[Brain death diagnosis after sedation with propofol or sufentanil. Recommendations for the usage of toxicological analytics]. / Hirntoddiagnostik nach Gabe von Propofol oder Sufentanil. Empfehlungen zum Umgang mit toxikologischer Analytik.

BACKGROUND: Before the clinical diagnosis of brain death is made, toxicological analyses are often performed for the exclusion of effective serum levels of previously applied sedating drugs. For propofol and sufentanil there are no uniform recommendations for the usage of toxicology test results. OBJECTIVES: To develop a standard practice in the diagnosis of brain death after therapeutic application of one of these drugs. MATERIAL AND METHODS: Based on the current literature and the available analytical assays, an ad hoc working group consisting of specialists in toxicology and intensive care medicine compiled recommendations for the usage of toxicological analytics in the diagnosis of brain death at the Rostock University Hospital. RESULTS: For propofol, current analytical assays allow the quantification of serum concentrations of 0.2 µg/ml and lower; the execution of clinical brain death diagnostics is recommended by the ad hoc group only at propofol serum levels lower than 0.4 µg/ml. For sufentanil, the currently prevalent assays set lower determination limits of about 0.2 ng/ml in serum and 0.1 ng/ml in urine, which is above the cautiously adopted lower therapeutic serum concentration of 0.02 ng/ml. Therefore after negative determination of sufentanil (< 0.2 ng/ml) in blood serum, the following alternative procedures are recommended: (1) the execution of clinical brain death diagnostics under administration of naloxone; or (2) at intact renal function the additional negative determination of sufentanil in urine (< 0.1 ng/ml). If an assay allowing the detection of sufentanil at ≤ 0.01 ng/ml is available, brain death diagnostics should be carried out only at a serum level lower than 0.02 ng/ml. CONCLUSION: These recommendations may serve as a proposal for similar standards in other hospitals.

Odour discrimination in the olfactory bulb of goldfish: contrasting interactions between mitral cells and ruffed cells.

Anatomical differences characterizing mitral cells and ruffed cells have been published by T. Kosaka and K. Hama in three teleost species. Physiological responses from both types of relay neurons were recorded extracellularly and simultaneously in the plexiform layer, using a single tungsten microelectrode. During interstimulus intervals mitral cells responded with higher, frequently burst-like impulse rates triggered by the activity of epithelial receptor neurons. Mitral cell activity could be totally suppressed by local anaesthesia of the olfactory epithelium. Ruffed cell impulse rates were low, and each action potential triggered a long-lasting (3-5 ms), continuously varying, summed granule cell potential. During olfactory stimulation with non-familiar stimuli and important biological stimuli such as amino acids, preovulatory and ovulatory pheromones, and a probable alarm pheromone, contrasting interactions between mitral cells and ruffed cells were recorded frequently, which resulted in a drastic intensification of centrally transmitted information. An excitation of mitral cells' activity via granule cells laterally inhibited the ruffed cells' activity, and an inhibition of mitral cells' activity simultaneously 'released' an excitation of ruffed cells.

Pheromone discrimination ability of olfactory bulb mitral and ruffed cells in the goldfish (Carassius auratus).

Significant anatomical differences characterizing mitral cells and ruffed cells were published by Kosaka and Hama in three teleost species. Physiological responses from both types of relay neurons have now been recorded extracellularly and simultaneously in the plexiform layer using a single tungsten microelectrode. During interstimulus intervals mitral cells responded with higher, frequently burst-like impulse rates triggered by the activity of epithelial receptor neurons. Ruffed cell impulse rates were low, and each action potential triggered a long-lasting, continuously variable, integrated granule cell potential. During olfactory stimulation with important biological stimuli such as preovulatory and ovulatory pheromones, a probable alarm pheromone and amino acids contrasting interactions between mitral cells and ruffed cells resulting in a drastic intensification of centrally transmitted information were frequently recorded. Individual neurons excellently discriminated stimuli. Irrespective of the physiological relevance of stimuli, however, similarities were recorded in the distribution of excitatory, inhibitory and indifferent responses.

Dietary fiber for reducing blood cholesterol.

Soluble dietary fiber, including psyllium, has been shown to have mild to modest cholesterol lowering properties. Psyllium hydrophilic mucilloid (Metamucil, Procter and Gamble, Cincinnati, OH), a bulk laxative, when used as a dietary supplement in combination with a low fat diet, can lower total serum cholesterol and low-density lipoprotein (LDL) cholesterol, and raise high-density lipoprotein (HDL) cholesterol in hypercholesterolemic patients. The cholesterol lowering effects of psyllium are much less evident than those observed with cholestyramine and the HMG-CoA reductase inhibitors. The mechanism for the cholesterol lowering effect of psyllium is not known. The substance is well tolerated with long-term use.

[Analysis of heroin samples with capillary gas chromatography. Comparison of glass capillary column and packed column]. / Analyse von Heroinproben mit der Kapillargaschromatographie. Vergleich von Glaskapillartrennsäule und gepackter Säule.

In forensic examination of illicit heroin samples high-resolution capillary gas chromatography is compared with gas chromatography with packed columns. Separation efficiency, reproducibility of qualitative and quantitative determinations and stability of the columns are examined. A practical method with silylation of the samples is presented which allows safe identification and quantification of many various compounds contained in illicit heroin samples. The gas chromatographic data of 35 substances (opium alkaloids and synthetic derivatives, adulterants and diluents) are listed. The method also allows the quantification of morphine, opium, and cocaine samples.

Drug-induced lipid peroxidation in mice--II. Protection against paracetamol-induced liver necrosis by intravenous liposomally entrapped glutathione.

If injected intravenously 2 hr before the drug, a dose of more than 175 mg/kg body weight glutathione (0.57 mmol/kg) protected male mice from acute liver necrosis induced by intraperitoneal administration of 400 mg/kg (2.65 mmol/kg) paracetamol. Soluble glutathione yielded a limited, and liposomally entrapped glutathione an optimal dose-dependent protective effect against drug-induced lipid peroxidation (as measured by in vivo ethane exhalation) liver necrosis (assessed by serum transaminases) and hepatic glutathione depletion (determined post mortem). N-Acetylcysteine solution had no effect in this model.