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K C Hayes

Publications and source records attributed to K C Hayes.

At least 55 records · Page 3Linked to original sources

Decreasing dietary lauric and myristic acids improves plasma lipids more favorably than decreasing dietary palmitic acid in rhesus monkeys fed AHA step 1 type diets.

Current dietary recommendations advocate reductions in saturated fatty acids (SFA) and cholesterol (C) as a primary intervention for achieving a more desirable plasma lipid profile. To ascertain whether it is more efficacious to decrease dietary lauric and myristic acids (12:0 + 14:0) or dietary palmitic acid (16:0) in conjunction with a reduction in dietary C, 11 rhesus monkeys (8 males, 3 females) were initially fed a control diet rich in SFA + C for 14 wk [dietary fat approximately 38% of energy (%en), SFA 16%en and C at 180 mg/1000 kcal]. Plasma lipids were measured between the 9th and 13th wk, and LDL metabolism was assessed after 13 wk. Monkeys were then split into two groups and fed one of two American Heart Association (AHA) Step 1 diets (approximately 30%en fat, 10%en SFA, 75 mg cholesterol/1000 kcal) for an additional 14 wk, and plasma lipids and LDL metabolism were re-evaluated. Group 1 received a 16:0-rich diet in which most 12:0 + 14:0 were deleted (approximately 8.6%en from 16:0 and approximately 0.3%en from 12:0 + 14:0), whereas Group 2 received a diet rich in 12:0 + 14:0 from which 16:0 was selectively removed (2.6%en from 16:0 and approximately 6.3%en 12:0 + 14:0). In all three diets, oleic and linoleic acid were held relatively constant so that only SFA, the level of total fat and cholesterol were manipulated. Only the Step 1 diet that selectively removed 12:0 + 14:0 (the 16:0-rich diet) significantly reduced all lipid fractions, including total cholesterol (TC), HDL-C, LDL-C, apolipoprotein B (apoB) and the LDL pool size. Plasma triglyceride (TG) and the ratio of TC/HDL-C were not altered by either Step 1 diet. The smaller LDL pool size following the 16:0-rich diet in Group 1 was attributable to a significantly higher fractional catabolic rate (FCR) of LDL because the transport rate of LDL apoB was unaffected. Although the FCR was increased with the 12:0 + 14:0-rich diet, the LDL apoB pool was not affected because the transport rate of LDL tended to increase as well. The data suggest that a Step 1 diet that reduces total fat by decreasing 12:0 + 14:0 in conjunction with dietary C, improves plasma lipids more favorably than a similar diet that selectively removes 16:0 and C. Previous data would imply that the benefit resulted from removal of 12:0 + 14:0 per se, but the possibility is not eliminated that removal of C (independent of 12:0 + 14:0) muted the potential interaction between C and palmitic acid that tends to raise TC.

Animals↗

Replacing dietary palmitic acid with elaidic acid (t-C18:1 delta9) depresses HDL and increases CETP activity in cebus monkeys.

The question whether dietary trans fatty acids affect lipoprotein metabolism similarly to specific saturated fatty acids was investigated in 11 normolipemic cebus monkeys by exchanging 5% dietary energy (%en) between elaidic (t-C18:1 delta9) and palmitic acid (16:0) in two test diets (30%en fat + 100 mg cholesterol/1000 kcal diet) conforming to the American Heart Association (AHA) Step 1 guidelines. These were compared with a normal control diet rich in saturated fat and cholesterol (38%en fat + 180 mg cholesterol/1000 kcal diet). The control diet was fed initially for 14 wk, followed by each of the the two test diets in a crossover design. Plasma lipid concentrations were determined four times between the 6th and 14th wk. Turnover studies (using 125I-HDL and 131I-LDL) were conducted after 9 wk in each dietary period. Relative to the control diet, both test diets significantly reduced plasma total cholesterol (TC), HDL cholesterol (HDL-C) and VLDL plus LDL cholesterol (LDL-C) concentrations; triglyceride (TG) concentrations tended to be lower. However, the trans diet resulted in a significantly greater reduction in HDL-C than the palmitate diet (124 +/- 17, 117 +/- 18 and 106 +/- 13 mg/dL for the control, palmitate and trans diets, respectively). The palmitate diet significantly decreased the TC/HDL-C ratio by 11% when compared with the control diet (1.68 +/- 0.17 vs. 1.89 +/- 0.30), whereas the trans diet had no effect (1.81 +/- 0.20 vs. 1.89 +/- 0.30). Kinetic studies revealed that, relative to the control diet, both test diets significantly lowered the LDL apolipoprotein B (apoB) pool size, principally reflecting an increase in the LDL apoB fractional catabolic rate (FCR) related to the reduced cholesterol intake. Between the two test diets, no significant differences in LDL kinetic parameters were observed. Both test diets significantly decreased HDL apoA1 concentrations in comparison with the control diet, which was partly explained by an increase in the fractional catabolic rate of HDL. Of the two test diets, the trans diet was associated with a 9.5% greater HDL FCR than the palmitate diet (P < 0.08) and a significant increase in plasma cholesteryl ester transfer protein (CETP) activity (% transfer 114 +/- 7 vs. 91 +/- 7; P < 0.03). Thus, palmitic acid- and elaidic acid-rich diets produced identical effects on LDL metabolism in normocholesterolemic cebus monkeys fed diets with low levels of cholesterol, whereas elaidic acid depressed HDL-C, attributable to both increased CETP activity and HDL clearance.

Animals↗

Cholesterol-lowering effects of modified animal fats in postmenopausal women.

OBJECTIVE: In an attempt to improve the nutritional value of animal fats (including milkfat and lard), two technological approaches (i.e., cholesterol removal by steam distillation and linoleic acid enrichment by addition of safflower oil) were tested for cholesterolemic effects in a cohort of 29 older women (age 68 +/- 7 years). METHODS: Test fat sources were incorporated into crackers, cookies, cheese, ice cream, whipped topping, sour cream, baking shortening, and table spreads. Subjects were permanent residents of a convent where meals were prepared in a centralized kitchen, allowing test fats to be provided in daily food menu items. The foods containing test fats were introduced into three sequential dietary treatment periods, each lasting 4 weeks, in the following order: cholesterol-reduced animal fat (CRAF): fatty-acid modified, cholesterol-reduced animal fat (FAMCRAF); and-unaltered animal fat (AF). Subjects were offered menu items cafeteria style and encouraged to make food selections consistent with their habitual diets, which were recorded daily. RESULTS: Fasted blood lipid profiles determined at the end of each treatment period showed that FAMCRAF reduced mean plasma total cholesterol, LDL cholesterol, and apolipoprotein B concentrations relative to AF (p < 0.05). Mean HDL cholesterol concentrations were not influenced by diet. DISCUSSION: Relative to native products, animal fats modified by cholesterol removal and linoleic acid enrichment reduced plasma total and LDL cholesterol concentrations in a predictable manner similar to that based on studies of men.

Aged↗

Sensitivity to platelet aggregation appears related to the lipoprotein profile and atherosclerosis risk in humans and across species.

Platelet aggregation sensitivity was assessed in nine species of animals, including humans, with disparate susceptibility to atherosclerosis and a wide range in their LDL/HDL profiles. Platelet aggregation sensitivity between species varied almost 20-fold. The most sensitive platelets were found in humans and rabbits, followed by squirrel and rhesus monkeys with the most resistant platelets in cats, hamsters, rats, cebus monkeys, and gerbils. Species platelet aggregation sensitivity correlated well with relative susceptibility to atherosclerosis. The relationship between LDL/HDL ratio and platelet aggregation was significant, both across species (r = 0.76, without cebus) and within species (r = 0.50 for humans).

Adenosine Diphosphate↗

Neck flexor muscle strength, efficiency, and relaxation times in normal subjects and subjects with unilateral neck pain and headache.

OBJECTIVE: To determine the test-retest reliability of a new method for measuring muscular strength, efficiency, and relaxation times of the neck flexor musculature of healthy adults, and to compare these neck flexor muscle properties in subjects who have unilateral neck pain and headache with those in controls. DESIGN: Subjects lay supine and isometrically flexed their necks against a force transducer attached to the back of a webbing and velcro helmet. Electromyograms (EMGs) were recorded from surface electrodes on the sternocleidomastoid (SCM) muscles. Two consecutive sessions of five contractions of varying levels of effort from minimal through moderate and maximal effort were analyzed. SETTING: Ambulatory referral center. PARTICIPANTS: Volunteer control subjects (n = 10, 3 men and 7 women) were recruited from hospital and university personnel. Volunteer neck pain subjects (n = 10, 3 men and 7 women) were recruited from a physiatric chronic pain practice and a hospital outpatient physical therapy practice. RESULTS: In the controls, the intraclass correlation coefficients (ICCs) for the first two maximum neck flexion contractions were; peak force ICC = .81; peak force/body weight ICC = .75; average force ICC = .75; force relaxation time ICC = .73; SCM EMG relaxation times: right ICC = .60 and left ICC = .67. Comparing sessions 1 and 2 the intraclass correlations for SCM efficiencies were right ICC = .58 and left ICC = .97. The peak force in controls (mean = 45.3 +/- 17.6N) was reduced by 50% in the neck pain subjects (mean = 22.4 +/- 13.1N) (p = .004). Similarly, peak force/body weight in the neck pain subjects (X = 0.3 +/- 0.2N/kg) was 46% of control (mean = 0.7 +/- 0.2N/kg) (p = .001), and average force in the neck pain subjects (X = 12.1 +/- 7.5N) was 43% of controls (mean = 28.5 +/- 11.0N) (p = .001). In two neck pain subjects. SCM, EMG and force relaxation times were abnormally long in both the affected and the unaffected SCM muscles, exceeding the control values by greater than 3 standard deviations. The difference between the right SCM efficiency of the control subjects (mean = 0.3 +/- 0.2N/ microV) and the affected SCM efficiency of the neck pain subjects (mean = 0.1 +/- 0.1 N/microV) approached the p < .05 criterion for significance (p = .055). CONCLUSION: The technique was found to be highly reliable for the measurement of neck flexor peak force, peak force/body weight, average force, and force relaxation time, and moderately reliable for the quantitation of SCM EMG relaxation times and SCM efficiency. All force values were significantly lower in the neck pain population compared with the controls. In the neck pain population, force and SCM EMG relaxation times, as well as efficiencies, suggested abnormalities. Neck pain subjects showed no significant differences in SCM EMG relaxation time or SCM efficiency between affected and unaffected SCM muscles.

Adult↗

Increased clearance of IgG in mice that lack beta 2-microglobulin: possible protective role of FcRn.

The mechanisms that regulate immunoglobulin G (IgG) catabolism are little understood. We have previously found unusually low IgG concentrations in sera of mice homozygous for a targeted disruption of the beta 2-microglobulin gene. We therefore investigated whether this might result, at least in part, from increased clearance of IgG from the systemic circulation in mice lacking beta 2-microglobulin. We compared the half-lives of radiolabelled mouse IgG1 injected intravenously into beta 2-microglobulin-/- mice and wild-type or heterozygous siblings. The clearance of 125I-labelled IgG1 was strikingly more rapid in the mice lacking beta 2-microglobulin. beta 2-microglobulin-/- mice lack functional molecules of the MHC class I-related Fc receptor, FcRn. Some mutations in mouse IgG1 that increase its clearance have recently been shown to prevent binding to FcRn in the gut. To determine whether the slower degradation of immunoglobulin in mice with beta 2-microglobulin correlated with the ability of the antibody to bind FcRn, we measured the clearance of chicken IgY, which does not bind this receptor. The 125I-labelled IgY was catabolized equally rapidly in beta 2-microglobulin-deficient and wild-type mice. We compared the half-lives of the four subclasses of mouse IgG in beta 2-microglobulin-/-, +/-, and +/+ mice to determine whether the difference we had noted for IgG1 was peculiar to this subclass. The 125I-labelled IgG of all subclasses, with the possible exception of IgG2b. was degraded more rapidly in the beta 2-microglobulin-deficient mice than in heterozygous or wild-type siblings. These data suggest that FcRn can protect IgG from degradation, and is therefore important in maintaining IgG levels in the circulation.

Animals↗

Dietary trans-monounsaturated fatty acids negatively impact plasma lipids in humans: critical review of the evidence.

Trans fatty acids (t-FA) are geometrical isomers of unsaturated fatty acids that assume a saturated fatty acid-like configuration. Human diets contain t-FA derived from animal sources (e.g., dairy products and ruminant meats), but most are supplied by products containing industrially hydrogenated vegetable oils (e.g., margarines, shortenings and baked goods). Typical intake of t-FA in American diets has been estimated to be between 8-15 g/day, although wide variation exists between individuals. Human clinical studies since 1990 have revealed that relative to cis-monounsaturated fatty acids (i.e., oleic acid), t-FA increase total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C), and tend to decrease high density lipoprotein cholesterol (HDL-C) concentrations. Additionally, t-FA tend to increase the atherogenic lipoprotein (a). Thus, t-FA induce an adverse plasma lipid profile (increased ratios of TC/LDL-C and LDL-C/HDL-C), which represents increased risk for coronary heart disease. The effects of t-FA on LDL-C and HDL-C appear to be directly related to intake and clinically measurable above 3%en as t-FA. The cholesterol-raising ability of t-FA is analogous to that of the 12-16 carbon saturated fatty acids, possibly reflecting increased LDL production or delayed LDL clearance. By contrast, t-FA are unlike the saturated fatty acids in their depression of HDL-C. Preliminary evidence suggests that at least part of their impact on lipoproteins reflects increased serum cholesteryl ester transfer protein activity, i.e., increased transfer of cholesteryl esters from HDL to LDL. Since the adverse effects of t-FA on human plasma lipids may be confined to specific isomers, future studies delineating their effects are warranted.

Animals↗

Conditioning lower limb H-reflexes by transcranial magnetic stimulation of motor cortex reveals preserved innervation in SCI patients.

Conditioning of lower limb H-reflexes by transcranial magnetic stimulation of motor cortex was used to detect preserved innervation in patients with long-standing spinal cord injury (SCI). Cortical stimulation was delivered at intensities suprathreshold or subthreshold for evoking motor evoked potentials (MEPs). The conditioning (C) cortical stimulation preceded the test (T) H-reflex stimulus at intervals between C-T: 10-300 msec. Conditioned H-reflex profiles in control subjects (n = 10), following both suprathreshold and subthreshold cortical conditioning, yielded evidence of early (C-T: 10-30 msec) and late arriving (C-T: 60-130 msec) excitatory inputs to the lateral gastrocnemius (LG) motoneuron pool. Demonstration of late inputs following subthreshold cortical conditioning suggested the inputs are mediated by slow conducting or oligosynaptic descending motor tracts, as distinct from afferent consequences of short latency MEPs. In SCI patients (n = 11) the conditioned H-reflex profile varied according to the patients' ASIA impairment rating. Higher functioning SCI patients (ASIA level C and D) revealed evidence of both early and late arriving inputs to the lumbosacral motoneuron pool whereas patients with more severe impairments (ASIA levels A and B) most often failed to exhibit early or late periods of H-reflex facilitation in LG. In three patients (i.e., 1 ASIA B; 2 ASIA C) the cortical modulation of H-reflex amplitudes yielded evidence of preserved corticospinal innervation that was not detectable by other MEP reinforcement procedures. These results introduce the cortical conditioning procedure as a sensitive means of detecting latent corticospinal and/or bulbospinal innervation in SCI patients consistent with the emerging neuropathological picture of preserved axonal integrity in descending motor tracts in the face of extensive functional loss.

Adult↗

Stability of walking frames.

Biomechanical tools were used to assess stability for 11 patients who, following the surgical amputation of one lower limb, required the assistance of a walking frame to ambulate. The Walker Tipping Index (WTI), as derived from the forces applied to the walking frame, was developed specifically for this study to examine the relationship between stability and walking frame height during ambulation. However, the WTI may be useful as a criterion of stability to assist clinicians in their evaluation of walker use in a variety of patient populations. Walker stability was examined as subjects, wearing their prostheses, completed 30-sec walking trials in each of the normal, high, and low walking frame height conditions. Adjusting the height of the walker to one setting (3 cm) above or below normal appears to redistribute the load of walking between the upper and lower extremities without adversely affecting stability.

Aged↗

Plasma and whole blood taurine concentrations respond differently to taurine supplementation (humans) and depletion (cats).

In the present study the relationship between plasma and whole blood taurine was examined under normal physiological circumstances in humans and cats. In addition, the effect of taurine supplementation on plasma and whole blood taurine was evaluated in humans and the depletion of taurine pools after a taurine-deprived diet was studied in cats. The normal plasma taurine concentration in humans was 44 +/- 8 mumol/L and the whole blood taurine concentration was 227 +/- 35 mumol/L. Under normal physiological conditions plasma and whole blood taurine were not correlated (r = 0.092). Plasma taurine responded rapidly to dietary supplementation in humans or the taurine depletion in cats. In contrast, the whole blood taurine pool was more inert and varied only under extremes of depletion (cats) or sustained taurine supplementation.

Analysis of Variance↗

Dietary fats rich in saturated fatty acids (12:0, 14:0, and 16:0) enhance gallstone formation relative to monounsaturated fat (18:1) in cholesterol-fed hamsters.

To test the possibility that dietary palmitic acid (16:0) may be lithogenic, different fats were blended to exchange 18:1 in olive oil with either 16:0 in palm stearin, 12:0 + 14:0 in coconut oil, or 14:0 + 16:0 in butterfat. Dietary 18:2 was held constant at 1.2% energy (en) (with extra safflower oil as needed) in these four purified diets containing low fat (11% of total energy) and 0.4% cholesterol. A fifth, high-fat diet provided 40% of the total energy as the 16:0-rich blend. All hamsters fed the low-fat 16:0-rich blend for six weeks developed cholesterol gallstones (8/8). Although the gallstone incidence was lower for the 12:0 + 14:0-rich diet (5/8), the severity of stone formation in affected hamsters was equal to that in the low-fat, 16:0-rich group. Mucin accumulation in gallbladder bile was often associated with cholesterol gallstones in diets containing 16:0, but was minimal in 18:1-rich and 12:0 + 14:0-rich groups. Neither the lithogenic index (all > 1.0), plasma lipids, nor liver cholesterol was a selective predictor of stone formation. The high-fat, 16:0-rich diet actually decreased cholesterol stone incidence (3/8) and severity, but yielded a high incidence of pigment stones (5/8). Thus, saturated fat and 16:0 per se were not responsible for the exaggerated lithogenesis. Because the antilithogenic 18:1-rich diet also normalized the 18:2 intake (1.2% en) relative to previous butter diets (0.3% en), the potential importance of essential fatty acids (EFA) deficiency in the model was tested in a second study by feeding graded amounts of 18:2 (0.3, 0.6, 0.9, and 1.2% en) as safflower oil in four low-fat, butter-rich diets (11% en as fat) without alleviating gallstone incidence or severity. These studies indicate that substitution of 18:1 for saturated fatty acids in low-fat diets reduces gallstone formation without affecting the lithogenic index. Furthermore, intake of 18:2 at or below the EFA requirement does not appear to be a major factor in this model.

Animals↗

Plasma lipids are affected similarly by dietary lauric or palmitic acid in gerbils and monkeys.

To compare the relative impact of dietary lauric acid (12:0) and palmitic acid (16:0) on plasma lipids, two fat-sensitive species, Mongolian gerbils and cebus monkeys, were fed cholesterol-free, purified diets enriched with either 12:0-rich or 16:0-rich fats, while all other fatty acids were held constant by selective blending of up to five natural fats or oils. The two gerbil diets (40 en% from fat) allowed for an 8 en% exchange between 12:0 and 16:0, and the monkey diets (31 en% from fat) allowed for 6 en% exchange between these two fatty acids. Eight gerbils received the diets for eight weeks, and 12 cebus monkeys were fed each diet in a cross-over design for up to 22 wk. Both diets resulted in similar plasma cholesterol, triglyceride, and high density lipoprotein cholesterol concentrations within each species. Additionally, separation of cebus lipoproteins by discontinuous density-gradient ultracentrifugation failed to show any dietary differences in concentration or composition of the three major lipoprotein classes (d < 1.019, 1.019-1.055, and 1.055-1.168 g/mL). Thus, in two species sensitive to manipulations in dietary fat while consuming cholesterol-free diets, 16:0 was not hypercholesterolemic relative to 12:0.

Animals↗

Conditioning effects of sural nerve stimulation on short and long latency motor evoked potentials in lower limb muscles.

The effects of conditioning sural nerve stimulation on motor evoked potentials (MEPs) in relaxed muscles of the lower limb were examined in 11 healthy adults. The study tested the hypothesis that cutaneous afferent stimulation, in the absence of muscle afferent input, facilitates the short latency MEPs evoked in lower limb muscles following transcranial magnetic stimulation of motor cortex. Non-painful (3.6 x sensory threshold) percutaneous electrical stimulation was delivered to the sural nerve at conditioning (C)-test (T) intervals of 0-150 msec. MEPs were elicited bilaterally in the tibialis anterior (TA) and lateral gastrocnemius (LG) muscles with and without preceding cutaneous stimulation. Mean MEP amplitudes were facilitated in the ipsilateral TA by 258% (n = 10 of 11), the ipsilateral LG by 275% (n = 7 of 8) and the contralateral TA by 313% (n = 7 of 7) within C-T: 60-100 msec. These results establish that cutaneous afferent stimulation per se does lead to a facilitation of short latency MEPs. In addition, two subjects who were examined at higher stimulation intensities both exhibited late responses (70-95 msec) at C-T: 0-15 msec. These responses, which were independent of the amplitude and appearance of short latency MEPs, suggest a convergence of the cutaneous stimulation with late arriving descending cortical or cortico-bulbospinal inputs to the target motoneuron pool.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Saturated fats and blood lipids: new slant on an old story.

In recent years the association between dietary saturated fat, hypercholesterolemia, and coronary artery disease has been re-explored. Prompted largely by the notion that dietary fats, and their attendant fatty acids, can specifically influence the distribution of the plasma cholesterol between low density (LDL) and high density (HDL) lipoprotein cholesterol, the focus of the original research has shifted from total cholesterol to lipoproteins. Several new, sometimes controversial, concepts have arisen that challenge underlying assumptions of the Keys-Hegsted regression equations. First, although saturated fats as a class raise LDL, they also appear to have primary responsibility among dietary fatty acids for raising HDL, possibly depending on a balanced intake of polyunsaturated fats. Second, not all saturated fatty acids are equally responsible for changes in LDL or HDL. Only natural triglycerides (TG) rich in lauric (12:0) and myristic (14:0) acids are especially cholesterolemic, whereas 16:0-rich fats can be neutral or cholesterol-raising depending on the metabolic circumstances (lipoprotein setpoint) of the host. In normolipemic individuals with normal lipoprotein metabolism, dietary palmitic acid (16:0) typically appears neutral. When lipoprotein metabolism is impaired, eg, if LDL receptor activity is depressed by the presence of dietary cholesterol, consumption of 16:0-rich TGs can contribute to hypercholesterolemia. Although stearic acid (18:0) is typically considered neutral, exaggerated consumption of 18:0-rich fat (cocoa butter) lowers both LDL and HDL. Third, the saturated fat effect is related both to the dietary cholesterol load and the lipoprotein setpoint of the host, eg, 16:0 becomes progressively cholesterolemic as dietary cholesterol raises the setpoint.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Use of adhesion counts to help predict symptomatic infection and the ability of fluoroquinolones to penetrate bacterial biofilms on the bladder cells of spinal cord injured patients.

There were three objectives to the present study: (1) compare the bladder infection rate and extent of biofilm formation for seven untreated spinal cord injured (SCI) patients and seven given prophylactic co-trimoxazole, (2) identify a level of bacterial adhesion to bladder cells which could be used to help predict symptomatic infection, and (3) determine from in vivo and in vitro studies whether fluoroquinolones were effective at penetrating bacterial biofilms. The results showed that the infection rate had not changed with the introduction of prophylaxis. However, the uropathogenic population had altered subsequent to the introduction of prophylaxis with E. coli being replaced by E. faecalis as the most common cause of infection. In 63% of the specimens from asymptomatic patients, the bacterial counts per cell were < 20, while 81% of specimens from patients with at least one sign and one symptom of urinary tract infection (UTI) had > 20 adherent bacteria per bladder cell. Therefore, it is proposed that counts of > 20 bacteria adherent to sediment transitional epithelial bladder cells may be predictive of symptomatic UTI. Clinical data showed that fluoroquinolone therapy reduced the adhesion counts to < 20 per cell in 63% of cases, while trimethoprim-sulfamethoxazole only did so in 44%. Further in vitro testing showed that ciprofloxacin (0.1, 0.5 and 1.0 micrograms/ml) partially or completely eradicated adherent biofilms from 92% of spinal cord injured patients' bladder cells, while ofloxacin did so in 71% cases and norfloxacin in 56%. These findings have important implications for the detection and treatment of bacteriuria in spinal cord injured patients.

Adult↗

4-Aminopyridine-sensitive neurologic deficits in patients with spinal cord injury.

4-Aminopyridine (4-AP) is a potassium channel blocking agent with the ability to restore conduction in demyelinated internodes of axons of the spinal cord. The present investigation sought to obtain electrophysiologic evidence of the effect of 4-AP in ameliorating central conduction deficits in a group of patients (n = 6) with spinal cord injury (SCI). The group was selected on the basis of having temperature-dependent central conduction deficits. 4-AP (24-25 mg total dose) was delivered intravenously at 6 mgh-1 or 15 mgh-1 while somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) were recorded as indices of central conduction. Two patients exhibited marked increases in the amplitude of cortical SEPs, and in one of these, 4-AP brought about a reduced central conduction time from L1 to cortex. Four patients revealed increased amplitude MEPs with concomitant reduction in latency indicative of enhanced conduction in corticospinal or corticobulbospinal pathways. Two of these patients demonstrated increased voluntary motor unit recruitment following 4-AP. Clinical examination revealed reduced spasticity (n = 2), reduced pain (n = 1), increased sensation (n = 1), improved leg movement (n = 3), and restored voluntary control of bowel (n = 1). These results support the hypothesis that 4-AP induces neurologic benefits in some patients with SCI. They are also consistent with the emerging concept that pharmaceutical amelioration of central conduction deficits caused by focal demyelination may contribute to the management of a select group of patients with compressive or contusive SCI.

4-Aminopyridine↗