Localized proton NMR observation of [3-13C]lactate in stroke after [1-13C]glucose infusion.

To assess whether elevated lactate in stable stroke is being actively produced from blood glucose localized 1H NMR stimulated echo spectra were obtained from a patient in the region of a 32-day-old cortical infarct before and 60-100 min after infusion of [1-13C]glucose. Prior to the infusion the spectrum from the region of the infarct contained an elevated resonance from C3 lactate and a greatly reduced resonance from N-acetyl groups relative to an unaffected contralateral region. After the infusion two additional resonances were observed at 62 and -64 Hz relative to the unlabeled resonance of C3 lactate which were assigned on the basis of chemical shift and relative intensity to [3-13C]lactate. The [3-13C]lactate fractional enrichment in the infarct region was measured to be 32% which is within error one-half the average [1-13C]plasma glucose enrichment during the postinfusion NMR measurement. The result suggests that the stroke lactate pool was completely derived from infused glucose.     

Immune interactions at the maternal-fetal interface

Models of murine allogeneic pregnancy have established that maternal T cells recognize fetal alloantigens and are normally suppressed or deleted. While the precise cellular interactions and mechanisms involved in maternal lymphocyte tolerance are not yet clear, the identity of some of the critical factors are beginning to be uncovered. Signals that have been shown in mice to have an obligatory role in immunological survival of the semiallogeneic fetus include, but are probably not limited to, indoleamine-2,3-dioxygenase and the newly discovered B7 family protein, B7-H1. Whether these proteins have intersecting functions is unknown, but it is possible that both are involved in the control of maternal T regulatory cells, which are also strictly required for successful allogeneic pregnancy in mice. Additional factors that are involved include trophoblast and/or maternally derived FasL, and in humans, class Ib HLA molecules. The potency of these mechanisms in protecting the fetal allograft is underscored by the scarcity of knockout and transgenic models in which pregnancy is immunologically compromised. Here, the current understanding of mechanisms of specific suppression of maternal lymphocytes is reviewed.     

Beitrag zum posttraumatischen Diabetes insipidus

Zusammenfassung Der posttraumatische Diabetes insipidus neurohormonalis als Ausdruck einer traumatisch gest?rten Zwischenhirn-Hypophysenfunktion ist selten. In der Therapie bewu?tloser Sch?delhirnverletzter ist eine genaue Flüssigkeitsbilanz von besonderer Bedeutung, da bei diesen Patienten die Polydipsie als Alarmsymptom eines Diabetes insipidus fehlt und folgenschwere Elektrolytentgleisungen m?glicherweise erst sp?t erkannt werden. Infolge der au?erordentlich gro?en Regenerationskraft der Neurohypophyse und der gro?en Regulationsbreite des neurosekretorischen Systems bilden sich leichte Diabetesinsipidus-Formen fast immer zurück. Auch bei schweren Formen gelingt es, unter entsprechender Elektrolyt- und Substitutionstherapie mit ADH in Kombination mit Tegretol eine Ausheilung oder doch zumindest eine wesentliche Besserung zu erreichen.

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Summary The post-traumatic diabetes insipidus neurohormonalis as symptom of a traumatically disturbed function of hypothalamus and neurohypophysis is comparatively rare.—Regarding the intensive care of unconscious craniocerebral injured persons an exact balance of body-water is of particular importance, since in case of these patients: the polydipsia having the signification of an alarming symptom of diabetes insipidus is missing and since disturbances of electrolytic metabolism of great consequence are often diagnosed at a later date.—In consequence of the effective regeneration force of the neurohypophysis and of the function of hypothalamus, slight forms of diabetes insipidus recede nearly always. —Even in case of occurrence of more severe forms it is possible by an appropriate therapy with electrolytes or with substitution of ADH in combination with Tegretol to achieve a normal function or at least a substantial change recovery.

     

Die homologe Transplantation des Ureters

Zusammenfassung Gekreuzte homologe Transplantationsversuche am Kaninchen, die das überleben eines von Niere und Blase getrennten denudierten Ureters nach Einhüllen in das gro?e Netz zum Ziel hatten, verliefen nach Vorbehandlung mit Spenderantigen, Thioamphenicol und Kortikosteroiden und Weiterbehandlung mit Azathioprin durch 4 Wochen erfolgreich.

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Summary Homologous transplantation of the ureter of the rabbit were carried out to investigate survival of the ureters separated from the kidney and the bladder and wrapped into the omentum majus. Transplantations were successful in animals pretreated with donor antigen, Thioamphenicol and corticosteroids and receiving postoperative Azathioprin medication.

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Auszugsweise vorgetragen auf der 17. Tagung der ?sterreichischen Gesellschaft für Chirurgie, Salzburg, 27. bis 29. Mai 1976.     

Der Wert der bakteriologischen Untersuchung von Redon-Drainspitzen bei der Erkennung post-operativer Wundinfektionen in der Traumatologie

Zusammenfassung Bericht über bakteriologische Untersuchungen von 100 Redon-Drainspitzen, die nach 100 aseptischen Operationen auf dem Gebiet der Traumatologie durchgeführt wurden. Keimbefall war in 13 F?llen (13%) nachweisbar. Es trat keine Wundheilungsst?rung oder Infektion auf. Das positive Bakteriogramm von Redon-Drainspitzen berechtigt nicht zur Annahme einer Wundinfektion und erm?glich keine spezifische antibiotische Therapie.

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Summary 100 tips of removed Redon-suction-drainage-tubes were examined bacteriologically, following 100 aseptic operations. Germs were found in 13 cases (13 per cent). In none of these 100 successive patients wound healing was disturbed, no infection was seen. Therefore a positive bacteriogram obtained from the tips of removed Redon-tubes is neither evidence for a wound infection nor an indicator for a specific antibiotic treatment.

     

Vigabatrin increases human brain homocarnosine and improves seizure control

Homocarnosine, a dipeptide of γ-aminobutyric acid (GABA) and histidine, is thought to be an inhibitory neuromodulator synthesized in subclasses of GABAergic neurons. Homocarnosine is present in human brain in greater amounts (0.4–1.0 μmol/g) than in other animals. The antiepileptic drug vigabatrin increases human cerebrospinal fluid homocarnosine linearly with daily dose. By using ¹H nuclear magnetic resonance spectroscopy, serial occipital lobe GABA and homocarnosine concentrations were measured in 11 patients started on vigabatrin. Daily low-dose (2 g) vigabatrin increased both homocarnosine and GABA. Larger doses of vigabatrin (4 g) further increased homocarnosine but changed GABA levels minimally. Seizure control improved with increasing homocarnosine and GABA concentrations. Patients whose seizure control improved with the addition of vigabatrin had higher mean homocarnosine, but the same mean GABA concentrations, than those whose seizure control did not improve. Increased homocarnosine may contribute to improved seizure control.