[Basic study on the mechanism of postanesthetic recovery acceleration caused by infusion of bicarbonated Ringer's solution].

BACKGROUND: Effect of bicarbonated Ringer's solution (BRS) on the liver function of rats with metabolic acidosis was compared with that of lactated Ringer's solution (LRS) and Ringer's solutions (RS). Furthermore, the effect of acidosis on the plasma protein binding ratio of propofol was examined. METHODS: Partial hepatectomized rats were divided into three groups, and BRS, LRS or RS was intravenously administered at 20 ml x kg(-1) x hr(-1) with propofol (45 mg x kg(-1) hr(-1)) for 90 min. Immediately after the administration, indocyanine-green (ICG) was infused. Blood sampling was done at 30, 60, 90 and 120 min after the ICG infusion, and the ICG concentration in plasma was measured. Propofol was added to plasma of rats with ketoacidosis or normal rats (final conc. 5 microg x ml(-1)), and incubated for 30 min at 37 degrees C. After incubation, plasma propofol concentrations were measured. RESULTS: The reduction of ICG in plasma of BRS group was the fastest among the three groups. Plasma protein binding ratio of propofol in plasma samples of rats with ketoacidosis tended to be lower than those of normal rats samples. CONCLUSIONS: These results suggest that metabolic acidosis induced the delay of awakening from anesthesia, suggesting that BRS accelerates recovery from anesthesia through amelioration of acidosis.

Transient left ventricular apical ballooning developing after the Central Niigata Prefecture Earthquake: two case reports.

Two patients presented with transient left ventricular apical ballooning (takotsubo cardiomyopathy) induced by emotional stress caused by the Central Niigata Prefecture Earthquake in 2004. These patients complained of chest pain immediately after the earthquake. In patient 1, electrocardiography (ECG) showed slight ST elevation in leads V5 to V6 and 1 mm ST depression in lead III. Serial ECG revealed inverted giant T waves in leads V3 to V6 and inverted T waves in leads I, II, aVL and aVF 13 days after the earthquake occurred. Patient 2 also complained of chest pain right after the earthquake, but consulted a doctor 15 days after the earthquake occurred. ECG showed inverted giant T wave in leads V1 to V6 and inverted T waves in leads I, II and aVL. Transthoracic echocardiography showed hypokinesis of the apical area of the left ventricle with normokinesis in the basal area in both patients. Coronary angiography showed no stenotic segments and coronary spasms were not induced by provocative testing. Serial cardiac radionuclide single photon emission computed tomography of myocardial functional sympathetic innervation using iodine-123-metaiodobenzyl-guanidine (MIBG) and thiallium-201 (201Tl) showed an MIBG uptake defect and increased wash-out in the apical area, but only mild decrease of apical 201Tl uptake. Due to strong emotional stress, earthquakes may induce transient left ventricular apical ballooning (takotsubo cardiomyopathy).

Effect of L-carnitine on erythroid colony formation in mouse bone marrow cells.

BACKGROUND: l-Carnitine can alleviate uraemic anaemia in haemodialysis patients by improving erythrocyte membrane functions or erythropoiesis, which are depressed under uraemic conditions. l-Carnitine and palmitoyl-l-carnitine were reported to increase the formation of colony-forming unit-erythroid (CFU-E) colonies in cultures of fetal mouse liver cells, an effect that depended on the concentration of palmitoyl-l-carnitine but not of l-carnitine. In this study, we investigated l-carnitine's effect on CFU-E colony formation in cell cultures of mouse bone marrow cells. METHODS: Bone marrow from normal female mice was placed in 35 mm culture dishes containing a medium composed of methylcellulose and various nutrients. The dishes were incubated for 48 h, and the colonies of erythroblasts, which were differentiated from CFU-E, consisting of >/=8 cells, were counted in each dish using an inverted microscope. RESULTS: The numbers of CFU-E colonies correlated well with both the initial numbers of bone marrow cells and concentrations of recombinant human erythropoietin (rhEPO) in the methylcellulose medium. In the presence of 0.5 or 1.0 IU/ml of rhEPO, l-carnitine at concentrations of 200 and 400 micromol/l significantly enhanced CFU-E colony formation (P<0.001). CONCLUSION: l-Carnitine significantly increased the number of CFU-E colonies in mouse bone marrow cell cultures. This finding suggests that l-carnitine stimulates erythropoiesis, partially accounting for its mitigating effect on renal anaemia.