Determination of deslanoside in antemortem and postmortem specimens. Unusual case report.

One case of the erroneous administration of deslanoside and high level of drug in antemortem plasma and postmortem specimens has been reported owing to the unusual surrounding circumstances. Deslanoside in antemortem plasma was determined by FPIA and the analysis was done by HPLC in the postmortem tissue samples. The analytical results and methods used in the examinations are discussed in the following paper.

[A case of psittacosis].

A 67-year-old Japanese housewife, who had been attended the out patient department of medicine, Fukuoka Dental College (FDC) Hospital for paroxysmal atrial fibrillation, was admitted to FDC Hospital because of high fever, exhaustion, anorexia, myalgia and mild stupor. Her ECG finding revealed atrial fibrillation and roentgenologic examination of the chest showed diffuse opacities in the left lung field (S10) without pleural effusion. As she had told her physician that her pet parakeet had been dead recently, she was diagnosed immediately as psittacosis. She was instantly treated with minocycline orally and deslanoside intravenously. Laboratory findings on admission disclosed the following results: Complement-fixing antibodies against Chlamydia psittaci were 1:64, and liver dysfunction (GOT 253, GPT 86, LDH 846) was shown. The white blood cell count was 4,700 associated with shift to the left, C-reactive protein was 6 plus and the erythrocyte sedimentation rate was 109 mm in 1 hour. The course in the hospital was satisfactory and after 38 hospital days she was discharged with complete recovery from the psittacosis. It is emphasized the importance of that the question about the history of contact with psittacine birds or other avian species is essential to diagnose psittacosis.

[Effect of digitalis on hemodynamics during rest in patients with arterial occlusive diseases, stage II, without cardiac insufficiency]. / Digitaliseffekt auf die Ruhedurchblutung nicht herzinsuffizienter Kranker mit arterieller Verschlusskrankheit Stadium II.

In 6 patients without clinical symptoms of myocardia insufficiency and with stage II occlusive disease of the femoral artery, blood flow volume at rest, arterial blood pressure and heart rate were measured before, during and for two hours after an iv. infusion of 1.0 mg desacetyl-lanatoside. Blood flow at rest decreased by 23% and peripheral vascular resistance increased by 34%. The increase in the blood pressure amplitude was compensated by a decrease in heart rate. The mechanism of action is discussed. It is concluded that patients suffering from stage II arterial occlusive disease do not benefit at rest from the prophylactic administration of digitalis.

Pharmacokinetics and serum concentration--effect relationship of intravenous deslanoside.

The antibodies of two commercially available digoxin-radioimmunoassay kits showed complete equimolar cross-reactivity with deslanoside and were used to determine serum levels of the latter glycoside. The serum concentrations of deslanoside were measured after a single intravenous dose of 1.2 mg in four patients recuperating after acute myocardial infarction. A phase of log-linear elimination (pseudoequilibrium) was reached after 4--8 h, and the biological half-life was 38-77 h (median 51 h). In a second study, the serum concentration was determined daily in 15 patients given multiple intravenous doses of the drug for atrial fibrillation and/or congestive heart failure. Symptoms or signs of digitalis toxicity occurred in six patients given a loading dose of deslanoside followed by daily maintenance doses of 0.4--0.6 mg. One of the patients tolerated a steady-state serum concentration of 3.9 micrograms/L (4.1 nmol/L) without toxicity symptoms. The findings in the remaining 14 patients suggest that the upper limit of the "therapeutic" concentration range is approximately 2.5 micrograms/L (2.7 nmol/L). A significant positive correlation (p less than 0.001) was found between the serum concentration of the drug and serum creatinine. Reduction of the maintenance dose of deslanoside is recommended in patients with impaired renal function.

Management of severe decompression sickness with treatment ancillary to recompression: case report.

Recompression remains the primary form of treatment in decompression sickness, but severe cases require ancillary treatment. The case of a compressed air worker with decompression sickness is presented who, in addition to recompression, required 5.5 of I.V. fluids in the first 8 h, heparin, digitalis, steroids, and respiratory support, to prevent death. The report includes a description of the precipitation causes, the course during recompression, the drugs and dosages used, and comments on respirator treatment.