scholarly journals The Vital Role of Thanatochemistry in the Postmortem Diagnostic of Diabetic Ketoacidosis—Case Report

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 988
Author(s):  
Nona Girlescu ◽  
Bogdan Stoica ◽  
Iuliana Hunea ◽  
Madalina Diac ◽  
Simona Irina Damian ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Glycated Hemoglobin ◽  
Ketone Bodies ◽  
Vital Role ◽  
Postmortem Diagnosis ◽  
Initial Manifestation ◽  
Beta Hydroxybutyrate ◽  
Postmortem Examinations

Diabetic ketoacidosis (DKA) is a lethal acute hyperglycemic complication of diabetes mellitus (DM) and it represents the initial manifestation of DM in about 15–20% of cases in adults and about 30–40% of cases in children. Postmortem diagnosis of DKA can only be made by applying thanatochemistry. Biochemistry applied postmortem is viewed with skepticism by many practitioners in the forensic field, completely lacking in many forensic services around the world, and especially in the national ones. This article aims to underline the importance of the postmortem application of biochemistry by reviewing the case of a person in the third decade of life who died suddenly at home due to diabetic ketoacidosis (DKA), whose autopsy was performed at an early PMI of approximately 24 h. Routine postmortem examinations (macroscopic, anatomopathological, and toxicological) could not establish a clear cause of death. When attention was turned to biochemical determinations (i.e., determination of glycated hemoglobin, glucose and ketone bodies (acetone, beta-hydroxybutyrate) in the blood, vitreous humor, and cerebrospinal fluid), the identified values clarified the thanatogenic mechanisms by establishing the diagnosis of DKA.

Validation of two-pool model for in vivo ketone body kinetics

1990 ◽  
Vol 258 (5) ◽  
pp. E850-E855 ◽  
Author(s):  
J. W. Bailey ◽  
M. W. Haymond ◽  
J. M. Miles
Keyword(s):  
Ketone Body ◽  
Ketone Bodies ◽  
Accurate Estimate ◽  
Isotope Data ◽  
Pool Model ◽  
Body Production ◽  
Beta Hydroxybutyrate

Previous studies have indicated that simultaneous infusions of two ketone body tracers ([13C]acetoacetate and [14C]beta-hydroxybutyrate) provide accurate estimates of exogenous ketone body inflow when an open two-pool model is employed. In the present studies, net hepatic ketone body production was determined from surgically placed arterial, portal venous, and hepatic venous catheters in conscious diabetic (n = 6) and 4-day fasted (n = 7) dogs. [13C]acetoacetate and [14C]beta-hydroxybutyrate were infused simultaneously, and ketone body production was calculated from either acetoacetate (AcAc) single-isotope data, beta-hydroxybutyrate (beta-OHB) single-isotope data, the sum of individual fluxes, or the two-pool model. In fasted animals, both the AcAc single-isotope calculation and the sum of individual fluxes overestimated net hepatic production by approximately 50% (P less than 0.05), whereas the beta-OHB single-isotope calculation and the two-pool model gave accurate estimates. In the diabetic animals, the beta-OHB single-isotope calculation underestimated net hepatic production by approximately 30% (P less than 0.05). The sum of individual fluxes overestimated net hepatic production by approximately 46% (P less than 0.05), whereas both the AcAc single-isotope calculation and the two-pool model gave accurate estimates. In conclusion, single-isotope methods give erroneous estimates of net hepatic production of ketone bodies. In contrast, a two-pool model provided an accurate estimate of net hepatic production and thus appears to be suitable for determination of ketone body kinetics in humans.

New approach to determination of total ketone bodies in serum.

1977 ◽  
Vol 23 (1) ◽  
pp. 46-49 ◽  
Author(s):  
L Siegel ◽  
N I Robin ◽  
L J McDonald
Keyword(s):  
Ketone Bodies ◽  
Clinical Implications ◽  
Gas Chromatograph ◽  
Single Measurement ◽  
New Approach ◽  
Enzymatic Reduction ◽  
One Step ◽  
Body Production ◽  
Beta Hydroxybutyrate

Abstract We describe a one-step assay for total ketone bodies in serum. D-BETA-Hydroxybutyrate is enzymatically oxidized by NAD+ to acetoacetate. This thermodynamically unfavorable reaction is driven to completion by coupling it with the enzymatic reduction of pyruvate by NADH. The acetoacetate so formed, as well as the pre-existing acetoacetate, is quantitatively decarboxylated to acetone in a gas chromatograph and measured directly. Thus by a single measurement for acetone, all three ketone bodies are simultaneously determined. In light of the ubiquity of situations associated with augmented ketone body production, the clinical implications of this approach are extensive.

Role of measurement of blood ketone bodies in the management of diabetic ketoacidosis

2013 ◽  
Vol 3 (4) ◽  
pp. 335 ◽  
Author(s):  
MdAbdur Rashid ◽  
Liaquat Ali ◽  
HabibSadat Chowdhury ◽  
MamunRashid Chowdhury ◽  
MdOmar Faruque ◽  
...  
Keyword(s):  
Diabetic Ketoacidosis ◽  
Ketone Bodies ◽  
Blood Ketone Bodies

Role of ketone bodies in nonshivering thermogenesis in cold-acclimated rats

1977 ◽  
Vol 42 (2) ◽  
pp. 159-165 ◽  
Author(s):  
H. Maekubo ◽  
K. Moriya ◽  
T. Hiroshige
Keyword(s):  
Energy Source ◽  
Fatty Acids ◽  
Turnover Rate ◽  
Ketone Bodies ◽  
Perfused Liver ◽  
Nonshivering Thermogenesis ◽  
Endogenous Substrate ◽  
Beta Hydroxybutyrate

The role of ketone bodies (KB) in nonshivering thermogenesis was investigated in warm- and cold-acclimated rats with and without norepinephrine (NE) loads. NE-induced calorigenesis, as evidenced by changes in rectal temperature, was highly developed in cold-acclimated rats, but the levels of blood KB and free fatty acids (FFA) remained almost unaltered. In contrast, FFA turnover rate in cold-acclimated rats under NE load was much greater than in warm-acclimated rats. Similarly, turnover rate of beta-hydroxybutyrate estimated from decay curves of the endogenous substrate in functionally eviscerated rats was significantly higher in cold- than warm-acclimated rats. Perfused livers from cold-acclimated rats produced more KB than warm-acclimated ones. No significant effect of NE load was observed in either group. Quantitative analysis shows that the turnover rate of KB in vivo essentially equals the production rate in the perfused liver when no exogenous NE is added. In contrast, under constant NE infusion the turnover rate in vivo was almost double that of the perfused liver. These results indicate that KB are an energy source as important as FFA in nonshivering thermogenesis. It may be further surmised that increased KB production in vivo, particularly in the cold-acclimated state, is affected by factor(s) other than NE.

Role of fat-derived substrates in the regulation of gluconeogenesis during fasting

1996 ◽  
Vol 270 (5) ◽  
pp. E822-E830 ◽  
Author(s):  
F. Fery ◽  
L. Plat ◽  
C. Melot ◽  
E. O. Balasse
Keyword(s):  
Ketone Body ◽  
Ketone Bodies ◽  
Glucose Turnover ◽  
Oxidation Rates ◽  
Relative Contribution ◽  
Beta Hydroxybutyrate ◽  
Hormonal Milieu ◽  
Body Concentration

To determine the role of fat-derived substrates in the regulation of glucose metabolism during fasting, glucose turnover, urea nitrogen production, alanine conversion to glucose, and substrate oxidation rates were measured in 34 normal 4-day-fasted volunteers treated with the antilipolytic drug acipimox or placebo for 8 h. The approximately 50% inhibition of lipolysis induced by acipimox increased glucose concentration and production, respectively, by approximately 35 and approximately 30%, whereas the protein breakdown and the amount of alanine converted to glucose were increased, respectively, by approximately 70 and approximately 85%. Insulin levels were reduced by approximately 40%, cortisol levels doubled, and growth hormone concentration increased sevenfold. The relative contribution of free fatty acid (FFA) and ketone body lowering to the observed response was evaluated in nine acipimox-treated subjects in whom ketone body concentration was clamped with an intravenous beta-hydroxybutyrate infusion. The results of these experiments suggest that, during fasting, both FFA and ketone bodies tend to suppress gluconceogenesis and to protect the protein stores. FFA seem to exert their effects mainly through their ability to modulate the hormonal milieu (especially insulin), whereas ketone bodies seem to act mainly by other mechanisms. Thus the widespread view according to which FFA exert a stimulatory role on gluconeogenesis does not apply to the fasting state in vivo.

scholarly journals Vaccine Interactions With the Infant Microbiome: Do They Define Health and Disease?

2020 ◽  
Vol 8 ◽  
Author(s):  
Candice E. Ruck ◽  
Oludare A. Odumade ◽  
Kinga K. Smolen
Keyword(s):  
Precise Determination ◽  
Vital Role ◽  
Therapeutic Interventions ◽  
Research Strategies ◽  
Vaccine Responses ◽  
The Past ◽  
Early Results ◽  
Health And Disease

Over the past decade, there has been a growing awareness of the vital role of the microbiome in the function of the immune system. Recently, several studies have demonstrated a relationship between the composition of the microbiome and the vaccine-specific immune response. As a result of these findings, the administration of probiotics has been proposed as a means of boosting vaccine-specific immunity. Early results have so far been highly inconsistent, with little evidence of sustained benefit. To date, a precise determination of the aspects of the microbiome that impact immunity is still lacking, and the mechanisms of action are also unknown. Further investigations into these questions are necessary to effectively manipulate the microbiome for the purpose of boosting immunity and enhancing vaccine-specific responses in infants. In this review, we summarize recent studies aimed at altering the neonatal gut microbiome to enhance vaccine responses and highlight gaps in knowledge and understanding. We also discuss research strategies aimed at filling these gaps and developing potential therapeutic interventions.

scholarly journals Tinjauan Atas Kebijakan Subsidi Public Service Obligation (PSO) Pada PT. PELNI

2019 ◽  
Vol 23 (4) ◽  
pp. 319
Author(s):  
Mahpud Sujai
Keyword(s):  
Public Service ◽  
Vital Role ◽  
Sea Transport ◽  
Subsidy Policy ◽  
Transport Services ◽  
Operational Costs ◽  
Sea Transportation ◽  
Public Service Obligation

As an archipelago state, sea transport services play an important role to connect the Indonesian region from the center and big islands to the remote islands and border area. The importance of sea transport caused the vital role of PT. Pelni as government agent in providing services to the community. As the embodiment of public service, government provide subsidy of public service obligation to PT. Pelni in order to support the operational costs and ease the burden on the community with an affordable tariff determination. This paper explores the problems that occur in line with the PSO subsidy policy for the PT. Pelni. This paper recommends that the PSO subsidy to PT. Pelni given based on the realization of the current year. Another recommendation is the importance of maintaining consistency in the determination of the amount of subsidy based on a predetermined calculation mechanism.Keywords: PT. Pelni, PSO Subsidy, Sea Transportation

Extinction of Radiation in the Universe: from F. G. W. Struve Up to Now

2011 ◽  
Vol 20 (2) ◽  
Author(s):  
T. Nugis ◽  
K. Annuk
Keyword(s):  
Vital Role ◽  
The Universe

AbstractWe briefly overview the most important studies that led to the understanding of the vital role of extinction of radiation in the Universe. We also point to the existing uncertainties in the determination of extinction corrections for stars and galaxies.

Mass Spectrometry Investigation of Glycosylation Aberration via De-N-Glycopeptide Analysis

2013 ◽  
Vol 66 (7) ◽  
pp. 770 ◽  
Author(s):  
Vivekananda Shetty ◽  
Ramila Philip
Keyword(s):  
Mass Spectrometry ◽  
Vital Role ◽  
Cellular Processes ◽  
Challenging Tasks ◽  
Proteomics Research ◽  
Disease Initiation ◽  
Branched Structures ◽  
Glycopeptide Analysis

Proteomics research on glycan alterations has received great attention owing to their implications in disease initiation and progression. Determination of the glycoprotein expression remains one of the most challenging tasks as the glycan residues in a given glycoprotein exist in complex branched structures and differ in linkage. In view of the vital role of glycan changes in cellular processes and disease progression, there has been an increased interest in developing methodologies for the detection of these changes. A subset of proteomics methods are discussed here that demonstrate the utility of the glycan-free de-N-glycopeptide analysis for the screening of complex glycoproteome as well as discovery of glycopeptide/glycoprotein biomarkers.

A dual-isotope technique for determination of in vivo ketone body kinetics

1986 ◽  
Vol 251 (2) ◽  
pp. E185-E191 ◽  
Author(s):  
J. M. Miles ◽  
W. F. Schwenk ◽  
K. L. McClean ◽  
M. W. Haymond
Keyword(s):  
Ketone Body ◽  
Specific Activity ◽  
Ketone Bodies ◽  
Turnover Rates ◽  
Dual Isotope ◽  
Pool Model ◽  
Isotope Technique ◽  
Beta Hydroxybutyrate

"Total ketone body specific activity" has been widely used in studies of ketone body metabolism to circumvent so-called "isotope disequilibrium" between the two major ketone body pools, acetoacetate and beta-hydroxybutyrate. Recently, this approach has been criticized on theoretical grounds. In the present studies, [13C]acetoacetate and beta-[14C]hydroxybutyrate were simultaneously infused in nine mongrel dogs before and during an infusion of either unlabeled sodium acetoacetate or unlabeled sodium beta-hydroxybutyrate. Ketone body turnover was determined using total ketone body specific activity, total ketone body moles % enrichment, and an open two-pool model, both before and during the exogenous infusion of unlabeled ketone bodies. Basal ketone body turnover rates were significantly higher using [13C]acetoacetate than with either beta-[14C]hydroxybutyrate alone or the dual-isotope model (3.6 +/- 0.5 vs. 2.2 +/- 0.2 and 2.7 +/- 0.2 mumol X kg-1 X min-1, respectively, P less than 0.05). During exogenous infusion of unlabeled sodium acetoacetate, the dual-isotope model provided the best estimate of ketone body inflow, whereas 14C specific activity underestimated the known rate of acetoacetate infusion by 55% (P less than 0.02). During sodium beta-hydroxybutyrate infusion, [13C]-acetoacetate overestimated ketone body inflow by 55% (P = NS), while better results were obtained with 14C beta-hydroxybutyrate alone and the two-pool model. Ketone body interconversion as estimated by the dual-isotope technique increased markedly during exogenous ketone body infusion. In conclusion, significant errors in estimation of ketone body inflow were made using single-isotope techniques, whereas a dual-isotope model provided reasonably accurate estimates of ketone body inflow during infusion of exogenous acetoacetate and beta-hydroxybutyrate.(ABSTRACT TRUNCATED AT 250 WORDS)

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