The effects of acid and acid/aluminum exposure on circulating plasma cortisol levels and other blood parameters in the rainbow trout, Salmo gairdneri

Softwater (Ca²⁺=50, Na⁺= 50(μequiv. l⁻¹) acclimated rainbow trout were fitted with chronic arterial catheters to allow for repetitive blood sampling. After 48 h recovery they were then exposed to either control (pH 6.5, Al = 0μg l⁻¹), acid (pH 4.8, Al = 0μg l⁻¹) or acid plus aluminum (pH 4.8, A1 = 112 μg l⁻¹) conditions for 72 h. Parameters measured included blood glucose, lactate, haemoglobin, haematocrit and plasma Na⁺, Cl⁻, protein and cortisol.
Exposure to pH 4'8 alone caused no mortality, a moderate ionoregulatory disturbance and a transient elevation in plasma cortisol. All other parameters were not significantly different from controls. Addition of aluminum to this exposure caused 100% mortality with a mean survival time of only 27.0 h. There was a marked decrease in plasma ions, hyperglycemia, lactate accumulation, haemoconcentration, red cell swelling, and a sharp rise in plasma cortisol becoming greatly increased as the fish neared death. The mechanism of toxicity of acute acid/aluminum exposure, the role for cortisol under such conditions, and the validity of cortisol and glucose as indicators of stress in fish are discussed.     

Haematology of juvenile Acipenser oxyrinchus and Acipenser brevirostrum at rest and following forced activity

In vivo experiments were conducted to examine the haematology of juveniles from two relic bony fishes, Atlantic sturgeon Acipenser oxyrhinchus and shortnose sturgeon Acipenser brevirostrum . Oxygen transport characteristics (haematocrit, haemoglobin and mean erythrocytic haemoglobin concentration), ionic composition (Na⁺, Cl⁻, K⁺ and osmolality), metabolite concentration (lactate, cortisol and glucose) and protein content in blood were measured or calculated at rest and during recovery from forced activity. Under resting conditions, plasma osmolality and concentrations of Na⁺, Cl⁻, lactate, cortisol and total protein were significantly different between Atlantic and shortnose sturgeon. All other resting variables were not different between species. Following forced activity, plasma lactate levels were significantly higher in both species than at rest. Plasma cortisol levels in both species were only significantly higher 1 h following forced activity compared to resting values. Plasma lactate levels were significantly higher in Atlantic sturgeon than in shortnose sturgeon, but these levels returned to resting levels by 1 h in both species. Cortisol increases were greater in shortnose sturgeon than in Atlantic sturgeon. In general, oxygen transport characteristics, blood glucose, plasma protein and plasma osmolality were not altered by forced activity in either sturgeon species. Overall, both species had reduced responses ( i.e . the magnitude of changes in measured variables) to forced activity compared with teleosts.     

Changes in serum cortisol, metabolites, osmotic pressure and electrolytes in response to different blood sampling procedures in cultured sea bass (Dicentrarchus labrax L.)

This study investigated the effect of five sampling procedures on serum cortisol, glucose, total protein, osmolality, Na⁺, Cl^–, K⁺ and Ca⁺⁺ concentrations in 2-year-old cultured sea bass ( Dicentrarchus labrax L).
Mild disturbance caused by rapid removal of fish and brief handling did not induce significant variation in any of the blood parameters investigated. Confinement and crowding elicited a high and significant increase in serum cortisol, glucose, osmolality, Na⁺, Cl^–, and Ca⁺⁺ concentrations. Exposure to MS 222 (140 mg L^–1) significantly increased osmolality, but not ionic concentration. Site of blood withdrawal (cardiac sinuses/caudal vein) had no effect on the concentration of analysed blood constituents, except for K⁺ levels. Scattered literature of sea bass blood chemistry is reviewed and compared with 'normal' ranges of blood constituents measured in this study. We conclude that it is necessary to select and rigorously execute an opportune blood sampling procedure whenever blood constituents are used as indicators of fish functional state.     

Effects of Osmotic Pressure on the Oxidative Metabolism of Leishmania major Promastigotes

Leishmania major promastigotes were washed and resuspended in an iso-osmotic buffer. The rate of oxidation of ¹⁴C-labeled substrates was then measured as a function of osmolality. An acute decrease in osmolality (achieved by adding H₂O to the cell suspension) caused an increase in the rates of ¹⁴CO₂ production from [6-¹⁴C]glucose and, to a lesser extent, from [1, (3)-¹⁴C]glycerol. An acute increase in osmolality (achieved by adding NaCl, KCl, or mannitol) strongly inhibited the rates of ¹⁴CO₂ production from [1-: ¹⁴C]alanine, [1-¹⁴C]glutamate, and [1, (3)-¹⁴C]glycerol. The rates of ¹⁴CO₂ formation from [1-¹⁴C]laurate, [1-¹⁴C]acetate, and [2-¹⁴C]glucose (all of which form [1-¹⁴C]acetyl CoA prior to oxidation) were also inhibited, but less strongly, by increasing osmolality. These data suggest that with increasing osmolality there is an inhibition of mitochondrial oxidative capacity, which could facilitate the increase in alanine pool size that occurs in response to hyper-osmotic stress. Similarly, an increase in oxidative capacity would help prevent a rebuild up of the alanine pool after its rapid loss to the medium in response to hypo-osmotic stress.     

Endocrine, osmoregulatory, respiratory and haematological parameters in flounder exposed to the water soluble fraction of crude oil

Flounders Pleuronectes flesus with an implanted vascular catheter were exposed to a 50% dilution of the water soluble fraction (WSF) of Omani crude oil (c. 6ppm total aromatic hydrocarbons) and serial blood samples taken to determine their endocrine status (cortisol, catecholamines and thyroid hormones) and the resultant and/or causal physiological (haematological, ionoregulatory and respiratory) disturbances. This resulted in a progressive increase in plasma cortisol concentrations from 3 h onwards (rising from 18 to 51 ng ml⁻¹ after 48-h exposure), and increased plasma glucose concentrations indicating a generalized stress response. Plasma T3 and T4 concentrations of both control and WSF-exposed groups declined progressively over the experimental period; exposure to the WSF of crude oil further depressed plasma T4 concentrations but not plasma T₃ concentrations relative to those of control fish. Plasma osmolality and sodium and chloride concentrations were stable in WSF-exposed fish, however, plasma potassium concentrations were increased significantly at the 24-and 48-h sampling points. The most profound physiological disturbance in WSF-exposed fish was a dramatic decline in blood oxygen content (CvO₂) (from 2–8 to 0–8 ml 100 ml⁻¹ after 48-h exposure), which is likely to be the cause of the increased plasma noradrenaline concentrations from 3 h onwards. Increased noradrenaline is likely in turn to have been responsible for the significant increase in blood haematocrit and blood haemoglobin at the 3-h sampling point, although the dominant effect in the longer-term was a significant decline in both of these haematological parameters.     

Effects of hypercapnia on the buffer capacity and haematological values in Salmo salar (L.)

The effects of high environmental carbon dioxide tension (PCO₂) on buffering status, pH, haematocrit, red blood cell (RBC) count, mean corpuscle volume (MCV), and chloride (Cl^–) distribution in the blood of young salmon were investigated after 30 min and 24 h. An increase in blood buffering capacity was observed after 24 h. As compared to the preacclimation situation, haematocrit, RBC, MCV and Cl^– content of the erythrocytes increased after 30 min but decreased if hypercapnia was sustained for 24 h. However the plasma bicarbonate (HCO₃) content increased over the whole experimental period. Plasma Cl^– content was decreased after 24 h, but the ratio of Cl^– between erythrocytes and plasma increased at the onset of hypercapnia, then remained unchanged during the rest of the investigation period.     

Partitioning of CO2 Production Between Glucose and Lactate in Excised Sympathetic Ganglia, with Implications for Brain

Abstract: Chains of lumbar sympathetic ganglia from 15-day-old chicken embryos were incubated for 4 h at 36°C in a bicarbonate-buffered salt solution equilibrated with 5% CO₂-95% O₂. Glucose (1–10 m M ), lactate (1–10 m M ), [U-¹⁴C]glucose, [1-¹⁴C]glucose, [6-¹⁴C]glucose, and [U-¹⁴C]lactate were added as needed. ¹⁴CO₂ output was measured continuously by counting the radioactivity in gas that had passed through the incubation chamber. Lactate reduced the output of CO₂ from [U-¹⁴C]glucose, and glucose reduced that from [U-¹⁴C]lactate. When using uniformly labeled substrates in the presence of 5.5 m M glucose, the output of CO₂ from lactate exceeded that from glucose when the lactate concentration was >2 m M . The combined outputs at each concentration tested were greater than those from either substrate alone. The ¹⁴CO₂ output from [1-¹⁴C]glucose always exceeded that from [6-¹⁴C]glucose, indicating activity of the hexose monophosphate shunt. Lactate reduced both of these outputs, with the maximum difference between them during incubation remaining constant as the lactate concentration was increased, suggesting that lactate may not affect the shunt. Modeling revealed many details of lactate metabolism as a function of its concentration. Addition of a blood-brain barrier to the model suggested that lactate can be a significant metabolite for brain during hyperlactemia, especially at the high levels reached physiologically during exercise.     

Cortisol and thyroid hormone responses to acid stress in the brown trout, Salmo trutta L.

Individual cannulated brown trout monitored during exposure to acidic water showed increased plasma cortisol after 3 h at pH 4.0 with low (0.05 mm) or high (2.8 mm) calcium (Ca) content, and after 2 days in acidic water with a high Ca content. Most fish did not survive for 2 days in acidic water with a low Ca content. Non-cannulated fish showed a similar increase in mean plasma cortisol after 2 days in high-Ca acidic water (pH 4.0–4.6), but not in acidic water of a low Ca content. After 7 days of exposure to acidic water, plasma cortisol appeared to recover when there was a high Ca content but increased 20-fold when Ca content was low. In cannulated fish severe acid stress resulted in a marked and rapid thyroid response. Plasma thyroxine (T₄) was elevated after 3 h exposure to acidic water of both low and high Ca content and remained elevated for 2 days of acid exposure with high Ca. In non-cannulated fish an increase in mean T₄ was apparent only after 7 days in low-Ca acidic water. Plasma triiodothyronine (T₃) levels were not significantly altered by any of the acid regimes. Plasma glucose of cannulated fish was elevated within 3 h of acid-exposure and remained elevated after 2 days in high-Ca acidic water.     

Effects of culture conditions on Pectinatus cerevisiiphilus and Pectinatus frisingensis metabolism: a physiological and statistical approach

The genus Pectinatus has been often reported in beer spoilage with off-flavours. The bacteria are strictly anaerobic, Gram-negative rods. Propionate and acetate are the main fermentation products from glucose in the two species belonging to the genus, P. cerevisiiphilus and P. frisingensis. Amino acids routinely present at a high level in beer were not growth substrates for both species, and a significant accumulation of succinate was observed with lactate as growth substrate. Both Pectinatus ssp. showed almost identical fermentation balances on glucose. Growth kinetics of both glucose-grown species were unchanged under a N₂, H₂ or 20% CO₂-containing atmosphere. Combinations of culture medium pH values from pH 3·9 to pH 7·2, of glucose levels between 5 and 55 mmol l^-1, and of lactate concentrations varied from 4 to 40 mmol l^-1 demonstrated that biomass and volatile fatty acids production were proportional to glucose concentration for both Pectinatus species. A significant increase of volatile fatty acid production was measured for both species at the lowest pH values with a lactate or a glucose concentration increase. The maximum biomass production was observed at pH 6·2 for P. cerevisiiphilus , and between pH 4·5 and pH 4·9 for P. frisingensis. Glucose and lactate or pH value were dependent with regard to propionate and acetate production in P. frisingensis. On the other hand, the variations of these three parameters were independent with regard to biomass production for both strains, and to volatile fatty acids production for P. cerevisiiphilus. Addition of ethanol to glucose-grown cultures completely inhibited growth at 1·3 mol l^-1 ethanol for P. cerevisiiphilus , and at 1·8 mol l^-1 for P. frisingensis.     

Physiological responses to handling in the turbot

Turbot Scophthalmus maximus were cannulated via the afferent branchial artery and were either net-confined in sea water or in air for 9 min to monitor the stress response of a hatchery-reared marine flatfish. No mortality was observed. Aerial exposure appeared to mobilize plasma free fatty acids and stimulate the interrenal tissue but had no effect on circulating glucose or lactate levels. This pattern was qualitatively similar to that induced by net-confinement in sea water, although the magnitude and duration of the changes were more marked in the turbot handled in sea water. Aerial exposure had no effect on plasma osmolality, protein, or Cl⁻ concentrations and only a minor effect on plasma Na⁺ concentrations, which was in sharp contrast to the ionoregulatory disturbance noted in turbot which were net-confined in sea water. However, plasma K⁺ and cortisol concentrations were similarly elevated by both handling procedures. The results from these experiments suggest that whilst similarities with the salmonid physiological stress response are apparent, the lack of a plasma glucose response may represent a fundamental difference in turbot stress physiology.     

Lactate Is Released and Taken Up by Isolated Rabbit Vagus Nerve During Aerobic Metabolism

Abstract: To determine if lactate is produced during aerobic metabolism in peripheral nerve, we incubated pieces of rabbit vagus nerve in oxygenated solution containing d -[U-¹⁴C]glucose while stimulating electrically. After 30 min, nearly all the radioactivity in metabolites in the nerve was in lactate, glucose 6-phosphate, glutamate, and aspartate. Much lactate was released to the bath: 8.2 pmol (µg dry wt)⁻¹ from the exogenous glucose and 14.2 pmol (µg dry wt)⁻¹ from endogenous substrates. Lactate release was not increased when bath P o ₂ was decreased, indicating that it did not come from anoxic tissue. When the bath contained [U-¹⁴C]lactate at a total concentration of 2.13 m M and 1 m M glucose, ¹⁴C was incorporated in CO₂ and glutamate. The initial rate of formation of CO₂ from bath lactate was more rapid than its formation from bath glucose. The results are most readily explained by the hypothesis that has been proposed for brain tissue in which glial cells supply lactate to neurons.     

Plasma cortisol stress response in fingerling rainbow trout, Salmo gairdneri Richardson, to various transport conditions, anaesthesia, and cold shock

Plasma cortisol levels of fingerling rainbow trout were measured as an index of the stress resulting from various procedures used for transport of the fish for stocking. When transported under 'normal' conditions, which included water at the hatchery acclimation temperature (10–11°C), O₂ saturation or supersaturation, and neutral pH, there was a marked increase in plasma cortisol levels within 0.5 h, which was maintained over the next 4 h of transport; there was a significant decrease in plasma cortisol by 8 h of transport. It was found that the plasma cortisol levels at 4 and 8 h were not appreciably altered by transport under partial O₂ desaturation, O₂ saturation, O₂ supersaturation, or 0.5% NaCl, or by anaesthesia with tricaine methanesulfonate (MS 222) prior to capture and transport in MS 222-free water or 0.5% NaCl. A 15 min exposure to an immobilizing dose of buffered or unbuffered MS 222, or 2-phenoxyethanol, caused an increase in plasma cortisol of about 2 h duration, indicating that anaesthetics are themselves stressful. Exposure to chilled water (1° C) caused a large increase in plasma cortisol levels by 4 h after initiation of exposure; plasma cortisol had decreased at 1 day, and by 2 days a constant level was reached which was above the level in fingerling trout under 'normal' hatchery conditions. Trout acclimated to chilled water for 24 h and transported in chilled water had an increase in plasma cortisol during transport. Anaesthesia prior to transport or addition of salt did not reduce the stress of transport as judged by plasma cortisol levels. The results indicate that stress from capture and transport during stocking cannot be avoided using present methods.     

Changes in ethanol, lactate and malate content in Acer pseudoplatanus cells: effects of fusicoccin and O2 availability

Changes in the contents of ethanol, lactate and malate were determined at different activities of the plasma membrane H⁺ pump [in the presence and absence of fusicoccin (FC)] and at different O₂ availability in cultured cells of Acer pseudoplatanus L. FC induced acidification of the medium under all tested conditions of O₂ availability. At low O₂ concentrations both ethanolic and lactic fermentations occurred, and FC markedly stimulated lactate production but had no effect on ethanol production. There was also a small, stimulating effect of FC on malate production. At high O₂ concentrations no ethanol production was observed and lactate production was reduced. Under these conditions the stimulating effect of FC on lactate production decreased, while that on malate production increased. FC-induced synthesis of lactate and malate is interpreted as depending on the activation of lactate dehydrogenase (EC 1.1.1.27) and phosphoenolpyruvate carboxylase (EC 4.1.1.31) (alkaline pH optima), respectively, due to the alkalinization of the cytoplasmic pH resulting from the stimulation of the H⁺ pump by FC. These results suggest that the balance between the two pH stat systems depends on the availability of O₂.     

Changes in selected blood component concentrations of rainbow trout, Salmo gairdneri Richardson, exposed to hypoxia or sublethal concentrations of phenol or ammonia

Rainbow trout were exposed to sublethal phenol or non-ionized ammonia concentrations or to hypoxia. Blood samples were taken after various exposure periods and the packed cell volume (PCV) value, the whole blood glucose concentration and the plasma cortisol and chloride ion concentrations measured. At low pollutant concentrations there were no significant changes in the blood components compared to control fish values. At higher concentrations the general response to the stressors was significant increases in the PCV value and the glucose and cortisol concentrations during the first few hours of exposure, followed by a gradual return to normal values in the subsequent exposure time. The increases in glucose and cortisol concentrations were approximately proportional to the pollutant concentrations no such correlation was found for the PCV values. No clear pattern of plasma chloride ion changes was found in any experiment. Levels of no acute effect, in terms of toxic units (TU) based on the pollutants' 48 h LC₅₀ values, were estimated for phenol as 0.3 TU and for un-ionized ammonia as 0.1 TU, using the plasma cortisol concentration measurements. The use of fish blood component measurements as general indicators of a stress response is discussed.     

Brain Carbohydrate Metabolism in Developing Rats During Hypercapnia

Abstract: Brain glucose metabolism was studied in developing rats at ages 10 and 20 days postnatal under normal and hypercapnic conditions. Brains were removed and frozen within 1 s with a freeze-blowing apparatus. Glucose utilization was measured with [2-¹⁴C]glucose and [³H]deoxyglucose as tracers. Metabolites were determined by standard enzymatic techniques. Data from [³H]deoxyglucose phosphorylation indicated that normal brain glucose utilization increased almost threefold between the 10th and 20th postnatal days. From the relative rates of utilization of the two isotopes in the 20-day-old control group, it appeared that about 25% of ¹⁴C label derived from metabolism of [2-¹⁴C]glucose was lost from brain (probably as lactate) rather than entering the Krebs cycle. Under hypercapnic conditions (20% CO₂-21% O₂-59% N₂), rates of glucose utilization by brain were decreased by one-half at both ages and there were progressive decreases in the concentrations of many intermediary metabolites. The bases for concluding that these metabolites were used to supplement glucose as a fuel for respiration, rather than being lost by leakage into blood, are discussed. Despite the differences in brain glucose metabolism between 10-day-old and 20-day-old rats, their responses to hypercapnia are remarkably similar: Rates of glucose utilization are reduced to approximately the same proportion of the original rate by 20% CO₂, and endogenous metabolites (particularly glutamate and lactate) appear to be oxidized as replacement fuels.     

Effect of hyperthermia on blood constituents in the domestic rabbit (Lepus cuniculus)

1. 1. Effects of exposing rabbits to temperatures 37–50°C on body-core temperature and some blood constituents were investigated.

2. 2. Heat stroke death occurred at or above a critical core-temperature of 43.0°C.

3. 3. Plasma osmolality and levels of glucose, urea and lactate were significantly elevated in hyperthermia.

4. 4. Widespread tissue damage was indicated by increases in plasma activities of glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT) and creatinine phosphokinase (CPK).

5. 5. The most sensitive indicators of impending heat stroke in heat stressed rabbits were plasma levels or urea, lactate and CPK.

Metabolism of position-labelled glucose in anoxic methanogenic paddy soil and lake sediment

Abstract Turnover times of radioactive glucose were shorter in paddy soil (4–16 min) than in Lake Constance sediment (18–62 min). In the paddy soil, 65–75% of the radioactive glucose was converted to soluble metabolites. In the sediment, only about 25% of the radioactive glucose was converted to soluble metabolites, the rest to particulate material. In anoxic paddy soil, the degradation pattern of position-labelled glucose was largely consistent with glucose degradation via the Embden-Meyerhof-Parnas (EMP) pathway followed by methanogenic acetate cleavage: CO₂ mainly originated from C-3,4, whereas CH₄ mainly originated from C-1 and C-6 of glucose. Acetate-carbon originated from C-1, C-2 and C-6 rather than from C-3,4 of glucose. In both paddy soil and Lake Constance sediment acetate and CO₂ were the most important early metabolites of radioactive glucose. Other early products included propionate, ethanol/butyrate, succinate, and lactate, but accounted each for less than 1–8% of the glucose utilized. The labelling of propionate by [3,4-¹⁴C]glucose suggests that it was mainly produced from glucose or lactate rather than from ethanol. Isopropanol and caproate were also detectable in paddy soil, but were not produced from radioactive glucose. Chloroform inhibited methanogenesis, inhibited the further degradation of radioactive acetate and resulted in the accumulation of H₂, however, did not inhibit glucose degradation. Since acetate was the main soluble fermentation product of glucose and was produced at a relatively high molar acetate: CO₂ ratio (2.5:1), homoacetogenesis appeared to be the most important glucose fermentation pathway.     

Energy conservation by pyrroloquinoline quinol-linked xylose oxidation in Pseudomonas putida NCTC 10936 during carbon-limited growth in chemostat culture

Abstract When grown in carbon source-limited chemostat cultures with lactate or glucose as the carbon and energy source and xylose as an additional source of reducing equivalents, Pseudomonas putida NCTC 10936 oxidized xylose to xylonolactone and xylonate. No other products were formed from this pentose, nor was it incorporated into biomass. The presence of xylose in these cultures resulted in higher Y_glucose and Y_lactate values as compared to cultures without xylose indicating that biologically useful energy was conserved during the periplasmic oxidation of xylose. As the Y₀ values for growth on glucose or on lactate alone were equal to the Y₀ values with xylose as co-substrate, it is concluded that for flucose- or lactate-limited growth energy conservation by PQQH₂ oxidation is as efficient as by NADH₂ oxidation.     

Poor water quality suppresses the cortisol response of salmonid fish to handling and confinement

Confinement of brown trout in small troughs of static water for 1 h at a density of six fish 251⁻¹ stimulated the hypothalamic-pituitary-interrenal axis and resulted in an elevation of plasma cortisol from basal levels (less than 2 ng m1⁻¹) to about 100 ng m1⁻¹, the degree of stimulation being dependent upon water temperature. Confinement at a density of 30 fish 251⁻¹ resulted in a 50% suppression of this response. It is demonstrated that this effect is mediated by changes in water chemistry and not by crowding per se . Experimental manipulation of the water chemistry showed that reduced pH (7.1 → 6.3), elevated free CO₂ (63 → 520 μmoll⁻¹) or elevated ammonia (8 → 1300 μg 1⁻¹ as total ammonia nitrogen) had no individual effects on the interrenal response to acute confinement. Elevated ammonia in combination with reduced pH significantly increased the plasma cortisol levels in response to acute confinement, whereas a combination of reduced oxygen (100 → 20% saturation), elevated free CO₂ and elevated ammonia markedly suppressed (∼ 50%) the cortisol response of both brown trout and rainbow trout to acute confinement in a manner similar to that observed with trout at high densities. A compensatory increase in plasma cortisol levels was observed during the subsequent recovery of fish which had been confined for 1 h in water of poor quality. These findings are discussed in relation to the exposure of fish to multiple stresses and to the role of corticosteroids in the stress response.     

Inhibition of Brain Glycolysis by Aluminum

Abstract: Aluminum inhibited both the cytosolic and mitochondrial hexokinase activities in rat brain. The IC₅₀ values were between 4 and 9 μ M . Aluminum was effective at mildly acidic (pH 6.8) or slightly alkaline (pH 7.2–7.5) pH, in the presence of a physiological level of magnesium (0.5 m M ). However, saturating (8 m M ) magnesium antagonized the effect of aluminum on both forms of hexokinase activity. Other enzymes examined were considerably less sensitive to inhibition by aluminum. The IC₅₀ of aluminum for phosphofructokinase was 1.8 m M and for lactate dehydrogenase 0.4 m M . At 10–600 μ M , aluminum actually stimulated pyruvate kinase. Aluminum also inhibited lactate production by rat brain extracts: this effect was much more marked with glucose as substrate than with glucose-6-phosphate. However, the IC₅₀ for inhibiting lactate production using glucose as substrate was 280 μ M , higher than that required to inhibit hexokinase. This concentration of aluminum is comparable to those reportedly found in the brains of patients who had died with dialysis dementia and in the brains of some of the patients who had died with Alzheimer disease. Inhibition of carbohydrate utilization may be one of the mechanisms by which aluminum can act as a neurotoxin.