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Supplementation with vitamins C and E suppresses
leukocyte oxygen free radical production in patients with
myocardial infarction
Herbaczynska-Cedro K.; Klosiewicz-Wasek B.; Cedro K.; Wasek
W.; Panczenko-Kresowska B.; Wartanowicz M.
Medical Research Centre, Polish Academy of Sciences, Dworkowa
3, 00-754 Warsaw Poland
European Heart Journal (United Kingdom), 1995, 16/8
(1044-1049)
Clinical studies suggest that neutrophil activation during
acute myocardial infarction (MI) aggravates tissue injury.
Activated neutrophils are an important source of oxygen free
radicals (OFR), the injurious effects of which are
counteracted by endogenous antioxidants. We have previously
shown in healthy subjects that supplementation with
antioxidant vitamins C and E suppresses OFR production by
isolated neutrophils assayed by chemiluminescence (CL). the
present study, performed in patients with acute MI aimed
(1) to investigate the effect of Vitamin-C and E
supplementation upon neutrophil OFR production and serum lipid
peroxides,
(2) to evaluate serum levels of vitamins C and E in the
course of MI.
Forty-five patients with acute MI were randomized to
receive either conventional treatment plus Vitamin-C and E aa
600 mg.day-1 p.o. for 14 days (VIT,n=23) or conventional
treatment only (control, n=22). All measurements were
performed on the 1st and 14th day. Neutrophil OFR production
assayed by CL decreased significantly in VIT patients
(Wilcoxon test for paired data P<0.01, Chi square test
P<0.01). In the control group, changes in OFR production
were not significant. Serum lipid peroxides (measured as
TBARS) increased in controls (P<0.05), but remained stable
in VIT patients. Mean (plus or minusSE) serum ascorbic acid
and tocopherol on the 1st day were 0.43 plus or minus 0.18mg%
and 3.25 plus or minus 1.32 microM.mM -1 cholesterol,
respectively, in all patients. On the 14th day in
non-supplemented patients mean tocopherol was unchanged,
whereas ascorbic acid increased significantly (0.63 plus or
minus 0.24 mg%, P<0.01) suggesting that a low basal level
was associated at least in part with the acute phase of the
disease. An expected increase in serum vitamin levels occurred
in VIT patients. In conclusion, supplementation with vitamins
C and E suppresses neutrophil OFR production and lowers the
marker of lipid peroxidation in patients with MI. These
effects, together with a deficiency of antioxidant vitamins,
particularly vitamin C in the early phase of the disease,
support the view that supplementation with antioxidant
vitamins is advisable in patients with MI.
Antioxidant therapy using high dose Vitamin-C:
Reduction of postburn resuscitation fluid volume
requirements
Matsuda T.; Tanaka H.; Reyes H.M.; Richter H.M. III;
Hanumadass M.M.; Shimazaki S.; Matsuda H.; Nyhus L.M.; Baxter
C.R.
Department of Surgery/Burn Center, Cook County Hospital,
University of Illinois, 700 S. Wood Street, Chicago, IL 60612
USA
World Journal of Surgery (USA), 1995, 19/2
(287-291)
Twenty-four guinea pigs with third degree burns over 70% of
the body surface area were divided equally into four groups.
At 0.5 hours postburn, all groups received Ringer's lactate
solution (R/L) according to the Parkland formula. The infusion
rate was then reduced to 25% of the Parkland formula at 1.5
hours postburn. Group 1 received only R/L, and groups 2, 3 and
4 received adjuvant Vitamin-C (14.2 mg/kg/hr) until 4, 8, and
24 hours postburn, respectively. The volume of R/L was reduced
by that of Vitamin-C solution so that the hourly sodium and
fluid intake in each group was the same. Groups 1 and 2
demonstrated higher hematocrit and lower cardiac output values
than did group 3, suggesting hypovolemia and hemoconcentration
in these groups. Group 3 showed hematocrit and cardiac output
values equivalent to those in group 4. We conclude that high
dose Vitamin-C infusion maintains hemodynamic stability in the
presence of a reduced resuscitation fluid volume provided
Vitamin-C is administered for a minimum of 8 hours
postburn.
Vitamin-C reduces ischemia-reperfusion injury in a
rat epigastric island skin flap model
Zaccaria A.; Weinzweig N.; Yoshitake M.; Matsuda T.; Cohen
M.
Division of Plastic Surgery, University of Illinois, M/C 958,
820 S Wood St, Chicago, IL 60612-7316 USA
Ann. Plast. Surg. (USA), 1994, 33/6 (620-623)
Free radicals have been implicated in the cause of
ischemia-reperfusion injury. Various agents have been used in
an attempt to reduce ischemia-reperfusion injury
pharmacologically, including free radical scavengers.
Vitamin-C (ascorbic acid), a well-known free radical
scavenger, has not, to the best of our knowledge, been
evaluated in this respect. Previous work at our institution
has shown that Vitamin-C decreases capillary permeability,
thus significantly reducing fluid resuscitation requirements
in postburn cases. Because this is due in part to the
scavenging effect of Vitamin-C on free radicals, we
investigated the role, if any, of Vitamin-C on
ischemia-reperfusion injury in a rat epigastric island skin
flap model. Twenty-four adult Sprague-Dawley rats were divided
into control and vitamin C groups. Superficial epigastric
island skin flaps measuring 6.0 x 3.5 cm were raised. Pedicles
were isolated and occluded with microvascular clamps for 6
hours. The flaps were then sutured back to their beds over
Steri-Drape barriers. Fifteen minutes before reperfusion, the
control group flaps were perfused via femoral artery
cannulation with normal saline (2.5 ml/kg). The Vitamin-C-
treated group was perfused in a similar fashion with 2.5 ml/kg
of a Vitamin-C/normal saline solution (27 mg/ml). The animals
were observed for 7 days, and the percentage of flap survival
was determined using a paper template technique. The
Vitamin-C-treated group demonstrated a significantly higher
percentage of flap survival than did the control group (25.8%
mean vs. 7.5% mean, p < 0.025). In this animal model,
Vitamin-C reduced or limited reperfusion injury after 6 hours
of ischemia. Its presumed mechanisms of free radical reduction
and its relative safety make Vitamin-C a promising area of
investigation in future animal studies as well as in human
studies examining reperfusion injury.
An experimental study on the protection against
reperfusion myocardial ischemia by using large doses of
Vitamin-C
Qiao S.; Chen Z.; Song L.
Cardiovascular Institute, CAMS, Beijing 100037 China
Chin. J. Cardiol. (China), 1994, 22/1 (52-54+80)
To obtain the practical measure for the
ischemia-reperfusion injury, we developed an open chest pig
model (occlusion for 1 hour and reperfusion for 2 hours).
Vitamin-C (Vit C 0.2 g/kg) was intravenously given within five
minutes to 8 pigs and 12 pigs received only saline as control.
The results showed that there were no differences in the
hemodynamic parameters, but the release of the creatine kinase
isoenzyme after the reperfusion was significantly decreased in
the vit C group (P < 0.05-0.01), and the ratio of the
infarct area and the risk area was 30.2% in the vit C group
and 49.2% in controls respectively (P < 0.05). Furthermore,
the content of myocardial malondialdehyde was significantly
decreased in the vit C group. In order to observe the
protective effect of vitamin C we also developed an open chest
rabbit model. After four-hour reperfusion, vit C group had
less severe bleeding and milder damage to the capillary
endothelium than that of control group. On the rabbit model,
the myocardial free radicals were directly measured with the
electron resonance spectrograph after one half hour
reperfusion (P < 0.05). It was found that the free radical
content was significantly elevated in the control group (P
< 0.05), vit C could inhibit such elevation (P < 0.01).
So it was evident that the protection of vit C was directly
related to scavenging the free radicals.
Vitamins as radioprotectors in vivo. I. Protection
by Vitamin-C against internal radionuclides in mouse testes:
Implications to the mechanism of damage caused by the auger
effect
Narra VR, Harapanhalli RS, Howell RW, Sastry KS, Rao DV
Department of Radiology, University of Medicine and Dentistry
of New Jersey, Newark 07103.
USA Radiat. Res. (USA), 1994, 137/3 (394-399)
The potential of Vitamin-C, an antioxidant, to protect the
radiosensitive spermatogonial cells in mouse testes against
the effects of chronic irradiation by radionuclides
incorporated into tissue was investigated. Interestingly, when
injected intratesticularly, a small and nontoxic amount of
Vitamin-C (1.5 microg in 3 microl saline) protected the
spermatogonia against the damage associated with high-LET
radiation caused by Auger electrons from similarly
administered 5-(125I)-iodo-2'-deoxyuridine (125IdU). A dose
modification factor (DMF) of 2.3 was obtained. In contrast, no
protection was observed when 210Po, an alpha-particle emitter,
was administered similarly. These findings suggest that the
mechanism of action of the Auger effect is of an indirect
nature, which is in contrast to the direct action generally
believed to be responsible for biological damage caused by
high-LET radiations.
Experimental studies on the treatment of frostbite
in rats
Purkayastha S.S.; Chhabra P.C.; Verma S.S.; Selvamurthy
W.
Defence Institute of Physiology, and Allied Sciences, Delhi
Cantt 110010 India
Indian J. Med. Res. Sect. B Biomed. Res. Other than Infect.
Dis. (India), 1993, 98/Aug. (178-184)
The effect of treatment by high dose of Vitamin-C, rapid
rewarming by 37degreeC water alone and with Vitamin-C, rapid
rewarming by 37degreeC decoction of Indian black tea alone and
with vitamin C for experimentally produced frostbite was
evaluated in 6 groups (25 each) of rats. Frostbite was
produced experimentally in the hind limbs by exposing the
animals at -15degreeC for 1h using the harness technique. The
degree of injury was assessed and classified on the basis of
tissue necrosis at the end of 15 days. Administration of high
dose of Vitamin-C for prolonged period and rapid rewarming at
37degreeC water bath immediately after cold exposure
apparently reduced the tissue damage. High dose of Vitamin-C
therapy preceded by rapid rewarming in plain water showed
additional benefit. Rapid rewarming in decoction of Indian tea
resulted in identical beneficial effect. The degree of tissue
preservation was highest with rapid rewarming in tea decoction
followed by high dose of Vitamin-C.
The effects of high-dose Vitamin-C therapy on
postburn lipid peroxidation
Matsuda T, Tanaka H, Yuasa H, Forrest R, Matsuda H,
Hanumadass M, Reyes H
Burn Center, Cook County Hospital, Chicago, IL 60612
USA
J. Burn Care Rehabil. (USA), 1993, 14/6
(624-629)
The effects of Vitamin-C treatment (14 mg/kg/hr) on
postburn lipid peroxidation were evaluated in 12 dogs. A lymph
duct above the ankle was cannulated bilaterally. Hourly lymph
flow rates, plasma and lymph total protein concentrations, and
plasma and lymph malondialdehyde concentrations were measured
before the burn injury and for 24 hours after the burn injury.
Four groups were employed: nonburn without treatment, nonburn
with Vitamin-C treatment, burn without treatment, and burn
with Vitamin-C treatment. The nonburn groups showed no
significant differences in lymph flow rates, total protein
flux, or lymph malondialdehyde level. In the burn groups the
postburn hourly lymph flow rate increased by 850% without
treatment and by 500% with Vitamin-C treatment, whereas the
postburn hourly total protein flux increased by fiftyfold and
twentyfold, respectively. There was a significant reduction in
the postburn lymph malondialdehyde level in the group treated
with Vitamin-C as compared with the nontreatment group. We
conclude that high-dose Vitamin-C administration diminishes
early postburn lipid peroxidation and reduces microvascular
leakage of fluid and protein.
Effect of antioxidant vitamin supplementation on
muscle function after eccentric exercise
Jakeman P.; Maxwell S.
Applied Physiology Research Unit, School Sport and Exercise
Sciences, University of Birmingham, Birmingham B15 2TT United
Kingdom
Eur. J. Appl. Physiol. Occup. Physiol. (Germany), 1993, 67/5
(426-430)
This study investigated the effects of antioxidant vitamin
supplementation upon muscle contractile function following
eccentric exercise and was performed double blind. Twenty-four
physically active young subjects ingested either placebo (400
mg; n = 8), vitamin E (400 mg; n = 8) or Vitamin-C (400 mg; n
= 8) for 21 days prior to and for 7 days after performing 60
min of box-stepping exercise. Contractile function of the
triceps surae was assessed by the measurement of maximal
voluntary contraction (MVC) and the ratio of the force
generated at 20 Hz and 50 Hz tetanic stimulation before and
after eccentric exercise and for 7 days during recovery.
Following eccentric exercise, MVC decreased to 75 (4)% (mean
(SE); n = 24; P < 0.05) of the preexercise values and the
20/50 Hz ratio of tetanic tension from 0.76 (0.01) to 0.49
(0.03) (mean (SE); n = 24; P < 0.05). Compared to the
placebo group no significant changes in MVC were observed
immediately post-exercise, though recovery of MVC in the first
24 h post-exercise was greater in the group supplemented with
Vitamin-C. The decrease in 20/50 Hz ratio of tetanic tension
was significantly less (P < 0.05) postexercise and in the
initial phase of recovery in subjects supplemented with
Vitamin-C but not with vitamin E. These data suggest that
prior Vitamin-C supplementation may exert a protective effect
against eccentric exercise-induced muscle damage.
Vitamin-C as a radioprotector against iodine-131 in
vivo
Narra VR; Howell RW; Sastry KS; Rao DV
Department of Radiology, University of Medicine and Dentistry
of New Jersey, Newark.
J Nucl Med 1993 Apr;34(4):637-40
The capacity of Vitamin-C (ascorbic acid) to mitigate
radiation damage resulting from the tissue-incorporated
radionuclide 131I is examined. Spermatogenesis in mice is the
experimental model and spermhead survival is the biological
endpoint. When a small nontoxic amount of Vitamin-C was
injected, followed by a similar injection of 131I, the 37%
spermhead survival dose (D37) increased by a factor of 2.2
compared with the D37 in animals receiving only the
radionuclide. Similar radioprotection was also observed when
the animals were maintained on a diet enriched with 1% vitamin
C (by weight). These results suggest that Vitamin-C may play
an important role as a radioprotector against accidental or
medical radiation exposures, especially when radionuclides are
incorporated in the body and deliver the dose in a chronic
fashion.
Effects of high-dose Vitamin-C administration on
postburn microvascular fluid and protein flux
Matsuda T, Tanaka H, Hanumadass M, Gayle R, Yuasa H, Abcarian
H, Matsuda H, Reyes H
Burn Center, Cook County Hospital, Chicago, IL 60612.
J Burn Care Rehabil 1992 Sep-Oct;13(5):560-6
The effects of Vitamin-C treatment (14 mg/kg/hr) on burn
injury were evaluated in the hind paws of 12 mongrel dogs. A
lymph duct above one hind paw of each dog was cannulated.
Hourly lymph flow rates (QL) and plasma and lymph total
protein concentrations were measured before the burn injury
and for 6 hours after the burn injury. Data from 24 paws were
divided into four groups: nonburn without treatment, nonburn
with treatment, burn without treatment, and burn with
treatment. The nonburn groups showed no significant
differences in QL or in total protein flux. In the burn groups
the postburn hourly QL increased by sevenfold in the
nontreatment group and only by threefold in the treatment
group, whereas the postburn hourly total protein flux
increased by fifteenfold and fivefold, respectively. We
conclude that administration of high-dose Vitamin-C reduces
early postburn microvascular leakage of fluid and protein.
Modification of the daily photoreceptor membrane
shedding response in vitro by antioxidants
Williams D.S.; Roberts E.A.
Indiana University, 800 East Atwater Avenue, Bloomington, IN
47405 USA
Invest. Ophthalmol. Visual Sci. (USA), 1992, 33/10
(3005-3008)
The shedding of rod outer segment disc membrane was
investigated in a commonly used frog eyecup preparation, with
respect to length of time in vitro. It was found that the
amplitude, but not the timing, of the 'dawn' (ie, when the
lights are turned on) shedding response was increased
threefold if the time in vitro was increased from 1.5-2 hr to
12-13 hr before dawn. After the overnight incubation,
morphologic deterioration of the photoreceptors was not
apparent by light or electron microscopy. The addition of the
antioxidants, Vitamin-C or alpha-tocopherol (vitamin E),
inhibited the increase in shedding, suggesting that it was
induced by oxidation. These results help define conditions
necessary for the maintenance of normal retinal metabolism in
vitro. They also suggest a link between the amplitude of the
dawn disc membrane shedding response and oxidation.
Ascorbate treatment prevents accumulation of
phagosomes in RPE in light damage
Blanks J.C.; Pickford M.S.; Organisciak D.T.
Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA
90033 USA
Invest. Ophthalmol. Visual Sci. (USA), 1992, 33/10
(2814-2821)
In dark-reared albino rats, exposure to 2 or 3 hr of
intense light interrupted by 2 hr dark periods resulted in
extensive degeneration of photoreceptor cells and degeneration
of the retinal pigment epithelium (RPE). Ascorbate (ie,
Vitamin-C) administration prior to light exposure protected
photoreceptors and the RPE from light damage. In the present
study, ascorbate-treated and untreated rats were exposed to
various cycles of intermittent light. Immediately after this
light exposure, phagosome frequency in the RPE was
morphologically evaluated in comparable 50 microm sections. In
untreated rats, exposure to 2 or 3 hr of intermittent light
resulted in a five- to sixfold increase in phagosome density
compared to unexposed controls. In contrast, no increase in
phagosome density was observed in ascorbate-treated rats. In
these animals, under all lighting regimens, phagosome levels
remained essentially identical to those in rats not exposed to
light. After a single nondamaging light exposure, phagosome
density remained at the level of dark controls in
ascorbate-treated and untreated rats. These results indicate
that phagosome frequency may serve as an index for light
damage and that the protective effect of ascorbate may be
linked to its capacity to prevent rod outer segment shedding
and phagocytosis under intense light conditions.
Topical Vitamin-C protects porcine skin from
ultraviolet radiation-induced damage
Darr D.; Combs S.; Dunston S.; Manning T.; Pinnell S.
Box 3135, Duke University Medical Center, Durham, NC 27710
USA
Br. J. Dermatol. (United Kingdom), 1992, 127/3
(247-253)
Ultraviolet radiation damage to the skin is due, in part,
to the generation of reactive oxygen species. Vitamin-C
(L-ascorbic acid) functions as a biological co-factor and
antioxidant due to its reducing properties. Topical
application of Vitamin-C has been shown to elevate
significantly cutaneous levels of this vitamin in pigs, and
this correlates with protection of the skin from UVB damage as
measured by erythema and sunburn cell formation. This
protection is biological and due to the reducing properties of
the molecule. Further, we provide evidence that the vitamin C
levels of the skin can be severely depleted after UV
irradiation, which would lower this organ's innate protective
mechanism as well as leaving it at risk of impaired healing
after photoinduced damage. In addition, Vitamin-C protects
porcine skin from UVA-mediated phototoxic reactions (PUVA) and
therefore shows promise as a broad-spectrum
photoprotectant.
The synergism of gamma-interferon and tumor
necrosis factor in whole body hyperthermia with vitamin C to
control toxicity
Rosen P.
Hasbrouck Laboratory, University of Massachusetts, Amherst,
MA 01003 USA
Med. Hypotheses (United Kingdom), 1992, 38/3
(257-258)
In a previous paper, the synergism of gamma-interferon and
tumor necrosis factor was considered with whole body
hyperthermia. Because of the toxic effect of TNF due to oxygen
radicals, it is suggested that Vitamin-C be added.
Tirilazad mesylate protects vitamins C and E in
brain ischemia-reperfusion injury
Sato P.H.; Hall E.D.
Department of Pharmacology, Michigan State University, East
Lansing, MI 48824 USA
J. Neurochem. (USA), 1992, 58/6 (2263-2268)
Brain concentrations of the antioxidant vitamins C and E
decreased following unilateral carotid occlusion and
reperfusion for 2 or 24 h in gerbils. Administration of the
21-aminosteroid inhibitor of lipid peroxidation, tirilazad
mesylate (U74006F), prevented the decrease in level of both of
these vitamins following 2 h of reperfusion. After 24 h of
reperfusion, however, alpha-tocopherol (vitamin E) continued
to be protected, but ascorbic acid (vitamin C) showed a
pronounced decrease in content. The changes in concentrations
of these vitamins are consistent with U74006F acting to
inhibit peroxidation in the CNS by scavenging of lipid peroxyl
radicals and suggest that, in the presence of this agent,
injury-induced depletion of ascorbic acid may occur without
irreversible tissue damage.
Vitamin-C supplementation in the patient with burns
and renal failure
Dylewski DF, Froman DM
Parenteral Nutrition Support Service, Francis Scott Key
Medical Center, Baltimore, MD.
J. Burn Care Rehabil. (USA), 1992, 13/3
(378-380)
Vitamin-C supplementation is an important component of
nutritional management in patients with burns. To supply
appropriate vitamin C therapy, complications such as renal
failure must be considered. An understanding of current
vitamin regimens and potential metabolic sequelae can assist
the practitioner in providing safe and therapeutic Vitamin-C
doses.
High-dose Vitamin-C therapy for extensive deep
dermal burns
Matsuda T.; Tanaka H.; Shimazaki S.; Matsuda H.; Abcarian H.;
Reyes H.; Hanumadass M.
Burn Center, Cook County Hospital, 700 S. Wood Street,
Chicago, IL 60612 USA
USA Burns (United Kingdom), 1992, 18/2 (127-131)
We studied the haemodynamic effects of antioxidant therapy
with high-dose Vitamin-C administration (170 mg/kg/24h) in
guinea-pigs with 70 per cent body surface area deep dermal
burns. The animals were divided into three groups of six
animals each. Group 1 was resuscitated with Ringer's lactate
solution according to the Parkland formula; group 2 with 25
per cent of the Parkland formula with Vitamin-C; and group 3
with 25 per cent of the Parkland formula without Vitamin-C.
There were no significant differences in heart rates or in
blood pressures between the groups throughout the 24-h study
period. Group 3 showed significantly higher haematocrit values
at 3 h postburn and thereafter as compared with those of group
2. The cardiac output values of group 2 were significantly
higher than those of group 3, but equivalent to those of group
1. The water content of the burned skin in group 2 was
significantly lower than that in the other groups, indicating
that increased postburn capillary permeability was minimized
by the administration of Vitamin-C. With adjuvant high-dose
Vitamin-C administration, we were able to reduce the 24-h
resuscitation fluid volume from 4 ml/kg/per cent burn to 1
ml/kg/per cent burn, while maintaining adequate cardiac
output.
Metabolic and immune effects of enteral ascorbic
acid after burn trauma
Nelson J.L.; Alexander J.W.; Jacobs P.A.; Ing R.D.; Ogle
C.K.
Shriners Burns Institute, 202 Goodman Street, Cincinnati, OH
45219 USA
Burns (United Kingdom), 1992, 18/2 (92-97)
A burned guinea-pig model (30 per cent BSA) was used to
study the effect of Vitamin-C on immune and metabolic
responses following burn trauma. Thirty-six guinea-pigs
received identical enteral diets (175 kcal/kg) except for the
amount of Vitamin-C. Groups I, II, III and IV were given
formulae delivering no Vitamin-C (1 RDA) 15 mg/kg/day 75
mg/kg/day or 375 mg/kg/day respectively. Resistance to
infection was evaluated by injecting each animal with 0.1 ml
of 1 x 109 Staph. aureus 502A subcutaneously on day 10. On day
14, Staph. aureus abscesses were excised and the numbers of
viable colonies were determined. Results showed no statistical
differences between groups in the clearance of Staph. aureus.
From days 2 to 12, animals in groups I, II and III had body
weights of approximately 97 per cent of preburn body weight.
Animals in group IV however, had a body weight gain, 102 per
cent of preburn body weight on day 12. Animals in group IV
also had significantly lower metabolic rates on day 12 as
compared to the animals in the other groups. These results
suggest that large amounts of Vitamin-C have beneficial
effects on the maintenance of body weight and metabolic rate
following burn trauma.
Reduced fluid volume requirement for resuscitation
of third-degree burns with high-dose Vitamin-C
Matsuda T.; Tanaka H.; Williams S.; Hanumadass M.; Abcarian
H.; Reyes H.
Burn Center, Cook County Hospital, 700 S. Wood St., Chicago,
IL 60612 USA
J. Burn Care Rehabil. (USA), 1991, 12/6
(525-532)
The effects of high-dose Vitamin-C therapy (170 mg, 340 mg,
and 680 mg/kg/day) were evaluated in 70% body surface area
third-degree burns in guinea pigs that were resuscitated with
1 ml/kg/%burn Ringer's lactate solution. The water content
measurements of the burned skin at 24 hours after burn injury
in the Vitamin-C-treated groups were significantly lower than
those of the control group (1 ml/kg/%burn) and those of the
standard resuscitation group (4 ml/kg/%burn). The cardiac
outputs in the group that received 340 mg Vitamin-C were
significantly higher than those of the control group but not
significantly different than those of the standard therapy
group at 2 hours after burn injury and thereafter. In
comparison with the regimen of 340 mg Vitamin-C, the regimen
of 680 mg Vitamin-C was no more beneficial, and the regimen of
170 mg was less effective. With administration of adjuvant
high-dose Vitamin-C, we were able to reduce the total 24-hour
resuscitation volume from 4 ml/kg/%burn to 1 ml/kg/%burn,
while a comparable cardiac output was maintained.
Biochemical basis of ozone toxicity
Mustafa M.G.
Department of Environmental Health Sciences, University of
California, School of Public Health, Los Angeles, CA 90024
USA
Free Radic. Biol. Med. (USA), 1990, 9/3
(245-265)
Ozone (O3) is the major oxidant of photochemical smog. Its
biological effect is attributed to its ability to cause
oxidation or peroxidation of biomolecules directly and/or via
free radical reactions. A sequence of events may include lipid
peroxidation and loss of functional groups of enzymes,
alteration of membrane permeability, and cell injury or death.
An acute exposure to O3 causes lung injury involving the
ciliated cell in the airways and the type 1 epithelial cell in
the alveolar region. The effects are particularly localized at
the junction of terminal bronchioles and alveolar ducts, as
evident from a loss of cells and accumulation of inflammatory
cells. In a typical short-term exposure the lung tissue
response is biphasic: an initial injury-phase characterized by
cell damage and loss of enzyme activities, followed by a
repair-phase associated with increased metabolic activities,
which coincide with a proliferation of metabolically active
cells, for example, the alveolar type 2 cells and the
bronchiolar Clara cells. A chronic exposure to O3 can cause or
exacerbate lung diseases, including perhaps an increased lung
tumor incidence in susceptible animal models. Ozone exposure
also causes extrapulmonary effects involving the blood,
spleen, central nervous system, and other organs. A
combination of O3 and NO2, both of which occur in
photochemical smog, can produce effects which may be additive
or synergistic. A synergistic lung injury occurs possibly due
to a formation of more powerful radicals and chemical
intermediates. Dietary antioxidants, for example, vitamin E,
Vitamin-C, and selenium, can offer a protection against O3
effects.
Decreases in tissue levels of ubiquinol-9 and -10,
ascorbate and alpha-tocopherol following spinal cord impact
trauma in rats
Lemke M.; Frei B.; Ames B.N.; Faden A.I.
Center for Neural Injury, Department of Neurology, University
of California, San Francisco, CA USA
USA Neurosci. Lett. (Netherlands), 1990, 108/1-2
(201-206)
Generation of free radicals and subsequent lipid
peroxidation have been proposed to contribute to delayed
tissue damage following traumatic spinal cord injury (SCI).
Ubiquinols (reduced coenzyme Q), ascorbate (Vitamin-C), and
alpha-tocopherol (vitamin E) are endogenous antioxidants;
decreases in tissue levels of these compounds may, therefore,
reflect ongoing oxidative reactions. In the present studies,
alterations in tissue levels of ubiquinol-9 and -10,
ascorbate, and alpha-tocopherol were examined after SCI of
varying severity in the rat. Levels of alpha-tocopherol did
not change significantly after injury. Ascorbate and ubiquinol
levels were decreased after trauma. Changes in tissue levels
of ubiquinol, but not ascorbate reflected the degree of
trauma. Thus, ubiquinol levels may provide a useful marker of
the oxidative component of the secondary injury response.
Nutritional considerations for the burned
patient
Pasulka P.S.; Wachtel T.L.
Burn and Trauma Service, Good Samaritan Medical Center,
Phoenix, AZ 85006 USA
Surg. Clin. North Am. (USA), 1987, 67/2
(109-131)
The metabolic response to injury is one of marked catabolic
hormonal predominance resulting in hypermetabolism and protein
wasting. Energy expenditure increases with increasing severity
of injury, but reaches a maximum of twice resting energy
expenditure when 50 percent TBSA is burned. We agree with the
nutritional recommendations of the group at the Boston
Shriner's Burn Institute and the Massachusetts General
Hospital. These include providing calories at twice the
resting energy expenditure, as predicted by the
Harris-Benedict equations, for patients with greater than 30
percent BSAB; protein is provided at 2.5 gm per kg per day
based on ideal body weight. It is important to recognize that
these are optimal goals, but their attainment must be governed
by safety considerations for the patient. It is probably safe
to supplement intake with a multivitamin and Vitamin-C, as
well as zinc, but our understanding of micronutrient therapy
for stressed patients is rudimentary.
Ascorbic acid metabolism in trauma
Mukherjee D.; Som S.; Chatterjee I.B.
Dep. Biochem., Univ. Coll. Sci., Calcutta 700019 India
Indian J. Med. Res. (India), 1982, 75/5
(748-751)
In major trauma such as severe head injury, burns or
lacerated injury, there was a precipitous fall in plasma
ascorbic acid level accompanied by a significant rise in blood
dehydroascorbate level. However, this change was temporary and
normal Vitamin-C status was regained after recovery from the
stress condition. A similar alteration in plasma ascorbate
level was also found after major surgery. This alteration in
ascorbic acid status was not due to lack of reduction of
dehydroascorbic acid to ascorbic acid but due to a high
turnover of ascorbic acid in trauma. Supplementation of
ascorbic acid in trauma resulted in a temporary increase in
the plasma ascorbic acid level.
Multiple pathologic fractures in osteogenesis
imperfecta
Gerber B.E.; Jani L.
Orthop. Klin., Chir. Dept., Univ. Basel, 4055 Basel
Switzerland
Orthopade (Germany, West), 1982, 11/3 (101-108)
The authors survey the current orthopedic possibilities in
treating multiple fractures in osteogenesis imperfecta. Also
the general influence of Vitamin-C treatment is discussed.
Effect of zinc supplementation in fracture
healing
Chaturvedi S.N.; Singh K.N.; Shukla R.K.; Singh R.K.
Dept. Orthop. Surg., G.S.V.M. Med. Coll., Kanpur India
Indian J. Orthop. (India), 1980, 14/1 (62-71)
In the present experimental study, 36 rabbits were
subjected to fracture of the of the fibula and were treated in
3 groups viz., Control group, Zinc sulphate supplemented group
and Zinc sulphate vit. C. + Methandienone supplemented group.
Each group consisted of 12 rabbits. After roentgenological,
macroscopic and histological examination of healing of
fractures of weekly intervals, it was concluded that the Zinc
supplementation to an appreciable extent enhanced the process
of bone healing which could be further hastened by addition of
Vitamin-C and Dianabol. No significant toxic or side effect of
zinc supplementation was observed in any of the rabbits. A
clinical trial of the same drugs was also conducted in
patients with fractures of the shaft of the femur.
Treatment results of spinal cord injuries in the
Swiss paraplegic centre of Basle
Zaech G.A.; Seiler W.; Dollfus P.
Swiss Paraplegic Cent., Basle Switzerland
Paraplegia (Edinb.) (Scotland), 1976, 14/1
(58-65)
The results concerning the last 117 acute traumatic spinal
cord lesions admitted in the Swiss Paraplegic Centre of Basle
have been analysed as regards the rate of neurological
recovery. The treatment not only concerns the vertebral damage
but also the medical aspects of the spinal cord lesion itself.
The routine use of combined Dexamethasone, Rheomacrodex and
Hydergine in the very early treatment might have accounted for
encouraging results which need to be confirmed in the
future.
Effect of piracetam on electroshock induced amnesia
and decrease in brain acetylcholine in rats
Bhattacharya S.K.; Upadhyay S.N.; Jaiswal A.K.
Department of Pharmacology, Institute of Medical Sciences,
Banaras Hindu University, Varanasi 221 005 India
Indian J. Exp. Biol. (India), 1993, 31/10
(822-824)
Piracetam, a prototype of a new class of psychotropic
agents, the nootropic agents, which improve learning ability
and memory retention, was found to induce a dose-related
prevention of disruption of acquisition of a passive avoidance
response produced by electroshock application. The amnesia
attenuating effect of piracetam was accompanied by prevention
of the decrease in acetylcholine concentrations of rat brain
induced by electroshock. The study indicates that the
cognition enhancing effect of piracetam may be due to a
facilitatory effect on cholinergic transmission.
Use of piracetam in treatment of head injuries.
Observations in 903 cases.
Cicerchia G.; Santucci R.; Palmieri M.
Ospedale della Misericordia, Servizio di Pronto Soccorso,
Area di Degenza per l'Emergenza, Grosseto Italy
Clin. Ter. (Italy), 1985, 114/6 (481-487)
The authors report on 903 patients with head concussion of
varying degrees of severity who were treated with anti-oedema
drugs associated with an activator of cerebral metabolism.
This treatment resulted in a swift disappearance of symptoms
and in a quick recovery of normal cerebral activity, and
moreover in a noticeable decrease of the time of
hospitalisation.
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