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Notes: Abstract Severe malnutrition has been associated with a decrease in fat and lean body mass, as well as in renal function. This study was designed to evaluate the estimation of glomerular filtration rate (GFR, ml/min per 1.73 m2) in malnourished teenagers, by using the formula GFR=kL/P cr (whereL is body height,P cr is plasma creatinine concentration and k is a proportionality constant relating muscle mass to body size that has been found to equal 0.7 in adolescent boys and 0.55 in girls). Body composition was estimated using anthropometric measurements and urinary creatinine excretion (UcrV). Malnourished female patients showed depletion of fat and muscle, whereas males had primarily decreased muscle mass. There was a good correlation (r=0.74) between anthropometric [arm muscle volume (AMV)] and chemical UcrV estimates of muscle mass. However, our previously validated estimate of GFR did not give reliable results in this group of malnourished teenagers, probably because their muscle mass was so greatly altered by the severity of malnutrition. Therefore, we used anthropometric measurements and Pcr, to estimate GFR by multiple linear regression. The best prediction was obtained by using AMV/Pcr and the observed/expected (for age, height and sex) weight ratio (WR): $$\begin{gathered} GFR (ml/min) = 0.06 AMV/P_{{\text{cr}}} + 131{\text{ WR - 79,}} \hfill \\ r = 0.82,n = 13. \hfill \\ \end{gathered} $$ We confirm that malnutrition in adolescents is associated with decreased GFR and conclude that the resulting variability in body composition limits the possibility of estimating GFR from Pcr and height. A somewhat better estimate may be obtained from simple anthropometric measurements and Pcr.

Notes: Abstract Background:This study was performed to evaluate thepharmacokinetics, bioequivalence, and feasibility of a combined oralformulation of 5-flurouracil (5-FU) and eniluracil (Glaxo Wellcome Inc.,Research Triangle Park, North Carolina), an inactivator of dihydropyrimidinedehydrogenase (DPD). The rationale for developing a combined eniluracil/5-FUformulation oral dosing form is to simplify treatment with these agents, whichhas been performed using separate dosing forms, and decrease the probabilityof severe toxicity and/or suboptimal therapeutic results caused byinadvertently high or conversely insufficient 5-FU dosing. Patients and methods:The trial was a randomized, three-waycrossover bioequivalence study of three oral dosing forms of eniluracil/5-FUtablets in adults with solid malignancies. Each period consisted of two daysof treatment and a five- to seven-day washout phase. Eniluracil at a dose of20 mg, which results in maximal DPD inactivation, was administered twice dailyon the first day and in the evening on the second day of each of the threetreatments. On the morning of the second day, all patients received a totaleniluracil dose of 20 mg orally and a total 5-FU dose of 2 mg orally as eitherseparate tablets (treatment A) or combined eniluracil/5-FU tablets in twodifferent strengths (2 tablets of eniluracil/5-FU at a strength (mg/mg) of10/1 (treatment B) or 8 tablets at a strength of 2.5/0.25 (treatment C)). Thepharmacokinetics of plasma 5-FU, eniluracil, and uracil, and the urinaryexcretion of eniluracil, 5-FU, uracil, and α-fluoro-β-alanine (FBAL),were studied. To determine the bioequivalence of the combined eniluracil/5-FUdosing forms compared to the separate tablets, an analysis of variance onpharmacokinetic parameters reflecting eniluracil and 5-FU exposure wasperformed. Results:Thirty-nine patients with advanced solid malignancies hadcomplete pharmacokinetic studies performed during treatments A, B, and C. Thepharmacokinetics of eniluracil and 5-FU were similar among the three types oftreatment. Both strengths of the combined eniluracil/5-FU dosing form and theseparate dosing forms were bioequivalent. Mean values for terminal half-life,systemic clearance, and apparent volume of distribution for oral 5-FU duringtreatments A/B/C were 5.5/5.6/5.6 hours, 6.6/6.6/6.5 liters/hour, and50.7/51.5/50.0 liters, respectively. The intersubject coefficient of variationfor pharmacokinetic variables reflecting 5-FU exposure and clearance intreatments ranged from 23% to 33%. The urinary excretion ofunchanged 5-FU over 24 hours following treatments A, B, and C averaged52.2%, 56.1%, and 50.8% of the administered dose of 5-FU,respectively. Parameters reflecting DPD inhibition, including plasma uraciland urinary FBAL excretion following treatments A, B, and C were similar.Toxicity was generally mild and similar following all three types oftreatments. Conclusions:The pharmacokinetics of 5-FU and eniluracil weresimilar and met bioequivalence criteria following treatment with the separateoral formulations of 5-FU and eniluracil and two strengths of the combinedformulation. The availability of a combined eniluracil/5-FU oral dosing formwill likely simplify dosing and decrease the probability of severe toxicityor suboptimal therapeutic results caused by an inadvertent 5-FU overdose orinsufficient 5-FU dosing in the case of separate oral formulations, therebyenhancing the overall feasibility and therapeutic index of oral 5-FU therapy.

Notes: An electron spin resonance (ESR) technique is employed to determine the free radical distribution in the articulating surfaces of retrieved acetabular cups and knee-joint plateaus (retrieved after more than 6 years of implantation). Similar measurements made on samples prepared from cyclically stressed and unstressed cups, and on samples following oxidations in nitric acid and intralipid solutions provided sufficient data to gain more knowledge about the combined chemical and mechanical effects on PE free radicals during implantation. In UHMWPE free radicals are primarily initiated by gamma-ray sterilization; however, during implantation, peroxy (scission type) free radicals are formed and reach a maximum concentration level (equilibrium state) due to oxidation by chemical (hemoglobin and/or synovial fluids) environment of the joints. Subsequently, due to frictional heating and stress in the loading zones, free radical reaction is accelerated and their number is reduced only in those areas. This is consistent with the observations of a temperature rise in acetabular cups during in vitro frictional wear stress tests and in vivo telemetry observations, as reported by others. Compared with the previously reported SEM micrographs the low-free-radical regions are correlated with high-wear areas and the high-free-radical regions with the low-wear areas.

Notes: Stress relaxation of commercial poly(vinyl chloride) (PVC) is measured at strains below 3% and at different temperatures below the glass transition temperature. First it is shown that below the yield point the material follows a linear viscoelastic behavior. Then the data at a fixed deformation level (0.03) are fitted by considering a lognormal distribution function of relaxation times. Furthermore, from the measured stress-strain curves, the temperature dependence of the elastic tensile modulus is determined. The temperature dependence of the elastic modulus, the relaxation strength, and the parameters of the distribution: mean relaxation time, τm, and half-width, β, are given. Moreover, the distribution function and the temperature dependence of its characteristic parameters are discussed in terms of a cooperative model of the mechanisms involved in the mechanical relaxation of glassy polymers. Finally, the relationship proposed between the tensile modulus and the free volume helps explain the temperature dependence of the relaxation strength. © 1996 John Wiley & Sons, Inc.