Lineage analysis using retroviral vectors

Knowledge of the genealogical relationships of cells during development can allow one to gain insight into when and where developmental decisions are being made. Genealogical relationships can be revealed by a variety of methods, all of which involve marking a progenitor cell and/or a group of cells and then following the progeny. The use of replication-incompetent retroviral vectors for the analysis of lineal relationships in developing vertebrate tissues is described. An overview of the relevant aspects of the retroviral life cycle is given, and the strategies and current methods in use in our laboratory are described.

Improved triglyceride control with low glycaemic index-high carbohydrate modified-lipid diet in a hypertriglyceridaemic child

This study reports a 7-y-old boy with severe hypertriglyceridaemia who was successfully treated for 6 y with a low glycaemic index-high carbohydrate modified-lipid diet that produced beneficial changes in triglyceride and total cholesterol levels. It is suggested that a selection of a complex digestible carbohydrate and an adequate ratio between polyunsaturated and monounsaturated fat may, in the long term, favourably improve the lipid profile.

Isozyme analysis of human polymorphonuclear leukocyte phosphofructokinase from insulin resistant individuals

Phosphofructokinase (PFK) from human polymorphonuclear leukocytes (PMN) was characterized by immunological titration with subunit specific antibodies and column chromatography on QAE-Sephadex in three different groups: control, type II diabetic, and obese individuals. It was found that PMN phosphofructokinase in the three groups consists mainly of a mixture of L4 and M4 homotetramers with possibly some hybrid forms. The predominant subunit was the L-type. A 24% decrease in the specific activity of the L-type isozyme was observed and an intermediate form (I-isozyme) having 23% of the total activity in diabetic individuals appeared. In obese individuals a 30% decrease was observed in the activity of M-type isozyme and 9% of the total activity corresponded to the intermediate form. Kinetic studies showed different regulatory properties among the isozymes from the three groups. The lower PFK activity found in diabetic and obese individuals can be associated with the decreased activity in the L-type isozyme (for diabetic individuals) and in the M-type isozyme (for obese individuals); the lower activity can also be associated with the four times lower affinity for F-6-P showed by the M-type isozyme, the decreased sensitivity to ATP inhibition (for both isozymes), and the appearance of an intermediate form with a different kinetic behaviour.

[Qualitative and quantitiative differences in the plasma lipoproteins of obese, hyperlipidemic or normolipidemic men and women]

The aim of this study was to evaluate the alterations of the lipoprotein composition and their relation with the insulin-resistance and/or hyperinsulinemia in non diabetic obese patients. Twenty-two no obese(13 women and 9 men) and 30 obese patients (BMI > 30) were studied, who were divided into two groups according to the total lipid levels. The first group was formed by 18 obese patients (10 women and 8 men) with normal serum cholesterol (Chol) concentration < 200 mg/dL and triglycerides (TG) < 150mg/dL (NO), while the second group were formed by 12 obese patients (3 women and 9 men) with elevated Chol level > 200mg/dL and/or TG > 150 mg/dL (HO). A clinical and anthropometric examination was performed to each patient, as well as a glucose tolerance test, including serum glucose and insulin determinations. Likewise, the plasma lipoproteins (VLDL, LDL, HDL2 and HDL3) were isolated by ultracentrifugation and their cholesterol and triglycerides content were determined by enzymatic methods. In this report, we demonstrate the existence of compensatory basal hyperinsulinemia in men and women on both obese patients populations as well as alterations in the lipoprotein composition, mostly a TG overload even on NO. On the other hand, the presence of lipids and lipoproteins modification were obvious in those patients with abdominal obesity, on whom the hyperinsulinemia was more evident, which could be related with the high risk of cardiovascular disease in this kind of patients.

Isozyme analysis of human normal polymorphonuclear leukocyte phosphofructokinase

Phosphofructokinase (PFK) from human polymorphonuclear leukocytes (PMN) was characterized by immunological titration with subunit specific antibodies, column chromatography on QAE-Sephadex and SDS-polyacrylamide gel electrophoresis. Two different isozymes, M-type and L-type, were found. The M(r) values of the M and L subunits were 79,500 +/- 1,914 and 74,250 +/- 1,258, respectively. The two isozymes presented different kinetic and regulatory properties. The results suggest that PFK from human normal PMN is a mixture of M-type and L-type homotetramers, mainly, with possible minor heterotetrameric forms.

[Dyslipidemia and hyperinsulinemia in normoglycemic-obese relatives of patients with non-insulin dependent diabetes mellitus]

To determine the most frequent dyslipidemias among first-degree relatives of NIDDM patients, and its association with their glucose-tolerance status and hyperinsulinemia, we have started to examine members of NIDDM pedigrees, according to American Diabetes Association guidelines for nuclear family studies. In a large family with 2 NIDDM siblings in the 2nd generation, and 4 siblings with NIDDM in the 3rd generation, we have evaluated 14 first degree relatives and also 15 sex and aged matched healthy control subjects without family history of diabetes. The NIDDM relative group presented BMI = 31.8 +/- 3.9 kg/m2, SBP = 128 +/- 18.2 mmHg, DBP = 84 +/- 12.7 mmHg. Both relatives and controls were subjected to a 2h 75g OGTT for glucose and insulin determinations. Although none of NIDDM relatives has IGT, both Glycemic Area (GA) and Insulin Area (IA) were greater (p < 0.01) in the NIDDM relative group. The Insulin/Glucose ratio was also higher (p < 0.01) at 0 and 120 min of OGTT, this might be indirect evidence of Insulin- Resistance. Fasting serum lipids in the NIDDM relatives were TG = 148 +/- 24mg/dl, T-Chol = 244 +/- 10.7mg/dl, HDL-C = 34.2 +/- 2.5mg/dl; lipids in the control group were TG = 84.8 +/- 10.1mg/dl, T-Chol = 167 +/- 10.2mg/dl, HDL-C = 44.4 +/- 2.6mg/dl. Electrophoretic pattern showed type IIa (30.7%) and IIb (61.5%) hyperlipidemias in the NIDDM relatives. In this group, there was a positive and significant association between basal insulin and DBP (r = 0.67; p < 0.01), and between DBP and both TG (r = 0.74; p < 0.01)) and VLDL-C (r = 0.58; p < 0.05). It was also obtained a negative association between basal insulin and HDL-C (r = -0.89; p < 0.001). These data suggest that hyperinsulinemia in association with lipid abnormalities could appear early (before the development of Impaired Glucose Tolerance and Diabetes) in first degree relatives of NIDDM patients.

[Role of environmental factors in the development of insulin-dependent diabetes mellitus (IDDM) in Venezuelan children]

In view of the controversy surrounding the role of environmental factors, such as the presence of bovine albumin in milk, or viral infections, in the etiology of IDDM, a study was undertaken to determine the relationship between these events and the subsequent risk of developing IDDM. On 40 venezuelan diabetic children (< 18 y) and forty, age, sex and race-matched controls were studied at the same time. Parents of children completed a questionnaire on the infant's feeding habits, its environment and family history. The X2 method and the Fischer's exact test were used to analyze the results. We found that 20% of the controls, and 10% of IDDM (NS), were never breast-fed. In 95% of controls vs 65% of IDDM (p < 0.001), cow's milk was given exclusively from birth, or combined with breast-feeding, 65% of IDDM and 60% of controls (NS) were breast-fed (alone or combined with milk substitutes) for more than three months. These results do not support the hypothesis that early exposure to breast milk substitutes increases the risk of IDDM in venezuelan children. The study revealed, however, that a family history of diabetes mellitus was present in 55% of IDDM vs 30% of controls (p < 0.05) and mumps infection before the onset of diabetes was recorded in 42.5% of IDDM in comparison with 12.5% of controls (p = 0.005). Other viral infections (rubella, chicken pox) had no statistical significance. The latter results suggest an association between a family history of diabetes mellitus and viral infections with the development of IDDM among this group of children.

[Glycemic index and insulin response to the ingestion of precooked corn flour in the form of "arepa" in healthy individuals]

With the purpose of exploring the glucose and insulin responses to a breakfast composed of a complex carbohydrate (CC) in the form of a "arepa" prepared with precooked corn flour, with or without the addition of protein and fat (CC + P + F), we studied 6 healthy volunteers, ages ranging from 26-50 years and body mass index of 24.5 +/- 1.32. Three tests were performed on each individual: 1) 75 g OGTT, 2) Ingestion of 75 g of CC ("arepa") and 3) Ingestion of 75 g of CC + 6.7 g protein (low fat cheese) and 4 g fat (margarine). Glycemic values (glucose - oxidase method) and insulinemia (radioimmunoassay) were determined at basal, 30, 60, 120, 180 and 240 min. Glucose (GA) and insulin (IA) areas, glycemic index (GI) and insulin/glucose ratio (I/G) were calculated. We found that the "arepa" has a high GI (71.5%) that it is increased, although not significatively to 140% with the addition of protein and fat. Total GA as well as IA obtained for CC and for CC + P + F were similar to OGTT, however the profiles of the glucose and insulin responses during CC and CC + P + F were less abrupt but more prolonged, resulting in a greater I/G ratio for OGTT in comparison with CC or CC + P + F during the initial steps. We conclude that GI of this corn bread ("arepa") is high in comparison to other complex carbohydrates and it is not altered by the addition of protein and fat. This is possibly due to glucose and insulin responses similar to that produced by OGTT.

Gerontology within district nurse education

This paper describes a research study designed to explore approaches to integrating gerontological principles within district nurse education courses. Data were collected by a descriptive survey approach. The findings of the study indicated that various approaches were used to incorporate gerontological content within the curriculum. The district nurse lecturer emerged as the crucial link in ensuring subject material related to the specialism of district nursing, and the community practice teacher was significant in enabling students to relate gerontological theory to practice-based learning. The district nurse lecturer also emerged as supportive of the multi-disciplinary nature of gerontology by encouraging shared learning activities with a range of other community health care students. Against the background of major changes in community health care delivery, district nurses are identifying areas of expertise within their role as community health care nurses. One such area of expertise lies in the care of older people within the community, who form a high percentage of patients on the district nurse's caseload. In order to ensure that district nurses are effectively prepared to meet the specialist needs of older people, district nurse education courses must incorporate gerontological content within their programmes.

Insulin and lipogenesis in rat adipocytes. II. Effect of high levels of insulin and glucose on lipid synthesis in isolated rat adipocytes

Insulin resistant states are characterized by receptor and post-receptor defects in insulin action. When the insulin resistant state progresses, elevated levels of insulin are accompanied by increasing levels of glucose. In a previous paper we demonstrated that treatment of isolated adipocytes with high levels of insulin led to a decrease in insulin binding as well as a decrease in basal and insulin-stimulated lipid synthesis. The results of the present study establish that the addition of high concentrations of glucose in combination with a high level of insulin, does not modify the decrease in binding of insulin to its receptor. However, the decrease in lipid synthesis previously observed in the presence of high concentrations of insulin was completely overcome by the presence of high glucose.

Insulin and lipogenesis in rat adipocytes. I. Effect of insulin incubation on lipid synthesis by isolated rat adipocytes

To assess the effect of insulin on lipid synthesis in isolated rat adipocytes, cells were preincubated for 3 h with high concentrations (16.6 nM) of the hormone and lipogenesis measured through 14C-acetate incorporation into lipids, analyzing at the same time the activity of some lipogenic enzymes. It was found that insulin induced not only a decrease in the number of insulin receptors but a 30% loss in basal and insulin-stimulated acetate incorporation into total lipids as well as a decrease in the activities of enzymes related to the novo fatty acid synthesis pathway as malic enzyme and glucose-6-phosphate dehydrogenase.

Kinetics of phosphofructokinase from granulocytes isolated from patients with insulin resistance

Phosphofructokinases from granulocytes isolated from insulin-resistant patients, mainly those from type II diabetics where the degree of insulin resistance was more pronounced, exhibit some changes in their kinetic behavior when assayed under allosteric conditions, characterized by an increased affinity for fructose-6-phosphate, being more resistant to ATP inhibition while it became more sensitive to citrate inhibitory effect. Those changes are suggestive of a isozymic modification to a more L-type enriched enzyme with a loss of the F-type component, probably present in the normal granulocyte.

All about patient-controlled analgesia

The goal of patient-controlled analgesia is to provide the patient with a serum analgesia level for comfort with minimal sedation. In light of the increased use of patient-controlled analgesia, this article details indications for the administration of pain control as well as available technology and monitoring parameters within the hospital and home care environment.

Kinetic studies of human polymorphonuclear leukocyte phosphofructokinase

Phosphofructokinase from human polymorphonuclear leukocytes has low cooperativity and high affinity for its substrate, F-6-P. It is resistant to ATP inhibition at pH 8; however, at pH 7.1 it becomes sensitive to the effect of this compound. It is activated by F-1, 6-P2; it is not very sensitive to citrate inhibition and F-2, 6-P2 has no effect on its activity. With these kinetic characteristics we assume that perhaps the predominant L-type subunit is accompanied by an F-type component.

Enzymatic changes in polymorphonuclear cells isolated from type II diabetics

The absolute values of several enzymes present in polymorphonuclear (PMN) cells isolated from subjects catalogued as Type II diabetics that never received insulin to control their hyperglycemia are reported. PMN from the blood of fasting diabetics and a control group were isolated by the dextran flotation technique. The enzymes were assayed in whole homogenates prepared by sonication of the cells. Serum glucose and immunoreactive insulin (IRI) were also determined from the same blood sample. We found a 40% decrease in the levels of phosphofructokinase (39.7 +/- 3.0 vs 66.1 +/- 6.3 mU/mg, P less than 0.001) and lactate dehydrogenase (350 +/- 22 vs 583 +/- 49 mU/mg, P less than 0.001) and a 25% decrease in malate dehydrogenase (250 +/- 29 vs 341 +/- 20 mU/mg, P less than 0.01). No differences in hexokinase (16.3 +/- 1.7 vs 18.2 +/- 1.7 mU/mg, P greater than 0.1) and glucose-6-phosphate dehydrogenase (66.6 +/- 2.5 vs 76.3 +/- 5.7 mU/mg, P greater than 0.05) were detected. These patients had normal or elevated levels of IRI (22.9 +/- 2.8 vs 14.5 +/- 2.4 microU/ml, P less than 0.05) concomitant with hyperglycemia (162.7 +/- 10.2 vs 78.0 +/- 1.6 mg/dl, P less than 0.001), revealing some degree of insulin resistance. It appears that glycolysis is affected not only at the phosphofructokinase step but beyond this point, glucose-6-phosphate dehydrogenase is not affected, and defective insulin action more than the lack of insulin might be responsible for the metabolic alteration.

Effect of chronic ingestion of iodide during pregnancy and lactation on rat pup brain enzymes

The developmental pattern of several key enzymes in brain of pups born to mothers receiving high levels of iodide (1.1 mg daily intake) during pregnancy and lactation were followed up to the weaning period. We found that in the initial states of postnatal development, glutamic dehydrogenase increased above control levels, whereas succinic dehydrogenase decreased. At late stages, we observed differences in phosphofructokinase and malic enzyme activities which were all increased at 30 days. There was no change in hexokinase. Animal weight did not vary with respect to controls and we only obtained discrete increases (not statistically different) in serum thyroxine values, which led us to assume that the enzymatic modifications might be a consequence of either a very mild hormonal alteration or to the direct effect of iodide.

Rat brain malic enzyme: subcellular distribution and kinetic studies from two brain regions

1. The subcellular distribution of malic enzyme in two different brain regions (frontal cortex and striatum) is studied in adult rats. 2. A bimodal distribution is found in both regions: 75% being localized in the mitochondrial fraction and the remaining 25% in the cytosol. 3. In the frontal cortex, free mitochondria is enriched with the enzyme, while, in striatum, free as well as synaptic mitochondria, presented the same activity. 4. Kinetic studies of the malic enzymes show two Km values when malate is used as substrate. A higher Km value for free mitochondria as compared with a lower one found for the cytosolic and synaptosomal mitochondria suggests the presence of two enzyme populations. 5. The following are common characteristics for the two enzyme populations: NADP dependence, use of either Mg2+ or Mn2+ as cofactor and hyperbolic malate saturation curves not affected by dicarboxylic acids.

Human Venezuelan equine encephalitis virus infection and diabetes in Zulia State, Venezuela

Venezuelan equine encephalitis (VEE) virus has been implicated as producing alterations in glucose metabolism in animals. We performed oral glucose tolerance tests and measured serum immunoreactive insulin responses in 13 patients who were infected by VEE virus during an epidemic in 1969, in Zulia State, Venezuela. No significant alterations in the glucose tolerance test were found. Sera of 86 diabetic outpatients and 98 control individuals with normal glycemia at a local hospital were tested for antibodies to VEE virus by hemagglutination inhibition. No statistically significant difference was found between the two groups; 10.4% of the diabetic patients had detectable antibodies against VEE virus, compared to 7.1% of controls. Seventy-three percent of the diabetics with antibodies were individuals over 40 yr old, whose diabetes could be catalogued as insulin independent. The results of these studies indicate no relationship of VEE virus infection to subsequent diabetes.