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Objective: Peridural fibrosis after laminectomy is an important surgical problem. Tenoxicam is a nonsteroidal antiinflammatory drug and an oxicam derivative acting by inhibiting the formation of prostaglandin and eicosanoids. Low dose methotrexate which has been used as an antiinflammatory agent rhomatoid arthritis inhibits the synthesis of potentially toxic compounds those accumulate in inflamed tissues. The aim of this study was to evaluate and compare the efficacy of these two independent pharmacological agents in the inhibition of peridural fibrosis. Methods: L3-4-5 bilateral laminectomy with sparing the dura mater integrity was perfomed to 30 male Wistar albino rats. Except the SHAM group, low dose methotraxate (0.2 mg/kg) or tenoxicam (0.5 mg/kg) was administered on the dura mater before the surgical closure. After 42 days, all rats were euthanized and their spinal columns performed laminectomy were removed for the histopathological evaluation. Results: The peridural fibrosis grades of the groups administered low dose methotrexate or tenoxicam were lower than SHAM group grades. They have lower fibroblast counts than SHAM group numerically, although there was no statistically significant difference among groups. Conclusion: Local usage of low dose methotrexate and tenoxicam may be helpful option for prevention of peridural fibrosis after laminectomy procedures in future. [ABSTRACT FROM AUTHOR]

Gestational trophoblastic neoplasia (GTN) is one of the most curable malignancies because of the intrinsic sensitivity of the tumor to certain antineoplastic agents, effective sensitive assays for human chorionic gonadotropin (hCG), and identification of high-risk factors that permit individualized treatment. Chemotherapy is the main modality of treatment in patients with GTN. The cure rate in patients with low-risk GTN is 100%, and is estimated to exceed 80% in patients with high-risk GTN. Management of GTN is based on staging (anatomical involvement staging) and scoring. Patients with persistent GTN and stage I or score ≤ 6 (low risk) should be managed with single agent chemotherapy (methotraxate or actinomycin), but patients with stage IV or score ≥ 7 (high risk) need combination chemotherapy. Gestational trophoblastic neoplasia is radiosensitive, because radiation has hemostatic and tumorocidal effect on GTN. Therefore, radiotherapy can be used in treatment of some patients with brain hepatic metastasis or in patients where chemotherapy is not possible due to medical problems. Surgery can be used in patients who are resistant to chemotherapy or in hemorrhagic cases. Surgical resection of the tumor is the main form of therapy for placental site trophoblastic tumor. This surgery consists of a hysterectomy for the majority of patients as the disease is confined to the uterus. [ABSTRACT FROM AUTHOR]

The absorption and elimination kinetics of 4-amino-N10-methylpteroyl-D-glutamic acid (D-MTX), the optical isomer of methotrexate (L-MTX), were examined. Test doses of 10 mg D-MTX were administered i.v. and orally to nine patients and its plasma concentration and urinary excretion were followed. The plasma curves after an i.v. bolus injection of D-MTX declined strictly biexponentially and reached zero after about 16 h. The elimination rate constants were estimated as the terminal first order rate constants. The absorption of orally administered D-MTX, estimated by its 24 h urinary recovery, in all cases was less than 3% of the dose administered. The insignificant intestinal absorption made it possible to estimate the renal and biliary secretion rates of D-MTX from the overall elimination rate constant and from the fraction of the dose excreted in urine. In three of the patients, elimination rate constants both for D-MTX and L-MTX were obtained. The renal elimination rates of the two compounds were found to be nearly identical. The median ratio of biliary/renal excretion of D-MTX was 0.94 (range 0.41-1.50), which indicates extensive entero-hepatic cycling and active reabsorption of L-MTX at the therapeutic dose levels used in psoriasis. [ABSTRACT FROM AUTHOR]