Direct enantiomeric separation of betaxolol with applications to analysis of bulk drug and biological samples

A direct method is described for the resolution of the enantiomers of betaxolol, a novel cardioselective beta-adrenergic blocking agent, using a tris(3,5-dimethylphenylcarbamate)cellulose chiral column. An excellent resolution of the two antipodes is obtained (Rs greater than 2) with high peak symmetries. The method is simple and ideally suited to the routine control of the enantiomeric excess in the bulk drug and the analysis of the enantiomers of betaxolol in hepatocyte suspensions. With modification of the polar modifier in a hexane-based mobile phase, most commercially available beta-blockers can be baseline resolved.

Islet cell and insulin autoantibodies in subjects at high risk for development of type 1 (insulin-dependent) diabetes mellitus: the Lyon family study

Genetic determination as well as prospective analysis of islet cell autoantibodies and autoantibodies to insulin were conducted in a population of 479 first degree relatives of 174 Type 1 (insulin-dependent) diabetic patients. Analysis of HLA haplotypes within families illustrated the high frequency of DR3 and DR4 alleles with preferential transmission from parent to both affected and unaffected offspring. DR4 was preferentially associated with DQw3.2 (TA10-) in 60/73 (82.2%) patients and 101/127 (79.5%) relatives. Relatives have been followed for a period of 800 subject-years. Twenty-two out of 430 relatives (5.1%) were found islet cell antibodies (ICA-IgG) positive. Seven sera with low titres became negative 6 months later at two different determinations. Fifteen sera ICA-IgG and ICA-protein A positive with high titres remained positive thereafter. Half of the ICA positive relatives were also found insulin autoantibodies (IAA) positive. All but 3 ICA negative relatives did not have IAA in their sera. Analysis of IAA specificity with competition experiments indicated that most antibodies recognised epitopes shared between human and pork insulins while four were specific for human insulin determinants. Analysis of class I and class II HLA antigen distribution indicated no particular allelic restriction in antibody positive individuals. Metabolic status of antibody positive relatives was determined with oral and intravenous charge of glucose. Two haplo-identical DR3-DQw2 brothers became diabetic during the study. One child and one mother both with DR4-DQw3.2 became intolerant to glucose. Each of these relatives had high titre ICA prior to metabolic deterioration.(ABSTRACT TRUNCATED AT 250 WORDS)

Structure, function, and immunogenicity of human insulinoma cells

Dissociated human insulinoma cells were plated onto plastic multiwell dishes. Cells were maintained for 1 mo on plastic with three passages. Cultures consisted of small colonies with some areas of stratification and few intercellular spaces. Ultrastructural studies indicated that cultured cells had epithelial features with desmosomes at cell-to-cell contacts and intermediate filaments in addition to secretory granules in the cytoplasm. Insulin and C-peptide were released in equimolar amounts in culture media. When challenged for 30 min with 16.7 mM glucose, 1 mM 3-isobutyl-1-methylxanthine, 4 mM tolbutamide, or 10(-6) M glucagon, insulinoma cells responded by a 1.5-, 1.5-, 2-, or 3-fold increase, respectively, in insulin release above baseline levels. A 15-min challenge with 10(-5) M isoproterenol increased insulin secretion by 1.85-fold. By indirect immunofluorescence, an anti-insulin antibody reacted positively with cell cytoplasm, whereas anti-somatostatin and anti-glucagon antibodies did not. Insulinoma cell surface expressed class I MHC molecules but not class II molecules. Immediately after isolation, crude insulinoma cells were contaminated by 2% of DR+ cells from nonislet components that disappeared after several weeks in culture. The ability of insulinoma cells to stimulate allogenic T-lymphocyte proliferation was assessed by [3H]thymidine incorporation in mixed culture combinations. Crude insulinoma cells elicited a strong lymphoproliferative response with a stimulation index ranging between 3.5 and 7, whereas no stimulation was found after 1 mo in culture. It is postulated that absence of class II-positive cells in the stimulatory cell preparation conditioned this immune tolerance across the major histocompatibility barrier.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative study of the pharmacokinetics of zuclopenthixol decanoate and fluphenazine decanoate

Seventeen outpatients were treated with depot neuroleptics, zuclopenthixol decanoate in Viscoleo or fluphenazine decanoate in sesame oil, with dosage intervals of 3 weeks. During the 4th, 6th, and 8th dosage interval blood samples were drawn in oxalated tubes. Plasma concentrations of the active neuroleptic drugs, zuclopenthixol and fluphenazine, were determined by high performance liquid chromatography. The concentrations indicated some interindividual as well as intraindividual variations. For zuclopenthixol the maximum concentration was most often seen at day 7 after injection, whereas the kinetics of the fluphenazine concentrations was more variable. There was an indication of more fluctuation in the 4th dosage interval than in the 8th dosage interval, possibly due to the fact that steady state has not yet been achieved at the 4th dosage interval.

Cellular immunity to Trypanosoma cruzi is mediated by helper T cells (CD4+)

The infection of mice with Trypanosoma cruzi has been used as an experimental model for human Chagas disease, because the murine and human infections have similar acute and chronic phases generating similar immunopathological phenomena. Histopathological studies of murine tissues showed that the inflammatory lesions were small during the acute phase and composed mainly of mononuclear cells. During the chronic phase, cellular infiltrates were clustered in large granulomata consisting of mononuclear and polynuclear neutrophil cells. Characterization of the infiltrating cells by surface markers showed that about 6% were Thyl.2+ T cells, and CD4+(Lyt 1+) T cells (T helper/DTH subset) were more numerous than CD8+(Lyt 2+) T cells. These observations suggest that delayed type hypersensitivity plays a role in the pathology of Chagas disease.

A preliminary metabolic study of alpidem in rat and man

The metabolism of alpidem, a new anxiolytic agent in the chemical series of imidazopyridines, was investigated in rat and man. In both species the compound is extensively metabolised by three main routes of biotransformation: aromatic oxidation of the imidazopyridine ring; n-dealkylation; and/or aliphatic oxidation of the substituted amide side chains.

Human islet cell autoantibodies specifically bind cloned rat islet cells

Sera from newly diagnosed type I (insulin dependent) diabetic patients and control subjects were tested by indirect immunofluorescence on a particular subclone of RINm5F cells for the presence of cytoplasmic antibodies. Cell cultures after biochemical fixation and frozen sections of cell sheets obtained after incubating confluent monolayers with dispase were used alternatively as substrate. Eight out of ten ICA positive sera previously tested on frozen sections of human pancreas bind RIN cells when fixed with acetone-ethanol whereas no staining was obtained after treating the cells with paraformaldehyde or glutaraldehyde. Four normal sera did not bind RIN cells under these conditions. Alternatively, frozen sections of cell sheets appeared to be a more sensitive substrate as all ICA positive sera tested reacted with cell cytoplasm. In addition, an immunoradiometric assay was developed using microtitre plate wells coated with Nonidet P40 solubilized RIN antigens. Coated wells were incubated with ICA positive and ICA negative diabetic sera along with sera from normal individuals. Antigen antibody complexes were detected by the binding of 125I-Protein A. A good correlation was found between binding values and results obtained by indirect immunofluorescence on frozen sections of human pancreas. Although this study indicates that RIN cells express a specific cytoplasmic antigen to which ICA positive sera bind, more information is required concerning the exact nature of this antigen before such assay can be reliably used for the detection of ICA.

Citalopram--a highly selective 5-HT uptake inhibitor--in the treatment of depressed patients

In an open, clinical trial comprising a total of 21 depressed in-patients (6 men and 15 women) citalopram was administered in doses of 20-60 mg once daily for a period of at least 3 weeks. Fourteen of the patients were treated for 4 weeks, and 6 of these patients were treated for another 2 weeks. The CPRS subscale for depression (MADRS) and a global evaluation were used for assessment of the therapeutic effect. Twelve patients showed complete or partial response to treatment, and generally onset of therapeutic effect was seen within the first 2 weeks of treatment. Side-effects were generally few and mild, anxiety being the most frequent one. No pathological laboratory values were recorded, and apart from one case of slight and transient bradycardia no changes were observed in the cardiovascular parameters. Determination of plasma levels in 16 of the patients under presumed steady-state conditions showed an inter-individual variation between 28 and 616 nM/l for citalopram and between 32 and 338 nM/l for its monodemethylated metabolite for daily citalopram doses of 30-60 mg. The average ratio citalopram-desmethyl citalopram was 1.70. No correlation was found between clinical response and the plasma levels.

Protein enrichment of sugar beet residue with the inoculation of conidia of Trichoderma album by solid state fermentation

Cellulosic material was inoculated with Trichoderma album by solid state fermentation and the change of protein, total nitrogen, mineral nitrogen, cellulose and total fiber contents of raw material were measured. It was found that the water holding capacity and bulk density of substrate increased as the fermentation progressed. The optimum C/N ratio for the conidia production was between 4 and 7, and the optimum pH was around 5. The protein enrichment of sugar beet residue were the best at the initial moisture content 76%, initial pH 4.5 and supplement with 1% nitrogen. After 4 days fermentation, the final product contained 22% of protein. From the present state of technological development, the protein enrichment of cellulosic materials by solid state fermentation proved to be valuable.

Effect of indolamines on beta-endorphin release by rat anterior pituitary cells

The effect of indolamine derivatives on beta-endorphin (beta-end) release has been studied in vitro using rat anterior pituitary cells. Incubation of primary cultures for 2 h with 100 nmol/l of melatonin, serotonin or 5-methoxytryptamine significantly increased the beta-end release in response to 20 nmol/l of ovine corticotropin-releasing factor (oCRF). Incubation of the cultures with 100 nmol/l of L-tryptophan, 5-hydroxy-L-tryptophan, 5-hydroxytryptophol or 5-methoxytryptophol had no effect on basal or CRF-induced beta-end release. The effect of serotonin and melatonin was further tested in a superfusion system of dispersed rat anterior pituitary cells. Superfusion with oCRF (200 nmol/l) for 4 min elicited an immediate rapid increase in beta-end release which lasted 30-40 min. Simultaneous superfusion with melatonin (1 mumol/l) or serotonin (1 mumol/l) significantly increased the effect of oCRF pulses on beta-end release. We conclude that melatonin and serotonin are able to act directly on anterior pituitary cells to potentiate the effect of oCRF on beta-end release.

Morphological and functional effects of extracellular matrix on pancreatic islet cell cultures

Extracellular matrix (ECM) has been reported to enhance epithelial cell attachment and proliferation as well as to induce differentiation in vitro. In an attempt to determine the benefits of culturing pancreatic islet cells on ECM, we studied the morphological and functional patterns of rat islet cells and an insulin-secreting tumor cell line. ECM enhanced islet cell attachment and proliferation when compared to plastic, as suggested by a higher specific activity of DNA synthesis and a higher mitotic index. Cells on ECM were heterogeneous in size and insulin content. They showed extended areas of confluence. Cultures on plastic demonstrated an organisation in clusters and low mitotic activity. However, ECM did not allow for reconstitution of an islet-like structure. When compared to plastic, an initial decrease in basal and stimulated insulin secretion per million cells was observed on ECM, but B-cell activity was restored after 6 days of culture. Glucagon and somatostatin secretion were similar on both substrates. These data suggest that ECM enhances markedly islet cells attachment and proliferation, as well as long-term culture maintenance.

Determination of citalopram, amitriptyline and clomipramine in plasma by reversed-phase high-performance liquid chromatography

The determination of citalopram, amitriptyline, clomipramine and their desmethyl metabolites after alkaline diethyl either extraction from plasma is achieved by high-performance liquid chromatography using two internal standards and mu Bondapak C18 as stationary phase. Elution is carried out isocratically at 0.5 or 1 ml/min with a mixture of acetonitrile-potassium dihydrogen phosphate-distilled water (45:50:5). Detection is monitored by absorption at 254 nm. The detection limit is less than 5 ng/ml for each compound. The coefficients of variation are between 1.3% and 9.4% for 8-360 ng/ml. Interference from 22 possible co-medications is discussed. The technique can be used for therapeutic monitoring of these antidepressants as well as in analytical toxicology.

[Exclusion prenatal diagnosis of chronic familial septic granulomatosis]

We report the prenatal diagnosis in a 20 week male fetus at risk of chronic granulomatous disease (CGD). A previous affected brother was known in the family and the mother was detected as heterozygote. Three different assays were performed on fetal blood obtained under fetoscopy: cytochemical reduction of nitroblue tetrazolium (NBT), chemiluminescence after activation by opsonized zymosan or phorbol myristate acetate (PMA) and production of superoxide anion (O2-.). Results were comparable to those obtained in 6 fetuses investigated for other inherited diseases. Absence of functional polymorphonuclear defects was confirmed at birth. The use of 3 different techniques performed on whole blood for prenatal diagnosis of CGD has to be recommended instead of an isolated technique adapted to whole blood tests.

[A rarely recognized metastatic localization. Secondary involvement of the occipito-cervical joint]

280 patients presenting osteophilic tumors were evaluated by conventional tomography of the cervical spine. Metastasis were found in 120 cases among which 70% had no symptoms. Axis was first concerned and sometimes lesions could not be detected on plain radiographs. Authors insist on the need of a systematic cervical spine tomographic study in patients with osteophilic tumors.

Blood and plasma kinetics of cis(Z)-clopenthixol and fluphenazine in psychiatric patients after intramuscular injection of their decanoic esters

Whole blood and plasma concentrations of active neuroleptic drugs were measured in eight schizophrenic outpatients who had received cis(Z)-clopenthixol decanoate in Viscoleo or fluphenazine decanoate in sesame oil by intramuscular injection. Whole blood and plasma concentrations were very similar, though there was a slight tendency for blood concentrations to be higher than plasma concentrations. Maximum concentrations appeared at 1 week after administration of cis(Z)-clopenthixol decanoate, whereas the highest concentrations after fluphenazine decanoate were seen at the end of the 3-week dosage interval. Some between-individual variation and a limited within-individual variation was seen.

Determination of chloroquine and monodesethylchloroquine in hair

Using thin-layer and gas chromatography and mass spectrometry, chloroquine and its major metabolite (monodesethylchloroquine) were identified in hair samples of numerous patients who received this antimalarial drug for several months. In two patients the amounts of chloroquine were, respectively, 310 and 145 mg/kg hair and those of the monodesethylchloroquine 23 and 11 mg/kg. The respective proportions (93 and 7%) are the same in the two subjects. The chloroquine percentage was near those in the spleen or stomach wall after poisoning. Other metabolites in hair are being identified. Hair analysis may provide a good toxicologic and forensic science complement to the blood, urine, and tissues. It may be useful for the control of chloroquine therapy.

[Subacute ischemia of the lower leg caused by a popliteal synovial cyst. Apropos of a case]

Based on the observation of a cyst compressing the popiteal artery, the authors discuss the characteristic clinical picture and radiology of this benign neoformation. They emphasize two possible causes: cystic degeneration of the arterial median or a cyst of articular derivation. Histological data from this observation supports the second hypothesis.

[Acute human and experimental poisoning with diethylene glycol]

Although acute poisoning with ethylene glycol (EG) used in antifreeze mixtures is well known in man, only a few reports have described acute intoxication with diethylene glycol (DEG) and only one has mentioned oxaluria. Furthermore, there is no experimental evidence that DEG is metabolized into oxalate. The ability of ethanol infusions to prevent hepatic oxidation of DEG has not been proved. Moreover, failure of this treatment has been reported by some authors. In order to resolve such questions, Wistar male adult rats possessing a hepatic alcohol deshydrogenase were given a single oral dose of 15 ml/kg-1 DEG. Rats were either untreated or treated with hydration alone or associated with bicarbonate or ethanol. Urinary output, urinary oxalate excretion, acid-base balance in peripheral blood and renal histology were studied. Acute poisoning induced metabolic acidosis, polyuria, hyperoxaluria with renal tubular necrosis and a 66% mortality. Massive hydration improved acidosis and prognosis, but mortality and renal lesions were avoided only when bicarbonate or ethanol were added. Only ethanol significantly decreased oxaluria. In acute DEG poisoning, both the mechanism and the treatment appear to be the same as in acute EG intoxication.

Time dependency of adriamycin and adriamycinol kinetics

Adriamycin was administered by IV injection to seven patients with various solid tumors at a dose of 30 mg/m2 during successive courses. Extraction was carried out by the SEP-PAK method for plasma and by solvents for urine. Plasma and urinary levels of adriamycin and adriamycinol were determined by high-performance liquid chromatography over 72-h period after injection. Pharmacokinetic parameters for adriamycin and adriamycinol were calculated for each course of treatment. The results show significant inter- and intra-individual variations in the kinetics and elimination of both compounds. The analysis of pharmacokinetic data reveals a wide variability in the fluctuations observed during the successive courses in different patients. This study confirms the time-dependency of ADR kinetics.

Quantitation of adriamycin in plasma and urine: Comparative study of radioimmunoassay and high-performance liquid chromatography methods

The response of tumours to adriamycin, and the cardiotoxicity of the drug, may be related to its pharmacokinetics and plasma levels. Rapid and sensitive methods of adriamycin determination in plasma and urine samples are thus needed. A comparative study shows that high-performance liquid chromatography with fluorimetric detection is a reliable and specific method, but it is relatively slow and sometimes lacks sensitivity. A commercially-available radioimmunoassay kit is convenient, but there is a cross reaction with the major metabolise adriamycinol and unless the assay is combined with an extraction step, it gives erroneously high results.

gamma-Aminobutyric acid (GABA) receptor stimulation. I. Neuropharmacological profiles of progabide (SL 76002) and SL 75102, with emphasis on their anticonvulsant spectra

Progabide (4-([(4-chlorophenyl) (5-fluoro-2-hydroxyphenyl)-methylene]amino) butanamide) is a gamma-aminobutyric acid (GABA) receptor agonist which readily enters the brain. In the body, progabide is metabolized to three active metabolites: SL 75102, gabamide and GABA. Progabide and SL 75102 readily enter the brain and GABA and gabamide are also formed within this organ. Both progabide and SL 75102 exhibit a broad spectrum of anticonvulsant activities against seizures which involve GABA-mediated events (bicuculline, picrotoxinin and pentylenetetrazol) or which are apparently independent of GABAergic mechanisms (penicillin, strychnine, electroshock and audiogenic seizures). These data support the hypothesis that direct GABA receptor stimulation is an effective means of controlling convulsions of various origins. Progabide and SL 75102 have relatively minor secondary effects in comparison to commonly used antiepileptics. Myorelaxation occurs, but only at doses higher than the ED50 values in convulsant tests. Furthermore, these compounds are not sedative. Finally, these GABA agonists have a complex action in the extrapyramidal system. Anticonvulsant doses are antagonistic to dopamine receptor-mediated behaviors, whereas much lower doses seem to facilitate the effects of dopaminergic transmission.

[Surgical treatment of calcanear fractures (103 cases). Reconstruction-arthrodesis, or reconstruction (author's transl)]

In a twelve-year period, 103 calcanear fractures (thalamus) were operated on, either by the Stulz procedure (calcanear Reconstruction-subtalar Arthrodesis [83 cases]), or by Reconstruction (20 cases). During the first seven years, the Stulz procedure had been performed systematically. During the following five years, indications were shaded between 28 reconstruction-arthrodesis and 20 reconstructions. A complete preoperative radiological study, including especially horizontal calcanear tomography enables to precise what type of injuries affects the four different parts of the calcaneus, and to choose between either procedure.

Qualitative and quantitative determination of metapramine and its metabolites in biological materials

The qualitative and quantitative determination of metapramine and its metabolites, after selective solvent extraction from biological materials, are achieved by gas-liquid chromatography with or without an internal standard, carried out directly or after derivatization, spectrofluorimetry and one- or two-dimensional thin-layer chromatography. The gas chromatographic procedures are the most sensitive for the quantitative determination fo the unchanged compound: 15 and 35 ng/ml in plasma and 5 and 10 ng/ml in urine; the detection limit for thin-layer chromatography is about 100 ng. These techniques can be used for pharmacokinetic studies and therapeutic controls, and also in analytical toxicology.

[Treatment of post-operative ventral hernia: elementary biomechanical basis. Report of 51 cases treated by mersilene mesh (author's transl)]

Elementary functional anatomy of the normal abdominal wall and following incisional hernia are described. The treatment of postoperative hernia should be based on this: its object is to restore the morphology and functions of the abdominal wall, in particular its respiratory function. It may be necessary to carry out gradual pneumo-peritoneum before parietal repair. A mersilene mesh was used by the authors in 51 cases. Certain rules should be observed when this prosthesis is placed in position so that the abdominal muscles find the conditions closest to their normal function.

Aortic atherosclerosis in Laënnec's cirrhosis. A comparative study using a planimeter

A postmortem comparison of atherosclerotic lesions of the aorta was made between 107 cirrhotic and 168 control subjects with mean ages of 61 and 64, respectively. The cause of death in 93 of the control subjects was malignant neoplasms. Individuals with a history of hypercholesterolemia, diabetes, hypertension, ischemic arterial disease, cerebral vascular accidents, or myocardial infarction were eliminated from this study. The entire aorta was removed during necropsy, and the ratio between the total aortic surface and the surface areas of fibrous, calcified, and ulcerated lesions was determined, using a planimeter. Statistical analysis disclosed no difference between the cirrhotic or control groups in either the extent or type of atherosclerotic lesions.

A study of mortality and urinary excretion of oxalate in male rats following acute experimental intoxication with diethylene-glycol. Preliminary report

Acute intoxication by diethylene glycol (LD 50) in male rats is associated with a considerable urinary excretion of oxalate, which is significantly decreased by alkalinisatin and/or intraperitoneal injection of ethanol with hydration. Mortality during the five days following intoxication is significantly decreased by major hydration only or together with pyridoxine administration, but is cancelled by major hydration together with alkalinisation or intraperitoneal administration of ethanol, plus hydration, with or without alkalinisation. -- It might be inferred that diethylene glycol has the same metabolic pathway as ethylene glycol and treatment of acute intoxication by diethylene-glycol should be the same as that of acute poisoning with ethylene glycol.

[Determination of chloroquine in biological material by gas-liquid chromatography (author's transl)]

A method is developed for the gas chromatographic determination of chloroquine after extraction from biological material, using medazepam as the internal standard and a column filled with 3% OV-17 on Gas-Chrom Q. The detection limits are: 0.15 mug/ml of urine, 0.25 mug/ml of whole blood, and 1.50 mug/g of tissue. The technique can be applied in toxicological analysis and in monitoring drug levels.

[Treatment of fractures of the humerus by intramedullary fixation]

The Hackethal's technique of intramedullaring wiring for humeral fracture represents the immobilisation procedure particularly convenient for this bone. This procedure can be realised without special instrumentation with Kirschner's wires and image intensifior. To allow the approach of the fracture, the patient's position is choosed upon the topography of the lesion. The intramedullaring wiring is always done from down to up. Indications for this procedure are: humeral shaft fracture, humeral neck fracture, and fractures of the shaft and of the neck. During the reduction of the fracture, the immoderate use of a image intensifior seams to be the major risk. Hackethal's technique for medullary wiring was used in 21 patients, only one pseudarthrosis was noted. The fonctionnal recovery of the arm is usually realised in three months.