Omphaloplasty

Two different omphaloplasty procedures are presented. The first procedure, resulting in a four-point, star-shaped navel and indicated for patients with classic abdominoplasties, aims at preventing widening of the navel, as well as stenosis, later on, postoperatively. The second procedure, based on the rotation of the remaining navel and indicated for both patients with midi or mini abdominoplasties and patients with secondary omphaloplasty, also aims at preventing stenosis and widening of the umbilical scar; however, no external scars remain after this procedure.

Human red blood cells as bioreactors for the inactivation of harmful xenobiotics

Human red blood cells are able to inactivate lipophilic electrophiles by conjugation with reduced glutathione. This metabolic ability was found to be limited by the rate of permeation of the xenobiotic into erythrocytes and by the amount of available reduced glutathione. By a procedure of hypotonic dialysis, isotonic resealing and reannealing human red blood cells were overloaded with increasing amounts of reduced glutathione up to three- to fourfold the normal level without modification of their metabolic functions or of their energetic state. These overloaded erythrocytes were able to conjugate increasing amounts of xenobiotics and to export the resulting conjugates from the cells. These properties of glutathione overloaded erythrocytes are significant for the use of carrier erythrocytes in cases of acute intoxication by lipophilic electrophiles.

Cell age dependent decay of human erythrocytes glutathione S-transferase

Human red blood cells contain both glutathione S-transferase sigma (GST sigma) and glutathione S-transferase rho (GST rho). While the first isozyme does not change in red blood cell fractions of different mean density (age), GST rho, the main isozyme, shows a pronounced cell age dependent decay. Ion-exchange chromatographic experiments show that GST rho consists of only one isozymic form in young erythrocytes but is present in two components, with different electric charge, in mature and old cells. The "secondary" GST rho isozyme is more heat stable than the "primary" GST rho isozyme with the result that the total GST activity shows an apparent increase in heat stability during cell aging due to the formation of "secondary" isozymes. The kinetic properties and specificity of this enzyme do not show appreciable modifications during cell ageing. The data reported in this paper suggest that red blood cell aging is associated with a reduced detoxifying ability due to GST rho decay.

Purine nucleoside phosphorylase from human erythrocytes: a kinetic study of the fully separated isoenzymes

Human red cell lysates contain at least seven electrophoretically distinct isoenzymes of purine-nucleoside phosphorylase (PNPase); the proportion of more anodal bands increases as the erythrocyte ages, suggesting that the native enzyme is subjected to progressive post-translational modifications. The age dependent electrophoretic changes observed in the hemolysate are associated with the downward curvature of the Lineweaver-Burk double reciprocal plot at high inosine-substrate concentrations unlike the single-banded PNPase from tissue cultures of rapidly dividing cells. Thanks to the high resolution power of the ion-exchange HPLC technique utilized we have been able to fully separate all the seven isoenzymes and correlate structural to functional modifications in PNPase from human erythrocytes. Our results indicate that the downward curvature of Lineweaver-Burk plot is not due to a mixture of isoforms with low and high Km for inosine but that the allosteric activation by the inosine substrate is the direct consequence of structural modification(s) on the "primary" form of the enzyme.

[Neurocysticercosis in childhood. I. Clinical and laboratory diagnosis]

Clinical and laboratory findings among 34 children (age range from 15 months to 13 years) with neurocysticercosis were reviewed. The main symptoms were: intracranial hypertension, 21 cases (62%); epilepsy, 20 cases (59%); hemiplegia, 4 cases (12%). Computed tomography (CT) in 33 children showed typical brain active cysts in 26 patients (79%) and calcifications in 2 (6%). The complement fixation reaction or the indirect immunofluorescent test for cysticercus antibody were positive in CSF in 77% (20 out of 26 patients) and serum in 78% (18 out of 23 patients). CSF pleocytosis was found in 57% of the cases (15/26 patients) with eosinophil cells in 27% (7/26 patients). The most efficient diagnostic test was CT scan of the head, and was confirmed immunologically by measurement of cysticercus antibody titers in CSF and serum.

[Neurocysticercosis in childhood. II. Computed tomography of 24 patients according to symptomatic and praziquantel treatment]

We studied 24 children (15 months to 13 years old) which clinical, CSF and CT findings were compatible to the diagnosis of active neurocysticercosis. The patients were divided into three groups based on the type of treatment: Group I (10 patients) treated with analgesics and/or anticonvulsants; Group II (4 patients) treated with analgesics and or anticonvulsants and corticosteroids; Group III (10 patients) treated with analgesics and/or anticonvulsants, corticosteroids and praziquantel. The first patients CT scan were compared with the sequential CT scan findings (1 month to 5 years). The initial CT scan of 12 patients showed multiple active cysts, in 5 patients an isolated active cyst, in 3 patients partial calcified cysts, in 2 patients cerebral edema and in 2 patients were normal. The final results of the three groups of patients, as far as concern the normalization of CSF abnormalities or calcification of the cysts were the same, no matter the type of treatment applied to them. These results, although the small number of patients, showed that most of the children have good final results, with improvement of clinical symptoms and CT findings. We suggest that neurocysticercosis in children need multicenter study. So, a great number of patients can be followed and better definition can be established on the treatment of neurocysticercosis.

Specificity of glucose 1,6-bisphosphate synthesis in rabbit skeletal muscle

1. To compare glucose 1,6-bisphosphate synthesis in different types of cells, we partially purified (2000-fold) a glycerate 1,3 P2-dependent glucose 1,6-bisphosphate synthase from rabbit skeletal muscle. 2. In agreement with the results reported by others for mouse brain and pig skeletal muscle, the enzyme can be separated from bulk phosphoglucomutase (PGM) activity by DEAE-cellulose chromatography of crude cellular extract. This cannot be achieved on human hemolysates where glycerate 1,3-P2-dependent glucose 1,2-bisphosphate synthesis is displayed only by multifunctional PGM2 isoenzymes. 3. The Km values for glycerate 1,3-P2 (0.50 microM), glucose 1-phosphate (90 microM), Mg2+ (0.22 mM), and also pH optimum (7.8) and mol. wt (70,000) of the rabbit skeletal muscle enzyme are similar to those of the enzymes from mouse brain and human red blood cells, but they differ from those reported for the pig skeletal muscle enzyme.

Purification and partial characterization of the phosphoglucomutase isozymes from human placenta

We have developed a simple procedure for the purification of phosphoglucomutase (PGM) isozymes from human placenta of healthy women. The technique involves the ammonium sulfate fractionation, ion-exchange and dye-ligand chromatographies. By this method we obtained homogeneous isozyme preparations of the products ("primary" and "secondary") of the two PGM1 and PGM2 loci. The final specific activities were 1134.6-1441.8 units/mg for PGM1 forms and 40.2-46.5 units/mg for PGM2 forms. On SDS-polyacrylamide gel electrophoresis analysis, the final preparations gave a single protein band of 58,500 and 69,000 Mr for PGM1 and PGM2 isozymes, respectively. These forms have the same kinetic properties, but from the substrate specificity experiments we have found that PGM2 forms are more effective for catalyzing the phosphoribomutase and glucose 1,6-bisphosphate synthase reaction than PGM1 forms. All these properties are shared by the same isozymes previously isolated from human erythrocytes but in this procedure the use of human placenta for the PGM isozymes purification takes advantage of high specific activity of PGM in the extracts of this tissue as well as obtaining highly homogeneous protein suitable for studies at molecular level.

Cell age dependent decay of human erythrocytes glucose-6-phosphate isomerase

Glucose-6-phosphate isomerase shows a biphasic decay pattern during red blood cell aging, which is very fast during the first part of cell's life span in circulation. This decay is not due to accumulation of inactive enzyme molecules, as shown by immunological studies, but is accompanied by the formation of secondary isozymes (i.e., chemically modified forms). Electrophoretic and ion-exchange chromatographic experiments show that glucose-6-phosphate isomerase (D-glucose-6-phosphate ketol-isomerase, EC 5.3.1.9) consists of only one isozymic form in young erythrocytes but is present in two components, with different electric charge, in mature and old cells. This secondary isozyme is more stable to heat treatment and is inactivated by IgG anti-glucose-6-phosphate isomerase with a lower affinity than the native isozyme. In vitro incubation of homogeneous human glucose-6-phosphate isomerase under conditions known to produce enzyme deamination does not reproduce the isozymic pattern found in erythrocytes, suggesting that one or more mechanisms other than those previously described to explain glucose-6-phosphate isomerase microheterogeneity occur in the human erythrocyte.

Isoenzymes of phosphoglucomutase from human red blood cells: isolation and kinetic properties

A procedure has been developed for the purification of phosphoglucomutase from human red cell (phenotype PGM1 a1 or a3) lysates. It yields homogeneous isoenzyme preparations of the products ("primary" and "secondary") of the two PGM1 and PGM2 loci with distinctive pI (from 6.07 to 5.29). There are substantial differences between PGM1 and PGM2 isoenzymes, having single polypeptide chains of 58,500 and 69,000 Mr respectively and showing different thermostability. The kinetic properties of all the isoenzymes for the phosphoglucomutase reaction are essentially the same (apart from the specific activity of 1089-1263 units/mg for PGM1 forms vs 37-42 units/mg for PGM2 forms), but there are striking differences in substrate specificity. In fact the products of PGM1 locus are "true" phosphoglucomutases, being specific to mutate glucose monophosphates, whereas the PGM2 forms also display phosphoribomutase and glucose 1,6-bisphosphate synthetic activities. Some kinetic properties of these "side activities" are also reported.

Simultaneous preparation from human placenta of several enzymes of glucose metabolism

A procedure for the simultaneous purification to homogeneity of hexokinase, phosphoglucomutase 1 and 2, aldolase, phosphoglucose isomerase and glucose-6-phosphate dehydrogenase from human origin has been developed. Human placenta homogenate was first chromatographed on DE-52 column which retains hexokinase and glucose-6-phosphate dehydrogenase while the other enzymes are recovered in the unabsorbed protein fraction. The other steps in the purification involve Matrex gel and specific affinity chromatography for the DE-52 retained enzymes and phosphocellulose and Matrex gel chromatography for the other enzymes. All the enzymes mentioned were obtained in one week, with recoveries from 14 percent for glucose-6-phosphate dehydrogenase to 75 percent for hexokinase. Thus, the procedures utilized seem to be useful in obtaining large amounts of enzymes in a a homogeneous form from an easily available human tissue.

[Application to an automatic system of a direct method for determining atypical variants of cholinesterase using succinyldithiocholine as substrate]

The determination of human serum cholinesterase (EC 3.1.1.8) is frequently requested to detect patients with atypical forms of the enzyme which reacts abnormally with succinylcholine (suxamethonium), employed as a neuromuscular blocking agent. Usually, for biochemical identification of succinylcholine sensitive individuals the standard reaction is run with and without the inhibitors, notably dibucaine. A new test for direct determination of succinylcholine sensitive individuals which use a substrate analogue of succinylcholine was applied to a automated instrument. The linearity, precision, recovery, interference and correlation of the method have been evaluated. We have estimated the reference intervals for a population of 364 healthy subjects subdivided for sex, three atypical homozygotes and two atypical heterozygotes. On the basis of analytical performance we can conclude that this test may offer a further parameter for preoperative screening of individuals with an abnormal response to the muscle relaxant succinylcholine, thus avoiding the determination of genotype by measurement of dibucaine number.

Isoelectric points and charge-dependent separation of erythrocyte phosphoglucomutase isoenzymes (PGM1 and PGM2)

Phosphoglucomutase can bind both negative and positive ions so that it may change its net electric charge according to the buffer species of the medium. For this reason the knowledge of the pIs of the erythrocyte phosphoglucomutase isoenzymes is not sufficient to forecast their separability by procedures based on charge separations such as ion exchange chromatography. In this paper we indicate the condition to obtain a satisfactory separation of the main erythrocyte phosphoglucomutase isoenzymes by DEAE-cellulose column chromatography. The pI values of the isolated isoenzymes are also reported and compared to those measured by others on whole hemolysates.

Relationships between the age-dependent decay of glucose-1,6-bisphosphate synthesis, phosphoribomutase and phosphoglucomutase in human red cells

In human red blood cells phosphoglucomutase exists in multiple molecular forms with different isoelectric points determined by two distinct loci called PGM1 and PGM2. With regard to the phosphoglucomutase PGM1 and PGM2 isoenzymes, the latter appear to be more important in erythrocyte metabolism owing to their ability to mutate ribose monophosphates and synthetize glucose-1,6-bisphosphate. In this paper we show that, beside undergoing age-related postranslational modifications, both phosphoglucomutase PGM1 and PGM2 forms decrease their activities as the mean cell age increases. Under the experimental conditions used to separate erythrocytes by age the comparison of the younger erythrocytes with the older shows that total phosphoglucomutase, phosphoribomutase and glucose-1,6-bisphosphate synthetic activities decay by 55%, 26% and 28%, respectively. We consider that these results substantiate the multifunctionality of PGM2 isoenzymes. Furthermore we discuss the role of these forms in the age-related decay of erythrocyte metabolism.

The relevance of glucose 1,6-bisphosphate formation and degradation to human red blood cell metabolism

In human erythrocytes, in the absence of specific enzymes, G1,6P2 synthesis and degradation are carried out by phosphoglucomutase PGM2 isoenzymes. The results presented, obtained by using partially purified preparations of these enzyme forms, suggest that erythrocyte G1,6P2 may play a crucial role in the physiological interconversion of several important sugar monophosphates.

Regulatory properties of human erythrocyte hexokinase during cell ageing

Human red blood cell hexokinase exists in multiple molecular forms with different isoelectric points but similar kinetic and regulatory properties. All three major isoenzymes (HK Ia, Ib, and Ic) are inhibited competitively with respect to Mg.ATP by glucose 6-phosphate (Ki = 15 microM), glucose 1,6-diphosphate (Ki - 22 microM), 2,3-diphosphoglycerate (Ki = 4 mM), ATP (Ki = 1.5 mM), and reduced glutathione (Ki = 3 mM). All these compounds are present in the human erythrocyte at concentrations able to modify the hexokinase reaction velocity. However, the oxygenation state of hemoglobin significantly modifies their free concentrations and the formation of the Mg complexes. The calculated rate of glucose phosphorylation, in the presence of the mentioned compounds, is practically identical to the measured rate of glucose utilization by intact erythrocytes (1.43 +/- 0.15 mumol h-1 ml red blood cells-1). Hexokinase in young red blood cells is fivefold higher when compared with the old ones, but the concentration of many inhibitors of the enzyme is also cell age-dependent. Glucose 6-phosphate, glucose 1,6-diphosphate, 2,3-diphosphoglycerate, ATP, and Mg all decay during cell ageing but at different rates. The free concentrations and the hemoglobin and Mg complexes of both ATP and 2,3-diphosphoglycerate with hemoglobin in the oxy and deoxy forms have been calculated. This information was utilized in the calculation of glucose phosphorylation rate during cell ageing. The results obtained agree with the measured glycolytic rates and suggest that the decay of hexokinase during cell ageing could play a critical role in the process of cell senescence and destruction.

Glucose 1,6-bisphosphate decline in human erythrocytes: possible involvement of phosphoglucomutase PGM2 isoenzymes

Human erythrocytes incubated with various sugars lower their glucose 1,6-bisphosphate (Glc-1,6-P2) content, as do haemolysates containing exogenous Glc-1,6-P2 incubated with sugar monophosphates (sugar-P). Experiments performed with isolated erythrocyte phosphoglucomutase (PGM) isoenzymes indicate that only definite isoenzymatic forms, namely PGM2, are able to consume Glc-1,6-P2 during the mutation of sugar-P other than glucose-P. In this process a phosphate group is released from Glc-1,6-P2 and can be partially recovered in the biphosphate of the mutated sugar-P. The relevance of this mechanism of Glc-1,6-P2 degradation is discussed in regard to the physiological turnover of the biphosphate.

Glucose-1,6-P2 synthesis, phosphoglucomutase and phosphoribomutase correlate with glucose-1,6-P2 concentration in mammals red blood cells

Glucose 1,6-biphosphate (G1,6P2) was measured in human, pig, cow, rabbit, rat and sheep red blood cells. Mean values are variable among the species and range from 33 to 122 nmol/ml RBC for pig and rabbit erythrocytes, respectively. The activities of G1,6P2 synthase, phosphoglucomutase (PGM) and phosphoribomutase (PRM) have also been assayed in red cell haemolysates of the same species. The correlations between the biphosphate content and the occurrence of the three enzymatic activities have been studied in order to gain an insight into the regulation of the G1,6P2 turnover in mammalian erythrocytes.

[Glucose 1,6-diphosphate in the erythrocytes of various species of mammal]

Red blood cells from human, pig, cow, rabbit, rat and sheep were investigated for the occurrence of phosphoglucomutase multiple forms, G1,6P2 level, PGM, PRM and G1,6P2 synthetic activities. In all cases a species specific pattern of PGM isoenzymes was detected by starch gel electrophoresis. G1,6P2 mean values range from 33 to 122 nmol/ml RBC for pig and rabbit erythrocytes, respectively. The study of the correlation between the biphosphate content and the occurrence of the three measured enzymatic activities indicates a possible role of PRM activity (property of PGM2 isoenzymes) in the erythrocytic G1,6P2 catabolism.

[Determination of the energy load of erythrocytes in long-distance and medium-distance runners]

In this study erythrocytes drawn from well-trained athletes (middle- and long-distance runners) and from sedentary subjects have been compared for their adenine nucleotide contents. ADP and AMP appeared to be significantly (p less than 0,001) increased only in red cells from athletes in the rest state. After athletes' race this difference with control subjects become insignificant. Nevertheless, the observed ADP and AMP modifications are not great enough to influence the energy charge (CE) of the compared erythrocytes.

Human erythrocyte phosphoglucomutase: comparison of the kinetic properties of PGM1 and PGM2 isoenzymes

Kinetic properties of PGM1 and PGM2 phosphoglucomutase "primary" isoenzymes from human erythrocytes were studied. The two enzyme forms share a "ping-pong" kinetic mechanism and show similar Km for substrate (glucose 1-P) and cofactor (glucose 1,6-P2). Micromolar concentrations of fructose 1,6-P2 and glycerate 2,3-P2 inhibit both PGM1 and PGM2 isoenzymes to a similar extent. The sole PGM2 form is affected by ribose monophosphates (ribose 1-P and ribose 5-P) that act as mutase inhibitors vs. glucose 1,6-P2 and as apparent activators vs. glucose 1-P. The interaction between PGM2 isoenzyme and ribose monophosphates is discussed in the light of the ability of this form to also display phosphoribomutase activity.

Acetaldehyde influences glucose 1,6-bisphosphate level of human erythrocytes in vitro and in vivo

In intact erythrocytes from normal adults, acetaldehyde, besides inducing metabolite modifications otherwise observed, markedly decreases the glucose 1,6-bisphosphate (G1,6P2) level. Pyruvate rapidly reverses the acetaldehyde effects. Also in vivo, the acetaldehyde that occurs in the blood stream after heavy alcohol intake produces a significant decrease of the erythrocyte G1,6P2 concentration. These changes support the role of 1,3-bisphosphoglycerate as the first substrate in the G1,6P2 synthesis. The significance of the glucose bisphosphate as glycolytic modulator is also discussed.

Vanadate affects glucose metabolism of human erythrocytes

Vanadate causes a rapid breakdown of 2,3-bisphosphoglycerate in intact erythrocytes. This metabolite is nearly stoichiometrically transformed into pyruvate, which changes the cell redox state and enhances the glycolytic flux. The results show that the vanadate effect on 2,3-bisphosphoglycerate, also evident in hemolysates, is attributable to the stimulation of a phosphatase activity of the phosphoglycerate mutase. In agreement with others (J. Carreras, F. Climent, R. Bartrons, and G. Pons (1982) Biochim. Biophys. Acta 705, 238-242), vanadate is thought to destabilize the phosphoryl form of this enzyme which shows competitive inhibition between the ion and 2,3-bisphosphoglycerate in the mutase reaction. A competitive inhibition between vanadate and glucose 1,6-bisphosphate is also found for phosphoglucomutase, without evidence for phosphatase activity toward the bisphosphate cofactor.

Red cell metabolism affects lactate and pyruvate partition across the plasma membrane

The influence on red cell metabolism of increasing the glucose concentration or the pH of the medium has been examined in order to compare the modification of the lactate/pyruvate ratio inside and outside the cell. In both situations, we evidenced a constancy in the intracellular lactate/pyruvate ratio and an increase in the extracellular one, thus suggesting that the cell efficiently opposes cytoplasmic modifications. In fact an increase of lactate efflux takes place when the intracellular pyruvate decreases. The implications of these changes in the two compartments are discussed on the basis of the available results.

Evidence for the selective release of lysosomal proteinases in fasted rabbits

The enzyme responsible for the conversion of "neutral" to "alkaline" fructose 1,6-bisphosphatase (EC 3.1.3.11) by removal of a 7000 dalton peptide (converting enzyme, Proteinase I) has been shown to be localized in rat liverlysosomes. Lysosomes also contain a specific proteinase (Proteinase II) that catalyzes the release of a small peptide from the NH2-terminus of the native subunits. In fasted rabbits Proteinase II is released into the cytoplasm, together with Cathepsin A, but Proteinase I remains associated with the lysosomal fraction. Increased osmotic fragility of liver lysosomes in fasted rabbits has also been observed, but this increased fragility does not result in the release of Proteinase I. The appearance of Proteinase II in the cytoplasm may be due either to its selective release from the lysosomes, without release of Proteinase I, or its localization in a different lysosomal fraction. Changes in lysosomal structure induced by fasting may play a dual role in : 1) the mobilization of amino acids for gluconeogenesis and 2) the modulation of activity of gluconeogenic enzymes.