Evaluating the changes in alveolar permeability and lung ventilation in patients with chronic renal failure after haemodialysis using 99mTc-DTPA radioaerosol inhalation lung scan.

Hypoxaemia occurring in patients with chronic renal failure (CRF) during haemodialysis (HD) has long been known. Several mechanisms of pathogenesis have been proposed. Before and after regular HD, lung ventilation (LV) and alveolar permeability (AP) were measured in 24 male patients with CRF (age, 61-75 years). LV and AP were determined by 99mTc-diethylenetriaminepentaacetic acid (99mTc-DTPA) radioaerosol inhalation lung scan (99mTc-DTPA lung scan). The LV images were visually interpreted according to established criteria, including the presence or absence of an inhomogeneous distribution, inverted base to apex gradient and segmental hypoventilation. The degree of AP in the total right lung was presented as the clearance rate (K; %.min-1) of the time-activity curve from dynamic total right lung images. Ten male normal controls (age, 62-76 years) were enrolled in the study for comparison. Ten of 24 (42%) cases showed an inhomogeneous distribution and eight of 24 (33%) cases showed hypoventilation on equilibrium LV images. After regular HD for 5 h, no significant changes in the LV images were found. Before HD, the CRF patient group (K=1.14+/-0.36%.min-1) had a significantly faster clearance rate than that of normal controls (0.75+/-0.14%.min-1, P<0.05). Moreover, the clearance rate after HD was significantly slower (0.87+/-0.15%.min-1, P<0.05) than that before HD. CRF can predispose patients to LV change and AP damage. After HD, the damage to AP is significantly improved. However, after HD, the change in LV is not significant.

Antiplasmodial activity of mono- and dimeric carbazoles.

A series of mono- and dimeric natural and structurally modified carbazoles has been tested for activity against Plasmodium falciparum. One of the monomers, the synthetic compound 1,4-diacetoxy-3-methylcarbazole (17), displays the highest activity, with an IC50 value of 1.79 micrograms/ml. It is distinctly more active than the as yet best natural compound, 1-hydroxy-3-methylcarbazole (4) (4).

Comparison of acute physiology and chronic health evaluation III and II for prediction of mortality in multiple organ failure patients treated by plasma exchange.

This study examined the efficacy of a different scoring system for multiple organ failure (MOF) patients treated by plasma exchange (PE). Twenty-five patients with MOF resulting from fulminant hepatitis who had been treated by PE for a total number of 91 PEs in a consecutive period of 22 months were included in our study. Data were collected from each patient to compute acute physiology and chronic health evaluation (APACHE) II and APACHE (AP) III scores. The sensitivity, specificity, and correct prediction of outcomes were measured. The correct prediction of outcomes was 86.5%in AP III and 77.5% in AP II. For the prediction of patient mortality, the AP III system seems to be more reliable than AP II.

Alkaloids of papaveraceous plants.

From the whole plants of Corydalis tashiroi Makino a new quaternary protoberberinium base dehydrodiscretamine chloride was isolated along with four known quaternary alkaloids by the application of droplet countercurrent chromatography (DCCC). The structure of the new base was established by spectral and chemical evidence. Eight known tertiary alkaloids were also isolated from the same plant.