Breath ethane in dialysis patients and control subjects

Oxidant stress may play a role in the accelerated pathology of patients on dialysis, especially in the development of cardiovascular disease, which is a frequent condition in end-stage renal disease (ESRD) patients. Measurement of hydrocarbons can be employed to assess oxidant stress since breath hydrocarbons have been directly traced to in vivo breakdown of lipid hydroperoxides. We undertook to measure ethane, a major breath hydrocarbon, in 15 control subjects, 13 patients on peritoneal dialysis (PD), and 35 patients on hemodialysis (HD). Within the HD group, we separately examined 12 diabetic and 23 nondiabetic patients. Breath samples were collected after patients had breathed purified air for 4 min, and ethane content was measured by GC and expressed as pmoles/kg-body weight-minute (pmol/kg-min). As the data for the hemodialysis patients appeared skewed, nonparametric statistical techniques were employed to analyze these data, which are reported as median and interquartile range (IQR). Ethane levels were similar in 15 control subjects (median, 2.50 pmol [1.38-3.30]/kg-min] and 13 PD patients (median, 2.51 pmol [1.57-3.17]/kg-min). Breath ethane was significantly elevated in a portion (18 of 35 patients, 52%) of the HD patients (median, 6.16 pmol [4.46-8.88]/kg-min) (p <.001 vs. control, Mann-Whitney U test). Two of the diabetic HD patients showed extremely high values of breath ethane. Breath ethane was not altered by a single hemodialysis session, suggesting that long-term metabolic processes contribute to its elevation. Measurement of breath ethane may provide insight into severity of oxidant stress and metabolic disturbances, and provide guidance for optimal therapy and prevention of pathology in patients on long-term hemodialysis.     

Empty sella in control subjects and patients with hypopituitarism

The frequency and distribution of various degrees of empty sellae have been examined in subjects without any pituitary disorder and in patients with hypopituitarism. Among them none had sellar enlargement. Sellar computed tomography (CT) with contiguous 2 mm slices (thickness in the axial projection) was performed in 56 control subjects. The CT findings on sella turcica were graded into 4 groups (0, 1+, 2+, and 3+), and grades 2+ and 3+ indicated moderate and marked empty sellae. Thirty-nine percent of the control subjects had empty sellae of grade 2+ or 3+. Sellar CT scans with contiguous 2 mm slices were also performed in 11 patients with hypopituitarism. The sellar volume ranged from 224 to 715 mm3. CT scan was carried out more than 2 years after the onset of hypopituitarism in 10 of 11 patients, and showed typical empty sellae of grade 3+ in all 10 patients. There was no empty sella in a patient with hypopituitarism whose CT scan was carried out 3 months after the massive postpartum hemorrhage. Our results indicate that moderate empty sella of grade 2+ can be seen in subjects without any pituitary disorder, and that a typical empty sella of grade 3+ is present in hypopituitarism with a normal sized sella turcica. An empty sella associated with hypopituitarism may be due to shrinkage of the pituitary gland related to its hypofunction.     

Phenylalanine and tyrosine metabolism in the facultative methylotroph Nocardia sp. 239

Nocardia sp. 239 is able to use l-tyrosine and both d- and l-phenylalanine as carbon-, energy- and nitrogen sources for growth. The catabolism of these compounds is by way of (4-hydroxy)phenylpyruvate and (4-hydroxy)-phenylacetate as intermediates and the pathways merge at the level of homogentisate. The conversion of the amino acids into (4-hydroxy)phenylpyruvate is catalyzed by an inducible NAD-dependent phenylalanine dehydrogenase and l-tyrosine aminotransferase, respectively. Incubation of the organism in media with l-phenylalanine plus phenyl-pyruvate resulted in diauxic growth, with phenylpyruvate used first. Phenylalanine dehydrogenase activity cold only be detected after depletion of phenylpyruvate, in the ensuing second growth phase on l-phenylalanine. During growth on phenylalanine plus methanol, low levels of phenylalanine dehydrogenase were detected and this resulted in simultaneous utilization of the two substrates. Following diepoxyoctane treatment, mutants of Nocardia sp. 239 affected in phenylalanine and phenylpyruvate degradation were isolated. Double mutants blocked in both phenylalanine dehydrogenase and phenylpyruvate decarboxylase completely failed to catabolize phenylalanine. The absence of these enzymes did not affect growth on tyrosine.Abbreviations RuMP ribulose monophosphate - EMS ethylmethanesulphonate - NTG N-methyl-N-nitro-N-nitrosoguanidine     

Effect of IGF-I on FFA and glucose metabolism in control and type 2 diabetic subjects

The effects of insulin-like growth factor I (IGF-I) and insulin on free fatty acid (FFA) and glucose metabolism were compared in eight control and eight type 2 diabetic subjects, who received a two-step euglycemic hyperinsulinemic (0.25 and 0.5 mU x kg(-1) x min(-1)) clamp and a two-step euglycemic IGF-I (26 and 52 pmol x kg(-1) x min(-1)) clamp with [3-(3)H]glucose, [1-(14)C]palmitate, and indirect calorimetry. The insulin and IGF-I infusion rates were chosen to augment glucose disposal (R(d)) to a similar extent in control subjects. In type 2 diabetic subjects, stimulation of R(d) (second clamp step) in response to both insulin and IGF-I was reduced by approximately 40-50% compared with control subjects. In control subjects, insulin was more effective than IGF-I in suppressing endogenous glucose production (EGP) during both clamp steps. In type 2 diabetic subjects, insulin-mediated suppression of EGP was impaired, whereas EGP suppression by IGF-I was similar to that of controls. In both control and diabetic subjects, IGF-I-mediated suppression of plasma FFA concentration and inhibition of FFA turnover were markedly impaired compared with insulin (P < 0.01-0.001). During the second IGF-I clamp step, suppression of plasma FFA concentration and FFA turnover was impaired in diabetic vs. control subjects (P < 0.05-0.01). CONCLUSIONS: 1) IGF-I is less effective than insulin in suppressing EGP and FFA turnover; 2) insulin-resistant type 2 diabetic subjects also exhibit IGF-I resistance in skeletal muscle. However, suppression of EGP by IGF-I is not impaired in diabetic individuals, indicating normal hepatic sensitivity to IGF-I.     

Systems analysis of the flow of associations in healthy subjects and patients with mental disorders

By means of mathematical apparatus of a model of frequency lexical structure the structure of repetitions was studied in association flows of 10 healthy persons, 10 patients with sequelae of closed craniocerebral injury, and 10 schizophrenics. In comparison to healthy persons in those after the brain injury the number of repetitions was increased and the distances between the first and the last use of the repeated words were significant. In schizophrenic persons the repetitions of the words were situated at the local portions of association flows. The structure of repetitions in these association flows was close to that of the usual connected text by the general quantitative norms. Such structure of repetitions should be explained by the presence of a parasitical system of connections between the words equivalent by its strength to usual rational connections in a meaningful text.     

Phenylalanine metabolism in isolated rat liver cells. Effects of glucagon and diabetes.

Tryptic digestion of histone H1 from the sperm of the sea urchin Sphaerechinus granularis leaves a limiting peptide of approx. 80 residues that is of similar size to the limit peptide from calf thymus H1 or chicken erythrocyte H5. The S. granularis limit peptide folds to form tertiary structure similar to that of the intact parent histone H1 (shown by n.m.r. spectra), but the helical content is decreased by the digestion from 64 residues to 28. In contrast, intact calf thymus H1 and chicken erythrocyte H5 histones have only about 28 helical residues, which are preserved in their limit peptides. The extra helix in S. granularis is shown to be rapidly digested away by trypsin, and its location in histone H1 is discussed. A possible relationship of this structural feature to the length of linker DNA is proposed.     

Computer model of the metabolism of phenylalanine in normal subjects and in patients with phenylketonuria

The techniques of systems analysis have been applied to the metabolism of phenylalanine in healthy subjects and in phenylketonuria to derive a computer model. The model consists of seven compartments and four biological functions. Enzyme reactions are assumed to obey Michaelis-Menten kinetics. The computer program is written in FORTRAN. A biological validation of the model has been performed. The computer model has potential value for estimating concentrations of key metabolites in human organs which are not accessible to direct analysis from measurement of metabolites in blood and urine and phenylalanine intake. Such estimates would be helpful in clinical decisions concerning modification or termination of dietary treatment in phenylketonuria.     

CYP2C polymorphisms, phenytoin metabolism and gingival overgrowth in epileptic subjects

Previous studies suggested that the onset of phenytoin-induced gingival overgrowth depended on serum phenytoin concentration. Cytochrome P450 2C (CYP2C) plays an important role in phenytoin metabolism. Recently, single nucleotide polymorphisms in the coding region of CYP 2C influencing phenytoin metabolism were identified. The purpose of the present study was to see if CYP 2C polymorphisms might relate to the onset and severity of phenytoin-induced gingival overgrowth. Twenty-eight epileptic patients taking phenytoin aged 15 to 75 (mean age: 42.2 years old, 20 males and 8 females) and 56 unrelated healthy subjects aged 30 to 48 (mean age: 36.8 years old, 48 males and 8 females) were examined for CYP 2C polymorphisms. All epileptic subjects were examined for the degree of gingival overgrowth, daily phenytoin dose and serum phenytoin concentration. The results indicated about 7% of the subjects including epileptic and healthy subjects examined were positive for CYP 2C9*3. However, the degree of gingival overgrowth did not directly correlate with CYP 2C polymorphisms. Nevertheless, the subjects with severer gingival overgrowth exhibited significantly higher serum phenytoin concentration, indicating that phenytoin metabolism is an important determinant for the severity of the disease. Additionally, CYP 2C9*3 carriers exhibited significantly higher serum drug concentration to drug dose. Therefore, we concluded although the gene analysis is not directly related to diagnose the disease itself, it can be utilized in estimating serum phenytoin concentration from drug dose, which in turn serves to predict the future development and clinical course of the disease.     

Arachidonic acid metabolism in alveolar macrophages. A comparison of cells from healthy subjects, allergic asthmatics, and chronic bronchitis patients

Arachidonic acid (AA) metabolism was studied in preparations of purified human alveolar macrophages (AM) from healthy subjects (HS = 5), allergic asthmatics (ABA = 9) and chronic bronchitis patients (CB = 7). AM incubated for 6 to 24 h in the presence of labeled AA and for an additional 5 h without labeled AA, released cyclooxygenase and lipoxygenase products into the medium. The study of the metabolites showed that the most abundant sulfidopeptide-leukotriene, was LTD4 as analyzed by TLC and identified by reversed phase HPLC. The release of LTD4 was time-dependent but it was shown to be significantly higher (p less than 0.01) in AM from ABA or CB than in those from HS. TLC analysis of radioactivity distributed between the different lipid classes at 24 h revealed more labeling in AM phospholipids from ABA and CB than in those from HS, and was reflected in phosphatidylethanolamine and phosphatidylinositol species. After 5 h without labeled AA the distribution was marked, by different in triglycerides, with a greater proportion of radioactivity in the control cells than in the pathological macrophages. Thus, the pathological lung state is an important factor affecting the release of LTD4 and the distribution of AA into cellular phospholipids. The differences observed between HS and ABA or CB phospholipid distribution suggests the existence of 2 different sources of AA release, one for inflammatory macrophages and another for quiescent cells.     

Glucose metabolism in the basal state and during a two-hour glucose infusion in low insulin responders and control subjects

Glucose metabolism was studied in eight low insulin responders to glucose and eight controls using a primed-constant tracer infusion technique. The tracer was 3-3H-glucose. The former group demonstrated a lower IVGTT than the controls, although the K-values were well within the normal range. They also attained higher blood glucose levels during iv administration of high and low glucose loads. Glucose turnover studies revealed normal hepatic glucose production, normal total glucose uptake and normal metabolic clearance of glucose in the low responders as a group. The findings suggest normal sensitivity to insulin in these subjects, and imply that the low insulin response is the sole mediator of the observed lowering in IVGTT.     

Apolipoprotein E metabolism in normolipoproteinemic human subjects

Human apolipoprotein E (apoE) is a constituent of plasma very low density and high density lipoproteins and is important in modulating the catabolism of remnants of triglyceride-rich lipoproteins. There are three common isoforms of apoE, designated apoE-2, E-3, and E-4, which are coded by three separate alleles (epsilon 2, epsilon 3, and epsilon 4) at a single genetic locus and inherited in the population in a co-dominant fashion. ApoE-3 is the predominant apoE isoform in the normolipidemic population, and epsilon 3 has been proposed to be the normal allele. ApoE-3 metabolism was studied in nine normolipidemic subjects homozygous for the epsilon 3 allele. In these subjects, the plasma apoE-3 concentration was 4.8 +/- 1.2 mg/dl (mean +/- SD), the plasma apoE-3 residence time was 0.73 +/- 0.18 days, and the plasma apoE-3 production rate was 3.4 +/- 1.5 mg/kg-day. The apoE in males, when compared to females, tended to have a shorter residence time (0.63 +/- 0.15 days versus 0.83 +/- 0.16), a higher production rate (4.20 +/- 1.73 mg/kg-days versus 2.60 +/- 0.78), but a similar plasma concentration (5.1 +/- 1.5 mg/dl versus 4.5 +/- 0.8). ApoE-3 had a more rapid catabolism from plasma than other apolipoproteins previously studied (apolipoproteins A-I, A-II, A-IV, B-100, C-II, and C-III) except for apolipoprotein B-48. The catabolism of apoE-3 in the individual lipoprotein subfractions was also examined and apoE was shown to be catabolized most rapidly from the VLDL and slowest from the HDL. The results of the kinetic analysis of apoE metabolism are consistent with apoE being important in the catabolism of triglyceride-rich lipoproteins and with HDL serving as a reservoir for apoE to reassociate with newly secreted triglyceride-rich lipoproteins.