[Late results of ileorectal anastomosis in proctocolitis]

In 1961-1986 at the Surgical Clinic of the Institute for Postgraduate Medicine in Prague 49 colectomies were performed with ileorectal anastomosis. The operations were usually made in several stages. The remote results were evaluated after an interval of 10 to 26 years in 33 patients and were good to satisfactory in 82%. Malignant degeneration in the rectum was not observed. The relatively favourable results can be ascribed to careful selection of patients and frequently also the multi-stage procedure. Ileorectal anastomoses are still justified in the surgical treatment of proctocolitis.

[Studies on the occurrence of texture types in calcium oxalate urinary stones]

A review of texture types of calcium oxalate calculi and a pattern of 4 basic texture types was presented. A method of texture classification as a part of the routine polarization microscopy urinary calculus analysis was developed. Thereby a representative material could presented on the distribution of texture types. A connection between pathological urinary parameters and the texture type was demonstrated.

Intravenous pancuronium bromide for fetal neuromuscular blockade during intrauterine transfusion for red-cell alloimmunization

Intravenous pancuronium bromide was administered into the umbilical cord by funipuncture to effect temporary fetal paralysis. Neuromuscular blockade was achieved in 12 fetuses undergoing a total of 34 intrauterine procedures for the treatment of severe red-cell alloimmunization. The same initial dose of 0.2 mg/kg fetal weight estimated by ultrasound was used in all cases, but anemic fetuses did not resume movement for prolonged periods. A relationship among fetal hematocrit, adjusted dose, and duration of paralysis was described by the equation: Duration (hours) = 5.24 + 10.30 adjusted dose (mg/kg) - 0.16 hematocrit (%) (R2 = 0.49; P less than .001). Intravenous pancuronium was found to be a safe and effective method for cessation of fetal movement during intrauterine procedures.

Can a rapidly-eliminated hypnotic cause daytime anxiety?

To test further the conclusions of preliminary reports that regular use of a rapidly-eliminated hypnotic might cause daytime anxiety, 82 women and 38 men, mean age 53, who claimed to be poor sleepers, took a capsule nightly for 45 nights. On 25 consecutive nights the capsule contained triazolam 0.5 mg (40 subjects), lormetazepam 2 mg (40 subjects) or continued placebo (40 subjects). Both drugs improved sleep, but compared with placebo or lormetazepam-takers, triazolam-takers became more anxious on self-ratings, were judged more often to have had a bad response by an observer, more often wrote down complaints of distress, and suffered weight loss. After about 10 days of regular triazolam they tended to develop panics and depression, felt unreal, and sometimes paranoid. The very short life of triazolam, leading to daytime withdrawal symptoms, may account for some of the observations, but enhancement of benzodiazepine inverse agonist activity is also hypothesized.

Human body temperature is inversely correlated with body mass

Forty-two women and 18 men of mean age 54 years had their sub-lingual oral temperature measured hourly from 0700 h to 2300 h. Mean oral temperature (averaged over the 17 readings) was inversely correlated with body mass in the group as a whole (r = -0.44, df = 58, p = 0.0003). The women had significantly higher mean oral temperatures than the men, but the inverse relationship between mean oral temperature and body mass was still significant when the data from the women were analyzed separately (r = -0.37, df = 40, p = 0.013). The results suggest that in humans, mean body temperature is inversely related to body mass, irrespective of gender.

Effects of repeated ritanserin on middle-aged poor sleepers

Nine subjects who believed themselves to be poor sleepers, of mean age 58 years, took a placebo for 7 days, then ritanserin 5 mg for 20 days, followed by 3 days on placebo. Sleep was recorded electrophysiologically on 2 nights during baseline, 2 early drug nights, 2 late drug nights and the 2nd and 3rd withdrawal nights. Ratings of sleep quality were collected each morning. Ritanserin, a 5HT2 antagonist, caused a persistent doubling of the amount of EEG slow wave sleep, without altering the total duration of sleep. Ritanserin decreased the frequencies of awakening and after about a week it appeared to improve the subjective quality of sleep. Sleep was then impaired during withdrawal, as indicated by decreased duration and poorer subjective quality, being worst on the 3rd withdrawal night.

The effects of magnesium sulfate therapy on Apgar scores

When intravenous magnesium sulfate is infused in women with pregnancy-induced hypertension, the hypermagnesemia does not result in lower Apgar scores. The mean maternal serum and cord magnesium levels at delivery were 5.3 +/- 0.72 and 5.3 +/- 1.1 mEq/dl, respectively. The most common negative Apgar score was assigned for color, not for muscle tone.

Total and percentage REM sleep correlate with body weight in 36 middle-aged people

Thirty-six volunteers of mean age 52 years had their sleep recorded in the laboratory on 5 consecutive nights. Eight factors were investigated as possible correlates of percentage REM sleep and of total minutes of REM sleep: age, height, weight, bedtime, arising time, oral temperature at bedtime and on arising, and total sleep time. REM percentage correlated significantly with body weight and with oral temperature at bedtime and correlated negatively with age. Owing to intercorrelations among the factors investigated, partial correlational analyses were done and revealed that body weight was the only factor that remained significantly correlated with REM percentage. Similarly, total sleep time and body weight were the only factors that remained significantly correlated with total minutes of REM sleep, whereas age and bedtime temperature just missed significance when other factors were held constant.

The hypnotic effects of an antihistamine: promethazine

Twelve volunteer poor sleepers of mean age 59 years took placebo on one night, promethazine 20 mg on one night and promethazine 40 mg on one night, in a double-blind balanced order study. Sleep in the EEG laboratory was increased by nearly 1 h after either dose of promethazine, and sleep interruptions were reduced. Slow-wave sleep was unaffected, but the larger dose reduced the percentage of sleep spent as REM sleep. Sleep was improved subjectively by both doses of promethazine which appears to be an effective hypnotic.

No effects on sleep of a histamine H1-receptor antagonist: temelastine

Twelve volunteer poor sleepers of mean age 57 years took placebo on each of 3 consecutive nights, and temelastine 100 mg on 3 consecutive nights in a double-blind balanced order study. Sleep in the EEG laboratory was unaffected by the drug.

Effects of paroxetine on human sleep

In a first double-blind, balanced order study, 12 subjects, mean age 57 years, took placebos at bedtime on 2 nights, paroxetine 15 mg on 2 nights and paroxetine 30 mg on 2 nights. In a second study, 12 subjects, mean age 56 years, took placebos on 2 mornings and paroxetine 30 mg on 2 mornings. Electrophysiological measures of all-night sleep were made on each night subsequent to medication. Paroxetine caused more frequent awakenings, reduced total sleep and strongly suppressed REM sleep, especially the 30 mg dosage. When it had been taken in the morning, paroxetine additionally delayed sleep onset and increased slow-wave sleep.

Physiological and psychological differences between good and poor sleepers

Eighteen poor sleepers and 18 good sleepers of mean age 52 yr, selected on the basis of their stated opinions about their sleep, were studied as pairs matched for sex, age, height and weight, on five consecutive nights and two consecutive days. Using EEG measures, the poor sleepers woke more often in the early hours of sleep and achieved half an hour less sleep. They had higher body temperatures by day and night and were more anxious. They tended to have higher urinary cortisol and adrenaline excretion. The groups did not differ in reaction time nor in excretion of urinary 3-methylhistidine. The poor sleepers over-estimated their sleep latency and both groups under-estimated their total sleep, the poor sleepers being significantly more inaccurate. It is concluded that those who complain of poor sleep have also metabolic differences from good sleepers.

Diurnal change in stature: effects of sleep deprivation in young men and middle-aged men

Sleep deprivation was associated with decreased stature and it blunted the normal 24-h rhythm in young and in middle-aged men. Loss in stature was regained during the first recovery night of sleep. The 24-h rhythm in height is not an endogenous circadian rhythm but depends upon the periods of recumbency over the sleep/wake cycle.

Effect of physical fitness and body composition on sleep and sleep-related hormone concentrations

The study assessed the effect of physical fitness and body composition on sleep and the nighttime secretion of the hormones, human growth hormone (hGH), prolactin, and cortisol. Two groups of 17 subjects, one of fit athletes and the other of unfit nonathletes, were selected so that the groups were matched for weight, height, lean body mass (LBM), and fat levels. Subjects slept in a sleep laboratory for 3 nonconsecutive nights: 1 adaptation night and 2 experimental nights. On 1 experimental night blood samples were collected; on the other, baseline sleep was assessed and the catheter was not inserted. Weight and height were measured and LBM assessed by 24 h urinary creatinine. The effect of physical fitness was tested by a comparison of the two groups; body composition was assessed by correlation analyses. Physical fitness did not have a significant effect on either sleep or hormone levels, although in the latter case the results were marginal. In contrast, body composition was related to both sleep and hGH. Percentage LBM was negatively correlated with slow-wave sleep and positively correlated with hGH levels. These results were significant for all subjects combined and for the fit group, although not the unfit group alone.

[Endogenous nitrogen metabolism in 15N-labeled swine. 1. Course of 15N-labeling and 15N excretion in urine and feces under 4 different diets]

Four male castrated pigs (55-65 kg) either received a wheat--fish meal diet (1 and 2) or a wheat--horse bean diet (3 and 4) without straw meal supplement (1 and 3) or with a supplement of 20% DM partly hydrolysed straw meal to the DM of the ration (2 and 4). In order to investigate whether a 15N-labelling of the pigs is also possible with a protein excess in the ration, the animals 1 and 2 received 24.8 g and the animals 3 and 4 = 11.6 g crude protein/kg0,75 live weight. During a 10-day 15N-labelling 385 mg 15N-excess (15N') per kg0,75 were applied in a mixture of ammonia acetate and ammonia chloride in the feed. During the period of 15N-labelling the following quotas of the applied 15N-amount were incorporated: 1 = 10.2%, 2 = 7.2%, 3 = 18.7%, 4 = 14.4%. 15N-excretion in both TCA fractions of faeces showed a highly significant positive correlation to the increasing content of crude fibre in the 4 diets. The immediate 15N-incorporation into the TCA-precipitable fraction of faeces (from the 2nd of the beginning of the 15N-application onwards) proves that 15N enters the large intestine endogenously (probably as 15N-urea) and serves bacterial protein synthesis. Three days after the last 15N-application the pigs were killed. The following values of atom-% 15N' could be determined in the TCA-precipitable blood plasma and in the TCA-precipitable fraction of the liver: 1 = 0.18 and 0.19 resp., 2 = 0.22 and 0.27 resp., 3 = 0.22 and 0.23 resp. and 4 = 0.24 and 0.26 resp. The other examined organs and tissues showed smaller differences between the test animals. The following atom-% 15N' were measured in the TCA-precipitable fractions on an average of the 4 test pigs: kidney = 0.20, pancreas = 0.18, intestinal wall tissue, duodenum = 0.18, jejunum (beginning) = 0.17, jejunum (end) = 0.15, ileum = 0.15, caecum = 0.16, colon (beginning) = 0.15, colon (middle) = 0.14, colon (end) = 0.13, stomach (cardia) = 0.11, stomach (fundus) = 0.12, spleen = 0.13, heart = 0.12, skin = 0.07 and skeleton muscles = 0.06. The results show that the 15N-labelling of tissues and organs of pigs is also possible at a high level of protein supply by means of an oral application of 15N ammonia salts.

[Effect of the content of crude plant protein in the ration on the utilization of urea in dairy cattle. 2. 15N-urea metabolism]

The metabolism of 15N-urea in the rations of dairy cows was investigated in dependence on the crude protein content of the rations. With energy concentration remaining unchanged, the rations contained 10.7 (I), 13.7 (II) and 17.1 (III)% plant crude protein and, after the supplementation of 150 g urea per animal and day, a total of 13.8, 16.7 and 20.2% crude protein in the dry matter. The urea was intraruminally infused during the feeding in the morning and the evening. In the morning feeding of each 1st measuring day it was labelled with 27.5 atom-% 15N-excess (15N'). The degree of labelling with 15N' of the N-fraction of rumen fluid, contents of the duodenum, faeces and milk, precipitable with trichloric acetic acid (TCA) decreased with the rising protein level of the ration. This effect was bigger than could be expected considering the low 15N'-quota in the total-N of the ration. In the sequence I ... III, 52.7, 32.2 and 30.6% of the 15N'-amount taken in passed the duodenal re-entrant cannula in TCA-precipitable form within 72 hours after the 15N-application. 33.3, 21.9 and 22.6% were apparently absorbed in the intestines as TCA-precipitable N within 120 h after the 15N'-application. In the same period 31.7, 43.1 and 72.8% of the 15N' taken in were excreted in urine. 12.3, 9.6 and 5.8% of the applied 15N' were found in milk protein. One can conclude that the utilisation of urea-N decreases with the rising level of crude protein in the ration and that, however, urea-N is still biochemically utilised when there is an excess of plant-N in the ration.