Injection Of Hydrocortisone Research Articles

Effect of Single Bolus Injection of Hydrocortisone for Prevention of Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Backgrounds: Recent study suggested that steroid can prevent the recurrence of AF. This study evaluated the effect of single bolus injection of hydrocortisone in the prevention of recurrence after PVI. Methods: We analyzed 55 patients (43 male, 55±11 years) with paroxysmal AF who received steroid (steroid group) and 55 sex and age-matched control (44 male, 55±11 years). In the steroid group, intravenous hydrocortisone (100 mg) was given the day of the PVI. Catheter ablation technique included only PVI and cavotricuspid isthmus block. Results: The patients with immediate AF recurrence (within 3 days after the PVI) was 6 (11%) and 4 (8%) in control and steroid groups (p=0.61), respectively. There was no difference in body temperature (p=0.61) and WBC count (p=0.63) during the initial 3 days after ablation between 2 groups. Single bolus injection of hydrocortisone did not decrease AF recurrences between 4 and 30 days after ablation (7% vs 8%, p=0.89). The AF-free rate at 12 months post-ablation was not different between two groups (91% vs 90%, p=0.79 by the log-rank test). Conclusions: Low dose single bolus injection of hydrocortisone shortly after AF ablation was not effective for preventing immediate and AF recurrences during mid-term follow-up period after AF ablation.

21 THE INJECTION OF CORTISOL TO UTERUS INCREASES THE IMPLANTATION RATE AND LITTER SIZE IN PIG ARTIFICIAL INSEMINATION USING CYROPRESERVED SPERMATOZOA

Cryopreserved boar spermatozoa are not routinely available to swine artificial insemination (AI) because conception and farrowing rates, along with litter size, have remained low. We have reported the positive roles of seminal plasma in frozen–thawed sperm functions (Okazaki et al. 2009 Theriogenology 71, 491–498). Moreover, the injection of seminal plasma to uterus with frozen–thawed spermatozoa significantly increased the implantation rate. Thus, the factors in seminal plasma act not only on sperm but also on uterus to induce successful fertilization and implantation in pig AI using cryopreserved spermatozoa. To test this hypothesis, we identified the factors in seminal plasma and then developed novel pig AI method using cryopreserved spermatozoa. The sperm-rich fraction was collected weekly from each boar using the gloved-hand technique. The seminal plasma was removed just after collection by centrifuge and then was frozen as described in our previous study (Okazaki et al. 2009 Theriogenology 71, 491–498). When the frozen–thawed sperm was incubated with Fluo-3/AM to determine the level of intercellular Ca2+, the level of Ca2+ was increased in a time-dependent manner, and spontaneous capacitation that was judged by tyrosine phosphorylation of sperm protein by Western blotting (Shimada et al. 2008 Development 135, 2001–2011), was also induced in post-thawed sperm. The addition of EGTA to thawing solution significantly suppressed the Ca2+-induced capacitation. Moreover, the treatment increased fertilization rate in in vitro fertilization and in vivo in artificial insemination as similar as those in sperm with seminal plasma. The same number of blastocyst was collected from uterus by AI using post-thawed sperm with EGTA. However, the pregnancy rate remained low, and the number of leukocytes in the uterus was increased. In the next experiment, we examined in seminal plasma, the level of cortisol that has been known to play an important role in controlling immune function. The results showed that cortisol (1.0 ng mL–1) was detected in seminal plasma. When the sows of natural oestrus were twice artificial inseminated with or without cortisol, the injection of cortisol (5 μg/50 mL) to uterus with sperm significantly decreased the number of leukocytes in the uterus or endometrium at 24 to 36 h after AI. The low number of leukocytes in the uterus was similar to that in uterus injected fresh semen. The cortisol injection significantly increased the implantation rate and litter size of sows as compared to AI without cortisol (implantation rate; 83% v. 51%, litter size; 10.6 v. 7.3). From these results, we concluded that the injection of cortisol with frozen–thawed spermatozoa by EGTA-containing solution was a novel method of pig AI using cryopreserved spermatozoa. This work was supported by the Programme for Promotion of Basic and Applied Researches for Innovations in Bio-oriented Industry, and JST-Grant (No. 12-068 and No. 12-104).

Maternal Restraint Stress Diminishes the Developmental Potential of Oocytes

Although studies of both humans and animals suggest detrimental effects of psychological (restraint) stress on reproduction, reports concerning the direct effect of psychological (restraint) stress on the oocyte are few and conflicting. In the present study, a restraint system that allows mice free intake of feed and water while restraining their movement was established, and effects of maternal restraint on oocyte competence were examined by observing embryo development in vitro and in vivo. The results indicated that restraint stress applied to both gonadotropin-stimulated and unstimulated females during oocyte growth and maturation increased their plasma cortisol level but impaired ovulation and oocyte developmental potential. Injection of cortisol also decreased oocyte developmental potential in both stimulated and unstimulated mice. However, whereas restraint stress reduced the plasma follicle-stimulating hormone (FSH) level of unstimulated mice, injection of cortisol did not. Because the stimulated mice had received very high doses of FSH and luteinizing hormone from injection with equine chorionic gonadotropin injection, the results suggested that whereas cortisol acts directly on the ovary to damage the oocyte, restraint stress impairs oocyte competence by actions on both the hypothalamic-pituitary-gonadal and the hypothalamic-pituitary-adrenal axes. However, exposing the cumulus-oocyte complexes (COCs) to physiological levels of cortisol did not affect oocyte nuclear and cytoplasmic maturation in vitro. Thus, cortisol might have impaired ovulation and oocyte potential by an indirect effect on ovarian tissues other than the COCs.

Effects of Chinese herbal medicine Bushen Gubiao Recipe on toll-like receptor 4 and CD4+CD25+foxp3+ regulatory T cells in mice with recurrent respiratory tract infections

To evaluate the effects of Bushen Gubiao Recipe (BGR), a compound traditional Chinese herbal medicine, on toll-like receptor 4 (TLR4) signaling pathway and CD4(+)CD25(+)foxp3(+)regulatory T cells (CD4(+)CD25(+)foxp3(+)Tregs) in mice with recurrent respiratory tract infections (RRTIs). A mouse model of kidney-yang deficiency which simulated physical characteristics of RRTIs was established by intraperitoneal injection of hydrocortisone for 14 d. The model mice were divided into 4 groups, model group, high-dose BGR group, low-dose BGR group, and nucleic acid and casein oral solution group. They were administered respectively with distilled water, high-dose BGR (50 g/kg body weight), low-dose BGR (25 g/kg body weight) and nucleic acid and casein oral solution. Besides, a normal control group was set up and gastrogavage with distilled water. The effect of intervention was evaluated 4 weeks later by estimating the changes in behaviors of mice. Expressions of TLR4 and nuclear factor-kappa B (NF-κB) p65 in lung tissue were detected by immunohistochemical SABC method, the expression of TLR4 mRNA in lung tissue was detected by fluorescence quantitative-polymerase chain reaction (FQ-PCR), and the level of blood CD4(+)CD25(+)foxp3(+) Tregs was determined by flow cytometry. A kidney-yang deficiency mouse model with RRTIs was successfully established by intraperitoneal injection of hydrocortisone. BGR could improve the abnormal behavioral condition of the mice and enhance the expressions of TLR4 and NF-κB p65 in the lung tissue. Expression of TLR4 mRNA in high-dose BGR group was higher than that in model group (P<0.05), while the difference was not statistically significant between high-dose BGR group and low-dose BGR group (P>0.05). Levels of CD4(+)CD25(+)foxp3(+)Tregs in high-dose BGR group and nucleic acid and casein oral solution group were lower than that in model group (P<0.05), while the difference was not statistically significant between high-dose BGR group and low-dose BGR group (P>0.05). BGR can improve the behavior of the kidney-yang deficiency mice, and improve the innate immune function by up-regulating TLR/NF-κB signaling pathway. BGR can adjust the immune imbalance of T-helper cell (Th) 1/Th2 through reducing the activity of CD4(+)CD25(+)foxp3(+)Tregs and enhancing the immune response of Th1 type.

DIABETIC RETINOPATHY

Introduction: 15 percent of the snakes are poisonous and present a potential life threatening risk to human lives. Objectives: (1) To review the demographic, epidemiological, clinical and laboratory findings of 48 patients of snake bite treated in a field hospital. (2) To evaluate the treatment and outcome of these patients. Design: A retrospective study. Setting: Field hospital in rural Sindh. Period: From January 2002 to December 2003. Material &amp; Methods: All patients diagnosed with snake bite had first aid treatment by a either a nursing staff close to the place of bite or by a quack and later on transferred to field hospital. The first aid treatment consisted of pain relief (injectable diclofenac, oral acetaminophen), application of bandage or tourniquet proximal to the bite, antihistamine (oral or injectable chlorpheniramine) anti- inflammatory (injection hydrocortisone) and immobilization of the affected limb with a splint. Results: We are treated 48 patients with snake bite. There were 45(94%) male patients and 3(6%) female patients. Age range was 18 to 56 years with a mean age of 29.8 years. 35(73%) patients suffered from snake bite between the months of May and September. The timing of the bite was also peculiar with 36(75%) patients bitten between 8pm and 8am whereas only 12(25%) patients during other times of the day. 38(79%) patients gave history of seeing the snake themselves and 10(21%) patients were not able to see the snake mainly because of darkness. Conclusion It should be remembered that not all snakes are poisonous and that they are more afraid of humans than we are of them. Psychological effects of the bite are at times more devastating than the clinical effects, therefore patient reassurance forms part of the treatment.

SNAKE BITE

Introduction: 15 percent of the snakes are poisonous and present a potential life threatening risk to human lives. Objectives: (1) To review the demographic, epidemiological, clinical and laboratory findings of 48 patients of snake bite treated in a field hospital. (2) To evaluate the treatment and outcome of these patients. Design: A retrospective study. Setting: Field hospital in rural Sindh. Period: From January 2002 to December 2003. Material &amp; Methods: All patients diagnosed with snake bite had first aid treatment by a either a nursing staff close to the place of bite or by a quack and later on transferred to field hospital. The first aid treatment consisted of pain relief (injectable diclofenac, oral acetaminophen), application of bandage or tourniquet proximal to the bite, antihistamine (oral or injectable chlorpheniramine) anti- inflammatory (injection hydrocortisone) and immobilization of the affected limb with a splint. Results: We are treated 48 patients with snake bite. There were 45(94%) male patients and 3(6%) female patients. Age range was 18 to 56 years with a mean age of 29.8 years. 35(73%) patients suffered from snake bite between the months of May and September. The timing of the bite was also peculiar with 36(75%) patients bitten between 8pm and 8am whereas only 12(25%) patients during other times of the day. 38(79%) patients gave history of seeing the snake themselves and 10(21%) patients were not able to see the snake mainly because of darkness. Conclusion It should be remembered that not all snakes are poisonous and that they are more afraid of humans than we are of them. Psychological effects of the bite are at times more devastating than the clinical effects, therefore patient reassurance forms part of the treatment.

Hydrocortisone Supplementation Enhances Hemodynamic Stability in Brain-dead Patients

Hemodynamic instability is frequent in brain-dead patients and may result, in part, from absolute or relative adrenal insufficiency. Corticosteroid supplementation is widely used to restore hemodynamic stability in septic shock and to reduce the time of shock resolution. The authors verified that supplementation with hydrocortisone may enhance hemodynamic stability in brain-dead patients. All consecutive brain-dead patients with hypotension requiring vasopressor agents were included in this single-center noninterventional clinical observation study. Assessment of baseline and adrenocorticotropic hormone (ACTH)-stimulated plasma cortisol concentrations was performed. Immediately after, patients were systematically treated with a single intravenous injection of hydrocortisone (50 mg), and norepinephrine administration was adjusted every 15 min to maintain mean arterial pressure between 65 and 90 mmHg. Adrenal insufficiency was defined as baseline plasma cortisol concentration less than 15 microg/dl and/or delta plasma cortisol concentration less than 9 microg/dl. Patients were considered as ACTH responders when delta cortisol concentration was more than 9 microg/dl 30 min after ACTH injection. Among the 31 patients included, the incidence of adrenal insufficiency was 87% [95% CI, 70-96%]. A significant (> or =30%) decrease in norepinephrine dose was obtained 180 min after hydrocortisone injection in 18 (59%) patients, from 0.31 [0.16-0.44] microg . kg(-1) . min(-1) to 0.18 [0.10-0.24] microg . kg(-1) . min(-1) (P < 0.01). The incidence of hemodynamic response was greater in ACTH nonresponders than in ACTH responders: 86% versus 50%, respectively, P < 0.05. Adrenal insufficiency with hemodynamic instability is frequent in brain-dead patients. After ACTH stimulation testing and hydrocortisone infusion, hemodynamic stability is enhanced especially in patients with true adrenal nonfunction.

Psoriatic arthritis of the temporomandibular joint – a surgical alternative to treating a medical problem

AbstractWe describe the case of a 43‐year‐old female who suffered pain and profound functional impairment in both tempormandibular joints (TMJ), secondary to psoriatic arthritis. The inability to eat and talk without severe pain had rendered the patient unable to seek employment and with a poor quality of life. Her symptoms had proved refractory to anti‐TNF medication (Etanercept) and other treatments such as hydrocortisone injections and bilateral TMJ condylar shaves. The patient underwent bilateral total temporomandibular joint (TMJ) replacements in May 2008. Her recovery was uneventful and she is now pain‐free and has a vastly improved quality of life. This case gives an overview of psoriatic arthritis, especially as it affects the TMJ and highlights the benefits of total TMJ replacement. We recommend that consideration should be given to its use as a surgical alternative in cases which prove refractory to medical management.

Cortisol promotes and integrates the osmotic competence of the organs in North African catfish ( Clarias gariepinus Burchell): Evidence from in vivo and in situ approaches

The short-term in situ and long-term in vivo effects of cortisol were examined in North African catfish ( Clarias gariepinus) to identify how this major corticosteroid integrates the osmotic competence of fish organs. In the in situ approach, the hydromineral effects of cortisol perfusion (75–300 ng ml −1) for 20 min were tested and the indices of hydromineral and metabolic regulations were measured in our in vivo experimental fish after three alternate intraperitoneal cortisol injections (40 and 200 ng g −1 body mass) for 5 days. Na +, K +-ATPase activity, a measure of cellular osmotic competence, responded to in situ and in vivo cortisol treatments. In situ cortisol delivery increased the Na +, K +-ATPase activity in the gill ( P < 0.001) and kidney ( P < 0.001) but decreased ( P < 0.01) in the liver and showed no effect on intestine. In vivo cortisol treatment, on the contrary, increased Na +, K +-ATPase activity in the gills ( P < 0.01), intestine ( P < 0.05) and liver ( P < 0.01) but decreased ( P < 0.05) in the kidney. As expected, plasma cortisol increased ( P < 0.001) with increasing doses of cortisol injections which produced direct effects on the metabolites and the mineral contents including the elevations of glucose ( P < 0.05), lactate ( P < 0.05) and Mg 2+ ( P < 0.05) and reductions of urea ( P < 0.05), Na + ( P < 0.05) and K + ( P < 0.05) in the plasma. A decline of triiodothyronine ( P < 0.01) occurred in the catfish after in vivo cortisol treatment and that implies a direct cortisol action on the homeostatic integration in this fish. Evidence is thus presented that in catfish cortisol regulates the whole body hydromineral and metabolite homeostasis by promoting and integrating the osmotic and metabolic functions of the multiple organ systems including liver.

Effects of Yiniao Recipe on serum antidiuretic hormone level and plasma ratio of cAMP to cGMP in rats with kidney-yang deficiency

To investigate the effects of Yiniao Recipe, a compound traditional Chinese herbal medicine, on contents of serum antidiuretic hormone, and plasma cyclic adenosine monophosphate and cyclic guanosine monophosphate in rats with kidney-yang deficiency. Forty male Wistar rats were randomly divided into blank control group, untreated group, desmopressin (Minirin) group, low-dose Yiniao Recipe group and high-dose Yiniao Recipe group, with 8 rats in each group. Rats in the blank control group were injected with 0.2 mL normal saline, and rats in the other groups were given intramuscular injection of hydrocortisone 25 mg/kg, 1 time daily for 21 consecutive days; from the 8th day of injection, rats were given double distilled water, Minirin, and high- and low-dose Yiniao Recipe respectively for 30 days. Before and after treatment, 24-hour urine volume was observed, and serum antidiuretic hormone (AVP) as well as plasma cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) contents were detected by enzyme-linked immunosorbent assay. The cAMP/cGMP ratio and morphological changes in renal tissues were also observed. Compared with blank control group, 24-hour urine volume, serum AVP content and cAMP/cGMP ratio in the untreated group were decreased; compared with the untreated group, Minirin and Yiniao Recipe at low and high doses reduced 24-hour urine volume and increased serum AVP content and cAMP/cGMP ratio significantly (P<0.05 or P<0.01). There were no obvious pathological changes in renal tissue in all groups. Yiniao Recipe may reduce 24-hour urine volume by increasing serum AVP content and regulating the ratio of cAMP to cGMP in kidney-yang deficiency rats.

The effect of different types of stressors during mid- and late pregnancy on lamb weight and body size at birth

Mid-pregnancy shearing has consistently been shown to increase lamb birth weight, which can lead to an increase in lamb survival rates. However, shearing ewes during the winter months and under outdoor pastoral farming conditions can expose the recently shorn ewe to a greater risk of hypothermia. The aim of this study was to determine if exposure of ewes to repeated stressors, in mid- and late pregnancy, would result in an increase in lamb birth weight. This information may assist in the elucidation of the mechanism for the birth weight response to mid-pregnancy shearing, which in turn could assist in the design of management options to increase lamb birth weight without placing the ewe at risk. One hundred and forty-four twin-bearing Romney ewes were allocated to one of six mid-pregnancy treatments: control, isolation on 2 or 10 occasions, sham-shearing on 10 occasions, intramuscular cortisol injection on 10 occasions or shearing. Isolation, sham-shearing and cortisol treatments were conducted twice a week beginning, on average, day 74 of pregnancy and shearing occurred on day 76. During pregnancy, ewe treatment had no effect on ewe live weight. However, average ewe body condition scores were higher in the shorn group than in the sham-shorn or cortisol groups (P < 0.05). Intramuscular injections of cortisol had a greater effect on ewe plasma cortisol concentrations than all other treatments (P < 0.05). Shearing produced a greater plasma cortisol response than isolation × 10 and sham-shearing (P < 0.05). Ewe plasma cortisol responses decreased during the 5 weeks of isolation and sham-shearing but cortisol injections produced a greater response during the fifth treatment than the first or ninth treatments (P < 0.05). Lambs born to shorn ewes were heavier and had a longer crown rump, forelimb and hind limb lengths than all other lambs (P < 0.05). In addition, lambs born to ewes in the cortisol treatment were lighter than lambs born to control, isolation × 2, isolation × 10 and shorn ewes (P < 0.05). The plasma cortisol concentrations observed for ewes injected with cortisol were far greater than those observed in all other groups, which is likely to explain the low birth weights of lambs born to ewes in that group. These results indicate that the mechanism by which mid-pregnancy shearing increases lamb birth weight is unlikely to be repeated stressors.

Study of Long Term Effects of Laser Therapy Versus Local Corticosteroid Injection in Patients with Carpal Tunnel Syndrome

INTRODUCTION: Carpal Tunnel Syndrome (CTS) is the most common compressive neuropathy. Several surgical and nonsurgical treatments have been proposed for this syndrome, but there is no consensus regarding the prioritization of the suggested nonsurgical treatments. The goal of this study was to compare the long term effects of laser therapy versus local corticosteroid injection in the treatment of CTS. METHODS: During this single-blind randomized clinical trial, 65 hands with mild or moderate CTS were divided randomly into two groups. One group received local corticosteroid injection (Hydrocortisone 50 mg) and the other received low level laser therapy (20J/cm² in 11 seconds/session for each of 5 points, 775nm, 10 sessions and 3sessions/week). Furthermore, wrist splints with extension degree of 0° (neutral position) were prescribed simultaneously for 6 weeks in each group.Pain severity and electrodiagnostic measurements were compared from before to 10 months after completing each treatment. Data were analyzed with SPSS 11.5 software and parametric tests. RESULTS: Generally, the mean age of patients was 43.9 years, duration of pain was 7.4 months, male to female ratio was 1:3, pain severity using Visual Analogue Scale (VAS) was 6.1 cm, and functional status measure was 15.5. The severity of the disease based on electrodiagnostic studies was 43.2% mild (41.2% in injection group and 45.2% in laser therapy group) and 56.8% moderate. The electrodiagnostic characteristics of the median nerve prior to treatment were included mean sensory peak latency of 4.3ms, mean sensory amplitude of 23.5μv, mean motor onset latency of 4.3ms and mean motor amplitude of 4.6mv. There was no meaningful difference between two groups regarding the demographic characteristics and electrodiagnostic measures (p>0.05). Ten months after treatments, the mean of pain severity was decreased 1.9cm in injection group and 1.7cm in laser therapy group, the mean of median sensory peak latencies was decreased 0.4ms in injection group and 0.25ms in laser therapy group and the mean of motor onset latencies was decreased 0.15ms in both groups,with no significant difference between the observed treatments variables (P>0.05). The severity of disease based on electrodiagnostic studies became 32.4% normal,23.5% mild, 41.2% moderate and 2.9% severe in the injection group and 38.7% normal,22.6% mild, 35.5% moderate and 3.2% severe in the laser therapy group. There was no meaningful difference between two groups regarding the changes in the pain severity, functional status and electrodiagnostic measures. CONCLUSION : Low level laser therapy can be as effective as local injection in reducing pain and severity of disease (based on electrodiagnostic medicine classification) in patients with mild and moderate CTS even in long term (after 10 months).

Effects of oral and external application of recipes for promoting granulation in rats with chronic skin ulcers

To investigate the efficacy of oral, external and oral plus external application of recipes for promoting granulation on chronic skin ulcers in rats. Sixty SD male rats were randomly divided into normal group, untreated group, oral group, external group and combined group (n=12). Chronic skin ulcer was induced by hydrocortisone injection and back skin incision. After oral administration of Fuzheng Huyu Recipe or (and) external application of Baiyu ointment, the compound traditional Chinese medicines for wound healing, healing time and healing rate of the ulcers were observed. The healing rate was lower and the healing time was longer in the untreated group than in the normal group (P<0.01). The healing rates of the oral group and the combined group were higher than those of the untreated group at all observation points (P<0.05), and the healing rate of the external group was higher on the 3rd and 14th day after model establishment (P<0.05). On the 7th and 10th day after model establishment, the healing rates of the oral group and the combined group were higher than those of the external group (P<0.05), and the healing time of the combined group was shorter than that of the oral group and external group (P<0.05). Both orally and externally administered wound healing recipes can promote the restoration of chronic refractory ulcers; the effect of combined administration is superior to single administration. Oral, external and combined application can all improve the wound healing in inflammatory phase. Oral and combined application can obviously improve the wound healing in granulation phase and epithelial phase.

Epidermal club cells and the innate immune system of minnows

Thousands of fish species belonging to the Superorder Ostariophysi possess specialized club cells in their epidermis. Damage to the cells, as would occur during a predator attack, releases chemical substances that evoke antipredator responses in nearby shoalmates. These chemical substances have often been referred to as alarm substances and the cells that release them as alarm cells. Understanding the evolution of the cells in an alarm context has been difficult. The fish needs to be captured prior to the chemicals being released, hence the benefit to the receiver is unclear. Recent studies have suggested that the club cells are part of the immune system and are maintained by natural selection owing to the benefits that they confer against pathogens, parasites, and general injury to the epidermis. In the present study, we gave fathead minnows intraperitoneal injections of cortisol, a known immunosuppressant, or injections of a control substance (corn oil). We found that fish exposed to cortisol had suppressed immune systems (as measured by a respiratory burst assay) and that they also reduced their investment in club cells. This is the best evidence to date indicating that the club cells of Ostariophysan fishes are part of the innate immune system and that the alarm function of the cells evolved secondarily.

Stress and Parental Care in a Wild Teleost Fish: Insights from Exogenous Supraphysiological Cortisol Implants

Male largemouth bass (Micropterus salmoides) provide sole parental care over a 4-6-wk period to a single brood, fanning the eggs to keep them oxygenated and free of silt and defending the brood until the offspring develop antipredator tactics. During this period, fish are highly active and have few opportunities for feeding, so this activity is energetically costly. To understand some of the consequences of stress during this challenging period, we injected fish with cortisol suspended in coconut oil to experimentally raise circulating cortisol in parental males for the first week of the parental care period. We compared parental care behavior between cortisol-treated, sham-treated (injected only with coconut oil), and control parental males. We further compared physiological parameters associated with metabolism and reproductive function between cortisol-treated and control males. The cortisol injections resulted in supraphysiological levels of circulating plasma cortisol, giving us insight into potential maximal effects of stress during parental care. At these supraphysiological levels, the cortisol-treated fish displayed higher concentrations of circulating glucose and cholesterol and lower concentrations of circulating triglycerides when compared with control fish, with no change in plasma concentrations of total protein. Plasma concentrations of androgen were similarly unaffected by cortisol treatment. In the short term (initial 1-2 wk), parental care of eggs and egg-sac fry was maintained by all groups, with no differences observed in behavior (e.g., tending, vigilance, defense) among the groups. However, the cortisol-treated fish abandoned their offspring at a higher rate than in the control or sham groups. The fish treated with cortisol also tended to develop external Saprolegnian infections, indicative of compromised immune function. These data demonstrate that exogenous cortisol elevation during parental care results in changes in energy use and a decrease in immune function. Interestingly, the data also suggest resistance to stress during parental care in largemouth bass, with no changes in parental care behavior before abandonment.

Cortisol-induced effects on human cortical excitability

Cortisol may fulfill all criteria for a neuromodulator. However, it is not known whether it may rapidly influence motor system activity in humans. Circulating cortisol levels were manipulated by administration of a single intravenous dose of hydrocortisone or saline solution, on separate days, to study changes in corticospinal and motor cortical excitability. Motor-evoked potentials (MEPs) to single- and paired-pulse transcranial magnetic stimulation from the resting first dorsal interosseous muscle, and cortisol plasma levels were assessed before and after either a bolus of 20 mg of hydrocortisone or saline solution in seven healthy subjects. Mean cortisol plasma level rapidly rose, peaked between 5 and 10 minutes after hydrocortisone injection, to slowly decay afterward. Mean MEP amplitude significantly increased from preinjection levels, and mean standard deviation of MEPs significantly increased between 8-12 minutes postinjection. Short-intracortical inhibition, tested during the same period, was significantly decreased. No significant changes in the above measures were observed after saline solution administration. Our results suggest that high circulating levels of cortisol rapidly increase corticospinal excitability and reduce gamma aminobutyric acid activity, as measured by short-intracortical inhibition, in humans. These effects, lasting about 10 minutes, were observed within 15 minutes from the pharmacological intervention. They are therefore compatible with a nongenomic mechanism. These findings are important in view of the notion that a decrease in intracortical gamma aminobutyric acid activity appears to be a prerequisite for motor learning and plastic processes in the human motor cortex.

Corticosteroid feedback: II. Role of hypothalamus and hypophysis.

The role of the paraventricular nucleus (PVN) of the hypothalamus and the hypophysis in ensuring the corticosteroid feedback of the pituitary-adrenocortical system (PACS) in rats was characterized by administration of increasing doses of hydrocortisone. The doses 100, 300 and 1200 micrograms/100 g b.w. of hydrocortisone were administered intraperitoneally. The injection of hydrocortisone in the dose of 1200 micrograms/100 g b.w. reduces the pituitrin-induced rise of ACTH content in plasma. The reduction of pituitary reactivity to pituitrin was not observed with the injection of smaller doses of hydrocortisone. The involvement of the hypothalamus in ensuring the corticosteroid feedback was estimated by the suppression of the stress-induced PACS reaction in animals with bilateral PVN lesions. The inhibition of the stress-induced corticosteroid rise did not occur in animals with the PVN lesions if they were treated with hydrocortisone in the dose of 100 and 300 micrograms/100 g b.w. At the dose of 1200 micrograms/100 g b.w. the inhibition of the stress-induced reaction is observed but it is less pronounced as compared to the control. The conclusion is made that at small, close to physiological doses of hydrocortisone (100 and 300 micrograms/100 g b.w.) the PACS inhibition is ensured by PVN involvement into the feedback pathways. At supraphysiological doses of hydrocortisone (1200 micrograms/100 g b.w.) the inhibition of PACS reaction is performed due to not only the hypothalamic PVN but the reduction in the pituitary reactivity.

Two independent effects of cortisol on chicken liver.

Activities of two key enzymes of glycogen metabolism have been measured after an acute administration of cortisol to 3d-old chickens. Glycogen synthase activity is enhanced 2-3 hours after a cortisol injection, and this activation is blocked by use of protein synthesis inhibitors. Glycogen phosphorylase activity is enhanced at an early stage, and this effect is not suppressed by protein synthesis inhibitors. Liver cAMP levels are not increased concomitantly with this early activation of glycogen phosphorylase; indeed they are depleted. These results point to the existence of an effect of cortisol previous to and independent of its nuclear interaction, and not mediated by an activation of the membrane adenylate cyclase.

Glycogenolytic effect of cortisol previous to its interaction with the cell nucleus in mouse liver.

Activities of hepatic glycogen synthase a and glycogen phosphorylase a have been studied in mouse liver at different times after an acute intraperitoneal administration of hydrocortisone. It has been observed an increase of glycogen synthase a activity and a decrease of glycogen phosphorylase a between 2 and 3.5 hours after cortisol injection. An early effect, previous to the synthase activation has been discovered. Cortisol caused an increase of glycogen phosphorylase a activity in mice 45 min after injection. This early effect of cortisol is independent of protein synthesis and it does not imply an increase in cAMP levels.

Charcot’s arthropathy secondary to herpetic encephalitis sequelae: an unusual presentation

Neuropathic arthropathy (Charcot's arthropathy) is a progressive articular disease associated with a reduced sensorial and protector proprioceptive reflex. Its etiology includes many different conditions such as syringomyelia, traumatic lesion causing medullary deformity, spina bifida, diabetic neuropathy, leprosy neuropathy, neurofibromatosis, amyloid neuropathy, alcohol, and repetitive injection of hydrocortisone into joints, among others. However, the relationship between Charcot's arthropathy and herpetic encephalitis has not yet been described. Herpes encephalitis causes acute and chronic diseases of the peripheral or central nervous system. It can manifest as subacute encephalitis, recurrent meningitis, or myelitis. It can also resemble psychiatric syndromes, diplopia, sensory changes in the face and limbs, personality changes, frontal dysexecutive syndrome, stiff neck, subclinical alterations of the vestibular function, intracranial hypertension, convulsion, hemiparesis, and generally includes motor components, among others. On the other hand, pure peripheral sensory disturbance has not been described. In this article, we report the clinical case of a patient with Charcot's arthropathy secondary to pure peripheral sensory polyneuropathy as a consequence of progressive herpetic encephalitis sequelae. In this article, the authors report the first case of Charcot's arthropathy secondary to herpetic encephalitis.