A case of cerebral venous occlusion is reported. X-ray computed tomography showed a high-density lesion mimicking an intracerebral hemorrhage. In contrast, magnetic resonance images taken at the early clinical stage revealed a high-intensity lesion in both T1- and T2-weighted images. Follow-up magnetic resonance images at the chronic phase revealed that the intensity of this lesion had changed to low in the T1-weighted image, while still being high in the T2-weighted image. These findings suggest that the lesion might be due to venous congestion produced by cerebral venous occlusion rather than hemorrhage into the cerebral parenchyma.

Cerebral Hemorrhage↗

PubMedDate not supplied

Assessment of right atrial (RA) and right ventricular (RV) function by gated blood pool scan with krypton-81m: RA and RV pressure-volume loops with simultaneous pressure data.

We developed a new method of analyzing right atrial (RA) and right ventricular (RV) function by Krypton-81m gated blood pool scan (Kr-81m-GBPS). Pressure data were recorded simultaneously with a modified Swan-Ganz catheter. Krypton-81m (Kr-81m) is ideally suited to hemodynamic study of the right heart because of the following characteristics: physical half-life of 13 seconds; high photon yield and gamma ray energy of 190 KeV; low radiation exposure; and deployment during exhalation when the left heart is not active. A computerized method for list mode data acquisition was developed to collect data from the gamma camera, ECG wave, and RA and RV pressure simultaneously. RA and RV volume curves were obtained by calibrating the time-activity curves with end-diastolic volumes and cardiac output. Ejection fraction (EF) was used in the calculation of volume and cardiac output (CO) was measured by the thermodilution method. From RA and RV pressure and volume curves, RA and RV pressure-volume (P-V) loops were created simultaneously and displayed on the same plane. One spanning cardiac cycle of RV beats was separated into four phases: the ventricular emptying phase, the early ventricular filling phase, equilibrium, and the late ventricular filling phase. One spanning cardiac cycle of RA beats also was separated into four phases as follows: the atrial filling phase, the early atrial emptying phase, equilibrium, and the late atrial emptying phase. P-V loops of RA and RV were shifted after sublingual nitroglycerin administration. This new method is potentially useful in the study of right heart hemodynamics.

Atrial Function, Right↗

PubMedDate not supplied

TNP-470 inhibits growth and the production of vascular endothelial growth factor of uterine carcinosarcoma cells in vitro.

BACKGROUND: Carcinosarcoma is the most aggressive neoplasm among the known uterine malignancies. Most patients who are affected with this biphasic neoplasm hardly show any response to common anti-cancer drugs or radiotherapy and thus they tend to show an extremely poor prognosis. This is the first study to examine the inhibitory and anti-angiogenic effects of angiogenesis inhibitor TNP-470, a synthetic analogue of fumagillin, for human uterine carcinosarcoma in vitro. MATERIALS AND METHODS: The direct growth-inhibitory effect of TNP-470 was examined by an MTT assay in vitro. The levels of vascular endothelial growth factor (VEGF) in the culture supernate of TNP-470 treated FU-MMT-1 cells were also analyzed by an enzyme-linked immunosorbent assay (ELISA). The VEGF expression of TNP-470 treated FU-MMT-1 cells was also immunohistochemically examined using an anti-VEGF antibody. RESULTS: TNP-470 inhibited the growth of FU-MMT-1 cells in vitro. The level of VEGF in the culture supernatant of TNP-470 treated FU-MMT-1 cells was significantly lower than that of the control (TNP-470 untreated FU-MMT-1 cells) in vivo. The expression of VEGF in TNP-470 treated FU-MMT-1 cells immunocytochemically decreased in comparison to that of the control TNP-470 untreated FU-MMT-1 cells). CONCLUSIONS: Our in vitro findings suggest that this angiogenesis inhibitor, TNP-470, might be a novel therapeutic agent for uterine carcinosarcoma. However, further in vivo experimental studies using TNP-470 for this tumor will be necessary before any definitive conclusions can be made.

Antibiotics, Antineoplastic↗

PubMedDate not supplied

Physiologically based pharmacokinetics of a new penem, SUN5555, for evaluation of in vivo efficacy.

SUN5555, (5R,6S)-6-[(R)-1-hydroxyethyl]-7-oxo-3-[(R)-2- tetrahydrofuryl]-4-thia-1-azabicyclo-[3.2.0]-hept-2-ene-carboxylic acid, is a newly developed and orally effective penem with a broad antibacterial spectrum. SUN5555 was degraded in rat tissue homogenates and serum, and its degradations in the kidney and lung homogenates were significantly inhibited by cilastatin, an inhibitor of dehydropeptidase I. The pulmonary extraction was evaluated to be 0.033 by comparing the AUCs resulting from iv and intra-arterial administration of 10 mg/kg. From the arterial-to-venous concentration differences under steady state conditions in rats, extraction ratios of SUN5555 across the kidney, hind leg, gut, and liver were determined to be 0.333, 0.104, 0.071 and 0.053, respectively, whereas no appreciable extraction across the brain was observed. Therefore, organ clearances of SUN5555 are limited by the product of plasma unbound fraction and organ intrinsic clearances in various tissues. Using a physiologically based pharmacokinetic model, unbound concentrations of SUN5555 in the tissue interstitial fluids, which are the measure of in vivo antibacterial efficacy, were estimated to be almost identical with, or higher than, those in plasma in rats. Similarly, serum concentration-time profiles of SUN5555 after iv administration in other animal species were predicted and found to be in good agreement with the observed data in dogs. A preliminary prediction of the pharmacokinetics of SUN5555 in a human subject was also attempted by animal scale-up technique.

Animals↗

PubMedDate not supplied

[Indications for percutaneous transvenous mitral commissurotomy: evaluation according to the Sellors classification].

Fifty-eight consecutive patients underwent percutaneous transvenous mitral commissurotomy (PTMC) for mitral stenosis from August 1987 to June 1990. Patients were divided by echocardiographic characteristics of the mitral valve according to the Sellors classification into three groups: group 1 (mobile cusps, 20 patients), group 2 (thickened cusps, 34 patients), group 3 (rigid cusps, 4 patients). Immediately after PTMC, the mitral valve area increased significantly from 1.41 +/- 0.37 to 2.07 +/- 0.38 cm2 (p < 0.01) in group 1 and from 1.09 +/- 0.21 to 1.64 +/- 0.25 cm2 (p < 0.01) in group 2. The mitral valve area did not increase significantly in group 3 (from 0.82 +/- 0.27 to 1.10 +/- 0.22 cm2). Mitral regurgitation developed or increased in severity in four patients (100%) in group 3 (p < 0.01 vs group 1, 20% and group 2, 21%). The symptomatic improvement was 0% for group 3 (p < 0.01 vs group 1, 90% and group 2, 91%). At follow-up period (mean 24.6 months), symptomatic improvement was maintained in 44 patients (76%) of the total patient population. The mitral valve area was maintained well in group 1 and group 2, but three patients in group 2 showed recurrence of symptoms due to valvular restenosis. PTMC is an effective nonsurgical treatment for patients with mobile or with thickened cusps. Surgical method is preferable for patients with rigid cusps.

Adult↗