Acute therapy of ischemic cerebral infarct

The ischaemic cerebral attack is a disease prevailingly of older age. Its prognosis is distinguished by a mortality rate as high as ever. From 1975 to 1985, 520 patients with ischaemic cerebral attack have been treated in hospital, with specific acute therapy changing from the so-called vasodilator therapy via osmotherapy into haemodilution therapy with lowmolecular dextrane. Since during vasodilator therapy any early mobilisation nor continuous physiotherapy were carried out and the patients prevailingly died of bronchopneumonia, the significantly lower mortality rate under osmotherapy and haemodilution therapy cannot be attributed to the specific drug therapy. In all probability it is a result of the improvement of care and of the active early mobilisation of the patients.     

Case Report: Giant choledochal cyst

We report an adult female with a rare giant choledochal cyst. The patient presented following a normal pregnancy with the classical triad of an abdominal mass associated with jaundice and right upper quadrant abdominal pain. The cyst was excised using an intramural technique and biliary reconstruction achieved with a Roux-en-Y hepaticojejunostomy. Our patient has remained well with no evidence of malignancy over a 12 year review period. The aetiology and current management of this condition are discussed.     

Determination of optimal cryoprotectants and procedures for their addition and removal from human spermatozoa

The objective was to test the hypothesis that the optimal cryoprotective agent for cryopreservation of human spermatozoa would be a solute for which cells have the highest plasma membrane permeability, resulting in the least amount of volume excursion during its addition and removal. To test this hypothesis, theoretical simulations were performed using membrane permeability coefficients to predict optimal procedures for the addition and removal of a cryoprotectant. Simulations were performed using data from four different cryoprotectants: (i) glycerol, (ii) dimethyl sulphoxide, (iii) propylene glycol and (iv) ethylene glycol. Thermodynamic formulations were applied to determine approaches for the addition and removal of 1 M and 2 M final concentrations of cryoprotectant, allowing the spermatozoa to maintain a cell volume within their osmotic tolerance limits. Based on these data, ethylene glycol was predicted to be optimal for minimizing volume excursions among the solutes evaluated. These predictions were then experimentally tested using glycerol as the control cryoprotectant and ethylene glycol as the experimental cryoprotectant. The results indicate that there was a higher (P < 0.05) recovery of motile spermatozoa after cryopreservation when using 1 M ethylene glycol than with 1 M glycerol, supporting the hypothesis that use of the cryoprotectant for which the cell has the highest permeability will result in higher cell survival.      

IGF-I and vanadate stimulate Na/Pi-cotransport in OK cells by increasing type II Na/Pi-cotransporter protein stability

 Insulin-like growth factor (IGF)-I and vanadate increase Na-dependent phosphate (Na/P_i) cotransport in opossum kidney (OK) cells. To gain more information about the mechanisms by which IGF-I and vanadate stimulate Na/P_i-cotransport, we measured type II Na/P_i-cotransporter (NaPi-4) protein abundance by Western blot analysis and investigated the effects of protein synthesis and tyrosine kinase inhibitors. The key findings in the present studies are as follows. First, incubation in IGF-I (10^–8 M) and/or vanadate (10^–3 M) for 3 h led to a non-additive 1.4-fold increase in Na/P_i-cotransport activity which was paralleled by a 1.5- to 2-fold increase in NaPi-4 protein. Second, actinomycin D did not abolish the increase in Na/P_i-cotransport and cycloheximide did not prevent the IGF-I-induced increase in Na/P_i-cotransport and NaPi-4 protein. Third, among the protein kinase inhibitors tested, only staurosporine substantially reduced the stimulation of Na/P_i-cotransport. In conclusion, the stimulatory effect of IGF-I on Na/P_i-cotransport is paralleled by an increased expression of NaPi-4 protein that is independent of protein synthesis and therefore results from increased protein stability. The observation that IGF-I and/or vanadate lead to similar increases in Na/P_i-cotransport and NaPi-4 protein abundance provides further evidence that the stimulation of Na/P_i-cotransport by IGF-I and vanadate involves protein tyrosine phosphorylation of the same signalling molecules. Received: 1 May 1998 / Received after revision: 25 August 1998 / Accepted: 1 September 1998