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Bioactivity of a peptide derived from acetylcholinesterase in hippocampal organotypic cultures.

While the molecular basis underlying the non-classical actions of acetylcholinesterase (AChE) is presently unknown, a candidate peptide sequence located at the C-terminus of AChE (AChE-peptide) has recently been identified. This study explored the bioactivity of synthetic AChE-peptide using in vitro organotypic cultures of rat hippocampus. Neurotrophic effects, detected as increased neurite outgrowth from MAP-immunopositive neurones, were apparent using 1 h exposure to 1-10 nM AChE-peptide. As exposure time increased, cell death occurred as indicated by TdT-mediated dUTP biotin nick-end labelling (TUNEL). This process was accelerated at higher AChE-peptide concentrations, with lactate dehydrogenase (LDH) efflux observed following prolonged exposure to 1-10 microM AChE-peptide. Apoptotic cells were detected by Hoechst 33342 staining following 24 h application of 10 nM AChE-peptide. However, propidium iodide reactivity revealed a simultaneous loss of membrane integrity indicative of necrosis, suggesting that AChE-peptide induces cell death via a continuum of apoptotic and necrotic processes. Prolonged exposure to AChE-peptide also resulted in a concentration-dependent reduction in neurite outgrowth from MAP2-positive neurons, although immunohistochemical studies provided some evidence of differential responsiveness in GABAergic, cholinergic and somatostatin neurones. In addition, bioactivity was sequence specific since a scrambled AChE-peptide analogue, as well as the corresponding BuChE-peptide, was ineffective. In conclusion, the bioactivity associated with the AChE-peptide sequence may account for the non-cholinergic actions of AChE, whilst its neurotrophic-apoptotic-necrotic spectrum of action may be involved in the aetiology of neurodegenerative disorders such as Alzheimer's disease.

Acetylcholinesterase↗

Comparison of various exercise tests with endurance performance during soccer in professional players.

To evaluate exercise procedures to test the endurance capacity during soccer, individual results in laboratory and field tests were compared to physical performance during the match and further to performance during long term, intermittent exercise. Twenty professional soccer players were video-taped during competitive soccer matches, and the longest total distance (match-distance) and high intensity distance were determined. Blood lactate and maximum oxygen uptake (VO2max) were measured during treadmill running. The subjects also carried out a continuous and an interval field test. Furthermore, eight players performed a prolonged, soccer-specific, intermittent test to exhaustion. Muscle enzymes and morphological characteristics were determined in biopsy samples obtained from the m. gastrocnemius. The distance covered during the prolonged, intermittent test (mean: 16.3 km; range: 14.8-18.5 km) was not related to match-distance (r = 0.16), however, its correlation coefficient with high intensity distance covered during the match was 0.70. The interval field test distance was strongly correlated (r = 0.83) with the distance covered during the prolonged, intermittent test distance. VO2max (r = 0.64) and blood lactate concentrations during submaximal running (r = 0.58) were related to match-distance, but not to the prolonged intermittent test distance (r = 0.18 and r = 0.27, respectively). The muscle enzyme activities and the morphological variables were not related to match activities nor to prolonged, intermittent exercise performance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Small accumulation of inosine monophosphate (IMP) despite high lactate levels in latissimus dorsi during transplantation.

The effects of prolonged ischaemia and subsequent reperfusion during and after reconstructive microsurgery on energy metabolism were studied. Repeated skeletal muscle biopsies were taken and analysed for high energy phosphates and their degradation products by high performance liquid chromatography and for lactate by a fluorometric procedure. Moderate changes in adenine nucleotides occurred during the first 4 h of ischaemia. After 6 h of ischaemia, when the creatine phosphate store was almost depleted and the lactate level had increased to 111 mmol kg-1 dry muscle, ATP content decreased and inosine monophosphate started to accumulate. The inosine monophosphate accumulation was however small, in spite of a high lactate level, which suggests that the increase in H+ associated with lactate formation is not important for the activation of AMP-deaminase during the present conditions. In spite of the accelerating metabolic deterioration during the later period of ischaemia, the reperfusion of the muscle resulted in a rapid normalization of all the studied metabolites, thereby indicating a rapid restoration of the muscle energy stores.

AMP Deaminase↗

Adaptations in muscle metabolism to prolonged voluntary exercise and training.

In previous research we established using a short-term (5-7 days) training model that increases in muscle oxidative potential are not a prerequisite for the characteristic energy metabolic adaptations (lower lactate, glycogen depletion, and phosphocreatine hydrolysis) observed during prolonged exercise. To investigate whether increased muscle aerobic potential further potentiates the metabolic adaptive response, seven healthy male volunteers [maximal O2 uptake (VO2max) = 45.1 +/- 1.1 (SE) ml.kg-1.min-1] engaged in an 8-wk training program consisting of 2 h of cycle exercise at 62% of pretraining VO2max 5-6 times/wk. Analysis of tissue samples obtained from the vastus lateralis after 60 min of exercise revealed that by 4 wk of training muscle lactate concentration, phosphocreatine hydrolysis, and glycogen depletion were depressed (all P < 0.05). Further training for 4 wk had no additional effect (P < 0.05). The ratio of fructose 6-phosphate to fructose 1,6-phosphate, an index of phosphofructokinase activity, was not altered with training. Muscle oxidative potential as estimated from the maximal activity of succinic dehydrogenase increased by 31% by 4 wk of training (P < 0.05) before plateauing during the final 4 wk of training. The increase in VO2max of 15.6% (P < 0.05) noted with training was also primarily expressed during the initial 4 wk. O2 uptake during submaximal exercise was unchanged. Because the metabolic response was similar in magnitude to that previously observed with short-term training, we conclude that, at least for the conditions of this study, the development of increased muscle aerobic potential is of minimal consequence on the magnitude of the energy metabolic adaptations examined.

Adaptation, Physiological↗

Pleuritis as a manifestation of reactivation tuberculosis.

PURPOSE: The purpose of this study was to determine the frequency with which tuberculous pleuritis is a manifestation of reactivation tuberculosis and to compare the clinical manifestations of reactivation tuberculous pleuritis with "classic" tuberculous pleuritis, in which chest roentgenograms reveal no parenchymal infiltrates. PATIENTS AND METHODS: We evaluated the medical records of 59 patients in whom tuberculous pleuritis was confirmed by histologic findings or mycobacterial culture. Twenty-seven patients (46%) had typical chest roentgenographic findings of reactivation tuberculosis, whereas 32 (54%) had classic tuberculous pleuritis. The clinical and laboratory features of these two groups were compared. RESULTS: Symptoms were more prolonged and pleural fluid glucose and lactate dehydrogenase concentrations were more markedly abnormal in patients with reactivation pleuritis than in those with classic pleuritis, suggesting a more chronic inflammatory process in the former group. Compared with patients with classic tuberculous pleuritis, those with reactivation pleuritis had a lower frequency of reactive tuberculin skin tests (61% versus 88%) and granulomatous pleural inflammation (25% versus 72%), but a higher bacillary burden, manifest by a higher frequency of positive sputum smears for acid-fast bacilli (50% versus 0%) and positive mycobacterial cultures from sputum (60% versus 23%) and pleural fluid (91% versus 66%). CONCLUSIONS: In contrast to previous reports, tuberculous pleuritis was a manifestation of reactivation tuberculosis in 46% (27 of 59) of patients. Tuberculous pleuritis is a more chronic process in patients with reactivation disease than in those with classic pleuritis. The lower frequency of reactive tuberculin skin tests and granuloma formation, combined with the higher bacillary burden in patients with reactivation pleuritis, suggest that these patients mount a less effective immune response to Mycobacterium tuberculosis infection than do patients with the classic form of tuberculous pleuritis.

Adult↗

Cellular defense against oxidized low density lipoproteins and fibrillar amyloid beta in murine cells of monocyte origin with possible susceptibility to the oxidative stress induction.

Reactive oxygen species (ROS) are associated with aging and the correlation between Alzheimer's disease and atherosclerosis is a subject of the discussion. The aim of this study was to determine whether genetic factors affect cellular defense against cytotoxic beta-amyloid (Abeta) which is considered to be the source of ROS. Low levels of Abeta (1-10 microM) led to a significant suppression of redox potential as measured by MTT assay in bone marrow-derived cell lines. The atherosclerosis-resistant cells (GG2EE) were less affected than the susceptible cells (ANA1) in the time-, dose-, and Abeta species-dependent manner. Cell death in amyloid treated resident susceptible macrophages (C57BL/6J), measured by lactate dehydrogenase release, was induced during prolonged incubation and increased when compared with the resistant macrophages (C3H/HeJ, P = 0.005). SDS-PAGE showed that Abeta persisted intracellularly during this period. The cytotoxicity of oxidized low density lipoproteins (oxLDLs) significantly affected only the susceptible cells which actually lowered this cytotoxicity, thus, implying that the harmful effect of the oxLDLs was diminished when compared to that of Abeta. This fact demonstrates that in vitro the defense by cells of monocyte origin against Abeta may be determined in part genetically whereas the reaction to oxLDLs could be fully underlined by genetic susceptibility.

Amyloid beta-Peptides↗

Uric acid as a prognostic factor for survival time: a prospective cohort study of terminally ill cancer patients.

The aim of this prospective cohort study was to determine whether serum uric acid level is useful as a predictor of survival in terminally ill cancer patients. One hundred eighteen terminally ill cancer patients, including 63 (53.4%) males, were categorized into four groups by serum uric acid levels and followed up until death or to the end of the study. Cox's proportional hazard model was adopted to evaluate the joint effect of some clinicobiological variables on survival. From an initial model containing 51 variables, a final parsimonious model was obtained by means of a stepwise method. Repetitive dispersion analysis was performed for serum uric acid level in 39 subjects for 3 weeks until death. During the study period, 113 (95.76%) subjects expired, and the median survival time was 14 days. In univariate analysis, survival time of the fourth highest group (> or =7.2mg/dL) was significantly shorter than that of the others (hazard ratio (HR)=2.784, P<0.001). After adjustment for low performance status, moderate to severe pain, prolonged prothrombin time, hypocholesterolemia, and high lactate dehydrogenase (LDH) level, high serum uric acid level (> or =7.2mg/dL) was significantly and independently associated with short survival time (HR=2.637, P=0.001). Serum uric acid levels were also significantly increased between the first and the second week before death. These findings suggest that serum uric acid level can be useful in predicting life expectancy in terminally ill cancer patients.

Adult↗

Iron and copper in human milk.

The reported concentrations of iron and copper in breast milk show a wide variation. Research published over the past 50 y has reported median values of 0.47 and 0.32 mg/L for iron and copper, respectively. The levels of both metals decrease with the progress of lactation. The calculated iron-to-copper ratio of reported means differs from 0.25 to 6.29 (median = 1.18). Maternal constitutional variables such as undernutrition, iron and copper body reserves, stage of lactation, adolescent motherhood, gestation length, and infection and environmental variables such as iron and copper dietary intake, in addition to supplementation, smoking, vegetarianism, and prolonged use of hormonal contraceptives before and during lactation did not consistently affect the concentrations of iron and copper in breast milk. Extreme cases of either low or high levels of body metal availability or altered metabolism due to chelating therapy or illnesses such as Wilson's disease and infections did not affect metal transfer from blood serum to breast milk. There is no clinical or scientific support for the need of extra iron or copper, besides the quantities provided by milk in the full-term breast-fed infant, at least during the first 6 mo.

Contraceptives, Oral↗

Predictors of patients who will develop prolonged occult hypoperfusion following blunt trauma.

BACKGROUND: Prolonged occult hypoperfusion or POH (serum lactate >2.4 mmol/L persisting >12 hours from admission) represents a reversible risk factor for adverse outcomes following traumatic injury. We hypothesized that patients at increased risk for POH could be identified at the time of admission. METHODS: Prospective data from adult trauma admissions between January 1, 1998 and December 31, 2000 were analyzed. Potential risk factors for POH were determined by univariate analysis (p < or =0.10= significant). Significant factors were tested in a logistic regression model (LR) (p < or =0.05= significant). The predictive ability of the LR was tested by receiver operating curve (ROC) analysis (p < or =0.05= significant). RESULTS: Three hundred seventy-eight patients were analyzed, 129 with POH. Injury Severity Score (ISS), emergency department Glasgow Coma Scale score, hypotension, and the individual Abbreviated Injury Scale score (AIS) for Head (H), Abdominal/Pelvic Viscera (A) and Pelvis/Bony Extremity (P) were significantly associated with POH. LR demonstrated that ISS, A-AIS > or =3 and P-AIS > or =3 were independent predictors of POH (p <0.05). ROC analysis of the LR equation was statistically significant (Area=0.69, p <0.001). CONCLUSIONS: We identified factors at admission that placed patients at higher risk for developing POH. Select patients may benefit from rapid, aggressive monitoring and resuscitation, possibly preventing POH and its associated morbidity and mortality.

Abdominal Injuries↗

Effect of L-NAME, an inhibitor of nitric oxide synthesis, on cardiopulmonary function in human septic shock.

STUDY OBJECTIVES: We tested the effects of continuous infusion of N(G)-nitro-L-arginine methyl ester (L-NAME), an inhibitor of nitric oxide (NO) synthesis, on cardiovascular performance and pulmonary gas exchange in patients with hyperdynamic septic shock. DESIGN: Prospective clinical study. SETTING: ICU of a university hospital. PATIENTS: Eleven critically ill patients with severe refractory septic shock. INTERVENTIONS: Standard hemodynamic measurements were made and blood samples taken before, during, and after 12 h of continuous infusion of 1 mg/kg/h of L-NAME. MEASUREMENTS AND RESULTS: Continuous infusion of L-NAME increased mean arterial pressure (MAP) from 65+/-3 (SEM) to 93+/-4 mm Hg and systemic vascular resistance (SVR) from 962+/-121 to 1,563+/-173 dyne x s x cm(-5)/m2. Parallel to this, cardiac index (CI) decreased from 4.8+/-0.4 to 3.9+/-0.4 L/min/m2 and myocardial stroke volume (SV) was reduced from 43+/-3 to 34+/-3 mL/m2. Left ventricular stroke work was increased in the first hour of L-NAME infusion from 31+/-3 to 43+/-4 g x m/m2 (all p<0.01 compared with baseline). Heart rate, cardiac filling pressures, and right ventricular stroke work did not change significantly (p>0.05). L-NAME increased the ratio of arterial PO2 to the fraction of inspired O2 from 167+/-23 to 212+/-27 mm Hg (p<0.05). Venous admixture (QVA/QT) was reduced from 19.4+/-2.6% to 14.2+/-2.1% (p<0.05) and oxygen extraction ratio increased from 21.1+/-2.4% to 25.3+/-2.7% (p<0.05). Oxygen delivery (DO2) was reduced following L-NAME, whereas oxygen uptake and arterial lactate and pH were unchanged. CONCLUSIONS: Prolonged inhibition of NO synthesis with L-NAME can restore MAP and SVR in patients with severe septic shock. Myocardial SV and CI decrease, probably as a result of increased afterload, since heart rate and stroke work were not reduced. L-NAME can improve pulmonary gas exchange with a concomitant reduction in QVA/QT. L-NAME did not promote anaerobe metabolism despite a reduction in DO2.

Enzyme Inhibitors↗

Effects of prolonged intravenous infusions of adrenaline on glucose utilization, plasma metabolites, hormones and milk production in lactating sheep.

Lactating ewes received continuous intravenous infusions of adrenaline (0.05 micrograms/kg liveweight) for 4 days. Prior to, during and after adrenaline infusions, milk yield and composition were monitored. Plasma concentrations of metabolites and hormones were measured each day and glucose biokinetics were measured in non-steady state at the start and end of adrenaline infusions. During adrenaline infusion, milk yield and content of solids-not-fat decreased and milk fat content was reduced on the first day of infusion. Plasma glucose was raised throughout the period of adrenaline infusion, plasma lactate increased over the first 4 h from the start of infusion and plasma non-esterified fatty acids increased for 2 h at the start of infusion and tended to increase during the first 2-3 h after withdrawal of adrenaline. Plasma growth hormone remained relatively stable except for a marked increase at 30 min after withdrawal of adrenaline. At the start and immediately after withdrawal of adrenaline infusion plasma insulin was increased approximately twofold. Glucose production, but not utilization, increased at the start of infusions. Immediately after withdrawal of adrenaline glucose utilization increased 2.5-fold with a smaller response in glucose production. There was essentially no change in glucose clearance during adrenaline infusion but a marked increase occurred after withdrawal of adrenaline.

Animals↗

Efficacy of osmolality and ionic composition of resuscitation fluids for treatment of acute blood loss in the spontaneously hypertensive rat (SHR).

The spontaneously hypertensive rat (SHR) has a deficient glucose mobilization in response to blood loss. Treatment of blood loss with hypertonic glucose might consequently be advantageous in SHR, but the importance of osmolality as compared to ionic composition of resuscitation fluids is still not fully elucidated. Therefore, SHR (n = 32) were subjected to hemorrhage (30% of calculated blood volume) followed by treatment with (1) hypertonic saline (HS; 4.5 ml/kg of 7.5% NaCl, 2,400 mOsm/L), (2) hypertonic glucose (HG; 4.5 ml/kg of 42.3% solution, 2,400 mOsm/L), and (3) normal saline (NS; 37.5 ml/kg of 0.9% NaCl) to provide an equal sodium load as with HS. All fluid regimens increased (P < 0.001 vs. control) mean arterial pressure (MAP). Hemodilution was more pronounced after HS and NS than after HG. Hypernatremia was evoked by HS. The hyperglycemic response to hemorrhage was intensified by HG, but it was accompanied by increased blood lactate levels. All three treatment regimens prolonged posthemorrhagic times until death (P < 0.01-0.05) (mean values: NS 363 min; HS 170 min; HG 146 min; nontreated controls 60 min). It is concluded, on the basis of hemodynamic, metabolic, and times-until-death data, that although treatment with small-volume HS seems superior to small-volume HG, an equal load of sodium given as NS is more effective for resuscitation after blood loss than HS in SHR.

Acute Disease↗

Glycogen depletion in exercising rats infused with glucose, lactate, or pyruvate.

The influence of an intravenous infusion of glucose, lactate, or pyruvate on the work capacity and rates of glycogen depletion in the liver and hindlimb skeletal muscles of rats has been studied. Running time to exhaustion at a speed of 21 m/min on a treadmill at a +10 degrees incline was prolonged by glucose infusion but shortened by lactate or pyruvate infusions. Blood glucose concentrations were only lowered in the terminal stages of the exercise, whereas at this point lactate was elevated. Declines in liver and muscle glycogen concentrations were retarded by glucose infusion but accelerated by either lactate or pyruvate infusions. In all cases a marked depletion of both muscle and liver glycogen existed at the point of exhaustion. It is concluded from the lack of any major elevation of glucose, lactate, or pyruvate in the blood of the rats during running that these materials were taken up and oxidized, presumably by the working muscles. These observations suggest that skeletal muscle can take up large amounts of glucose and when it is supplied from an external source this can exert a glycogen sparing effect on the liver and working skeletal muscles.

Animals↗

Randomized study on the effect of adding oxytocin to ethacridine lactate or misoprostol for second-trimester termination of pregnancy.

OBJECTIVE: To compare effectiveness of misoprostol and ethacridine lactate with or without oxytocin in second-trimester medical abortions. SUBJECTS AND METHODS: A randomized prospective study. A total of 388 women with genetic indications for termination of pregnancy at 13-24 weeks of gestation were recruited. Group I (n=85) were treated with extra-amniotic ethacridine lactate, 10 ml instilled per gestational week, to a maximum of 200 ml. Group II (n=93) were treated with misoprostol administered intravaginally (200 microg), followed by 100 microg of oral misoprostol 4 hourly for 24 h. Group III (n=102) were treated with a combination of ethacrine lactate and oxytocin. An initial dose of 6 mU/min oxytocin was given, followed by additional 6 mU/min doses every 20 min. Group IV (n=96) were treated with a combination of misoprostol and oxytocin administered in a similar way as in group III. The main outcome measures were time to induce abortion, side effects, and failure/success rates. RESULTS: The mean time to induce abortion was 14.2+/-3.6, 13.2+/-3.4, 10.8+/-2.6, and 9.9+/-2.4 h in groups I, II, III, and IV, respectively (p<0.001). Addition of oxytocin to ethacridine lactate did not decrease the risk of prolongation of induction beyond 24 h but use of oxytocin with misoprostol did reduce the risk of induction beyond 24 h (OR: 0.46, 95%CI: 0.21-1, p<0.05). The occurrence of minor side effects was similar in all groups. CONCLUSION: Addition of oxytocin to ethacridine lactate or misoprostol significantly decreases the length of time to induce abortion without supplementary side effects.

Abortifacient Agents↗

Plasma levels of glucose, alanine, lactate, and beta-hydroxybutyrate in the unfed spiny dogfish shark (Squalus acanthias) after surgery and following mammalian insulin infusion.

Serial blood samples were collected from the unfed spiny dogfish shark (Squalus acanthias) by use of a cannula chronically implanted in the dorsal aorta. Plasma glucose, alanine, lactate, and beta-hydroxybutyrate levels were estimated by standard enzymatic procedures. The metabolite levels were estimated immediately after the surgery, for an additional 3 to 5 postoperative days before experimental use, and for 7 to 9 days after a single infusion of mammalian insulin (50, 100, and 250 IU/kg body wt) or the control solution. Plasma glucose, alanine, and lactate levels declined for 1 or 2 days after the surgery, but beta-hydroxybutyrate levels were essentially unchanged. Plasma glucose levels remained relatively stable for the remainder of the pretreatment period, and in the control animals during the subsequent treatment period. In contrast, plasma alanine and beta-hydroxybutyrate levels increased during both the pretreatment period and the treatment period in the control animals. Plasma lactate levels increased in the control animals after Day 3 of the treatment period. Insulin infusions resulted in severe, prolonged depressions of plasma glucose and alanine levels. Plasma lactate levels also fell after insulin infusion, but the depressed levels were interrupted by precipitous, large increases, followed by sharp declines, that were evident for one to three sampling periods and whose onset varied between Days 3 and 5 in individual animals. The levels increased again in some animals between Days 6 and 9. Plasma beta-hydroxybutyrate levels were comparatively resistant to insulin. After an early decline, plasma beta-hydroxybutyrate rose to levels that were near the control levels by Days 2 through 4, but fell to near the initial levels by Day 5 and thereafter. The results suggest that the spiny dogfish, a species that consumes reliable and abundant amounts of protein and lipid, but little carbohydrate, and that may feed as seldom as every 2 weeks, uses ketone bodies (beta-hydroxybutyrate and presumably acetoacetate) as primary fuels. Glucose is apparently synthesized by gluconeogenesis, alanine and lactate are probable substrates, and ketone bodies are the likely sources of energy. The evidence supports the hypothesis that glucose is synthesized to maintain muscle glycogen reserves that are used for anaerobic glycolysis when the animal is engaged in predation, escape, or other circumstances that dictate vigorous swimming. If other tissues and organs require glucose as a fuel source, the amounts must be exceptionally small.

3-Hydroxybutyric Acid↗

Prolonged vasodilation following fatiguing exercise of dog skeletal muscle.

Prolonged vasodilation follows 20- and 60-min periods of stimulation (4 twitches/s) of dog skeletal muscle with blood flow held constant at 23 plus or minus 2 ml/100 g per min. During stimulation isometric tension development fell 61 plus or minus 3%, and we have operationally defined this as fatiguing exercise. During stimulation vasodilation was maximum. Following stimulation vascular resistance returned to control with average half-times of 6.9 plus or minus 0.6 and 5.8 plus or minus 0.4 min after 20 and 60 min of stimulation, respectively. This prolonged vascular recovery following fatiguing exercise is an order of magnitude slower than vascular recovery following less severe exercise. The pressor response to an intra-arterial bolus of angiotensin (0.5 mug) is not depressed during prolonged vasodilation. Prolonged vasodilation does not appear to be closely linked to changes in tissue oxygen consumption. In addition, the changes in resistance can be dissociated from changes in K+, osmolality, and lactate production following fatiguing exercise. We conclude that prolonged vasodilation following fatiguing exercise is caused by a metabolic vasodilator substance which is yet to be identified.

Angiotensin II↗