Triple primary cancers of the head and neck: case report and literature review.

BACKGROUND: Coincident thyroid and head and neck squamous cell carcinomas are rare. This paper presents a case of synchronous laryngeal squamous cell carcinoma, follicular thyroid carcinoma and micropapillary thyroid carcinoma. METHODS: A PubMed search was performed for articles describing synchronous thyroid and head and neck squamous cell carcinomas, using the search terms 'thyroid cancer', 'cancer of the head and neck', 'synchronous' and 'synchronous neoplasm'. RESULTS: The literature suggests that the head and neck squamous cell carcinoma stage is a better predictor of outcome than the extent of surgical treatment of the thyroid gland in synchronous malignancies. CONCLUSION: The decision regarding surgical treatment of the thyroid in synchronous thyroid and head and neck squamous cell carcinomas should take several factors into account. The head and neck squamous cell carcinoma stage is the strongest predictor of outcome, although patient-related factors and the location of malignant thyroid tissue may also affect management.

Development and validation of a sensitive solid-phase extraction and high-performance liquid chromatographic assay for the novel bio-reductive anti-tumor agent RH1 in human and mouse plasma.

A HPLC assay and solid-phase extraction technique from human plasma has been developed and validated for the experimental anticancer agent, RH1 (2,5-diaziridinyl-3-hydroxymethyl-6-methyl-1,4-benzoquinone) which is currently being evaluated by the CRC phase I/II committee. A 500 mg amino propyl solid-phase extraction cartridge was used to isolate RH1 from human plasma. Analysis was performed on a reversed-phase chromatography system using a 15 cm cyanopropyl column and isocratic elution with a 10% methanol-90% water (double distilled) solution. The lower limit of quantitation for RH1 was found to be 0.00375 microg/ml (3.75 ng/ml+/-8.3%) in water and following extraction from plasma. Recovery of >80%(+/-11.9%) was achieved over a five-day validation study. This method was used to carry out pre-clinical studies in BDF mice (standard strain of hybrid mice) at three dose levels (2, 5 and 10 mg/kg of RH1 in 0.9% (w/v) saline via an intraperotoneal injection). Standard Version of PC Winnonlin pharmacokinetic modelling software was used to model the data. A none-compartmental model was used to describe the disposition of RH1 in mice plasma. RH1 was rapidly eliminated from plasma with a mean plasma clearance of 23.4 ml/min, mean volume of distribution of 321.6 ml and mean t(1/2) alpha and beta decays of 4.8 and 9.6 min, respectively. RH1 in human and mouse whole blood and plasma was found to be stable up to 2 h.

Development and validation of a high-performance liquid chromatographic assay using solid-phase extraction for the novel antitumor agent pancratistatin in human plasma.

The stability of the experimental anti-tumour agent pancratistatin in human plasma has been investigated. A solid-phase extraction technique and an HPLC assay with external standards have been developed and validated. Extraction was performed using C18 cartridges and HPLC, analysis was performed on a 15 cm Hypersil BDS column using isocratic elution with 13% acetonitrile and aqueous solution of 1% (w/v) acetic acid. The lower limit of quantification for pancratistatin in 5% DMF-95% water was found to be 0.58 ng/ml (+/-10.58%) and 2.3 ng/ml (+/-9.2%) following extraction from human plasma. Mean recovery of 89.4% (+/-4.73%) was obtained over the concentration range 0.0023-9.45 microg/ml for a five day validation study. Pancratistatin was stable at room temperature in light or dark for at least 15 days, in the refrigerator at 4 degrees C for at least 16 days and in the freezer at -20 degrees C or -80 degrees C for at least 28 days. Under all conditions monitored, % recovery of pancratistatin from human plasma was greater than 95% and no evidence of degradation had occurred. There also was no loss of pancratistatin after three cycles of freezing and thawing.

Defective antigen processing correlates with a low level of intracellular glutathione.

Previously, we reported that Chinese hamster ovary (CHO) cells transfected with murine mouse major histocompatibility complex class II genes, exhibit a unique antigen (Ag) processing defect whereby these cells are impaired in processing only Ag with disulfide bonds. Here, we examined various aspects of the intracellular reducing environment in the CHO cells to understand the underlying mechanism causing the defect. A cell hybrid generated by the fusion of CHO cells and L cell fibroblasts was used for comparison due to their competency in processing Ag. The transport pathway of cysteine within the CHO cells appeared normal. However, these cells had a significantly lower level of glutathione, a major physiological reducing thiol, compared to the cell hybrid. Treatment of the CHO cells with N-acetyl-L-cysteine did not augment their glutathione content nor their ability to process Ag. When the cell hybrid was treated with L-buthionine-(S,R)-sulfoximine (BSO), which significantly decreased their glutathione level, the hybrid poorly processed hen egg lysozyme (HEL) and ovalbumin, which have disulfide bonds. In contrast, BSO treatment did not affect the capacity of the hybrid to process pigeon cytochrome c and carboxymethylated HEL, which lack disulfide bonds. Therefore, low intracellular glutathione levels in antigen-presenting cells correlated with defective processing of Ag with disulfide bonds, indicating that this thiol may be a critical factor in regulating productive Ag processing.

Diabetes update and implications for care.

Home healthcare nurses see many patients daily with diabetes as a primary or secondary diagnosis. This article provides the nurse with an updated review of all the factors necessary to provide the highest quality care to these patients in the home.

Alcohol and Drug use by Students on a University Campus in Thailand.

This survey was conducted with 501 students from a university in eastern Thailand. The questionnaire was based on the Core Alcohol and Drug Survey designed to survey U.S. higher-education students throughout the United States. It has been translated into Thai language with some modifications in content. Stratified cluster sampling was done based on year in attendance and Faculty (School) affiliation. Two-thirds of the respondents were female. Results showed that males are more involved in alcohol and drug use than females and suffer more consequences as a result. Although Thai students do not use these addictive substances as frequently as U.S. students, there is still cause for concern regarding alcohol use. The number of family members reported by students as having a problem with alcohol or drugs is especially significant.

Nursing: caring or codependent?

Can nurses practice caring within a healthcare system that promotes codependency? Caring promotes mutual empowerment of all participants while codependent caring disempowers. Nurses are expected to practice caring with clients, The authors contend, however, that nursing, as historically and currently practiced within bureaucratic/patriarchal organizations, is founded on a value system that fosters codependency. Until nursing is practiced within the context of caring organizations and a caring healthcare system, nurses will continue to be powerless to shape their own practice as carers and burnout will continue to be a problem.

The regulation of haemolymph potassium activity during initiation and maintenance of diuresis in fed Rhodnius prolixus.

The blood-sucking insect Rhodnius prolixus rapidly eliminates a Na(+)-rich K(+)-poor urine after its large meals. K(+)-rich fluid is first secreted by the upper Malpighian tubules and passes to the lower tubules where most of the potassium is reabsorbed. During the initial stimulation of the tubules, the lower tubules must be activated first to avoid loss of potassium. The major element in this is that they respond more rapidly than do the upper tubules to particular hormonal concentrations rather than that they react to lower hormonal concentrations than do the upper tubules. During subsequent diuresis, regulation of the haemolymph potassium concentration depends on three cooperative homoeostatic mechanisms in the tubules. A fall in potassium concentration of the medium bathing the tubules causes (i) a decrease in the rate of fluid secretion by the upper tubules, (ii) a decrease in potassium concentration in the fluid secreted by the upper tubules and (iii) an increase in the rate of potassium absorption by the lower tubules. The tubules respond in the opposite direction to an increase in potassium concentration of the medium. As a result, the potassium concentration of the urine can be adjusted to match the potassium concentration of the fluids absorbed from the gut, so that the potassium concentration of the insect's haemolymph remains unaltered.

Dimethanesulphonate esters in receptor mapping studies. 2. Antitumour activities of alkyl and alkoxy dimethanesulphonates substituted on a benzene nucleus.

The antitumour activities of 15 novel aromatic dimethanesulphonate esters were studied. Several alkyl and alkoxy compounds have shown good antitumour activity whilst similar isomers have proved ineffective as antitumour agents. These differences in activity have been correlated with the length of the sidechain substituents and their relative flexibilities.

Family care of the elderly in Northeast Thailand: Changing patterns.

Using exchange theory, the effects of the change from a kin-based to a cash-based economic system on family care to the elderly in rural Northeast Thailand are examined. Eighty-nine households from three sites representing three levels of development were analyzed in relation to family and household membership, as well as economic and employment status. In addition, 32 elders from two old age homes were interviewed. This study found that, in general, the more land a household owns, the more likely the traditional pattern of elder caregiving will be maintained. When land is limited, children leave to find employment elsewhere and will try to send money to help their parents as they are able. Poverty plays a major role in the perceived quality of life of these elders.

Caregiving to the elderly in Northeast Thailand.

Caregiving has been extensively explored in developed countries, but less so in developing regions. In Thailand, a rapidly expanding elderly population and a declining birthrate have important implications for future care of the elderly. This report is based on further exploration of data obtained from a larger study in rural Northeast Thailand of 89 households with elderly age 65 and over. Four levels of caregiving and methods for caregiver selection were identified from this data. In addition, a subgroup of 39 caregivers were interviewed for their perspectives on the activities of caregiving, the impact of caregiving on caregivers' lives, support of kin and the meaning of caregiving to the involved caregivers. Poverty was the most common problem identified by these caregivers, but caring for men and difficulty in pleasing the elders were seen as contributing to the non-enjoyment of caregiving. Affective rewards and a strong norm of filial obligation may be the motivating forces for children to continue to care for parents in the context of cultural change.

Counter-attack on cocaine trafficking: the strategy of drug law enforcement.

In the past cocaine was abused by the affluent and the famous members of society while at present it is widely abused by people in all social strata. Both abuse and availability of cocaine are increasing in the United States of America. Cocaine traffickers possess enormous assets, financial resources and means of transport that enable them to remain in operation. The incidence of violent activities, including homicides, is higher among cocaine traffickers than among traffickers in other drugs. Certain cocaine-related criminal groups are routinely engaged in wanton violence. Cocaine trafficking is closely connected with various sorts of crime, corruption and subversive activities. Suppression of cocaine traffic is among the most important priorities of the Drug Enforcement Administration (DEA). Coca plant eradication is regarded as the most effective weapon against cocaine trafficking. DEA special agents, in co-operation with their counterparts from concerned countries, are conducting intelligence exchange, international cocaine investigations and training programmes in cocaine source areas. The United States Government has focused on coordination of efforts of various concerned agencies at the federal, state and local levels to combat drug abuse and trafficking. The Department of Justice has mandated the establishment of law enforcement coordinating councils throughout the United States to ensure appropriate utilization of prosecution resources and to co-ordinate criminal investigative efforts. Task forces against organized crime are established in 12 key areas of the country. Control of precursors and essential chemicals that are used clandestine drug manufacturing is one among other measures currently being undertaken by the Government to suppress trafficking in cocaine and other drugs.