Muscle injury in organophosphorous poisoning and its role in the development of intermediate syndrome

Muscle injury and its role in the development of Type II paralysis was studied in 25 patients with acute organophosphate poisoning. All patients were assessed for severity of poisoning at admission and through the course of poisoning for the development and duration of intermediate syndrome (IS) (Type II paralysis). Blood levels of acetylcholinesterase, creatine kinase, creatine kinase MM, LDH and LDH5 were estimated through the course of the poisoning. Of the 25 patients, 22 were severely poisoned and 3 had mild to moderate poisoning. Severely poisoned patients had a significantly greater rate of developing intermediate syndrome (17/22) (P = 0.026). Type I paralysis and fasciculations occurred in 76 and 70.5% of patients who developed intermediate syndrome, in comparison to 38 and 50%, respectively, of those who did not develop intermediate syndrome. Weakness developed in the same groups of muscles in both Types I and II paralysis but was of longer duration in patients who developed Type II paralysis. Acetylcholinesterase was inhibited > 90% throughout the course of poisoning with greater inhibition in patients with longer duration intermediate syndrome. Muscle injury was seen in all patients beginning at admission, peaking over the first 5 days and then declining over the next 5 days. Temporal profiles of blood muscle isoenzymes showed significantly greater muscle injury in those patients with greater severity of poisoning at admission, those who developed intermediate syndrome and in patients with longer duration intermediate syndrome. The findings of this study suggest that Types I and II paralysis in organophosphate poisoning are not separate syndromes but a clinical continuum determined by the severity of poisoning. The magnitude of organophosphate exposure and of muscle injury during the cholinergic crises appears to determine the occurrence and severity of intermediate syndrome.

Rat brain membrane-bound delta opioid receptor: loss and reactivation of binding on dialysis and aging at low temperature

A change in the environment of rat brain membranes by dialysis from phosphate buffered saline (PBS) to 10 mM potassium phosphate (pH 7.2) led to a 35% loss in delta opioid receptor binding, while alteration of membrane structure on freezing at -20 degrees C for 55 days led to 85% loss of receptor binding. The dialysate, 200 mM KCI and NaCl restored receptor binding lost on dialysis. This K+ and Na+ restabilization of the receptor can be through cation-pi bonding, interactions that are suited to the lipid bilayer. In membranes stored at -20 degrees C, the loss of binding is attributed to increased membrane fluidity by phospholipase A2 action on membrane phospholipids, resulting in an increase of free fatty acids. K+ but not Na+ restabilization of these membrane receptors may be due to the ability of K+ to decrease membrane fluidity.

Neuroparalysis and oxime efficacy in organophosphate poisoning: a study of butyrylcholinesterase

The temporal profile of butyrylcholinesterase (BuChE) and in vitro pralidoxime-reactivated BuChE was studied in a cohort of 25 organophosphate-poisoned patients to examine their relationship to the development of intermediate syndrome and to understand reasons for lack of efficacy of oxime treatment. The clinical severity of poisoning (assessed by the Namba Scale) correlated significantly with the severity of intermediate syndrome. BuChE activity increased significantly over time and showed significant relationship to muscle power. The temporal profile of the enzyme was correlated to the clinical severity of poisoning. Reactivation potentials of BuChE (the difference between oxime-reactivated and -unreactivated enzyme activity) declined significantly with time after organophosphate ingestion. The reactivation potential of the enzyme at admission decreased significantly with increasing severity of poisoning and was lower in patients who developed intermediate syndrome. Patients who received oxime prior to hospitalization had a higher rate of intermediate syndrome and lower levels of BuChE at admission than those who had not. The study suggests that (i) BuChE reflects the clinical course of poisoning, confirming earlier studies; (ii) intermediate syndrome may be associated with a persistent inhibition of BuChE; and (iii) the lack of oxime efficacy in our patients maybe due to their severity of poisoning and the timing of oxime treatment.

Utility of the cysticercus immunoblot in a patient with an atypical solitary cerebral cysticercus granuloma

The value of the enzyme linked immunotransfer blot (EITB) assay in avoiding an invasive diagnostic procedure in a patient with an atypical solitary cerebral cysticercus granuloma is presented.

A molecular weight study of adenosine deaminase

Adenosine deaminase exists in its smallest molecular form (ADA-S) of < 42 kDa in primate and rodent brain, intestine and liver, human erythrocytes, avian liver and in bovine spleen and intestine. The enzyme exhibits molecular heterogeneity in monkey and chicken liver and human erythrocytes. The large form of adenosine deaminase is seen in monkey liver and intermediary forms of the enzyme in chicken liver and human erythrocytes. Large forms of the enzyme predominate in rabbit intestine. Molecular weights of adenosine deaminase molecular forms were determined by gel filtration and by non denaturing gel electrophoresis with construction of Ferguson plots. Anomalous migration of the enzyme on SDS-PAGE possibly due to charge, disulfide bonds and proline content, did not allow for molecular weight determination on denaturing gels.

A study of the normal position of auricle in neonates

The term "low-set ears" has been in common use for several decades to describe various malformation syndromes. But an accurate description of the normal position of the auricles is lacking in relevant literature. This study was designed to determine the normal position of auricles using bony landmarks that are less variable. The normal position of the auricle was determined in 1,000 neonates without any obvious congenital anomalies. A fixed bony point (point z) on the upper border of the posterior part of the zygomatic process of the temporal bone opposite the condyle of the mandible was selected. This point lies in front of the auricle and is easily palpable in neonates. The distance between point z and the upper and lower attachments of the auricle were measured as well as the distance between point z and the upper and lower poles of the auricle. The results were compared between the two sexes and between right and left sides. There was a wide variation in the distances measured in normal neonates. This highlights the importance of redefining the term "low-set ears."

Molecular forms of adenosine deaminase do not aid the diagnosis of tuberculosis

To investigate the diagnostic utility of adenosine deaminase as a test for tuberculosis, molecular forms of the enzyme indicative of cell-mediated immunity were studied in tuberculosis pleural effusion, peritonitis and meningitis. Twenty-six pleural, 21 peritoneal, and 24 cerebrospinal tuberculous and non-tuberculous fluids were examined for adenosine deaminase and the large and small forms of the enzyme were differentiated on immunoblots. Adenosine deaminase levels ranged from zero to 81 units/L, zero to 31 units/L and zero to 31 units/L in the pleural, peritoneal and cerebrospinal fluids, respectively. The large form of adenosine deaminase (280 kDa) was detected in one of 14 proved tuberculous cases, a peritoneal fluid. The small form of the enzyme (35-39 kDa) was seen in both tuberculous and non-tuberculous conditions in 6 pleural, 7 peritoneal and 8 cerebrospinal fluids. Molecular forms of adenosine deaminase did not appear to help in the diagnosis of tuberculosis in this patient population and may not be suited for analysis in fluids with low enzyme activity.

A molecular weight study of the rat brain delta opioid receptor

The molecular weight of the rat brain delta opioid receptor, studied with antiidiotypic antibodies to anti-leucine enkephalin that mimic leucine enkephalin in binding to the receptor, was examined by molecular sieving and Western Blots under nondenaturing, denaturing and reducing conditions. The receptor appeared to be 55-65 kDa, which on solubilization may exist in equilibrium with receptor oligomers of 130-150 kDa and aggregates of > 200 kDa. These forms may also represent aggregation due to solubilization. A 38-43 kDa molecule was considered a minor form of the receptor in the brain.

Ontogeny, glycosylation and modulation by dialysis, sodium and nucleotides of the rat brain delta opioid receptor studied with anti-idiotypic antibodies to anti-leucine enkephalin

Ontogeny of the rat brain delta opioid receptor in 1-60 days old animals has been studied with anti-idiotypic antibodies to anti-leucine enkephalin. It is found that delta opioid receptors are present in rats from birth and attain adult levels by 28 days and these receptors are glycosylated and inhibited by Na+, GTP, ATP and CTP at all ages. Adult membrane-bound and solubilized delta opioid receptors are inhibited to similar extents by Na+ (100 mM), GTP, ATP and CTP (50 microM). Dialysis of the adult membrane-bound receptor led to 81% loss in binding which was restored by 100 mM Na+, 50 microM GTP, ATP and CTP to 77, 72, 87 and 94% respectively and by 100 mM NH4+, Mg2+, Ca2+ and Mn2+ to 63, 43, 57 and 73% respectively. Dialysis of the solubilized receptor resulted in 23% loss in binding with Na+ (100 mM), GTP and ATP (50 microM) inhibiting receptor binding to 46, 62 and 54% respectively, while CTP (50 microM) restored binding to 88%. These studies indicate that the delta opioid receptor can be probed with anti-idiotypic antibodies to anti-leucine enkephalin, that functional, glycosylated receptors are present at birth in rats and that the adult membrane-bound and solubilized receptors are modulated differently by dialysis.

Immunohistochemical mapping of rat brain delta opioid receptor

Delta opioid receptors were immunohistochemically mapped in the rat brain with anti-idiotypic antibodies to anti-leucine enkephalin specific for the receptor. Regions of highest receptor binding were in the cerebral cortex and caudate putamen Lower receptor binding was mapped to the hypothalamus and claustrum.

The elicitor-inducible alfalfa isoflavone reductase promoter confers different patterns of developmental expression in homologous and heterologous transgenic plants

In legumes, the synthesis of infection- and elicitor-inducible antimicrobial phytoalexins occurs via the isoflavonoid branch of the phenylpropanoid pathway. To study transcriptional regulation of isoflavonoid pathway-specific genes, we have isolated the gene encoding isoflavone reductase (IFR), which is the enzyme that catalyzes the penultimate step in the synthesis of the phytoalexin medicarpin in alfalfa. Chimeric gene fusions were constructed between 765- and 436-bp promoter fragments of the IFR gene and the beta-glucuronidase reporter gene and transferred to alfalfa and tobacco by Agrobacterium-mediated transformation. Both promoter fragments conferred elicitor-mediated expression in cell suspension cultures derived from transgenic plants of both species and fungal infection-mediated expression in leaves of transgenic alfalfa. Developmental expression directed by both promoter fragments in transgenic alfalfa was observed only in the root meristem, cortex, and nodules, which is consistent with the accumulation of endogenous IFR transcripts. However, in transgenic tobacco, expression from the 765-bp promoter was observed in vegetative tissues (root meristem and cortex, inner vascular tissue of stems and petioles, leaf tips, and stem peripheries adjacent to petioles) and in reproductive tissues (stigma, placenta, base of the ovary, receptacle, seed, tapetal layer, and pollen grains), whereas the 436-bp promoter was expressed only in fruits, seed, and pollen. These data indicate that infection/elicitor inducibility of the IFR promoter in both species and developmental expression in alfalfa are determined by sequences downstream of position -436, whereas sequences between -436 and -765 confer a complex pattern of strong ectopic developmental expression in the heterologous species that lacks the isoflavonoid pathway.

The rat brain delta opioid receptor studied with anti-idiotypic antibodies to anti-leucine enkephalin

Anti-idiotypic antibodies to anti-leucine enkephalin raised in rabbits immunized with leucine enkephalin conjugated to BSA, were purified and characterized for their ability to mimic leucine enkephalin in binding to the rat brain delta opioid receptor. An ELISA was standardized to assay the delta opioid receptor using these antibodies. The rat brain receptor was purified to 308 fold with a yield of 1.5% using these antibodies for assay. The receptor, probed with these anti-idiotypic antibodies, was characterized with respect to binding parameters, molecular weight and effect of divalent cations.

Poor diagnostic value of adenosine deaminase in pleural, peritoneal & cerebrospinal fluids in tuberculosis

Adenosine deaminase (ADA) was estimated in 84 pleural, 140 peritoneal and 136 cerebrospinal fluids to study its diagnostic usefulness as a routine test for tuberculosis. The sensitivity, specificity, positive and negative predictive values for diagnosing tuberculosis in pleural fluids (ADA > 30 U/l) was 67, 92, 78 and 87 per cent respectively, in peritoneal fluids (ADA > 15 U/1) it was 89, 81, 25 and 99 per cent respectively and in cerebrospinal fluids (ADA > 10 U/l) it was 50, 90 21 and 97 per cent respectively. The differences in mean ADA levels between tuberculous (28.0 and 19.5 U/1) and non-tuberculous (9.7 and 4.8 U/1) peritoneal and cerebrospinal fluids although statistically significant (P < 0.001), were of no practical clinical value. A wide scatter in ADA values was seen in both tuberculous and non-tuberculous fluids. ADA estimation in plasma, lymphocytes and cell fractions of fluids was also not diagnostically useful nor did it throw light on the source of elevated ADA in fluids.

Cleavage specificity of chloroplast and nuclear tRNA 3'-processing nucleases

tRNAs in eukaryotic nuclei and organelles are synthesized as precursors lacking the 3'-terminal CCA sequence and possessing 5' (leader) and 3' (trailer) extensions. Nucleolytic cleavage of the 3' trailer and addition of CCA are therefore required for formation of functional tRNA 3' termini. Many chloroplast tRNA genes encode a C at position 74 which is not removed during processing but which can be incorporated as the first base of the CCAOH terminus. Sequences downstream of nucleotide 74, however, are always removed. Synthetic yeast pre-tRNA(Phe) substrates containing the complete CCA74-76 sequence were processed with crude or partially purified chloroplast enzyme fractions. The 3'-extended substrates (tRNA-CCA-trailer) were cleaved exclusively between nucleotides 74 and 75 to give tRNA-COH, whereas a 3'-mature transcript (tRNA-CCAOH) was not cleaved at all. A 5'-, 3'-extended chloroplast tRNA-CAG-trailer was also processed entirely to tRNA-COH. Furthermore, a 5'-mature, 3'-extended yeast pre-tRNA(Phe) derivative, tRNA-ACA-trailer, in which C74 was replaced by A, was cleaved precisely after A74. In contrast, we found that a partially purified enzyme fraction (a nuclear/cytoplasmic activity) from wheat embryo cleaved the 3'-extended yeast tRNA(Phe) precursors between nucleotides 73 and 74 to give tRNA(OH). This specificity is consistent with that of all previously characterized nuclear enzyme preparations. We conclude that (i) chloroplast tRNA 3'-processing endonuclease cleaves after nucleotide 74 regardless of the nature of the surrounding sequences; (ii) this specificity differs from that of the plant nuclear/cytoplasmic processing nuclease, which cleaves after base 73; and (iii) since 3'-mature tRNA is not a substrate for either activity, these 3' nucleases must require substrates possessing a 3'-terminal extension that extends past nucleotide 76. This substrate specificity may prevent mature tRNA from counterproductive cleavage by the 3' processing system.

N-acetyl-beta-D-glucosaminidase in the localisation of urinary tract infection in patients with spinal cord injury

This study evaluates the pattern of urinary N-acetyl-beta-D-glucosaminidase (NAG) isoenzyme excretion in patients with spinal cord injury (SCI) and its use as a diagnostic tool in localising the site of urinary tract infection (UTI). NAG-B excretion in 27 control SCI patients (mean 207.78 units) was significantly higher than in 10 normal controls (mean 12.6 units) p less than 0.001). The relative isoenzyme distribution as represented by NAG-B/Total NAG percentage is however similar in both groups, 24.27 and 20.38% respectively. NAG-B excretion in 6 SCI patients with upper UTI was not significantly higher than in 12 SCI patients with lower UTI. NAG-B/Total NAG percentage was significantly different between these two groups (35.3% and 24.98% respectively, p less than 0.05). There was no significant difference in NAG-B excretion or NAG-B/Total NAG percentage between control SCI patients and those with lower UTI. The results indicate that there is a non-selective increase in urinary NAG excretion in control SCI patients and those with lower UTI. In SCI patients with upper urinary UTI there is a selective increase in NAG-B excretion. The overlap in enzyme values between the different groups suggests that the test may not be clinically useful in localising the site of UTI.

Single-step labeling of DNA using restriction endonucleases and T4 polynucleotide kinase

DNA restriction fragments can be end-labeled in a combined digestion and labeling reaction with restriction endonuclease plus T4 polynucleotide kinase, omitting a dephosphorylation step. Both pBR322 and phage lambda DNA digests are efficiently labeled in one step, one tube and one incubation.

Blood-brain-barrier and intrathecal immunoglobulin changes in tuberculous meningitis and demyelinating disorders: a preliminary report from a south Indian hospital

Sixty-three paired serum and CSF samples (15 controls and 48 patients) were studied for CSF albumin quotient, IgG index and synthesis rate. Control values for albumin quotient and IgG index were less than 10.0 and less than 0.6 respectively. IgG synthesis rate/day was calculated according to the Tourtellotte formula and a value of greater than 3.0 mg/day is considered high. Our findings in patients with central demyelinations, subacute sclerosing panencephalitis, Guillain Barré Syndrome and cerebrovascular accidents are comparable to earlier studies. Fifteen tuberculous meningitis patients were studied and could be separated into 2 groups, 9 with elevated albumin quotients and 6 with normal albumin quotients. Three patients with elevated albumin quotients and 4 with normal albumin quotients showed increased intrathecal IgG synthesis.

ELISA using mycobacterial antigens as a diagnostic aid for tuberculous meningitis

An enzyme-linked immunosorbent assay (ELISA) was studied as a possible laboratory test to aid in the diagnosis of tuberculous meningitis (TBM) in an Indian population. The assay detected mycobacterial antibodies in the cerebrospinal fluid (CSF) of TBM patients. Three antigens, PPD, BCG and M. tuberculosis were tested for use in the assay and of these, M. tuberculosis was found to be the most suited. A sensitivity of 72% and specificity of 92% with M. tuberculosis as antigen was obtained for the ELISA under discussion. The system therefore does hold promise as a diagnostic laboratory test for TBM.

A monoclonal antibody recognizes an epitope common to an avian-specific nuclear antigen and to cytokeratins

X3, a monoclonal antibody of unusual specificity, is described. This antibody reacts with one or more cytokeratin polypeptides and also reacts with an avian (chicken, quail) nuclear antigen that appears to be present in all cell types (chicken) tested, although with variable staining pattern and intensity. This antigen is distinct from the cytokeratins but does have an epitope in common with this class of proteins. It disappears from the nucleus during the early stages of cell division and reappears during anaphase as a granular cytoplasmic structure. In late telophase the antigen is relocated in the nucleus. This antigen, which we have designated as avian-specific nuclear antigen ( AVNA ), is not associated with chromatin or ribonucleoproteins. From immunoblotting experiments on chicken fibroblast nuclei, AVNA is probably a complex composed of one or several polypeptides, one of which has a molecular weight of approximately 60 kD. The proteins were identified as nuclear matrix proteins rather than pore complex-lamina proteins by immunoblotting experiments on the purified nuclear matrix of chicken erythrocytes. The major polypeptide had a molecular weight of 60 kD and the minor polypeptide a molecular weight of 69 kD.

Characterization of chicken T cell growth factor

Chicken spleen and peripheral blood lymphocytes were tested for their ability to produce T cell growth factor (interleukin 2, IL 2) upon stimulation with phytohemaglutinin or concanavalin A (Con A). Using a qualitative microassay, peak activity was found in 24-h supernatants of mitogen-stimulated lymphocytes. These supernatants permitted continuous growth of chicken lymphocytes for several weeks and increased the Con A response of chicken thymocytes. A quantitative probit microassay was developed and used in the further studies when appropriate. Chicken IL2 binds specifically to thymocytes and activated T cells and its action upon T blast cells cannot be blocked by cyclosporin A. The molecular weights of the two biological active peaks found by gel filtration of the native IL2 preparation were in the range 19500-21500 and 9000-11500. A single polypeptide of molecular weight 13000 was found by gel electrophoresis under reducing conditions.

Monoclonal antibody which recognizes a common antigenic determinant on intermediate filament proteins, actin, and myosin

A monoclonal antibody is described which reacts with the intermediate filament proteins vimentin, desmin, keratins, actin, and myosin. This is the first report of an epitope common to intermediate filament proteins and myosin. X1, the wide-spectrum monoclonal antibody in question, was isolated in the course of screening monoclonal antibodies to chicken thymocytes. Cross-reactivities were investigated by immunofluorescence on various types of cultured cells and sectioned tissues, ELISA with a panel of purified antigens, immunoprecipitation, immunodot tests, and immunoblotting.