Herpes simplex viral (HSV) hepatitis is uncommon in adults. Two new cases are reported herein; a literature review revealed an additional 33 patients. Ages ranged from 13 to 87 years; the mean age was 32.6 years, and the median was 28 years. HSV hepatitis usually occurs as part of disseminated HSV infection and is characterized by fulminant hepatic necrosis with serum transaminase levels frequently elevated 100- to 1,000-fold. Disseminated intravascular coagulation was present in 90% of the cases. Outcome was poor; 86% of the patients died. Eighty-six percent of the patients had an underlying condition associated with impaired host defenses. Renal transplantation (26%), steroid use other than in renal transplant patients (26%), and pregnancy (23%) were the most frequent underlying conditions. Early recognition and prompt initiation of antiviral therapy may offer a chance for improved survival rates.

Adult↗

PubMedDate not supplied

An algorithm to distinguish the need for sedative, anxiolytic, and analgesic agents.

This article discusses the use of an algorithm developed by nurses at the University of Minnesota Hospital and Clinic in Minneapolis, that can be used to distinguish the need for sedative, anxiolytic, and analgesic agents for patients in the medical intensive care unit (MICU). Many problems associated with patient sedation and analgesia exist within the critical care environment. These problems include undersedating patients with neuromuscular blockade; rapidly tapering or abruptly discontinuing high-dosage sedation, which often results in withdrawal symptoms; over-use of high-dosage continuous intravenous infusions of short-acting benzodiazepines and analgesics; failure to recognize delirium; and resistance to modifying drug regimens when patient outcomes are not satisfactory.

Adult↗

PubMedDate not supplied

Automatic shimming for localized spectroscopy.

Localized in vivo nuclear magnetic resonance studies often require a high spectral resolution not achievable with the basic shim of a whole-body magnetic resonance magnet. Therefore, the magnetic field homogeneity needs to be optimized in the selected volume of interest within a reasonable time. For this purpose, a method of automatic shimming was developed and tested on phantoms and volunteers. The volume selection is performed by means of a surface coil or by using a localization method which generates a stimulated echo from the volume of interest. The optimization procedure uses the time integral over the magnitude of the free induction decay or echo signal as homogeneity criterion. A complete shimming process generally requires only 80 transients. Test experiments were conducted on various volume sizes ranging from 2 X 2 X 2 cm3 to 15 X 15 X 15 cm3 inside a large phantom. The resulting linewidth in small volumes at the magnet center compared well with the natural linewidth determined by means of the Carr-Purcell-Meiboom-Gill sequence. As expected, shimming in selected volumes at off center positions led to somewhat broader lines. Results obtained on volunteers demonstrate the practical value of this rapid, automatic shimming method for in vivo studies.

Algorithms↗

PubMedDate not supplied

Neutral triglyceride lipase in macrophages.

High levels of neutral triglyceride lipase activity have been demonstrated in several types of macrophages (J774 cells, human monocyte/macrophages, rabbit alveolar macrophages, and resident mouse peritoneal macrophages). The pH optima ranged from 6.5 to 7.4 depending upon the buffer and the conditions of incubation. The addition of bovine serum albumin stimulated activity at low concentrations, as expected for a fatty acid-releasing reaction, but strongly inhibited at higher concentrations; maximal activity was observed in the presence of 0.625 mg/ml of bovine serum albumin. The enzyme was remarkably thermostable, showing no apparent loss of activity at 50 degrees C for as long as 6 hours. The lipase was inhibited 80% by 0.1 M NaCl. Assayed under optimal conditions, the specific activity of the neutral triglyceride lipase from J774 cells was more than 100-fold greater than the activity of lipoprotein lipase or neutral cholesterol esterase from those cells; this activity was 10-fold greater than the levels of hormone-sensitive lipase from 3T3-L1 adipocytes. This neutral triglyceride lipase may play an important role in the degradation and mobilization of cytosolic triglyceride in macrophage-derived foam cells.

Animals↗