Studies on the mechanism of oxidative modification of human glyceraldehyde-3-phosphate dehydrogenase by glutathione: catalysis by glutaredoxin

In this report the protein human glyceraldehyde-3-phosphate dehydrogenase (GAPDH) has been examined to clarify the roles of (a) direct oxidation and (b) thiol-disulphide exchange (with glutathione disulphide) on the modification of its catalytic activity. An in vitro system using purified human GAPDH and [35S]-GSSG (glutathione disulphide), has permitted clarification of these possibilities by showing that S-glutathionylation of GAPDH does not result in an inactivation of the enzyme. Rather, the direct oxidation of GAPDH with hydrogen peroxide is responsible for inhibition of the catalytic activity of the protein. Furthermore, pre-treatment of the enzyme with hydrogen peroxide enhances the formation of glutathione-GAPDH mixed disulphides in the presence of glutathione disulphide. This may serve as a molecular "switch" directing the protein to other reported functions in the cell. It is also shown that the efficiency of S-glutathionylation of either native or oxidised GAPDH is enhanced by the presence of recombinant glutaredoxin (thiol transferase) of either bacterial or human origin. Under the conditions of analysis the glutaredoxin itself is also shown to readily undergo S-glutathionylation external to its active site. Taken together, the data indicate the complexity of mechanisms likely to be involved in regulating cellular proteins during oxidative stress and implicate controlled enzyme-catalysed S-glutathionylation as a potential selectivity factor in the redox modification of protein function by glutathione.

Enzyme immunoassay for measuring 25-hydroxyvitamin D3 in serum

We developed a rapid, competitive enzyme immunoassay (EIA) for measuring 25-hydroxyvitamin D3 [25(OH)D3] in serum. The EIA was based upon 25(OH)D3-3-hemisuccinate covalently coupled to secondary amino groups grafted onto the polystyrene surface of microtiter wells. Optimal coupling conditions were established, and we found that inclusion of 40 mumol/L chloramine T, an agent not previously described for use in coupling to these plates, resulted in both more reproducible coupling as well as more than a twofold increase in the coupling efficiency. Before EIA, 25(OH)D3 was extracted from the serum samples by acetonitrile, and the redissolved extract was incubated with polyclonal rabbit antibody raised against 1,25-dihydroxyvitamin D3-3-hemisuccinate conjugated to bovine serum albumin. Peroxidase-labeled antibody raised in goat against rabbit immunoglobulins was used for detection. The detection limit of the EIA was 4.4 micrograms/L; recovery 102%; on-plate CV 11%; within-run CV including extraction 12%, and between-run CV 15%. There was no clinically important cross-reactivity with other vitamin D metabolites, and results obtained by the EIA were compared with results obtained by a previously described RIA.

First impressions of the nurse and nursing care

Patients (N = 1,180), nurses (N = 918), and administrators (N = 332) in 22 acute care hospitals across the country were surveyed regarding their first impression of the professional image communicated by nurses' uniforms. The Nurse Image Scale, with pictures of the same nurse in nine different uniforms, was used as the data gathering tool. A comparison of the mean score of each uniform as rated by all respondents (N = 2,430) showed the white pant uniform with stethoscope was rated significantly higher than other uniforms. The white pant uniform with cap, dress with cap, pants suit, and dress with stethoscope scored closely in a second place grouping. The white dress uniform and street clothes with laboratory coat tied for third place. Colored designer scrubs and white pants with colored top scored lowest. Ratings of patients, nurses, and administrators were similar, although patients tended to rank some uniforms significantly differently than nurses and administrators. The nurse in the pant uniform with stethoscope was most preferred for care. Least preferred was the nurse in colored scrubs and street clothes with lab coat. These findings point to the need for nurses to be differentiated from auxiliary health care personnel and to project a professional image in a competitive health care environment.

Microdose 14C-urea breath test offers diagnosis of Helicobacter pylori in 10 minutes

OBJECTIVES

The urea breath test diagnoses Helicobacter pylori infection of the stomach by identifying the urease enzyme activity of the bacterium. In this "microdose" version of the test, 1 microCi 14C-urea is given orally in a capsule. Our objectives were: 1) to evaluate a microdose 14C-urea breath test capsule in a gastroenterology outpatient setting, 2) to determine the diagnostic ranges of the 14C-urea breath test for HP-positive and HP-negative patients, 3) to define the sensitivity and specificity of the test, and 4) to see whether breath sample results changed when they were mailed to a remote site for analysis.

METHODS

In a prospective blinded study, we breath-tested 200 fasted patients before elective outpatient endoscopy. At endoscopy, two gastric biopsy samples were taken and were examined for curved organisms; a third biopsy specimen was evaluated with a rapid urease test (CLOtest). Breath samples were mailed in aluminized balloons to a testing laboratory.

RESULTS

Using a single breath sample collected at 10 min, with > or = 200 dpm as positive, the breath test correctly classified 63 of 65 HP-positive patients (sensitivity 97%, CI 89-99%), and 128 of 135 HP-negative patients (specificity 95%, CI 90-98%). Radiation exposure from the test equated to natural background received in 1 day. No adverse events were caused by the breath test.

CONCLUSIONS

The 14C-urea capsule breath test (PYtest) is a convenient noninvasive test for the detection of gastric H. pylori infection. Accuracy is equivalent to invasive methods such as histology. Results can be obtained within 15 min if a counting instrument is nearby, or breath samples can be mailed to a testing laboratory for analysis.

Determination of intracellular glutathione in human skeletal muscle by reversed-phase high-performance liquid chromatography

A chromatographic method for the specific determination of cellular low molecular mass thiols has been applied to human muscle tissue. The method is based on the derivatisation of thiols using monobromobimane, which is a specific reagent for the sulphydryl group. The glutathione and cysteine bimane adducts were separated by reversed-phase HPLC, whilst quantitation of the cysteine and glutathione adducts was achieved by fluorescence spectroscopy. The method was found to yield a quantitative recovery of glutathione (ca. 96%), to be sensitive (down to 20 pmol glutathione/per injection) and reveal a low intra-individual coefficient of variation (C.V. < 5%) of the glutathione concentrations in human skeletal muscle. The concentrations of reduced and total glutathione were 1320 +/- 37 mumol/kg wet weight (mean +/- S.E.M.) and 1525 +/- 66 mumol/kg wet weight, respectively. The method was also applied to tissues from nine healthy volunteers to determine if fluctuations in glutathione level occurred over a 24-h period. No diurnal variation of glutathione level in human skeletal muscle was observed.

Choosing talkers for the BKB/A Speechreading Test: a procedure with observations on talker age and gender

A procedure is described for choosing talkers for the BKB/A (BKB/Australian version) Speechreading Test. The main aims were: to select several talkers from a pool of potential talkers, to avoid adventitiously choosing a markedly atypical single talker; to assess speechreading as a general skill rather than as talker-specific; and to select talkers who were acceptable to speechreaders, relatively easy to speechread, and comparable in their speechreadability. Because of the number of variables involved and the demanding nature of the task for speechreaders, a three-stage selection procedure was adopted. In the resulting BKB/A 21-sentence list Speechreading Test, four of the 16 sentences in a list are each spoken by four talkers, chosen as follows. In Stage 1, 16 talkers (four of each age/gender set: older men, older women, younger men, younger women) were selected from an original pool of 40 (10 of each set), via rankings made by eight hearing-impaired judges with speechreading experience. In Stage 2, the final four talkers (one of each set) were selected from the 16 via the speechreading scores of further hearing-impaired subjects with speechreading experience. In Stage 3, the order of talker appearance within lists (in random order versus over blocks of four consecutive sentences) was determined. This three-stage approach to talker selection identified differences between talker candidates within sets, except for younger men, and suggested that, overall, younger women were the easiest to speechread. The discussion addresses the merits and disadvantages of this approach to talker selection, and suggests some reasons for the documented differences in speechreadability among talkers of different age and gender.

Lack of influence of simple premenopausal hysterectomy on bone mass and bone metabolism

OBJECTIVE

Our purpose was to investigate the influence of premenopausal hysterectomy on bone mass.

STUDY DESIGN

A cross-sectional study was performed on 69 women who had premenopausal hysterectomy and 427 women with natural menopause 50 to 59 years old. Bone mineral density was measured in the distal forearm by single-energy x-ray absorptiometry. Body composition and bone mineral density in the anteroposterior spine, proximal femur, and total body was measured by dual-energy x-ray absorptiometry. Bone turnover was determined by plasma osteocalcin, serum alkaline phosphatase, and fasting urinary calcium corrected for creatinine excretion.

RESULTS

Women who had undergone premenopausal hysterectomy had similar bone mineral densities compared with women with an intact uterus in all compartments, apart from a 6% to 11% higher bone mineral density (p < 0.05 to 0.001) in the proximal femur. The women who had undergone premenopausal hysterectomy had 2% to 11% more fat (significant for arm fat, p < 0.05), 9% to 13% lower serum follicle-stimulating hormone levels (p < 0.01), 10% to 13% higher serum estradiol levels (not significant), and 8% to 9% lower osteocalcin levels (p < 0.05 to 0.07). This bone mineral density difference could thus be explained by extragonadal sex hormone production.

CONCLUSION

Premenopausal hysterectomy did not reduce ovarian function and increase bone turnover and bone loss.

Free amino acids in biopsy specimens from the human colonic mucosa

The content of free amino acids and total protein was determined in endoscopic biopsy specimens from the rectum, descending colon, transverse colon, and ascending colon in 10 patients. The amino acids were quantified by ion-exchange chromatography and were detected by fluorescence. The amino acid pattern and the rank order of the individual amino acids in the colon were different compared to those in plasma. Glutamate, taurine, aspartate, glutamine, glycine, alanine, serine, lysine, valine, and ornithine were the 10 most abundant amino acids in the colon. The rank order was the same in all of the different segments of the colon. The concentrations of the amino acids decreased the more aborally the biopsies were taken. The protein content in the rectum was significantly lower than that in the transverse colon, but there were no difference between the different segments otherwise. The study demonstrated the possibility of determining free amino acids from endoscopic biopsies of human colonic mucosa. Biopsy specimens from the descending colon and/or rectum/sigmoid colon may be considered representative of the entire large intestine. The technique may be used for repeated sampling in studies of the amino acid metabolism of the intestinal mucosa.

[Effects of carotid endarterectomy on various neuropsychologic parameters. A neuropsychologic longitudinal study]

Carotid endarterectomy was performed in 25 patients with symptomatic cerebrovascular disease. All patients underwent detailed neuropsychological investigations immediately before surgery, immediately after surgery, and again after a follow-up period of 14 months. Immediately after surgery the flicker fusion frequency was temporarily reduced, indicating an impairment of global cognitive functioning. Postoperatively, verbal attention was found to be improved, particularly in younger patients, in patients with TIA, and in patients with left-sided operation. Finally, visual retention (Benton) was improved at the end of the observation period, especially in older patients and in patients with left-sided operation. Considering the complexity of pathologic brain perfusion, the effects of carotid endarterectomy can only be explained if a multidimensional approach is adopted.

Variation in mitochondrial translation products in fertile and cytoplasmic male-sterile sugar beets

Intact and functional mitochondria were isolated from sugar beet plants (Beta vulgaris L.) containing normal fertile (F) or cytoplasmic male-sterile (S1-S4) cytoplasms. Incorporation of (35)S-methionine by mitochondria isolated from both roots and leaves showed approximately 20 major and ten minor translation products. Comparison of the polypeptide synthesis patterns produced by leaf mitochondria from fertile plants of three different species within the genus Beta revealed several taxonomically related differences. Contrary to this, the patterns of polypeptides synthesized by mitochondria from roots and leaves of sugar beet plants containing the F and S1-S4 cytoplasms were very similar; in the S1 and S2 cytoplasms no qualitative, and only a few quantitative, differences from the F cytoplasm were observed. Thus, in these cases, cytoplasmic male sterility in sugar beet is not correlated with the constitutive expression of variant polypeptides. In the S3 cytoplasm, however, an additional 6 kDa polypeptide was synthesized and in the S4 cytoplasm an additional 10 kDa polypeptide was observed when compared with the F cytoplasm. The expression of cytoplasmic male sterility in sugar beet may be associated with these variant polypeptides. The mitochondrial polypeptides synthesized were identical in plants with different nuclear backgrounds but with identical S1 cytoplasms. Mitochondria from plants with variants of the S4 cytoplasm in the same nuclear genotype also showed identical patterns of polypeptide synthesis, including the synthesis of the 10 kDa S4-specific polypeptide. Pulse-chase experiments did not affect the synthesis of this polypeptide.

Separation and characterization of isoforms of DT-diaphorase from rat liver cytosol

Rats were treated with 3-methylcholanthrene (MC) and DT-diaphorase from liver was partially purified on an azodicoumarol-Sepharose 6B column and applied to an FPLC-chromatofocusing column in order to resolve isoforms. Six peaks showing significant DT-diaphorase activity were eluted from this column with a pH gradient between 7.30 to 4.80. The amino acid compositions of the two major peaks (II and VIb) were found to be nearly identical, suggesting existence of isoforms rather than isozymes of DT-diaphorase. The isoforms of DT-diaphorase showed broad substrate specificities towards four different quinones (menadione, vitamin K-1, benzo(a)pyrene 3,6-quinone and cyclized-dopamine ortho-quinone), although quantitative differences in the specific activities were also found. All isoforms are glycoproteins but contain different carbohydrates. Thus isoform II reacts with biotinylated lectins which are specific for N-acetylgalactosamine, mannose, fucose and galactosyl(beta-1,3)N-acetylgalactosamine, while isoform VIb reacts only with biotinylated lectins specific for mannose and N-acetylgalactosamine. Separation of DT-diaphorase isoforms from control rat liver cytosol using FPLC-chromatofocusing revealed that the induction of the isoforms is not uniform, since isform II was not found and the major isoform was composed of three peaks, whereas the major isoform of DT-diaphorase from liver cytosol of rats treated with 3-methylcholanthrene was composed of only two peaks.

[Etiology of Alzheimer's disease]

The major factor that causes problems in studies on the aetiology of Alzheimer's disease (AD) is the clinical heterogeneity of the condition. Familial early-onset AD and familial late-onset AD are differentiated from sporadic AD. Aetiologically a genetic defect on chromosome 21 is the most important factor, at least in some cases of AD. In familial AD and autosomal dominant inheritance with complete penetrance in old age is thought to be possible. In sporadic AD the role of genetic and exogenous factors (infectious agents, aluminium) is unknown. The current status of knowledge about the aetiology of Alzheimer's disease is reviewed with reference to the literature.

Human somatosensory cortical finger representation as studied by combined neuromagnetic and neuroelectric measurements

We studied somatotopy of human hand somatosensory cortex using evoked responses recorded on magnetoencephalogram (MEG) and scalp-electroencephalogram (EEG) in conjunction with dipole modeling. We found a somatotopic arrangement of cortical digit representations with a sensory sequence from lateral inferior to medial superior in the anatomical order thumb, index finger, middle finger, ring finger, and little finger. MEG alone was able to reproduce this sensory sequence more accurately than scalp-EEG alone. However, the combined information provided by both techniques improved localization accuracy even further. As MEG and scalp-EEG are complementary and confirmatory techniques, this combined approach was useful to get more complete information on the functional organization of human hand somatosensory cortex.

Perceptions of nurses' uniforms

Patients (N = 100), nurses (N = 30), and administrators (N = 15) in a regional medical center were surveyed about the professional image inherent in different styles of nurses' uniforms. The Nurse Image Scale (NIS) was used as the data-gathering tool with pictures of the same nurse in a variety of uniforms. Results showed that patients rated some uniforms significantly differently for professional image than did nurses and administrators. There was general agreement among all respondents on the nurse they would most like to have care for them (dress with stethoscope) and the nurse they would least like to have care for them (white pants with colored top).

[Prognosis after transient ischemic attacks]

Transient ischemic attacks (TIAs) are reversible neurological deficits due to cerebral ischemia in a vascular territory lasting less than 24 hours, usually less than one hour. The natural course of TIAs is variable. One third of the patients suffer from a subsequent completed stroke with lasting disability, one third of the patients continues to experience TIAs and in one third no further symptoms are encountered. TIAs are a warning symptom of a generalized vascular process, myocardial infarction being the most common cause of mortality and ischemic brain infarction being the most common cause of morbidity. Clinical parameters--besides age--seem to be of minor prognostic relevance. Vascular risk factors should be evaluated in all TIA patients; especially, a cardiac work up including 2D-echocardiography and an exercise stress test should be performed. Duplex sonography of craniocervical vessels shows atherosclerotic lesions in a considerable proportion of patients with TIA; however, localization of these lesions does not always correspond to clinical symptomatology. Some angiographic features are of prognostic relevance. Computed tomography (CT) and magnetic resonance imaging (MRI) show ischemic lesions in a considerable proportion of patients, which connects TIAs directly to ischemic brain infarcts. The extent and localization of these lesions are of some prognostic relevance. Blow flow studies on single photon emission computed tomography (SPECT) and studies of brain metabolism on positron emission tomography (PET) are abnormal in many TIA patients for prolonged periods and also have some prognostic impact. TIA patients probably are a heterogeneous group with a common symptom. A detailed diagnostic work-up may have implications on a more specific and efficient therapy.

[The significance of laboratory findings in long-term antiepileptic therapy]

A retrospective study of 316 patients (173 men, 143 women; mean age 39 [17-87] years) who had taken antiepileptics (phenytoin, phenobarbital, carbamazepine, valproic acid) for at least six months, was carried out to assess the biochemical and haematological changes in relation to the drug used, the therapeutic programme and the drug serum levels. The most frequent change was isolated elevation of gamma-GT (9-89% of cases depending on the drug), followed by elevation of alkaline phosphatase (16-44%). Increases in the transaminases GOT (4-13%) and GPT (4-19%) were infrequent and minor. Changes in the blood picture were very infrequent and never more than minimal. Correlation between all these changes and serum drug levels was poor (r less than 0.15). Correlations between drug serum level and dose were found in the case of phenobarbital (r = 0.6) and valproic acid (r = 0.5). There was hence no evidence of any clear connection between the biochemical findings and the serum concentrations of antiepileptic drugs or their-dosage. The results indicate that undue importance has previously been attached to routine checks of biochemical parameters; abnormal biochemical findings by themselves are not usually enough to necessitate changes in treatment. Determination of biochemical and haematological parameters is necessary only if there are clinical grounds for it such as suspicion of side effects, the occurrence of epileptic attacks despite therapy, or change from one drug to another.

Galanthamine treatment in Alzheimer's disease

18 patients who had fulfilled the NINCDS-ADRDA criteria for "possible AD" took part in a clinical study to evaluate the effect of the cholinesterase inhibitor Galanthamine, 30 mg/day. Neuropsychological und social parameters were rated. This open clinical pilot-study showed no statistic significant change in neuropsychological test-results. However after 1 year treatment 6 patients are still taking the drug. According to their care-persons there was a positive changes in competence of everyday-routine and/or in the emotional situation.

Early diagnosis of Alzheimer dementia?

The main problems in early diagnosis of Alzheimer dementia (AD) are: 1. The differentiation between normal aging and AD i.e. difficulties in the assessment of cognitive disturbances in the healthy elderly and in early demented subjects. 2. Interference with other dementia syndromes. 3. Lack of information in the population and among physicians about the different causes and courses of dementia syndromes. The first two aspects are discussed in this paper.

Cytoplasmic male sterility in beta is associated with structural rearrangements of the mitochondrial DNA and is not due to interspecific organelle transfer

Chloroplast (ct) and mitochondrial (mt) DNAs from four cytoplasmic male sterile (cms) and 22 normal fertile sugar beet lines and accessions of wild beets from the genus Beta have been compared with restriction analyses and Southern hybridizations. We have used restriction analyses of ctDNA as a phylogenetic marker to confirm the taxonomic relationships between the different cytoplasms. According to the ctDNA data, all four cms cytoplasms belong to the same taxonomic section, Beta. Restriction patterns of ct and mtDNA from fertile accessions produced analogous trees of similarity and showed a close correlation between the organellar DNA diversity and the accepted taxonomic classification of the species studied. However, the mt-DNA restriction profiles of the four cms types differed dramatically from each other and from those of all fertile accessions from the genus. No indication of cytoplasmic introgression was found in any of the four investigated cms types. Southern hybridization to mtDNA revealed variant genomic arrangements in the different fertile and cms cytoplasms, indicating that rearrangement of the mitochondrial genome is a common denominator to the different cms systems in Beta. It may, indeed, be a common property to spontaneously occurring cms in all or most species.