Cannabinoids inhibit the release of [3H]glutamate from rodent hippocampal synaptosomes via a novel CB1 receptor-independent action

In this study we investigated the effect of cannabinoids on [3H]glutamate release from hippocampal synaptosomes of rat and CB1-null mutant mouse. In the rat, cannabinoid receptor agonists, i.e. CP55,940 (EC50, 0.84 microm), WIN55,212-2 (EC50, 3.47 microm), ACEA (EC50, 17.8 microm), and R-(+)-methanandamide (EC50, 19.8 microm) concentration-dependently inhibited the 25-mm-K+ depolarization-evoked release of [3H]glutamate and, among them, WIN55,212-2 displayed the greatest efficacy. The CB1 receptor antagonists SR141716A (1-5 microm) and AM251 (1 microm) and the VR1 vanilloid receptor antagonist capsazepine (10 microm) did not antagonize the effect of the agonists. SR141716A by itself attenuated the evoked [3H]glutamate release. WIN55,212-2 inhibited the release of [3H]glutamate in CB1 -/- mice as well. These data demonstrate that the action of cannabinoids on glutamate release in the hippocampus is pharmacologically distinct and independent from the cloned CB1 receptor.     

The effect of different anxiolytics on the anxiety state occurring in rats after stopping the electrical stimulation of the dorsal hippocampus

The work shows growing anxiety of rats after electrical stimulation of the hippocampus during a conflict and according to the findings of multimetric testing. Various anxiolytics (diazepam, melatonin, and propranolol) completely relieved the symptoms of hippocampal hyperactivity.     

Beiderseitige angeborene Aplasie der Nebennieren mit accessorischer Nebenniere

Zusammenfassung Es ist uns somit gelungen, den einwandfreien anatomischen Nachweis des beiderseitigen Nebennierenmangels zu erbringen. Aus dem gleichzeitigen Fehlen krankhafter Veränderungen in anderen Organen geht hervor, daß diese Entwicklungsstörung als selbständiges Krankheitsbild vorkommt. Unser Fall beweist weiter, daß der beiderseitige Mangel der Nebennieren mit dem Leben nicht vereinbar ist, also bei Erwachsenen nicht angetroffen werden kann. Unser Fall scheint endlich die Angaben, Verwandtenehen 1. und 2. Grades könnten in ihrer Nachkommenschaft Mißbildungen aufweisen, zu bestätigen.Mit 3 Textabbildungen.     

Status of the hypophysis-adrenal cortex system during treatment with glucocorticoids by the method of intermittent (every other day) administration

The authors discuss the advantages of the use of glucocorticoids in the treatment of autoimmune diseases, if the drugs are administered every other day. A total of 149 patients with autoimmune thyroiditis, endocrine ophthalmopathy, myasthenia and bronchial asthma were examined. Of these, 3 patients received glucocorticoids every other day, whereas the remainder took them every day. The former method consisted in the use of a single daily dose of glucocorticoids (20 to 80 mg) at 7 to 8 o'clock in the morning over 2 months to 5 years. The function of the pituitary-adrenal system was tested by the measurement of the blood content of ACTH, hydrocortisone and testosterone with the aid of a kit of standard tests. It was shown that glucocorticoids administered every other day did not produce any suppression of the pituitary-adrenal system in contrast to those who received prednisolone every day. The lack of the side effects in the form of exogenous hypercorticoidism can be explained by the anabolic action of steroid hormones produced by the reticular zone of the adrenal cortex. Examination of the blood serum content of testosterone in women who received glucocorticoids every other day has demonstrated that modulations in its secretion were similar to those in the content of ACTH and hydrocortisone. Thus, the stimulating hormonal therapy with glucocorticoids administered every other day appears more physiological as compared to the daily schedule.     

Efficacy of Goal-Directed Fluid Therapy via Pleth Variability Index During Laparoscopic Roux-en-Y Gastric Bypass Surgery in Morbidly Obese Patients

Background

There is no well-recognized guideline for intraoperative fluid management in bariatric surgery. Goal-directed fluid therapy (GDFT) is a new concept of perioperative fluid management which was shown to improve patients’ prognoses. Dynamic indicators may better predict fluid response compared to static indicators. In this study, we aimed to assess effects of administering GDFT protocol via Pleth Variability Index (PVI) in morbidly obese patients undergoing laparoscopic Roux-en-Y gastric bypass (RYGB) surgery.

Methods

The study included 60 patients who underwent elective laparoscopic RYGB surgery. Subjects were randomized to two groups as being managed with either standard fluid regimen (control group) or PVI (PVI group) during intraoperative period. After induction of general anesthesia, control group received 500 ml crystalloid bolus followed by 4–8 ml/kg/h infusion. Fluid management of the control group was guided by central venous pressure and mean arterial pressure. PVI group received 500 ml crystalloid bolus followed by 2 ml/kg/h infusion. If PVI had been > 14%, 250 ml colloid was administered. Norepinephrine was given by infusion to keep mean arterial pressure > 65 mmHg, if needed. Perioperative lactate levels, hemodynamic parameters, and renal functions were recorded.

Results

In PVI group, volume of crystalloid and total fluid infusion during intraoperative period was significantly lower than the control group (p < 0.05). The groups did not significantly differ in terms of lactate or creatinine levels before or after the surgery (p > 0.05).

Conclusions

There is no need to administer extra volume of fluid to obese patients undergoing laparoscopic bariatric surgery. Use of dynamic indicators like PVI helps to decrease intraoperative volume of infused fluids with no effects on either intraoperative or postoperative lactate levels in laparoscopic bariatric interventions.