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Clinical and demographic data in 75 patients with near-fatal choking episodes.

The clinical background and circumstances of 75 patients who had survived a near-fatal choking episode, i.e., had undergone a Heimlich maneuver, oropharyngeal suctioning, or intubation, is reported. Sixty had choked on a solid bolus (often of a complex texture like sandwiches and chicken soup). Four patients had choked on mashed banana. In 30 patients neurologic disease (such as cerebrovascular disease, Parkinson disease, or dementia) was present. Choking occurred during breakfast (16 patients), lunch (21), dinner (26), and snacks (12). Twenty-five choked at home, 18 in nursing homes, 14 in hospitals, nine in restaurants, and nine in drinking establishments. Twelve were being fed at the time of choking. Fifty-eight of the individuals had oral, pharyngeal, or esophageal abnormalities on radiographic examination that could explain the choking episode. Fourteen patients who were able to vocalize during the choking episode had probably suffered from esophageal impaction. Our study indicates that elderly individuals and those with neurogenic dysphagia are at risk for choking. Dysphagia diet (semisolids) may actually contribute to the risk in these patients. Young adults may also be at risk during episodes of consumption of alcohol and snacks.

Adult↗

Standardized system for quantifying residual dirt on medical appliances cleansed in hospital washers--disinfectors: dirt detection by different methods.

An easy-to construct, easy-to-operate standardized system was developed for determining the residual biological contamination of surgical instruments, endoscopes and other medical appliances subjected to hospital cleansing and/or disinfection. It consists of standard-sized pieces of glass, metal or endoscope plastic--dirt carriers--either bare or enclosed in truncated Eppendorf caps to simulate hard-to-access conditions. The surface of the carriers is covered with model dirt simulating biological contamination and the carriers are then affixed to sturdy metal holders. Conventional model dirt were found to peel or flake off the carrier surface, lowering the precision of residual soil determination. A newly developed model dirt consisting of liver mash, lactose and sunflower oil and exhibiting low tendency to peel off surfaces was therefore used. The whole setup was subjected to chemical or enzymic cleansing programs at elevated temperature in hospital washer-disinfectors of two types, and the residual dirt after cleansing was determined by three methods. The method using toxicant-doped dirt that quenches the luminescence of an indicator bacterium Photobacterium phosphoreum gave satisfactory data under laboratory conditions but with hospital-washed samples it exhibited excessive fluctuations caused by bacterium--dirt interactions and by physical influences. Both other methods gave better results but displayed some process sensitivity. The luciferin-luciferase-based ATP bioluminescence assay sometimes gave low or even negative dirt level values and showed a low effect of reduced dirt accessibility on cleansing of metal carriers. The Bradford protein assay showed about equal cleansing efficiency for both easily and poorly accessible carriers after enzymic cleansing. Our system can be used for determining low levels of residual contamination of medical appliances after cleansing/disinfection and assessing the efficiency of commercial washer-disinfectors; its efficiency can be further increased by using a cleansing process-insensitive method for soil detection and quantification.

Adenosine Triphosphate↗

[Tolerance of early oral feeding after operations of the lower gastrointestinal tract].

INTRODUCTION: Oral feeding is usually offered following surgery of the lower gastrointestinal tract when clinical signs of normal intestinal motility are present. However, some studies have shown that early oral feeding is well tolerated with low morbidity. METHODS: A prospective cohort study was performed to evaluate whether early oral feeding according to a standardized schedule is tolerated under normal clinical circumstances. One hundred consecutive patients following small- or large-bowel resection with anastomosis were offered fluids on post-operative day 1, soup on post-operative day 2, mashed food on post-operative day 3 and a regular diet on post-operative day 4. Parenteral nutrition was only given if necessary. Tolerance of oral feeding and the amount of food were checked twice a day. End points of the study were nausea (VAS score 1-100), vomiting (> 200 ml), reinsertion of a nasogastric tube, level of food intake, parenteral nutrition (ml), appetite and well-being. RESULTS: Loop ileostomies were done in 21 patients, colonic resections above the sigmoid in 32, and sigmoid and rectal resections in 47. The average age was 63 +/- 13 years. The frequency of nausea was less than 30% and of vomiting less than 10%. Only in two cases was a nasogastric tube inserted. Forty-three percent of all patients tolerated feeding very well according to the schedule. On post-operative day 3 more than 60% tolerated oral intake, on post-operative day 4, 74% and on post-operative day 5, 88%. Only 22% of the patients needed parenteral fluids on post-operative day 4. The first bowel movement was noted after 2.8 +/- 1.1 days. Surgical complications were documented in 18 patients and general complications in 6 patients. CONCLUSION: Most patients tolerated early oral feeding very well according to the schedule with low morbidity. Therefore, early feeding is now a substantial component of the postoperative treatment following small- or large-bowel resections.

Aged↗

Chronic administration of olanzapine induces metabolic and food intake alterations: a mouse model of the atypical antipsychotic-associated adverse effects.

RATIONALE: Most of atypical antipsychotics (AAPs) are highly related to a major risk of metabolic drawbacks leading to dyslipidemia and obesity. OBJECTIVE: To set up a mouse model of the AAP-associated weight gain in mice under the influence of chronic olanzapine regimen. MATERIALS AND METHODS: Female mice were housed in pairs and habituated to spontaneous feeding with a high-palatable diet (10% sucrose wet mash). Firstly, we orally administered olanzapine (0.75, 1.5 and 3 mg/kg), evaluating body weight and periuterine fat mass, as well as insulin, non-esterified fatty acids, triglycerides, and glucose levels. In a second experiment, we assessed the effect of olanzapine on energy expenditure through indirect calorimetry (IC). A third experiment was conducted to investigate the effects of olanzapine on a high fat-high sweet palatable diet (10% sucrose + 30% fat, HF-HS) in mice implanted with subcutaneous osmotic mini-pumps. Locomotor activity was also assessed. RESULTS: In experiment 1, the highest dose of chronically administered olanzapine (3 mg/kg) induced significant weight gain accompanied by augmentation of periuterine fat depots, with no changes in locomotor activity. In experiment 2, chronic administration did not alter energy expenditure, whereas, decreased respiratory quotient (RQ). In experiment 3, subcutaneously infused olanzapine evidenced a dose and time-dependent increase of body weight and HF-HS diet consumed. Notably, serum analyses revealed a hyperinsulinemia together with increased levels of triglycerides and glucose. CONCLUSIONS: In this study, we describe in female mice metabolic alterations matching the metabolic syndrome, thus resembling the clinical situation of schizophrenic patients taking AAPs.

Administration, Oral↗

Characterization of Rat8 localization and mRNA export in Saccharomyces cerevisiae during the brewing of Japanese sake.

Ethanol affects the nuclear export of mRNA in a similar way to heat shock in Saccharomyces cerevisiae. We recently reported that the nuclear accumulation of Rat8 caused by ethanol stress correlates well with blocking of the export of bulk poly(A)(+) mRNA. Here, we characterize the localization of Rat8 and bulk poly(A)(+) mRNA in sake (Japanese rice wine) yeast during the brewing of sake. In wine must and synthetic dextrose medium, sake yeast showed the same responses to ethanol regarding changes in the localization of Rat8 as wine yeast and a laboratory strain: i.e., cells began the nuclear accumulation of Rat8 at an ethanol concentration of 6% and completed it at 9%. In contrast, during the sake-brewing process, sake yeast showed unique phenomena: i.e., cells did not start the nuclear accumulation of Rat8 until the ethanol concentration of the sake mash reached around 12% and they showed a normal localization of Rat8 around the nuclear envelope at the late stage of fermentation. These results provide new information about the transport of mRNA in yeast cells during actual alcoholic fermentation.

Alcoholic Beverages↗

Cloning of beta-1,3-1,4-glucanase gene from Bacillus licheniformis EGW039 (CGMCC 0635) and its expression in Escherichia coli BL21 (DE3).

Beta-1,3-1,4-glucanase has been applied in the brewing and animal feed additive industry. It can effectively improve digestibility of barley-based diets and reduce enteritis. It also reduces viscosity during mashing for high-quality brewers malt. The aim of this work is to clone beta-1,3-1,4-glucanase-encoding gene and express it heterogeneously. The gene was amplified by polymerase chain reaction using Bacillus licheniformis genomic DNA as the template and ligated into the expression vector pET28a. The recombinant vector was transformed into Escherichia coli. The estimated molecular weight of the recombinant enzyme with a six-His tag at the N terminus was about 28 kDa, and its activities in cell lysate supernatant were 1,286 and 986 U ml(-1) for 1% (w/v) barley beta-glucan and 1% (w/v) lichenan, respectively. Accordingly, the specific activities were 2,479 and 1,906 U mg(-1) for these two substrates. The expression level of recombinant beta-1,3-1,4-glucanase was about 60.9% of the total protein and about 12.5% of the total soluble protein in crude cell lysate supernatant. Acidity and temperature optimal for this recombinant enzyme was pH 5.6 and 40 degrees C, respectively.

Bacillus↗

Optimization of multienzyme production by two mixed strains in solid-state fermentation.

F(3) and F(4) strains of Aspergillus niger were screened from five strains of fungi to produce multienzyme preparations (containing cellulase, hemicellulase, glucoamylase, pectinase, and acidic proteinase) as dietary supplementation. Enzyme activities indicated that 1:4 (F(3) to F(4)) was the optimum mixture proportion, and 0.3% (W/W) was the preferable pitching rate. In bran mash containing 54.5% (W/W) water, F(3) and F(4) could produce the supplementation better when cultured 30 to 36 h at 30 degrees C. Monofactorial and orthogonal experiments were performed to optimize media. Results of the variance and range analysis showed that the optimum medium contained 80 g of bran, 20 g of cottonseed powder, 1 g of (NH(4))(2)SO(4), and 0.1 g of KH(2)PO(4). When F(3) and F(4 )strains were cultured in the optimum medium containing 54.5% (W/W) water, the activity of cellulase, hemicellulase, glucoamylase, pectinase, and acidic proteinase reached 996; 15,863; 13,378; 7,621; and 5,583 U/g, respectively.

Animal Feed↗

A comparative study of five fatal cases of Taxus poisoning.

The study presents five fatal cases of poisoning with Taxus spp., all of which were suicides of young people aged between 16 and 26 years. Yew leaves were consumed in four fatalities, whereas a mash from Taxus was ingested in one case. No relevant concentrations of alcohol, narcotic drugs, and pharmaceuticals were determined in postmortem toxicological screening. At forensic autopsy, a widely dilated pupil was found in two decedents. Furthermore, autopsy showed unspecific findings of intoxication in all cases: acute blood congestion of lungs, liver, kidney, and brain as well as dilated cardiac ventricles. No signs of violence could be found in any of the fatalities. Yew leaves were identified in four cases in the stomach and duodenum. 3,5-Dimethoxyphenol, the aglycon of the Taxus ingredient taxicatine, was determined as toxicological evidence for the absorption of yew ingredients. Taxus intoxication could be confirmed by 3,5-dimethoxyphenol concentrations in cardiac blood between 31 and 528 ng/ml for all cases. 3,5-Dimethoxyphenol was also detected in stomach contents as well as in urine, liver, kidneys, and brain samples. Based on the different concentrations of 3,5-dimethoxyphenol determined in the cardiac blood samples, it was concluded that the form of ingestion plays a decisive role in the process of poisoning. Finally, a toxic range for Taxus poisoning based on 3,5-dimethoxyphenol as marker substance is proposed as orientation.

Adolescent↗

Protection of turkeys against furazolidone-induced cardiomyopathy.

When fed furazolidone, 700 ppm, with their mash, most turkey poults develop dilated cardiomyopathy characterized by gross left ventricular dilatation with thinning of both the left ventricular free wall and ventricular septum. Birds fed propranolol, but not digoxin, did not develop this cardiomyopathy. It is not known what pharmacologic property of propranolol conferred protection or if mammals would receive similar protection.

Animals↗

A rapid, large-scale method for purification of the metallo-carboxypeptidase inhibitor from potato tubers.

A rapid, large-scale procedure has been developed for the preparation of metallo-carboxypeptidase inhibitor (CPI) from potatoes. The inhibitor is extracted with 80% ethanol from partially cooked potato tubers. After the ethanol is removed and the salts are dialyzed away, the inhibitor is isolated in pure form by chromatography on sulfopropyl Sephadex. Ten pounds of potatoes yields 250 mg pure inhibitor, representing over 40% recovery. Commercial mashed potato flakes contain about 0.02% carboxypeptidase inhibitor and can be utilized as a starting material in the procedure described to yield over 70 mg inhibitor from a pound of flakes.

Hot Temperature↗

A comparison of the effects of tasting and chewing foods on the flow rate of whole saliva in man.

The objective was to determine the relative contributions from gustatory and mechanical stimulation of salivary flow in response to consumption of three foods. In a preliminary study on 6 males and 6 females the weights of normal bite-size portions and their chewing times for rhubarb pie, boiled rice, and raw carrot were established for each subject. In the main study the foods were either (a) divided into the calculated bite-size normal portions or (b) the portions were mashed (rhubarb pie), untreated (rice) or finely ground (raw carrot). The subjects chewed the foods of type (a) in the normal way but, with type (b), simply held the food between the palate and the dorsum of the tongue, with no masticatory movements (tasting). After the normal chewing time the food was not swallowed but spat into a weighed container; the volume of saliva secreted was determined from the increase in weight of the food portions. Rhubarb pie elicited a significantly higher flow rate than did the rice and carrot; the flow rates in response to tasting, as a percentage of those in response to chewing were 86.7 +/- 12.2, 79.3 +/- 17.9 and 73.4 +/- 15.4, respectively. It is concluded that in humans the effect of the gustatory stimulation of foods is much more important than the mechanical stimulation from chewing in producing the flow of saliva.

Adult↗

Properties of a thermoactive beta-1,3-1,4-glucanase (lichenase) from Clostridium thermocellum expressed in Escherichia coli.

A Clostridium thermocellum gene (licB) encoding a thermoactive 1,3-1,4-beta-glucanase (lichenase) with a molecular weight of about 35,000 was localized on a 1.5-kb DNA fragment by cloning and expression in E. coli. The enzyme acts on beta-glucans with alternating beta-1,3- and beta-1,4-linkages such as barley beta-glucan and lichenan, but not on beta-glucans containing only 1,3- or 1,4-glucosidic bonds. It is active over a broad pH range (pH 5-12) and has a temperature optimum around 80 degrees C. The C. thermocellum lichenase is unusually resistant against inactivation by heat, ethanol or ionic detergents. These properties make the enzyme highly suitable for industrial application in the mashing process of beer brewing.

Cloning, Molecular↗

Microstructural analysis of the anorectic effect of N-0437, a highly selective dopamine D2 agonist.

Drug actions, mediated by dopamine D2 receptors, have been shown to reduce food consumption in rodents. The present study used a microstructural approach to feeding responses to determine the behavioural changes which underlie the anorectic effect of a selective D2 agonist, N-0437. Non-deprived male rats were trained to consume a palatable, sweetened mash in a 30 min test under familiar test conditions. N-0437 (1.0 and 3.0 mg/kg) significantly reduced food intake, but had no effect on the duration of feeding, the duration and frequency of feeding bouts, or on the time course of feeding. Its anorectic effect depended upon a selective reduction in the rate of eating. Microstructural analysis of other behavioural changes which followed treatments with N-0437 indicated that, at 0.3 mg/kg, the drug may have selective dopamine autoreceptor activity, but at 1.0 and 3.0 mg/kg it acts postsynaptically at D2 receptors. The results show that the anorectic effects of N-0437 can be clearly distinguished from the effects of psychomotor stimulants like D-amphetamine or cocaine, but they overlap in part with the effect of the mixed D1/D2 agonist, apomorphine. The results are discussed in relation to a proposed D2 receptor-mediation of one component of the behavioural changes that underlie feeding satiation.

Animals↗

The beta-carboline abecarnil, a novel agonist at central benzodiazepine receptors, influences saccharin and salt taste preferences in the rat.

Abecarnil is a recently described beta-carboline which acts at central benzodiazepine receptors (BZR) and has anxioselective/anticonvulsant properties. While it may be classified provisionally as a partial agonist at BZR, there is also evidence that its pharmacological profile may be due to a selective action at BZR subtypes. The general aim of the present series of experiments was to investigate the effects of abecarnil on ingestional behaviour in the rat. The results indicated that abecarnil (0.3-10 mg/kg, i.p.) selectively increased the intake of preferred 0.05% sodium saccharin and 0.9% sodium chloride solutions in two-choice tests using water-deprived rats. These results confirm and extend previous work with the potent BZR agonist clonazepam. Moreover, abecarnil significantly increased the ingestion of sweetened mash and 3% sucrose solution in nondeprived animals. In general, these results indicate that abecarnil is effective in increasing ingestional responses, a characteristic it shares with classical agonists like diazepam. The results could be accounted for in terms of a partial agonist profile for abecarnil, but do not rule out the possibility of selective actions at BZR subtypes.

Animals↗

A comparison of the effects of the 5-HT1 agonists TFMPP and RU 24969 on feeding following peripheral or medial hypothalamic injection.

Experiments were conducted to compare the food intake suppressant effects of the 5-hydroxytryptamine (5-HT)1 agonists 1-3-trifluoromethylphenylpiperazine hydrochloride (TFMPP) and 5-methoxy-3-(1,2,3,6-tetrahydropyridinyl)1H indole (RU 24969) following either peripheral or medial hypothalamic injections. The effects of these manipulations were examined in 3 different paradigms involving the stimulation of feeding by: (1) infusion of 25 nmol noradrenaline (NA) into the medial hypothalamus, (2) adaptation to a 20 h food deprivation schedule, and (3) the presentation of a palatable wet mash diet for 1 h each day to ad libitum-fed rats. In all 3 paradigms TFMPP and RU 24969 (0.31-5 mg/kg, i.p.) induced dose-dependent reductions of food intake. Both drugs were somewhat less potent at inhibiting feeding that resulted from food deprivation. In contrast to these results medial hypothalamic infusion of TFMPP or RU 24969 (12.5-50 nmol) failed to affect food intake in any of the 3 tests. This occurred in spite of the fact that both 5-HT (12.5-50 nmol) and fluoxetine (12.5-50 nmol) mildly attenuated the feeding that resulted from NA infusion into the same site. The results provide clear evidence that the food intake suppressant effects of peripherally injected TFMPP and RU 24969 are not mediated in the medial hypothalamus. They also suggest that even though manipulations of serotonergic function within the medial hypothalamus can alter food intake, this probably does not involve selective activation of 5-HT1C and/or 5-HT1B receptors.

8-Hydroxy-2-(di-n-propylamino)tetralin↗

Cocaine: a microstructural analysis of its effects on feeding and associated behaviour in the rat.

Cocaine (5.6-30 mg/kg, i.p.) was administered to nondeprived male rats trained to eat a palatable sweetened mash. Over a 60-min period, their behaviour was observed and recorded for a microstructural analysis. Cocaine suppressed feeding in a dose-dependent manner (significantly at 10 mg/kg and greater), and this was due in the main to a reduction in the frequency of eating bouts. In contrast, the mean duration of eating bouts was unaffected, except at the highest dose, 30 mg/kg. In addition, the rate of eating was not significantly affected by cocaine at any dose. Time-course data revealed that cocaine, at anorectic doses (10-30 mg/kg), initially suppressed feeding completely, and the duration of this suppression was proportional to the dose. In effect, cocaine delayed the initiation of feeding, thus bringing about the reduction in the number of eating bouts. Cocaine caused some stimulation of locomotor activity and rearing to the side of the observation tank, but did not affect rearing away from the centre, or immobility. Grooming proved to be very sensitive to cocaine's suppressant effect, with substantial inhibition occurring at 5.6 mg/kg (a sub-anorectic dose). These data are compared with previously published work with D-amphetamine and are contrasted with results for selective D1 and D2 dopamine receptor agonists.

Animals↗

Galanin receptor antagonists M40 and C7 block galanin-induced feeding.

Two peptide antagonists of the galanin receptor, M40 (galanin[1-13]-Pro-Pro-[Ala-Leu]2-Ala amide) and C7 (galanin[1-13]-spantide amide), significantly inhibited galanin-induced consumption of a palatable wet cookie mash, when microinjected intraventricularly to satiated rats. Antagonists were effective at doses equimolar to or less than the active doses of galanin. Feeding induced by an overnight fast was not significantly different in rats microinjected with saline as compared to M40 or C7, at doses which inhibited galanin-induced feeding. The activity of the chimeric compound, C7, did not appear to be linked to the properties of its C-terminal spantide-like sequence, as C7 did not induce barrel rolling at doses which inhibited galanin-induced feeding. The IC50 for displacement of 125I-[Tyr26]-porcine galanin 1-29 binding in rat hypothalamic membranes was 15 nM for M40, and 0.2 nM for C7, as compared to 0.8 nM for unlabelled porcine galanin(1-29). These two structurally different galanin antagonists, both demonstrating antagonist activity in vivo in awake, behaving rats, provide promising tools for further analyses of the functional activity of galanin in the mammalian brain.

Amino Acid Sequence↗

Effect of ATP level and its metabolic turnover in liver on the proteosynthesis postmortem.

The level of ATP in liver tissue kept at 37 degrees C decreases rapidly. Its concentration decreases to 20% of the original one 2 hr postmortem and disappears completely in the following 2 hr. The decrease of ATP concentration is independent of both the degree of mechanical disintegration of the tissue (mash, homogenate) and of the presence of inhibitors of ATP biosynthesis (2,4-dinitrophenol, monoiodoacetate). The application of precursors of ATP biosynthesis, labeled with suitable radionuclides (32Pi and [14C]ADP), makes it possible to prove that ATP is formed in the absence of inhibitors. Increased biosynthesis of ATP simultaneously enables an increase in metabolic turnover. Higher consumption of ATP, under conditions of its higher biosynthesis, is the reason for the identical decrease of ATP concentration in liver postmortem, independently of the intensity of its biosynthesis. The gradual fall of ATP level postmortem causes a corresponding decrease of proteosynthesis. At that moment when ATP disappears, proteosynthesis is stopped as well. However, the synthesis of proteins can continue even in this period if exogenous source of energy (ATP) is added.

2,4-Dinitrophenol↗