Detection of cytomegalovirus reactivation in cancer patients receiving chemotherapy.

While increasing numbers of cytomegalovirus (CMV)-associated diseases are occurring in patients undergoing conventional chemotherapy, information regarding CMV reactivation is limited. This pilot study was conducted to investigate CMV reactivation induced by chemotherapy. Seven blood samples were collected from each of 15 patients with newly diagnosed malignant disease, at baseline before chemotherapy, and once every month after chemotherapy was commenced. CMV viral loads in leukocytes were determined by real-time PCR. Host responses to changes in viral loads were assessed by assaying CMV-specific IgG titres and tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma levels in each of the blood samples, and by scoring the number of CMV-associated clinical symptoms that developed. All except one patient experienced CMV reactivation during the course of chemotherapy, with the average viral load peaking after the third course of treatment. Titres of CMV-specific IgG increased in line with the increase in viral load. Plasma levels of TNF-alpha and IFN-gamma initially decreased from baseline, and then rose to peak levels at the same time as, or shortly after, the highest viral loads were recorded. Clinical symptoms potentially attributable to CMV infection appeared as the viral load increased. It was concluded that the incidence of CMV reactivation in patients receiving conventional chemotherapy is high. Reactivation is not asymptomatic, but was self-limiting in most of these cases. Increases in plasma TNF-alpha and IFN-gamma occur after reactivation, but not before.

Pre-medication with intravenous clonidine suppresses fentanyl-induced cough.

BACKGROUND: A reflex cough is often observed after an intravenous bolus of fentanyl. This study was conducted to determine whether pre-treatment with intravenous clonidine could effectively attenuate fentanyl-induced cough. METHODS: Three hundred ASA I-II patients, aged between 18 and 80 years, undergoing various elective surgeries, were enrolled in this study. All patients were randomly assigned to one of two groups treated with intravenous clonidine 2 microg/kg (clonidine group) or the same volume of normal saline (control group). Intravenous fentanyl (2 microg/kg in 2 s) was injected 2 min after the clonidine or normal saline injection. Changes in the hemodynamics, auditory evoked potentials (AEPs) and Observer Assessment of Alertness/Sedation (OAA/S) rating scale were recorded before and 2 min after the clonidine or normal saline injection and 1 min after the fentanyl injection. The number of coughs 1 min after the fentanyl injection was also recorded. RESULTS: Patients in the clonidine group showed a significantly lower incidence of cough than those in the control group (17.3% vs. 38.7%, respectively; P < 0.01). The blood pressure was lower in the clonidine group than in the control group. There were no significant differences in AEP or OAA/S rating scale. CONCLUSIONS: Pre-treatment with intravenous clonidine (2 microg/kg) suppressed the reflex cough induced by fentanyl, with mild hemodynamic changes. Therefore, intravenous clonidine may be a clinically useful method of suppressing fentanyl-induced cough.

Comparison of the effects of thoracic epidural analgesia and i.v. infusion with lidocaine on cytokine response, postoperative pain and bowel function in patients undergoing colonic surgery.

BACKGROUND: Both thoracic epidural analgesia (TEA) and i.v. lidocaine were able to decrease postoperative pain and duration of ileus. We compared TEA and i.v. lidocaine (IV) regarding their effects on cytokines, pain and bowel function after colonic surgery. METHODS: Sixty patients were randomly allocated to one of the three groups. TEA group had lidocaine 2 mg kg(-1) followed by 3 mg kg(-1) h(-1) epidurally and an equal volume of i.v. normal saline. The IV group received the same amount of lidocaine i.v. and normal saline epidurally. The control group received normal saline via both routes. These regimens were started 30 min before surgery and were continued throughout. Blood cytokines were measured at scheduled times within 72 h. RESULTS: Both TEA and IV groups had better pain relief. The total consumptions using patient-controlled epidural analgesia were 81.6 (6.5), 55.0 (5.3) and 45.6 (3.9) ml (P<0.01) and the times of flatus passage were 50.2 (4.9), 60.2 (5.8) and 71.7 (4.7) h (P<0.01) in the TEA, IV and control groups, respectively. The TEA group exhibited the best postoperative pain relief and the least cytokine surge. The IV group experienced better pain relief and less cytokine release than the control group. CONCLUSIONS: The TEA lidocaine had better pain relief, lower opioid consumption, earlier return of bowel function and lesser production of cytokines than IV lidocaine during 72 h after colonic surgery; IV group was better than the control group.

Generation of electrospray from a solution predeposited on optical fibers coiled with a platinum wire.

This study examines the feasibility of generating electrospray directly from the tip of two optical fibers bound together with Teflon tape. This approach does not require a capillary and syringe pump. The electrospray source is simply constructed by coiling the two optical fibers with a platinum (Pt) wire. The optical fibers extend beyond the Pt coil for approximately 1 cm. The sample solution is predeposited on the Pt coil by a micropipette. As the high voltage required for electrospray is applied to the coil, the sample solution moves along the grooves between the two optical fibers. A stable electrospray is subsequently generated at the tip of the fibers. The mass spectra of insulin, lysozyme, and ubiquitin are exactly the same as those obtained by conventional electrospray using a capillary and syringe pump. Rapid determination of the active ingredient in a tablet by this technique is demonstrated.

Application of direct electrospray probe to analyze biological compounds and to couple to solid-phase microextraction to detect trace surfactants in aqueous solution.

This work presents two novel direct electrospray probes (DEP) to generate an electrospray without using a capillary and/or syringe pump. One of the DEPs is simply a copper coil connecting to a high-voltage power supply. The sample solution is deposited on the coil by a micropipet and the electrospray is subsequently generated at the tip of the copper coil after high voltage is applied to it. Another DEP is constructed by inserting two parallel optical fibers through the copper coil. The two fibers extend one end of the copper coil by 1 cm. Electrospray is generated at the tip of the fibers through the solution predeposited on the copper coil as the high voltage is applied on the copper coil. The ES mass spectra of myoglobin in liquid or solid phases can be obtained using this DEP-MS. Coupling the DEP to a solid-phase microextraction fiber is extremely easy, and a trace amount (in ppb range) of surfactants (Triton X-100) in the aqueous solution are selectively concentrated and detected.

Tunable holographic Fabry-Perot étalon fabricated from poor-quality glass substrates.

A novel holographic recording method has been demonstrated for fabricating highly reflectant mirror coatings on a glass substrate of poor surface quality. Electro-optically tunable characteristic fringes of a high-finesse Fabry-Perot étalon have been observed from a cavity consisting of a thin nematic liquid-crystal layer and coated with holographic mirrors. Good agreement has been found between measured values and values predicted by coupledwave theory.

Optical fibers with negative group-velocity dispersion in the visible.

Dispersion measurements have been performed in optical fibers having a photoinduced refractive-index grating in the core. The results show that negative group-velocity dispersion can be obtained in these fibers over a frequency region of 500 MHz for wavelengths shorter than 550 nm.