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[Medical gas delivery systems. Activity report of the local commission for surveillance of gas delivery at the University Hospital of Nancy].

Local commissions for the surveillance of medical gas supply systems were made compulsory in France in 1985. This article analyses the activity of the local commission of the University hospital of Nancy. Main anomalies which occurred in the pipeline network, especially tightness problems, are discussed. Difficulties concerning the planning and the course of the visits of the gas supply systems by the commission are analysed. Finally, the actual power and responsibility of the commission members are considered.

Accidents, Occupational↗

Improved delivery through biological membranes. 3. Delivery of N-methylpyridinium-2-carbaldoxime chloride through the blood-brain barrier in its dihydropyridine pro-drug form.

Administration of N-methyl-1,6-dihydropyridine-2-carbaldoxime hydrochloride, the pro-drug form of 2-PAM, resulted in an average of 13-fold increase in the amount of 2-PAM delivered into the brain of mice as compared to the administration of 2-PAM. The pro-drug which crossed the BBB resulted in a dramatic increase in the reactivation of AChE blocked by DFP. In vivo studies of the "aging" of the phosphorylated AChE in the brain of mice could also be studied using pro-2-PAM.

Acetylcholinesterase↗

Augmentation of tumour delivery of macromolecular drugs with reduced bone marrow delivery by elevating blood pressure.

Effects of angiotensin II (AT-II)-induced hypertension on the distribution of macromolecules to Walker carcinoma and to bone marrow of SMANCS [poly(styrene-co-maleic-acid)-neocarzinostatin conjugate] were investigated in rats. AT-II-induced hypertension from about 100 to 150 mmHg significantly increased the accumulation of the macromolecular drug SMANCS and 51Cr-labelled bovine serum albumin ([51Cr]BSA), representatives of macromolecular drugs, in tumour tissue. At 1 h after i.v. administration, intratumour concentrations of [51Cr]BSA and SMANCS were elevated by 1.2-1.8-fold. The higher drug accumulation in the tumour that was produced by the artificial hypertension was retained even 6 h after administration. This observation indicates an additive effect to that under normotensive conditions where intratumour macromolecular drug concentrations increase steadily during this period. Furthermore, distributions of these drugs in the bone marrow and the small intestine decreased during artificial hypertension to 60-80% of those in the normotensive state. Therefore, the drug concentration ratios of tumour/bone marrow and tumour/small intestine were increased by 1.8-2.4-fold. A decreased distribution of SMANCS to normal tissues under hypertensive conditions was also confirmed by the significant reduction of its toxicity e.g. leukopenia, diarrhoea, and body weight loss, even at a lethal dose. On the contrary, [3H]methylglucose showed no remarkable difference in tumour or bone marrow accumulation under this hypertensive condition. These results show the advantages of macromolecules over small molecules for AT-II-induced hypertension chemotherapy.

Angiotensin II↗

Cesarean delivery on maternal request versus planned vaginal delivery: impact on development of pelvic organ prolapse.

Pelvic floor disorders (PFDs) (ie, pelvic organ prolapse, urinary and fecal incontinence) are prevalent and impact quality of life as well as our health care system. It has been estimated that the demand for health care related to PFDs will increase at twice the rate of the population itself. This speaks to the fact that PFDs are an important women's and public health issue, warranting studies aimed at their prevention.

Cesarean Section↗

Does delivery matter? Users' perceptions of the significance of trust in the delivery of the Personal Advisor Service in the New Deal for Disabled Persons.

PURPOSE: In the context of welfare pluralism where government in the UK has been contracting a number of public services out to a range of private and voluntary sector organisations, the aim of this study is to explore the extent to which decisions to become involved in employment support programmes are affected by the users' perceptions of those delivering the service. METHOD: A qualitative design involving two focus groups of fourteen participants was employed to examine the attitudes and perceptions of participants in the government's New Deal for Disabled Persons. The study sample was purposefully selected from client records of Shaw Trust a national charity for disabled persons, one of the organisations who have been contracted by the government to provide this service. RESULTS: Two distinct but related themes of disillusionment with the government and the importance of trust emerged from the focus groups. Overall, the data suggests that the identity of those delivering the service significantly influences the decision to participate. As Shaw Trust is a voluntary organisation promoting the rights of disabled persons they were deemed to be trustworthy. The users were sceptical about the government's commitment to improving the lives of disabled people and were reluctant to engage with the state. CONCLUSIONS: Making the transition from dependency on disability benefits to paid employment is a quantum leap. For many the decision to put themselves forward for voluntary support schemes is affected by the extent to which they believe they can trust the agency delivering the service. It is imperative that the government listen to the service users who have been involved in these projects and learn from their experiences.

Adult↗

Renal oxygen delivery: matching delivery to metabolic demand.

The kidneys are second only to the heart in terms of O2 consumption; however, relative to other organs, the kidneys receive a very high blood flow and oxygen extraction in the healthy kidney is low. Despite low arterial-venous O2 extraction, the kidneys are particularly susceptible to hypoxic injury and much interest surrounds the role of renal hypoxia in the development and progression of both acute and chronic renal disease. Numerous regulatory mechanisms have been identified that act to maintain renal parenchymal oxygenation within homeostatic limits in the in vivo kidney. However, the processes by which many of these mechanisms act to modulate renal oxygenation and the factors that influence these processes remain poorly understood. A number of such mechanisms specific to the kidney are reviewed herein, including the relationship between renal blood flow and O2 consumption, pre- and post-glomerular arterial-venous O2 shunting, tubulovascular cross-talk, the differential control of regional kidney blood flow and the tubuloglomerular feedback mechanism. The roles of these mechanisms in the control of renal oxygenation, as well as how dysfunction of these mechanisms may lead to renal hypoxia, are discussed.

Animals↗

A polymeric drug delivery system for the simultaneous delivery of drugs activatable by enzymes and/or light.

Three water soluble copolymers based on N-(2-hydroxypropyl)methacrylamide were prepared. Copolymer I contains adriamycin, a chemotherapeutic agent, attached via enzymatically degradable oligopeptide (glycylphenylalanylleucylglycine; G-F-L-G) side chains. The other two copolymers contained the photosensitizer, meso-chlorin e6 monoethylene diamine disodium salt (Mce6). In Copolymer II, the chlorin is attached via the degradable G-F-L-G sequence, and it was bound by the nondegradable glycyl spacer in Copolymer III. Initially, the copolymers were characterized separately in vitro and in vivo. Combinations of the copolymer bound chemotherapeutic agent and each of the copolymer bound photosensitizers were then assessed for antitumor effect in vivo. Localization/retention studies (A/J mice; Neuro 2A neuroblastoma solid tumor) were performed with the two copolymers containing Mce6 as well as the free drug. Results of these experiments demonstrated a very different tumor uptake profile for the two copolymers. While the free drug was rapidly cleared from tumor tissue, the copolymer containing Mce6 attached via the non-degradable bond was retained for an extended period; drug concentrations in the tumor were high even after 5 days. On the other hand, a high concentration of the copolymer containing Mce6 bound via the degradable sequence was taken up by the tumor, yet its concentration in the tumor was substantially diminished at 48 h after administration. This shows indirect evidence of in vivo cleavage of Mce6 from the copolymer in the lysosomal compartment which is supported by direct evidence of cleavage by cathepsin B (a lysosomal enzyme) in vitro. Antitumor effects were assessed on Neuro 2A neuroblastoma induced in A/J mice for all three copolymers. Photodynamic therapy (PDT) proved the copolymer with Mce6 bound via the degradable oligopeptide sequence to be a more effective photosensitizer in vivo than the other chlorin containing copolymer. The difference in activity was consistent with the results obtained by photophysical analyses in which the free drug had a higher quantum yield of singlet oxygen generation than the polymer bound drug in buffer. The quantum yield of singlet oxygen generation increased with the enzymatic cleavage of the chlorin from the copolymer. Conditions were subsequently determined for which chemotherapy or PDT would show some antitumor effect, yet be incapable of curing tumors. Finally, combination therapy experiments were performed in which the copolymer bound adriamycin was mixed with either of the copolymer bound chlorin compounds and injected intravenously (i.v.) into the tail veins of mice.(ABSTRACT TRUNCATED AT 400 WORDS)

Acrylamides↗

Predicting preterm delivery and lowering very preterm delivery rate.

The chances and quality of survival depend on gestational age at birth. Why has PTD not decreased during the last decade, in spite of all the known risk factors? Perinatal data bases tend to include biomedical risk factors and are assembled and analysed retrospectively. These data should form the basis for prediction, and risk factors such as stress, anxiety, inflammation (leading to elevated CRH with its role in PTD), short cervix etc, should be added when assessed prospectively. The goal is preconception and early prediction in pregnancy. Only with the implementation of efficient intervention will we lengthen pregnancies and lower the VPTD rate. More articles about the PTD and complications of preterm births should be published in the lay press. There is no room for pessimism: if everybody involved would do just a little in the right direction, the result would be enormous. Constant auditing of interventions is necessary. The most difficult to "cure" and most likely to relapse are stress, anxiety and social factors, and discrimination in obtaining basic health care. Long forgotten lessons of compassion with pregnant women have not yet been acknowledged as proven to change VPTD into PTD, but are available at no cost world wide.

Female↗