Quantitative imaging of trace elements in solid samples by online isotope dilution laser ablation-inductively coupled plasma-mass spectrometry.

For quantitative visualization of trace elements, an online isotope dilution (ID) laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) method capable of accurately correcting the detection amount of targets is presented. Two aerosols from an ablated sample and a nebulized isotopically enriched spike solution were mixed online using a dual-port spray chamber. In this paper, transmission efficiency (TE) of each of the two gas streams to the ICP-MS detector is revealed, and the quantification values were corrected by including the ratio of TEs in the calculation of the online ID method. To verify the developed method, Fe and Sr as model elements in five certified reference materials (CRMs, glass: SRM 610, 612, 614, alloy: SS-356, -383) were quantified without the use of matrix-matched CRMs. The resultant values agreed with the certified values of CRMs in the range of 92.7-104.7% and 92.8-109.0% for Fe and Sr, respectively. The LODs (3σ) were 0.54 and 0.17 µg g-1 for Fe and Sr, respectively. In addition, the applicability of this method to quantitative imaging of unknown solid samples was demonstrated for actual biological hard tissues (a mouse incisor, human primary tooth, and fish otolith) using the result of shot-analysis. The results were consistent with the reported concentration range obtained by wet chemical analysis.

Split Flow Online Solid-Phase Extraction Coupled with Inductively Coupled Plasma Mass Spectrometry System for One-Shot Data Acquisition of Quantification and Recovery Efficiency.

Online solid-phase extraction (SPE) coupled with inductively coupled plasma mass spectrometry (ICPMS) is a useful tool in automatic sequential analysis. However, it cannot simultaneously quantify the analytical targets and their recovery percentages (R%) in one-shot samples. We propose a system that simultaneously acquires both data in a single sample injection. The main flowline of the online solid-phase extraction is divided into main and split flows. The split flow line (i.e., bypass line), which circumvents the SPE column, was placed on the main flow line. Under program-controlled switching of the automatic valve, the ICPMS sequentially measures the targets in a sample before and after column preconcentration and determines the target concentrations and the R% on the SPE column. This paper describes the system development and two demonstrations to exhibit the analytical significance, i.e., the ultratrace amounts of radioactive strontium (90Sr) using commercial Sr-trap resin and multielement adsorbability on the SPE column. This system is applicable to other flow analyses and detectors in online solid phase extraction.

A case of traumatic hematoma in the basal ganglia that showed deterioration after arrival at the hospital.

A case of traumatic hematoma in the basal ganglia that showed deterioration after arrival at the hospital was reported. A 65-year-old man crashed into the wall while riding a motorcycle. His Glasgow coma scale was E3V4M6 and showed retrograde amnesia and slight right motor weakness. Because head CT in the secondary trauma survey showed subarachnoid hemorrhage in the right Sylvian fissure and multiple gliding contusions in the left frontal and parietal lobe, he was entered into the intensive care unit for diagnosis of diffuse brain injury. He showed complete muscle weakness of left upper and lower limbs 5 h after the accident. Head CT newly showed hematoma, 2 cm in diameter, in the right basal ganglia. The patient vomited following the CT scan, and so his consciousness suddenly deteriorated into a stupor. We performed head CT again. The hematoma had enlarged to 5 cm at the same lesion and partially expanded into midbrain. The patient died on the 13th day of trauma. Based on retrospective interpretation, we conclude that clinical examinations, follow-up CT scans and blood examinations should be performed frequently as part of ICU management for all TBI patients in the early phase after trauma.

Analysis of groundwater flow line of the Goshiki-numa pond community using elevation-considered principal component analysis.

To reveal the dynamics of underground water flows, measuring many factors and chemical components are usually required. However, it is difficult for the human sense to find the right answers using the many chemo-data in different factors. Although principal component analysis is one of the useful means in a multivariate analysis (chemometrics) that can reduce the multivariable to only 2-D or 3-D and can successfully categorize quantitative multidata into several groups based on the similarity of water quality, underground water flows are difficult to elucidate owing to the lack of continuous information. This paper presents the dynamics of groundwater around the Goshiki-numa pond community (Goshiki-numa), National park of Japan, using multi-chemical component analysis and elevation-considered principal component analysis. Despite the difficulty of understanding the dynamics of groundwater flows of the pond community using limited factors thus far, an elevation-considered principal component analysis (e-PCA) presented herein has revealed the underground water flows around Goshiki-numa ponds by inputting 19 factors × 102 water (total 1,938 data) collected from 2011 to 2014 and 2016. This e-PCA proved to be an effective chemometrics technique for revealing underground water flows. It is believed to apply not only to analytical sciences but also to environmental sciences, civil engineering, and other fields dealing with multidata of water quality.

Arctangent normalization and principal-component analyses merge method to classify characteristics utilizing time-dependent material data.

We propose a technique for classifying paints with time-dependent properties using a new method of merging principal-component analyses (the "PCA-merge" method) that utilizes shifting of the barycenter of the PCA score plot. To understand the molecular structure, elemental concentrations, and the concentrations in the evolved gaseous component of various paints, we performed comprehensive characterizations using Fourier transform infrared spectroscopy, inductively coupled plasma mass spectrometry, and head-space-gas chromatograph/mass spectrometry while drying the paint films for 1-48 h. As various detected intensity- and time-axis variables have different dimensions that cannot be handled equally, we normalized those data as an angle parameter (θ) using arctangent to reduce the influence of high/low intensity data and the various analytical instrument. We could classify the paints into suitable categories by applying multivariate analysis to this arctangent-normalized data set. In addition, we developed a new PCA-merge method to analyze data groups that include different time components. This method merges the PCA data groups of each time-component axis into that of specific-component axes and distinguishes each sample by utilizing the shift in the barycenter of the PCA score plot. The proposed method enables the simultaneous utilization of various data groups that contain information about static and dynamic properties. This provides further insight into the characteristics of the paint materials via shifts in the barycenter of the PCA scores without requiring numerous peak identifications.

Effects of bag-mask versus advanced airway ventilation for patients undergoing prolonged cardiopulmonary resuscitation in pre-hospital setting.

BACKGROUND: There is no evidence that the advanced airway ventilation (AAV) method improves patient outcome in the pre-hospital cardiac arrest setting. OBJECTIVE: The aim of this study was to estimate the effectiveness of AAV vs. bag-mask ventilation (BMV) for cardiopulmonary arrest (CPA) patients, when administered by a licensed emergency medical technician in the pre-hospital setting. METHODS: The study used the database of patients who suffered out-of-hospital cardiogenic CPA from 2006 to 2007 in our hospital. Patient records were searched for the method of pre-hospital airway management (BMV or AAV) and the patient's outcomes were compared between groups. The primary endpoint was a favorable neurological outcome; the secondary endpoints were rate of return of spontaneous circulation (ROSC) and rate of admission to the intensive care unit (ICU). RESULTS: A total of 355 CPA patients (156 BMV and 199 AAV) were retrospectively enrolled. There was no significant difference in demographics between the two groups. The transportation time exceeded 30 min in both groups. The overall ROSC rate and ICU admission rate were significantly higher in the AAV group (p = 0.0352 and p = 0.0089, respectively). The data showed that AAV (odds ratio 1.960; 95% confidence interval 1.015-3.785) resulted in a higher overall ROSC rate than BMV, but there were no significant differences in either the rate of pre-hospital ROSC or in favorable neurological outcome. CONCLUSION: AAV may yield advantages over BMV in the overall rate of ROSC in CPA patients, but both approaches for airway management in this study resulted in a comparably favorable neurological outcome. Earlier ROSC would be required for improved overall outcome.

Sensitivity enhancement in inductively coupled plasma mass spectrometry using nebulization methods via nitrogen mixed gas effect.

We demonstrate the sensitivity enhancement in inductively coupled plasma mass spectrometry (ICP-MS) by combining ultrasonic nebulization via the nitrogen mixed gas effect. We showed the effect of nitrogen gas concentration (0-5%) in the nebulizer gas on the signal sensitivity for 63 elements using commercially available (concentric and ultrasonic) nebulizers. In addition, the limit of detection (ng L-1) was calculated in each case. Finally, we compared the sensitivity (i.e., the slope of the calibration curve), background noise intensity, and three-dimensional intensity distribution in the plasma to elucidate the effects of the concurrent use of mixed gas plasmas and nebulization methods.

Online solid-phase extraction-inductively coupled plasma-quadrupole mass spectrometric quantification of 90Sr using 88Sr/86Sr isotope dilution method.

Due to the lack of a correlation with the natural Strontium (Sr) isotopes, it is difficult to apply the isotope dilution (ID) method to an artificial radioactive mononuclide Strontium-90 (90Sr), in inductively coupled plasma-quadrupole mass spectrometry (ICP-QMS). Meanwhile, online solid-phase extraction (SPE)-ICP-QMS (SPE-ICP-QMS) serves as an automatic sequential analytical technique for measuring the ultra-trace amounts of radionuclides; however, apparent assay values obtained using this method are often negatively affected by differences in the sample matrix composition between standard and actual samples. In this study, the pg L-1 level of 90Sr was successfully measured by combining online SPE-ICP-QMS and the ID method with 88Sr/86Sr ratios in one sample injection, without the radioactive standard. Although naturally occurring abundant isobaric 90Zr significantly influences 90Sr quantification during mass spectrometry, consecutive separations between automated SPE and dynamic reaction cell (DRC) oxidation enable 90Sr quantification, even in the presence of isobaric 90Zr (acceptable down to 5.7 × 10-9 of 90Sr/Zr in sample solution), using this method. Through this method, both radioactive 90Sr and naturally occurring Sr were simultaneously quantified using 88Sr-to-86Sr and 88Sr-to-90Sr ratios without radioactive 90Sr standard solutions. This simultaneous quantification of stable Sr and 90Sr was achieved within 15 min with good recovery rates. The limit of detection of 90Sr was 1.1 pg L-1 (equivalent to radioactivity 5.6 Bq L-1) for a 10 mL injection. Finally, water collected from an actual contaminated water storage tank at the Fukushima Daiichi Nuclear Power Plant (Fukushima, Japan) was analyzed using the proposed method, and the obtained results agreed well with those obtained using conventional analytical methods.

Change in brain glucose after enteral nutrition in subarachnoid hemorrhage.

BACKGROUND: The alteration of brain extracellular glucose after enteral nutrition (EN) remains unclear. In this study, we used brain microdialysis methods to estimate whether the physiologic elevation of plasma glucose following EN affects brain glucose metabolism of aneurysmal subarachnoid hemorrhage (SAH) patients. METHODS: Brain extracellular glucose, lactate, glycerol, glutamate, and pyruvate were measured with a brain microdialysis probe in 12 patients (mean age: 60.0 y+/-7.8 y) after SAH. The EN was initially administered a mean of 3.2 d after the onset of SAH. All of the measured parameters were estimated before and after EN. RESULTS: Cerebral perfusion pressure did not significantly change after SAH during the study period. Plasma glucose rose significantly after EN (141.4+/-11.6mg/dL before EN versus 183.8+/-26.2mg/dL immediately after EN (P=0.0006), 177.7+/-30.2mg/dL at 2h after EN (P=0.0033)). The brain extracellular glucose before EN (2.5+/-0.92mmol/L) was significantly lower than the levels measured just after (3.49+/-1.0mmol/L, P=0.0186) and 2h after the end of EN (3.70+/-1.0mmol/L, P=0.0053). Brain extracellular concentrations of lactate, glutamate, pyruvate, and glycerol showed no significant changes. CONCLUSIONS: Brain extracellular glucose increased after the transient elevation of plasma glucose following EN. These results suggest that brief, physiologic elevations in plasma glucose after EN produced no changes in brain extracellular glutamate concentration or lactate/pyruvate ratio. These data may help determine the plasma glucose levels most effective for avoiding brain metabolic acidosis in patients after SAH. It remains unclear, however, how SAH itself influences these findings.

Development of Online Dilution System for Quantification of 90Sr Using Automatic Solid-phase Extraction Inductively Coupled Plasma Mass Spectrometry.

In this paper, we propose an online dilution system for the rapid quantification of radioactive strontium-90 (90Sr) with inductively coupled plasma mass spectrometry coupled solid-phase extraction and O2 dynamic reaction (cascade ICP-MS). The proposed system automatically provides a higher dilution ratio, which is at most 3.3 ± 0.2-times the ratio obtained by the previous method, without increasing the analysis time (<15 min). A detection limit of 2.7 Bq/kg wet (0.54 pg/kg wet) was achieved. The recovery test results were consistent with two different spiked values.

Efficient Degradation of Poly(ethylene terephthalate) with Thermobifida fusca Cutinase Exhibiting Improved Catalytic Activity Generated using Mutagenesis and Additive-based Approaches.

Cutinases are promising agents for poly(ethylene terephthalate) (PET) bio-recycling because of their ability to produce the PET monomer terephthalic acid with high efficiency under mild reaction conditions. In this study, we found that the low-crystallinity PET (lcPET) hydrolysis activity of thermostable cutinase from Thermobifida fusca (TfCut2), was increased by the addition of cationic surfactant that attracts enzymes near the lcPET film surface via electrostatic interactions. This approach was applicable to the mutant TfCut2 G62A/F209A, which was designed based on a sequence comparison with PETase from Ideonella sakaiensis. As a result, the degradation rate of the mutant in the presence of cationic surfactant increased to 31 ± 0.1 nmol min-1 cm-2, 12.7 times higher than that of wild-type TfCut2 in the absence of surfactant. The long-duration reaction showed that lcPET film (200 µm) was 97 ± 1.8% within 30 h, the fastest biodegradation rate of lcPET film thus far. We therefore believe that our approach would expand the possibility of enzyme utilization in industrial PET biodegradation.

Correction to: Sepsis patients with complication of hypoglycemia and hypoalbuminemia are an early and easy identification of high mortality risk.

In the original article, there were errors in Unit of serum albumin level and the Cases numbers in Table 4.

Sepsis patients with complication of hypoglycemia and hypoalbuminemia are an early and easy identification of high mortality risk.

Either hypoglycemia or hypoalbuminemia alone is an independent condition associated with increased risk of mortality in critical illness. This study evaluates whether the mortality risk increases in septic patients if these conditions are combined. Patients admitted to our hospital from 2008 to 2015 who satisfied the definition of sepsis were targeted (n = 336). We classified cases into three groups based on blood glucose (BG) level measured at admission: hypoglycemia (Hypo-G; BG < 80 mg/dl), intermediate glycemia (Inter-G; 80-199 mg/dl), and hyperglycemia (Hyper-G; ≥ 200 mg/dl) group, and then estimated mortality. We also compared the clinical data of these glycemic groups in combination with hypoalbuminemia (Hypo-A) or Inter-G with non-hypoalbuminemia (Inter-G + Nonhypo-A), as a secondary analysis. Diagnostic cut-off level of Hypo-A (< 2.8 mg/dl) was determined using the ROC curve between blood albumin and mortality. In Hypo-G group (n = 40), APACHE II/SOFA scores are significantly higher than in the Inter-G (n = 196) and Hyper-G groups (n = 100). Mortality is 52.5% in the Hypo-G and 60.0% in the Hypo-G with Hypo-A (Hypo-G + Hypo-A) groups. Significantly higher APACHE II or SOFA scores and mortality are observed in the Hypo-G + Hypo-A group compared to the Inter-G + Nonhypo-A group. A higher mortality risk is observed in cases with Hypo-G + Hypo-A (OR 5.065) than those with Hypo-G (OR 3.503), Inter-G (OR 1.175), Hyper-G (OR 1.756) or Hypo-A (OR 3.243), calculated by a single logistic-regression analysis. Hypo-G + Hypo-A in patients with sepsis is related to higher ICU mortality. Physicians should be keenly aware of these conditions to provide immediate intensive treatment after admission of septic patients.

Rapid Quantification of Radioactive Strontium-90 in Fresh Foods via Online Solid-Phase Extraction-Inductively Coupled Plasma-Dynamic Reaction Cell-Mass Spectrometry and Its Comparative Evaluation with Conventional Radiometry.

This paper describes a rapid quantification method for radioactive strontium (90Sr) in fresh foods (perishable foods) and has been comparatively evaluated with the common classical radiometric quantification method. Inductively coupled plasma-dynamic reaction cell-mass spectrometry with online solid-phase extraction (cascade-ICP-MS) rapidly determines 90Sr in a pure water-based sample. Despite its advantages, its application to fresh foods (perishable foods) has not yet been reported; however, the analytical potential of this method for fresh foods must be evaluated. In this study, 90Sr was determined in 12 fresh foods via improved cascade-ICP-MS (Icas-ICP-MS). Addition and recovery tests were demonstrated using real samples of grape, apple, peach, Japanese pear, rice, buckwheat, soybean, spinach, shiitake mushroom, grass, sea squirt, and flounder. With a decomposed solution of Japanese pear, the measurement value coincided with the amount of spiked 90Sr. The reproducibility of the measurements was represented by relative standard deviations of 14.2 and 5.0% for spiked amounts of 20 and 200 Bq/kg, respectively (n = 10), and the recovery rates were 93.7 ± 7.1%. In this case, the limit of detection (LOD) was 2.2 Bq/kg (=0.43 pg/kg). These results were compared with the data obtained using a common classical radiometric quantification method (nitrate precipitation-low background gas flow counter (LBC) method) in the same samples. Both the methods showed equivalent performances with regard to reproducibility, precision, and LODs but different analysis times. Icas-ICP-MS required ∼22 min for analysis, whereas the nitrate precipitation-LBC method required 20 days, confirming that Icas-ICP-MS is the suitable method for analyzing 90Sr in fresh foods.

Ultrasonic Mist Generation Assist Argon-Nitrogen Mix Gas Effect on Radioactive Strontium Quantification by Online Solid-Phase Extraction with Inductively Coupled Plasma Mass Spectrometry.

The Ar-N2 mix gas effect can easily improve the sensitivity of ICPMS; however, this effect discriminates against Sr. In this study, it was found that Ar-N2 mixed gases introduced into nebulizing gas enhanced the sensitivity of online solid-phase extraction (SPE) with inductively coupled plasma mass spectrometry (ICPMS) for radioactive strontium quantification. An ultrasonic nebulizer (USN) improved the Ar-N2 mixture gases effect of Sr and the mix gases (with USN) enhanced 3.7-times the signal intensity of Sr in normal pure Ar gas (with USN) in an online SPE-ICPMS. By adapting the gas-loading means from a nebulizing gas unit via USN, no careful tuning was necessary for the plasma turning. With this signal enhancement, a 0.06 pg/L detection limit (0.3 Bq/L) was achieved for radioactive strontium (90Sr) in online SPE-ICPMS within 30 min. In addition, environmental paddle water in the Fukushima Nuclear Power Plant was measured and the valued correspond to that obtained by radiometry.

Acceleration of Enzymatic Degradation of Poly(ethylene terephthalate) by Surface Coating with Anionic Surfactants.

Enzymatic degradation of poly(ethylene terephthalate) (PET) is promising because this process is safer than conventional industrial approaches. Recently, a cationic PET hydrolase (PETase) was identified from Ideonella sakaiensis. Pre-incubation of a low-crystallinity PET film with anionic surfactants prior to initiating the reaction was found to improve PETase activity 120-fold. After 36 h at 30 °C, the film thickness decreased by 22 %. The binding of surfactants to the film makes the surface anionic, thereby attracting the cationic PETase. Mutagenesis of PETase showed that the surface cationic region formed by R53, R90, and K95, which are located on the same side as the substrate binding pocket, was crucial for efficient acceleration of activity by the anionic surfactant. Thus, surfactant bound on PET aligns the orientation of the active site to the surface, resulting in efficient hydrolysis. We believe that this approach using PETase could be further improved by designing surfactant molecules for the more efficient enzymatic PET degradation.

The Clinical Significance of Low Serum Arachidonic Acid in Sepsis Patients with Hypoalbuminemia.

Objectives Fatty acids (FAs) have various roles in pro-inflammatory and anti-inflammatory functions. Hypoalbuminemia is often observed in sepsis patients. An imbalance among these compounds formed from FAs caused by hypoalbuminemia may be related to increased mortality in sepsis patients. The purpose of this study was to investigate the correlations between serum albumin and FAs in sepsis and the outcome. Methods This study was an observational investigation. The clinical and laboratory data of sepsis patients were recorded and the Sequential Organ Failure Assessment (SOFA) score was calculated at admission. The serum arachidonic acid (AA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and dihomo-gamma-linolenic acid (DHLA) levels were also measured as FAs. The body mass index (BMI) was used to determine the general nutrition status. Results Two hundred sepsis patients were enrolled during the study period. No significant correlations were observed between the BMI and the SOFA score or the serum albumin level at admission. The FA levels of the non-survivors were significantly lower, but there were no significant differences in the EPA/AA levels of the survivors and non-survivors. A low serum albumin level was closely related to low AA (p<0.0001), EPA (p<0.0001), DHA (p=0.0003), and DHLA levels (p<0.0001). A multiple logistic-regression analysis revealed that a high SOFA score [adjusted odds ratio, 1.19; 95% confidence interval (CI), 1.02-1.39, p=0.026] and low AA (adjusted odds ratio, 0.98; 95% CI, 0.978-0.994, p=0.041) were associated with a poor outcome. Conclusion A lower AA level was an important determinant of the outcome of patients with sepsis. These findings are consistent with the findings of previous studies, which reported that hypoalbuminemia might alter the AA metabolism in sepsis patients.

Thromboembolic Complications Following Tissue Plasminogen Activator Therapy in Patients of Acute Ischemic Stroke - Case Report and Possibility for Detection of Cardiac Thrombi.

Many reports focus on the probability of intracranial hemorrhage as a complication after recombinant tissue plasminogen activator (rt-PA) therapy. However, thromboembolic complications are not well discussed. We experienced a case in which severe thromboembolic complications occurred in the right radial and right ulnar artery. Arterial fibrillation was observed in this case. If multiple thrombi exist in the atrium or ventricle, multiple small embolic particles may appear following thrombolytic therapy, and that may be a potential risk of secondary thromboembolic complications due to incomplete dissolution of thrombi. Transesophageal echocardiography is a standard method to detect intracardiac sources of emboli in the case of arterial fibrillation. Transesophageal echocardiography is, however, an invasive method for patients with ischemic stroke during rt-PA therapy. High resolution enhanced CT could be a useful tool and may be a reliable alternative to transthoracic echocardiography. Careful assessment of thromboembolic complications following rt-PA therapy in patients with arterial fibrillation is needed. In this case report and mini review, we would like to discuss about the accurate diagnostic methods to detect cardiac or undetermined embolic sources and provide expedited stroke care. These embolic sources may be more readily discovered during rt-PA therapy within the limited therapeutic time window.

Delayed increase in serum acetaminophen concentration after ingestion of a combination medications: a case report.

Acetaminophen is absorbed rapidly after oral intake, and serum concentration peaks within 4 hours. The Rumack-Matthew (RM) nomogram is widely used to identify the potential risk of liver dysfunction. However, the RM nomogram was intended for use only when a single agent was ingested. We report the case of a patient with overdose ingestion of an over-the-counter combination cold medication that contained acetaminophen, where the patient's serum concentration increased over time. Over-the-counter combination cold medications are designed to relieve cold symptoms. However, the possibility that other agents that were present in the drug may change gastrointestinal kinetics should also be considered. The risk of liver dysfunction cannot be accurately determined from a single serum acetaminophen concentration measurement. Because of the risk of a delayed increase in the serum acetaminophen concentration, monitoring for liver dysfunction and developing a treatment strategy that includes N-acetylcysteine are required. This case report is targeted to clinical physicians who treat patients with acetaminophen overdose resulting from ingestion of multiple agents, and it reviews points of consideration when using the RM nomogram in acute intoxication.

Inhibition of lipopolysaccharide stimulated interleukin-1beta production after subarachnoid hemorrhage.

PURPOSE: To identify the characteristics of cytokine production from peripheral blood mononuclear cells (PBMCs) in response to lipopolysaccharide (LPS) in patients with subarachnoid hemorrhage (SAH). METHODS: Blood samples were collected on the first day and 3 days after SAH (n = 12) to measure plasma concentrations of catecholamines, tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1beta and IL-10. PBMCs from SAH patients or healthy volunteers were incubated with LPS (1 microg) for 24 hours. In the second phase, PBMCs from healthy volunteers (n = 6) were incubated with or without catecholamine (10 micromol/1) for 6 hours. After pre-treatment, the cells were treated with LPS (1 microg) for 18 hours. Supernatants were extracted and subjected to measurement by enzyme-linked immunosorbent assay. RESULTS: Plasma concentrations of epinephrine or dopamine prolong increased significantly 3 days after SAH, involved in elevation of plasma IL-10. In the PBMCs from the SAH patients, LPS-stimulated IL- 10 production was inhibited significantly. Pre-treatment with epinephrine or dopamine inhibited LPS-stimulated IL-1beta production significantly in the PBMCs from the healthy volunteers. CONCLUSIONS: The initial SAH involved in an impaired production of pro-inflammatory cytokines in response to LPS with an elevation of plasma epinephrine, dopamine and IL-10 after acute stressful conditions. This phenomenon may play an important role of an early immnosupression in patients with poor grade SAH.