Synthesis of analogs of the serum thymic nonapeptide, "facteur thymique serique" (FTS). Part II

New analogs of FTS (Facteur Thymique Sérique), less than (Formula: see text), a circulating thymic factor, were prepared by replacing the amino acid residues in positions, 1, 3, 4, 5, 6 and 3 and 6 together. Five other analogs of C-terminal heptapeptide were prepared by replacing the amino acid residues in position 3 or 6. These peptides were synthesized using conventional synthesis in solution.

The importance of the amino acid in position 27 of cholecystokinin in determining its biological activity on pancreatic acini

We tested the synthetic C-terminal heptapeptide of cholecystokinin, which has the same biologic activity as cholecystokinin, and various synthetic analogs of the C-terminal heptapeptide for their abilities to increase amylase secretion from dispersed acini prepared from guinea-pig pancreas. We found that altering the chemical character of the amino acid in position 27 altered the potency with which the peptide stimulated amylase secretion but did not alter the efficacy of the peptide. We also found that, in the amino acid in position 27, the major function of the side-chain seems to be to position to the sulfate ester group at a proper distance from the backbone of the peptide chain, whereas the chemical structure of the side-chain per se seems to be of relatively minor importance.

Plasma infusion for thrombotic thrombocytopenic purpura during pregnancy

Thrombotic thrombocytopenic purpura (TTP), a disease of unknown cause, has been reported relatively frequently during pregnancy. The disorder typically runs a fulminant course with a high mortality, and survival of both mother and fetus has been exceedingly rare. We report here the fourth case of TTP during pregnancy in which both the mother and fetus survived. Therapeutic approaches to TTP have included corticosteroids, antiplatelet agents, splenectomy, and, more recently, exchange plasmapheresis, exchange transfusion, and plasma infusion. The patient described herein was refractory to corticosteroids, antiplatelet agents, and only transiently responsive to exchange transfusion. The administration of plasma infusions achieved a sustained partial remission that allowed full gestation of the developing fetus. The patient attained full remission following cesarean section and simultaneous splenectomy.

Upbeat nystagmus and internuclear ophthalmoplegia with brainstem glioma

We describe the unusual association of two ocular motor abnormalities: upbeat nystagmus and internuclear ophthalmoplegia in a young woman originally believed to have demyelinating disease. Quantitative eye movement recordings documented a unidirectional defect in upward visual pursuit with preservation of the vertical vestibulo-ocular reflexes. The ocular oscillation was characterized as a type of "pursuit defect" nystagmus. An enhancing lesion of the upper brainstem seen on computerized tomography was primarily localized to the midbrain on pneumoencephalography. Biosy of the lesion disclosed a malignant glial tumor. The patient's course initally progressed but became stable following radiotherapy and chemotherapy during the next eight months. We believe the association of upbeat nystagmus and internuclear ophthalmoglegia should prompt a detailed search for a structural lesion.

Proteins specified by African swine fever virus. II. Analysis of proteins in infected cells and antigenic properties

Infection of MS cells with African swine fever virus (ASFV) produces inhibition of protein synthesis which is detectable from 4.5 hours after infection. At least 34 viral polypeptides have been indentified with molecular weights ranging between 9500 and 243,000 daltons. Three of these proteins show affinity for the cell nucleus and nine are in both the nuclear and cytoplasmic fractions. Ten early proteins were found, and most of the structural proteins were late proteins. Most of the proteins are synthesized within the first 8 hours after infection. At least nine proteins induced antibodies in the natural infection. Six of these proteins are structural proteins. The antigenic determinants of VP172, VP162, VP146, VP73, VP34, and IP23.5 are in the primary structure of the proteins.

[Mono-dimensional echocardiography in emergency diagnosis in the infant]

32 babies aged under three months underwent emergency echocardiography before further investigation and treatment. The diagnosis was made in 30 cases, a significant improvement on clinical examination alone. The echocardiographic analysis was concentrated on:--the interventricular septum,--septo-aortic continuity,--mitro-aortic continuity,--the position of the aorta,--the dimensions of the aorta, from which the size of the pulmonary artery could be deduced in cases of VSD with pulmonary obstruction. This analysis is completed by a study of the other cardiac structures, to give a rapid and reliable diagnosis. Additional essential information on the afferent and efferent cardiac arteries and veins is obtained by angiography. Echocardiography orientates the clinical diagnosis before catheterisation so increasing its value or, on the other hand, making it unnecessary (primary heart failure, Ebstein's anomaly, left ventricular hypoplasia). The ultrasonic examination orientates and limits the indications of angiography, so decreasing the risk of this procedure, and assuring the optimal conditons for the initiation of treatment.

Cutaneous and renal geotrichosis in a giant tortoise (Geochelone elephantopus)

A case of cutaneous and renal geotrichosis in a giant tortoise, Geochelone elephantopus, at the Zoological Park of Barcelona is reported. Fungal hyphae and spores were seen in skin and kidney. Culture of these tissues yielded Geotrichum candidum. This fungus was isolated from the faeces of 5 other giant tortoises that were housed with the dead animal and from specimens of corn hydroponic culture which is part of their diet. Arthrospore suspensions of the 2 strains isolated from the dead animal's skin and kidney were experimentally inoculated into mice and turtles (Testudo horsfiedi) in order to determine the pathogenicity of G. candidum for animal tissues. Our results confirm its low pathogenicity.

In vivo immunomodulating properties of two synthetic agents: azimexon and tuftsin

Mice were submitted to various immunologic tests at different times after a single intravenous (IV) injection of azimexon or tuftsin in order to determine the mode of action of these chemically defined immunomodulators. Azimexon, (BM 12,531) an aziridine derivative, potentiated antibody responses to both thymus-dependent (TNP-KLH) and thymus-independent (TNP-LPS) antigens and DTH reaction to oxazolone when injected at least 1 day before the antigen. It activated macrophages, rendering them cytostatic for tumor cells, but depressed ADCC activity of spleen cells directed against antibody-coated CRBC. Tuftsin, a basic tetrapeptide, potentiated antibody response to TNP-KLH when injected at least 3 days before the antigen. The response to TNP-LPS was stimulated on days 1 and 3, but was slightly depressed on day 7. It rendered macrophages highly cytostatic for tumor cells but, as observed with azimexon, the activation process required 7 days to develop. ADCC was enhanced throughout the period of observation.

Synthesis of analogs of the serum thymic nonapeptide, "facteur thymique serique" (FTS). Part I

Analogs of FTS (Facteur Thymique Sérique), less than :formula: (see text), a circulating thymic factor, were prepared by replacing the amino acid residues in positions 1, 2, 8 and 9, or by shortening the nonapeptide chain at the N- or C-terminal end. These peptides were synthesized by two different schemes using the conventional synthesis in solution.

Side reactions in peptide synthesis. X. Prevention of O-acylation during coupling with active esters

Acylation of the hydroxyl groups in the side chains of serine, threonine or tyrosine occurs in coupling with active esters. This side reaction, which is quite pronounced in histidine-containing peptides, can be prevented with additives. From a series of compounds tested, 2,4-dinitrophenol and pentachlorophenol were the most effective.

Determination of the minimal inhibitory concentration of amphotericin B and miconazole for 21 strains of Aspergillus

The susceptibility of 21 strains of Aspergillus (11 of A. fumigatus, 8 of A, niger, and 2 of A. flavus) isolated from human pathologic specimens to Amphotericin B and Miconazole has been comparatively studied. Determination of the minimal inhibitory concentration of both drugs in a liquid medium showed a noticeably variability for the different strains. The values obtained for Amphotericin B varied between 0.25 microgram/ml (2 strains) and 1.25 microgram/ml (5 strains) after 48 hours, and between 1,25 microgram/ml (1 strain) and 50 microgram/ml (1 strain) after 10 days. For Miconazole the results varied between 0.1 microgram/ml (1 strain) and 25 microgram/ml (1 strain) after 48 hours of incubation, and between 0.5 microgram/ml (5 strains) and greater than 100 microgram/ml after 10 days. The variability of these results indicates the usefulness of carrying our in vitro sensitivity studies whenever it is possible.

Cholecystokinin (pancreozymin). 4. Synthesis and properties of a biologically active analogue of the C-terminal heptapeptide with epsilon-hydroxynorleucine sulfate replacing tyrosine sulfate

The influence of tyrosine O-sulfate, the 27th residue in the sequence of cholecystokinin (pancreozymin) (CCK-PZ), on the contraction of gall bladder of guinea pigs and on the release of amylase in isolated pancreatic cells of the same animal was studied with an analogue of the biologically active C-terminal heptapeptide, CCK-PZ-(27--33). In the new analogue, tyrosine O-sulfate was replaced by epsilon-hydroxynorleucine O-sulfate. The synthetic peptide was found a full agonist in these tests, not quite as potent as the unaltered heptapeptide, but much more active than the previously prepared and studied serine O-sulfate containing analogue. Thus, the distance of the sulfate ester group from the peptide backbone has a major influence on the biological activity of CCK-PZ.

Study of a kindred with partial deficiency of red cell 2,3-diphosphoglycerate mutase (2,3-DPGM) and compensated hemolysis

A kindred with partial deficiency of red cell 2,3-diphosphoglycerate mutase (2,3-DPGM) was studied. The propositus presented with indirect hyperbilirubinemia, normal hemoglobin (15.8 g/dl), and elevated reticulocyte count (4.6%). The red cell 51Cr survival was decreased (tau1/2 16 days). Incubated osmotic fragility was normal; autohemolysis was increased and corrected with glucose and ATP. The P50 was 18.5 mm Hg (normal 25.5 +/- 3), but the stability, electrophoresis, and fingerprinting of hemoglobin were normal. The concentration of 2,3-diphosphoglycerate (2,3-DPG) was reduced to 43% of normal. Red cell 2,3-DPGM was decreased to 59% of normal; 2,3-DPG phosphatase was similarly decreased. All red cell glycolytic and hexose monophosphate shunt enzymes, glycolytic intermediates other than 2,3-DPG, and glucose consumption and lactate production were normal. Five family members showed similar hematologic findings. The deficiency appears to be secondary to decreased enzyme synthesis and to be inherited as an autosomal dominant trait in this family. Partial deficiency of 2,3-DPGM should now be considered in the differential diagnosis of compensated hemolysis associated with increased oxygen affinity.

The effects of ancrod, the coagulating enzyme from the venom of Malayan pit viper (A. rhodostoma) on prothrombin and fibrinogen metabolism and fibrinopeptide A release in man

The action of ancrod on fibrinogen and prothrombin metabolism was studied in six healthy individuals by the use of 131I-fibrinogen and 125I-prothrombin and by measurement of blood levels of fibrinopeptide A. Two untreated healthy controls were studied at the same time. Rapid defibrinogenation occurred during the initial 3 hr ancrod infusion, and fibrinogen levels were maintained near zero throughout the study. Large quantities of non-thrombin-clottable TCA-precipitable 131I material could be demonstrated in the circulation, reaching a maximum 3 to 6 hr after ancrod infusion and clearing with a half-life of 6 hr. Gel filtration of 6 hr plasmas demonstrated the presence of complexes larger than fibrinogen, as well as degradation products of fibrinogen-fibrin. Prothrombin concentration and metabolism were unchanged by ancrod treatment. Fibrinopeptide A levels in the ancrod group were greather than 4,000 ng/ml during the initial defibrinogenation, declined to greater than 80 ng/ml, and then increased to high levels after 3 days. These studies provide explanations of previous observations concerning the specificity of ancrod and demonstrate that rapid clotting of fibrinogen and dissolution of fibrin can occur in vivo without recruitment of the classic coagulation mechanism.

Abnormal sialic acid content of the dysfibrinogenemia associated with liver disease

To evaluate the possibility that the carbohydrate composition of fibrinogen may be altered in the dysfibrinogenemia associated with liver disease, we studied the sialic acid content of purified fibrinogen from 12 patients with liver disease and its relationship to the prolongation of the thrombin time. Purified fibrinogen showed that Aalpha-, Bbeta-, and gamma-chains when reduced and analyzed by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and exhibited prolongation of the thrombin time similar to that of the plasma from which it was derived. Sialic acid content of the purified fibrinogen ranged from 12.7 to 71.4% higher in patient fibrinogens when compared to normal controls. A progressive delay in thrombin time was associated with increasing sialic acid content of the patient fibrinogen. Enzymatic removal of sialic acid from four of the abnormal fibrinogens resulted in a shortening of their thrombin times to the range of the desialylated normal control. Periodic acid-Schiff reagent stained only the Bbeta- and gamma-chains of the reduced patient fibrinogens after sodium dodecyl sulfate-polyacrylamide gel electrophoresis suggesting that the excess sialic acid is located on these two chains. These studies demonstrate a biochemical alteration of the functionally abnormal fibrinogen found in some patients with liver disease, and indicate that the excess sialic acid plays an important role in the functional defect of this protein.

Reversibility of cerebral atrophy in anorexia nervosa and Cushing's syndrome

Two patients, one with malnutrition due to anorexia nervosa and one with Cushing's syndrome, showed evidence of cerebral atrophy by computed tomography (CT) of the brain. Several months after the original diagnosis of cerebral atrophy, follow-up CT studies demonstrated essentially total return to normality. It is postulated that the mechanism responsible for the described atrophic changes may be related to protein loss or fluid retention, or both. Correction of these metabolic abnormalities may be followed, as in the two cases reported here, by reversion of the CT findings to normality.

Dysfibrinogenemia associated with liver disease

To test the possibility that a functionally abnormal fibrinogen may exist in some patients with liver disease, we studied the plasma and purified fibrinogens of five patients whose plasma thrombin times were prolonged at least 40% over normal controls. In no patient was there evidence of disseminated intravascular coagulation and/or fibrinolysis. No abnormalities were detected by immunoelectrophoresis of plasmas or purified fibrinogens. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis of reduced patient fibrinogens showed normal mobility and amount of Aalpha, Bbeta, and gamma chains. Alkaline polyacrylamide gel electrophoresis and gradient elution, DEAE-cellulose chromatography of admixtures of radio-iodinated patient (125)I-fibrinogen and normal (131)I-fibrinogen showed identical mobility in the gel and simultaneous elution from the column, respectively. Thrombin and Reptilase (Abbott Scientific Products Div., Abbott Laboratories, South Pasadena, Calif.) times of purified patient fibrinogens were prolonged, and calcium ions improved but did not completely correct these defects. Increasing amounts of thrombin progressively shortened the clotting times of patient fibrinogens but not to the level of normal. Addition of equal amounts of patient fibrinogen to normal fibrinogen resulted in a prolongation of the thrombin time of the normal protein. Thrombin-induced fibrinopeptide release was normal. Fibrin monomers prepared from patient plasmas and purified fibrinogens demonstrated impaired aggregation at low (0.12) and high (0.24) ionic strength. These studies demonstrate that some patients with liver disease and prolonged plasma thrombin times have a dysfibrinogenemia functionally characterized by an abnormality of fibrin monomer polymerization.

Immobilised monomers of human liver arginase

Human liver arginase (L-arginine amidinohydrolase, EC 3.5.3.1) was immobilised by attachment to nylon with glutaraldehyde as a crosslinking agent. Incubation of the immobilised tetrameric enzyme with EDTA followed by dialysis resulted in the dissociation of the enzyme into inactive matrix-bound and solubilised subunits. Both species recovered enzymatic activity after incubation with Mn2+, and the activity of the reactivated matrix-bound subunits was nearly 25% of that shown by the enzyme initially attached to the support in the tetrameric form. When the reactivated bound subunits were incubated with soluble subunits in the presence of Mn2+, they 'picked-up' from the solution an amount of protein and enzymatic activity almost identical to that initially lost by the immobilised tetramer after the dissociating treatment with EDTA. This occurred only in the presence of Mn2+. It is suggested that the reactivation of the subunits of arginase involves the initial formation of an active monomer, which then acquires a conformation that favours a reassociation to the tetrameric state.

Functional and metabolic properties of human asialofibrinogen

The role of sialic acid in the functional and metabolic properties of purified human fibrinogen was investigated. Fibrinogen treated with Vibrio cholerae neuraminidase released 90 percent of its sialic acid without evidence of proteolysis, as indicated by the presence of intace A alpha, B beta, and gamma chains on sodium dodecylsulfate (SDS)-polyacrylamide gels of the reduced asialoprotein. The thrombin and Reptilase clotting times of human asialofibrinogen were shortened compared to those of normal fibrinogen. Fibrinopeptide release was normal in rate and amount, but asialofibrin monomer aggregation was increased at both low and high ionic strength. Similarly, the asialo-derivative of fibrinogen Philadelphia (functionally characterized by impairment of fibrin monomer aggregation) demonstrated shortening of its thrombin and Reptilase times and improvement in its monomer aggregation especially at high ionic strength. Asialofibrin showed a normal capacity to form cross-linked fibrin as demonstrated by normal gamma-chain dimerization and alpha-chain polymerization. Simultaneous metabolic studies of human normal fibrinogen and asialofibrinogen in rabbits revealed only a modest decrease in the half-life of the asialoprotein compared to the intact protein, with no preferential uptake of the asialo-derivative by the liver. Control studies with rabbit normal fibrinogen and asialofibrinogen in rabbits revealed the same modest difference in half-life. Thus, asialofibrinogen clots faster due to enhancement of its monomer aggregation, has a normal capacity to form cross-linked fibrin, and does not differ significantly in its metabolic properties from normal fibrinogen. The possible influence of sialic acid in the functional abnormality of some congenital dysfibrinogenemias is discussed.

Fluid-percussion model of mechanical brain injury in the cat

Mechanical brain injury was produced in 36 cats with a fluid-percussion model in which brain damage or dysfunction is produced by a single, brief, hydraulically-induced pressure transient that is conducted through the brain. Fluid-percussion injury induce elastic deformation of the brain resembling the brain deformation known to occur following head impact. Physiological responses and pahtological changes following injury were expressed as a function of peak pressure. Macroscopic central nervous system lesions concentrated at the pontomesencephalic junction, cervicomedullary junction, and in the cerebellar tonsils were consistently observed at and above 2.6 atmospheres (atm). At higher levels of injury (greater than or equal to 3.2 atm) there was extensive basal subarachnoid hemorrhage. At very high levels of injury (greater than 4.0 atm) hemorrhagic contusions were noted at the cerebral hemisphere impact site. A spectrum of neuronal alterations was identified in the damaged areas. Computer analysis showed correlation of electroencephalographic (EEG) changes with the neuropathological changes, since EEG recovery became severely impaired above 2.6 atm. No EEG changes were noted below 1.5 atm. From 1.5 to 2.2 atm there was a physiological response to injury but no significant changes were seen on neuropathological examination. This range of injury should permit further studies of the more subtle changes following mechanical brain injury without intraparenchymal hemorrhage or subarachnoid hemorrhage. The fluid-percussion model relates brain deformation following mechanical loading to a single pressure transient that is easily measured and controlled. Further quantitative investigation into the pathobiology of mechanical brain injury following graded brain deformation is thus made possible.

[Lengthening of the peptide chain at the C-terminal end of a glycosylamino acid]

An O-glycodipeptide was synthesized by lengthening the peptide chain on the C-terminal side of a glycosylamino acid unit. N-(Benzyloxycarbonyl)-3-O-(2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl)-L-threonine o-nitrophenyl ester and pentachlorophenyl ester were condensed with glycine benzyl ester to give both the same glycodipeptide, [N-(benzyloxycarbonyl)-3-O-(2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl)-L-threonyl]glycine benzyl ester (9). The two anomers, N-(benzyloxycarbonyl)-3-O-(2,3,4,6-tetra-O-acetyl-alpha- and beta-D-glucopyranosyl)-L-threonine pentachlorophenyl ester were also prepared. 1H-N.m.r. studies ascertained the structure and anomeric configuration expected.

Immunosuppressive therapy of Factor VIII inhibitors

Immunosuppressive therapy was used in seven hemophiliac and three nonhemophiliac patients with factor VIII inhibiors. Permanent disappearance of the inhibitor occurred in three hemophiliac and two nonhemophiliac patients following treatment with cyclophosphamide and factor VIII. Critical factors influencing the response to therapy may include both the titer and duration of the inhibitor and the degree of intervening factor VIII exposure prior to immunosuppressive therapy. Two severe hemophiliacs with low titer inhibitors that disappeared without specific therapy are also reported.

[Interpretation of the right bundle-branch block appearing after repair of ventricular septal defect]

Based on a study of 43 cases the authors attempt to assess the exact aetiology of the appearance of right bundle branch block, which is seen very frequently after repair of a ventricular septal defect. A comparison of the electrocardiograms with the anatomical type of VSD, the surgical approach, and the size of the septal defect would seem to indicate that a monofascicular block by a lesion of the right branch of the bundle of His is responsible. The correlations are not, however, absolute, and in a certain number of cases a simple peripheral lesion was to blame. The importance of precise knowledge of the case of the branch is that it is possible that first a bi- and then a tri-fasicular block will develop; this means that complete atrioventricular block is one of the long-term sequelae of surgery. In the authors' experience of 43 cases, only one tri-fascicular block developed.

The influence of donor characteristics and preparation methods on the potency of human cryoprecipitate

An investigation of the influence of donor characteristics and preparative procedural variation on the potency of human cryoprecipitate was carried out on 30 whole blood and 139 plasmapheresis donors. Recovery of plasma Factor VIII in cryoprecipitate ranged from 11.2 to 89.4 per cent (average, 38 +/- 18%). The Factor VIII content of bags of cryoprecipitate ranged from 29 to 379 units (average, 111 +/- 77 units). No difference existed between whole blood donors and regular plasmapheresis donors. The only donor characteristic which was related to the potency of cryoprecipitate was the plasma concentration of Factor VIII which varied as much as sixfold on repeated visits of the same donor. The findings indicate that, within the limitations imposed by the regulations of the American Association of Blood Banks and the practicalities of an ordinary blood bank workload, no donor characteristic or variation in preparative procedures was of predictive value in obtaining cryoprecipitate of high potency. The potency of cryoprecipitate from individual donors appears to be related to factors inherent in the donor plasma itself.

[Abnormal origin of 1 of 2 pulmonary arteries from the ascending aorta]

In relation with 4 cases of anomalous branching of one pulmonary artery from the ascending aorta, the main clinical, angiographic, physiopathologic, therapeutic and embryologic features of this malformation were reviewed. It appeared that the natural history of this malformation is a severe one, and only a corrective surgical treatment is liable to secure survival and cure. This anomaly was also encountered, very rarely, in Fallot's tetralogy, and two cases of this combination were reported.

Fibrinogen Philadelphia. A hereditary hypodysfibrinogenemia characterized by fibrinogen hypercatabolism

A new, autosomally inherited abnormal fibrinogen associated with hypofibrinogenemia has been described in several members of a family. Plasma fibrinogen measured either as thrombin-clottable protein or by immunodiffusion revealed a fibrinogen level ranging between 60 and 90 mg/100 ml. The thrombin time of plasma or purified fibrinogen was prolonged and only partially corrected by the addition of calcium. Purified fibrinogen prolonged the thrombin time of normal plasma. Fibrinopeptide release by thrombin was normal in rate and amount, but fibrin monomer aggregation was grossly disturbed, especially in a high ionic strength medium. We have designated this fibrinogen "fibrinogen Philadelphia." Acrylamide gel electrophoresis of mixtures of [121I]normal and [125I]abnormal fibrinogens revealed a slight increase in the anodal mobility of fibrinogen Philadelphia. Similarly, DEAE-cellulose chromatography showed slightly stronger binding of fibrinogen Philadelphia than normal. To elucidate the mechanism responsible for the low plasma fibrinogen concentration, simultaneous metabolic studies of autologous (patient) and homologous (normal) fibrinogen, labeled with 125I and 121I, respectively, were performed in two affected subjects. Autologous fibrinogen half-life was short and the fractional catabolic rate was markedly increased in both family members. In contrast, homologous fibrinogen half-life and fractional catabolic rate were normal. These metabolic studies demonstrate that rapid degradation of fibrinogen Philadelphia is largely responsible for the depressed levels of a plasma fibrinogen. This represents the first example of a mutant plasma protein in which the molecular defect is associated with an altered catabolism.