Growth hormone acts on liver to stimulate autophagy, support glucose production, and preserve blood glucose in chronically starved mice

When mice are subjected to 60% calorie restriction for several days, they lose nearly all of their body fat. Although the animals lack energy stores, their livers produce enough glucose to maintain blood glucose at viable levels even after a 23-hour fast. This adaptation is mediated by a marked increase in plasma growth hormone (GH), which is elicited by an increase in plasma ghrelin, a GH secretagogue. In the absence of ghrelin, calorie-restricted mice develop hypoglycemia, owing to diminished glucose production. To determine the site of GH action, in the current study we used CRISPR/Cas9 and Cre recombinase technology to produce mice that lack GH receptors selectively in liver (L-Ghr−/− mice) or in adipose tissue (Fat-Ghr−/− mice). When subjected to calorie restriction and then fasted for 23 hours, the L-Ghr−/− mice, but not the Fat-Ghr−/− mice, developed hypoglycemia. The fall in blood glucose in L-Ghr−/− mice was correlated with a profound drop in hepatic triglycerides. Hypoglycemia was prevented by injection of lactate or octanoate, two sources of energy to support gluconeogenesis. Electron microscopy revealed extensive autophagy in livers of calorie-restricted control mice but not in L-Ghr−/− mice. We conclude that GH acts through its receptor in the liver to activate autophagy, preserve triglycerides, enhance gluconeogenesis, and prevent hypoglycemia in calorie-restricted mice, a model of famine.

Three Cases of Cardiac Arrest with Massive Flecainide Intoxication Treated with Extracorporeal Assistance

Flecainide acetate is a Vaughan Williams class 1C anti-arrhythmic agent. Overdose causes severe cardiac and neurologic disturbances and carries a risk of fatality. No antidote is currently available.We present three cases of massive flecainide intoxication in which the patients were kept alive by extracorporeal circulation. Extracorporeal support in cases of flecainide intoxication is the only approach that can alleviate acute cardiac dysfunction, preserve blood flow to vital organs, and maintain liver metabolism and renal excretion of the toxin, while waiting for the improvement of cardiac function. Furthermore, clinical practice highlights that age, duration of CPR, PH, and lactate levels should not be a hindrance to decision-making, and demonstrates the positive, long-term neurologic and cardiologic outcomes that can be achieved with the use of extracorporeal assistance in the setting of severe flecainide intoxication.

Reconstruction with Jejunal Pouch after Gastrectomy for Gastric Cancer

The construction of a gastric substitute pouch after gastrectomy for gastric cancer has been proposed to help ameliorate postprandial symptoms and nutritional performance. Adequate reconstruction after gastrectomy is an important issue, because postoperative patient quality of life (QOL) primarily depends on the reconstruction method. To this end, jejunal pouch (JP) reconstructions were developed to improve the patient's eating capacity and QOL by creating large reservoirs with improved reflux barriers to prevent esophagitis and residual gastritis. It is important that such reconstructions also preserve blood and extrinsic neural integrity for maintaining pouch function, because JP motility is associated directly with QOL. Some problems remain to be resolved with the JP reconstructions method including gastrointestinal motility, which plays a major role in food transfer, digestion, and absorption of nutrients. Further studies including basic research and larger prospective randomized control trials are also needed to obtain definitive results. With persistent innovations in surgical techniques, JP after gastrectomy could become a safe and preferable reconstructive modality to improve patient QOL after gastrectomy.

A comparison of fluoride-oxalate and plain (serum gel) tube on glucose measurement

A continuing problem in the accurate measurement of glucose is its decline in concentration due to erythrocytic glycolysis after sampling, transport and processing. Eliminating this problem requires the use of an anti-glycolytic agent that can be added to the sampling tubes without altering cellular integrity while measuring blood glucose. This study was therefore conducted to compare fluorideoxalate and plain tube on glucose measurement at the Komfo Anokye Teaching Hospital. A total of 100 subjects were recruited from an adult population at the Komfo Anokye Teaching Hospital. Six milliliters of venous blood sample was collected from each patient and 1ml each was dispensed into three separate fluoride-oxalate and plain tubes and were centrifuged at different time intervals to obtain plasma and serum respectively. 1%, 4% and 8% of the subjects presented with hypoglycaemia at immediate, after 1 hour and 2 hours fluoride-oxalate while that of plain tubes were 3%, 6% and 14% respectively. 58%, 53% and 49% of the subjects presented with hyperglycaemia at immediate, after 1 hour and 2 hours for fluoride-oxalate while that of plain tubes were 58%, 49% and 47%. Decrease in glucose concentration after 1 hour and 2 hours in fluoride-oxalate tubes were 6.5% and 13% respectively while those in plain tubes were 8.9% and 16.7%. Though, fluoride-oxalate does not completely inhibit erythrocytic glycolysis within two hours, its effect when left on the bench at different time intervals does not show a significant change in test results. Plain tubes however show significant change in test results at different time intervals since they do not contain any antiglycolytic agents needed to preserve blood glucose.Keywords: Glucose estimation, preservative, serum gel, glucose oxidase, Ghana

Stability of Water Soluble Antioxidants in Cattle Blood Collected in Different Media

The study was carried out to compare between different media used to preserve blood samples taken in the field, and to determine in which of these media is the water soluble antioxidative capacity (ACW) is most stable, because sometimes it takes long time for the blood samples taken in the field to be transported to the laboratory where different biochemical tests are made, in this time during transport the samples underly many factors that have an effect on the content of the samples under study like light, temperature, and time itself. Also the effect of centrifugation was tested to see weather direct or delayed centrifugation has an effect on the water soluble antioxidative capacity of the blood.There are no studies related directly to choosing the proper medium for preserving blood samples when the water soluble antioxidative capacity will be tested. In this study the highest values were achieved using serum samples, and this was the reason why serum tubes were chosen in the rest of the study.In this study four different media were tested, and compared with each other, the measured ACW values in the different media were arranged as follows:serum>NaF-LiH>LiH> EDTA.DOI: http://dx.doi.org/10.3329/bjvm.v12i1.20461 Bangl. J. Vet. Med. (2014). 12 (1): 35-40