Determination of cyclophosphamide and its metabolites in human plasma by high-performance liquid chromatography-mass spectrometry

A sensitive HPLC-MS method was developed for the simultaneous determination of cyclophosphamide and its metabolites 4-hydroxycyclophosphamide (aldocyclophosphamide), 4-ketocyclophosphamide, caboxyphosphamide and 3-dechloroethylifosfamide in human plasma. 4-Hydroxycyclophosphamide was converted with methylhydroxylamine to the stable methyloxime form. We used a solid-phase extraction with C18 cartridges followed by HPLC-MS with the single mass spectrometer SSQ 7000 of Finnigan. The limits of detection were 15 ng/ml for cyclophosphamide, 3-dechloroethylifosfamide and ketocyclophosphamide in each case and 30 ng/ml for carboxyphosphamide and 4-hydroxycyclophosphamide, respectively. First results of pharmacokinetics are shown.

[Late results of joint-preserving femur head necrosis surgery]

Early diagnosis of nontraumatic avascular necrosis of the femoral head has been much improved by introduction of magnetic resonance imaging (MRI). Intertrochanteric osteotomies are dominating in operative treatment of advanced necrosis of the femoral head. Studies concerning with long-term results are rare in literature. The aim of the present study was the assessment of the long-term results (> 10 years) of advanced avascular necrosis (n = 33 hips, 8 stage Ficat II, 19 stage Ficat III, 6 stage Ficat IV). In 29 cases of joint-preserving operation was primarily performed. The average follow up time of the patients was 13 years. In 13 patients a joint-destructive operation (total hip replacement or arthrodesis) was secondarily necessary. The average time interval between joint-preserving and -destructive operation was 53 months (minimal 10, maximal 180 months). Quality of life is often reduced in patients after joint-preserving hip operations. Only 3 of 14 patients with still existing joint-preserving operation were painless postoperatively and could continue their former job. The other patients suffered from pain and reductions of their activity of daily life. 4 of them had to retire early.

Hypothalamic-pituitary-adrenal system function in patients with Alzheimer's disease

The neuropathologic hallmarks of Alzheimer's disease (AD) are very prominent in the hippocampus, a brain site which is pivotal for the regulation of the hypothalamic-pituitary-adrenal (HPA) system. Thus, the combined dexamethasone-suppression/CRH-stimulation-test outcome in patients with AD was compared to that of healthy elderly controls to assess--with a more refined neuroendocrine challenge procedure--HPA function in AD. Cortisol secretion after dexamethasone (DEX) pretreatment and before CRH was increased in Alzheimer's patients and 21% of this group were DST-nonsuppressors. None of the healthy control subjects escaped DEX-induced suppression of cortisol. However, after additional CRH administration, AD patients released significantly less cortisol and ACTH than the control subjects. No correlations were found between any of the endocrine parameters and degree of severity of dementia. It is concluded that the DST part of the DEX/CRH test better reflects glucocorticoid feedback disturbances, probably at a suprapituitary level. The CRH part of the DEX/CRH-test outcome might indicate the loss of endogenous CRH-Arginine-Vasopressin (AVP) synergism of the HPA system of these patients.

CARS Investigation of Changes in Chromophore Geometry of C-Phycocyanin from Mastigocladus laminosus Induced by Titration with p-Chloromercuribenzenesulfonate

Titration of trimers of C-phycocyanin with p-chloromercuribenzenesulfonate (PCMS) changes spectroscopic and kinetic properties of chromophore B84. The resonance-enhanced CARS spec­tra of room temperature solutions indicate that these changes are due to a modification in B84 chromophore geometry (movement of ring D) as judged by the disappearance of the 1245 cm-1 vibration.

Diffuse and local effects of light adaptation in photoreceptors of the honey bee drone

Intracellular recordings from drone photoreceptors were made by means of glass microelectrodes in superfused retinae. Exposure of a small portion of a cell to white light decreased the amplitude of responses to a small stimulus subsequently applied at different sites of the photoreceptor cell, i.e. light adaptation occurred throughout the cell. After 7 min of darkness, the responses had completely recovered. When a violet light (404 nm) was used to adapt a small portion of the cell, the responses at the site of exposure to the adapting stimulus remained depressed for at least 30 min. Illumination at the site of the violet adapting stimulus with green light (585 nm) caused an immediate recovery of the amplitude of the response. These results can be explained by the existence of two processes responsible for light adaptation: one is localized and persistent and appears to be due to changes in concentration of rhodopsin. The other affects the whole cell, is spontaneously reversible and depends upon the ability of the light to produce a receptor potential but not on any lasting change in rhodopsin concentration.

Sleep deprivation: effect on sleep stages and EEG power density in man

Sleep was analysed in 8 young adults subjects during two baseline nights and two recovery nights following 40.5 h sleep deprivation. Sleep stages were scored from the polygraph records according to conventional criteria. In addition, the EEG records of the entire nights were subjected to spectral analysis to compute the frequency distribution of the power density in the 0.25-25 Hz range for 0.5 Hz or 1.0 Hz bins. In the first recovery night, the power density in the delta band was significantly higher than baseline for total sleep time as well as for sleep stages 2, 3 and 4, 4 and REM. These changes were not restricted to the delta band, but extended to higher frequency bands. Minor, but significant, effects of sleep deprivation were seen in the power density distribution of the second recovery night. In the baseline nights, a progressive reduction of power density in the delta/theta range was present for successive non-REM-REM sleep cycles for total sleep time and stages 2, 3 and 4, and 4. The results show that effects of sleep deprivation as well as trends within the sleep periods are readily apparent from spectral analysis, but are inadequately reflected by conventional sleep scoring. When the power density values were integrated over the entire frequency range (0.75-25 Hz) for each non-REM-REM sleep cycle, an exponential decline from cycle 1 to cycle 3 was suggested. The present findings support the hypothesis that the EEG power density in the low frequency range is an indicator of a progressively declining process during sleep whose initial value is determined by the duration of prior waking.

Ventral capsular denervation. An operative treatment of periarthropathia humero-scapularis

Based on the neuro-anatomical situation and clinical observations a new method has been developed to treat the chronically recurrent humero-scapular periarthropathy together with a contraction of the joint and sometimes tendinitis and subacromial bursitis. The new method, a ventral denervation of the capsule, causes an immediate and continuing decrease or elimination of the pain in the shoulder. An increased and painless mobilization is possible until the extensive or even total rehabilitation of the joint function. Twenty shoulder joints have been treated in 19 patients. Within a period of 12 until 28 months 12 of them became continuously painless, 2 improved considerably and 4 satisfactorily. Depending on the initial clinical result the function could be restored in 85% of the patients approximately or even totally.

[Nodular vasculitis in the current practice of phlebology]

In current phlebological practice nodular vasculitic lesions are described as being characterised by hypodermal perivascular inflammation. The aetiology is diverse: in this article hypodermatitis of varicose and postphlebitic origin, both of which are due to basic vein disorders and which are certainly the most often encountered phlebopathies in daily practice, are studied and then there is a further study of acute and sub-acute nodular hypodermatitis which in practice represents a differential diagnosis to the former but are less frequently encountered. Finally, other cases of hypodematitis due to yet more rare causes are recalled. Rare though these may be, the practicing physician must not fail to consider them when a patient who has come to see him presents with suspect nodular lesions of the lower limbs.

[Early treatment of intraoperative infections based on bacteriological testing (author's transl)]

Validity and efficiency of an antibiotic prophylaxis after extensive orthopedic and traumatological procedures are not universally accepted. Often the systematic antibiotic prophylaxis is withhold because of considerable disadvantages. A new method is reported, which enables a bactericidal antibiotic therapy based on bacteriological testing of swabs taken during and after surgery. Thus the administration of antibiotics is possible long before the clinical manifestation of an infection. Immediate therapy diminishes the danger of complications from infections. With this method microbial contamination was found and treated in 53 (17.44%) of 305 operations. Of these, only 0.66% resulted in deep infections and 3.6% delayed healings without further complications.

[The extension nail. A new method for lengthening of the femur and tibia (author's transl)]

The paper introduces a new method for limb lengthening using an extension nail. Animal and clinical results are encouraging. Further clinical results and long term observations will be presented soon.

[Osteochondritis dissecans of the carpal scaphoid (author's transl)]

One case of osteochondrosis dissecans of the carpal scaphoid is reported. The diagnosis is built upon clinical, radiographical, intraoperative and histological statements. Concerning the aetiology there exists as well a dysplay on the scaphoid on the other side. It might be caused by overcharging of the wrist.

Role of intracellular calcium and sodium in light adaptation in the retina of the honey bee drone (Apis mellifera, L)

In the honey bee drone, the decrease in sensitivity to light of a retinula cell exposed to background illumination was found to be accurately reflected by the difference in amplitude between the initial transient depolarization and the lowest steady depolarization evoked by the background light. It is shown that both the decrease in sensitivity to light and the accompanying drop in potential from the transient to the plateau can be prevented by injecting EGTA intracellularly. A decrease in duration and amplitude of responses to short test flashes such as observed immediately after illumination was found to occur too when Ca or Na, but not K, Li, or Mg injected into dark-adapted retinula cells. Injection of EGTA into a retinula cell maintained a steady state of light adaptation, was found to cause an increase in amplitude and duration of the response to a short test flash, thus producing the effects of dark adaptation. It is suggested that, in the retina of the honey bee drone, an increase in intracellular calcium concentration plays a central role in light adaptation and that an increase in intracellular sodium concentration, resulting from the influx of sodium ions during the responses to light, could lead to this increase in intracellular free calcium.

[The problem of hypertension in Switzerland. Analysis of a blood pressure study in 21,589 persons]

Blood pressure measurements (Phyiometrics SR1) were performed on 21 589 persons visiting the Swiss Trade Fair in Basel in 1974. Diastolic pressures were found to be greater than or equal 110 mm Hg in 3%, greater than or equal 100 mm Hg in 7% and greater than or equal 95 mm Hg in 12% of the screened population. Including those under antihypertensive treatment, the prevalence of high blood pressure (diastolic pressure greater than or equal 95 mm Hg) amounted to 19% of the adult population. In 68% of the hypertensive screenees the condition was already known, 49% were under treatment and 35% were controlled (i.e. diastolic pressure less than 95 mm Hg). In other words - and here lies the unsolved problem - 32% of hypertensives are as yet undetected, 19% of the known cases are not treated, and 14% are inadequately treated. Of the hypertensive population 35% are adequately treated and 30% have mild hypertension. The remaining 35%, with diastolic pressure greater than or equal 100 mm Hg, require urgent attention and action. In Switzerland this problem can be tackled and solved by the general practitioner, who already play the major role in detection and treatment.