RESUMEN
OBJECTIVE: To review the causes of drug-induced hypoglycaemia in patients not taking hypoglycaemic medications. DESIGN: Retrospective study. SETTING: Regional hospitals in Hong Kong. PATIENTS: Patients with suspected drug-induced hypoglycaemia without a known history of exposure to hypoglycaemic agents, referred to the Hospital Authority Toxicology Reference Laboratory from June 2005 to March 2006 inclusive. MAIN OUTCOME MEASURES: Rate of positive cases, laboratory findings, possible causes, age distribution, and final outcomes. RESULTS: A total of 51 such patients were referred, in whom the presence of oral hypoglycaemic agents was detected (or inferred) in 23 (45%). In 12 of the 23 patients, oral hypoglycaemic agents could only be detected by target analysis, not through broad-spectrum screening. Gliclazide and glibenclamide were detected in 14 and eight patients respectively, whereas glimepiride, nateglinide and rosiglitazone were detected in the remaining patient. Possible sources of oral hypoglycaemic agents included drug administration errors in residential care homes for the elderly (n=9), mistakenly taking medication of a family member or employer (n=6), taking stock medication by mistake (n=2), taking Chinese proprietary medicine adulterated with oral hypoglycaemic agents (n=1), taking unknown pills bought from a retail pharmacy (n=1), and unknown (n=4). Regarding these 23 patients, 17 (74%) were aged 70 years or above and 21 (91%) recovered uneventfully. CONCLUSION: Hypoglycaemia due to inadvertent use of oral hypoglycaemic agents is a recognised problem, particularly in cases where family members living in the same household are taking similar medications. Possible drug administration errors in residential care homes for the elderly should be investigated, and procedures rectified if confirmed. Health care providers should be vigilant to such potential errors, especially in cases of unexplained hypoglycaemia.
Asunto(s)
Hipoglucemia/inducido químicamente , Adulto , Anciano , Anciano de 80 o más Años , Preescolar , Femenino , Hogares para Ancianos , Humanos , Hipoglucemiantes/análisis , Hipoglucemiantes/toxicidad , Masculino , Errores de Medicación , Persona de Mediana EdadRESUMEN
PURPOSE: A multi-centre randomized phase II study of single agent nolatrexed dihydrochloride versus doxorubicin was undertaken in Chinese patients with advanced hepatocellular carcinoma (HCC) to study and compare the clinical efficacy of the two drugs. METHODS: Fifty-four patients with clinical or histological diagnosis of HCC were randomized in a 2:1 ratio to receive nolatrexed or doxorubicin. Nolatrexed 725 mg/m(2)/day was given by continuous infusion via a central venous device for 5 days and doxorubicin 60 mg/m(2) was given as a rapid intravenous infusion every 3 weeks. RESULTS: No objective responses were observed in either treatment arm. Two patients in the nolatrexed arm and none in the doxorubicin arm had >50% decline in serum alpha-fetoprotein. The median survival for the patients in the nolatrexed and doxorubicin arms was 139 days and 104 days, respectively. Moderate toxicities including leukopenia, thrombocytopenia, mucositis and skin rash were observed in both treatment arms. CONCLUSION: Nolatrexed and doxorubicin are minimally active in the treatment of advanced HCC. Given the small sample size, no difference is observed between the two drugs.
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Antimetabolitos Antineoplásicos/uso terapéutico , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/tratamiento farmacológico , Doxorrubicina/uso terapéutico , Neoplasias Hepáticas/tratamiento farmacológico , Quinazolinas/uso terapéutico , Adulto , Anciano , Antimetabolitos Antineoplásicos/efectos adversos , Antineoplásicos/efectos adversos , Carcinoma Hepatocelular/mortalidad , Doxorrubicina/efectos adversos , Femenino , Humanos , Infusiones Intravenosas , Neoplasias Hepáticas/mortalidad , Masculino , Persona de Mediana Edad , Quinazolinas/efectos adversos , Análisis de SupervivenciaRESUMEN
AIMS: The aim of this study was to establish the cytokeratin expression profile of different types of thyroid carcinoma. MATERIALS AND METHODS: The expression of cytokeratins (CKs) 1, 4, 6, 7, 10/13, 18, 19 and 20 in 153 thyroid carcinomas were examined by immunohistochemistry. RESULTS: All papillary carcinomas (n=86) and follicular carcinomas (n=19) showed expression of CK7 and CK18. The staining was often diffuse. CK19 staining was expressed in all papillary carcinomas and the staining was often diffuse. The staining was noted in 68% of follicular carcinomas and the staining was often focal. No difference in the expression was noted between the minimally invasive and widely invasive follicular carcinomas. Poorly differentiated carcinomas (n=10) showed CK7, CK18, CK19 expression in 60%, 60% and 40%, respectively. Anaplastic carcinomas (n=25) expressed CK7 in 84%, CK18 in 80%, CK19 in 76% and CK10/13 in 16%. Medullary carcinomas (n=13) showed CK7 expression in 100%, CK18 in 85% and CK19 in 77%. None of the medullary carcinomas showed diffuse positivity to CK19. All the thyroid carcinomas were negative for CKs 1, 4, 6 and 20. CONCLUSIONS: Cytokeratin expression profile for each type of thyroid carcinoma was established.
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Biomarcadores de Tumor/sangre , Carcinoma/sangre , Queratinas/sangre , Neoplasias de la Tiroides/sangre , Anciano , Carcinoma/patología , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Proteínas de Filamentos Intermediarios/sangre , Queratina-20 , Queratinas/clasificación , Masculino , Persona de Mediana Edad , Neoplasias de la Tiroides/patologíaRESUMEN
Localized folate deficiency may be a risk factor for cancer. Since, folate binding proteins (FBP) and reduced folate carrier proteins (RFC) mediate cellular transport of folate, we compared FBP concentrations in several organs from tumor-bearing transgenic (TBT) mice and tumor-free non-transgenic controls (NTC) of the same strain, age, and fed identical diets. Liver, spleen, brain, small intestine and kidney were individually homogenized in phosphate-buffered saline (PBS) and separated into membrane, cytoplasmic, mitochondrial/lysomal and nuclear fractions (confirmed with marker enzymes). Homogenates and fractions was analyzed for total protein, and FBP. We used rabbit anti-bovine milk antibody and ELISA to measure FBP. FBP concentrations in kidney, small intestine, and spleen of TBT mice were higher than those of NTC mice; the opposite was true in liver and lung. FBP seemed to be upregulated in kidneys (all fractions), small intestine (all fractions), and spleen (cytoplasmic and nuclear fractions only) of TBT mice compared to NTC mice; the opposite appeared true in liver (all fractions) and lung (all fractions). FBP concentrations in brain, heart, and muscle of TBT mice were not different from those in brain, heart and muscle of NTC mice. A longitudinal study will determine if these changes in FBP concentrations precede tumor onset.
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Proteínas Portadoras/metabolismo , Ácido Fólico/metabolismo , Neoplasias Experimentales/metabolismo , Receptores de Superficie Celular , Animales , Bovinos , Fraccionamiento Celular , Electroforesis en Gel de Poliacrilamida , Ensayo de Inmunoadsorción Enzimática , Femenino , Receptores de Folato Anclados a GPI , Masculino , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos CBA , Ratones Transgénicos , Conejos , Fracciones Subcelulares , Distribución TisularRESUMEN
An incomplete prepenile scrotum is an unusual anomaly. Two cases of incomplete prepenile scrotum are presented here, both of which are associated with a small phallus, hypospadias and a bifid scrotum. No sex chromosome disorder or hereditary factors contribute to such a disorder. Early surgical correction is recommended.
Asunto(s)
Escroto/anomalías , Niño , Preescolar , Anomalías Congénitas/cirugía , Humanos , MasculinoRESUMEN
This study was conducted to investigate the effects of nitric oxide (NO) on human sperm activity, human sperm-oocyte fusion and mouse embryonic development. Results showed that various concentrations of NO synthase blocker, N(omega)-nitro-L-arginine methyl ester, did not affect sperm cell motility at 0, 1, 2 or 4 hr, respectively. In contrast, sodium nitroprusside (SNP) significantly inhibited sperm cell motility and caused apoptosis. The adversely dose-dependent effect was only observed if SNP was freshly prepared. Adenosine triphosphate reversed the hazardous effect of SNP on sperm activity/viability. Hemoglobin neutralized the adverse effect of SNP. In hemi-zona sperm fusion test, the number of sperm bound to the zona in the presence of 10(-4) M SNP was significantly less than the control group. SNP at 10(-4) M caused all mouse embryonic development arrest. 46% and 56% of zygote reached the blastocyst stage with the treatment of 10(-6) M and 10(-8) M SNP, respectively, while the control reached 70%. NO adversely affected human sperm activity, human sperm-zona binding and embryonic development. It would appear that high concentration of NO may potentially decrease fertility.