Pharmacokinetics of vidarabine in the treatment of infants and children with infections due to herpesviruses

The pharmacokinetics of vidarabine were studied on 22 occasions in nine infants and three older children with herpesvirus infection. The drug was administered for 10 days in doses of 15-30 mg/kg per day. Vidarabine was not detected in the serum of any patient, although small quantities were detected in the urine of two of the older children. Peak serum concentrations of arabinosyl hypoxanthine, the major metabolite of vidarabine, ranged from 2.3 to 11.4 micrograms/ml. Concentrations of this metabolite were higher in two preterm infants than in full-term infants receiving comparable doses. The mean elimination half-life estimated from cumulative urinary excretion was 2.4 hr in a preterm infant, 3.1 hr in full-term infants, and 2.8 hr in older children. Neither clearance nor half-life changed when multiple doses were administered. Vidarabine and arabinosyl hypoxanthine did not accumulate during therapy. The rates of recovery of drug from the urine and of renal clearance of arabinosyl hypoxanthine were directly related to the age and maturity of the patient. Arabinosyl hypoxanthine readily diffused into cerebrospinal fluid.

Purification and characterization of posterior pituitary calmodulin and its activation of neurosecretosome Ca2+ + Mg2+-ATPase activities

Calmodulin was isolated as an electrophoretically homogeneous protein from bovine posterior pituitary glands. The yield indicated that this gland is a particularly rich source. Purified bovine posterior pituitary calmodulin and bovine brain calmodulin had identical electrophoretic mobilities on 10% and 12% polyacrylamide gels. The protein was further identified by molecular weight determination and by amino acid analysis which showed that it contained trimethyllysine, one residue per molecule. Bovine posterior pituitary calmodulin was found to activate a preparation of calmodulin-deficient phosphodiesterase from bovine heart. In addition, pituitary calmodulin stimulated Ca+ + Mg2+-ATPase activity associated with a purified nerve ending plasma membrane fraction. This dependence could only be demonstrated after successive washing of the membranes with EGTA buffers, a procedure designed to remove endogenous calmodulin.

Sequential methotrexate and 5-FU in the treatment of colorectal cancer

Administration of methotrexate (MTX), 5-FU, and leucovorin rescue in 29 patients with metastatic colorectal cancer produced an objective response rate of 41.7%, with two complete remissions. Two patients developed fatal toxic effects and three others had severe toxic effects. This trial, however, supports the evidence for the synergistic effect of this drug combination.

An analysis of the human genetics content of 13 general biology textbooks

Professionals in genetics, medicine, and biology education have in recent years called for placing greater emphasis on human genetics in the education of the nation's citizenry. Since a large collegiate audience for such education is found in the general biology classroom, we elected to analyze 13 current and widely used general biology textbooks to determine their human genetics content. The analyses revealed that from 6.68 to 15.51 percent of the books' pages were devoted to genetics, but only 0.75 to 3.44 percent of the pages dealt specifically with human genetics. The number of human genetic traits discussed in the books ranged from four to 24, with a mean of 15.77. Nine different chromosome aberrations were cited, with Down, Klinefelter, and Turner syndromes being mentioned most often. Twenty autosomal dominant, fifteen autosomal recessive, and seven X-linked traits were used as examples in the various textbooks. Most frequently cited single-gene conditions were the ABO blood groups, sickle cell anemia, phenylketonuria, hemophilia, and red/green colorblindness. The books varied considerably in the emphasis given to social applications of medical genetics. Based on the findings of this study, we offer several recommendations for the improvement of the human genetics content of general biology textbooks and courses.

Physiologic observations in a controlled clinical trial of the antiemetic effectiveness of 5, 10, and 15 mg of delta 9-tetrahydrocannabinol in cancer chemotherapy. Ophthalmologic implications

One hundred twenty patients about to receive their first treatment with potentially nauseant cancer chemotherapy were randomized to one of six antiemetic treatments: (1) no treatment; (2) placebo; (3) prochlorperazine (PCPZ), 10 mg; (4) delta 9-tetrahydrocannabinol (THC), 5 mg; (5) THC, 10 mg; (6) THC, 15 mg. Four doses of each medication were given orally at 4-hour intervals starting 2 hours before chemotherapy. A study nurse was responsible for both objective (nurse) and subjective (patient) symptom questionnaires. Serum levels were obtained at intervals for cross-reacting cannabinoids. Physiologic measurements including intraocular pressure (IOP), blood pressure, and pulmonary function were also recorded. In summary, the patients were remarkably free of adverse physiologic effects. All intraocular pressures before and after treatment were within the normal range, although a surprising statistically significant increase in IOP occurred in the group receiving 5 mg THC.

Treatment of primary breast cancer with chemotherapy and tamoxifen

We studied the possibility that the addition of tamoxifen to L-phenylalanine mustard combined with 5-fluorouracil enhances the benefit from the latter two drugs that has been observed in women with primary breast cancer and positive axillary nodes. Recurrence of disease was reduced at two years in patients given the three-drug regimen whose tumor estrogen-receptor levels were greater than or equal to 10 fmol. Among patients greater than or equal to 50 years old treatment failure was significantly reduced (P less than 0.001): by 51 per cent in those with one to three positive nodes and by 64 per cent in those with four or more. Higher receptor levels were associated with a greater probability of disease-free survival. Patients less than or equal to 49 years old were less responsive: those with one to three positive nodes received no benefit from tamoxifen at any receptor level, whereas those with four or more appeared to have reduced treatment failure associated with higher receptor levels. This adjuvant chemotherapy is not indicated in patients less than or equal to 49 years old whose tumor receptor levels are below 10 fmol; there is a suggestion of benefit in patients greater than or equal to 50 years old whose levels are low.

Bond strength of three orthodontic adhesives

A method was devised to study the bond strength of direct-bonding orthodontic adhesives. A shear load was applied parallel to the tooth-adhesive-bracket interface by means of an Instron Universal Testing Machine. The bond strength was found to increase for some products after 27 days. However, no significant differences could be detected 1 day after placement. The interface was studied to determine the mode of failure. In all cases bond failure occurred as mixed adhesive-cohesive phenomena.