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Designed to measure the syntactic maturity of oral speech, the K-Ratio Index was devised for use in an investigation of the relationships between certain measures of syntactic maturity of oral languages and silent reading comprehension scores. Preparation for computing the ratio was accomplished by transcribing oral speech samples, excluding syntactically irrelevant matter, dividing into T-units, placing each T-unit at the top of its own data sheet, and counting the number of kernel structures imbedded in each T-unit. [This document is one of those reviewed in The Research Instruments Project (TRIP) monograph, "Measures for Research and Evaluation in the English Language Arts" to be published by the Committee of Research of the National Council of Teachers of English in cooperation with the ERIC Clearinghouse on Reading and Communication Skills. A TRIP review which precedes the document lists its category (Language Development), title, author, date, and age range (intermediate), and describes the instrument's purpose and physical characteristics.] (RB)

A clinical study of nolatrexed dihydrochloride (AG337, ThymitaqTM) in combination with paclitaxel was performed. The aims were to optimize the schedule of administration and determine any pharmacokinetic (PK) interactions between the two drugs. In vitro combination studies were performed to assist with schedule optimization. Three patients were entered on each of three different schedules of administration of the two drugs: (1) paclitaxel 0–3 h, nolatrexed 24–144 h; (2) nolatrexed 0–120 h, paclitaxel 48–51 h; (3) nolatrexed 0–120 h, paclitaxel 126–129 h. Paclitaxel was administered at a dose of 80 mg m−2over 3 h and nolatrexed at a dose of 500 mg m−2day−1as a 120-h continuous intravenous infusion. Plasma concentrations of both drugs were determined by high performance liquid chromatography. In vitro growth inhibition studies using corresponding schedules were performed using two head and neck cancer cell lines. In both HNX14C and HNX22B cell lines, synergistic growth inhibition was observed on schedule 2, whereas schedules 1 and 3 demonstrated antagonistic effects. In the clinical study, there was no effect of schedule on the pharmacokinetics of nolatrexed. However, patients on schedules 1 and 3 had a higher clearance of paclitaxel (322–520 ml min−1m−2) than those on schedule 2 (165–238 ml min−1m−2). Peak plasma concentrations (1.66–1.93 vs 0.86–1.32 μM) and areas under the curve (392–565 vs 180–291 μM min−1) of paclitaxel were correspondingly higher on schedule 2. The pharmacokinetic interaction was confirmed by studies with human liver microsomes, nolatrexed being an inhibitor of the major routes of metabolism of paclitaxel. Toxicity was not schedule-dependent. Nolatrexed and paclitaxel may be safely given together when administered sequentially at the doses used in this study. Studies in vitro suggest some synergy, however, due to a pharmacokinetic interaction, paclitaxel doses should be reduced when administered during nolatrexed infusion. © 2000 Cancer Research Campaign

A total of 303 patients underwent attempted laparoscopic cholecystectomy (LC) over a four-year period by two consultant surgeons or a senior trainee under their supervision. The procedure was completed in 291 with a conversion rate to open cholecystectomy of 3.9% and a median postoperative length of stay of two days, range zero to nine days. In eighteen patients the indication for LC was failure of symptoms to settle, two of whom required conversion (11.1%). Diathermy dissection was avoided in Calot's triangle and dissection started at the junction of Hartmann's pouch and cystic duct with full mobilisation of this area prior to clip application. Pre-operative endoscopic retrograde cholangiopancreatography ERCP was performed in patients suspected of having common bile duct stones without routine intra-operative cholangiography. There was one death in this series (0.3%) and an overall complication rate of 6.3 %. There was no incidence of either bile duct injury or leak. LC can be performed with a low complication rate with attention to careful dissection technique in the region of Calot's triangle.