Increased excretion of lactate, glutarate, 3-hydroxyisovalerate and 3-methylglutaconate during clinical episodes of propionic acidemia

Metabolic changes dependent upon clinical conditions were studied in an eight-month-old girl with propionyl CoA carboxylase deficiency. Only methylcitric acid and 2-methyl-3-oxovaleric acid were detected in the urine of the patient under clinically favorable conditions. During episodes of clinical decompensation, she excreted increased amounts of all the metabolites associated with this disorder. Four acetyl CoA precursors increased during clinical episodes: glutaric acid, a catabolic intermediate of lysine; 3-hydroxyisovaleric acid and 3-methylglutaconic acid, catabolic intermediates of leucine; and lactic acid. This suggests that under clinically favorable conditions the patient has an altered propionate metabolism which proceeds via normal acetyl CoA metabolism with sufficient capacity for acetyl CoA plus propionyl CoA metabolism. When the production of propionyl CoA exceeds the metabolic capacity, however, the catabolism of potent ketogenic amino acids is effectively suppressed in order to reduce acetyl CoA production.

Analysis of organic acids in the hearts of patients with idiopathic cardiomyopathy by gas chromatography-mass spectrometry

Organic acids in the hearts of patients with idiopathic cardiomyopathy, obtained by biopsy, were studied using gas chromatography--mass spectrometry. The profiling of organic acids was compared among eight cases of hypertrophic cardiomyopathy, three cases of congestive cardiomyopathy, and nine cases of other heart diseases, which were regarded as controls. It was found that almost all organic acids, especially deoxyaldonic acids of 2-deoxytetronic acid, 2,3-dideoxypentonic acid, 3-deoxy-2-C-(hydroxymethyl)tetronic acid, 3-deoxyerythropentonic acid and 3-deoxy-2-C-(hydroxymethyl)erythropentonic acid, were accumulated in large amounts in the heart in congestive cardiomyopathy, while these acids were decreased in hypertrophic cardiomyopathy. It was therefore suggested that deoxyaldonic acid metabolism in the heart in congestive cardiomyopathy is quite different from that in hypertrophic cardiomyopathy.

Involvement of a tyrosyl residue in the interaction of peanut lectin with lactose

The role of a tyrosyl residue in the binding of Arachis hypogaea (peanut) agglutinin, AHA, to lactose has been studied using two techniques, titration of the phenolic hydroxyl group of the tyrosine residue and chemical modification of the tyrosine with iodine. More than three tyrosyl residues per mol of AHA were masked when AHA was titrated in the presence of lactose. Lactose also protected some tyrosyl residues of AHA from the modification with iodine. Upon interaction with lactose, AHA iodinated in the presence of lactose gave a UV-difference spectrum with similar peaks to those of native AHA, while AHA iodinated in the absence of lactose gave a spectrum without such peaks. Though not only native AHA but also iodinated AHA was completely adsorbed on a column of lactamyl-Sepharose 6B, equilibrium dialysis showed that the binding constant and the number of binding sites of native AHA and iodinated AHA with lactose were 4.3 x 10(3) and 3.0 x 10(3) M-1, and 3.2 and 1.8, respectively. These results suggest that about two of four sugar binding sites have tyrosyl residues which induce the UV-difference spectra upon binding with lactose, and that the iodination of these tyrosyl residues results in a decrease of the number of binding sites on AHA.

Changes of organic acids in rat heart muscle under ischemic-like conditions

Gas chromatographic--mass spectrometric analysis demonstrated the presence of organic acids such as lactic acid, glycolic acid, compounds related to the tricarboxylic acid cycle., fatty acids, and deoxyaldonic acids in rat heart muscle. The variation of these organic acids was examined over a range of time elapsed after decapitation. The results showed that lactic acid, glycolic acid and deoxyaldonic acids of 3-deoxy-2-C-(hydroxymethyl)-tetronic acid, 3-deoxyerythropentonic acid and 3-deoxy-2-C-(hydroxymethyl)erythropentonic acid increased until 4 min after decapitation, but then decreased from 6 min after decapitation. On the other hand, 2-deoxytetronic acid and dideoxypentonic acid markedly increased and unknown peaks appeared on the gas chromatogram from 6 min after decapitation.

Degradation of band-3 glycoprotein in vitro by a protease isolated from human erythrocyte membrane

The use of soybean-trypsin-inhibitor-Sepharose-4B to purify a protease present in human erythrocyte membranes is described. The fraction bound in the presence of calcium to the affinity absorbent is active on band-3 glycoprotein in a non-ionic detergent solution at neutral pH. Band-3 glycoprotein is degraded into components having the mobilities of the proteins of bands 4.5, 7 and of lower molecular weights. When calcium is omitted from the membrane extract, an inactive form of this enzyme can be purified. By DEAE-cellulose chromatography this inactive form can be converted into the active form, presumably by dissociation of an enzyme-inhibitor complex.

Increased excretion of four acetyl-CoA precursors during clinical episode of propionic acidaemia

Propionic acidaemia (McKusick 23200) is caused by reduced activity of propionyl-CoA carboxylase (EC 6.4.1.3). A number of metabolites characteristic of this disease are excreted in patients' urine. We have developed a method of chemical diagnosis using gas chromatography-mass spectrometry (GC-MS). Since our first chemical diagnosis (Matsumoto et al., 1978), we have diagnosed seven patients. Profiles of urinary acids, however, varied from patient to patient. Factors affecting these profiles may be genetic make-up, age, or the patient's clinical and nutritional conditions. We have compared two metabolic profiles of a girl under different clinical conditions and found increased excretion of acetyl-CoA precursors during clinical episodes.

Application of a gas chromatography mass spectrometry computer system for clinical diagnosis

Currently, one of the major clinical problems is diagnosis of inherited metabolic disorders in neonates which are caused by a defect of specific enzymes. In order to diagnose such diseases at an earlier stage, we have developed a new mass screening method, consisting of a gas chromatography mass spectrometry computer system with a newly developed 'Diagnosis Computer Program'. In this program, the chromatographic pattern of the urine of a patient with an inherited metabolic disorder is compared with that of a normal person. Internal standards are applied to simplify the comparison. The total ion current chromatogram is drawn with the relative retention times plotted on the horizontal axis and the relative intensities on the vertical axis. Diseases are diagnosed by characteristics and quantity of abnormal compounds in the urine. Reference to the stored mass spectra of abnormal compounds by a library search enables the diagnosis to be more precise. Using this program, twenty-six inherited metabolic disorders are routinely diagnosed. The diagnosis of tyrosinosis is used here as an example.

Structural requirements for the binding of oligosaccharides and glycopeptides to immobilized wheat germ agglutinin

The structural requirements for the interaction of asparagine-linked oligosaccharide moieties of glycoproteins with wheat germ agglutinin (WGA) were investigated by using affinity chromatography on a WGA-Sepharose column. So-called hybrid-type glycopeptides obtained from ovalbumin [Yamashita, K., Tachibana, Y., & Kobata, A. (1978) J. Biol. Chem. 253, 3862--3869] were found to have high affinity for WGA--Sepharose, whereas high mannose-type and complex-type glycopeptides were shown to have low affinity. The elution profiles of various glycopeptides modified by glycosidase treatment, Smith periodate degradation, acetolysis, and hydrazinolysis showed that the GlcNAcbeta 1--4Manbeta 1--4GlcNAc beta 1--4GlcNAc-Asn structure was essential for the binding of glycopeptides to a WGA-Sepharose column. Thus, it was revealed that both the N,N'-diacetylchitobiose moiety and the beta-N-acetylglucosaminyl residue linked to C-4 of the beta-linked mannose residue contributed to the interaction of the glycopeptide with WGA-Sepharose. The substitution at C-6 of the innermost beta-N-acetylglucosaminyl residue by an alpha-fucosyl residue or at C-6 of the beta-linked mannose residue by another mannose residue in the above structure reduced the affinity of glycopeptides for the column.

Congenital cricoid stenosis

A case of congenital cricoid stenosis in a 9-year-old girl was reported. The stenosis was confirmed by direct laryngoscopy and laryngotracheograms performed through the tracheostoma. The excess cartilaginous tissue was removed under a midline incision of the cricoid cartilage (cricoidplasty). Seventeen cases of cricoid stenosis reported since 1960 were studied and the clinical entity was discussed. On the basis of the embryology of the larynx, the mechanism of origin of this malformation was also discussed. Although cricoid stenosis was a fatal malformation before 1968, it is now a curable disease using an emergency tracheostomy and a cricoidplasty.

Purification and characterization of a Cytisus-type Ulex europeus hemagglutinin II by affinity chromatography

Ulex europeus hemagglutinin II [Cytisus-type anti-H(O) hemagglutinin] inhibited most by di-N-acetylchitobiose has been purified by affinity chromatography on a column of chitobiose-Sepharose 4B, followed by gel filtration on Sephacryl S-300. The purified hemagglutinin was homogeneous by ultracentrifugal analysis and gave a single band by electrophoresis on polyacrylamide gel, and had a molecular weight of 105 000 by sedimentation equilibrium and an isoelectric point of pH 6.66. This hemagglutinin was found to be composed of four, apparently identical, subunits of a molecular weight of 25 000 +/- 2 000 by dodecyl sulphate-polyacrylamide gel electrophoresis, and to contain 10.3% carbohydrate in which mannose (3.7%) was the predominant sugar, with smaller amounts of glucose, glucosamine, xylose, fucose and galactose. Amino acid analysis of the purified hemagglutinin II showed a large amount of aspartic acid and serine, but as little as 0.1 mol/100 mol of cystine or methionine could be detected.

Interaction of sulfated glycosaminoglycans with lectins

The sulfated glycosaminoglycans, such as keratan sulfate and chitin sulfate having 3-hydroxy free N-acetyl-beta-D-glucosaminyl residues as constituents, reacted with wheat germ agglutinin and Solanum tuberosum agglutinin by sugar-specific interaction. The glycosaminoglycans showed different inhibitory activities to the hemagglutination reaction of these lectins and keratan sulfate and its modified products formed insoluble complexes with both of the lectins at pH 7.0 in physiological saline solutions (0.15 M NaCl). S. tuberosum agglutinin was precipitated within a particularly narrow concentration range of keratan sulfate, and the formation of a soluble complex was observed by gel chromatography. These interactions were specifically inhibited by N,N'-diacetylchitobiose but not by 2 M NaCl. The specific interactions of the glycosaminoglycans with S. tuberosum agglutinin were confirmed by their ultraviolet difference spectra with two peaks at 285 and 298 nm attributable to the tryptophan residues in the binding site of the agglutinin. It was also found that S. tuberosum agglutinin and wheat germ agglutinin have different binding specificities. The presence of sulfate groups in either keratan sulfate or chitin sulfate did not interfere with their specific interactions with S. tuberosum agglutinin as strongly as with wheat germ agglutinin. The N-acetylneuraminic acid residues in keratan sulfate were found to be receptor sites for wheat germ agglutinin but not for S. tuberosum agglutinin.

A new test of Eustachian tube function with otoadmittance meter: tubotympanometry

A new method for testing Eustachian tube function using an otoadmittance meter (Tubotympanometry) is reported. The otoadmittance meter is set for the aural reflex test, namely in the position of Y-T- recording. The patient is asked to carry out deep breathing. Valsalva's maneuvre, normal breathing, and swallowing in succession. In normal 40 ears, three types of the tubotympanogram were classified. In type A, observed in 32 ears, the graph shows no changes during deep breathing, a sudden downward deflection with Valsalva's maneuvre, a return to a level after the maneuvre and on repeated swallowing the graph returns to the initial level in stepwise. In type B, observed in 5 ears, the graph returns to the initial level directly after Valsalva's maneuvre without swallowing. This indicates a slightly patent tube, even though in the normal range. Type C was observed in 3 ears of patients who failed to perform Valsalva's maneuvre correctly. In the case of a patent tube, the graph shows a remarkable fluctuation synchronizing with inspiration and expiration. In the case of an occluded tube, the graph shows slower recovery after Valsalva's maneuvre and no complete return to the initial level even after repeated swallowing. In another case of occluded tube, the graph was deflected upward by Valsalva's maneuvre and showed no change on deglutition. The greatest advantage of this test is the simplicity of the equipment and of the test procedure.

Direct stimulatory effect of histamine on aldosterone secretion of the perfused dog adrenal gland

The left adrenal gland of the hypophysectomized-nephrectomized dog was perfused in situ with the blood from the femoral artery of the hypophysectomized-nephrectomized donor dog. After infusion of histamine (0.1 mg/min for 5 min) into the arterial inflow circuit, the rates of secretion of aldosterone, corticosterone and cortisol (ng/100 mg adrenal wt. each min) increased from the basal level of 0.66+/-0.21 (mean+/-S.E.M.) to 2.24+/-0.45 at 10 min, from 4+/-1 to 20+/-4 at 5 min and from 19+/-5 to 64+/-15 at 5 min, respectively. The maximal increments above the basal value after the infusion of histamine in the secretory rates of aldosterone, corticosterone and cortisol were 51, 16, and 13% that of the respective steroid after the infusion of ACTH (20mIU/min for 5 min). The results indicate that histamine has a direct stimulatory effect on the secretion of aldosterone by the adrenal gland as well as on that of corticosterone and cortisol.

Adrenal secretion of aldosterone in response to anaphylactic shock in hypophysectomized-nephrectomized dogs

The adrenal secretion of aldosterone in response to anaphylactic shock was examined in intact and hypophysectomized-nephrectomized dogs which had been sensitized by horse serum injections (s.c. and i.v.) 24-30 days before the experiment. On the day of the experiment, dogs were injected intravenously with horse serum under pentobarbital anesthesia. During anaphylactic shock induced by horse serum, the adrenal secretion of aldosterone in intact and hypophysectomized-nephrectomized dogs increased from 1.32 +/- 0.55 (mean +/- S.E.M.) to 8.43 +/- 1.99 ng/(kg.min) and from 0.23 +/- 0.10 to 2.38 +/- 0.63 ng/(kg.min), respectively. Plasma potassium concentration increased slightly and plasma sodium concentration did not change after the injection of horse serum in hypophysectomized-nephrectomized dogs. The results suggest the possibility that the adrenal secretion of aldosterone in response to anaphylactic shock in hypophysectomized-nephrectomized dogs is due mainly to a direct effect of histamine on the adrenal cortex or occurs via some unknown factors, and only in a small part to an increase in plasma potassium concentration. The adrenal secretion of corticosterone and cortisol during anaphylactic shock increased slightly but significantly in hypophysectomized-nephrectomized dogs, whereas it increased markedly in intact dogs.

Direct effect of histamine on the production of adrenocortical hormone by guinea-pig adrenal cells

In trypsin-dispersed adrenal cells of the guinea-pig, the production of 11-hydroxycorticosteroids in vitro was found to be significantly stimulated by 10(-7) -10(-4)M histamine and the maximum steroidogenic response (1.7-fold increase in 11-hydroxycorticosteroid production) was observed at 10(-6)M. The stimulatory action of histamine on steroidogenesis was blocked by cycloheximide treatment.