Sumatriptan improves postoperative quality of recovery and reduces postcraniotomy headache after cranial nerve decompression.

BACKGROUND: Microvascular decompression (MVD) is a surgical treatment for cranial nerve disorders via a small craniotomy. The postoperative pain of this procedure can be classified as surgical site somatic pain and postcraniotomy headache similar in nature to a migraine, including its association with photophobia, nausea, and vomiting. This headache can be difficult to treat and can impact on postoperative recovery. Sumatriptan is used to treat migraine-like headaches in various settings. This single-centre randomized controlled trial investigated whether postoperative administration of sumatriptan after MVD surgery impacts the quality of postoperative recovery. METHODS: Fifty patients who complained of postoperative headache after MVD were randomized to receive an s.c. injection of sumatriptan (6 mg) or saline. The primary outcome was quality of recovery as measured by the Quality of Recovery-40 (QoR-40) score at 24 h. RESULTS: The QoR-40 scores were significantly higher in the sumatriptan group (median 184; interquartile range 169-196) than in the placebo group (133; 119-155; P<0.01), suggesting higher quality of recovery. The sumatriptan group also had significantly lower headache scores at 4, 12, and 24 h. There were no significant differences in other secondary outcomes. CONCLUSIONS: Use of sumatriptan improved the quality of recovery as measured by the QoR-40 and reduction of headache at 24 h after surgery. Sumatriptan is a useful alternative treatment for postcraniotomy headache. The mechanism remains unknown but could be related to reduction in headache, mood modulation, or both, mediated by a serotonin effect. CLINICAL TRIAL REGISTRATION: NCT01632657.

Dexmedetomidine vs propofol-remifentanil conscious sedation for awake craniotomy: a prospective randomized controlled trial.

BACKGROUND: Awake craniotomy (AC) is performed for the resection of brain tumours in close proximity to areas of eloquent brain function to maximize reduction of tumour mass and minimize neurological injury. This study compares the efficacy and safety of dexmedetomidine vs propofol-remifentanil-based conscious sedation, during AC for supratentorial tumour resection. METHODS: Prospective, randomized, controlled trial including 50 adult patients undergoing AC who were randomly assigned to a dexmedetomidine (DEX group, n=25) or propofol-remifentanil group (P-R group, n=25). The primary outcome was the ability to perform intraoperative brain mapping assessed on a numeric rating scale (NRS). Secondary outcome was the efficacy of sedation measured by the modified Observer's Assessment of Alertness/Sedation (OAA/S) scale. Other outcome measures including haemodynamic and respiratory variables, pain, sedation and anxiety scores, adverse events, and patient satisfaction were also compared. RESULTS: There were no differences between DEX and P-R groups regarding the ability to perform intraoperative brain mapping [mean NRS score (95% CI): 10.0 (9.9-10.0) vs 9.7 (9.5-10.0), P=0.13] and level of sedation during mapping [mean OAA/S score (95% CI): 4.1 (3.5-4.7) vs 4.3 (3.9-4.7), P=0.51], respectively. Respiratory adverse events were more frequent in the P-R group (20 vs 0%, P=0.021). Heart rate was significantly lower in the DEX group across time (P<0.001); however, the need for treatment of bradycardia was not different between groups. CONCLUSIONS: Quality of intraoperative brain mapping and efficacy of sedation with dexmedetomidine were similar to propofol-remifentanil during AC for supratentorial tumour resection. Dexmedetomidine was associated with fewer respiratory adverse events. CLINICAL TRIAL REGISTRATION: NCT01545297.

Effect of different surgical positions on the cerebral venous drainage: a pilot study using healthy volunteers.

Excessive neck flexion and rotation in certain surgical positions may cause kinking of the internal jugular vein that obstructs cerebral venous blood flow and results in elevated intracranial pressure. The objective of this study was to measure internal jugular vein flow and identify potential impediments to venous flow in supine, prone, and park bench positions using non-anaesthetised volunteers. Twenty-seven volunteers were recruited. Venous flow rate was derived from ultrasound measurements of the vessel cross-sectional area and flow velocity. Change from supine to prone position produced a significant increase in both jugular vein cross-sectional areas without affecting venous flows. In the right park bench position, the right internal jugular vein cross-sectional area decreased from 1.2 to 0.9 cm(2) (p = 0.027) without substantive changes in mean venous flow rate (p = 0.91) when compared with supine. In summary, the internal jugular vein flow was not compromised by either prone or park bench positions in non-anaesthetised volunteers, and careful positioning may prevent kinking of the jugular vein. Further studies in anaesthetised and ventilated patients are needed to validate these results for clinical practice.

East-West gradient in the incidence of inflammatory bowel disease in Europe: the ECCO-EpiCom inception cohort.

OBJECTIVE: The incidence of inflammatory bowel disease (IBD) is increasing in Eastern Europe. The reasons for these changes remain unknown. The aim of this study was to investigate whether an East-West gradient in the incidence of IBD in Europe exists. DESIGN: A prospective, uniformly diagnosed, population based inception cohort of IBD patients in 31 centres from 14 Western and eight Eastern European countries covering a total background population of approximately 10.1 million people was created. One-third of the centres had previous experience with inception cohorts. Patients were entered into a low cost, web based epidemiological database, making participation possible regardless of socioeconomic status and prior experience. RESULTS: 1515 patients aged 15 years or older were included, of whom 535 (35%) were diagnosed with Crohn's disease (CD), 813 (54%) with ulcerative colitis (UC) and 167 (11%) with IBD unclassified (IBDU). The overall incidence rate ratios in all Western European centres were 1.9 (95% CI 1.5 to 2.4) for CD and 2.1 (95% CI 1.8 to 2.6) for UC compared with Eastern European centres. The median crude annual incidence rates per 100,000 in 2010 for CD were 6.5 (range 0-10.7) in Western European centres and 3.1 (range 0.4-11.5) in Eastern European centres, for UC 10.8 (range 2.9-31.5) and 4.1 (range 2.4-10.3), respectively, and for IBDU 1.9 (range 0-39.4) and 0 (range 0-1.2), respectively. In Western Europe, 92% of CD, 78% of UC and 74% of IBDU patients had a colonoscopy performed as the diagnostic procedure compared with 90%, 100% and 96%, respectively, in Eastern Europe. 8% of CD and 1% of UC patients in both regions underwent surgery within the first 3 months of the onset of disease. 7% of CD patients and 3% of UC patients from Western Europe received biological treatment as rescue therapy. Of all European CD patients, 20% received only 5-aminosalicylates as induction therapy. CONCLUSIONS: An East-West gradient in IBD incidence exists in Europe. Among this inception cohort--including indolent and aggressive cases--international guidelines for diagnosis and initial treatment are not being followed uniformly by physicians.

Depression and early retirement: prospective population based study in middle aged men.

BACKGROUND: Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement. METHODS: This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension. RESULTS: During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p<0.001) respectively. CONCLUSIONS: A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.

Plasma tacrine concentrations are significantly increased by concomitant hormone replacement therapy.

BACKGROUND: In vitro results suggest that the synthetic hormones used in postmenopausal hormone replacement therapy (HRT) may be significant inhibitors of oxidative drug metabolism. Moreover, HRT has been reported to enhance response to tacrine in postmenopausal patients with Alzheimer's disease, but the mechanism of this interaction remains unclear. OBJECTIVE: To examine the effect of HRT with 2 mg estradiol valerate and 0.25 mg levonorgestrel once daily on the pharmacokinetics of tacrine. METHODS: Ten healthy female volunteers received treatment for 10 days with once-daily HRT or placebo in a randomized, double-blind crossover study. One hour after the last HRT or placebo capsule on day 10, the subjects received a single 40-mg dose of tacrine. Plasma samples were collected for 30 hours and urine samples were collected for 24 hours after tacrine intake for the measurement of tacrine and 1-hydroxytacrine concentrations. RESULTS: HRT increased the mean plasma concentration-time curve calculated from zero to infinity (AUC) of tacrine by 60% (P = .009); the greatest individual increase in the AUC was about threefold. Similarly, the mean peak concentration in plasma of tacrine was 46% (P = .031) higher in the HRT phase compared with the placebo phase. HRT reduced the mean apparent oral clearance of tacrine by 31% (P = .014), but no significant difference was found in the elimination half-life or the renal clearance of tacrine between the HRT phase and the placebo phase. The metabolic ratio (1-hydroxytacrine AUC/tacrine AUC) was significantly (mean, 26%; P < .001) reduced in all 10 subjects. CONCLUSIONS: HRT with estradiol and levonorgestrel significantly increased plasma tacrine concentrations. This interaction between tacrine and HRT involves reduced metabolic conversion of tacrine to its main metabolite 1-hydroxytacrine by CYP1A2 during the first-pass phase. The interaction may be clinically important with regard to both enhanced efficacy and increased likelihood of concentration-dependent adverse effects of tacrine in the long-term treatment of patients with Alzheimer's disease. Accordingly, smaller doses of tacrine may be appropriate when coadministered with HRT.

Synthesis and antibacterial activity of U-100592 and U-100766, two oxazolidinone antibacterial agents for the potential treatment of multidrug-resistant gram-positive bacterial infections.

Bacterial resistance development has become a very serious clinical problem for many classes of antibiotics. The 3-aryl-2-oxazolidinones are a relatively new class of synthetic antibacterial agents, having a new mechanism of action which involves very early inhibition of bacterial protein synthesis. We have prepared two potent, synthetic oxazolidinones, U-100592 and U-100766, which are currently in clinical development for the treatment of serious multidrug-resistant Gram-positive bacterial infections caused by strains of staphylococci, streptococci, and enterococci. The in vitro and in vivo (po and iv) activities of U-100592 and U-100766 against representative strains are similar to those of vancomycin. U-100592 and U-100766 demonstrate potent in vitro activity against Mycobacterium tuberculosis. A novel and practical asymmetric synthesis of (5S)-(acetamidomethyl)-2-oxazolidinones has been developed and is employed for the synthesis of U-100592 and U-100766. This involves the reaction of N-lithioarylcarbamates with (R)-glycidyl butyrate, resulting in excellent yields and high enantiomeric purity of the intermediate (R)-5-(hydroxymethyl)-2-oxazolidinones.

Does psychological distress predict disability?

STUDY OBJECTIVE: To evaluate psychological distress as a predictor of disability due to common chronic disorders. STUDY POPULATION AND METHODS: A 10-year follow-up study was carried out among a representative cohort (N = 8655) of 18-64 year old Finnish farmers, who had participated in a health survey in 1979 and were able to work at baseline. A record linkage with the nationwide register of the Social Insurance Institution was made to identify disability pensions granted between 1980 and 1990 in the cohort. The medical certificates of 1004 (11.6%) prematurely retired farmers were reviewed to confirm and classify disabling conditions. A sum score based on self-reports of 11 symptoms at the baseline was used as a measure of psychological distress. RESULTS: After adjustment for age, sex, smoking and body mass index, the cause-specific relative risks (RR) (95% confidence intervals [CI]) of disability in the highest quartile of the psychological distress score as compared with the lowest quartile were for myocardial infarction 2.34 (95% CI: 1.17-4.69), for depression 2.50 (95% CI: 1.09-5.72), for neck-shoulder disorders 1.98 (95% CI: 1.26-3.11), for unspecified low-back disorders 1.76 (95% CI: 1.24-2.49), for knee osteoarthritis 1.55 (95% CI: 0.91-2.63) and for trip osteoarthritis 0.89 (95% CI: 0.42-1.85). The corresponding RR for overall disability was 1.76 (95% CI: 1.44-2.14) in the highest quartile of psychological distress score as compared with the lowest quartile. CONCLUSIONS: Psychological distress is an independent risk factor for disability. Its predictive significance varies between disorders leading to functional deterioration. The association mechanisms are likely to vary from one disorder to another.

Brain tumor surgery with the Toronto open magnetic resonance imaging system: preliminary results for 36 patients and analysis of advantages, disadvantages, and future prospects.

OBJECTIVE: Frameless navigation systems represent a huge step forward in the surgical treatment of intracranial pathological conditions but lack the ability to provide real-time imaging feedback for assessment of postoperative results, such as catheter positions and the extent of tumor resections. An open magnetic resonance imaging system for intracranial surgery was developed in Toronto, by a multidisciplinary team, to provide real-time intraoperative imaging. METHODS: The preliminary experience with a 0.2-T, vertical-gap, magnetic resonance imaging system for intraoperative imaging, which was developed at the University of Toronto for the surgical treatment of patients with intracranial lesions, is described. The system is known as the image-guided minimally invasive therapy unit. RESULTS: Between February 1998 and March 1999, 36 procedures were performed, including 21 tumor resections, 12 biopsies, 1 transsphenoidal endoscopic resection, and 2 catheter placements for Ommaya reservoirs. Three complications were observed. All biopsies were successful, and the surgical goals were achieved for all resections. Problems included restricted access resulting from the confines of the magnet and the imaging coil design, difficulties in working in an operating room that is less spacious and familiar, inconsistent image quality, and a lack of nonmagnetic tools that are as effective as standard neurosurgical tools. Advantages included real-time imaging to facilitate surgical planning, to confirm entry into lesions, and to assess the extent of resection and intraoperative and immediate postoperative imaging to confirm the extent of resections, catheter placement, and the absence of postoperative complications. CONCLUSION: Intraoperative magnetic resonance imaging has great potential as an aid for intracranial surgery, but a number of logistic problems require resolution.

Speciation of chromium by coupled column HPLC-ICP-MS - the effects of interfering ions.

ICP-MS is used as an element selective detector for chromium species in aquatic samples using a coupled columm system consisting of a cation guard column and an anion column. The effects of large concentrations of disturbing ions, like NO(3)(-), Cl(-), CO(3)(2-) and SO(4)(2-), are discussed and the comparison with the use of different chromium isotopes for data acquisition is given. Quite low concentrations such as 100 mg/l of CO(3)(2-), 10 mg/l Cl(-) and even 5 mg/l SO(4)(2-) can cause an overestimation of chromium if not properly resolved1995 / Accepted: 24 October 1995

Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men.

BACKGROUND: Early retiring is a major social problem in many western countries. AIM: To investigate whether good cardiorespiratory fitness prevents disability pensioning in Finnish middle-aged men. METHODS: Subjects were a random population based sample of 1307 men who were 42-60 years old at baseline, had not retired before baseline or died during follow up, and had undergone a cycle ergometer test at baseline. Cardiorespiratory fitness was assessed at baseline with a maximal but symptom limited exercise test on an electrically braked cycle ergometer. RESULTS: During a follow up of 11 years on average, 790 (60.4%) men were awarded a disability pension, only 254 (19.4%) men reached the old-age pension without previous early pension, and 263 (20.1%) men were still working at the end of follow up. After adjustment for age, body mass index, alcohol consumption, smoking, education, occupation, and baseline chronic diseases, an inverse association was observed between cardiorespiratory fitness and the risk of disability pension. Men with VO2max <25.98 ml/kg/min (lowest fifth) had a 3.28-fold (95% CI 1.70 to 6.32) and men with the duration of exercise test <9.54 minutes (lowest fifth) had a 4.66-fold (95% CI 2.43 to 8.92) risk of disability pension due to cardiovascular diseases compared with men in the highest fifths. Men with lowest fitness level also had an increased risk of disability pension due to musculoskeletal disorders, or all reasons combined. CONCLUSIONS: Physical fitness is inversely associated with the risk of disability pension and especially with the risk of disability due to cardiovascular diseases.

A new frontier: magnetic resonance imaging-operating room.

Developments in technology have led to the merger of two distinct environments, that of magnetic resonance imaging and that of the operating room. The major advantage of this merger for neurosurgical procedures is the ability to perform real-time imaging to help guide surgery. This review discusses the role of the anesthesiologist in the planning and administration of safe anesthesia in this new and challenging environment.

Monitoring of somatosensory evoked potentials during temporary arterial occlusion in cerebral aneurysm surgery.

Somatosensory evoked potentials (SSEP) have been used during cerebral aneurysm surgery to monitor the integrity of neural pathways. The purpose of this study was to evaluate the effectiveness of SSEP monitoring as a predictor of neurological outcome during temporary arterial occlusion. In a series of 157 patients monitored, 97 patients had temporary occlusion of the feeding artery. Twenty-three patients developed a SSEP change during temporary occlusion, 15 reversible (recovery of the change after the release of occlusion), and 8 persistent (no recovery) changes. A persistent change predicted a postoperative neurological deficit in each case, whereas, of the 15 patients with reversible changes, only 5 had postoperative deficits. Seventy-four patients had no change on SSEP monitoring but 10 patients did have new neurological deficits postoperatively. The false positive rate was 43% and the false negative rate was 14%. SSEP was a better predictor of neurological deficits in patients with aneurysms of the carotid circulation than of the vertebral-basilar arteries. Despite these limitations, we find SSEP monitoring useful during temporary occlusion in cerebral aneurysm surgery.

Association between electrocardiographic abnormalities and intracranial blood in patients following acute subarachnoid hemorrhage.

The etiological factors that influence the development of electrocardiographic (ECG) abnormalities following a subarachnoid hemorrhage are not fully understood. The purpose of this study was to assess if there was an association between ECG abnormalities and the amount of intracranial blood seen on computerized tomographic (CT) scanning following an acute bleed in patients with a cerebral aneurysm. The charts of 70 patients who had had a preoperative CT scan and a preoperative ECG within 96 h of bleed were reviewed. The neurological status of the patients was graded according to the Botterell classification and the amount of blood seen on the CT scan was graded by the Fisher classification. Thirty patients had an abnormal ECG. Seventy percent of these abnormalities involved the T wave or the ST segment. The incidence of ECG abnormalities was statistically greater for patients who had an increased amount of intracranial blood or an intracerebral clot, as seen on CT scan. All patients had treatment (surgical n = 69, embolization n = 1) of the aneurysm. Neither the amount of blood seen on CT scan nor the incidence of ECG abnormalities was useful in predicting patient outcome. In conclusion, an increased quantity of intracranial blood was associated with an increased incidence of ECG abnormalities.

Perioperative monitoring of the electrocardiogram during cerebral aneurysm surgery.

Electrocardiographic (ECG) abnormalities occur frequently following a subarachnoid hemorrhage and may also occur intraoperatively and postoperatively in patients undergoing neurovascular procedures. The aim of this study was to assess the relationship between ECG changes and the neurological status of the patient, the size and the location of the aneurysm, and the influence of these changes on the cardiac and neurological outcome. The preoperative ECG was analyzed in 270 patients. Forty-five patients had intraoperative Holter monitoring. An immediate postoperative ECG was recorded in 120 patients and 60 patients had three consecutive postoperative ECGs. Preoperatively, 52% of the patients had an abnormal ECG and the incidence was highest in patients with a poorer neurological status. Most of the ECG changes involved the T wave or the ST segment. Intraoperative and postoperative changes occurred in 35 and 65% of the patients, respectively, and were independent of the studied factors. There were no documented cardiac events. The presence of an abnormal preoperative ECG did not influence the neurological outcome of the patient, but fluctuating postoperative changes were associated with a worse outcome.

N-acyl 3-alkylidenyl- and 3-alkyl azetidin-2-ones: a new class of monocyclic beta-lactam antibacterial agents. 1. Structure-activity relationships of 3-isopropylidene and 3-isopropyl analogs.

The synthesis and antibacterial activity of a series of N-acyl 3-isopropylidenyl- and 3-isopropyl 2-azetidinones having potent in vitro antibacterial activity, particularly against anaerobic organisms, is described. A distinguishing structural feature of these compounds is the lack of any ionizable moiety appendant to the lactam nitrogen.

Identification of milk fat triacylglycerols by capillary supercritical fluid chromatography-atmospheric pressure chemical ionization mass spectrometry.

Identification of milk fat triacylglycerols was accomplished by capillary supercritical fluid chromatography (SFC) combined with atmospheric pressure chemical ionization mass spectrometry [(APCI)MS]. Supercritical carbon dioxide was the carrier fluid in SFC. Ionization was achieved by introducing vapor of ammonia in methanol into the ionization chamber which resulted in the formation of abundant [M + 18]+ and [M - RCCO]+ ions of triaclyglycerols. These ions defined both the molecular weight and the fatty acid constituents of a triacylglycerol, respectively. SFC on a nonpolar stationary phase provided an efficient separation of triacylglycerols according to the combined number of carbon atoms in the acyl chains a molecule. In addition to the identification of the major chromatographic peaks representing molecules with 26-54 acyl carbons, minor peaks representing triacylglycerols with an odd number of acyl carbons were separated and identified. Furthermore, compositional information on partially separated isobaric triacylglycerols, which differed substantially in the chain length of the fatty acyl residues, was achieved within some of the peaks. A new finding of the present study was the formation of abundant [M + 18]+ ions of saturated triacylglycerols in addition to diagnostic fragment ions,being of primary importance in structure elucidation. This extends the applicability of capillary SFC-(APCI)MS in the analysis of both saturated and unsaturated triacylglycerols.

Capillary supercritical fluid chromatography--atmospheric pressure chemical ionization mass spectrometry of gamma- and alpha-linolenic acid containing triacylglycerols in berry oils.

The effect of the gamma-linolenic acid (18:3n-6) residue on the elution of triacylglycerols on a 25% cyanopropyl-25% phenyl-50% methylpolysiloxane stationary phase was confirmed by using capillary supercritical fluid chromatography-atmospheric pressure chemical ionization mass spectrometry [cSFC-(APCI)MS]. The general elution rule on this stationary phase is that triacylglycerols having the same ACN + 2n value coeluted (ACN = acyl carbon number and n = combined number of double bonds in the acyl chains). The different effect of gamma- and alpha-linolenic acid residues on the retention of triacylglycerols and the use of cSFC-(APCI)MS allowed the study of the number of different linolenic acid residue isomer combinations in triacylglycerols with an identical ACN and degree of unsaturation. Stearidonic acid (18:4n=3) residue was found to have a similar effect on the retention behavior of triacylglycerols as that of gamma-linolenic acid residue. The abundance of the [M - RCOO]+ ion, formed by the loss of one fatty acid moiety of a triacylglycerol, was found to be clearly higher in the case of gamma-isomer of the linolenic acid than that of alpha-isomer in the identical regiospecific position. This indicates that the distance of the double bonds from the glycerol backbone in the acyl chain affects the stability of a triacylglycerol molecule in the (APCI)MS system. The triacylglycerol composition and the fatty acid combinations of triacylglycerols were found to be almost identical in black currant (Ribes nigrum) and alpine currant (R. alpinum) seed oils.

Separation of gamma- and alpha-linolenic acid containing triacylglycerols by capillary supercritical fluid chromatography.

The separation of gamma- and alpha-linolenic acid containing triacylglycerols with an identical acyl carbon number and degree of unsaturation was obtained on capillary supercritical fluid chromatography using a 25% cyanopropyl-75% methylpolysiloxane stationary phase. The resolution of 1,3-dioleoyl-2-alpha-linolenoyl-sn-glycerol was 1.35 on a 10 m x 50 microns i.d. column, whereas the resolution was enhanced to 1.66 by combining two 10-meter columns in series. The difference in the position of double bonds in one linolenic acid residue of triacylglycerols resulted in two series of peaks in the separation of alpine currant (Ribes alpinum) and black currant (R. nigrum) seed oils. The use of the 10-meter column was found to be appropriate for the screening of the triacylglycerol profile in both seed oils studied.

Postparturition changes in the triacylglycerols of cow colostrum.

The changes in the triacylglycerol (TAG) composition of colostrum fat of three cows were studied. In addition to the determination of fatty acid composition by gas chromatography, the distribution of TAG according to the acyl carbon number (ACN) and molecular weight was analyzed utilizing both supercritical fluid chromatography (SFC) and ammonia negative-ion chemical ionization mass spectrometry (MS). Colostrum TG contained substantially less stearic and oleic acids and more myristic and palmitic acids than the normal Finnish milk fat. The major trends in the changes of fatty acids and TAG were similar for each cow, although clear differences between individuals were found. During the first week of parturition, the proportions of short-chain fatty acids (C4-C10) typically increased as well as those of stearic and oleic acids, whereas the relative amounts of C12-C16 acids decreased, especially those of myristic and palmitic acids. Distinct changes occurred also in TAG distributions: the proportions of molecules with ACN 38-40 increased and those with ACN 44-48 decreased. Although there were distinct differences between individuals shortly after delivery, both the fatty acid compositions and TAG distributions of the milk samples of the cows started to resemble each other after one week. The theoretical profiles of colostrum TAG calculated based on the fatty acid compositions differed clearly from the ACN distributions analyzed by SFC and MS. Thus, the analysis of TAG is essential, because the changes in molecular species composition of colostrum TAG cannot be estimated according to the fatty acid analysis alone.