Identification of alcohol abuse using laboratory tests and a history of trauma

In a study involving 68 ambulatory patients with known alcohol problems and 68 social drinkers matched for age and sex, a questionnaire about the patients' history of trauma identified 7 out of 10 subjects with drinking problems. In contrast, abnormal values for gamma-glutamyl transferase, mean corpuscular volume, or high-density lipoproteins had only moderate sensitivity (26% to 40%) for identifying alcohol problems but excellent specificity (88% to 99%) for ruling out cases. Similar rates of sensitivity and specificity were found among 61 family practice patients. Diagnostic accuracy was improved by combining tests results, using computer-based logistic regression analysis. This study suggests that a brief questionnaire on history of trauma is valuable for the earlier detection of problem drinking in ambulatory populations, in contrast to laboratory tests, which appear to have high sensitivity only with more chronic alcoholics.

Microvascular blood flow: evidence indicating a cubic dependence on arteriolar diameter

The primary objectives of this study were 1) to determine the functional relationship between microvascular blood flow (Q) and arteriolar internal diameter (D) and 2) to determine whether this relationship conformed to a theoretical optimality prediction--that blood flow is proportional to the cube of the diameter (Q = kD3). Paired blood velocity and arteriolar diameter measurements in the cremaster muscle microvasculature of eight normotensive (WKY) and eight hypertensive (SHR) rats were made under control conditions and following maximal dilation of the microvasculature with topically applied adenosine. A total of 160 paired flow-diameter measurements were made in arteriolar vessels with diameters ranging from 6 to 108 micron. Analysis of this data showed that Q and D were functionally linked by Q = kDm with k = 417 and m = 3.01 with D expressed in centimeters. Confidence intervals at the 99.9% level were 331-503 and 2.86-3.14 for k and m, respectively. A theoretical development based on the minimization of the energy cost of blood volume and arteriolar wall volume led to a theoretical estimate for the range of k to be 92-132 and a value for m to be 3. Predicted pressure gradients in single vessels of the cat mesentery and shear rates in the rat cremaster based on Q = kD3 compared well with measured data reported in the literature and that determined in the present study. On the basis of the direct and predictive evidence, it is concluded that the relationship Q = kD3 represents a general average property of the microvasculature.

Role of the carboxamide groups of the asparagine and glycinamide residues of oxytocin. Syntheses and biological properties of [5-beta-cyanoalanine] oxytocin and [9-alpha-aminoacetonitrile] oxytocin

In an attempt to see whether the C=O and the NH2 of CONH2 of asparagine5 and glycinamide9 are both essential for biological activity, [5-beta-cyanoalanine] oxytocin and [9-alpha-aminoacetonitrile] oxytocin have been synthesized. Each of these analogs contains a nitrile group in place of the carboxamide group of Asn5 and GlyNH92 respectively; the nitrile group can simulate the carbonyl portion of the carboxamide, but lacks the hydrogen-bond donating capacity of its NH2 portion. Substitution of a nitrile group produced opposite biological effects in the 5 and the 9 positions; the 5-substituted analog showed very low activities (less than 3% of those of oxytocin) while the 9-substituted analog showed extremely high activities (with an in vivo uterine activity of 906 U/mg almost twice that of oxytocin). The results clearly suggest that the mechanisms of interaction of the carboxamide groups with the receptor sites are different for residues 5 and 9.

Biofunctional evaluation of two hydrogen bonds stabilizing the beta-turn in the acyclic component of oxytocin

The depsipeptide [8-alpha-hydroxyisocaproic acid, 9-glycolic amide]-oxytocin, which has ester linkages replacing the peptide linkages between the 7th and 8th and the 8th and 9th residues of oxytocin, has been synthesized by a (6 + 3) condensation of Boc-tocinoic acid with Pro-O-HyIc-O-Glyc-NH2, followed by deprotection of the resulting product. The analog exhibited the following activities in rats: 258 +/- 11 and 28 +/- 5 U/mg, uterus in vitro in the absence and presence, respectively, of Mg+2; 54 +/- 4 U/mg, uterus in vivo; 19.3 +/- 2.1 U/mg, milk ejection; 0.153 +/- 0.026 U/mg, antidiuretic activity; and no pressor activity. The need for the presence of the peptide linkages mentioned above as sources for internal hydrogen bonds to stabilize the "biologically significant" conformation is discussed.

[1-Desaminopenicillamine, 8-alpha-hydroxyisocaproic acid] oxytocin. A selective inhibitor in rats of the uterine response to oxytocin

[1-Desaminopenicillamine, 8-alpha-hydroxyisocaproic acid] oxytocin was synthesized by a 6 + 3 fragment condensation from precursors which had been formed by solution methods. This analog inhibited uterine responses to oxytocin (pA2 7.37, 7.9, 6.17; uterus in vitro without Mg++, in vitro with Mg++, and in vivo, respectively) and showed little or no activity in other bioassays.

In vitro synthesis of genome length complementary RNA of vesicular stomatitis virus in the presence of inosine 5'-triphosphate

The virion-associated RNA polymerase of vesicular stomatitis virus (VSV) synthesizes RNA in vitro when GTP is replaced by inosine 5'-triphosphate (ITP). The synthesis is optimal at an ITP concentration of 200 microM and the extent of synthesis is between 15 to 20% compared to normal transcription in the presence of GTP. Analyses of the RNA products revealed that approximately 10% of the product RNA represented plus-strand complement of the genome RNA. Defective interfering particles of VSV were also capable of synthesizing complementary RNA in the presence of ITP, in addition to 46-base RNA, although in lesser amount (2%). Since I substitution facilitates read-through of the genome RNA, these results suggest that interaction of the product RNA with the genome template or ITP-mediated modification of a viral protein may be involved in the read-through process in vitro.

Radio-labelling of 1-O-alkyl, 2-O-acetyl, sn-glycero-3-phosphorylcholine, 1-O-(9,10-di3H)-octadecyl PAF-acether

3H-labelling of 1-3H-PAF-aceter was prepared by catalytic reduction of 1-O-(9,10)-octadecenyl-2-O-benzyl-sn-glyceryl-3-phosphorylcholine and then acetylated. 5 mumoles of this dehydro derivative dissolved in methanol was treated during 4 hours with tritium gas (80 Ci) and compressed until 1.1 bar by an automatic tritium transfer unit [1]. The catalyst was removed by filtration over Millex (Millipore) and labile tritium atoms eliminated by rotatory flash evaporation. The chemical purity was checked by 3H scanning and autoradiography. It was finally recovered through preparative thin-layer chromatography and then acetylated. The specific radioactivity was found to be close to 40-50 Ci/mmole.

Enkephalin dipeptidyl carboxypeptidase (enkephalinase) activity: selective radioassay, properties, and regional distribution in human brain

The compound [3H]Tyr1,D-Ala2,Leu-OH5]enkephalin has been synthesised as a potentially selective substrate for enkephalin dipeptidyl carboxypeptidase (enkephalinase) activity in brain. Incubations in the presence of homogenates and particulate fractions from rodent and human brain result in the formation of [3H]Tyr-D-Ala-Gly, which can be conveniently isolated by polystyrene bead column chromatography. The enzyme activity responsible for the hydrolysis of the Gly3-Phe4 amide bond of this substrate displays close resemblance to that hydrolysing the natural enkephalins at the same level. In addition, enkephalinase activity characterised in postmortem human brain is closely similar to that in rodent brain, with regard to optimal pH and apparent affinities of various substrates and inhibitors, including the potent compound thiorphan. Enkephalinase activity is distributed in a highly heterogeneous fashion among regions of human brain, the highest levels being found in globus pallidus and pars reticulata of the substantia nigra. This distribution is poorly correlated with that of opiate receptor binding sites but displays some resemblance to that of reported Met5-enkephalin levels.

Biofunctional evaluation of a hydrogen bond stabilizing the conformation in the cyclic part of oxytocin

[5-beta-Malamidic acid]oxytocin was synthesized to study the importance of the hydrogen bond between the C=O of Tyr2 and the peptide N-H of Asn5 for the stabilization of a biologically functional conformation of oxytocin. This analog lacks the peptide N-H at residue 5 required for the formation of a hydrogen bond with the C-O of Tyr2. [5-beta-Malamidic acid] oxytocin exhibited 45.1 +/- 2.5 U/mg and 65.6 +/- 5.9 U/mg of uterotonic activity, in vitro, in the absence and in the presence, respectively, of Mg2+, 147 +/- 14 U/mg of uterotonic activity in vivo, 203 +/- 13 U/mg of milk-ejecting activity, 0.37 +/- 0.03 U/mg of pressor activity and 0.32 +/- 0.29 U/mg of antidiuretic activity. It is concluded that devoid of the hydrogen bond under question, an oxytocin-like peptide can still assume the conformation needed to interact with the oxytocin receptors.

Binding and metabolism studies with [3H](D-Ala2,Leu5)enkephalinamide and [3H](D-Ala2,Pro5)enkephalinamide: evidence for a selective interaction of (D-Ala2,Pro5)enkephalinamide with mu-receptors

We have compared the binding characteristics of [3H](D-Ala2,Leu5)enkephalinamide and [3H](D-Ala2,Pro5)enkephalinamide on a washed homogenate from mouse brain. The maximum number of binding sites for [3H](D-Ala2,Leu5)enkephalinamide was twice that obtained with [3H](D-Ala2,Pro5)enkephalinamide. Hill slopes of the displacement curves for opiates and (D-Ala2,Pro5)enkephalinamide obtained against [3H](D-Ala2,Leu5)enkephalinamide were considerably lower than that of (D-Ala2,Met5)enkephalinamide and (D-Ala2,Leu5)enkephalinamide. In contrast, Hill slopes for morphine, ketocyclazocine and (D-Ala2,Leu5)enkephalinamide were similar for the displacement of [3H](D-Ala2,Pro5)enkephalinamide. These results are discussed and interpreted in terms of a selective interaction for (D-Ala2,Pro5)enkephalinamide with mu-receptors and a similar affinity of (D-Ala2,Leu5)enkephalinamide for mu- and delta-receptors. Since metabolism studies did not show any difference in the degradation rate of these two enkephalin analogs, the discrepancy between in vitro and in vivo activity cannot result from the catabolism processes. Another possible explanation is proposed.

Effects of traumatic manipulations on grafts, sutures, and host arteries during vascular surgery procedures. Experiments on dogs

Scanning electron microscopy was used to diagnose incidents of trauma and the pattern of healing following surgical implantation of microporous blood vessel substitutes. Vascular reconstruction procedures using autogenous or synthetic prosthetic material inflict damage to the adjacent tissues as well as the prosthesis. This affects the thrombotic behavior and healing pattern of the area. The prognosis for long-term success are, as a consequence, directly influenced. Various vessel-occluding devices were evaluated in canine models with respect to their ability to damage blood vessels at the clamped site. The impact of suture needles on tissues and prosthetic materials was also considered. Of the various vessel-clamping devices which are commercially available, those which have elastomeric shields on the clamping components were found to be most satisfactory. The development of less traumatic surgical devices is discussed with the aim of further reducing surgical trauma.

Defibrinogenation as an alternative to heparinization in prolonged extracorporeal circulation

Complications arising from difficulty controlled bleeding and thrombus formation during procedures which require extracorporeal circulation with heparin as anticoagulant motivate the search for better hemostasis and anticoagulant technology. An enzyme (Defibrase), having a specific interaction with fibrinopeptide A such as to cause fibrin depletion in a soluble form, has been proposed as an alternative to heparin. Defibrase, in contrast to heparin, does not affect blood platelet function. Heparin and Defibrase as anticoagulants were compared in 8 h perfusion studies using arterio-venous extracorporeal blood circuits in dogs; the circuitry included pumps, membrane oxygenators and filters serially. Thrombus formation, in the filters and the oxygenators as well as pathology of the perfused animal were investigated. The results suggest that defibrase-like enzymes have potential for enhanced control of hemorrhagic and thrombotic phenomena. Although impeded by a latency of several hours before the full anticoagulant properties are developed in vivo, it appears that enzymatically mediated defibrinogenation of blood may be a valuable alternative to heparinization in extracorporeal circulation procedures.

[The treatment of fracture-dislocation of the humeral head by blind pinning (author's transl)]

The authors have treated 7 fracture-dislocations of the humeral head by blind pinning. The fractures were reduced by traction under general anaesthesia. 3 or 4 pins were then introduced into the olecranon fossa and driven up through the humeral head. After an average follow up of 29 months, the results were excellent in 9 cases, good in 5 and fair in 3. In 3 cases only, necrosis of the humeral head was noted.

Synthesis of [8-alpha-hydroxyisocaproic acid]oxytocin. Biological activities and comparison of its in vivo uterine actions to those of deamino-[8-alpha-hydroxyisocaproic acid]oxytocin, deamino-oxytocin and oxytocin

The synthesis and biological activities of [8-alpha-hydroxyisocaproic acid]oxytocin are reported. The in vivo uterine responses to [8-alpha-hydroxyisocaproic acid] oxytocin are prolonged and those to deamino-[8-alpha hydroxyisocaproic acid] oxytocin (as well as those we have previously reported for deamino-oxytocin) are very prolonged as compared with those of oxytocin. Time courses of the in vivo uterine responses to deamino-[8-alpha-hydroxyisocaproic acid]oxytocin and deamino-oxytocin (as followed by plotting the intervals between the individual contractions of a response vs. time after peptide injection) differ from those to [8-alpha-hydroxyisocaproic acid]oxytocin and oxytocin.

Biofunctional evaluation of a hydrogen bond stabilizing the beta-turn in the acyclic part of oxytocin

In a continued effort to determine the importance of the hydrogen bonds for stabilization of the biologically active conformation of oxytocin, deamino-[9-glycolicamide] oxytocin was synthesized in order to study, in this respect, the hydrogen bond between the peptide N--H of Gly9 and the C=0 of Cys6. In this analog the amide linkage between residues at positions 8 and 9 is replaced by an ester. Thus the residue at position 9 cannot be involved in hydrogen bond formation with the C=O of Cys6. Deamino-[9-glycolicamide] oxytocin exhibited 134 +/- 13 U/mg and 355 +/- 48 U/mg of uterotonic activity in absence and in presence, respectively, of Mg2+, 108 +/- 8 U/mg of milk-ejecting activity, 0.35 +/- 0.03 U/mg of pressor activity and 2.5 +/- 0.1 U/mg of antidiuretic activity. It is concluded that the hydrogen bond under question is not critical for the conformation required for biofunctional interaction of oxytocin with its receptors in the uterus, mammary gland and other target organs.

[On preclotting of woven Dacron vascular prostheses (author's transl)]

The role and the clinical value of common protocols of preclotting for a woven Dacron vascular prosthesis have been investigated. A comparative study of blood loss was carried out for Standard Woven De Bakey protheses inserted in a specially constructed extracorporeal blood circuit with canine models. The system detected transport of blood across the wall of the prostheses. These measurements were supplemented by gravimetric assessment of blood clot density and scanning electronmicroscopy examination of the internal surfaces of the prostheses. The pre-operative protocols investigated included : absence of pre-treatment, precoagulation with anticoagulant-free blood and various techniques using heparinized blood subsequent to an initial blood contact (modified method of Sauvage). The effect of using heparinized animals was also investigated. Leakages in unclotted prostheses could be reduced almost five fold by any precoagulation technique. Heparinization did not cause a significant increase in leakage and considerably improved the quality of the newly deposited blood product lining on the prostheses which consisted almost entirely of fibrin and eliminated any embolization.

Studies on the importance of the asparagine residue in oxytocin. Synthesis and some pharmacological properties of [1-alpha-mercaptoacetic acid, 5-isoasparagine] oxytocin

[1-Alpha-Mercaptoacetic acid, 5-isoasparagine] oxytocin was synthesized to study the effects of moving the side chain carboxamide group of the amino acid residue in position 5 of oxytocin from the beta to the alpha position. The analog has an isoasparagine residue in position 5 and the 20-membered ring size of oxytocin is maintained by substituting cysteine in position 1 of oxytocin by alpha-mercaptoacetic acid. The analog was found to possess 0.098 +/- 0.002 U/mg of uterotonic activity but no milk-ejecting, antidiuretic or rat pressor activity could be detected. The substance did not inhibit the uterotonic or milk-ejecting activity induced by oxytocin nor the antidiuretic or rat pressor responses to the USP posterior pituitary standard. These results, together with the data available in the literature, indicate that an analog of oxytocin lacking the asparagine residue in position 5 is neither an agonist nor an antagonist. The observations may mean that the asparagine residue is critically important for the interaction of oxytocin with its receptor.