Nineteen cases of bronchopulmonary leiomyosarcoma and 13 cases of bronchopulmonary fibrosarcoma in the files of the Armed Forces Institute of Pathology, as well as 48 cases of each of these tumors previously reported, were reviewed in an attempt to clarify their histopathologic criteria and biologic behavior. The number of mitoses, the size, and the endobronchial or intrapulmonary location of the tumors seemed to be the best bases for predicting their biologic behavior. The small endobronchial tumors confined to the bronchial wall had a benign behavior for the most part. On the other hand, the intrapulmonary tumors varied in their degree of malignancy, depending upon their number of mitoses and size. Contrary to earlier belief, many of the latter tumors were found to be of a relatively high grade of malignancy because of their large size, local extension, or metastasis.
The clinical pharmacokinetics of amitriptyline were studied in four volunteers after the oral administration of 75 mg. Peak amitriptyline plasma concentrations ranged from 10.8 to 43.7 ng/ml. The disappearance was biphasic and followed first-order kinetics. The mean elimination half-life was 36.1 hours. The mean estimated first-pass metabolism of amitriptyline was 60 per cent. Significant quantities of the metabolite, nortriptyline, were produced although peak concentrations ranged from only 5.9 to 12.3 ng/ml. The relationship between these findings to clinical practice and earlier reports is discussed.
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