After injection of microspheres into the pulmonary artery approximately 50% of spheres 2.8–4.0 µ in diameter can be found in the systemic circuit during the first circulation, but only 6% of those 8 µ or larger get through the pulmonary circuit when compared with simultaneously injected tagged erythrocytes. If vessels are impeding the flow of spheres and are circular in cross section, then more than half of the erythrocytes must be distorted while passing through the pulmonary circuit. A continuous infusion of norepinephrine (1–4 µg/kg/min) brings about a reduction in the percentage of the various sizes of spheres passing through the pulmonary vessels. This suggests vasoconstriction. Acetylcholine iodide (13–40 µg/kg/min) usually diminishes the percentage of spheres 2.8 µ and smaller, which can go through the pulmonary circuit, but increases the percentage of microspheres 5.7 µ and larger. During prolonged inspiration the percentage of microspheres passing through in each group studied was less than during expiration. If all microspheres injected are to pass through the pulmonary circuit in inspiration they must be 1.4 µ or smaller.
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In a 12-week double-blind study with 36 patients with major depressive episode (DSM-III), paroxetine (Seroxat, Aropax) showed significantly quicker onset of efficacy on the Melancholia Scale, and better tolerance than imipramine. Plasma concentration analyses showed no clear concentration-efficacy correlation in either treatment group. During long-term treatment paroxetine seemed to be superior to imipramine in preventing relapse; both treatments were well tolerated. A significant correlation between baseline plasma tryptophan: large neutral amino acids ratio and final Hamilton Rating Scale for Depression (HRSD) score and a trend towards an inverse correlation between this ratio and percentage reduction in HRSD score were seen in the paroxetine group but not in the imipramine group. In line with previous studies, these results support the hypothesis that paroxetine is an effective and well tolerated antidepressant.
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