Effect of diphenolic laxatives on Na+-K+-activated ATPase and cyclic nucleotide content of rat colon mucosa in vivo

1. The effect of bisacodyl and oxyphenisation on the Na+-K+- and Mg2+-activated ATPase and on the mucosa levels of cAMP and cGMP was investigated in transporting ligated loops of the rat colon in acute studies and in chronic feeding experiments 2. The specific activity of the Na+-K+-ATPase was lowered in both types of experiments, concomitantly with a reduction in net sodium absorption. The specific activity of the Mg2+-activated ATPase was unaffected. 3. The cAMP content per mg protein was elevated and the cGMP content decreased in the acute experiments in which the effect on transport was most marked. The content of cyclic nucleotides returned to normal within 2 h whereas absorption, Na+-K+-ATPase specific activity and the mucosal potential difference were still significantly depressed at that time. In chronic experiments with bisacodyl, cAMP was not affected and cGMP was increased in colon loops exhibiting reduced absorption. 4. The results indicate that the inhibition of the Na+-K+-activated ATPase by diphenolic laxatives may play a role in the inhibition of intestinal fluid absorption caused by these compounds. The increase of cAMP in acute experiments could point to a cAMP-mediated stimulation of secretory processes under this condition.     

A comparison of propofol and remifentanil for sedation and limitation of movement during periretrobulbar block

STUDY OBJECTIVES: To compare clinical conditions in patients sedated with propofol or remifentanil during combined peri-bulbar and retrobulbar block (PRBB) for cataract surgery. DESIGN: Prospective, randomized, double-blind study. SETTING: Private clinic. PATIENTS: 106 ASA physical status I and II patients scheduled for cataract surgery. INTERVENTIONS: Patients were randomized to receive either 0.5 mg/kg propofol (Group P) or 0.3 microg/kg remifentanil (Group R) as an intravenous (IV) bolus 1 minute prior to PRBB. At the same time, patients in both groups also received 0.5 to 1 mg midazolam IV. Movement of the hands, arms, head, and eyes were counted during each stage of the procedure by an observer who was blinded to the sedation used. Heart rate (HR), blood pressure (BP), respiratory rate (RR), expiratory CO(2) (PECO(2)), and hemoglobin oxygen saturation (SaO(2)) were recorded every minute for 10 minutes after the PRBB. Anesthetic complications, recall, and the pain experienced with the block and surgery were compared between the two groups. Means and variance of the results were compared with one-way analysis of variance and Fisher's exact test. MEASUREMENTS AND MAIN RESULTS: Movements of the hands, arms, and head were significantly greater in Group P during all stages of the block. Almost no movements were recorded in the remifentanil group. Immediately after the PRBB (1 to 6 min), HRs were higher in Group P (73 +/- 11 bpm vs. 67 +/- 10 bpm; p = 0.0075), whereas the RRs were slower in Group R for the period 1 to 5 minutes after the PRBB (16 +/- 5 breaths/min vs.14 +/- 4 breaths/min; p = 0.0206). At these times, the mean PECO(2) was higher in Group R (36 +/- 7 mmHgvs. 32 +/- 9 mmHg; p = 0.0125). Nineteen patients in the propofol group sneezed during the medial peribulbar injection compared with none in the remifentanil group. Anesthetic and surgical complications were unremarkable and similar for the two groups. CONCLUSIONS: Respiratory depression with remifentanil was mild and not clinically significant. Remifentanil sedation for this application was superior to sedation with propofol.     

Counterimmunoelectrophoresis of Reiter Treponeme Axial filaments as a diagnostic test for syphilis.

Purified axial filaments from the cultivable Reiter treponeme, previously shown to share an antigenic component with pathogenic Treponemia pallidum, were evaluated as antigen in a diagnostic test for syphilis. Antibody to the filaments was revealed by counterimmunoelectrophoresis. Conditions that produced optimal results in the test were established. A total of 343 sera from normal individuals, biological false-positive reactors, and from patients in the different stages of syphilis were subjected to the test. The results indicate the test to be sensitive and highly specific for detecting treponemal antibodies in human syphilis.     

Mutations conferring foscarnet resistance in a cohort of patients with acquired immunodeficiency syndrome and cytomegalovirus retinitis

The clinical significance of cytomegalovirus (CMV) foscarnet resistance was studied in patients with acquired immunodeficiency syndrome and CMV retinitis. Sequencing of the CMV pol gene was performed in 30 isolates. Phenotypic resistance was characterized by the DNA hybridization assay (DHA) in 30 isolates and by plaque-reduction assay (PRA) in 18 isolates. Nine isolates had foscarnet resistance mutations, including V787L and E756Q that were confirmed by marker transfer experiments. Seven of 9 isolates with a 50% inhibitory concentration (IC(50)) >600 microM by DHA had genotypic resistance, compared with 2 of 21 with an IC(50) < or =600 microM (P=.0005). By PRA, 5 isolates had an IC(50) >400 microM and genotypic resistance, whereas only 1 of 13 susceptible isolates had genotypic resistance (P=.0007). Sixteen of 18 isolates had concordant PRA and DHA phenotypes. Among 44 patients treated with foscarnet, drug resistance increased the risk of retinitis progression (odds ratio, 14; P=.016). The incidence of foscarnet resistance after 6, 9, and 12 months of therapy was 13%, 24%, and 37%, respectively.     

Dysphagia and expiratory air flow

Expiratory air flow preserves the freedom of the upper airway from foodway contamination in patients with dysphagia. Valving the tracheostomy cannula, quad coughing, the Heimlich maneuver, the supraglottic swallow, and coupling to a ventilator each has a place among the measures used for treating aspiration.     

Hemolytic anemia, recurrent metabolic acidosis, and incomplete albinism associated with glutathione synthetase deficiency

The clinical and laboratory features of a 3-mo-old black male infant with glutathione (GSH) synthetase deficiency of the generalized type was evaluated. Partial albinism, brisk hemolytic anemia, recurrent febrile episodes, and mental retardation were noted. Also, severe recurrent metabolic acidosis and marked oxoprolinemia and oxoprolinuria were found in the proband but not in his first-degree relatives. The relationship of these disease manifestations to the underlying metabolic defect is discussed.     

Experimental Achylia Gastrica and Iron Absorption

S ummary . Achylia gastrica with lowered iron stores was produced in rats by direct X-irradiation of the exposed stomach. Absorption of ⁵⁹Fe as a ferrous salt was measured in these and in normal and iron-deficient control rats to study the effect of various components of gastric juice on iron absorption. Hydrochloric acid had no effect in rats with achylia gastrica, but neutralized rat gastric juice, pernicious anaemia gastric juice, and intrinsic factor increased absorption two-fold. Untreated rat and human gastric juice increased absorption four-fold while antigastric mucosal serum reduced absorption four-fold. This reduction was corrected by adding rat gastric juice. Gastric juice appears to play a significant role in iron absorption.     

Age‐Dependent Effect of β‐Amyloid Toxicity on Basal Forebrain Cholinergic Neurons and Inflammation in the Rat Brain

Beta‐amyloid (Aβ) accumulation, neuroinflammation, basal forebrain cholinergic loss and hippocampal degeneration are well‐described pathologies associated with Alzheimer's disease (AD). However, the role that age plays in the susceptibility of the brain to these AD pathologies and the relationships between them is still not well understood. This study investigated the age‐related response to intracerebroventricular injection of Aβ_25–35 in 3‐, 6‐ and 9‐month‐old rats. Aβ toxicity resulted in an age‐related increase in cholinergic loss and microglial activation in the basal forebrain along with neuronal loss in the hippocampal CA3 subfield. Performance in the Morris water maze revealed impairments in long‐term reference memory in 6‐month‐old Aβ administered animals, which was not seen in 3‐month‐old animals. These results support a role of Aβ administration in inducing age‐dependent cholinergic loss and neuroinflammation, and additionally provide evidence for a more age‐appropriate model of adult‐onset Aβ toxicity demonstrating pathological changes that reflect the early stages of AD pathogenesis including neuroinflammation, cholinergic loss and beginning stages of memory impairment.