Search

Aim To determine short-term efficacy and safety of Paxerol®, novel immediate:sustained (50%:50%) release tablets containing 325 mg acetaminophen and 150 mg ibuprofen per tablet. Methods One of three dose levels, corresponding to the amounts in 1, 2, and 3 tablets, of Paxerol and placebo were administered for 14 consecutive days to patients with severe nocturia (defined in this study as an average nocturnal voids [NV] ≥2.5) associated with overactive bladder (OAB). Changes in NV, as well as Nocturia Quality of Life (NQOL), duration of first uninterrupted sleep (DFUS), and total hours of nightly sleep (THNS) associated with treatment were assessed. Short-term safety/tolerability was assessed throughout the study and for at least 30 days post-treatment. Results Paxerol at all three doses reduced NV to a greater degree than placebo (average NV -1.1, -1.4, -1.3 voids for low, mid, and high doses, respectively, vs -0.3 void for placebo). NQOL and THNS were similar between baseline and treatment values in all four groups. There were also no between-group differences. Paxerol at high dose tended to (although not statistical significantly) increase DFUS to a greater degree than placebo (1.2 vs 0.4 h, P = 0.057). There were no treatment related adverse events in any of the four groups. Conclusions This study demonstrates short-term efficacy and short-term safety of Paxerol in patients with severe nocturia associated with OAB. The results warrant further investigation of the long-term efficacy and safety of Paxerol in larger patient populations.

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%).

Chromatography and electrophoresis have been used for the last half-century to separate small and large molecules. Advances in MS instrumentation and techniques for sample introduction into the mass analyzer (i.e. matrix-assisted laser desorption/ionization and electrospray ionization), chromatography in all its formats and modes and two-dimensional gel electrophoresis, including two-dimensional difference gel electrophoresis, enabled the separation of complex biological mixtures, such as the proteome and the metabolome, in a biological sample. These advances have made it possible to identify compounds that can be used to discriminate between two samples taken from healthy and diseased individuals. The objective is to find proteins or metabolites that can be used as a clinical test for the early diagnosis, prognosis and monitoring of the disease and the outcome of therapy. In this manuscript, we present an overview of what has been achieved in the search for biomarkers, with emphasis on cancer, using separation science and MS.

With the increasing interest in using nanoparticles as vehicles for drug delivery and image contrast agents, there is a need to develop assays for their detection and quantitation in complex matrices to facilitate monitoring their biodistribution. In this study, we developed a CE approach for the analysis of two nanoparticles: carboxyfullerene (C3) and dendrofullerene (DF1) in both standard solutions and a serum matrix. These highly soluble, charged C(60) derivatives were characterized by CZE using either a bare or dynamically coated fused-silica capillaries. The resolution of both nanoparticles was slightly lower with the coated capillary; however, their migration times were faster. While separation of the DF1 nanoparticles using MEKC resulted in a greater number of observable peaks, the peak profile of C3 was basically unchanged regardless of whether SDS micelles were added to the running buffers or not. The MEKC and/or CZE assays were then used to quantitate the C3 and DF1 nanoparticles in spiked human serum samples. The quantitation of the nanoparticles was linear from 0-500 microg/mL with detection limits ranging from 0.5 to 6 microg/mL.

Many key processes central to bone formation and homeostasis require the involvement of osteoblasts, cells responsible for accumulation and mineralization of the extracellular matrix (ECM). During this complex and only partially understood process, osteoblasts generate and secrete matrix vesicles (MVs) into the ECM to initiate mineralization. Although they are considered an important component of mineralization process, MVs still remain a mystery. To better understand their function and biogenesis, a proteomic analysis of MVs has been conducted. MVs were harvested by two sample preparation approaches and mass spectrometry was utilized for protein identification. A total of 133 proteins were identified in common from the two MV preparations, among which were previously known proteins, such as annexins and peptidases, along with many novel proteins including a variety of enzymes, osteoblast-specific factors, ion channels, and signal transduction molecules, such as 14-3-3 family members and Rab-related proteins. To compare the proteome of MV with that of the ECM we conducted a large-scale proteomic analysis of collagenase digested mineralizing osteoblast matrix. This analysis resulted in the identification of 1,327 unique proteins. A comparison of the proteins identified from the two MV preparations with the ECM analysis revealed 83 unique, non-redundant proteins identified in all three samples. This investigation represents the first systematic proteomic analysis of MVs and provides insights into both the function and origin of these important mineralization-regulating vesicles.

Cleavable isotope-coded affinity tag (cICAT) reagents were utilized to identify and quantitate protein expression differences in control and inorganic phosphate-treated murine MC3T3-E1 osteoblast cells. Proteins extracted from control and treated cells were labeled with the light and heavy isotopic versions of cICAT reagents, respectively. The cICAT-labeled samples were combined, proteolytically digested, and the cICAT-derivatized peptides isolated using immobilized avidin chromatography. The cICAT-labeled peptides were resolved into 96 fractions by strong cation-exchange (SCX) liquid chromatography (LC). Analysis of the SCX-LC cICAT peptide fractions by microcapillary reversed-phase LC-tandem mass spectrometry resulted in the identification and quantitation of 7227 unique peptides corresponding to 2501 proteins, or roughly 9% of the proteins currently predicted to be encoded by the mouse genome. A false positive analysis indicated a 98% confidence in the peptide identifications. To corroborate changes in abundance measured by cICAT with those detectable in traditionally prepared cell lysate, we chose to analyze cyclin D1. Cyclin D1 has been previously identified as a phosphate-responsive gene and was likewise identified as a phosphate-responsive protein in the current analysis. The 1.76-fold increase in abundance in cyclin D1 determined from cICAT corresponds well with the 2.41-fold increase as determined by Western blotting. These results demonstrate that quantitative proteomics is capable of providing a quantitative view of thousands of proteins in mammalian cells within a defined set of experiments.

In this report, we describe a surfactant-mediated electrokinetic capillary chromatography (SM-EKC) system for the separation of 9-fluoroenylmethyl chloroformate (FMOC)-derivatized anilines by capillary electrophoresis (CE). The SM-EKC system consisted of dioctyl sulfosuccinate (DOSS)/acetonitrile mixtures and was suited for the CE separation of the relatively hydrophobic FMOC-aniline analytes and other neutral compounds, e.g. alkylphenyl ketones. While the organic modifier acetonitrile (ACN) allowed the solubilization of the hydrophobic solutes and maintained the DOSS surfactant in its monomeric form by inhibiting micellization, the DOSS surfactant associated with the FMOC anilines to a varying degree thus leading to their differential migration and separation. Under these conditions, the FMOC-anilines were readily detected at the 10(-6) M level by UV at 214 nm and at the 10(-8) M level by laser-induced fluorescence (LIF) using a solid-state UV laser operating at 266 nm line as the excitation wavelength. The FMOC precolumn derivatization was also readily performed in lake water spiked with anilines at near the limit of detection (LOD) level. The lake water matrix showed no significant effects on the extent of derivatization at the LOD level as well as on the detection of the analytes due to the selectivity of the FMOC derivatization. The derivatization and detection of spiked lake water necessitated only the removal of microparticles by microfiltration prior to derivatization and detection.

Two solid-state UV lasers were applied to the laser-induced fluorescence (LIF) detection of various groups of compounds after separation by capillary electrophoresis. These lasers are thermoelectric-cooled, highly compact, and inexpensive. Such lasers provide few mW of quasi-continuous wave (CW) power which are sufficient and stable for LIF detection. Native fluorescence detection of tryptophan-containing proteins and peptides and related indoles was achieved at the nM level with the laser operating at 266 nm. Detection of fluorescamine-labeled amino acids and peptides was also possible at the nM level with the laser operating at 355 nm. Amino acids at a concentration as low as 10 ng/mL could be labeled with fluorescamine. Solid-state UV-LIF detection of the tryptic digest of cytochrome c after fluorescamine derivatization was demonstrated.

A two-dimensional high performance liquid chromatography/capillary electrophoresis (HPLC/CE) instrumental set-up was assembled from commercially available equipment. Fractions of the effluent from the HPLC system are collected into microtiter plates with a microfraction collector. The fractions are then dried under vacuum at room temperature, reconstituted, and analyzed by capillary zone electrophoresis (CZE). This method allows the collection of samples by time, drops, or external signal (peaks). Any size or type of HPLC or CE column can be used with no limitation on the amount of sample injected into the HPLC. Any CE detection, laser-induced fluorescence (LIF), mass spectrometry (MS), ultraviolet (UV) or other, can be used. This set-up is practical, simple, robust and allows the separation of complex mixtures. Preliminary results show the utility of this system for the analysis of protein digest.

The trypsin digest of a mixture of two proteins, namely cytochrome c and myoglobin, was first separated in the first dimension by high-performance liquid chromatography (HPLC). Fractions from the HPLC were collected every 30s with the aid of a fraction collector into a 96-well microtiter plate. After concentration, all the collected fractions were analyzed simultaneaosly in the second dimension by a 96-array capillary electrophoresis system. The labeled peptides were detected by laser-induced fluorescence. An internal standard, allura red, was added to all the fractions, prior to capillary electrophoretic analysis. The internal standard serves two functions, migration time correction and signal intensity correction. The data are presented in two different formats, as an electropherogram of all the fractions and in a two-dimensional (2-D) format. The 2-D plot of the data shows the density of each spot, which corresponds to the concentration of the migrating peptides. The total experimental time for the HPLC and capillary electrophoretic analyses ist less than 1 h, which ist much faster than using 2-D slab-gel electrophoresis or single-capillary capillary electrophoresis.

Ipazilide fumarate is a novel antiarrhythmic currently undergoing clinical evaluation. Since most antiarrhythmics have adverse cardiovascular side effects, we examined the potential effects of ipazilide on cardiac muscle and vascular hemodynamic function utilizing in vivo and in vitro models. The cardiovascular effects of ipazilide and selected reference antiarhythmics, disopyramide and sotalol, at relevant antiarrhythmic concentrations were compared. All agents decreased cardiac contractility, as evident by reductions in dP/dt and cardiac output in anesthetized dogs, and by decreases in contractile force in isolated guinea pig papillary muscles. In vivo, ipazilide was approximately 3–10 × less potent than disopyramide or sotalol while in vitro, ipazilide produced a greater decrease in contractility at a relatively high concentration (30 μM). All three agents increased cardiac preload as reflected by increases in left ventricular end diastolic pressure and right atrial pressure, with ipazilide 2–3 × less potent than disopyramide or sotalol. Differential effects on vascular function were also evident with the three agents. Disopyramide and sotalol significantly increased systemic vascular resistance, and either pulmonary vascular resistance (disopyramide) or left coronary arterial vascular resistance (sotalol); ipazilide did not significantly affect any of these parameters. In isolated rat arterial or canine coronary arterial smooth muscle, ipazilide produced concentration-related vasorelaxation, with EC50 values ranging from 11–300 μM. Efficacy of ipazilide was higher in depolarized vascular tissue. In conclusion, since previous preclinical studies have indicated equal or greater antiarrhythmic activity of ipazilide relative to disopyramide or sotalol, the current data indicate the possibility for lessened in vivo hemodynamic effects of ipazilide at efficacious antiarrhythmic dosages. © 1992 Wiley-Liss, Inc.

The myocardial salvaging properties of Trolox (Trix; a water- and lipid-soluble vitamin E analog with antioxidant properties) and ascorbic acid (Asc; a water-soluble antioxidant) were evaluated in anesthetized male dogs and rabbits. Myocardial infarction (MI) was induced by occlusion and reperfusion of the left anterior descending coronary artery: a 2-hr occlusion and 4-hr reperfusion in dogs, and a 15-min occlusion and 3-hr reperfusion in rabbits. This occlusion/reperfusion protocol induced %MI (MI normalized to area at risk) of approximately 20% beyond that induced by occlusion alone in both species. Trlx, Asc (100 and 150 mg/kg/injection, respectively, by injection; or 100 and 150 mg/kg/min, respectively, by continuous infusion), or vehicle (Veh) were administered into the ascending aorta in dogs and into the left atrium in rabbits. In severely ischemic dogs (myocardial collateral blood flow < 0.1 ml/min/g), a single injection of Trlx plus Asc, but not Asc alone, at the onset of reperfusion reduced %MI (Trlx + Asc = 24.3 ± 5.4%, n = 7; Asc = 50.1 ± 9.6%, n = 4; Veh = 45.0 ± 5.0%, n = 5). In rabbits, %MI was reduced (or tended to be reduced) by either 3 hourly injections (Trlx + Asc = 33.3 ± 4.0%, n = 19; Asc = 48.3 ± 6.3%, n = 11; Veh = 43.7 ± 3.3%, n = 8) or an injection followed by continuous infusion (Trlx + Asc = 36.0 ± 4.0%, n = 9; Veh = 49.0 ± 3.0%, n = 8), beginning at the onset of reperfusion. %MI in rabbits was not affected by either hourly injections beginning from 1 hr after, or a single injection at 1–3 × the dosages (i.e., 100–300 and 150–450 mg/kg for Trlx and Asc, respectively), during onset of reperfusion. Hemodynamic variables (arterial pressure, heartrate, rate-pressure-product and left ventricular contractility) were similar among all treat- ment groups in both species. In conclusion, Trlx/Asc combination, but not Asc alone, re- duces %MI in dogs and rabbits. The salvaging effects of Trlx/Asc are unrelated to any changes in hemodynamics. These results are consistent with the hypothesis that lipid peroxidation is involved in myocardial reperfusion injury. © 1992 Wiley-Liss, Inc.

Cicletanine, a vasorelaxant/natriuretic agent, inhibits low Km cGMP/phosphodiesterase (PDE) (IC50 = 300 μ). The objectives of this study were to compare the cardiovascular and renal effects of cicletanine with another cGMP-PDE inhibitor, zaprinast (IC50 = 0.3 μ), at intravenous dosages of 0.3–3 mg/kg, and to examine the influence of β-adreno-receptor blockade (nadolol, 1 mg/kg, i.v.) upon the responses to cicletanine in anesthetized dogs. Cicletanine (3 mg/kg) and zaprinast (0.3−3 mg/kg) decreased mean arterial pressure (−21.2±3.9 mm Hg [mean±SEM, max. change] at 3 mg/kg and −64.7 ± 4.8 mm Hg at 0.3 mg/kg, respectively). The response curve of zaprinast was negatively related to the dosages. Cardiac output was increased or tended to increase by approximately 0.3 liter/min by both cicletanine and zaprinast at 3 mg/kg. Renal, but not femoral, blood flow was increased by both cicletanine and zaprinast (18.8±3.7 ml/min at 3 mg/kg and 17.0±4.6 ml/min at 1 mg/kg, respectively). These agents did not have major effects upon heart rate, left ventricular end diastolic pressure, and maximum rates of rise and decline in left ventricular pressure. These agents also did not affect pulmonary systolic, mean and diastolic arterial pressures, nor arterial blood pO2, pCO2, and pH. Both cicletanine and zaprinast increased or tended to increase urinary output (0.66±0.05 and 0.43±0.22 ml/min, respectively, both at 3 mg /kg) and urinary Na+ excretion (150.4±19.7 and 67.0±30.9 μEq/min, respectively, both at 3 mg/kg). Neither agents affected urinary K+ excretion. None of the responses to cicletanine were altered by β-, suggesting that β- adrenoreceptors were not in volved in mediating the affects of cicletanine. In conclusion, the cGMP-PDE inhibitors cicletanine and zaprinast vasodilate, increase renal blood flow, and induce diuresis and natrluresis in anesthetized dogs. However, the differences in the natriuretic and vasodilator effects of these agents cannot be explained by the difference in their potencies in PDE inhibition, suggesting that their effects in these dogs may involve additional mechanisms of action.

The hemodynamic effects of the low Km cAMP peak III PDE inhibitor medorinone (0.01–0.3 mg/kg, i. v. ) were evaluated in anesthetized dogs in the presence and absence of β-adrenoreceptor blocked. Medorinone increased the peak derivative of left ventricular pressure (+ dP/dt) in non-blocked (all doses) and β-blocked dogs (≥0.03 mg/kg) (2,766±259 and 1,403±262 mm Hg/sec, respectice max. changes). Heart rate (HR) was increased by medorinone in non-blocked (≥0.1 mg/kg) and β-blocked dogs (≥0.03 mg/kg) (77.4±8.9 and 25.5±4.3 beats/min, respective max. changes). In non-blocked dogs only, medorinone (all doses) decreased left ventricular end-diastolic pressure (LVEDP) (7.7±1.7 mm Hg, max. change). Mean arterial pressure (MAP) was similarly decreased by medorinone (