AREA MONITORING OF AMBIENT DOSE RATES IN PARTS OF SOUTH-WESTERN NIGERIA USING A GPS-INTEGRATED RADIATION SURVEY METER.

A radiation monitoring system comprising a Geiger-Muller counter connected to a smart phone via Bluetooth was used for a dose rate survey in some parts of south-western Nigeria. The smart phone has the Geographical Positioning System, which provides the navigation information and saves it along with the dose rate data. A large number of data points was obtained that shows the dose rate distribution within the region. The results show that the ambient dose rates in the region range from 60 to 520 nSv -1 and showed a bias that is attributable to the influence of geology on the ambient radiation dose in the region. The geology influence was demonstrated by superimposing the dose rate plot and the geological map of the area. The potential applications of the device in determining baseline information and in area monitoring, e.g. for lost or abandoned sources, radioactive materials stockpiles, etc., were discussed in the article, particularly against the background of Nigeria's plan to develop its nuclear power program.

Estrogen-receptor-directed neoadjuvant therapy for breast cancer: results of a randomised trial using formestane and methotrexate, mitozantrone and mitomycin C (MMM) chemotherapy.

BACKGROUND: We wanted to determine whether neoadjuvant systemic chemoendocrine therapy guided by the estrogen receptor (ER) status of the primary breast cancer, followed by conventional surgery and/or radiotherapy, reduces local and distant recurrence and improves survival compared with adjuvant treatment given conventionally postoperatively. PATIENTS AND METHODS: Two hundred ten patients with primary breast cancer (T1-T4, N0, N1-2) were randomised to receive treatment with neoadjuvant chemoendocrine therapy or conventional post-operative chemoendocrine therapy. Systemic therapy was based on the estrogen receptor (ER) status of the primary tumour obtained by trucut core biopsy. ER-negative patients received MMM chemotherapy (methotrexate (30 mg/m2), mitozantrone (7 mg/m2) and mitomycin (7 mg/m2) three-weekly for three months and ER-positive patients who were premenopausal received goserelin (3.75 mg monthly), and post menopausal women formestane (250 mg every two weeks) over three months. RESULTS: With a minimum of five years follow-up, there is no evidence of any survival benefit from the pretreatment neoadjuvant therapy regimen, with five year overall survival being 79% +/- 4.7% (neoadjuvant) and 87% +/- 3.4% (adjuvant). Similarly, there was no apparent benefit in terms of disease-free survival. There was, however, a significant reduction in the incidence of distant metastases in responders (4 of 51; 8%) compared with non-responders (17 of 49; 35%) (P < 0.01). There was a reduction in the need for surgery in responding patients with T1 and T2 tumours, since 10 of 74 (14%) had no detectable residual tumour, without any apparent increase in the risk of local or distant recurrence. CONCLUSION: In this study neoadjuvant treatment with endocrine or chemotherapy provided no obvious survival benefit to women with breast cancer. However, it does allow avoidance of surgery in some cases. Also, the patients whose tumours respond to neoadjuvant systemic therapy have a lower incidence of distant metastases after five year follow-up compared to those whose tumours fail to respond.

Assesssment of the effect of pretreatment with neoadjuvant therapy on primary breast cancer.

Patients with invasive cancer of the breast (T1-4, N0-2, M0) were assigned to pretreatment based on oestrogen receptor (ER) status; patients with ER-negative tumours received chemotherapy [mitozantrone, methotrexate and mitomycin C (MMM)] for 3 months, patients with ER-positive tumours underwent endocrine therapy [luteinising hormone releasing hormone (LHRH) agonist goserelin (leuprolide-premenopausal) or 4-hydroxyandrostenedione (formestane-post-menopausal)] for 3 months. Of the first 100 patients assessed at 3 months, 47 with ER-positive tumours had a 40.4% response (premenopausal 53.8%; post-menopausal 35%) and 53 with ER-negative tumours had a 60% response (premenopausal 57%; post-menopausal 63%). Patients with early breast cancer (T1/T2) had a complete clinical resolution in 41% (16/39) of cases after MMM and in 20% (7/35) of cases following endocrine therapy compared with 14% (2/14) advanced tumours (T3/T4) following MMM and (0/12) following endocrine therapy. However, in those patients achieving a complete clinical response, subsequent appropriate surgery showed that 16 of 19 patients (84%) had evidence of residual viable tumour on histological examination.

Elevated cytosolic calcium levels in human lymphocytes during surface virus infections.

Generalised metabolic and electrolyte disturbances are known to accompany both plasma and surface virus infections. We have investigated whether these infections could impair the transport of Ca2+ from cells under conditions of controlled concentrations of the energy substrate glucose. Thus, cytosolic calcium levels ([Ca2+]i) were measured in single isolated lymphocytes obtained from healthy volunteers or those suffering from coryza. Before making measurements using a Ca(2+)-sensitive fluorescent dye indo 1, we incubated lymphocytes in buffers containing 0 mM-, 5.6 mM- or 11.2 mM-[glucose]. We found that [Ca2+]i of lymphocytes obtained from the sick were significantly higher than those from healthy controls both at 0 mM and 5.6 mM-[glucose], and that [Ca2+]i was inversely related to the media glucose concentration for both groups. These results suggest a diminished capacity of cation pumping in viral infections, such as coryza, in relationship to the available glucose as energy substrate.

Effect of 17 beta-oestradiol on lymphocyte subpopulations, delayed cutaneous hypersensitivity responses and mixed lymphocyte reactions in post-menopausal women.

High-dose steroids are known to be potent modulators of the immune response. We accordingly investigated the effect of therapeutic doses of 17 beta-oestradiol (E2) on cellular immune responses in post-menopausal women. Fifteen (15) healthy women who had undergone a natural menopause were treated with E2 in the form of 100 mg estraderm patches applied twice weekly for 3 out of every 4 weeks over a 3-month period, followed by combined oestrogen and progestogen formulations as long-term therapy. Blood samples were taken on two occasions prior to treatment and at weeks 1, 3, 4, 7, 9, 12 and 24 after commencing therapy. Lymphocyte subsets (CD2, CD4, CD8, CD19, HLA-DR and NK) were studied in each blood sample using a monoclonal antibody kit and a two-colour fluorescence flow-cytometer. One-way mixed lymphocyte reactions (MLRs) were performed using the same stimulator throughout. Delayed hypersensitivity skin tests (DHTs) were carried out twice before treatment and at weeks 3, 4, 12 and 24 using Multitest 7-antigen kits (Institut Mérieux). Lymphocyte subsets did not change significantly with treatment, but both the MLRs and the DHTs were significantly depressed, maximally so by the third week of treatment. We conclude that therapeutic doses of E2 modulate certain immune responses. The significance of this is discussed in the light of the increasing use of long-term oestrogen replacement therapy.

Regulation of glucose uptake by stressed cells.

Lactate production by BHK cells is stimulated by arsenite, azide, or by infection with Semliki Forest virus (SFV). In the case of arsenite or SFV infection, the increase correlates approximately with the increase in glucose transport as measured by uptake of [3H] deoxy glucose (dGlc); in the case of azide, the increase in lactate production exceeds that of glucose transport. Hence glucose utilization by BHK cells and its stimulation by anaerobic and other types of cellular stress is controlled at least in part at the level of glucose transport. The glucose uptake by BHK cells is also stimulated by serum and by glucose deprivation. In these circumstances, as with arsenite, stimulation is reversible, with t1/2 of 1-2 hours; stimulation is compatible with a translocation of the glucose transporter protein between an intracellular site and the plasma membrane (shown here for serum and previously for arsenite). The surface binding and rate of internalization of [125I]-labelled transferrin and [125I] alpha 2-macroglobulin was studied to determine whether changes in glucose transport are accompanied by changes in the surface concentration or rate of internalization of membrane proteins. The findings indicate that changes in glucose transport do not reflect a consistent and general redistribution of membrane receptors. Taken together, the results are compatible with the proposal that BHK cells exposed to stimuli like insulin or serum, or to stresses like arsenite, azide, SFV infection, or deprivation of glucose, respond in the same manner: namely, by an increased capacity to transport glucose brought about by reversible and specific translocation of the transporter protein from an (inactive) intracellular site to the plasma membrane.

Effects of pancuronium and vecuronium on creatine phosphokinase in rat isolated heart, liver, kidney and diaphragm.

1. The effects of two muscle relaxants, namely, pancuronium and vecuronium, on creatine phosphokinase (CPK) release from four different types of tissues, namely, heart, liver, kidney and diaphragm, were studied in the rat in vitro. 2. The total, neat and CPK levels (units/ml), released by muscle relaxants were measured using spectrophotometric determination at 340 nm. 3. The results showed that both muscle relaxants, in low concentrations, i.e. 0.34 or 0.32 microM, close to a clinical dose of 0.1 mg/kg, had no significant effect on CPK leakage in all four types of tissues studied. However, in concentrations 12-122 times clinical dose, the two muscle relaxants produced differential adverse effects in the tissues studied. 4. In most concentrations, pancuronium and vecuronium produced significant increases in the CPK release in the kidney and diaphragm. In contrast, pancuronium had no significant effect on CPK release in the liver and the lowest effect in the heart. Similar results were obtained with vecuronium. 5. The clinical relevance and/or implications of the present results are discussed and the results are compared to those previously reported by other workers in other preparations.

Effects of pancuronium and vecuronium on plasma levels of immunoglobulins, IgG, IgM and IgE, in patients undergoing minor gynaecological surgery.

1. The effects of two competitive neuromuscular blocking agents, pancuronium and vecuronium, on plasma levels of immunoglobulins, IgG, IgM and IgE, were studied and compared, using the ELISA assay, in patients undergoing minor gynaecological surgery. 2. The results showed that neither pancuronium (0.1 mg/kg) nor vecuronium (0.1 mg/kg) had any significant effect on IgG, IgM and IgE levels in these patients. However, the underlying trend was that both pancuronium and vecuronium slightly increased the IgG and IgM levels, (by 19.5%, 22.1%, of control IgG, and by 17.3%, 28.8% of control IgM, respectively), with vecuronium being more effective than pancuronium). In addition, pancuronium, but not vecuronium, also slightly increased the IgE levels (by 5.9% of control IgE). Vecuronium, on the other hand, slightly decreased the IgE level (by 4.9% of control IgE). However, these increases or decreases were not statistically significant. 3. The significance of the present results are discussed in relation to changes in immunoglobulins and adverse effects induced by drugs, such as muscle relaxants.

Comparative effects of vecuronium and pancuronium on release of lactate dehydrogenase in rat isolated diaphragm, liver, kidney and heart.

The comparative effects of two muscle relaxants, namely pancuronium and vecuronium, on the release of intracellular lactate dehydrogenase (LDH), released from four different types of tissues, namely, the heart, liver, kidney and diaphragm, were studied in the rat in vitro. The LDH and its leakage into extracellular space, was used as an indicator for cellular membrane damage, and the aim was to see if the two muscle relaxants enhanced the release of LDH, and hence, by implication, caused adverse effects, i.e., damage to cell membrane. The total amount of LDH, the neat (LDH), and the increase in LDH release caused by different concentrations of the two muscle relaxants were measured using spectrophotometric determination at 340 nm. The results showed that both muscle relaxants, in low concentrations (0.32 or 0.34 microM, a concentration which is close to a clinical dose of 0.1 mg/ml), did not significantly enhance the LDH release from any of the 4 different types of tissues studied. However, in concentrations of 10-130 times the clinical dose, both drugs significantly enhanced the LDH release in all the 4 tissues, with pancuronium being more effective than vecuronium. In addition, the diaphragm and kidney were most affected, whereas the heart and liver being the least affected. The clinical relevance and/or implications of these comparative effects are discussed, and the results are compared to those previously reported by other workers. Pancuronium and vecuronium are among the non-depolarising neuromuscular blocking drugs currently-used in clinical anaesthesia.(ABSTRACT TRUNCATED AT 250 WORDS)

Reflection of disease activity in rheumatoid arthritis by indices of activation of the classical complement pathway.

Levels of C4d, a fragment of C4 generated during activation of the classical complement pathway, were measured in the plasma of 77 patients with rheumatoid arthritis and 30 healthy subjects. Disease activity was judged according to Ritchie's articular index to be mildly active in 31 (group 1), moderately active in 29 (group 2), and severely active in 17 patients (group 3). Plasma levels of C3d, a fragment of C3, and serum levels of C4, C3, and immune complexes were also measured. The ratios C4d/C4 and C3d/C3 were calculated. The C4d/C4 and C3d/C3 ratios and the levels of circulating immune complexes correlated with the degree of disease activity without significantly departing from linear trend and discriminated between patients with different grades of disease activity. C4d, C3d, C4, and C3 also correlated with disease activity but in a non-linear relationship. A significant correlation was found between C4d and C3d, and between C4d/C4 and C3d/C3. C4d and C4d/C4 also correlated with circulating immune complexes. These results indicate that indices of C4 and C3 activation, in particular the ratios C3d/C3 and C4d/C4, provide a sensitive assessment of disease activity in rheumatoid arthritis, and confirm the major part played by the classical complement pathway in the pathogenesis of this disease.

Correlation of the activation of the fourth component of complement (C4) with disease activity in systemic lupus erythematosus.

Levels of C4d, a fragment of C4 generated during activation of the classical complement pathway, were measured in the plasma of 48 patients with systemic lupus erythematosus, 11 with inactive (group 1), 23 with mildly active (group 2), 14 with moderately/severely active disease (group 3), and 30 healthy subjects. Levels of C3d, C4, and C3 were also measured and the C4d/C4 and C3d/C3 ratios calculated. C4d levels correlated with the degree of disease activity, being higher in group 3 than in group 2, in group 2 than in group 1, and in group 1 than in controls. C4d/C4 gave a similar result. Activation indices of the common complement pathway, C3d and C3d/C3, also correlated with disease activity, but in a non-linear relationship, failing to discriminate between patient groups. C4 and C3 showed no correlation with disease activity. These results indicate that indices of C4 activation, C4d and C4d/C4, provide a laboratory measure of disease activity in lupus patients, for whom an objective assessment of the severity of the disease is not readily available.

Histamine release by some new skeletal muscle relaxants studied at the rat ileum.

The effects of 6 non-depolarizing muscle relaxants on histamine release were investigated, pharmacologically, using histamine and histamine antagonists, e.g. mepyramine, clemastine, dimotane. The results showed that gallamine, pancuronium, vecuronium, atracurium, tubocurarine and alcuronium produced concentration-dependent contractions in the rat ileum, gallamine and pancuronium being the most effective agents in producing muscle contraction. The H1 blocker, mepyramine, reduced the contractions produced by the muscle relaxants, as well as that produced by histamine. However, there was always some residual contraction, not blocked by high concentrations of mepyramine in the case of the muscle relaxants, but not in the case of histamine, the contraction of which was totally blocked by high concentrations of mepyramine. These results also suggested that, in part, the contraction produced by muscle relaxants, may be due to a mechanism other than histamine release, e.g. release of other mediators and/or an effect on intracellular calcium ions. Since very high concentrations of atracurium and vecuronium (40-50 times higher than clinical concentrations) were used in this study to produce marked contractions, the implication is that in clinical concentrations, they have little effect on histamine release. In contrast, gallamine and pancuronium can release histamine even at low concentrations, i.e. at or near their clinical concentrations in man. These, therefore, are the cause of the adverse reactions seen after drug administration.

Activation of the alternative complement pathway: clinical application of a new technique to measure fragment Ba.

A new laser nephelometric technique for the measurement of the alternative complement pathway fragment Ba has been developed. Activation of the alternative complement pathway was assessed in 16 patients with Gram negative bacteraemia, six with Gram positive bacteraemia, 20 with rheumatoid arthritis, and 18 healthy subjects. Patients with Gram negative bacteraemia had significantly higher values of Ba (median 14.8%) than controls (9.3%) (p less than 0.01), while patients with Gram positive bacteraemia and rheumatoid arthritis had values similar to those of controls (10.1% and 9.5%). The technique proved sensitive and precise, and is suitable for the routine laboratory evaluation of complement activation through the alternative pathway.

A pharmacologic study on the histamine releasing effect of atracurium and other muscle relaxants in rat isolated ileum.

In this study, the effects of histamine, antihistamines (terfenadine and mepyramine), 5-hydroxytryptamine, and muscle relaxants, atracurium, vecuronium and gallamine, on the tone and contractility of rat ileum were studied and compared in vitro. The aim of the present investigation was to measure, pharmacologically, the histamine releasing effect of muscle relaxants, e.g atracurium, vecuronium and gallamine, by comparing their contractile response in the absence and presence of antihistamines and comparing their mechanical responses with those produced by histamine and 5-hydroxytryptamine (5-HT). The results showed that the antihistamines, triludan(terfenadine) and mepyramine produced opposite effects in rat ileum. Terfenadine (0.1-20 microM) produced concentration-dependent contractions in the rat ileum, whereas mepyramine (0.1-10 microM) relaxed the muscle, e.g. by 1.2 g tension. Atracurium (0.5-500 microM), vecuronium (0.2-200 microM), and gallamine (0.1-7.0 microM) produced marked contractions (1.5-4.0 g tension) in rat ileum, and these contractions were markedly reduced by mepyramine (1.3 microM) or terfenadine (5 microM), implicating histamine release in the generation of these contractions. However, there was some residual contraction which was not blocked by mepyramine, but by 5-HT antagonist, methysergide (1 microM), indicating that a mechanism other than histamine release may be responsible for the residual contraction, i.e. release of other mediators such as 5-HT, prostaglandins, or calcium. 5-HT (0.5-500 microM) and histamine (0.5-500 microM) produced contractions in the rat ileum, but 5-HT was more effective than histamine in producing these contractions. Similarly, gall amine was more effective than atracurium and vecuronium in contracting the rat ileum.(ABSTRACT TRUNCATED AT 250 WORDS)