Postoperative Infusion of Amino Acids Induces a Positive Protein Balance Independently of the Type of Analgesia Used

Background: Net loss of body protein is a prominent feature of the catabolic response to surgical tissue trauma. Epidural analgesia with hypocaloric dextrose has been demonstrated to attenuate leucine oxidation but was unable to make protein balance positive. The current study was set to determine whether an infusion of amino acids on the second day after colon surgery would revert the catabolic state and promote protein synthesis while maintaining glucose homeostasis in patients receiving epidural analgesia as compared with patient-controlled analgesia with morphine (PCA).

Methods: Sixteen patients undergoing colorectal surgery were randomly assigned to receive epidural blockade or PCA as analgesic techniques and underwent a 6-h stable isotope infusion study (3 h fasted, 3 h fed) on the second postoperative day. Whole body glucose kinetics and protein turnover were measured using [6,6-2H2]glucose and l-[1-13C]leucine as tracer.

Results: The infusion of amino acids caused a decrease in endogenous glucose rate of appearance in both groups (P < 0.05), with greater changes in the PCA group (P < 0.05). Administration of amino acids suppressed the appearance of leucine from protein breakdown in both groups (P < 0.05), although the decrease was greater in the PCA group (P < 0.05). Leucine oxidation increased in both groups (P < 0.05), with greater change in the epidural group (P < 0.05). Protein synthesis increased to the same extent in both groups (P < 0.05). Protein balance became positive after the infusion of amino acids, and the effect was greater in the PCA group (P < 0.05).     

Fat Digestion in the Newborn: CHARACTERIZATION OF LIPASE IN GASTRIC ASPIRATES OF PREMATURE AND TERM INFANTS

We have measured lipolytic activity in gastric aspirates obtained at birth in a group of 142 infants. The infants ranged in gestational age from 26 to 41 wk. Lipolytic activity, measured by the hydrolysis of long chain triglyceride ([tri-³H]oleate), and expressed as nanomoles FFA per milliliter gastric aspirate per minute was 333±66 in 55 small premature infants (gestational age 26-34 wk and body wt 750-2,000 g) and 558±45 in a group of 87 larger infants (gestational age 35-41 wk and body wt 2,020-4,000 g). No activity was detected in seven infants with an unusually low pH in the gastric aspirate, 2.88±0.44 (compared with a mean pH level of 5.59±0.22 in the other 135 infants).     

Comparison of haemagglutination-inhibition and single radial haemolysis techniques for detecting antibodies to influenza A and B viruses

The sensitivities of haemagglutination-inhibition (HI) and single radial haemolysis (SRH) techniques in detecting antibodies against influenza A/Bangkok/1/79, A/Brazil/11/78, B/Singapore/222/79, B/Hong Kong/5/72 strains, in human sera were compared. For antibodies to influenza B viruses the HI tests employing ether-treated antigens were also evaluated. The SRH technique appears to be more sensitive for detecting protective titres of antibodies against influenza B strains and influenza A/Brazil/11/78.     

Case report of adverse effect of reserpine on tardive dyskinesia

The authors used reserpine to treat a case of tardive dyskinesia. Like neuroleptics, reserpine improved the symptoms of tardive dyskinesia during administration but appeared to aggravate the underlying illness, as evidenced by increased symptoms after reserpine discontinuation.     

Biomechanical considerations in implant prosthodontics

The dentist who uses implants in conjunction with natural abutment teeth should apply the same principles and guidelines that have proved themselves in fixed and removable prosthodontics. This article reviewed the basic biomechanical principles of span deflection and Class I lever systems as they may apply to fixed prosthodontics with and without implant abutments.     

Mapping a mouse limbic seizure susceptibility locus on chromosome 10

Purpose: Mapping seizure susceptibility loci in mice provides a framework for identifying potentially novel candidate genes for human epilepsy. Using C57BL/6J × A/J chromosome substitution strains (CSS), we previously identified a locus on mouse chromosome 10 (Ch10) conferring susceptibility to pilocarpine, a muscarinic cholinergic agonist that models human temporal lobe epilepsy by inducing initial limbic seizures and status epilepticus (status), followed by hippocampal cell loss and delayed‐onset chronic spontaneous limbic seizures. Herein we report further genetic mapping of pilocarpine quantitative trait loci (QTLs) on Ch10. Methods: Seventy‐nine Ch10 F₂ mice were used to map QTLs for duration of partial status epilepticus and the highest stage reached in response to pilocarpine. Based on those results we created interval‐specific congenic lines to confirm and extend the results, using sequential rounds of breeding selectively by genotype to isolate segments of A/J Ch10 genome on a B6 background. Key Findings: Analysis of Ch10 F₂ genotypes and seizure susceptibility phenotypes identified significant, overlapping QTLs for duration of partial status and severity of pilocarpine‐induced seizures on distal Ch10. Interval‐specific Ch10 congenics containing the susceptibility locus on distal Ch10 also demonstrated susceptibility to pilocarpine‐induced seizures, confirming results from the F₂ mapping population and strongly supporting the presence of a QTL between rs13480781 (117.6 Mb) and rs13480832 (127.7 Mb). Significance: QTL mapping can identify loci that make a quantitative contribution to a trait, and eventually identify the causative DNA‐sequence polymorphisms. We have mapped a locus on mouse Ch10 for pilocarpine‐induced limbic seizures. Novel candidate genes identified in mice can be investigated in functional studies and tested for their role in human epilepsy.     

Electromyographic analysis of core trunk, hip, and thigh muscles during 9 rehabilitation exercises

STUDY DESIGN: Prospective, single-group, repeated-measures design. OBJECTIVE: To identify exercises that could be used for strength development and the exercises that would be more appropriate for endurance or stabilization training. BACKGROUND: The exercises analyzed are often used in rehabilitation programs for the spine, hip, and knee. They are active exercises using body weight for resistance; thus a clinician is unable to determine the amount of resistance being applied to a muscle group. Electromyographic (EMG) analysis can provide a measure of muscle activation so that the clinician can have a better idea about the effect the exercise may have on the muscle for strength, endurance, or stabilization. METHODS AND MEASURES: Surface EMG analysis was carried out in 19 males and 11 females while performing the following 9 exercises: active hip abduction, bridge, unilateral-bridge, side-bridge, prone-bridge on the elbows and toes, quadruped arm/lower extremity lift, lateral step-up, standing lunge, and using the Dynamic Edge. The rectus abdominis, external oblique abdominis, longissimus thoracis, lumbar multifidus, gluteus maximus, gluteus medius, vastus medialis obliquus, and hamstring muscles were studied. RESULTS: In healthy subjects, the lateral step-up and the lunge exercises produced EMG levels greater than 45% maximum voluntary isometric contraction (MVIC) in the vastus medialis obliquus, which suggests that they may be beneficial for strengthening that muscle. The side-bridge exercise could be used for strengthening the gluteus medius and the external oblique abdominis muscles, and the quadruped arm/lower extremity lift exercise may help strengthen the gluteus maximus muscle. All the other exercises produced EMG levels less than 45% MVIC, so they may be more beneficial for training endurance or stabilization in healthy subjects. CONCLUSION: Our results suggest these exercises could be used for a core rehabilitation or performance enhancement program. Depending on the individual needs of a patient or athlete, some of the exercises may be more beneficial than others for achieving strength.