RESUMO
Objective: To analyze the age distribution characteristics of different cancers in the world according to the database from Cancer Incidence in Five Continents published by the International Association of Cancer Registries, and to compare the age differences of cancer incidence in different regions. Methods: Cancer incidence data from volume XI of Cancer Incidence in Five Continents including 339 population-based cancer registries in 65 countries during 2008-2012 have been extracted. The average age of cancer incidence in different regions, gender and cancer sites were analyzed and stratified according to the human development Index and the level of national or regional development UN Development. The Segi's world standard population (world standard) was standardized to calculate the average age of the cancer incidence and to analyze the effect of age structure of the population on the average age of cancer diagnosis. Results: This study included 4 812 008 148 person-years in the global population (including 2 367 458 302 men and 2 444 549 846 women), and 21 892 093 of the new cancer cases, including 11 450 515 men and 10 441 578 women. The analysis showed that the average age of cancer incidence in the world was 65.73 years, and men and women were 66.70 and 64.67 years old, respectively. Among them, the average incidence age of testicular cancer was the youngest, with an average age of 36.67 years, and that of gallbladder cancer was the highest with average age of 71.55 years. After adjusting for population structure, the average incidence age was highest in gallbladder cancer, followed with bladder cancer and prostate cancer, and the testicular was with the lowest average age of incidence, followed by bone cancer and brain tumor. The results showed that the average age of cancer incidence in developed countries or regions was 66.38 years old, and that in less developed countries or regions was 61.75 years old, but in China it was 63.47 years old. According to the human development index (HDI), the higher the country or region with HDI, the higher the average age of cancer incidence, and the difference is reduced after the adjustment of the age structure of the population. Conclusions: There are different characteristics of the age distribution for different cancer sites. In terms of the age of cancer incidence, those of gallbladder cancer and bladder cancer are relatively old, while those of the testis, bone and thyroid cancer are relatively young. The average age of cancer incidence in China is between developed and less developed countries. Prevention and control of cancer should be carried out according to the age distribution characteristics of different cancers.
Assuntos
Distribuição por Idade , Saúde Global/estatística & dados numéricos , Neoplasias/diagnóstico , Neoplasias/epidemiologia , Adulto , Idoso , China , Bases de Dados Factuais , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Neoplasias Embrionárias de Células Germinativas/diagnóstico , Neoplasias da Próstata/diagnóstico , Neoplasias da Próstata/epidemiologia , Sistema de Registros , Distribuição por Sexo , Neoplasias Testiculares/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Neoplasias da Glândula Tireoide/epidemiologia , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/epidemiologiaRESUMO
To select an appropriate prognostic model in the treatment of mature T- and natural killer (NK) -cell lymphoma (peripheral T-cell lymphoma (PTCL) and NK-/T-cell lymphoma (NKTCL)) is crucial. This study investigated the usefulness of Ann Arbor staging classification International prognostic index (IPI), prognostic index for T-cell lymphoma (PIT) and International peripheral T-cell lymphoma Project score (IPTCLP). Between 2000 and 2009, 176 patients (122 males) with PTCL and NKTCL were diagnosed and treated from a single institute in Taiwan. The correlation between complete response (CR) rate, 3-year overall survival (OS), early mortality rate and four prognostic models was analyzed. Thirty-one patients received hematopoietic stem cell transplantation (HSCT) and were analyzed separately. Three-year OS rate was 34.7%, and anaplastic large-cell lymphoma harbored better outcome than others. IPI score had the lowest Akaike information criterion value (1081.197) and was the best score in predicting OS and early mortality (P=0.009). Ann Arbor stage classification can predict CR rate more precisely (P=0.006). OS was significantly better in patients who received HSCT, even in patients with unfavorable features compared with chemotherapy alone. All prognostic models were useful to evaluate the outcome of patients with PTCL and NKTCL but IPI score did best in predicting OS in PTCL and PIT score in NKTCL. This study also supported the role of HSCT in patients with high-risk or refractory PTCL or NKTCL.
RESUMO
The purpose of this study was to establish the distribution, speciation and bioavailability of mercury in mangrove sediments. A systemic survey of surficial sediments from 13 mangrove wetlands of China was carried out. Hg concentrations ranged from 2.3-903.6ngg(-1), with an average value of 189.4ngg(-1). Of the 13 areas surveyed, the Hg content in sediments was similar to background levels in 6 areas but was much higher in the other seven areas. Hg levels were affected by natural and anthropogenic factors, including terrestrial pollutants, geomorphic properties, and indirectly by economic status. Hg levels were positively correlated with organic matter, pH, and silt and clay fractions, but Hg was negatively correlated with sand fraction. In most mangrove wetlands, Hg existed primarily in the form of volatile Hg. Hg is easily bioaccumulated in mangrove wetlands and may be the natural source of Hg emissions to the atmosphere.
Assuntos
Sedimentos Geológicos/química , Mercúrio/análise , Rhizophoraceae , Poluentes Químicos da Água/química , Áreas Alagadas , China , Monitoramento Ambiental , Cinética , Água/químicaRESUMO
AIM: To evaluate the antioxidant and pro-oxidant properties of chlorhexidine (CHX). METHODOLOGY: The scavenging and generation of reactive oxygen species (ROS) by CHX in the presence or absence of saturated Ca(OH)(2) solutions was evaluated. The reaction emitted chemiluminescence in the presence of lucigenin thus was determined by a luminometer to evaluate the levels of ROS production. Changes in DNA conformation were analysed by agarose gel electrophoresis. Paired Student's t-test was used to compare the difference between groups. RESULTS: Chlorhexidine (0.00002-0.02%) effectively scavenged 56-88% of the superoxide radicals generated by the xanthine/xanthine oxidase reaction. Through analysis of PUC18 DNA conformation changes, CHX was shown to be a mild scavenger of hydroxyl radicals generated by H(2)O(2) plus FeCl(2). However, CHX (>0.083%) decreased the mobility of PUC18 plasmid DNA with potential production of DNA-DNA cross-link and severe DNA breaks (presence of DNA smear) at further higher concentrations. Furthermore, CHX induced ROS production including H(2)O(2) and superoxide radicals in 0.1N NaOH (pH = 12.76) or Ca(OH)(2) (pH = 12.5) solutions. CONCLUSION: Chlorhexidine exhibited both antioxidant and pro-oxidant properties under different conditions. These events are possibly involved in the killing of root canal and periodontal microorganisms when CHX and Ca(OH)(2) were used in combination or separately. Potential genotoxicity and tissue damage when extruded into the periradicular tissue and at higher concentrations should be considered during periodontal and endodontic practice.
Assuntos
Clorexidina/química , Clorexidina/toxicidade , Irrigantes do Canal Radicular/química , Irrigantes do Canal Radicular/toxicidade , Hidróxido de Cálcio/química , Dano ao DNA , Interações Medicamentosas , Sequestradores de Radicais Livres/química , Peróxido de Hidrogênio/química , Espécies Reativas de Oxigênio/química , Hidróxido de Sódio/químicaRESUMO
BACKGROUND AND PURPOSE: Zotepine is claimed to be a neuroleptic drug with atypical features. However, there have been few double-blind studies in Asian patients. The purpose of this study was to compare the efficacy and safety of zotepine and haloperidol in Taiwanese patients with schizophrenia. PATIENTS AND METHODS: Patients with positive symptoms (n = 70) were enrolled into this double-blind, randomized study. Each patient received either zotepine 150 mg/day or haloperidol 9 mg/day. The Positive and Negative Syndrome Scale (PANSS), Brief Psychiatric Rating Scale (BPRS), and Clinical Global Impression (CGI) were assessed on Days 0, 3, 7, 14, 28, and 42 after the start of treatment. Adverse events were recorded during the trial period. The analyses were carried out on an intent-to-treat basis with the last observation carried forward. RESULTS: In terms of the score reduction in the PANSS, BPRS, and CGI, all analyses indicated that there were no significant differences between the groups at the end of the trial. Patients who received zotepine had no acute dystonia and less severe parkinsonism (p < 0.05 or 0.10), but significantly more dizziness, body weight gain, and pulse rate increase. CONCLUSION: In this 6-week trial, zotepine at 150 mg/day was as efficacious as haloperidol 9 mg/day in the treatment of Taiwanese patients with schizophrenia. Zotepine treatment produced fewer extrapyramidal symptoms but had a greater frequency of sedative effects compared to haloperidol.
Assuntos
Antipsicóticos/uso terapêutico , Dibenzotiepinas/uso terapêutico , Haloperidol/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/efeitos adversos , Dibenzotiepinas/efeitos adversos , Método Duplo-Cego , Feminino , Haloperidol/efeitos adversos , Humanos , Masculino , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Esquizofrenia/diagnósticoRESUMO
This study investigated the stabilization of heavy metals in a sewage sludge composting process using kaoline addition. The results indicate that the temperature increased rapidly to the thermophilic phase (>55 degrees C) at day 1. The additives enhanced the rate of biodegradation and microbial activity during the co-composting process. The changes in pH (ranging from 8 to 8.5) and electrical conductivity (EC) (< or =3 mS/cm) were in compliance with the best conditions during the co-composting process. The C/N ratio was determined in each co-compost sample as an indicator of the co-compost maturity. From the end product of the co-compost experiment, changes in the ratios indicate that the additives promote the co-compost maturation rate. Based on the physicochemical characteristics of the co-compost, the potential use for sewage sludge resource recovery as manure is suggested. The total concentrations of Pb, Cd, Cr, Cu, and Zn in the co-compost product were far below the limit values for agricultural use. The leachability of Pb, Cu, and Cr decreased with increasing co-composting time. That is, the kaoline additive has an inhibitory capacity for leaching heavy metals. The Cd concentrations in the sludge compost were below the detection limits. Because the total concentration of Zn was high in the sludge compost and most soluble Zn was leachable, the leachability of Zn ranged from 25% to 29%. As a result of the physicochemical characteristics and heavy metal stabilization, the selected additive was shown to improve the sewage sludge compost quality and provide information for agricultural applications.
Assuntos
Conservação dos Recursos Naturais , Metais Pesados/química , Esgotos/química , Agricultura , Bactérias , Biodegradação Ambiental , Poluição Ambiental/prevenção & controle , Concentração de Íons de Hidrogênio , Metais Pesados/análise , TemperaturaRESUMO
As with mammalian enzymes, green crab (Scylla serrata) alkaline phosphatase can be activated by Mg2+ through a time-dependent course. The activation is mainly a Vmax effect. Tsou's method was used to study the kinetic course of activation. The results show that the enzyme was activated by a complexing scheme that had not been previously identified: the enzyme first reversibly and quickly binds Mg2+ and then undergoes a slow reversible course to activation, with a relatively high activation energy (78 +/- 4 kJ/mol) and a slow conformational change. The activation reaction is a single molecule reaction, and the apparent activation rate constant is independent of Mg2+ concentration if the concentration is sufficiently high. The microscopic rate constants of activation and the association constant were determined from the measurements. The proposed scheme may also be applied to the Mg2+ activation mechanism for mammalian enzyme, to explain why the activation rate is time-dependent and not diffusion controlled. Substrate binding was also shown to affect the activation rate constant.
Assuntos
Fosfatase Alcalina/metabolismo , Braquiúros/enzimologia , Magnésio/metabolismo , Animais , Braquiúros/fisiologia , Ativação Enzimática , Cinética , Espectrometria de Fluorescência , TemperaturaRESUMO
To help determine whether sustained attention deficits as measured with the Continuous Performance Test (CPT) are stable vulnerability indicators of schizophrenia, we compared the CPT performance of schizophrenic patients before and after treatment with risperidone or haloperidol. In this double blind trial, 56 schizophrenic patients were randomly assigned to a 12-week regimen of either risperidone or haloperidol, after a 1-week washout period. The patients undertook two sessions of the CPT (undegraded and 25% degraded) twice, one at the end of the washout period and the other at the end of the study. Thirty-eight patients completed the study, 19 in each group. Both groups experienced significant improvements in clinical symptoms, and the risperidone group showed no change in the severity of extrapyramidal symptoms. Despite those improvements, the CPT performance indexes did not change significantly from the beginning to the end of the study. These findings indicate that sustained attention deficits might be stable vulnerability indicators of schizophrenia.
Assuntos
Antipsicóticos/uso terapêutico , Atenção/efeitos dos fármacos , Haloperidol/uso terapêutico , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Atenção/fisiologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Testes NeuropsicológicosRESUMO
The inhibition of alkaline phosphatase from green crab (Scylla serrata) by L-cysteine has been studied. The results show that L-cysteine gives a mixed-type inhibition. The progress-of-substrate-reaction method previously described by Tsou [(1988), Adv. Enzymol. Related Areas Mol. Biol. 61, 391-436] was used to study the inactivation kinetics of the enzyme by L-cysteine. The microscopic rate constants were determined for reaction of the inhibitor with the free enzyme and the enzyme-substrate complex (ES) The results show that inactivation of the enzyme by L-cysteine is a slow, reversible reaction. Comparison of the inactivation rate constants of free enzyme and ES suggests that the presence of the substrate offers marked protection of this enzyme against inactivation by L-cysteine.
Assuntos
Fosfatase Alcalina/antagonistas & inibidores , Braquiúros/enzimologia , Cisteína/farmacologia , Inibidores Enzimáticos/farmacologia , Animais , Cinética , Especificidade por SubstratoRESUMO
There are still some difficulties in prosthetic reconstruction of cleft lip and palate patients with conventional prostheses or implant retained prostheses. The most common difficulties are insufficient alveolar bone quality and quantity, inadequate soft tissue, and abutment teeth. The patient we report on was a 23-year-old man with a clinical diagnosis of right incomplete cleft lip and palate combined with midface dysplasia. The maxillary six anterior teeth were reconstructed. The maxillary right central incisor and canine were used as abutments for an extracoronal resilient attachment (ERA) retained removable partial overdenture. The STERN ERA SYSTEM is a hinged resilient attachment with an ideal stress breaking characteristic, a good retentive function, and easy chairside replacement. The 2-year follow-up examination revealed an adequate esthetic appearance with good retention and stability of the prosthesis. A removable partial overdenture using the teeth adjacent to the cleft area as abutments with an adequate attachment design is an alternative method for prosthetic reconstruction of cleft lip and palate deformity.
Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Encaixe de Precisão de Dentadura , Revestimento de Dentadura , Prótese Parcial Removível , Obturadores Palatinos , Adulto , Humanos , MasculinoRESUMO
Green crab (Scylla Serrata) alkaline phosphatase (EC 3.1.3.1) is a metalloenzyme which catalyzed the nonspecific hydrolysis of phosphate monoesters. In the present paper, the effects of several N-thiophosphoryl amino acids on the activity of green crab alkaline phosphatase have been studied. The results show that these derivatives of amino acids can lead to reversible inactivation. The equilibrium constants for inhibitors binding with the enzyme and/or the enzyme-substrate complexes have been determined. The obtained results show that both N-thiophosphoryl-Cys and N-thiophosphoryl-Glu were non-competitive inhibitors, while other five N-thiophosphoryl amino acids were un-competitive inhibitors. For the un-competitive inhibitors, the inhibition strength follows the order N-thiophosphoryl-Ile > -Val > -Lys > -Ala > -Tyr. Compared with respective free amino acids, it can be seen that N-thiophosphorylation of the amino acids increased their inhibition strength except the N-thiophosphoryl-Cys.
Assuntos
Fosfatase Alcalina/antagonistas & inibidores , Aminoácidos/farmacologia , Braquiúros/enzimologia , Aminoácidos/química , Animais , Ligação Competitiva , Inibidores Enzimáticos/farmacologiaRESUMO
Seventy DSM-III schizophrenic patients were assessed for positive and negative symptoms using Andreasen's scales for the assessment of positive and negative symptoms (SANS and SAPS) on admission. The correlation structure of the items in the SANS and SAPS was explored in dimension and item levels by use of correlation plots through a distinct analytical method displaying the proximity matrix. The results revealed at least three major dimensions of symptoms delineated as Negative Symptoms, Disorganized Thoughts and Delusions and Hallucinations. The latter two dimensions were derived from the SAPS, while Negative Symptoms comprised most of the items in the SANS. Items in Disorganized Thoughts were more correlated to Negative Symptoms than to the other items in the SAPS. 'Loss of ego boundary' delusions and experience of auditory hallucinations appeared as two sub-clusters in the group of Delusions and Hallucinations. The relative independence of persecutory, grandiose, religious, somatic and reference delusions gives support to the concept that paranoid schizophrenia stands as a distinct clinical subtype of schizophrenia. The graphical method introduced here well expresses the information of correlation matrix and is useful for exploring inter-item or inter-cluster associations.
Assuntos
Testes Psicológicos , Esquizofrenia/diagnóstico , Adolescente , Adulto , Delusões/etiologia , Feminino , Alucinações/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Esquizofrenia/complicações , Psicologia do Esquizofrênico , Pensamento/fisiologiaRESUMO
Plasma reduced haloperidol (RH) concentrations or RH to haloperidol (HL) ratios have been suggested to be important in determining the clinical efficacy and extrapyramidal side effects of HL. In this study, we measured the steady-state plasma HL and RH levels by high performance liquid chromatography and analyzed the effects of various variables (dose, gender, age, and body weight) on RH/HL ratios in four dose groups of Chinese schizophrenic inpatients: 10 mg/day (n = 84), 20 (n = 111), 30 (n = 29), and 60 (n = 55). In addition, the polymorphic distribution of RH/HL ratios, suggested by previous investigators, was further tested in each dosage group (for controlling the potential dosage effect on RH/HL ratios). As a result, both age and body weight could influence RH/HL ratios. Each year increase in age (after adjusting the effects of gender, body weight, and dosage) would elevate the RH/HL ratio by 0.0067 (P < 0.0001). On the other hand, after adjusting gender, age, and dosage effects, each kg increment in body weight would decrease the RH/HL ratio by 0.0044 (P < 0.01). Gender did not influence the ratio. Furthermore, the high dosage groups had higher RH/HL ratios (even with other variables being controlled). In comparison with the 10 mg group, the 60 mg group exhibited a higher mean RH/HL ratio by 0.84 (P < 0.0001) and the 30 mg group did by 0.31 (P < 0.0001). The 20 mg group was almost equal to the 10 mg group in RH/HL ratios. Besides, at each dosage group, the frequency distribution of RH/HL ratios seemed to be predominantly unimodal with a small proportion of extreme outliers. The results of this study clearly indicate that aging or a high dose (> or = 30 mg/day) of HL could raise the plasma RH/HL ratio, while an increasing body weight would reduce that. In contrast, gender does not affect the ratios.
Assuntos
Antipsicóticos/farmacocinética , Discinesia Induzida por Medicamentos/sangue , Haloperidol/análogos & derivados , Haloperidol/farmacocinética , Esquizofrenia/sangue , Adulto , Fatores Etários , Antipsicóticos/administração & dosagem , Antipsicóticos/efeitos adversos , Peso Corporal/fisiologia , Relação Dose-Resposta a Droga , Discinesia Induzida por Medicamentos/diagnóstico , Feminino , Haloperidol/administração & dosagem , Haloperidol/efeitos adversos , Humanos , Masculino , Taxa de Depuração Metabólica/fisiologia , Pessoa de Meia-Idade , Esquizofrenia/tratamento farmacológico , Fatores SexuaisRESUMO
Steady-state plasma concentrations of clozapine and its metabolites, desmethylclozapine and clozapine-N-oxide, were measured in 162 Taiwanese patients with refractory schizophrenia. The daily doses of clozapine ranged from 100 to 900 mg, with a mean value of 379.5 +/- 142.2 mg. A dosage of 400 mg/day or lower was used for most patients (n = 131, 81%). Plasma concentrations of clozapine and its two major metabolites were measured using high performance liquid chromatography with ultraviolet detection. The mean plasma clozapine concentration was 566.9 +/- 398.8 ng/mL. The plasma concentrations of desmethylclozapine and clozapine-N-oxide were 46% and 16% of the concentration of the parent drug, respectively. We used an approximate rule that each 100 mg/day dose results in about 150 ng/mL plasma clozapine. This value is about 30% to 50% higher than that reported in Caucasians. The suggested therapeutic plasma clozapine concentration range of 300 to 700 ng/mL can be achieved with a dose range of 200 to 500 mg/day in most Taiwanese patients. Dose-dependent plasma clozapine concentrations were found. The interpatient variation was up to 12-fold in patients receiving the same dose, eg, 400 mg/day (n = 62). In four of these patients, the plasma drug concentrations were very high (1,446 +/- 114 ng/mL). The application of therapeutic drug monitoring in clozapine-treated patients with refractory schizophrenia is important, not only in dose adjustment, prediction of severe side effects such as seizures, and exploration of drug interactions, but also in the effective use of this expensive drug.
Assuntos
Antipsicóticos/sangue , Clozapina/sangue , Adulto , Idoso , Clozapina/administração & dosagem , Relação Dose-Resposta a Droga , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
We have semisynthesized 19 species of mixed-chain phosphatidylethanolamines (PEs) in which the sn-1 acyl chain is derived from saturated fatty acids with varying chain lengths and the sn-2 acyl chain has different chain lengths but contains 0, 1, and 2 cis double bond(s). The gel-to-liquid crystalline phase transition temperatures (Tm) of lipid bilayers prepared from these 19 mixed-chain PEs were determined calorimetrically. When the Tm values are compared with those of saturated and monounsaturated counterparts, a common Tm profile is observed in the plot of Tm versus the number of cis double bonds. Specifically, a marked stepwise decrease in Tm is detected as the number of cis double bonds in the sn-2 acyl chain of the mixed-chain PE is successively increased from 0 to 1 and then to 2. The large Tm-lowering effect of the acyl chain unsaturation can be attributed to the increase in Gibbs free energy of the gel-state bilayer as a result of weaker lateral chain-chain interactions. In addition, we have applied molecular mechanics calculations to simulate the molecular structure of dienoic mixed-chain C(X):C(Y:2 delta n,n+3)PE in the gel-state bilayer, thus enabling the three independent structural parameters (N, delta C, and LS) to be calculated in terms of X, Y, and n, which are intrinsic quantities of C(X):C(Y:2 delta n,n+3)PE. When the Tm values and the corresponding N and delta C values of all dienoic mixed-chain PEs under study are first codified and then analyzed statistically by multiple regressions, the dependence of Tm on the structural parameters can be described quantitatively by a simple and general equation. The physical meaning and the usefulness of this simple and general equation are explained.
Assuntos
Ácidos Graxos Insaturados , Bicamadas Lipídicas/química , Fosfatidiletanolaminas/química , Varredura Diferencial de Calorimetria , Gráficos por Computador , Simulação por Computador , Géis , Bicamadas Lipídicas/síntese química , Modelos Moleculares , Conformação Molecular , Fosfatidiletanolaminas/síntese química , Software , Relação Estrutura-AtividadeRESUMO
This study examined the relationship between the metabolic ratios of dextromethorphan/dextrorphan, haloperidol disposition, and the incidence of extrapyramidal side effects in schizophrenic patients. Eighteen schizophrenic patients were phenotyped with a test dose of dextromethorphan prior to the initiation of haloperidol treatment. The metabolic ratio of dextromethorphan/dextrorphan was determined in each patient. Patients were treated with oral haloperidol 10 mg/day for 2 weeks. Blood samples for haloperidol and reduced haloperidol were obtained at week 2 of haloperidol treatment. Haloperidol and reduced haloperidol plasma concentrations were assayed by HPLC with electrochemical detection. Significant correlations of dextromethorphan/dextrorphan metabolic ratios vs. plasma haloperidol concentrations, reduced haloperidol concentrations, and reduced haloperidol/haloperidol ratios were found (r = 0.726, P = 0.0007; r = 0.782, P = 0.0001; and r = 0.619, P = 0.006, respectively). Ten patients who experienced extrapyramidal side effects had higher reduced haloperidol concentrations and reduced haloperidol/haloperidol ratios than the other patients (2.49 +/- 1.42 [S.D.] ng/ml vs. 1.10 +/- 0.46 ng/ml, P = 0.014 and 0.287 +/- 0.102 vs. 0.192 +/- 0.065, P = 0.030). The former also had a trend to have higher haloperidol concentrations and dextromethorphan/dextrorphan ratios than the latter (8.04 +/- 2.91 ng/ml vs. 5.83 +/- 1.79 ng/ml, P = 0.066 and 0.023 +/- 0.017 vs. 0.011 +/- 0.010, P = 0.077). Phenotyping patients has the potential to assist clinicians in predicting plasma drug concentrations during the subsequent neuroleptic drug treatment. Further research with phenotyping and psychotropic drug metabolism in psychiatric patients is needed.
Assuntos
Dextrometorfano/farmacocinética , Haloperidol/farmacocinética , Esquizofrenia/metabolismo , Adulto , Povo Asiático , Doenças dos Gânglios da Base/induzido quimicamente , Feminino , Haloperidol/efeitos adversos , Haloperidol/uso terapêutico , Humanos , Masculino , Fenótipo , Esquizofrenia/tratamento farmacológico , Esquizofrenia/genética , População BrancaRESUMO
1. The studies of relationships between blood levels of reduced haloperidol HL (RH) and clinical efficacy in haloperidol (HL)-treated patients have yielded variable results. On the other hand, the contribution of RH upon HL's extrapyramidal side effects (EPS) had been suggested in animal models as well as in preliminary clinical studies with limited subjects. 2. This study explored the relationships between blood drug levels and clinical effects and EPS of HL in 48 Chinese acutely exacerbated schizophrenic inpatients. After a single-blind placebo period of one week, the patients were treated with a fixed dose 10 mg of HL for two weeks. Steady-state levels of HL and RH in plasma (n = 48) and in red blood cells (RBC) (n = 37) were measured by high performance liquid chromatography. 3. The mean RH/HL ratio in RBC in the Chinese (0.55) is lower than that in non-Chinese patients as reported in the literature (> 2), so is the RH/HL ratios in plasma. 4. No significant relationship emerged between percent improvement in BPRS total score and any of drug indices (HL, RH, sum of two compounds (HL+RH), and RH/HL ratio) in plasma and in RBC. Furthermore, the responders did not differ significantly from the nonresponders in each drug index. 5. Plasma RH levels were significantly higher in 30 patients experiencing EPS compared with the other 18 patients (mean 2.14 +/- 1.71 (S.D.) ng/ml vs. 1.38 +/- 0.37 ng/ml, p < 0.05). No significant differences in other drug indices were noted between subjects with or without EPS.
Assuntos
Tratos Extrapiramidais/efeitos dos fármacos , Haloperidol/efeitos adversos , Haloperidol/sangue , Haloperidol/farmacologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The dependence of the phase transition temperature, Tm, on the structural parameters of the lipid molecule has been firmly established for lipid bilayers composed of saturated phosphatidylcholines (PC) or phosphatidylethanolamines (PE). It is from such a dependence that conversions of Tm values from saturated PC to PE and vice versa have been successfully demonstrated. In this communication, similar chain-melting-structure relationships are sought for monoenoic PC and PE in which the long hydrocarbons linked at the sn-1 and sn-2 positions are saturated and cis-mono-unsaturated chains, respectively. Specifically, various molecular species of monoenoic PC and PE were first semisynthesized and their Tm values were subsequently determined by high-resolution differential scanning calorimetry. Based on the crankshaft-like kink motif model, the synthesized monoenoic PC and PE can each be divided into two groups, each group being characterized by three structural parameters. For each group of monoenoic PC or PE, a specific equation correlating the changes in Tm with variations in the structural parameters was derived using the multiple regression analysis. Furthermore, within each group of lipids including both PC and PE, an explicit equation describing the interconversion of Tm values between PC and PE with the same fatty acyl chain composition was established. The present work not only extends the earlier work relating the chain-melting temperature of saturated PC and PE to their structural parameters, but also indicates that the basic topology of the sn-2 mono-unsaturated acyl chain of PC and PE in the gel-state bilayer can be approximated by the crankshaft-like kink motif with the longer segment being packed much more orderly than the shorter segment.
Assuntos
Bicamadas Lipídicas/química , Fosfatidilcolinas/química , Fosfatidiletanolaminas/química , Varredura Diferencial de Calorimetria , Ácidos Graxos/química , Técnicas In Vitro , Conformação Molecular , Estrutura Molecular , Temperatura , TermodinâmicaRESUMO
The influence of the lipid mixing properties on the lateral organization in a two-component, two-phase phosphatidylcholine bilayer was investigated using both an experimental (fluorescence recovery after photobleaching (FRAP)) and a simulated (Monte Carlo) approach. With the FRAP technique, we have examined binary mixtures of 1-stearoyl-2-capryl-phosphatidylcholine/1,2-distearoyl-phosphat idylcholine (C18C10PC/DSPC), and 1-stearoyl-2-capryl-phosphatidylcholine/1,2-dipalmitoyl-phospha tid ylcholine (C18C10PC/DPPC). Comparison with the 1,2-dimyristoyl-phosphatidylcholine/1,2-distearoyl-phosphatidylcholine (DMPC/DSPC) previously investigated by FRAP by Vaz and co-workers (Biophys. J., 1989, 56:869-876) shows that the gel phase domains become more effective in restricting the diffusion coefficient when the ideality of the mixture increases (i.e., in the order C18C10PC/DSPC-->C18C10PC/DPPC-->DMPC/DSPC). However, an increased lipid miscibility is accompanied by an increasing compositional dependence: the higher the proportion of the high-temperature melting component, the less efficient the gel phase is in compartmentalizing the diffusion plane, a trend that is best accounted for by a variation of the gel phase domain shape rather than size. Computer-simulated fluorescence recoveries obtained in a matrix obstructed with obstacle aggregates of various fractal dimension demonstrate that: 1) for a given obstacle size and area fraction, the relative diffusion coefficient increases linearly with the obstacle fractal dimension and 2) aggregates with a lower fractal dimension are more efficient in compartmentalizing the diffusion plane. Comparison of the simulated with the experimental mobile fractions strongly suggests that the fractal dimension of the gel phase domains increases with the proportion of high-temperature melting component in DMPC/DSPC and (slightly) in C18C10PC/DPPC.
Assuntos
Bicamadas Lipídicas , Fosfatidilcolinas/química , 1,2-Dipalmitoilfosfatidilcolina/química , 4-Cloro-7-nitrobenzofurazano , Varredura Diferencial de Calorimetria , Simulação por Computador , Géis , Conformação Molecular , Espectrometria de Fluorescência , Relação Estrutura-Atividade , TermodinâmicaRESUMO
In this study, we have semisynthesized the following three molecular species of mixed-chain phosphatidylethanolamine: C(22):C(12)PE, C(16):C(18:1 delta 9)PE, and C(10):C(24:1 delta 15)PE. These lipids share a common structural characteristic, that is, they all have the same total number of carbon atoms in their acyl chains. Aqueous dispersions prepared from three sets of binary lipid mixtures, C(16):C(18:1 delta 9)PE/C(22):C(12)PE, C(10):C(24:1 delta 15)PE/C(22):C(12)PE, and C(16):C(18:1 delta 9)PE/C(10):C(24:1 delta 15)PE, were studied by high-resolution differential scanning calorimetry, leading to the construction of three temperature-composition phase diagrams. A computer program developed on the basis of the thermodynamic equations for non-ideality of mixing (or Brigg-Williams approximation) was applied to fit the calorimetric data, yielding the non-ideality parameters of mixing in the gel and the liquid-crystalline bilayers (pG and pL). Based on the shapes of these phase diagrams and the values of pG and pL, it is concluded that any two of the three molecular species of phosphatidylethanolamines under study can mix nearly ideally in the bilayer plane of the liquid-crystalline bilayer. However, these binary lipid mixtures do exhibit the gel-gel phase immiscibility over an extensive compositional region in the gel-state bilayer. By comparison with experimental data obtained with binary mixtures of saturated identical-chain phospholipids, we can conclude that mixed-chain cis-monounsaturated lipid molecules and saturated lipid molecules are highly demixed in the same two-dimensional plane of the gel-state bilayer, although the bilayer thickness difference between the lipid bilayer composed of cis-monounsaturated lipids and that of saturated lipids may be only one or two C-C bond lengths at T < Tm.