S.I. Magalini

Total parenteral nutrition infusate. An approach to its optimal composition in post-trauma acute renal failure

Abstract A study on 46 patients suffering from acute post-traumatic oliguric renal failure was carried out in order to provide adequate nutritional support. It was found that a high nitrogen intake was achieved by combined infusion of essential (EAA) and non-essential (NEAA) free amino acids; the essential amino acid/total ( E T ) nitrogen ratio had to be higher than four for the improvement of nitrogen balance and protein metabolism.

Plasma and cerebrospinal fluid free amino acid concentration in post-traumatic cerebral oedema in patients with shock.

Abstract The concentrations of free amino acids in plasma and cerebrospinal fluid (CSF) in 15 patients with post-traumatic cerebral oedema with hyperventilatory syndrome have been analyzed. Hypotheses are proffered to interpret the observed alterations of amino acids cerebral metabolism in this condition.

The action of phosphocreatine and fructose 1,6-diphosphate on blood in vitro

Blood in vitro has been used to evaluate the effects of phosphocreatine and fructose 1,6-diphosphate on the adenylate cycle. These compounds, following different metabolic pathways, increased the ATP concentration, phosphocreatine through a direct action on the adenylic phosphate cycle and fructose 1,6-diphosphate mainly by it glycolytic effect.

ANTICATABOLIC PROPERTIES OF BRANCHED CHAIN AMINO ACIDS IN TRAUMA

The anticatabolic properties of branched chain amino acids enriched protein solutions in 22 patients with multiple trauma have been evaluated. Nitrogen balance, nitrogen output, the daily change of blood urea nitrogen, plasma albumin and total protein levels were recorded daily. Each 2 days free amino acids and 3-methyl histidine urinary concentrations were measured. The results obtained in the study suggest that in trauma patients high ratios of essential amino acids/total nitrogen are needed and that amino acid solutions enriched in branched chain amino acids are most effective in preventing muscle catabolism and promoting protein synthesis.

Comparison of CSF-free amino acid concentrations among various neuropathological conditions.

The level of free amino acids in cerebrospinal fluid from eight patients in comatose states has been determined. The variations of cerebrospinal fluid-free amino acids observed in coma have been compared with those reported by other authors in patients affected by epilepsy, multiple sclerosis, infantile amaurotic idiocy (GM2-gangliosidosis) and phenylketonuria.

The acid-base status: a mathematical approach to its definition

The respiratory and non-respiratory factors of acid--base status have been evaluated mathematically. New units of measurement for derangements of the acid--base balance are proposed.

Concentrations of free amino acids in plasma, erythrocytes and cerebrospinal fluid in coma

The concentrations of free amino acids were measured in plasma and erythrocytes in 15 patients, and in cerebrospinal fluid in eight patients, who were in coma. Although there was a variety of causes of coma, there seemed to be a characteristic pattern of the concentrations of amino acids for coma, and the plasma/cerebrospinal fluid ratios also showed constant patterns.

A comparative study of free amino acids in coma of different aetiologies

A comparative study of the concentrations of free amino acids in the plasma and cerebrospinal fluid in cases of coma of different origins has been made. Hypotheses are put forward to explain the biochemical steps involved in cerebral metabolism of protein.

Effect of respiratory acidosis on plasma and CSF free amino acids.

Acid-base data and levels of selected cerebrospinal fluid (CSF) free amino acids were analyzed in a series of 8 patients in acute respiratory failure. In these patients, there were increased CSF concentrations of methionine, phenylalanine, tyrosine, histidine, α-amino-N-butyric acid, glutamic acid, glutamine, glycine, alanine, and ammonia, while arginine decreased. Phenylalanine, tryosine, and alanine were correlated with CSF Pco2; and α-amino-N-butyric acid to the buffer capacity of co2 and pH. The data suggest the hypothesis that there are two metabolic phases for ammonia removal from brain tissue, that could explain some of these pathophysiological conditions.

Carbonic anhydrase in human nasal epithelium: Localization and effect of the inhibition by dichlorphenamide

Carbonic anhydrase has not hitherto been reported in nasal mucosa. In the first part of this study, five specimens of human nasal mucosa from the inferior turbinate were obtained from five healthy subjects and tested for this enzyme with a histochemical reaction. Carbonic anhydrase was identified in the columnar ciliated respiratory epithelium, but was absent in the adjacent stratified squamous epithelium. The effect of the inhibition of this enzyme on the pH values and Na, K, and Cl activity in nasal secretion was subsequently investigated. Fifteen patients, affected by endocranial hypertension and to whom dichlorphenamide—an inhibitor of carbonic anhydrase—was administered, were studied. The pH value, determined with a surface electrode before giving the drug and 30, 60, and 90 minutes later, significantly increased and reached a peak at 60 minutes. Na, K, and Cl concentration was assessed by indirect potentiometry in the nasal secretion and in the plasma both before giving dichlorphenamide and 60 minutes later. Although no change was observed in the plasma, in the nasal secretion Na and Cl concentration increased and K concentration decreased. As a consequence, the gradients of Na and K between plasma and secretion decreased, and that of Cl increased. We assume analogous changes in the rate of transport through the mucosa to occur. These results thus suggest that carbonic anhydrase is involved in control of the pH of nasal secretions as well as in the electrolyte transport through the epithelium.