Parenteral glutamine infusion alters insulin-mediated glucose metabolism

There is no consensus of opinion on the treatment of hypertensive putaminal hemorrhage (HPH), especially in patients older than 65 years. The purpose of this study was to study the surgical outcome of HPH in patients older than 65 years while considering mortality and activity of daily life. Among eighty-three patients aged 65 or older with HPH, fifty-one patients received only medical treatment and 32 were operated upon to remove the hematoma. Each patient was measured by the intracerebral hemorrhage-intracranial hemorrhage grading scale (ICH Grade) which used the sum of eye opening and motor response scores derived from Glasgow Coma Scale. The cubic content of the HPH was calculated from measurement of maximum width (X), length (Y) and height (Z), and the hematoma volume taken as 1/2 that volume (X. Y. Z/2). The acute mortality in surgically treated group was 40.6% and three patients died during the follow-up period from one to six months after the operation. Determinant for the prognosis was the ICH grade and the volume of the hematoma. Patients who returned to ADL 1 and 2 (good recovery) after surgical treatment were 40.0% in ICH Grade I, 16.7% in ICH Grade II, and 20.0% in ICH Grade III. Among those patients who were in ICH Grade IV, none had good recovery. The acute mortality was zero in ICH Grade I, 16.7% in ICH Grade II, 40.0% in ICH Grade III, and 62.5% in ICH Grade IV. The crucial size was 60 ml with a mortality of 77.8% for hematomas larger and 39.1% for hematomas smaller than that. From our lim ited experience, we learned that operation in elderly patients with HPH was considered only in patients with hematomas between 20 to 60 ml, with a high operative mortality and only one-fourth having a good recovery postoperatively.     

Combined treatment of acute EAE in Lewis rats with TNF-binding protein and interleukin-1 receptor antagonist

Experimental autoimmune encephalomyelitis (EAE) is a term given to describe a collection of animal models representing the human disease multiple sclerosis (MS). Although not fully understood, the involvement of cytokines and the immune system in either EAE or human MS is well established. Past efforts have shown that inhibition of proinflammatory cytokines tumor necrosis factor (TNF-alpha) or interleukin-1 (IL-1) result in amelioration of acute EAE in Lewis rats. The present study examined this model for the effect of concomitant inhibition of both TNF-alpha and IL-1, which resulted in a modest but significant therapeutic effect that was superior to inhibition of either single agent alone with respect to four of the five variables used to follow the progression of disease in this model, i.e., clinical severity, frequency of disease, loss of body weight, and day of onset. These results are in accordance with the idea that combination treatments are likely to prove superior to single agent therapy in the treatment of autoimmune inflammatory disease.     

Experimental infection of domestic sheep with culture-derived Leishmania donovani promastigotes

Domestic sheep were intradermally inoculated with culture-derived stationary phase Leishmania donovani promastigotes. Sampling of site of inoculation, liver and spleen for 244 days showed that this parasite can stay alive in the skin for up to 28 days post-inoculation. Apart from pyrexia that was evident in all the animals for 42 days, no other symptoms of kala-azar were seen. No parasites were recovered from the visceral organs throughout the sampling period, suggesting that sheep are not susceptible to infection with L. donovani. It is therefore unlikely that sheep can be synanthropic reservoirs for this parasite.     

Oral glutamine challenge in cirrhotics pre- and post-liver transplantation: a psychometric and analyzed EEG study

Latent or sub-clinical hepatic encephalopathy is a recognized complication of cirrhosis and is thought to represent one end of the spectrum of neuropsychiatric impairment, which occurrs as a result of portal-systemic shunting. We studied the psychometric, analyzed electroencephalography (EEG), and venous blood ammonia responses to an oral glutamine challenge in 17 patients with cirrhosis and in 4 normal controls. The cirrhotics were attending for liver transplant assessment and had no clinical evidence of hepatic encephalopathy. The oral glutamine challenge was repeated following liver transplantation. Five of sixteen patients (31%) showed impaired performance on at least one of the baseline psychometric tests. There was a correlation between fasting venous ammonia and choice reaction time (r = .7, P < .01). Following glutamine challenge there was a significant increase in blood ammonia from a mean fasting value ranging between 58 micromol/L to 120 micromol/L (P < .01), between significant prolongation of reaction times of 387 ms to 428 ms (P < .01), and an increase in mean EEG amplitude between 68.5 microV to 78.6 microV (P < .001). Four normal controls who were challenged with glutamine and 6 cirrhotic patients who were challenged with water showed no change in any of these parameters. Following orthotopic liver transplantation (OLT) the eight patients studied had normal baseline psychomotor performance with significant improvements in digit symbol, digit span, information processing, number connection tests (P < .05), and reaction time (P < .005). Posttransplantation, there were no significant changes in blood ammonia, analyzed EEG, or choice reaction time in response to oral glutamine challenge (six patients). We conclude that short lived changes in blood ammonia (in cirrhotics) can cause significant impairment of sensitive tests of brain function and that psychometric performance is improved following OLT.     

几种火灾探测器在公路隧道中的应用

如何迅速探测公路长隧道的火灾,一直是国内外研究的课题。隧道火灾报警是隧道安全系统非常重要的一部分。隧道火灾探测器的种类很多,本文根据隧道几种常见火灾探测器的工作原理、结构、性能特点及优缺点,简述其在高速公路隧道上的应用,并为公路隧道火灾探测器的选择提供参考。     

Regulation of protein synthesis in ventricular myocytes by vasopressin. The role of sarcoplasmic/endoplasmic reticulum Ca2+ stores

Protein synthesis in H9c2 ventricular myocytes was subject to rapid inhibition by agents that release Ca2+ from the sarcoplasmic/endoplasmic reticulum, including thapsigargin, ionomycin, caffeine, and arginine vasopressin. Inhibitions were attributable to the suppression of translational initiation and were coupled to the mobilization of cell-associated Ca2+ and the phosphorylation of eIF2alpha. Ionomycin and thapsigargin produced relatively stringent degrees of Ca2+ mobilization that produced an endoplasmic reticulum (ER) stress response. Translational recovery was associated with the induction of ER chaperones and resistance to translational inhibition by Ca2+-mobilizing agents. Vasopressin at physiologic concentrations mobilized 60% of cell-associated Ca2+ and decreased protein synthesis by 50% within 20-30 min. The inhibition of protein synthesis was exerted through an interaction at the V1 vascular receptor, was imposed at physiologic extracellular Ca2+ concentrations, and became refractory to hormonal washout within 10 min of treatment. Inhibition was found to attenuate after 30 min, with full recovery occurring in 2 h. Translational recovery did not involve an ER stress response but rather was derived from the partial repletion of intracellular Ca2+ stores. Longer exposures to vasopressin were invariably accompanied by increased rates of protein synthesis. Translational inhibition by vasopressin, but not by Ca2+-mobilizing drugs, was both preventable and reversible by treatment with phorbol ester, which reduced the extent of Ca2+ mobilization occurring in response to the hormone. Larger and more prolonged translational inhibitions occurred after down-regulation of protein kinase C. This report provides the first compelling evidence that hormonally induced mobilization of sarcoplasmic/endoplasmic reticulum Ca2+ stores is regulatory upon mRNA translation.