The effects of exercise on skeletal and heart muscle citrate synthase and carnitine palmitoyltransferase mRNA expressions in high-calorie fed rats.

In this study, the effect of high-calorie feeding and aerobic exercise on skeletal and cardiac muscle citrate synthase (CS), carnitine palmitoyltransferase-I (CPT-I), and -II (CPT-II) mRNA expressions were evaluated. Genetically non-obese rats were grouped as normal-high calorie and sedentary-exercising. Gastrocnemius-soleus and heart muscles' CS, CPT-I, and CPT-II expressions and skeletal muscles' histopathological characteristics were evaluated. High-fat diet had increased body weight by 10% and aerobic exercise did not make any difference. Skeletal muscle CS expression was increased significantly in normal-calorie exercising group. Exercise and high-fat diet did not change CPT-I and CPT-II expressions in both heart and skeletal muscle. Histopathological evaluations demonstrated increased cytoplasmic lipid droplets in high-calorie fed sedentary rats, and exercise had reduced lipid droplets in skeletal muscle. Also, both mitochondria and nuclei distribution were impaired in high-calorie groups. In conclusion, aerobic exercise without food restriction was not enough to make significant changes in fat transportation mechanism into skeletal and heart muscle.

A Comparison of the Maximal Fat Oxidation Rates of Three Different Time Periods in The Fatmax Stage.

This study aimed to compare the maximal fat oxidation (MFO) rates obtained from the stage average, last 2 min average, and highest value in the Fatmax stage determined with a 6 min step protocol. A total of 35 overweight, sedentary healthy men (age: 25.4 ± 0.7 years, body mass index: 26.0 ± 0.6 kg/m2) participated in the study. Substrate oxidation was calculated using breath-by-breath gas exchange data for each stage. When the change in the fat oxidation rate for every min throughout the Fatmax stage was evaluated, the average value of the 4th min was significantly lower than that of the 2nd and 3rd min (p < 0.01). In addition, the 5th and 6th min fat oxidation rates were significantly lower than the rates of the 1st, 2nd, 3rd, and 4th min (0.30 ± 0.01 and 0.29 ± 0.01 g/min for the 5th and 6th min, respectively, vs. 0.35 ± 0.02, 0.34 ± 0.02, 0.33 ± 0.02, and 0.31 ± 0.01 g/min for the 1st, 2nd, 3rd, and 4th min, respectively; p < 0.01). Most of the participants had MFO rates in the 1st min of the stage (16/35 participants), and the MFO rates of the remaining participants were observed in the 2nd, 3rd, and 4th min (7/35, 4/35, and 8/35 participants, respectively). None of the participants had MFO rates in the 5th or 6th min. The individual MFO rate (highest fat oxidation rate during Fatmax) was significantly higher than the fat oxidation rate calculated with the last 2 min average values (0.36 ± 0.02 and 0.30 ± 0.01 g/min, respectively; p < 0.05). In conclusion, the calculation of the fat oxidation rate by averaging the last portion of the Fatmax stage data may cause the underestimation of the MFO rate, which probably occurs earlier in the Fatmax stage.

Neurological complications after liver transplantation.

This was a single-centre, prospective study to assess the frequency of neurological complications and their impact on prolonged hospitalization in 137 liver transplant patients presenting between September 1997 and June 2010. Neurological complications were seen in 22 (16%) patients during their postoperative stay in the intensive care unit. Complications included new-onset, recurrent headache (five patients), generalized seizures (four patients), dysarthria (two patients), delirium with agitation (three patients), persistent flapping tremor (two patients), alteration in level of consciousness (three patients), central pontine myelinolysis (one patient), myopathy (one patient) and visual hallucinations (one patient). Seizures were associated with immunosuppressive drug toxicity (tacrolimus). Myopathy presenting as quadriplegia was diagnosed by muscle biopsy. The patient with central pontine myelinolysis lived in a persistent vegetative state for 2 years and died of pneumonia. In conclusion, neurological complications are frequently encountered after liver transplantation, and are an important cause of severe morbidity and prolonged intensive care unit and hospital stay.

Determination of pK(a) values of some hydroxylated benzoic acids in methanol-water binary mixtures by LC methodology and potentiometry.

An accurate estimation of pK(a) values in methanol-water binary mixtures is very important for several separation techniques such as liquid chromatography and capillary electrophoresis that use these solvent mixtures. In this study, the pK(a) values of 11 polyphenolic acids have been determined in methanol-water binary mixtures (10%, 20% and 30% (v/v)) by potentiometry, liquid chromatography (LC) and LC-DAD methodology. The results show a similar trend for the pK(a) values of all the studied compounds, as they increase with increasing concentration of organic modifier, which allows a linear relationship between pK(a) values and mole fraction of methanol to be obtained. The pK(a) values obtained in aqueous medium have been compared with those given in the literature, and also with the values predicted by the SPARC on-line pK(a) calculator. The data obtained have been used to test the feasibility of an estimation of dissociation constants in a methanol-water medium from the relationship between pK(a) values and the organic cosolvent fraction in the mixtures.

Correlation of peripheral venous pressure and central venous pressure in kidney recipients.

BACKGROUND AND OBJECTIVE: Previous studies in adults have demonstrated a clinically useful correlation between central venous pressure (CVP) and peripheral venous pressure (PVP). The current study prospectively compared CVP measurements from a central versus a peripheral catheter in kidney recipients during renal transplantation. METHODS: With ethics committee approval and informed consent, 30 consecutive kidney recipients were included in the study. We excluded patients who had significant valvular disease or clinically apparent left ventricular failure. For each of 30 patients, CVP and PVP were measured on five different occasions. The pressure tubing of the transducer system was connected to the distal lumen of the central or to the peripheral venous catheter for measurements following induction of anesthesia, after induction, 1 hour after induction, reperfusion of the kidney, and the end of the operation, yielding 150 hemodynamic data points. Each hemodynamic measurement included heart rate, mean arterial pressure, mean CVP, and mean PVP determined at end-expiration. RESULTS: The mean PVP was 13.5 +/- 1.8 mm Hg and the mean CVP was 11.0 +/- 1.5 mm Hg during surgery. The mean difference was 2.5 +/- 0.5 (P < .01). Repeated-measures analysis of variance indicated a highly significant relationship between PVP and CVP (P < .01) with a Pearson correlation coefficient of 0.97. CONCLUSION: Under the conditions of this study, PVP showed a consistently high agreement with CVP in the perioperative period among patients without significant cardiac dysfunction.

Effects of hyperbaric spinal ropivacaine for caesarean section: with or without fentanyl.

BACKGROUND AND OBJECTIVE: Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoing caesarean section under spinal anaesthesia. METHODS: Thirty-seven healthy, full-term parturients were randomly assigned into two groups: Group S (saline group, n=17) received 15 mg hyperbaric ropivacaine in 2.5 mL + 0.5 mL saline; Group F (fentanyl group, n=20) received 15 mg hyperbaric ropivacaine in 2.5 mL + 10 microg fentanyl in 0.5 mL, intrathecally. Characteristics of spinal block, intraoperative quality of spinal anaesthesia, time to first feeling of pain (complete analgesia), time to first request of analgesics postoperatively (effective analgesia), side-effects and fetal outcomes were evaluated. RESULTS: Regression of sensory block to L5 was significantly prolonged in the fentanyl group compared with the saline group (P = 0.001). Time to the first feeling of pain (130.6 +/- 15.8 min vs. 154.3 +/- 31.1 min; P = 0.008) and the first analgesic requirement (161.2 +/- 32.6 min vs. 213.0 +/- 29.3 min; P < 0.001) were significantly shorter in the saline group compared with the fentanyl group. Side-effects, umbilical arterial and venous blood gases did not differ between the groups. Apgar scores were similar in both groups and no infants had an Apgar score < or =7 at 5 min. CONCLUSIONS: The addition of fentanyl 10 microg, to hyperbaric ropivacaine 15 mg, for spinal anaesthesia increased the duration of analgesia in the early postoperative period in patients undergoing caesarean delivery.

Intrathecal fentanyl added to hyperbaric ropivacaine for transurethral resection of the prostate.

BACKGROUND: Our purpose was to evaluate the effect of intrathecal fentanyl 25 microg added to 18 mg of 6 mg ml(-1) hyperbaric ropivacaine on the characteristics of subarachnoid block and postoperative pain relief in patients undergoing TURP surgery. METHODS: The patients were randomly assigned into two groups: Group S (saline group, n=16) received 3 ml of 18 mg hyperbaric ropivacaine + 0.5 ml saline--in total, a 3.5-ml volume intrathecally; and Group F (fentanyl group, n=15) received 3 ml of 18 mg hyperbaric ropivacaine + 0.5 ml of 25 microg fentanyl--in total, a 3.5-ml volume intrathecally. In both groups the onset and recovery times of the sensory block, degree and recovery times of the motor block and side-effects were recorded and statistically compared. RESULTS: There was no significant difference between the groups in achieving the highest level of sensory block, and in the times taken to reach the peak level. Regression to L1 was significantly prolonged in the fentanyl group compared with the saline group (P=0.004). Times to the first feeling of pain and the first analgesic requirement were significantly prolonged in the fentanyl group compared with the saline group (P=0.011 and P=0.016, respectively). The frequency of pruritus was significantly higher in the fentanyl group compared with the saline group (P=0.022). CONCLUSION: Addition of fentanyl 25 microg to hyperbaric ropivacaine 18 mg for spinal anesthesia in patients undergoing TURP may significantly improve the quality and prolong the duration of analgesia, without causing a substantial increase in the frequency of major side-effects.

The analgesic and sedative effects of intrathecal midazolam in perianal surgery.

BACKGROUND AND OBJECTIVE: Our purpose was to evaluate the analgesic and sedative effects of intrathecal midazolam when added to spinal bupivacaine in patients undergoing perianal surgery under spinal anaesthesia. METHODS: Forty-four patients were randomly allocated into two equal groups: Group I (B) received hyperbaric bupivacaine 0.5% 2 mL + saline 0.9% 1 mL in a total volume of 3 mL intrathecally; Group II (BM) received hyperbaric bupivacaine 0.5% 2 mL + 1 mL of 2mg preservative-free midazolam in a total volume of 3 mL intrathecally. In both groups, the onset and recovery times of sensory block, the degree and recovery times of motor block as well as the sedation and visual analogue pain scores were recorded, and statistically compared. RESULTS: In Group BM, the postoperative visual analogue pain scores were significantly lower at the first 4 h (P < 0.05), the average time until the first dose of additional analgesic requirement was significantly longer (P < 0.05), and sedation scales were significantly higher (P < 0.05), compared to Group B. There were no statistically significant differences in the onset and the full recovery times of sensory and motor blocks in the two groups. CONCLUSION: The use of intrathecal midazolam combined with intrathecal bupivacaine produces a more effective and longer analgesia with a mild sedative effect in perianal surgery.

The pterion in Turkish male skulls.

This study was conducted to determine the location and type of pterion in Turkish males. The importance of the pterion is its relation to the middle meningeal artery, Broca's motor speech area on the left side, and surgical interventions relating to pathologies of the sphenoid ridge and optic canal. Specific measurements were taken on both sides of 26 Turkish human male skulls, none of which showed any obvious pathology or trauma. The sphenoparietal type of pterion was the most common (96% right side, 79% left side), followed by the frontotemporal (4% right side, 17% left side), and finally the epipteric type (4% left side only). The distances on the right and left sides respectively from the center of the pterion to the frontozygomatic suture were 3.30+/-0.40 cm and 3.44+/-0.39 cm, to the zygomatic arch 4.05+/-0.39 cm and 3.85+/-0.25 cm, to the optic canal 4.39+/-0.40 cm and 4.36+/-0.40 cm, and to the sphenoid ridge 1.40+/-0.33 cm and 1.48+/-0.32 cm. The thickness of the skull at the center of the pterion was 0.41+/-0.14 cm and 0.39+/-0.12 cm on the right and left sides respectively. These findings should be of use in surgical approaches and interventions via the pterion.

Pathogenesis of high-altitude pulmonary edema / Patogénesis de la edeme pulmonar en la altura

Ratas Sprague-Dawley de la especie Madison fueron expuestas a baja presión barométrica de 294 y 236 torr, o 8.5 por ciento de oxígeno a presió normal por 8-10 horas. Esto resultó en un aumento de la presión de la arteria pulmonar y de la presión sistólica ventricular derecha de 30.5 a 49 torr. Los estudios ultraestructurales del pulmón mostraron evidencia de una insuficiencia por stress de los capilares pulmonares que incluyen una interrupción de la capa endotelial capilar, la capa epitelial alveolar, o todas las capas de la pared, eritrocitos y edema en el intersticio de la pared alveolar, fluido proteinaceo y eritrocitos en los espacios alveolares, y protusiones llenas del líquido del endotelio en la luza de los capilares. Estas características son consistentes con los cambios estructurales previamente hemos descrito en pulmones de conejos cuando los capilares son expuestos a altas presiones transmurales, lo que fuertemente sugiere que la patogénesis de HAPE es una insuficiencia por stress de los capilares pulmonares.