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Summary: In exercise, little is known about local cere bral glucose utilization (LCGU), which is an index of functional neurogenic activity. We measured LCGU in resting and running (=85% of maximum O2 uptake) rats (n = 7 in both groups) previously equipped with a tail artery catheter. LCGU was measured quantitatively from 2-deoxY-D-[1-14C]glucose autoradiographs. During exer cise, total cerebral glucose utilization (TCGU) increased by 38% (p < 0.005). LCGU increased (p < 0.05) in areas involved in motor function (motor cortex 39%, cerebel lum = 110%, basal ganglia =30%, substantia nigra =37%, and in the following nuclei: subthalamic 47%, posterior hypothalamic 74%, red 61%, ambiguus 43%, pontine 61 %), areas involved in sensory function (somatosensory 27%, auditory 32%, and visual cortex 42%, thalamus =75%, and in the following nuclei: Darkschewitsch 22%, cochlear 51%, vestibular 30%, superior olive 23%, cuPronounced motor, sensory, and autonomic ad aptation is known to occur in response to both static and dynamic exercise. Such changes must be thought to evoke marked regional changes in cere bral functional activity, but little is known about the effect of exercise on regional cerebral blood flow and in particular on regional cerebral metabolism, which are both indexes of the functional activity of regional neurons (Sokoloff, 1991(Sokoloff, , 1992 729neate 115%), areas involved in autonomic function (dor sal raphe nucleus 30%, and areas in the hypothalamus =35%, amygdala =35%, and hippocampus 29%), and in white matter of the corpus callosum (36%) and cerebel lum (52%). LCGU did not change with exercise in pre frontal and frontal cortex, cingulum, inferior olive, nu cleus of solitary tract and median raphe, lateral septal and interpenduncular nuclei, or in areas of the hippocampus, amygdala, and hypothalamus. Glucose utilization did not decrease during exercise in any of the studied cerebral regions. In summary, heavy dynamic exercise increases TCGU and evokes marked differential changes in LCGU. The findings provide clues to the cerebral areas that par ticipate in the large motor, sensory, and autonomic adap tation occurring in exercise. Key Words: Autoradiogra phy-Brain glucose metabolism-2-Deoxyglucose.

Repaglinide was safe and well tolerated in subjects with varying degrees of renal impairment. Although adjustment of starting doses of repaglinide is not necessary for renal impairment or renal failure, severe impairment may require more care when upward adjustments of dosage are made.

Background and Purpose-We sought to evaluate the effects of the combination of cytidine-5Ј-diphosphocholine (citicoline) and thrombolysis on infarct size, clinical outcome, and mortality in a rat embolic stroke model. Methods-Eighty-three Sprague-Dawley rats were embolized in the carotid territory with a single fibrin embolus and randomly assigned to the following treatment groups: (1) control (saline), (2) citicoline 250 mg/kg, (3) citicoline 500 mg/kg, (4) recombinant tissue plasminogen activator (rtPA) 5 mg/kg, (5) rtPA 5 mg/kg plus citicoline 250 mg/kg, and (6) rtPA 5 mg/kg plus citicoline 500 mg/kg. rtPA was administered as a continuous intravenous infusion over 45 minutes starting 45 minutes after embolization; citicoline was given intraperitoneally 30 minutes and 24, 48, and 72 hours after embolization. At 96 hours, the brains were fixed and stained by hematoxylin-eosin, and infarct volumes were measured. Neurological scores were determined daily. Results-The median infarct size, measured as percentage of the affected hemisphere, in the control group was 37% (interquartile range, 26% to 69%) compared with 22% (5% to 52%; PϭNS) in group 2, 11% (5% to 34%; PϭNS) in group 3, 24% (12% to 31%; PϭNS) in group 4, 11% (3% to 22%; Pϭ0.02) in the combined group 5, and 19% (9% to 51%; PϭNS) in group 6. The infarct size was significantly reduced in the combined citicolineϩrtPA-treated groups to a median of 13% (5% to 30%; PϽ0.01). Citicoline 500 mg/kg and citicoline combined with rtPA also promoted functional recovery. Conclusions-These results demonstrate that the combination of low-dose citicoline and rtPA significantly reduced infarct size in this focal ischemia model.