Radiation acute

Cysteine proteases, called calpains, are known to be activated by sustained elevations in intracellular free calcium. Once activated, calpains degrade the cytoskeleton, transmitter and membrane channels, and metabolic enzymes (Hou and MacManus 2002 Mattson 2003 Nicholls 2004). Functionally, calpains have been characterized as pivotal mediators of both active necrotic cell death and PCD (Wang 2000) following cell-damaging stressors and insults such as soman exposure, excitotoxic challenges, toxins, free radicals, UV radiation, acute hypoxia, traumatic brain injury, cytokines, heat, and in chronic neurodegenerative conditions (Fischer et al. 1991 Caner et al. 

Pentoxifylline is stmcturaHy related to other methylxanthine derivatives such as caffeine [58-02-2] (1,3,7-trimethylxanthine), theobromine [83-67-0] (3,7-dimethylxanthine), and theophylline [58-55-9] (3,7-dihydro-1,3-dimethyl-1 H-piirine-2,6-dione or 1,3-dimethylxanthine), which also show radioprotective activity in some instances, suggesting that methylxanthines as a dmg class may radioprotect through a common mechanism (see Alkaloids). In a retrospective analysis of cervical and endometrial cancer patients receiving primary or adjuvant XRT, no association between caffeine consumption and incidence of acute radiation effects has been found. However, there was a decreased incidence of severe late radiation injury in cervical cancer patients who consumed higher levels of caffeine at the time of thek XRT (121). The observed lack of correlation between caffeine consumption and acute radiation effects is consistent with laboratory investigations using pentoxifylline. 

Not only is TCDO a potent therapeutic agent in acute radiation syndrome, but treatment using TCDO from days 4—11 after TBI increases the survival rate in rats for up to one year, protects against the development of late GI ulcers, and also reduces the development of y-ray-induced leukemias and malignant epitheHal tumors, but not sarcomas (202). The anticarcinogenic effect of TCDO maybe related to the inhibition of PGs, which promote carcinogenesis, or to immunostimulation, which may result in a more effective elimination of malignant cells. 

The proteolytic enzymes, trypsin, chymotrypsin, and chymoral [8076-22-0] in combination, have been used for the treatment of post-operative hand trauma, athletic injuries, and sciatica (214—216). Trypsin has also been used successfully in treating hyaline membrane disease of newborn babies, a condition usually fatal without treatment (217). Immobilized preparations of trypsin are useful in treating acute radiation cystitis following pelvic x-irradiation therapy (218). 

The reader should note tliat since many risk assessments have been conducted on the basis of fatal effects, there are also uncertainties on precisely what constitutes a fatal dose of thennal radiation, blast effect, or a toxic chemical. Where it is desired to estimate injuries as well as fatalities, tlie consequence calculation can be repeated using lower intensities of exposure leading to injury rather titan dcatli. In addition, if the adverse healtli effect (e.g. associated with a chemical release) is delayed, the cause may not be obvious. Tliis applies to both chronic and acute emissions and exposures. 

CohnenM, WittsackHJ, Assadi S, Muskalla K, Ringelstein A, Poll LW, Saleh A, Modder U. Radiation exposure of patients in comprehensive computed tomography of the head in acute stroke. Am J Neuroradiol 2006 27 1741-1745. 

Empey, L.R., Papp, J.D., Jewell, L.D. and Fedorak, R.N. (1992). Mucosal protective effects of vitamin E and misoprostol during acute radiation-induced enteritis. Dig. Dis. Sci. 37, 205-214. 

Tubular and interstitial diseases (e.g., analgesic nephropathy, drug-induced nephritis, oxalate nephropathy, radiation nephritis, acute tubular necrosis, and sarcoidosis)... 

This royal-blue-colored drug is an anthracenedione that inhibits DNA topoisomerase II. The pharmacokinetics of mitoxantrone may best be described by a three-compartment model, with an a half-life of 3 to 10 minutes, a 3 half life of 0.3 to 3 hours, and a median terminal half-life of 12 days. Biliary elimination appears to be the primary route of elimination, with less than 10% of the drug eliminated by the kidney.23 Mitoxantrone has shown clinical activity in the treatment of acute leukemias, breast and prostate cancer, and non-Hodgkin s lymphomas. Myelosuppression, mucositis, nausea and vomiting, and cardiac toxicity are side effects of this drug. The total cumulative dose limit is 160 mg/m2 for patients who have not received prior anthracycline or mediastinal radiation. Patients who have received prior doxorubicin or daunorubicin therapy should not receive a cumulative dose greater than 120 mg/m2 of mitoxantrone. Patients should be counseled that their urine will turn a blue-green color. 

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