Role of serum markers for liver function and liver regeneration in the management of chloroform poisoning.

Accidental or intentional chloroform poisoning is rare, but a few such cases have been reported in literature. We report here a successful management of acute chloroform toxicity in a 33-year-old white female who attempted suicide by injecting one half milliliter of chloroform, followed by drinking half a cup the next morning. Plasma chloroform levels, measured by headspace gas chromatography declined rapidly. Sequential measurement of biomarkers in serum for liver cell necrosis, liver function, and liver regeneration indicated the presence of initial liver damage followed by recovery. These results suggest that in addition to biomarkers for liver cell necrosis, serial determinations of markers for liver regeneration provide objective evidence for recovery from chloroform poisoning and possibly other hepatotoxins.

Amino acid arterial concentration and muscle exchange during submaximal arm and leg exercise: the effect of dihydroxyacetone and pyruvate.

The mixture of dihydroxyacetone and pyruvate (DHAP) is an ergogenic aid that enhances muscle glucose extraction during prolonged aerobic exercise. In order to evaluate the effect of DHAP on muscle amino acid extraction during exercise, we measured arterial concentration and muscle exchange of amino acids in 18 untrained healthy male subjects (aged 20-30 years) performing dynamic arm (60% VO2 max, n = 9) or leg (70% VO2 max, n = 9) exercise to exhaustion with and without dietary supplementation of DHAP. The subjects consumed diets (146 kJ kg body weight-1 day-1) containing either 100 g polyglucose, Polycose (placebo, P) or DHAP (3:1, treatment) substituted for a portion of carbohydrate. The two diets were administered in a double-blind, random, crossover order for a 7-day period. At least 7 days separated the dietary protocols. Blood samples were drawn through radial artery and axillary or femoral vein catheters at rest, during exercise and at exhaustion. Arterial alanine concentration increased by 30% during arm exercise and by 50-60% during leg exercise. No other arterial amino acid concentration changed during exercise. At exhaustion, arterial alanine concentration decreased to pre-exercise levels with arm exercise but remained elevated after leg exercise. Despite changes in arterial concentrations of alanine with exercise, muscle exchange of alanine was not altered with exercise. Exercise did not alter muscle exchange of any amino acid. Arterial amino acid concentrations and muscle exchange of amino acids with exercise were similar with or without DHAP feeding.(ABSTRACT TRUNCATED AT 250 WORDS)

Addition of rifampin to ticarcillin-tobramycin combination for the treatment of Pseudomonas aeruginosa infections: assessment in a neutropenic mouse model.

The efficacy of ticarcillin (100 mg/kg), tobramycin (1 mg/kg), and rifampin (43 and 7.2 mg/kg) individually and in combination was assessed in neutropenic mice infected with an LD90 of one of four Pseudomonas aeruginosa isolates. The study end point was survival at 120 hours after infection. Treatment with the triple combination, ticarcillin plus tobramycin plus rifampin (43 mg/kg), was significantly superior to the double combination of ticarcillin plus tobramycin (p less than 0.01). Although treatment with rifampin (43 mg/kg) alone yielded results similar to treatment with the triple combination in mice infected with three of the four isolates, rifampin-resistant mutants (minimal inhibitory concentration greater than 1000 micrograms/ml) of P. aeruginosa were frequently isolated from surviving mice (26% of mice sampled). In contrast, in mice treated with the triple combination, rarely were rifampin-resistant mutants isolated (3% of mice sampled). Rifampin alone was active against P. aeruginosa isolates only when peak serum concentrations of rifampin exceeded the rifampin minimal bactericidal concentration of the infecting isolate. The addition of rifampin to a "standard" therapy of antipseudomonal penicillin plus aminoglycoside may be useful in the treatment of serious P. aeruginosa infection.