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  • Adrenaline  (2)
  • Indocyanine-green extraction  (2)
  • L-(methyl-2H3)-leucine  (2)
  • 1
    Electronic Resource
    Electronic Resource
    Glucose and urea production and leucine, ketoisocaproate and alanine fluxes at supraphysiological plasma adrenaline concentrations in volunteers (1994)
    Springer
    Intensive care medicine 20 (1994), S. 113-118 
    Details
    ISSN: 1432-1238
    Keywords: Adrenaline ; Glucose ; Amino acids ; Urea ; Stable isotopes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine the magnitude and time course of adrenergic effects on metabolism in volunteers and possible implications for the use of sympathomimetics in the critically ill. Design Descriptive laboratory investigation. Subjects 7 volunteers. Intervention Primed continuous infusions of stable isotope tracers ([15N2]-urea, [6,6-D2]-glucose, [methyl-D3]-L-leucine, [15N]-L-alanine) were used. After isotopic steady state had been reached an infusion of adrenaline (0.1 μg/kg/min) was administered (4 h). Isotopic enrichment was measured using gas chromatography-mass spectrometry and the corresponding rates of appearance were calculated. Measurements and main results Glucose production increased from 14.1±1.2 to 21.5±2.0 μmol/kg/min (p〈0.05) after 80 min of adrenergic stimulation and then decreased again to 17.9±1.2 μmol/kg/min after 240 min. Leucine and ketoisocaproate (KIC) fluxes were 2.3±0.2 and 2.6±0.2 μmol/kg/min, respectively, at baseline and gradually decreased to 1.8±0.2 and 2.2±0.1 μmol/kg/min, respectively, after 240 min of adrenaline infusion (bothp〈0.05). Alanine flux increased from 3.7±0.5 to 6.9±0.9 μmol/kg/min (p〈0.05) after 80 min of adrenergic stimulation. Urea production slightly decreased from 4.8±0.9 to 4.3±0.8 μmol/kg/min during adrenaline (p〈0.05). Conclusions Adrenaline induced an increase in glucose production lasting for longer than 240 min. The decrease in leucine and KIC flux suggests a reduction in proteolysis, which was supported by the decrease in urea production. The increase in alanine flux is therefore most likely due to an increase in de-novo synthesis. The ammonia donor for alanine synthesis in peripheral tissues and the target for ammonia after alanine deamination in the liver remain to be investigated. These results indicate that adrenaline infusion most probably will not promote already enhanced proteolysis in critically ill patients. Gluconeogenesis is an energy consuming process and an increase may deteriorate hepatic oxygen balance in patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01707665
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of human growth hormone therapy on L-(Methyl-2H3)-leucine turnover and urinary pseudouridine concentration in patients with Ullrich-Turner syndrome (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 275-280 
    Details
    ISSN: 1432-1076
    Keywords: Key words Ullrich-Turner ; syndrome ; Human growth hormone ; Growth rate ; L-(methyl-2H3)-leucine ; Pseudouridine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The effect of daily human growth hormone (hGH) injections (3 I.U./m2/day) on tissue anabolism was determined in six patients with Ullrich-Turner syndrome (XO) (8.7–19 years of age) using novel techniques such as whole body leucine kinetics during continuous infusion of L-(Methyl-2H3)-leucine and urinary pseudouridine (5-ribosyluracil) excretion on the one hand and traditional methods like serum urea and amino acid concentrations on the other. Pseudouridine is only found in ribonucleic acid (RNA) and is neither reincorporated nor catabolically broken down and is therefore considered an ideal index of whole body RNA turnover. The mean L-(Methyl-2H3)-leucine turnover of the six XO patients before hGH was 1.90 ± 0.15 μmoles/kg per minute. After 3 months of hGH-treatment it had increased in three patients, whereas it had decreased in the other three. The results obtained with the stable isotope technique were correlated with the urinary pseudouridine concentrations (r = 0.68; P 〈 0.01). The growth rates were positively correlated with leucine turnover (r = 0.63; P 〈 0.02) and urinary pseudouridine concentration (r = 0.73; P 〈 0.006) as well as negatively correlated with the serum urea concentrations r = –0.62; P 〈 0.03). The decrease in the individual serum urea concentrations were tightly correlated with the hGH induced change in growth rate (r = –0.90; P 〈 0.01). The individual bone ages were negatively correlated with the hGH induced changes in leucine turnover (r = –0.77; P 〈 0.003) as well as with the urinary pseudouridine concentrations (r = –0.87; P 〈 0.0002). The hGH effect on leucine and RNA turnover, showing effectiveness only until a developmental age between 11 and 12 years, leads the discussion of the ideal moment of oestrogen supplementation when girls with Ullrich-Turner syndrome are treated with hGH in early adolescence. Conclusion The protein metabolism of patients with Ullrich-Turner syndrome is influenced by hGH in an age dependent manner. In a clinical setting, pseudouridine, an easily determined derivative of ribonucleic acids, may be able to replace the tedious work with expensive stable isotopes when questions related to tissue anabolism are to be answered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004310050400
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  • 3
    Electronic Resource
    Electronic Resource
    The effect of human growth hormone therapy on L-(Methyl-2H3)-leucine turnover and urinary pseudouridine concentration in patients with Ullrich-turner syndrome (1996)
    Springer
    European journal of pediatrics 155 (1996), S. 275-280 
    Details
    ISSN: 1432-1076
    Keywords: Ullrich-Turner syndrome ; Human growth hormone ; Growth rate ; L-(methyl-2H3)-leucine ; Pseudouridine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Abstract The effect of daily human growth hormone (hGH) injections (3 I.U./m2/day) on tissue anabolism was determined in six patients with Ullrich-Turner syndrome (XO) (8.7–19 years of age) using novel techniques such as whole body leucine kinetics during continuous infusion of L-(Methyl-2H3)-leucine and urinary pseudouridine (5-ribosyluracil) excretion on the one hand and traditional methods like serum urea and amino acid concentrations on the other. Pseudouridine is only found in ribonucleic acid (RNA) and is neither reincorporated nor catabolically broken down and is therefore considered an ideal index of whole body RNA turnover. The mean L-(Methyl-2H3)-leucine turnover of the six XO patients before hGH was 1.90±0.15 μmoles/kg per minute. After 3 months of hGH-treatment it had increased in three patients, whereas it had decreased in the other three. The results obtained with the stable isotope technique were correlated with the urinary pseudouridine concentrations (r=0.68;P〈0.01). The growth rates were positively correlated with leucine turnover (r=0.63;P〈0.02) and urinary pseudouridine concentration (r=0.73;P〈0.006) as well as negatively correlated with the serum urea concentrationsr=−0.62;P〈0.03). The decrease in the individual serum urea concentrations were tightly correlated with the hGH induced change in growth rate (r=0.90;P〈0.01). The individual bone ages were negatively correlated with the hGH induced changes in leucine turnover (r=−0.77;P〈0.003) as well as with the urinary pseudouridine concentrations (r=−0.87P〈0.0002). The hGH effect on leucine and RNA turnover, showing effectiveness only until a developmental age between 11 and 12 years, leads the discussion of the ideal moment of oestrogen supplementation when girls with Ullrich-Turner syndrome are treated with hGH in early adolescence. Conclusion The protein metabolism of patients with Ullrich-Turner syndrome is influenced by hGH in an age dependent manner. In a clinical setting, pseudouridine, an easily determined derivative of ribonucleic acids, may be able to replace the tedious work with expensive stable isotopes when questions related to tissue anabolism are to be answered.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02002712
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    Paper (German National Licenses)
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  • 4
    Electronic Resource
    Electronic Resource
    Aerosolized prostacyclin and inhaled nitric oxide in septic shock – different effects on splanchnic oxygenation? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 880-887 
    Details
    ISSN: 1432-1238
    Keywords: Key words Septic shock ; Nitric oxide ; Prostacyclin ; Gastric intramucosal pH ; PCO2 gap ; Splanchnic oxygenation ; Indocyanine-green extraction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives: To compare the effects of inhaled nitric oxide and aerosolized prostacyclin (PGI2) on hemodynamics and gas exchange as well as on the indocyanine-green plasma disappearance rate and gastric intramucosal pH in patients with septic shock. Design: Prospective, randomized, interventional clinical study. Setting: Intensive care unit in a university hospital. Patients: Sixteen patients with pulmonary hypertension and septic shock according to the criteria of the ACCP/SCCM consensus conference all requiring norepinephrine and/or epinephrine to maintain mean arterial blood pressure above 65 mmHg. Methods and interventions: Patients were randomly assigned to receive either nitric oxide or aerosolized prostacyclin. Nitric oxide was inhaled using a commercially available delivery system, prostacyclin was administered with a modified ultrasound nebulizer. Both nitric oxide and prostacyclin were incrementally adjusted to obtain a 15% decrease of mean pulmonary artery pressure. Hemodynamics and gas exchange as well as indocyanine-green plasma disappearance rate and gastric intramucosal pH were determined at baseline after 90 min in steady state, after 90 min of nitric oxide inhalation or prostacyclin aerosol administration had elapsed in stable conditions, and after 90 min in stable conditions after nitric oxide or prostacyclin withdrawal. Results: Both inhaled nitric oxide and aerosolized prostacyclin selectively reduced the mean pulmonary artery pressure from 35±4, 30±4 mmHg (p〈0.05) and 34±4 to 30±3 mmHg (p〈0.05) respectively; after removal of nitric oxide and prostacyclin, the mean pulmonary artery pressure returned to the baseline values. Systemic hemodynamics remained unaltered during the vasodilator treatment. While the mean PaO2 was not significantly influenced, it increased in 4/8 of the NO- and 3/8 of the PGI2– treated patients. Neither of the drugs influenced indocyanine-green plasma disappearance rate, but prostacyclin – unlike nitric oxide – significantly increased gastric intramucosal pH (from 7.26±0.07 to 7.30±0.05, p〈0.05) which remained elevated in four of these patients after prostacyclin removal, and decreased the arterial-gastric mucosal pressure of carbon dioxide gap from 19±6 to 15±4 mmHg (p〈0.05). Conclusions: Our data suggest that aerosolized prostacyclin – unlike nitric oxide – has similar beneficial effects on splanchnic perfusion and oxygenation as intravenous prostacyclin without detrimental effects on systemic hemodynamics. The different effects of prostacyclin and nitric oxide might be explained by the longer half-life of prostacyclin associated with a certain spillover into the systemic circulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050182
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Are the effects of noradrenaline, adrenaline and dopamine infusions on $$\dot VO_2 $$ and metabolism transient?and metabolism transient? (1995)
    Springer
    Intensive care medicine 21 (1995), S. 50-56 
    Details
    ISSN: 1432-1238
    Keywords: Noradrenaline ; Adrenaline ; Dopamine ; Oxygen consumption ; Blood pressure ; Heart rate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective To determine whether noradrenaline, adrenaline and dopamine have persistent on $$\dot VO_2 $$ and metabolism. Design Descriptive laboratory investigation. Setting Laboratory of the Department of Anaesthesiology at a University Hospital. Subjects 9 volunteers. Intervention $$\dot VO_2 $$ and the plasma concentration of glucose and free fatty acids were measured prior to and during a 4 h infusion of saline (control), noradrenaline (0.14 μg/kg min) adrenaline (0.08 μg/kg min) or dopamine (7 μg/kg min),n=9 each. $$\dot VO_2 $$ was measured using an open circuit gas exchange system. Measurements and main results $$\dot VO_2 $$ increased from 250±22 ml/min to 280±38 ml/min during noradrenaline, to 298±30 ml/min during adrenaline and to 292±39 ml/min during dopamine infusion. The plasma glucose concentration increased from 6.2±0.6 mmol/l to 8.8±0.8 mmol/l, 13.2±1.4 and 7.3±0.4 mmol/l during infusion of noradrenaline, adrenaline or dopamine, respectively. The plasma free fatty acid concentration increased from 0.28±0.10 mmol/l to 0.79±0.21 mmol/l during noradrenaline and to 0.52±0.09 mmol/l during dopamine. In contrast, free fatty acid values averaged baseline values at the end of the adrenaline infusion after an initial increase to 0.72±0.31 mmol/l. Conclusions Administration of noradrenaline, adrenaline or dopamine resulted in persistent increases in $$\dot VO_2 $$ in volunteers. With the exception of the transient adrenaline effect on fatty acids the metabolic actions were steady during 4 h of adrenergic stimulation. Since the adrenergic effect on $$\dot VO_2 $$ is persistent over time a similar action in patients (e.g. septic shock) during treatment with adrenoceptor agonists may be important. Thus, an increase in $$\dot VO_2 $$ during therapy may not only reflect an oxygen debt but also a pharmacodynamic action of adrenoceptor mediated calorigenic and metabolic induction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02425154
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    Paper (German National Licenses)
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  • 6
    Electronic Resource
    Electronic Resource
    Aerosolized prostacyclin and inhaled nitric oxide in septic shock — different effects on splanchnic oxygenation? (1996)
    Springer
    Intensive care medicine 22 (1996), S. 880-887 
    Details
    ISSN: 1432-1238
    Keywords: Septic shock ; Nitric oxide ; Prostacyclin ; Gastric intramucosal pH ; PCO2 gap ; Splanchnic oxygenation ; Indocyanine-green extraction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objectives To compare the effects of inhaled nitric oxide and aerosolized prostacyclin (PGI2) on hemodynamics and gas exchange as well as on the indocyanine-green plasma disappearance rate and gastric intramucosal pH in patients with septic shock. Design Prospective, randomized, interventional clinical study. Setting Intensive care unit in a university hospital. Patients Sixteen patients with pulmonary hypertension and septic shock according to the criteria of the ACCP/SCCM consensus conference all requiring norepinephrine and/or epinephrine to maintain mean arterial blood pressure above 65 mmHg. Methods and interventions Patients were randomly assigned to receive either nitric oxide or aerosolized prostacyclin. Nitric oxide was inhaled using a commercially available delivery system, prostacyclin was administered with a modified ultrasound nebulizer. Both nitric oxide and prostacyclin were incrementally adjusted to obtain a 15% decrease of mean pulmonary artery pressure. Hemodynamics and gas exchange as well as indocyaninegreen plasma disappearance rate and gastric intramucosal pH were determined at baseline after 90 min in steady state, after 90 min of nitric oxide inhalation or prostacyclin aerosol administration had elapsed in stable conditions, and after 90 min in stable conditions after nitric oxide or prostacyclin with-drawal. Results Both inhaled nitric oxide and aerosolized prostacyclin selectively reduced the mean pulmonary artery pressure from 35±4, 30±4 mmHg (p〈0.05) and 34±4 to 30±3 mmHg (p〈0.05) respectively; after removal of nitric oxide and prostacyclin, the mean pulmonary artery pressure returned to the baseline values. Systemic hemodynamics remained unaltered during the vasodilator treatment. While the mean PaO2 was not significantly influenced, it increased in 4/8 of the NO- and 3/8 of the PGI2 — treated patients. Neither of the drugs influenced indocyanine-green plasma disappearance rate, but prostacyclin — unlike nitric oxide — significantly increased gastric intramucosal pH (from 7.26±0.07 to 7.30±0.05,p〈0.05) which remained elevated in four of these patients after prostacyclin removal, and decreased the arterial-gastric mucosal pressure of carbon dioxide gap from 19±6 to 15±4 mmHg (p〈0.05). Conclusions Our data suggest that aerosolized prostacyclin — unlike nitric oxide — has similar beneficial effects on splanchnic perfusion and oxygenation as intravenous prostacyclin without detrimental effects on systemic hemodynamics. The different effects of prostacyclin and nitric oxide might be explained by the longer half-life of prostacyclin associated with a certain spillover into the systemic circulation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02044111
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
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