Thermogenic response to intravenous nutrition in patients with cirrhosis.

Energy expenditure was determined using continuous indirect calorimetry in the basal state and during 3 h of total parenteral nutrition (TPN) in 8 patients with cirrhosis and 8 healthy volunteers. TPN consisted of glucose, fat and amino acids and had a glucose/fat ratio of 50:50. The infusion rate was set to provide energy corresponding to 62.

Esmolol infusion during nitroprusside-induced hypotension: impact on hemodynamics, ventricular performance, and venous admixture.

The impact of esmolol infusion on hemodynamics, ventricular performance, venous admixture, sympathoadrenal, and renin-angiotensin system responses during sodium nitroprusside (SNP)-induced hypotension was studied in 11 patients undergoing lymph node dissection during general anesthesia with 60% nitrous oxide and fentanyl. Radial arterial and thermistor-tipped pulmonary catheters were employed for hemodynamic monitoring. Arterial and mixed venous blood gas tensions, arterial plasma renin activity (PRA), and plasma catecholamine levels were measured.

Histone acetylation and globin gene switching.

An affinity-purified antibody that recognises the epitope epsilon-acetyl lysine has been used to fractionate chicken erythrocyte mononucleosomes obtained from 5 and 15 day embryos. The antibody bound chromatin was enriched in multiply acetylated forms of the core histones H3, H4 and H2B, but not in ubiquitinated H2A. The DNA of these modified nucleosomes was probed with genomic sequences from the embryonic beta rho gene (active at 5 days) and from the adult beta A gene (active at 15 days).

Heat leakage across the abdominal wall and meal-induced thermogenesis in normal-weight and obese subjects.

The mechanism behind the meal-induced increase in energy expenditure in humans and its reduction in obesity was examined in 15 normal-weight and seven obese subjects. The subjects were studied by indirect calorimetry in the basal state and during 2 hours after a mixed meal corresponding to 40% of the 24-hour basal energy requirement. Artificial thermal insulation was applied over the abdominal area before the study in seven of the normal-weight subjects.

Decreased insulin-stimulated 3-0-methylglucose transport in in vitro incubated muscle strips from type II diabetic subjects.

Peripheral insulin resistance in type II diabetes mellitus has been attributed to alterations in skeletal muscle glucose metabolism. However the direct dose-response relationship between insulin and glucose transport has not yet been studied in human skeletal muscle. We investigated 3-0-methylglucose transport in in vitro incubated skeletal muscle strips from eight healthy controls (age 61 +/- 6 yrs) and six lean type II diabetic patients treated with oral antidiabetic medication (age 73 +/- 3 yrs).

Metformin increases insulin-stimulated glucose transport in insulin-resistant human skeletal muscle.

The effect of metformin (0.1 mM) on glucose transport was investigated in healthy control and in insulin-resistant human skeletal muscle. Muscle samples (200-400 mg) were obtained from the rectus abdominis muscle (abdominal surgery) or from the vastus lateralis portion of the quadriceps femoris muscle (open biopsy technique) from 8 healthy controls (age 38 +/- 4 yrs, BMI 23 +/- 1) and from 6 insulin-resistant subjects (age 53 +/- 5 yrs, BMI 30 +/- 2).

Anticholinergic challenge and cognitive functions: a comparison between young and elderly normal subjects.

Challenges of the central cholinergic function with anticholinergic agents have been shown to produce disruption of cognitive performance in young normal people. The purpose of the study was to compare the effects of a low dose of scopolamine in young and elderly subjects and to determine which cognitive functions are most sensitive to disruption by anticholinergics in an elderly population. Scopolamine (0.

Energy expenditure and outcome in patients with multiple organ failure following abdominal surgery.

A possible relationship between hypermetabolism (energy expenditure expressed as percentage above the estimated basal metabolic rate) and clinical outcome was investigated in 29 artificially ventilated patients with infection and multiple organ failure following abdominal surgery. The average energy expenditure and hypermetabolism were 126 +/- 19 kJ (30 +/- 5 kcal)/kg/24 h and 36 +/- 12%, respectively. Survivors of the intensive care period (n = 20) had a 15% higher hypermetabolism (41 +/- 11 vs 26 +/- 8%, p less than 0.

Pharmacologic treatment of noncognitive behavioral disturbances in elderly demented patients.

Fifty-nine elderly residents of long-term care facilities who had DSM-III diagnoses of dementia were studied in an 8-week randomized, double-blind comparison trial of haloperidol, oxazepam, and diphenhydramine to test the efficacy of these agents in the treatment of clinically significant behavioral disturbances in patients with dementia. All three agents demonstrated modest but significant efficacy as measured by clinician ratings of agitated behavior and activities of daily living. The absolute magnitude of improvement was greater for haloperidol and diphenhydramine than for oxazepam, but differences among groups did not approach statistical significance.

Patterns of histone acetylation.

The N-terminal domains of all four core histones are subject to reversible acetylation at certain lysine residues. This modification has been functionally linked to transcription, histone deposition at replication and to histone removal during spermatogenesis. To increase understanding of the significance of this modification we have studied the specificity of site utilisation in the monoacetyl, diacetyl and triacetyl forms of histones H3, H4 and H2B (histone H2A has only a single modification site), using pig thymus and HeLa cells as the source of histones.

Diminished meal-induced thermogenesis in elderly man.

The purpose of this study was to examine the possible influence of age on thermogenic response to a mixed meal in healthy subjects. Twenty-five healthy male subjects participated in the study and they were divided into three groups, comprising 10 young subjects with an average age of 27 years (22-35 years), seven middle-aged individuals (51 years, 42-60 years) and eight elderly men (70 years, 67-74 years). They were all studied with continuous indirect calorimetry in the basal state and for 3 h after the ingestion of a mixed meal in liquid form.

Muscle and plasma amino-acid patterns in severely depleted surgical patients.

Plasma and muscle free amino-acid concentrations were determined in 7 post-operative patients with extensive skeletal muscle protein depletion, and in a group of age- and sex-matched volunteers. All patients had a slightly positive energy balance during the study as verified by indirect calorimetry. In plasma, the concentration of phenylalanine was increased whereas threonine, isoleucine, leucine, serine, glutamine, glycine, citrulline, ornithine, histidine and arginine concentrations were reduced.

The effect of carnitine supplementation on carnitine balance in patients with persistent post-operative infection.

The effect of L-carnitine (C) supplementation on body C balance, muscle C concentration, the leg exchange of C and some amino-acids was investigated in 8 patients with persistent post-operative infection. Before supplementation, total C concentration was 81 +/- 13 micromol/l plasma (SEM) and 15.4 +/- 1.

Accuracy of plasma turbidity measurement for determining fat intolerance during total parenteral nutrition.

The accuracy of plasma turbidity measurements in predicting ability to metabolise intravenous fat emulsions during total parenteral nutrition was studied in 35 adult surgical patients. Plasma turbidity, expressed as a light scattering index (LSI), was determined by nephelometry and compared with measured triglyceride (TG) concentrations. A poor coefficient of correlation was found between LSI and TG (r = 0.

Awareness and general anaesthesia.

A state exists after the induction of anaesthesia in which patients may be aware of their surroundings yet unable to communicate. This problem of awareness and recall during general anaesthesia is a recent one in the relatively short history of anaesthesia. Prior to the introduction of muscle relaxants in 1942 by Griffith and Johnson, it was felt that "light anaesthesia" would be signified by violent movements.

Meal-induced thermogenesis in previously obese patients.

Meal-induced thermogenesis is reported to be reduced in obese patients and the purpose of this study was to find out whether thermogenesis after a mixed meal differs between previously obese (post-obese) subjects and non-obese controls. Nine post-obese patients (body mass index 27 +/- 1) and nine age- and sex-matched non-obese volunteers (body mass index 22 +/- 1) were studied with continuous indirect calorimetry in the basal state and after the ingestion of a standardized test meal. Following treatment with vertical banded gastroplasty for the obesity, the weight of the patients had decreased by an average of 44 +/- 5 kg.

Diet-induced thermogenesis. An experimental study in healthy and obese individuals.

Diet-induced thermogenesis (DIT) denotes the increase in energy expenditure that occurs in response to food ingestion. The purpose of the present study was to examine the possible influence of age, training state and sympatho-adrenal activity on the early phase of DIT in healthy individuals and further to study whether the magnitude of DIT is reduced in human obesity and, if so, to what extent DIT is influenced by weight reduction induced by surgical treatment, i.e.

Muscle alkali-soluble protein, carnitine, water and electrolytes in patients with persistent post-operative infection.

The muscle contents of water, electrolytes, creatine, alkali-soluble protein (ASP) and carnitine were determined using percutaneous muscle biopsy technique. Seven patients with prolonged catabolic states and subsequent respiratory failure were studied. Twelve age- and sex-matched healthy subjects were used for comparison.

Meal-induced thermogenesis in obese patients before and after weight reduction.

The purpose of this study was to find out whether human obesity is associated with a diminished meal-induced thermogenesis and, if so, to what extent this response is influenced by weight reduction. Ten obese subjects (body mass index 42 +/- 2) and 10 age- and sex-matched non-obese volunteers were studied with continuous indirect calorimetry in the basal state and after the ingestion of a standardized test meal. Six obese subjects (body mass index 44 +/- 2) were examined on two occasions, once before and once after gastric banding and an average weight reduction of 18 +/- 3 kg.

A "minimal epitope" anti-protein antibody that recognises a single modified amino acid.

Antibodies that recognise proteins bind to epitopes of varying size, but a grouping of the order of six amino acids, contiguous or not, is regarded as a typical number. By using as immunogen a highly abundant and universal eukaryotic nuclear protein (histone H4) modified in a manner not typical of secreted proteins (acetylation of lysine side chains), antiserum has been raised in rabbits having the single amino acid epsilon-N-acetyl lysine as the recognition epitope. The affinity-purified antibody should be useful for studying the functional role of this modification.

Beta-adrenergic blockade does not influence the thermogenic response to a mixed meal in man.

The sympathetic nervous system has been implicated in the regulation of glucose-induced thermogenesis in man. The present study was undertaken to examine the influence of a pharmacological beta blockade on the thermogenic response after ingestion of a mixed meal. Ten healthy male volunteers were examined on two occasions, once during intravenous administration of beta-blocking agent (Series 1) and once without (Series 2).

Esmolol for potentiation of nitroprusside-induced hypotension: impact on the cardiovascular, adrenergic, and renin-angiotensin systems in man.

Esmolol infusion at rates of 200, 300, and 400 micrograms.kg-1.min-1 was used to potentiate hypotension (mean arterial pressure = 60 mm Hg) induced with sodium nitroprusside (SNP) in 10 male patients undergoing radical cancer surgery during nitrous oxide-oxygen and fentanyl anesthesia.