ICUAP is independently associated with increased hospital mortality. Handgrip strength is also independently associated with poor hospital outcome and may serve as a simple test to identify ICUAP. Clinical trial registered with www.clinicaltrials.gov (NCT00106665).

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β-Endorphin-containing neurons in the rat central nervous system were localized using three improvements of the unlabelled antibody-enzyme bridge immunocytochemical technique. These improvements were (1) the use of brains from colchicine-treated rats; (2) the proteolytic pretreatment of sections with pronase, and (3) a ‘double-bridge’ staining procedure. In addition to the known localization of β-endorphin-like immunoreactivity in perikarya in the medial basal hypothalamus, we have observed nerve fibers and terminals with β-endorphin-like immunoreactivity to be more widely distributed than reported in previous studies. This includes discrete areas of the septal, preoptic, hypothalamic, thalamic and subthalamic regions, the amygdala, the periaqueductal gray, the inferior colliculus, the nucleus tegmenti pontis, the nucleus raphe dorsalis, several regions of the reticular formation, the locus ceruleus, the parabrachial nuclei, the mesence-phalic trigeminal nucleus, the nucleus raphe magnus, the solitary tract and the nucleus of the solitary tract. The distribution of β-endorphin-like immunoreactivity is in good agreement with many of the physiological, neuroendocrine and behavioral effects attributed to this peptide such as analgesia, the regulation of the release of pituitary hormones, thermoregulation and feeding behavior. This implicates β-endorphin as an important neurotransmitter or modulator with specific functions within the central nervous system.

No abstract

The immunocytochemical localization of enkephalin-like immunoreactivity (ELI) throughout the rat central nervous system (CNS) was investigated. The detection of ELI-containing structures was facilitated through the use of (1) brains from colchicine-treated rats, (2) the proteolytic pretreatment of sections with pronase and (3) the "double-bridge" staining technique. Our findings confirm the presence of ELI in perikarya, neuronal processes and terminals in many areas of the CNS. In addition, the localization of ELI-containing perikarya is reported for the first time in the following areas: the olfactory bulb, the olfactory tubercle, the lateral preoptic nucleus, several nuclei within the amygdaloid nuclear complex, the hippocampus, the neocortex, the cingulate cortex, the posterior mammillary nucleus, the medial nucleus of the optic tract, the brachium of the inferior colliculus, the ventral tegmental nucleus, the locus ceruleus, the sub-ceruleal region, the lateral trapezoid nucleus, the nucleus reticularis lateralis, and lamina VII of the cervical spinal cord. Our results demonstrate ELI in neurons which are heterogeneous in size, some probably functioning as interneurons and others as projection neurons in different areas of the CNS. The location of these neurons within the brain suggests that these pentapeptides serve diverse functions which include, in addition to nociception, the regulation of neuroendocrine, respiratory, auditory, vestibular, and olfactory functions.