukemia subpanel.

3-Arylsulphonyl-5-arylamino-1,3,4-thiadiazol-2(3H)ones as anti-inflammatory and analgesic agents

Two series of 3-arylsulphonyl-5-arylamino-1,3,4-thiadiazol-2(3H)ones 2 with potential anti-inflammatory and analgesic activity were prepared and tested. Pharmacological results revealed that all the title compounds, endowed with an arylsulphonyl side chain, possess good antalgic activity and fair anti-inflammatory properties. The analgesic profile of the two series, evaluated by the acetic acid writhing test, showed that compounds 2c, 2f and 2h, in particular, were the most active. Structure-activity relationships are briefly discussed.

Synthesis of new N,N-disubstituted 4-amino-5,6-dihydro-3-phenyl-2H-thieno[2,3-h]-1-benzopyran-2-ones

The synthesis of some N,N-disubstituted 4-amino-5,6-dihydro-3-phenyl-2H-thieno[2,3-h]-1-benzopyran-2-ones (4a-f), by reaction of phenylchloroketene with a series of N,N-disubstituted (E)-5-aminomethylene-6,7-dihydrobenzo[b]thiophen-4(5)-ones, followed by dehydrochlorination in situ of the primary adducts with DBN, is described. A moderate local anaesthetic activity was observed in the title compounds, particularly in 4e.

Synthesis of substituted N-(4-piperidyl)-N-(3-pyridyl)amides with antiarrhythmic activity. Note 1

The synthesis of analogues of N,2-diphenyl-N-(4-piperidyl)acetamide endowed with antiarrhythmic activity is reported. Benzoyl, cinnamoyl, acetyl and propionyl groups replace the phenacyl group as N-acyl substituent, while pyridine replaces benzene as aromatic ring bound to the amide nitrogen. The title compounds were evaluated for antiarrhythmic activity on experimental arrhythmias induced by aconitine in rats. The presence of a n-propyl chain and an unsubstituted cinnamoyl moiety (1j) gives the highest protection against aconitine induced extrasystoles while the best efficacy against lethal effects is due to the presence of a n-propyl chain and an acetyl moiety (1m).

Characterization of clinical tolerance to inhaled zinc oxide in naive subjects and sheet metal workers

Clinical tolerance to the acute effects of zinc oxide inhalation develops in workers during periods of repeated exposure. The aims of this study were to determine whether clinical tolerance is accompanied by a reduction in the acute pulmonary inflammatory and cytokine responses to zinc oxide exposure and whether tolerance can be demonstrated in sheet metal workers who chronically inhale low levels of zinc oxide. Naive (never-exposed) subjects inhaled 5 mg/m3 zinc oxide on 1 or 3 days and underwent bronchoalveolar lavage 20 hours after the final exposure. Sheet metal workers inhaled zinc oxide on 1 day and control furnace gas on another day. Among naive subjects in whom tolerance was induced, bronchoalveolar lavage fluid percent neutrophils and interleukin-6 (IL-6) levels were significantly decreased compared with subjects who underwent only a single exposure. Sheet metal workers were much less symptomatic, but they still experienced a significant increase in plasma IL-6. The results indicate that clinical tolerance to zinc oxide is accompanied by reduced pulmonary inflammation and that chronically exposed sheet metal workers are not clinically affected by exposure to zinc oxide fume at the Occupational Safety and Health Administration Permissible Exposure Limit. The increase in IL-6 levels observed in the clinically responsive, and to a lesser extent, tolerant, states following zinc oxide inhalation is consistent with the dual role of IL-6 as a pyrogen and anti-inflammatory agent.

Synthesis and preliminary biological evaluation of novel N-substituted 1-amino-3-[1-methyl(phenyl)-1H-indazol-4-yloxy]-propan-2-ols interesting as potential antiarrhythmic, local anaesthetic and analgesic agents

A series of indazoloxypropanolamines 7 and 8, pindolol isosteres, were synthesized to extend the structure activity relationship (SAR) which was observed in an earlier series of related derivatives. Compounds 7, characterized by methyl substitution on the N-1 indazole nucleus, generally exhibited significant antiarrhythmic, local anaesthetic and analgesic activities. The preliminary radioligand binding assay highlighted, in compounds 7, an interesting beta 1-affinity which can be well correlated to their antiarrhyhtmic activity. Analogues 8 characterized by a phenyl group on the N-1 indazole nucleus, were generally less active as antiarrhyhtmic agents but generally interesting as local anaesthetics. Due to the importance of the indazole moiety as a carrier of antiphlogistic activity, the two classes of derivatives 7 and 8 were evaluated for their NSAID behaviour. Once again, compounds 7 resulted having more interesting analgesic and antipyretic effects than analogues 8.

Synthesis of N-[4-(propyl)cyclohexyl]-amides with anti-inflammatory and analgesic activities

Seventeen (un)substituted N-[4-(propyl)cyclohexyl]-amides (6a-h, 7a-h and 8) were synthesized and tested as anti-inflammatory and analgesic agents. The substituents on the aromatic ring were chosen in order to study the influence of electron-withdrawing or electron-donating residues, that change the electronic density on the aromatic moiety. The pharmacological results allow drawing some preliminary considerations on structure-activity relationships.

O-[2-hydroxy-3-(dialkylamino)propyl]ethers of (+)-1,7,7-trimethyl bicyclo[2.2.1]heptan-2-one oxime (camphor oxime) with analgesic and antiarrhythmic activities

A novel series of O-[2-hydroxy-3-(dialkylamino)propyl]ethers of (+)-camphor oxime was prepared and tested for its cardiovascular, analgesic and anti-inflammatory properties. No significant anti-inflammatory and hypotensive activities were displayed by any of the compounds, whereas several of them are reasonably active as antiarrhythmic and analgesic agents.

N-substituted 3-(arylamino)-4,5-dihydro-2H-benz[g]indazol-2-yl acetamides with anti-inflammatory and analgesic activities

A series of substituted 3-(arylamino)-4,5-dihydro-2H-benz[g]indazol-2-yl acetamides was synthesized and tested in comparison with former analogues. The title compounds showed only weak antiarrhythmic properties but good anti-inflammatory and antinociceptive activity, particularly evident in the morpholino derivative.

Antibiotic drug prescription in respiratory tract infections: a pharmacoepidemiological survey among general practitioners in a region of Italy

Data concerning patients undergoing antibiotic treatment for upper (URTI) or lower (LRTI) respiratory tract infections were collected from 23 General Practitioners (GPs) in the Campania Region of Italy from November 15, 1997 to March 15, 1998. The objectives of the study were: a) to assess the occurrence of URTIs and LRTIs; b) to document the factors that influence GPs' choice of therapy; c) to correlate antibiotic choice with duration and outcome of treatment; d) to assess the incidence of unwanted effects. 2198 questionnaires were collected. Patients were +/-43.9 of age. URTIs were diagnosed in 65.4% and 34.6% LRTIs. The mean duration of antibiotic treatment was 4.5 days in URTIs and 5.6 days in LRTIs. The choice of antibiotic treatment was influenced by clinical assessment of infections (67.1%). The most commonly used antibiotic categories in URTIs were macrolides (39.3%), penicillins (27.4%) and cephalosporins (23.8%) whereas for LRTIs mainly cephalosporins (63.8%), penicillins (9.2%) and fluoroquinolones (7.4%) were used. Adverse events were experienced by 3.9% of patients.

Anti-inflammatory and analgesic amides: new developments

A series of substituted N-cycloalkyl benzamides, cinnamamides, and indole-3-carboxamides were synthesized and evaluated for their analgesic, antiinflammatory activities as well as for their gastrointestinal irritation liability. Indomethacin was used as reference drug in both tests. Compounds 1k, 1b, 1h, 1j, and 1g were the most active in the antiinflammatory paw edema inhibition test, with a sharply dose-dependent effect. In terms of the analgesic activity (acetic acid writhing test), the most active compound was 5a followed by 3a, but many other compounds were found to have a non-negligible potency. Even in this case, the effect was dose dependent.

Distinct effects of Rac1 on differentiation of primary avian myoblasts

Rho family GTPases have been implicated in the regulation of the actin cytoskeleton in response to extracellular cues and in the transduction of signals from the membrane to the nucleus. Their role in development and cell differentiation, however, is little understood. Here we show that the transient expression of constitutively active Rac1 and Cdc42 in unestablished avian myoblasts is sufficient to cause inhibition of myogenin expression and block of the transition to the myocyte compartment, whereas activated RhoA affects myogenic differentiation only marginally. Activation of c-Jun N-terminal kinase (JNK) appears not to be essential for block of differentiation because, although Rac1 and Cdc42 GTPases modestly activate JNK in quail myoblasts, a Rac1 mutant defective for JNK activation can still inhibit myogenic differentiation. Stable expression of active Rac1, attained by infection with a recombinant retrovirus, is permissive for terminal differentiation, but the resulting myotubes accumulate severely reduced levels of muscle-specific proteins. This inhibition is the consequence of posttranscriptional events and suggests the presence of a novel level of regulation of myogenesis. We also show that myotubes expressing constitutively active Rac1 fail to assemble ordered sarcomeres. Conversely, a dominant-negative Rac1 variant accelerates sarcomere maturation and inhibits v-Src-induced selective disassembly of I-Z-I complexes. Collectively, our findings provide a role for Rac1 during skeletal muscle differentiation and strongly suggest that Rac1 is required downstream of v-Src in the signaling pathways responsible for the dismantling of tissue-specific supramolecular structures.

[Splenic infarction caused by vascular pedicle torsion]

We report a case of a spleen infarction caused by the vascular pedicle torsion. A 25 year-old-man, heterozygous for HbS, presented with severe abdominal pain especially in the left upper quadrant in front and in the back, fever other symptoms related to acute abdomen. First we excluded most common disease (occlusive one and hematologic one) through conform investigation, then we suspected a spleen problem. So we did further investigation with ultrasonography which showed splenomegaly and the spleen looked twisted with its hilum in contact with previous abdominal wall, moreover (here were are as of decreased signal intensity characteristic of splenic infarction under the capsule and some blood in the Douglas pouch. The patient underwent splenectomy urgently. During the intervention we saw a splenomegaly like the ultrasonography showed, moreover there were a long twisted vascular pedicle and many areas of infarctions, some of which had ruptured causing emoperitoneum. The surgical intervention was successful and the clinical spectrum was solved. The splenic infarction might be clinically silent or to represent a surgical emergency. In front a case of acute abdomen, after exclusion of most common etiology, we underline the importance to suspect a spleen suffering, especially vascular one, when (here was no history of trauma. Considering this fact, a simple not invasive examination like ultrasonography is able to confirm this kind of hypothesis and to give soon information to make the surgical choose.

Synthesis of N-[4-(alkyl)cyclohexyl]-substituted benzamides with anti-inflammatory and analgesic activities

Two series of N-[4-(alkyl)cyclohexyl]-substituted benzamides, i.e. a series of N-[4-(tert-butyl)cyclohexyl]-substituted benzamides and a series of N-[4-(ethyl)cyclohexyl]-substituted benzamides, were synthesised and evaluated for their anti-inflammatory and analgesic potencies, and gastrointestinal irritation liability.

Synthesis and biological evaluation of [alpha-(1,5-disubstituted 1H-pyrazol-4-yl)benzyl]azoles, analogues of bifonazole

A series of pyrazole analogues of bifonazole, an antifungal drug used in clinical practice, 2a-h and 4a-h were synthesized and tested in vitro against Candida albicans, Cryptococcus neoformans and Aspergillus fumigatus, with no significant results. Imidazoles 2a-h were also tested in vivo for antiarrhythmic and antihypertensive activities; two of these compounds showed moderate activity against ventricular fibrillation caused by aconitine in rats. The above compounds were prepared by reaction of phenyl-[5 substituted 1-phenyl (or 1-methyl)-1H-pyrazol-4-yl]methanols with N,N'-carbonyldiimidazole (2a-h) or of the respective chloro derivatives with 1H-1,2,4-triazole (4a-h).

Induction of telomerase activity in v-myc-transformed avian cells

Telomerase activity is detectable in the majority of tumors or immortalized cell lines, but is repressed in most normal human somatic cells. It is generally assumed that reactivation of telomerase prevents the erosion of chromosome ends which occurs in cycling cells and, hence, hinders cellular replicative senescence. Here, we show that the expression of v-Myc oncoprotein by retroviral infection of telomerase-negative embryonal quail myoblasts and chicken neuroretina cells is sufficient for reactivating telomerase activity, earlier than telomere shortening could occur. Furthermore, the use of a conditional v-Myc-estrogen receptor protein (v-MycER) causes estrogen-dependent expression of detectable levels of telomerase activity in recently infected chick embryo fibroblasts and neuroretina cells. We conclude that the high levels of telomerase activity in v-Myc-expressing avian cells are not the mere consequence of transformation or of a differentiative block, since v-Src tyrosine kinase, which prevents terminal differentiation and promotes cell transformation, fails to induce telomerase activity.