Effects of cathepsins B and L inhibition on postischemic protein alterations in the brain.

The effects of selective inhibition of cathepsins B and L on postischemic protein alterations in the brain were investigated in a rat model of middle cerebral artery occlusion (MCAO). Cathepsin B activity increased predominantly in the subcortical region of the ischemic hemisphere where the levels of collapsing mediator response protein 2, heat shock cognate 70 kDa protein, 60 kDa heat shock protein, protein disulfide isomerase A3 and albumin, were found to be significantly elevated. Postischemic treatment with Cbz-Phe-Ser(OBzl)-CHN(2), cysteine protease inhibitor 1 (CP-1), reduced infarct volume, neurological deficits and cathepsin B activity as well as the amount of heat shock proteins and albumin found in the brain. Our data strongly suggests that the decrease in heat shock protein levels and the significant reduction of serum albumin leakage into the brain following acute treatment with CP-1 is indicative of less secondary ischemic damage, which ultimately, is related to less cerebral tissue loss and improved neurological recovery of the animals.

Intractable respiratory failure in a term newborn.

Birth depression unresponsive to conventional resuscitative measures merits careful consideration. The case of a term infant with primary respiratory failure at birth despite extensive intervention is presented. Postmortem examination revealed bilateral pulmonary artery thrombi, which underscores the importance of careful exploration of possible pathogenetic mechanisms.

The effect of placental abruption on the short-term outcome of premature infants.

The purpose of this study was to analyze the effect of abruption on the outcome of preterm infants. Live-born infants of 23 to 32 weeks gestation born at Beaumont Hospital between 1995 and 1999 who suffered abruption constitute the study group. Controls were matched to cases by sex, gestational age, and birth weight. Medical records were retrospectively reviewed for confirmation of abruption, determination of abruption grade, and subsequent neonatal outcome. Univariate analysis of the grade 2 abruption group revealed statistically significant differences in time from diagnosis to delivery (p = 0.04), Apgar scores at 5 minutes (p = 0.04), and acidotic cord blood (p = 0.04) between cases and controls. However, no differences in short-term outcome were appreciated. In addition, no differences in mortality or morbidity were noted between grade 1 abruption case and control infants. We conclude that abruption is not an independent risk factor for poor outcome among infants born between 23 and 32 weeks gestation, but instead induces the preterm delivery that is the main determinant of outcome.