Low-risk persistent gestational trophoblastic disease treated with low-dose methotrexate: efficacy, acute and long-term effects

The aim of this study was to evaluate the efficacy and toxicity of low-dose methotrexate with folinic acid rescue in a large series of consecutively treated patients with low-risk persistent gestational trophoblastic disease. Between January 1987 and December 2000, 250 patients were treated with intramuscular methotrexate (50 mg on alternate days 1, 3, 5, 7) with folinic acid (7.5 mg orally on alternate days 2, 4, 6, 8) rescue. The overall complete response rate without recurrence was 72% for first-line treatment and 95% for those who required second-line chemotherapy. Eight women (3.2%) had recurrence following remission and two (0.8%) had new moles. Two women (0.8%) died of their disease giving an overall cure of 99%. Only 10 women (4%) experienced grade III/IV toxicity during the first course of treatment and 13 women (5.2%) subsequently. Toxicity included mucositis and stomatitis, pleuritic chest pain, thrombocytopenia, uterine bleeding, abdominal pain, liver function changes, rash and pericardial effusion. A total of 59 women (23.6%) required second-line chemotherapy; 48 women had methotrexate resistance, eight had methotrexate toxicity and an empirical decision to change therapy was made in three. In all, 11 women (4.4%) had a hysterectomy before, during or after treatment; 141 women (56.4%) became pregnant following treatment: in 128 (90.7%), the outcome was successful. Methotrexate with folinic acid rescue is an effective treatment for low-risk persistent trophoblastic disease. It has minimal severe toxicity, excellent cure rates and does not appear to affect fertility

Online monitoring of aluminium primary production gas composition by use of Fourier-transform infrared spectroscopy

Online monitoring of aluminium primary production raw gas is challenging due to the high concentration of HF in the presence of water. Tunable Diode Laser (TDL) analyzers retrofitted with sapphire optical windows allow for online monitoring of raw gas composistion. These systems are however limited to one or two gas constituents. In order to make use of multi-component analyzers like Fourier-Transform InfraRed Spectrometers (FTIR), HF must be selectively removed by filtration. This work presents some results from complete mapping of raw gas composition by comparing results from HF filtrated as well as non-filtrated measurements. The multivariate calibration models established for mapping of the raw gas is discussed. Open-path FTIR spectroscopy was applied in order to quantify fugitive emissions of HF and SO2. Quantitation showed good correlation with reported emissions. Monitoring of fugitive PFC emissions was also evaluated.acceptedVersio