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A new apparatus for chronic intravenous infusion in unrestrained rats.

A new apparatus incorporating a unique type of swivel device was devised for chronic intravenous infusion in unrestrained rats. The swivel requires very little torque for rotation, ie, one-fourth that of the standard swivel, yet is 1/30 as expensive. A coil spring tube, located between the swivel and the catheter, allows the rat unhampered movement within the metabolic cage. Because the catheter follows the rats' movements freely, only two silk sutures are required to secure it to the animal. No statistically significant differences between experimental and control rats were observed in terms of body weight gain, food intake, nitrogen balance, or caloric efficiency. This apparatus should prove useful in many areas of research.

Animals↗

Cellular hyperplasia in rats following continuous intravenous infusion of recombinant human epidermal growth factor.

In this study, we determined in vivo morphologic effects of continuous intravenous infusion of recombinant human epidermal growth factor (EGF) in adult Wistar rats. The EGF used consisted of the amino acid residues 1-48 of the human 53-amino-acid EGF molecule, purified from transfected Escherichia coli. Doses of 25, 100, or 250 micrograms/kg body weight were administered using Harvard digital syringe infusion pumps for 4 weeks. At necropsy, the submandibular salivary glands, Harderian glands, liver, kidneys (females only), and ovaries were enlarged and urinary bladders were thickened in 100- and 250-micrograms/kg rats. Numerous tissues of the 100- and 250-micrograms/kg rats contained hyperplastic epithelial cells, and selected organs also had mesenchymal cell proliferation. Epithelial proliferation was most pronounced in the trachea, nasal cavity, nasolacrimal duct, tongue, stomach, small intestine, large intestine, urinary tract, salivary gland ducts, and Harderian gland. Periportal hepatocytes were hypertrophic, correlating with increased liver weight. In addition, mesenchymal cell proliferation was evident in the gastric mucosa lamina propria and in heart valves in 100- and 250-micrograms/kg rats. Increased ovarian weight correlated with increased number and size of corpora lutea and an increased incidence of luteal cysts. Continuous systemic exposure of adult Wistar rats to high doses of EGF resulted in generalized epithelial hyperplasia and tissue-selective mesenchymal proliferation.

Amino Acid Sequence↗

Population pharmacokinetics of theophylline. I: Intravenous infusion to children in the acute episode of asthma.

The population pharmacokinetics of theophylline during constant-rate intravenous infusion has been studied in 66 children (8.7 +/- 4.7 year of age; 26.0 +/- 12.8 kg, mean +/- S.D.) with an episode of acute asthma. One hundred and twelve theophylline serum concentrations (13.9 +/- 4.8 micrograms/ml) collected retrospectively were analyzed using a nonlinear mixed-effect model. The influence of hepatic dysfunction, age, gender, days after admission, blood gas measurements (PaO2, PaCO2, blood pH) and clinical analyses data (total serum protein, albumin concentration, haemoglobin concentration, haematocrit) on theophylline clearance was examined by the likelihood ratio test. A final estimate of population mean clearance was 58.6 ml/kg/h, which was decreased by 36% in patients with hepatic dysfunction. Other factors tested displayed no statistically significant effect on theophylline clearance. The inter-individual variability in clearance was 26% while the intra-individual variability in theophylline concentrations was 2.6 micrograms/ml as a standard deviation, which was almost double that observed for stable patients. Taking into account that the therapeutic window of this drug is 10-20 micrograms/ml, this value indicates a relatively large intra-individual variability and suggests that frequent (daily) monitoring of serum concentrations is necessary for patients with an episode of acute asthma.

Acute Disease↗

Metabolic responses of lactating dairy cows to 14-day intravenous infusions of glucagon.

Twenty cows were assigned at parturition to two groups to study metabolic effects of continuous intravenous infusions of glucagon. Groups were control cows and cows treated with glucagon at 10 mg/d for 14 d starting at d 21 postpartum. Daily blood samples and nine liver biopsies were taken from d 7 to 49 postpartum. Plasma glucagon increased six- to seven-fold during infusions of treated cows. Plasma insulin was increased heterogeneously by glucagon infusions. Plasma glucose increased 11.5 and 9.0 mg/dl during wk 1 and 2 of glucagon infusions. No other plasma metabolites tested (nonesterified fatty acids, beta-hydroxybutyrate, and urea N) were affected by glucagon infusions. Liver glycogen decreased by d 2 of glucagon infusion but was repleted to preinfusion values by d 7 and increased to 169% of the preinfusion baseline values at 3 d after cessation of glucagon. Milk production decreased transiently during glucagon infusions. Both milk production and milk protein percentage decreased during glucagon infusion, which could imply a decreased availability of amino acids for milk protein synthesis. Feed intakes did not increase during glucagon infusions, which was in contrast to the control group. Results indicated that glucagon infusions caused liver glycogenolysis initially and probably enhanced gluconeogenesis but glucagon did not appear to increase lipolysis from adipose tissue in these early lactating dairy cows.

3-Hydroxybutyric Acid↗

Phase I study of 24-hour continuous intravenous infusion of recombinant human tumor necrosis factor.

Sixteen patients with cancer were treated with a 24-h continuous intravenous infusion of recombinant human tumor necrosis factor (rHuTNF) to investigate the spectrum of side-effects, the maximum tolerated dose, the pharmacokinetics, and possible antitumor effects. Fever, chills, and flu-like symptoms were the most common side-effects. The maximum tolerated dose was 6 x 10(5) U/m2 (261 micrograms/m2). Severe hypotension, fluid retention, watery diarrhea, and central nervous deficits culminated in a profound prostration as the dose-limiting toxicity. No allergic reactions, positive skin tests, or antibodies against rHuTNF were observed. Plasma levels of rHuTNF were detected at doses of greater than or equal to 3 x 10(5) U/ml2. Maximal plasma levels were 19 U/ml (8.2 ng/ml). No objective tumor responses were observed.

Adult↗

Radiochemical purity, at expiry, and radiochemical stability of iodine-131 labelled meta-iodobenzylguanidine concentrates for intravenous infusion.

AIM: The determination of the amount of free [131I]iodide in [131I]metaiodobenzylguanidine ([131I]MIBG) concentrates for intravenous infusion under different storage conditions derived from daily practice. METHOD: The percentage of free [131I]iodide was determined in [131I]MIBG concentrates (1.6-3.9 GBq in 7.5 ml), kept on dry ice (up to expiry, 3 days after production) or, after thawing, at room temperature (up to 24 h). A validated solid phase extraction (SPE) assay was used. RESULTS: Free [131I]iodide increased from 1.9% +/- 0.34% at production to 4.4% +/- 0.67% (mean +/- SD; n = 5) at expiry in 3.7 GBq per 7.5 ml [131I]MIBG infusion concentrates stored on dry ice (-78 degrees C). At room temperature, formation of free [131I]iodide was found to be dependent on the radioactive concentration of the fluid. [131I]iodide levels increased from 3.1%, immediately after thawing, to 6.6% and 16.6% at t = 5 and 24 h, respectively, for a 3.9 GBq per 7.5 ml concentrate. CONCLUSION: The investigated formulation of [131I]MIBG concentrates, stored in its original packing containing dry ice, can generally be used up to expiry. After thawing, the undiluted concentrates should be administered to a patient within 3.5 h.

3-Iodobenzylguanidine↗

[Outpatient chemotherapy with continuous intravenous infusion for patients with recurrent renal cell carcinoma or advanced prostate carcinoma].

We tried outpatient chemotherapy with continuous intravenous infusion of 5-fluorouracil (5-FU) and cisplatin (CDDP) for patients with recurrent renal cell carcinoma or advanced prostate carcinoma. This study was designed to evaluate the efficacy of our drug delivery system using two disposable balloon pumps and subcutaneous port, subjective symptoms caused by chemotherapy, and quality of life (QOL). There were 12 patients, including 7 cases of recurrent renal cell carcinoma and 5 cases of advanced prostate carcinoma. Their performance status (PS) was grade 0 or 1. The protocol for renal cell carcinoma consisted of combined chemotherapy with continuous infusion of 5-FU 250 mg/m2/day and CDDP 3 mg/m2/day in 2 weeks for 1 cycles (4 weeks). 5-FU and CDDP were administered with the Baxter infuser pumps (Intermate LV 1.5) and after 1 week we changed the new pumps. In treating advanced prostate carcinoma, Honvan 100 mg/day was substituted for 5-FU. We experienced 2 cases of problems with the drug delivery system during 10 months, which needed a change of the subcutaneous port. QOL score and subjective symptoms showed that patients were not always free because of carrying pumps and the side effects of chemotherapy, but they can return to social life and family instead of spending much time in the hospital. In conclusion, our drug delivery system is safe for outpatient chemotherapy, and QOL of patients with home anti-cancer chemotherapy is higher than that of patients with chemotherapy in the hospital.

Adult↗

Langerhans cells that migrate to skin after intravenous infusion regulate the induction of contact hypersensitivity.

Intravenous infusion of hapten-derivatized epidermal cells (EC) in syngeneic mice leads to two competing signals for contact hypersensitivity (CH), a dominant effector signal attributable to Langerhans cells (LC) and a suppressor signal from Thy-1+ EC. In vitro exposure of LC to low dose ultraviolet B (UVB) radiation before hapten-derivatization and infusion not only results in the abrogation of their effector signal but also causes the down-regulation of subsequent CH responses. To delineate the relevance of i.v. immunization to the study of CH and of LC as the immunologic targets of low dose UVB radiation, we examined the migratory and immunogenic properties of EC after i.v. infusion. Unsorted EC migrated from blood to skin and lymphoid tissues, reaching steady state distributions at 16 h after infusion. No significant differences were observed between the trafficking of EC in syngeneic and allogeneic transfers. LC localized preferentially to skin, whereas Thy-1+ EC trafficked to skin, the thymus, mesenteric lymph nodes, and spleen. The pattern of trafficking of unirradiated and low dose UVB-irradiated LC were identical, suggesting that low dose UVB radiation had little effect on LC migration. Finally, skin graft experiments demonstrated i.v. infused, hapten-derivatized LC that migrate to skin to retain their capacity to induce CH, a property that was converted by in vitro pretreatment with low dose UVB radiation into down-regulation. These findings confirm the relevance and utility of the i.v. immunization model in the study of CH and the influence of low dose UVB on this immune response. Our data also provide a basis for investigating the role of disparate trafficking patterns in generating effector and suppressor signals when hapten-derivatized EC are employed for CH.

Animals↗

Stroke volume and cardiac output hypoxemic hypoxia produced by intravenous infusion of carbon dioxide.

Hypoxia produced by intravenous infusion of gaseous carbon dioxide was associated in conscious rabbits with decreases in cardiac output and stroke volume. At the same time the arterial blood pressure, oxygen uptake and blood pH decreased, whereas carbon dioxide pressure and lactate level in the arterial blood increased. Pulmonary ventilation increased too, due to the rise in the respiratory frequency and tidal volume. The fall in cardiac output and stroke volume explains a great fall of oxygen uptake in response to decrease of oxygen pressure in the blood.

Animals↗

[Subcutaneous injections and intravenous infusion of sodium salt of heparin in the treatment of thrombosis of deep veins of the lower extremities].

Ninety-four patients with deep vein thrombosis of inferior limbs were randomly allocated to receive sodium heparin either by subcutaneous injections or by continuous intravenous infusion for six days. No significant difference was observed in the therapeutic efficiency as judged by phlebographic examinations and in rate of symptomatic pulmonary embolism between the two groups. There was one instance of major bleeding in the subcutaneous group. Minor bleedings occurred in 10 of the 48 patients treated with subcutaneous heparin and in 13 of the 46 patients receiving intravenous heparin. The results showed that subcutaneous injections of sodium heparin are as effective and safe as continuous intravenous infusion of this drug in the treatment of deep vein thrombosis.

Adult↗

[Analysis of efficacy and safety of multiple intravenous infusion of anti-tumor necrosis factor-alpha monoclonal antibody (Remicade) combined with methotrexate compared with sodium aurothiomalate and intramuscular depot methylprednisolone in rheumatoid arthritis].

The objective of the paper was compare the effects and tolerability of combined therapy of multiple intravenous infusions of anti-tumour necrosis factor-alfa (TNF-alfa) monoclonal antibody (Remicade) with methotrexate versus treatment with sodium aurothiomalate and intramuscular depot methylprednisolone in rheumatoid arthritis (RA). We investigate also the interval necessary to obtain the improvement in both treatment groups. 36 patients commencing intramuscular sodium aurothiomalate therapy with intramuscular depot methylprednisolone acetate at weeks 0, 4, 8 and 12 in addition to chrysotherapy were compared in retrospective analysis with 32 patients starting with multiple intravenous infusions of infliximab, anti-TNF-alfa monoclonal antibody (Remicade) and methotrexate at a stable dose. Patients were assessed by composite clinical score (DAS 28) and C-reactive protein during 22 weeks of therapy. At week 2 and 6 a significantly greater percentage of infliximab-treated than gold-treated RA patients achieved improvement in each clinical measurement of disease activity. At 22 week of treatment moderate and good response according to EULAR criteria was achieved in 91% of infliximab-treated patients and 58% gold treated patients (p < 0.001). Adverse events were more frequently observed in infliximab-treated patients, but only gold-treated patients discontinued treatment because adverse events (2 patients due to proteinuria, 2 patients due to mucocutaneous changes and one patient due to leucopenia). The higher percentage of adverse events in infliximab-treated patients was caused mainly by the occurrence of infusion reactions (23 reactions out of 160 infusions); most of them were mild (somnolentia and headache) and transient. Viral infections (including herpes simplex and zoster) were more common in patients treated with infliximab and methotrexate. Combination therapy of infliximab and methotrexate is more effective in reducing clinical and biochemical disease activity than gold with methylprednisolone treatment in RA patients during 22 weeks of treatment, especially in the first 6 weeks.

Antibodies, Monoclonal↗

The pharmacokinetics of ifosfamide given as short and long intravenous infusions in cancer patients.

1. We investigated the pharmacokinetics of ifosfamide 5 g m-2 given by two regimens. Six patients (one female), median age 55 (range 40-71) years, all with lung cancer received 5 g m-2 ifosfamide (median ifosfamide dose 8.95 g) as an intravenous infusion over 0.5 h with mesna. Four other cancer patients (all male) of median age 52.5 (range 23-72) years were studied on seven treatment occasions with 5 g m-2 ifosfamide (median ifosfamide dose 8.88 g) as a 24 h intravenous infusion with mesna. Plasma was assayed for ifosfamide by gas liquid chromatography and for alkylating activity by the nitrobenzylpyridine method. 2. After ifosfamide 5 g m-2 infused over 0.5 h, the decay of the plasma ifosfamide concentration was monoexponential with a median (range) t1/2,z of 5.4 h (3.6-10.4 h). The median clearance was 60 ml min-1 (47-104) and the median volume of distribution was 388 (329-783) ml kg-1. Plasma nitrobenzylpyridine alkylating activity showed a biexponential decay in four patients and a monoexponential decay in two, with a median AUC of 102 (24-177) nmol nor nitrogen mustard eq h ml-1. 3. When ifosfamide 5 g m-2 was given as a 24 h infusion, the decay of the plasma ifosfamide concentration was monoexponential, the median (range) t1/2,z was 4.5 (3.4-6.1), the median volume of distribution was 563 (292-818) ml kg-1 and the median clearance was 79 (59-116) ml min-1. Plasma nitrobenzylpyridine alkylating activity decayed monoexponentially and the median AUC was 49 (45-131) nmol nor nitrogen mustard eq ml-1 h.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Neuroprotective effects of the N-terminal tripeptide of insulin-like growth factor-1, glycine-proline-glutamate (GPE) following intravenous infusion in hypoxic-ischemic adult rats.

The N-terminal tripeptide of insulin-like growth factor-1, GPE is neuroprotective when given intracerebroventricularly 2 h after hypoxic-ischemic (HI) brain injury in rats. We have now examined whether GPE can cross the blood-brain barrier and exert neuroprotective actions following intravenous administration. Following a single bolus intravenous injection, GPE was rapidly metabolized and cleared from the circulation. The short half-life (<2 min) in blood was subsequently associated with modest and inconsistent neuroprotection. In contrast, potent neuroprotection of GPE was consistently observed in all brain regions examined following 4 h intravenous infusion (12 mg/kg). The neuroprotective effects of GPE after infusion showed a broad effective dose range (1.2-120 mg/kg) and an extended window of treatment to 7-11 h after injury. The central penetration of GPE after intravenous infusion was injury-dependent. GPE also improved long-term somatofunction with a comparable neuronal outcome. GPE reduced both caspase-3-dependent and -independent apoptosis in the hippocampus. Treatment with GPE also inhibited microglial proliferation and prevented the injury-induced loss of astrocytes. In conclusion, the neuroprotective actions of GPE infusion were global, robust and displayed a broad effective dose range and treatment window. GPE's activity included the prevention of neuronal apoptosis, promotion of astrocyte survival and inhibition of microglial proliferation. With injury specific central penetration, GPE has considerable promise as a systemic neuroprotective treatment after acute encephalopathies.

Animals↗

Intravenously infused adenosine increases the blood flow to brown adipose tissue in rats.

The effects of intravenously infused adenosine (ADO) and its analogues, N6-R(-)-phenylisopropyladenosine (R-PIA), 5'-N-ethylcarboxamide adenosine (NECA), on the blood flow to interscapular brown adipose tissue were studied in urethane-anesthetized rats. ADO and NECA, but not R-PIA, caused a dose-dependent increase in interscapular brown adipose tissue blood flow. The relative potency of these compounds to increase this blood flow was NECA greater than ADO greater than R-PIA. Infusing R-PIA and NECA intravenously caused a fall in diastolic blood pressure and heart rate whereas an infusion of ADO up to 380 nmol/rat per min did not elicit any systemic cardiovascular effect. A 10-mg/kg dose of alkylxanthines such as caffeine, 8-phenyltheophylline (8-PT) and 8-sulfophenyltheophylline (8-SPT) inhibited the half-maximum responses of interscapular brown adipose tissue blood flow to ADO by 41, 71 and 65% respectively indicating that caffeine is less potent than 8-PT and 8-SPT. The ADO uptake inhibitor, dipyridamole, significantly potentiated the ADO effect. These results suggest that the increased interscapular brown adipose tissue blood flow caused by ADO might possibly be mediated by A2 receptors.

Adenosine↗

Rostromedial hypothalamic monoamine changes in response to intravenous infusions of insulin and glucose in freely feeding obese Zucker rats: a microdialysis study.

We have shown previously that intravenous infusions of insulin, known to induce glucoprivic hunger, and of insulin combined with glucose, known to induce satiety, produce in the VMH and PVN of Wistar rats monoaminergic changes that differ from those related to spontaneously occurring hunger and satiety, while the genetically obese Zucker rat is totally resistant to the behavioural effects of insulin and insulin + glucose infusions. In the present study, the impact of these infusions on VMH and PVN monoamines in obese Zucker rats was assessed using microdialysis. Monaminergic changes (increase in DOPAC and 5-HIAA and decrease in DA and 5-HT) were quite similar in obese rats to those we found in normal rats when insulin was infused. In contrast, changes in 5-HT or DA in response to insulin and glucose were quite different in the Zucker rat. Monoaminergic changes related to meals were more dramatic in the Zucker rat and so were able to reverse the background changes produced by the insulin infusion. These data confirm the idea that the effect on monoamines of spontaneously occurring hunger and satiety is different from the effect on monoamines by insulin and glucose-induced hunger and satiety. The results show disturbances of the obese Zucker rat related both to insulin and to hypothalamic monoamines that may be involved in the hyperphagia and obesity of this model.

3,4-Dihydroxyphenylacetic Acid↗

Continuous intravenous infusion of fentanyl: case reports of use in patients with advanced cancer and intractable pain.

The use of continuous intravenous infusion of opioids may be efficacious in managing pain related to advanced cancer. Short-acting opioids, such as morphine and hydromorphone, are commonly used. We describe the use of a fentanyl infusion in four cases. This experience suggests that fentanyl may be considered an alternative drug for infusion in the treatment of refractory cancer pain.

Adult↗

Induction of circulating phospholipase A2 activity by intravenous infusion of endotoxin in patients with neoplasia.

The purpose of this study was to evaluate the impact of repeated intravenous infusions of endotoxin (EN) in patients with cancer on the systemic release of extracellular proinflammatory phospholipase A2 (PLA2) and its relationship to the release of tumor necrosis factor (TNF) and interleukin-6 (IL-6). Six patients received 15 infusion of EN isolated from Salmonella abortus equi at a dose of 4 ng/kg. Marked increase in the activity of circulating PLA2 was noted within 3 h after the first EN infusion and reached a maximal level of 20.4-fold greater than baseline 24 h after infusion. In five patients challenged with EN 2 weeks later, PLA2 reached peak levels 15.5-fold greater than baseline. In two patients who received three sequential daily infusions, the incremental increase in PLA2 activity after the second and third challenge reached maximum levels 6 h after EN infusion. PLA2 response followed those of TNF and IL-6 but was quantitatively different. Whereas maximal levels of TNF and IL-6 declined substantially after repeat EN challenges, no such decline occurred in PLA2 activity. Since, in the clinical setting of gram-negative sepsis, there is recurrent increase in circulating EN, our study approximates this clinical situation and shows that extracellular release of PLA2 follows temporally that of proximal cytokines such as TNF and IL-6. These cytokines may be related to PLA2 release and sustained high activity in the systemic circulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

Hemodynamic changes associated with intravenous infusion of the calcium antagonist verapamil in the treatment of severe gestational proteinuric hypertension.

The calcium antagonist verapamil was intravenously infused after plasma volume expansion with dextran-70 in nine patients with severe gestational proteinuric hypertension. The hemodynamic response of these patients was monitored using a flow-directed pulmonary artery catheter. Verapamil produced a statistically significant reduction in mean arterial pressure and systemic vascular resistance without adversely affecting the cardiac output. The decrease in blood pressure was smooth and controlled and was associated with an insignificant increase in heart rate. There were no adverse fetal effects as evidenced by cardiotocographic monitoring. The apparent efficacy of verapamil in this study justifies further investigation.

Adult↗