Stability of U-10 and U-50 dilutions of insulin lispro.

BACKGROUND: Insulin lispro, a rapid acting analog of human insulin, has been shown to be useful in the treatment of children with diabetes. However, lower concentrations of this insulin may be needed to facilitate optimal clinical use. Therefore, the stability of insulin lispro when diluted with an appropriate diluent was evaluated. METHODS: Insulin lispro (U-100, 100 U/mL) was diluted with sterile Neutral Protamine Hagedorn (NPH) diluent to U-10 and U-50. After storage for 7, 14, 21, 28, and 32 days at 5 degrees C and 30 degrees C, the diluted insulins were analyzed by high-performance liquid chromatography (HPLC) to determine potency, purity, polymer, and preservative (metacresol or phenol) content in addition to physical appearance and pH determinations. Microbiological testing for preservative effectiveness was performed on the U-10 and U-50 solutions after 32 days at both temperatures. RESULTS: U-10 and U-50 dilutions of insulin lispro stored at 5 degrees C and 30 degrees C maintained potency and purity throughout the 32-day testing period. Additionally, both control and diluted vials maintained antimicrobial effectiveness. CONCLUSION: Insulin lispro when diluted with the appropriate diluent demonstrates acceptable stability when stored at 5 degrees C and 30 degrees C for a period of 32 days.

Cervical carcinoma: determination of recurrent tumor extent versus radiation changes with MR imaging.

PURPOSE: To evaluate the effectiveness of magnetic resonance (MR) imaging for assessment of the present and extent of tumor recurrence as determined with pathologic and surgical findings. MATERIALS AND METHODS: MR findings were retrospectively examined in 37 patients with a history of cervical carcinoma. Inter- and intraobserver variability was analyzed. Surgical or pathologic results were acquired in 34 of these patients; the remaining three patients were clinically followed up for at least 4 years. RESULTS: MR imaging allowed correct detection of recurrent tumor in 18 of 21 patients who had histologically documented recurrence. It helped correctly exclude recurrent disease in 15 of 16 patients. Sensitivity and specificity for detection of recurrence was 86% and 94%, respectively. Good intra- and interobserver agreement was demonstrated. CONCLUSION: MR imaging is a useful modality for differentiation of recurrent cervical carcinoma from radiation changes. Determination of the extent of recurrence with MR imaging may offer clinical assistance in the selection of optimal therapy.

Pelvic masses: aspiration biopsy with transrectal US guidance.

Biplanar, transrectal ultrasound guidance was used in the transrectal aspiration of two pelvic abscesses, one recurrent tumor, and one sterile, nonmalignant fluid collection. This method provides an alternative path that allows precise localization for aspiration biopsy of pelvic masses.