Understanding the Relationship between Social Cognition and Word Difficulty. A Language Based Analysis of Individuals with Autism Spectrum Disorder.

BACKGROUND: Few quantitative studies have been conducted on the relationship between society and its languages. Individuals with autistic spectrum disorder (ASD) are known to experience social hardships, and a wide range of clinical information about their quality of life has been provided through numerous narrative analyses. However, the narratives of ASD patients have thus far been examined mainly through qualitative approaches. OBJECTIVES: In this study, we analyzed adults with ASD to quantitatively examine the relationship between language abilities and ASD severity scores. METHODS: We generated phonetic transcriptions of speeches by 16 ASD adults at an ASD workshop, and divided the participants into 2 groups according to their Social Responsiveness Scale(TM), 2nd Edition (SRS(TM)-2) scores (where higher scores represent more severe ASD): Group A comprised high-scoring ASD adults (SRS(TM)-2 score: ≥ 76) and Group B comprised low- and intermediate-scoring ASD adults (SRS(TM)-2 score: < 76). Using natural language processing (NLP)-based analytical methods, the narratives were converted into numerical data according to four language ability indicators, and the relationships between the language ability scores and ASD severity scores were compared. RESULTS AND DISCUSSION: Group A showed a marginally negative correlation with the level of Japanese word difficulty (p < .10), while the "social cognition" subscale of the SRS(TM)-2 score showed a significantly negative correlation (p < .05) with word difficulty. When comparing only male participants, Group A demonstrated a significantly lower correlation with word difficulty level than Group B (p < .10). CONCLUSION: Social communication was found to be strongly associated with the level of word difficulty in speech. The clinical applications of these findings may be available in the near future, and there is a need for further detailed study on language metrics designed for ASD adults.

Preliminary development and evaluation of the support system for care of mechanically ventilated patients.

BACKGROUND: We wanted to demonstrate the feasibility of a novel computer-assisted ventilator alarm system, the support system for care of mechanically ventilated patients (SCMVP), to detect gas leaks and provide graphical information on the site of the leak in a manikin model. METHODS: We tested six leakage scenarios. Four scenarios were applied to both the respiratory circuits with the SCMVP and without the SCMVP (conventional system), and two scenarios were each specific to one of the systems. Fifteen registered nurses were asked to manage three scenarios each (two mutual and one system-specific scenario). Time to identify the site of the leak was measured and compared between the two systems. RESULTS: The SCMVP showed significantly shorter time for troubleshooting in one of the four mutual scenarios and shorter accumulated time for troubleshooting in the four mutual scenarios [18.0 (range, 14.5-19.5) and 48.5 (9.0-180.0) s, respectively] compared with the conventional system [76.0 (47.0-133.8) and 82.5 (16.0-180.0) s, respectively]. In the mutual scenarios, SCMVP resulted in significantly more frequent incidences of successful troubleshooting within 30 s and less frequent incidences of troubleshooting requiring >180 s [43.3% (13/30) and 6.7% (2/30), respectively] compared with the conventional system [13.3% (4/30) and 30% (9/30), respectively]. CONCLUSIONS: The SCMVP can facilitate rapid and successful recognition of the site of leak in a respiratory circuit in a simulation environment.

Characterization of the cell surface protein gene of Corynebacterium ammoniagenes.

Three dominant cell surface proteins of Corynebacterium ammoniagenes ATCC 6872 were identified in the cell wall fraction. The cspA gene, which encodes one of the major cell surface proteins, was cloned using the N-terminal amino acid sequence of the protein. Then the cloned chromosomal fragment containing the cspA gene was sequenced and was shown to encode a mature polypeptide of 333 amino acids with a molecular mass of 36654 Da. The amino acid sequence of the cspA gene showed similarity to the amino acid sequence of C. glutamicum CspA, one of the two major secreted proteins of C. glutamicum, although C. ammoniagenes CspA and C. glutamicum CspA differed in size. Northern blot analysis and primer extension analysis respectively revealed a 1.1 kb transcript and a promoter sequence resembling that of the C. ammoniagenes fatty acid synthase B (fasB) gene.

Phosphorylation of guanosine using guanosine-inosine kinase from Exiguobacterium acetylicum coupled with ATP regeneration.

Guanosine 5'-monophosphate (5'-GMP) and inosine 5'-monophosphate (5'-IMP) are widely used as flavor enhancers. Recently, a novel process for 5'-IMP production by phosphorylation of inosine using guanosine-inosine kinase coupled with ATP regeneration was reported. In this study, we demonstrated the practical possibility of producing 5'-GMP by phosphorylation of guanosine using a guanosine-inosine kinase from Exiguobacterium acetylicum coupled with ATP regeneration.

End-product regulation and kinetic mechanism of guanosine-inosine kinase from Escherichia coli.

Escherichia coli guanosine-inosine kinase was overproduced, purified, and characterized. The native and subunit molecular weights were 85,000 and 45,000, respectively, indicating that the enzyme was a dimer. A pI of 6.0 was obtained by isoelectric focusing. In addition to ATP, it was found that deoxyadenosine 5'-triphosphate, UTP, and CTP could serve as phosphate donors. The phosphate acceptors were guanosine, inosine, deoxyguanosine and xanthosine, but not adenosine, cytidine, uridine, or deoxythymidine. Maximum activity was attained at an ATP/Mg2+ concentration ratio of 0.5. In the presence of pyrimidine nucleotides, enzyme activity was slightly increased, while it was markedly inhibited by GDP and GTP. Initial velocity and product inhibition studies support an ordered Bi Bi mechanism in which guanosine was the first substrate to bind and GMP was the last product to be released. Guanosine kinase may be a regulatory enzyme that has a role in modulating nucleotide levels.

Development of an improved assay for purine nucleoside kinase activity in cell extracts and detection of inosine kinase activity in Brevibacterium acetylicum ATCC 953, related species, and Corynebacterium flaccumfaciens ATCC 6887.

An improved assay was developed to detect direct purine nucleoside phosphorylating activity in cell-free extracts. Direct inosine phosphorylating activity was detected in 2 of 70 species tested. Both activities, which depended on magnesium ion and ATP, phosphorylated a hydroxyl group at the 5' position of inosine. The new assay was shown to be useful for screening of direct purine nucleoside phosphorylating activity and have the potential to detect inosine kinase in the presence of a background of nucleoside phosphorylase and purine phosphoribosyltransferase activities. Previously, the latter two activities made it difficult to correctly detect direct phosphorylation of inosine by inosine kinase.

The effects of intraoperative glucose infusion on portal blood insulin concentration and hepatic mitochondrial redox state during surgery: comparison of short-term and continuous infusions.

The relationships between the blood glucose level, portal blood immunoreactive insulin (IRI) concentration, ketogenesis, and hepatic mitochondrial redox state associated with intraoperative glucose administration were evaluated in patients undergoing total gastrectomy. A total of 26 patients were randomly allocated to two groups according to the type of infusion given; group 1 was given a short-term glucose infusion of 25 g in 30 min and group 2 was given a continuous glucose infusion of 10 g/h. The blood glucose concentration peaked 30 min after the glucose infusion was commenced, then decreased in group 1, despite a continuous rise in group 2. A temporary but significantly higher blood glucose level was observed in group 1 than in group 2, 30 and 60 min after the infusion was commenced. The portal blood IRI concentrations and arterial ketone body ratio (AKBR) continued to increase and the blood ketone body concentrations continued to decline after the start of the glucose infusion in both groups; however, after 60 and 120 min, the portal blood IRI and AKBR levels were significantly higher, and the blood ketone body levels significantly lower in group 1 than in group 2. These findings suggest that intraoperative glucose administration is beneficial for insulin secretion, ketogenesis, and the hepatic mitochondrial redox state, and that short-term infusion is superior to continuous infusion.

Molecular characterization of guanosine kinase gene from a facultative alkalophile, Exiguobacterium aurantiacum ATCC 35652.

Guanosine kinase activity was identified in an alkalophile, Exiguobacterium aurantiacum ATCC 35652, and the gsk gene encoding it was isolated as a homologous fragment of the Brevibacterium acetylicum gsk. The cloned chromosomal fragment contained an open reading frame which encodes a polypeptide of 308 amino acids with a molecular mass of 33349 Da. The Ex. aurantiacum Gsk shows strong sequence similarity to B. acetylicum Gsk, but possesses five additional amino acids at the C-terminus. An Mr 39200 protein synthesized in Escherichia coli harboring plasmids carrying Ex. aurantiacum gsk was purified and characterized. A 0.9 kb transcript revealed by Northern blot analysis and the presence of a factor-independent terminator structure suggest that Ex. aurantiacum gsk is monocistronic, although B. acetylicum gsk has been shown to be bicistronic. The striking alterations in the 3'-untranslated region resulted in a different gene organization.

[Usefulness of positron emission tomography to STA-MCA anastomosis for the case with cerebral infarction].

The ischemic area surrounding the cerebral infarction in the eloquent area was salvaged by STA-MCA bypass surgery. Both the misery perfusion area evaluated by positron emission tomography (PET) using the [15O] gas inhalation steady-state method and clinical symptoms improved within a year after surgery. To confirm the ischemic area and select the suitable recipient artery was important for successful bypass surgery, because only an artery covering the ischemic area is expected to have low resistance. In this case a large ischemic area with disturbed, vasodilatation by Diamox was detected on the SPECT. However, PET clearly exposed the localized misery perfusion area in the overestimated ischemic area by SPECT. We describe our experience and discuss the technique and efficacy of PET for STA-MCA anastomosis surgery.

Acute effects of distal pancreatectomy on portal and peripheral blood insulin concentrations in patients undergoing total gastrectomy.

The influence of distal pancreatectomy on portal and peripheral blood immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) concentrations was evaluated in patients undergoing total gastrectomy. There were 22 patients studied, 12 of whom did not undergo distal pancreatectomy (group 1), and 10 who did (group 2). In group 2, the increase in portal blood IRI concentrations after a glucose infusion of 25 g over 30 min was suppressed, and reelevation of the portal blood IRG concentration after the glucose-induced depression was inhibited compared to group 1. In contrast, the peripheral blood IRI concentration did not reflect these changes in the portal blood IRI concentration. The rise in the arterial ketone body ratio (AKBR) and the fall in the total ketone body concentration after glucose infusion were also attenuated after distal pancreatectomy in group 2. These findings suggest that distal pancreatectomy has an immediate suppressive effect on the pancreatic secretion of insulin and glucagon, and might disturb metabolism in the liver.

Molecular cloning and transcriptional analysis of a guanosine kinase gene of Brevibacterium acetylicum ATCC 953.

The Brevibacterium acetylicum gsk gene, which encodes guanosine kinase (ATP:guanosine 5'-phosphotransferase), a kinase that is involved in guanosine salvage pathways, has been cloned by using the N-terminal amino acid sequence of the purified protein. The cloned chromosomal fragment containing the gsk gene was sequenced and shown to encode a polypeptide of 303 amino acids with a molecular mass of 32,536 Da, which is in good agreement with the measured molecular weight of the purified enzyme. Recombinant Escherichia coli strains harboring plasmids carrying the B. acetylicum gsk gene overexpressed both guanosine and inosine kinase activities. The primary structure of the gsk gene shows similarity to amino acid sequences of sugar kinases classified in the ribokinase family stronger than to those of the E. coli gsk gene encoding guanosine kinase and other nucleoside kinases. Northern blot analysis and primer extension analysis revealed a 1.4-kb transcript and promoter sequences, like the E. coli sigma70 and B. subtilis sigmaA consensus sequences, respectively. These results, together with the nucleotide sequence of the downstream region of gsk, suggested that the organization of B. acetylicum gsk is bicistronic. The second gene, orf2, shows significant similarity to the mutT mutator genes of several organisms, although its function has not yet been identified. The gsk gene was specifically transcribed in the early exponential growth phase, which seems to correspond to the specific guanosine kinase activity profile and suggests a role in controlling the nucleoside monophosphate level by efficiently recycling guanosine when cells are in the early exponential phase.

Characterization of guanosine kinase from Brevibacterium acetylicum ATCC 953.

Guanosine kinase (GKase) activity was identified in a cell-free extract of Brevibacterium acetylicum ATCC 953. We have purified the enzyme 4000-fold from the cell-free extract to apparent homogeneity. Molecular weight of 71,300 and 36,300 determined by gel filtration and sodium dodecyl sulfate gel electrophoresis, respectively, revealed that the enzyme is a dimer molecule. Maximum activity of the GKase was attained when the magnesium/ATP concentration ratio was close to 1. The GKase activity was dependent on the presence of a divalent cation. The Km values for guanosine, inosine, and 2'-deoxyguanosine as phosphate acceptors were determined to be 0.022, 0.87, and 2.83 mM, respectively. In addition to ATP and dATP, GTP and dGTP were shown to be effective phosphate donors for the GKase. The optimal pH seemed to be around pH 8.3, although relatively high activity was observed in the alkaline pH range of 7.5-9.8. The addition of 0.1 mM pyrimidine nucleotides, especially CMP and CTP, activated the GKase activity. On the other hand, the addition of 1 mM AMP, ADP, and GMP inhibited the GKase activity. It is thus likely that the GKase activity might be regulated in vivo by nucleotide concentrations and may control the nucleoside monophosphate level by efficiently recycling guanosine.

Influence of blood sample oxygen tension on blood glucose concentration measured using an enzyme-electrode method.

OBJECTIVE: To determine the accuracy of a bedside glucometer with an enzyme-electrode sensor based on enzyme oxidation by glucose oxidase. DESIGN: Prospective, cross-sectional clinical study. SETTING: Operating room in a public hospital. PATIENTS: Fifty-four patients undergoing surgical procedures for a derivation (n = 17) and a validation (n= 37) study. INTERVENTIONS: Arterial blood samples were obtained via a 20-gauge cannula inserted into each patient's radial artery. MEASUREMENTS AND MAIN RESULTS: Glucose measurements and arterial blood gas analyses were concurrently performed, using 48 blood samples for the derivation study and 45 blood samples for the validation study of this technique. Blood glucose concentrations were measured with both a bedside glucometer using an enzyme-electrode method and a laboratory glucometer based on the colorimetric method. The bedside glucometer consistently underestimated the glucose concentrations and the underestimation was related to the sample oxygen tension but not to hematocrit, plasma protein, creatinine, uric acid, or bilirubin. The present investigation used the following correction formula: (corrected glucose value) = (glucose concentration obtained by a bedside glucometer) + 0.1 x (sample oxygen tension) + 16. The corrected data were in agreement with the laboratory-determined glucose values (i.e., the mean difference and precision were 0.4 and 7.1 mg/dL, respectively). A validation study confirmed the generalization of the present correction formula which facilitates a more accurate estimation of blood glucose concentrations. CONCLUSIONS: Blood glucose values measured using a bedside glucometer in this study were influenced by the sample oxygen tension. We used a corrective equation which improved the accuracy of estimating blood glucose values to a clinically acceptable range.

[Cytomegalovirus colitis in a normal woman].

A 32-year-old woman was admitted to our hospital because of diarrhea, fever, and liver dysfunction. IgM antibody to hepatitis C antibody and hepatitis B makers were negative. Antibodies to human deficiency virus was negative. Bacterial cultures of the stool were negative. Sigmoidoscopy on the 9th hospital day showed diffuse edematous and inflated mucosa in the rectum and left-sided colon. Multiple erosions and small ulcers were also present. Polymerase chain reaction examination revealed cytomegalovirus (CMV) DNA in the biopsy specimen of the rectum and the blood on the 10th hospital day. IgG antibody titer to CMV was low, but IgM titer was high. Her physical state had improved and fever resolved without anti-CMV therapy. Second sigmoidoscopy on the 24th hospital day showed normal mucosa. One month later the patient was free from any symptoms. Immunocompromised patients such as recipients of solid organ and bone marrow transplants, patients with AIDS, and patients with malignancies frequently complicate CMV colitis, which can be a major cause of death. Thus, CMV colitis is rarely overlooked in immunocompromised patients. Only a few cases of CMV colitis are reported in adult patients with no risk for CMV infection or associated disease. CMV colitis should be concluded in the differential diagnosis of acute or subacute colitis even in immunocompetent patients.

Pulmonary endocrine cell hyperplasia and papilloma in rats induced by intratracheal injections of extract from particulate air pollutants.

We investigated the effect of intratracheal injections of an extract of suspended particulate matter (SPM) obtained from the urban ambient air of Tokyo, upon the development of proliferative lesions of pulmonary endocrine cells (PECs) in the rat. We also examined the modification effects of nitrogen dioxide, sulfur dioxide, or both of them on the PEC lesions. Male F344 rats were divided into six experimental groups of 5 animals each. Twenty animals were treated with intratracheal instillations of SPM admixed with carbon once a week for 4 weeks with or without additional gaseous exposure (6 ppm nitrogen dioxide or 4 ppm sulfur dioxide) 16 hrs a day for 11 months. Five animals were given intratracheal injections of carbon suspended in saline and the other five were untreated. The subcardiac lobes of the right lung were fixed with 4% paraformaldehyde, and embedded in paraffin. PEC hyperplasias and papillomas were counted in 200 serial sections, 4 microns thick. The average incidences of PEC hyperplasia in the untreated animals and in those treated with carbon were 194 and 200/cm3, respectively. The average incidences of PEC hyperplasia in the animals exposed to SPM tar only, SPM tar plus nitrogen dioxide and sulfur dioxide, SPM tar with nitrogen dioxide and SPM tar with sulfur dioxide were 376, 378, 372 and 349/cm3, respectively. These were significantly higher than the levels of the control animals, and additional gaseous stimuli had no effect on the incidence of PEC hyperplasia. Besides PEC hyperplasia, a few PEC papillomas were found in the animals treated with SPM tar, regardless of gaseous exposure, but in the control animals no papilloma was evident. Thus, compounds in airborne particulates are considered to be responsible for the development of PEC hyperplasias and papillomas.

Molecular cloning of the Corynebacterium glutamicum ('Brevibacterium lactofermentum' AJ12036) odhA gene encoding a novel type of 2-oxoglutarate dehydrogenase.

The Corynebacterium glutamicum ('Brevibacterium lactofermentum' AJ12036) odhA gene, encoding 2-oxoglutarate dehydrogenase (E1o subunit of the 2-oxoglutarate dehydrogenase complex), has been isolated and identified as an homologous counterpart of the Escherichia coll sucA and Bacillus subtilis odhA genes. The nucleotide sequence of a 4394 bp chromosomal fragment containing the C. glutamicum odhA gene was determined. The odhA gene comprised 3771 bp (1257 codons, including the initiation codon) and a molecular mass of 138656 Da was predicted for the OdhA polypeptide. Northern blot analysis revealed a 3.9 kb transcript. The size of the transcript, together with the presence of a rho-independent terminator-like structure, suggests that C. glutamicum odhA is monocistronic. Cells harbouring plasmids carrying C. glutamicum odhA showed a threefold increase in specific 2-oxoglutarate dehydrogenase complex activity and expression of a protein with an apparent molecular mass of 136 kDa, in good agreement with the predicted size of the OdhA polypeptide. The C-terminal region of the C. glutamicum OdhA protein shows strong sequence similarity to E1os from other organisms. C. glutamicum OdhA has an N-terminal extension not found in previously reported E1os. The amino acid sequence of this extension shows similarity to that of the C-terminal region of dihydrolipoamide S-succinyltransferase (E2o) subunits of 2-oxoglutarate dehydrogenase complexes and dihydrolipoamide S-acetyltransferase (E2p) subunits of pyruvate dehydrogenase complexes. It suggests that the C. glutamicum odhA gene might encode a novel bifunctional protein with E1o and E2o activities.

In vivo growth and differentiation potential of tracheal basal cells of rabbits in vitamin A deficiency.

The growth and differentiation potential of rabbit tracheal basal cells were investigated in vitamin A deficient mice. Denuded rat tracheal grafts were xenotransplanted into nude mice made vitamin A deficient by feeding them retinol-free pellets from mid-gestation. Rabbit tracheal epithelial cells harvested enzymatically or cells derived from a basal-cell-rich fraction obtained by elutriation (purity 93.3%) had previously been inoculated into the grafts (n = 8, each). The grafts were implanted into the vitamin A deficient or control mice aged about 10 weeks. Four weeks later, the grafts were retrieved for histological examination. The graft epithelium established by either basal cells or un-fractionated cells in vitamin A deficient hosts (groups 1 and 2, respectively) was atrophic, whereas grafts repopulated with both cell types in the controls had pseudostratified columnar epithelium. Group 1 and 2 grafts both showed squamous metaplasia; 10 metaplastic foci in 32 tracheal rings in group 1 (P < 0.02 or 0.002, compared with values for group 2 or controls, respectively), and 2 foci in 35 rings in group 2 (no statistical difference compared with controls). In conclusion, during vitamin A deficiency, rabbit tracheal epithelial cells, including the progeny of highly-purified basal cells, lost their potential for establishing a mucociliary epithelium and rather appeared to undergo squamous metaplasia.

Intra-arterial blood gas monitoring system: more accurate values can be obtained.

OBJECTIVE: To compare values measured by a continuous intra-arterial blood gas monitoring system with those measured by conventional blood gas analyzer for the assessment of the clinical performance of a new device for measurement of PaO2, PaCO2, and arterial pH. METHODS: Forty-six patients undergoing cardiopulmonary bypass were enrolled in this study. All patients had a continuous intra-arterial sensor (PB 3300) placed into the radial artery through a 20-gauge catheter. A total of 319 arterial blood gas and pH values were obtained for comparison with a conventional blood gas analyzer. The measurements were performed every 12 hrs after the initial in vitro calibration of the sensor for each patient. RESULTS: Measurements were made over a range of 12 to 192 hrs. The overall bias and precision determined by the two methods were 4.5 and 17.1 mmHg for PaO2; 4.5 and 6.2 mmHg for PaCO2; and 0.009 and 0.035 for pH, respectively. For the range of PO2 less than 150 mmHg, the bias and precision improved to 4.2 and 9.5 mmHg. The sensor-derived PCO2 value, PCO2 (IABG), increased significantly more than the conventional blood gas analysis value, PCO2(ABG), even within 72 hrs (2.8 and 4.1 mmHg). The relationship between the two measurements can be described as: PCO2(IABG)/PCO2(ABG) = 1 + 0.0026.t where t is the time period of use (in hours). By correcting the PCO2(IABG) value using this formula, the overall bias and precision of the values measured by two methods decreases to -0.4 and 3.6 mmHg. CONCLUSIONS: The PO2 and pH values derived from an intra-arterial blood gas monitoring system agreed well with the values measured by a conventional blood gas analyzer. However, the PCO2 value must be corrected due to an increase of drift, especially with extended use for more than 72 hours.

[Lessons from experience of bertrand's selective peripheral denervation for splenius type torticollis].

A 23-year-old male with splenius type torticollis underwent selective denervation of C1 and C2 roots and C3-C6 spinal posterior rami, with excellent results. Based on this experience, we stress the importance of dynamic EMG and thorough review of video recording for identifying the involved neck muscles. In the operative procedures, the nerve rami are identified under the semispinalis muscle. To dissect the correct plane under the semispinalis muscle, the key point to keep in mind is to follow the great occipital nerve to the proximal part. An ultrasonic blood flow meter is useful to locate the vertebral artery in the spaces between the occiput and the C1 lamina and between C1-C2 laminae. Because fine nerve branches run in the soft tissues over the laminae, to avoid transient neuroapraxia, dissection around the C1, C2 arches should not be carried out under the periosteum, as is usually done in case of laminectomy. Dissection of C1 and C2 rami as far as the very medial part is rather difficult because of bleeding from the venous plexus and the presence of the vertebral artery. Therefore, the intradural approach might be easier for sectioning the C1 and C2 roots. We would like to add these points to the original description by Bertrand.

[Portal and peripheral blood insulin concentrations and arterial ketone body ratio before and after glucose infusion during gastrectomy].

The effect of glucose infusion on portal and peripheral blood immunoreactive insulin (IRI) concentrations and arterial ketone body ratio (AKBR) during gastrectomy were evaluated on twenty patients divided into two groups. Portal and peripheral blood IRI concentrations, AKBR, total ketone body concentration (TKB: acetoacetate + beta-hydroxybutyrate), and blood glucose were determined before and 30, 60, and 120 minutes after 25g glucose infusion in 30 minutes in ten patients (group 1) and 50 g glucose infusion in 30 minutes in ten patients (group 2). In both groups, the rate of increase in the portal blood IRI concentration was markedly higher than that in the peripheral blood IRI concentration after glucose infusion and AKBR increased and TKB decreased with the increase of the portal blood IRI concentration. These findings suggest that the peripheral blood IRI concentration does not reflect the pancreatic insulin secretion after glucose infusion during surgery and that portal insulin plays an important role for elevating and maintaining AKBR at higher levels. On the other hand, in both groups, the blood glucose had its peak just after completion of glucose infusion and then decreased gradually. After glucose infusion, however, the blood glucose in group 2 increased markedly and was significantly higher than that in group 1. It is suggested that, during surgery, glucose infusion rate of 50 g in 30 minutes may be too rapid.