Pain-free intravenous injections.
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The validity and reliability of plasma volume estimation using indocyanine green were investigated in five in vitro experiments and in three in vivo series. The in vitro measurements reflected real volumes with an error of about 1%. Comparative measurements in the same patients using indocyanine green or Cr51 labelled red cells differed by 1.7% (r = 0.97). The mean (SD) plasma volume difference between two successive plasma volume measurements using indocyanine green was 38 (43) ml (r = 0.99). Plasma volume measured before and about 7 min after a hyperosmolar saline bolus (100 ml, 1 molar) was increased by 223 (102) ml and 286 (49) ml when determined by indocyanine green and plasma protein changes respectively. Nevertheless, the necessity for central venous injection and arterial sampling restricts the possible application of the method to intra-operative or emergency care use.
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A 72-year-old woman with chronic renal failure requiring haemodialysis developed acute iododerma twice, after receiving iodide contrast dye for radiological procedures. Iododerma was localized to the face, scalp and elbows and was associated with papular purpura of the legs. Histopathology of the skin lesions showed acute necrotizing vasculitis. During the second skin eruption the patient developed acute respiratory distress, which was treated with corticosteroids. During the first eruption asymptomatic infiltrates were present on chest X-ray which disappeared 2 months later. At the present time iododerma seems more frequent in patients with renal failure. Iodides may also be responsible for pulmonary abnormalities, which are sometimes asymptomatic. All these features may be due to leucocytoclastic vasculitis following iodide ingestion.
We have recently reported an impaired growth hormone (GH) response to a single i.v. bolus dose of growth hormone releasing factor (1 microgram/kg body weight) in obese women. We have now investigated whether the i.v. administration of low dose GHRF(1-29)NH2 (0.33 microgram/kg/h) by 15 min pulsed injections for 3 h followed by an i.v. bolus (1 microgram/kg) to four normal weight women and six obese women results in an enhancement of GH release. In the control women low dose GHRF, given either as a single 10 microgram injection or in pulses of equivalent total dosage, produced a GH response identical to that seen after a single bolus of 60 micrograms (mean peak GH low dose 30 +/- 2 mU/l, peak GH large dose 30 +/- 0.5 mU/l). In the obese women GH release was significantly less than the controls after low doses of GHRF (P less than 0.01) and the peak was delayed compared to that following a single large bolus dose (peak GH 7 +/- 1.2 mU/l). However, three of the obese women who previously showed no response to a large dose of GHRF did release GH after low dose pulsed injections. The final bolus of GHRF after 3 h of pulsed injections did not elicit any additional GH release in the subjects irrespective of body weight. We conclude that obesity may be characterized by impaired GH release to i.v. GHRF. The finding that some obese women do not respond to a single large dose injection of GHRF but do release GH after low dose pulsed injections supports the hypothesis of a hypothalamic disorder in these women.(ABSTRACT TRUNCATED AT 250 WORDS)
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1. High doses of vitamin B12 (cyanocobalamin) may be therapeutically effective to treat neurological alterations secondary to a wide range of disease states. The aim of the present study was to evaluate the effect of dose and repeated administration on the pharmacokinetics of cyanocobalamin in rats. 2. Forty-eight rats were randomly assigned to receive 1, 5, 25 or 100 mg/kg cyanocobalamin for 182 days (26 weeks). Cyanocobalamin plasma levels were quantified by HPLC on days 1, 85 and 182 of treatment and were analysed by means of non-compartment pharmacokinetic (PK) analysis. In addition, population PK analysis was used to fit cyanocobalamin plasma concentrations to time by means of a two-compartment model for intravascular administration. 3. The half-life of cyanocobalamin ranged from approximately 20 to 50 min, clearance ranged from 4.5 to 9 mL/min and the volume of distribution at steady state ranged from 140 to 470 mL. A statistically significant negative relationship existed between the dose of cyanocobalamin and the normalized area under the plasma concentration-time curve (AUC). This non-linearity was not exhibited in population PK analysis. No evidence of toxicity was observed. 4. At very high and prolonged doses (up to 100 mg/kg for 26 weeks), intravascular administration of cyanocobalamin in rats follows a two-compartment kinetic model and cyanocobalamin undergoes extensive extravascular distribution. The negative relationship between dose and normalized AUC is compatible with possible saturation of tubular reabsorption, thus increasing renal clearance at higher doses.
OBJECTIVE: To assess the histopathological vascular changes after injection of N-butyl-2-cyanoacrylate into the vessels of adult rabbits. METHODS: The animals used were 42 pure-blood New Zealand white rabbits weighing 2-3 kg. 0.2 mL cyanoacrylate with lipiodol was injected into the external jugular vein and femoral artery of each rabbit. Tissue specimens were obtained for histopathological study at 3 days, 7 days, 2 weeks, 3 weeks, 4 weeks, 2 months and 3 months after injection. RESULTS: The vessels were obliterated immediately after the injection. The main manifestation of histopathology at 3 days to 2 weeks was an acute inflammatory reaction; this progressed to subacute vasculitis at 3 weeks and a chronic granulomatous foreign body reaction developed at 4 weeks. The glue mass essentially disappeared in 2-3 months, replaced by fibrotic tissue with partial vascular recanalization. At 3 weeks after injection, the elastic fibrils of the arterial wall proliferated distinctly, resulting in narrowing of the lumen with subsequent obliteration, whereas the venous wall still showed inflammation and necrosis without hyperplasia of elastic fibrils. Extrusion of glue was observed over 1-3 months in both arteries and veins and was obvious in the latter. CONCLUSIONS: The histopathological changes after injection of N-butyl-2-cyanoacrylate were similar in the arteries and the veins with the exception of hyperplasia of elastic fibrils in the arterial wall and inflammation and necrosis in the venous wall at 2-3 weeks. Glue extrusion was seen in both arteries and veins.
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The distribution and excretion of bemegride labelled at the alpha carbon atoms with (14)C were studied in mice, rats, and guinea-pigs. These studies were supplemented by others made by colorimetric and absorptiometric methods on unlabelled bemegride in the body fluids of rabbits and dogs. Bemegride passed rapidly from plasma to all tissues, including brain, muscle, and fat. In addition it passed readily into the cerebrospinal fluid and the aqueous humour and to the foetus. It persisted in the tissues for longer than 24 hr., to some extent preferentially in the central nervous system. Approximately two-thirds of the dose was excreted in the bile, faeces, and urine within 24 hr. The glutarimide ring of bemegride was not completely degraded biologically.
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