Effect of influenza immunization on CYP3A4 activity.

A number of clinical reports of drug interactions with influenza vaccine have been made. We hypothesized that CYP3A4 activity would decrease following influenza immunization. Fifteen healthy subjects had erythromycin breath tests (ERMBT) and influenza antibody titer hemagglutinin inhibition assay (HIA) before and after receiving influenza vaccine. The mean age of the subjects was 31.9 years (S.D. 10.2). The change in ERMBT following influenza immunization was not significant (mean -4%, S.D. 17%, P=0.25). Influenza immunization does not significantly change CYP3A4 activity. Changes in serum drug concentrations noted previously after influenza immunization are either due to very small changes in CYP3A4 activity or other pharmacokinetic interactions.

Radiopharmaceutical-related pitfalls and artifacts.

The primary goal of this review article is to increase the reader's knowledge and understanding of problems associated with the radiopharmaceuticals commonly used in daily practice. To achieve this objective, problems related to the commonly used radiopharmaceuticals are divided into pitfalls and artifacts related to radiopharmaceutical preparation (technetium-99m [99mTc]-labeled and non-99mTc-labeled radiopharmaceutical) and those related to radiopharmaceutical administration. For the radiopharmaceutical formulation-associated pitfalls and artifacts, problems are discussed in terms of factor categories, such as factors associated with radionuclides, factors associated with components, factors associated with preparation procedures, and miscellaneous factors. As for the pitfalls and artifacts caused by radiopharmaceutical administration, these problems are categorized into errors associated with administration technique and nontechnical errors. Clinical manifestations (ie, appearance upon imaging) from the numerous literature-based examples are presented. The effect of the causative factors and the reason each factor can result in radiopharmaceutical preparation and administration problems are discussed. In addition, the possible preventive actions are presented for each group. However, the cause of some pharmaceutical related problems may not be easily recognized, and thus it is difficult to develop preventive and/or corrective plans for these cases.

[Elimination of hydroxyethyl starch after autologous retransfusion of cryopreserved erythrocytes]. / Elimination von Hydroxyethylstärke nach autologer Retransfusion von damit kryokonservierten Erythrozyten.

In the case of the biodegradable cryoprotectant hydroxyethyl starch (HES) no deglycerolization process is required prior to the transfusion of frozen red blood cells (RBC). In a first study the elimination of an HES 200,000/0.62 from the plasma of 6 dogs was investigated by means of a novel HPLC-GFC method. 16% of the blood volume were replaced by autologous HES protected frozen/thawed RBC. In a second study the HES concentration in the plasma of 7 healthy volunteers was determined following the substitution of 8% of the blood volume, but a washing step has been performed to reduce the concentration of the cryoprotectant (HES 200,000/0.5). In a third study, however, this step was omitted. The elimination of the HES followed always first order kinetics. In the case of the transfusions without postthaw washing in dogs and humans, the initial plasma concentrations amounted to 2.11 +/- 0.15 g/dl and 0.75 +/- 0.26 g/dl, respectively. The corresponding value for the washed preparations was less than 0.03 g/dl. Within 4-5 h the concentrations dropped to less than 50% of the initial values. The 9-hour value was less than 35% (dogs), the 20-hour value about 15% (humans) of the initial concentration. As HES is primarily eliminated via the kidneys, within this period the concentrations of HES in the urine dropped from 4.3 +/- 2.11 g/dl to less than 0.03 g/dl (humans, no washing step). In conclusion, the elimination of the accompanying cryoprotectant HES was no problem in the concentrations applied. A simple washing step with isotonic saline, however, effectively reduced the concentration of the extracellular cryoprotectant HES far below critical levels.

Imaging of acute myocardial infarction and reperfusion.

During the last 20 years there has been a large amount of investigation designed to determine what is the best way of imaging acute myocardial infarction (AMI) using radiopharmaceuticals. 99mTc pyrophosphate is ideal for cases where the clinical diagnosis cannot be made but it is insensitive to detect subendocardial AMI and is taken up by reversibly-injured myocytes. Antimyosin antibody imaging is specific for AMI but it is flow-dependent at low myocardial flows and it distributes in a nonuniform way in reperfused infarcts requiring high nuclear imaging (SPECT or PET) spatial resolution for proper measurement. 18F fluorodeoxyglucose (FDG) is taken up by viable cells but likely by macrophages too, in the core of AMI. 99mTc glucarate has not been investigated in detail but this sugar analog is more accurate than FDG in AMI. 99mTc sestamibi has been extensively used for AMI measurement but SPECT quantitation of transmural infarcts has not been achieved. Unresolved issue is imaging of AMI during reperfusion where there is widespread microvascular injury and capillary plugging.

Forage systems for beef production from conception to slaughter: I. Cow-calf production.

Six year-round, all-forage, three-paddock systems for beef cow-calf production were used to produce five calf crops during a 6-yr period. Forages grazed by cows during spring, summer, and early fall consisted of one paddock of 1) tall fescue (Festuca arundinacea Schreb.)-ladino clover (Trifolium repens L.) or 2) Kentucky blue-grass (Poa pratensis L.)-white clover (Trifolium repens L.). Each of these forage mixtures was combined in a factorial arrangement with two paddocks of either 1) fescue-red clover (Trifolium pratense L.), 2) orchardgrass (Dactylis glomerata L.)-red clover, or 3) orchardgrass-alfalfa (Medicago sativa L.), which were used for hay, creep grazing by calves, and stockpiling for grazing by cows in late fall and winter. Each of the six systems included two replications; each replicate contained 5.8 ha and was grazed by eight Angus cow-calf pairs for a total of 480 cow-calf pairs. Fescue was less than 5% infected with Acremonium coenophialum. Pregnancy rate was 94%. Cows grazing fescue-ladino clover maintained greater (P less than .05) BW than those grazing bluegrass-white clover, and their calves tended (P less than .09) to have slightly greater weaning weights (250 vs 243 kg, respectively). Stockpiled fescue-red clover provided more (P less than .05) grazing days and required less (P less than .05) hay fed to cows than stockpiled orchardgrass plus either red clover or alfalfa. Digestibilities of DM, CP, and ADF, determined with steers, were greater (P less than .05) for the orchardgrass-legume hays than for the fescue-red clover hay. All systems produced satisfactory cattle performance, but fescue-ladino clover combined with fescue-red clover required minimum inputs of harvested feed and maintained excellent stands during 6 yr.

The accumulation of a platelet protein, thrombospondin, at the site of arterial thrombus formation: preliminary report.

There are many methods available for the detection of thrombosis, none of which are noninvasive, rapid and accurate. Thrombospondin is a platelet protein that is present in the developing thrombus and may be an effective substance to use for imaging thrombosis. Vascular stenosis and thrombosis were produced in coronary, carotid and femoral arteries in eleven adult mongrel dogs. 131I labeled thrombospondin was administered to each animal to determine whether the radiotracer accumulated at the site of thrombus formation. The radioactivity per gram of vessels with thrombi was significantly different from the control vessels or whole blood (p = 0.0037 and p = 0.0015, respectively, paired t-test). This preliminary work suggests that iodinated thrombospondin accumulates at the site of thrombus formation. Labeled thrombospondin may be a rapid, safe and accurate method of detecting arterial thrombosis.