Phase 1 drug interaction study of suramin and warfarin in patients with prostate cancer.

Potential interaction between suramin and warfarin was evaluated when coadministered to patients with cancer. Thirteen men with advanced hormone-refractory prostate cancer were initially stabilized with warfarin to a prothrombin time (PT) of 2 +/- 0.2 International Normalized Ratio (INR) during a lead-in period of 4 weeks. A baseline daily warfarin dose was established, and treatment with suramin plus hydrocortisone was then started. The effect of suramin on the anticoagulant activity of warfarin was assessed in each patient by comparing his baseline warfarin dose with average daily doses required to maintain the same INR level over each of the initial 6 weeks of a 12-week course of suramin treatment. The average daily dose of warfarin required to maintain PT at 2 +/- 0.2 INR decreased from a baseline value of 4.2 to between 3.4 and 4.0 during the 6 weeks of suramin plus warfarin treatment. Despite failing to demonstrate equivalence applying a 90% confidence interval approach, required reductions in warfarin dose were clinically minor and the combination was well tolerated. Based on these results, the eligibility criteria for a large ongoing randomized study were amended to allow entry of men receiving warfarin therapy. This interaction study, together with experience gained in a larger trial setting, has confirmed that warfarin and suramin can be safely coadministered, provided that coagulation status is appropriately monitored.

Processes involved in the development of latent fingerprints using the cyanoacrylate fuming method.

Chemical processes involved in the development of latent fingerprints using the cyanoacrylate fuming method have been studied. Two major types of latent prints have been investigated-clean and oily prints. Scanning electron microscopy (SEM) has been used as a tool for determining the morphology of the polymer developed separately on clean and oily prints after cyanoacrylate fuming. A correlation between the chemical composition of an aged latent fingerprint, prior to development, and the quality of a developed fingerprint has been observed in the morphology. The moisture in the print prior to fuming has been found to be more important than the moisture in the air during fuming for the development of a useful latent print. In addition, the amount of time required to develop a high quality latent print has been found to be within 2 min. The cyanoacrylate polymerization process is extremely rapid. When heat is used to accelerate the fuming process, typically a period of 2 min is required to develop the print. The optimum development time depends upon the concentration of cyanoacrylate vapors within the enclosure.

The Golgi apparatus of the scaly green flagellate Scherffelia dubia: uncoupling of glycoprotein and polysaccharide synthesis during flagellar regeneration.

The flagella of the green alga Scherffelia dubia are covered by scales which consist of acidic polysaccharides and glycoproteins. Experimental deflagellation results in the regeneration of flagella complete with scales. During flagellar regeneration, scales are newly synthesized in the Golgi apparatus, exocytosed and deposited on the growing flagella. Flagellar regeneration is dependent upon protein synthesis and N-glycosylation, as it is blocked by cycloheximide and partially inhibited by tunicamycin. Metabolic labeling with [35S]methionine/cysteine demonstrated that scale-associated proteins were not newly synthesized during flagellar regeneration, suggesting that the proteins deposited on regenerating flagella were drawn from a pool. Quantitative immunoelectron microscopy using a monospecific antibody directed against a scale-associated protein of 126 kDa (SAP126) revealed that the pool of SAP126 was primarily located at the plasma membrane, with minor labeling of the scale reticulum and trans-Golgi cisternae, both before deflagellation and during flagellar regeneration. Since SAP126 was sequestered during flagellar regeneration into secretory vesicles together with newly synthesized scales, it is concluded that the persistent presence of SAP126 in the trans-Golgi cisternae during scale biogenesis requires retrograde transport of the protein from the plasma membrane to the Golgi apparatus.

Burn care in the home.

Burn injuries present a special challenge to the home health care team. The most severely injured individuals are cared for in the hospital, but many patients with burns are cared for at home. Even those cared for in the hospital will eventually be discharged, and many will be referred for home health care. Coordination of services and a team approach are essential to obtain favorable outcomes. Physicians, nurses, occupational and physical therapists, social workers, psychiatrists, psychologists, case managers, and others collaborate as needed to evaluate and promulgate a plan of treatment. The home health care team plays an important role in this collaboration, assisting the patient to cope with these injuries and to prevent complications.

Transesophageal echocardiographic diagnosis of a ruptured tricuspid valve chordae tendinae as the etiology for cardiogenic shock.

Acute tricuspid insufficiency is an uncommon cause of cardiogenic shock. Previous reported cases have involved patients with right ventricular infarction. We report a case of acute tricuspid insufficiency causing cardiogenic shock in a patient without evidence of right ventricular infarction. Transesophageal echocardiography (TEE) was used to diagnose a ruptured chordae tendinae as the etiology of tricuspid insufficiency.