Sequential liver and bone biochemical changes in hyperthyroidism: prospective controlled follow-up study

OBJECTIVE

To reexamine the prevalence and sequential changes of liver and bone biochemical abnormalities in patients with hyperthyroidism.

METHODS

A consecutive series of 95 patients with hyperthyroidism and 66 controls with euthyroid goiter seen during same period were studied. The patients were treated with propylthiouracil (PTU) 300 mg/day for 2 months, followed by 100-150 mg/day for 3 months and a subsequent maintenance dose of 100 mg/day. Serum aspartate amino-transferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), bilirubin, ALP isoenzymes, and hepatitis markers were studied before therapy and at 2 and 5 months after PTU therapy was begun.

RESULTS

Seventy-two [75.8%, confidence interval (CI) 67.2-84.4%] of the 95 patients had at least one biochemical abnormality. AST, ALT, ALP, GGT, and bilirubin were elevated in 27.4%, 36.8%, 64.2%, 16.8%, and 5.3%, respectively. Of the 34 patients with ALT elevation, 62% showed gradual normalization of ALT, whereas 38% (CI 21.9-54.5%) showed transient, asymptomatic, but significant (p < 0.025) further elevation of ALT during PTU therapy. Overt hepatitis developed in one patient. None of these changes was due to hepatitis A, B, C, or delta virus infection or autoimmune hepatitis. Changes of serum GGT parallel those of ALT. In contrast, serum ALP (primarily bone isoenzyme) rose significantly (p < 0.01) as T4 and T3 levels declined at 2 months after therapy.

CONCLUSIONS

The results suggest that hyperthyroidism is often associated with abnormal biochemical tests, particularly ALP elevation, and thus may pose diagnostic confusion. The increase of bone isoenzyme accounts for the elevations in total ALP level before and during therapy. Serum ALT and GGT abnormalities usually subside during PTU therapy, but transient asymptomatic PTU hepatotoxicity occurs in one-third of the patients. Discontinuation of PTU is not required unless overt hepatitis develops.

Trace analysis of acetaldehyde as fluorogenic derivative by high performance liquid chromatography

A sensitive method is described for the determination of acetaldehyde as a fluorogenic derivative of decahydroacridin-1,8-dione by high performance liquid chromatography. The analytical derivatization is based on the reaction of acetaldehyde in an acidic aqueous system with 1,3-cyclohexanedione and ammonium acetate. The resulting derivative was separated by a reversed-phase C-18 column and monitored with a fluorescent detector (lambda ex, 375nm; lambda em, 512nm). Several parameters affecting the derivatization of acetaldehyde were studied. The linear range of the method for the quantitation of acetaldehyde was between 20 and 800 pmol in aqueous sample (0.5 mL). Application of the method to the analysis of acetaldehyde in plasma was performed.

Cholangiography of icteric type hepatoma

OBJECTIVES

Icteric type hepatoma caused by floating tumor debris in the major bile duct was rare. Such cases were often incorrectly identified as biliary carcinoma or choledocholithiasis until pathological proof. The goal of this study was to analyze the cholangiograms of icteric type hepatomas, and to identify the characteristic cholangiographic features of this rare disease.

METHODS

A retrospective analysis of 20 cholangiographies of icteric type hepatomas during a 10-yr period was carried out.

RESULTS

There were 15 males and five females in this series. Seventeen (85%) patients were hepatitis B virus carriers, and liver cirrhosis was detected in 16 (80%) patients. Serum alpha-fetoprotein levels in 13 (65%) of the patients were over 400 ng/ml. The cholangiographic findings included: 1) intraductal filling defects resulting in partial or complete obstruction and ductal dilation in 14 cases (70%), 2) abrupt complete obstruction of the common hepatic duct with an irregular cut surface in three cases (15%), and 3) tumor encasement and stricture of the biliary system in three cases (15%). Management of these patients included hepatic resection, choledochotomies with T tube stenting, or PTCD. Most of them died within one-half year after diagnosis, but one patient in our series, who received hepatic resection, survived more than 70 months.

CONCLUSIONS

It is important to recognize this group of patients. Because with proper management, good palliation or cure is possible. The cholangiographic appearances, when taken alone, are not diagnostic of icteric type hepatomas. Once these cholangiograms are seen in patients with associated risks of developing a hepatoma, such as liver cirrhosis, chronic viral hepatitis, and elevated serum alpha-fetoprotein, however, an icteric type hepatoma should be suspected.

Antitumor agents. 144. New gamma-lactone ring-modified arylamino etoposide analogs as inhibitors of human DNA topoisomerase II

The trans-fused gamma-lactone ring of etoposide is readily epimerized to its cis epimer, which is biologically inactive, or is metabolized to the inactive ring-opened hydroxy acids. Modification of this gamma-lactone ring of 4 beta-(arylamino)-4'-O-demethyl-4-desoxypodophyllotoxin resulted in several compounds (15-16, 21-22, and 24) that should block this epimerization and the resulting biological deactivation. In a topoisomerase II inhibition assay, compounds 21, 22, and 24 showed comparable activity to etoposide. In a protein-linked DNA complex formation assay, compounds 21 and 22 were more active than etoposide.

[Acute upper gastrointestinal bleeding in Chang Gung Memorial Hospital: comparison between 1980 and 1989]

Upper gastrointestinal (UGI) bleeding remains a great medical problem despite the improvement in both diagnostic and therapeutic management. We retrospectively analyzed 560 cases (male 429 cases, female 131 cases, mean age 45.8 +/- 23.1 years) of acute UGI bleeding within one year from January to December 1980, and 1872 cases (male 1395 cases, female 477 cases, mean age 48.7 +/- 27.5 years) within one year from January to December 1989, in order to define the changing pattern of etiology in the past 10 years. The major cause of bleeding was duodenal ulcer bleeding, which occurred at the age of 20-40 years. The incidence significantly decreased (57.8% in 1980 VS. 46.3% in 1989, P < 0.001). The second common cause was gastric ulcer (11.1% VS. 13.5%), which occurred mainly at the age of 50-70 years. The third was esophageal varices bleeding with a significantly increased incidence (6.6% VS. 11.4%, P < 0.001), which occurred mainly at the age of 40-60 years. The other less common causes included gastric cancer (5.9% VS. 5.8%), which occurred mainly at the age of 50-70 years, gastric erosion (5.2% VS. 6.1%), Mallory Weiss tear (2.1% VS. 3.1%), esophagitis (1.9% VS. 2.9%), Dieulafoy's ulcer (1.6% VS. 2.7%), vascular lesion (1.6% VS. 2.6%), and non-diagnostic cases (6.2% VS. 5.6%). The ratio of male to female for each etiology of UGI bleeding was about 3 to 1 in both 1980 and 1989.(ABSTRACT TRUNCATED AT 250 WORDS)

Hepatic injury during propylthiouracil therapy in patients with hyperthyroidism. A cohort study

OBJECTIVE

To evaluate the incidence, severity, and course of propylthiouracil-induced hepatic injury in patients with hyperthyroidism.

DESIGN

Cohort study.

SETTING

Outpatient clinic of a university-based hospital.

PATIENTS

Fifty-four patients with normal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values and a definite diagnosis of hyperthyroidism.

INTERVENTION

Treatment with propylthiouracil, 300 mg/d for 2 months followed by 100 to 150 mg/d for 3 months and a subsequent maintenance dose of 100 mg/d.

MEASUREMENTS

Liver biochemical tests were studied before therapy and 2 months and 5 months after starting propylthiouracil therapy. The patients were monitored with clinical evaluation and weekly liver biochemical tests after AST or ALT levels became abnormal. Serologic markers of hepatitis A, B, C, and delta virus infection were also studied when appropriate.

RESULTS

Fifteen (28%; 95% CI, 16% to 42%) of the 54 patients showed ALT elevations 2 months after propylthiouracil therapy. The mean peak ALT level for these patients was 1.35 mu kat/L (range, 0.65 3.85 mu kat/L). None of these patients had symptoms or hyperbilirubinemia. Liver biopsy in three patients showed mild perivenular focal necrosis or ill-defined granuloma composed of foamy histiocytes with ceroid pigment and mild fatty metamorphosis. Despite continued propylthiouracil therapy at a reduced dose, ALT levels returned to normal in 13 of 15 patients in the following 3 months. None of these ALT elevations resulted from hepatitis A, B, C, or delta virus infection. No statistical difference was seen in the pretreatment characteristics between patients with and those without ALT elevation, except that the former had a higher pretreatment T4 level (270 +/- 12.9 compared with 237 +/- 7.72 nmol/L, P = 0.027) and T3 level (7.22 +/- 0.72 compared with 5.85 +/- 0.39 nmol/L, P = 0.048).

CONCLUSIONS

Propylthiouracil-induced subclinical liver injury is common and is usually transient and asymptomatic. Therapy with propylthiouracil may be continued with caution in the absence of symptoms and hyperbilirubinemia.

[Characteristics of clinical pathology and changes of liver function in blood stasis syndrome in liver diseases]

The experimental study on 30 patients of the Blood Stasis Syndrome of liver diseases was discussed in this paper. Two characteristics were found. One was the pathological feature which manifested as follows: (1) DIAGNOSIS: the Blood Stasis Syndrome of liver disease was mainly diagnosed in the chronic active hepatitis and the early stage of cirrhosis of liver, while that of non-Blood Stasis was mainly observed in the chronic persistent hepatitis (P less than 0.01); (2) Pathological change: The histological changes such as piecemeal necrosis, bridging necrosis, the destruction of limiting plate, eosinophilic change, etc. It was more obvious in the Blood Stasis group than that with non-Blood Stasis Syndrome (P less than 0.01), (3) The manifestation of Blood Stasis Syndrome was not in parallel with the severity of the liver disease. The another characteristic was the changes of liver function, which expressed more markedly in the Blood Stasis group with higher level of SGPT, lower ratio of A/G and increased globulin, they were more obvious than that in non-Blood Stasis group (P less than 0.01).

The predictive value of bone marrow morphologic characteristics and immunostaining in primary (AL) amyloidosis

The authors previously demonstrated that bone marrow plasmacytosis in primary (AL) amyloidosis may be monoclonal or polyclonal. However, the clinical implications of the degree of plasmacytosis and its clonality have not been studied. The authors evaluated 62 patients with AL amyloidosis, 40 of whom had monoclonal medullary plasma cells. There was complete concordance between the light chain class of the plasma cells in the monoclonal cases and that of the circulating paraprotein in the 22 cases associated with a paraprotein. The remaining 22 patients had polyclonal plasma cells, although a paraprotein was detected in 6. The degree of plasmacytosis was significantly higher among patients with monoclonal plasma cells and correlated inversely with length of survival. The authors' findings indicate that the quantitation of bone marrow plasma cells in AL amyloidosis by immunoperoxidase studies may predict the clinical course.

Interference screw fixation of cervical grafts: a biomechanical study of a new method of cervical fixation

The dislodgement of anterior bone graft in the cervical spine is a frequent complication of attempted fusion following discectomy or corpectomy. It has been hypothesized that fixation augmented with interference screws may increase the pull-out strength of the construct and decrease the rate of these complications. Mechanical tests were conducted to compare interference screw fixation methods for enhancing the fixation between the bone graft and the adjacent vertebra. The anterior pull-out strengths of cervical bone grafts were compared using fixation with and without the addition of interference screws. Both discectomy and corpectomy graft models were examined in vitro. The mean pull-out force for a Smith-Robinson type bone graft alone was 58.1 N (SD +/- 11.4 N); for the graft augmented with two 3.5 mm cancellous bone screws, 153.9 N (+/- 58.9 N); for the graft with four 3.5 mm screws, 217.1 N (SD +/- 69.9 N). The pull-out strengths of the two and four 3.5 mm screw constructs were significantly greater than the strength of the graft alone (p less than 0.05). Similarly placed 2.7 mm cortical screws of the same length provided increased pull-out strength (123.7 N +/- 38.6 N and 142.5 N +/- 38.2 N for two and four screws, respectively); however, in comparison to the graft alone, these differences were not statistically significant. For both screw types, the four screw fixations were stronger than the two-screw fixations, although these differences were not statistically different.(ABSTRACT TRUNCATED AT 250 WORDS)

Spinal transpedicular drill guide: design and application

Short-segment stability problems of the spine, such as fracture, pseudoarthrosis, tumor, degenerative disc, and spondylolisthesis should be resolved by short-segment stabilization methods. The "rod long, fuse short" technique using traditional Harrington or Luque rods still have unavoidable problems of facet arthritis at the segments temporarily instrumented but not grafted. Transpedicular fixation of the spine is currently being used in many systems. Biomechanical studies have shown that three-level transpedicular fixation is more rigid than five-level fixation of Harrington or Luque rods. Regardless of the system used, the primary concern is how the transpedicular screw can be inserted safely through the pedicle as deep into the vertebral body as possible. A spinal transpedicular drill guide has been designed for transpedicular screws, and a prototype has been completed. Cadaver studies have been carried out and transpedicular screw position has been confirmed by computed tomography scan. Early clinical experience has demonstrated its efficacy and safety.

Spinal pedicle finder for transpedicular screw fixation--design and early clinical result

Spinal transpedicular fixation has gained widespread popularity in the past 5 years. In biomechanical studies, the deeply-inserted transpedicular screws withstood the largest number of cycles in the cephalad-caudad and medial-lateral direction before failure. However, in clinical practice, the risk of screw placement which is too far medially or too far laterally do exist. The optimization of increasing screw depth to avoid complication is of significant clinical importance. A Spinal Pedicle Finder (S.P.F) has been designed for transpedicular screws and a prototype has been completed. It is composed of an I-shaped body with a pair of front rails and a pair of rear rails. The front rail comprises two positioning arms that fit against the laminal bony crest, and the rear rail comprises two guiding bases that provide the transpedicular pin inserted with a specific angle. Both positioning arms and both guiding bases can be adjusted synchronously, and the specific angle over the guiding bases can be pre-set preoperatively according to the angle of pedicle axis. To date, in 7 cases (5 fracture and 2 spondylolisthesis) transpedicular screw fixation has been applied by aid of the S.P.F. Two-level fixation was applied in a fracture group and three-level fixation was applied in a spondylolisthesis group. The position of the transpedicular screw has been checked by CT scan postoperatively. A total of 32 transpedicular screws were inserted and all were in the pedicle and vertebral body except in one instances. One transpedicular screw was malpositioned on one side, partially lateral to the pedicle. However, this malposition did not cause any neurologic problem, such as dural tear, nerve root injury or other. Clinical experience has demonstrated its efficacy and safety.

1H and 31P nuclear magnetic resonance investigation of the interaction between 2,3-diphosphoglycerate and human normal adult hemoglobin

High-resolution 1H and 31P nuclear magnetic resonance spectroscopy has been used to investigate the binding of 2,3-diphosphoglycerate to human normal adult hemoglobin and the molecular interactions involved in the allosteric effect of the 2,3-diphosphoglycerate molecule on hemoglobin. Individual hydrogen ion NMR titration curves have been obtained for 22-26 histidyl residues of hemoglobin and for each phosphate group of 2,3-diphosphoglycerate with hemoglobin in both the deoxy and carbonmonoxy forms. The results indicate that 2,3-diphosphoglycerate binds to deoxyhemoglobin at the central cavity between the two beta chains and the binding involves the beta 2-histidyl residues. Moreover, the results suggest that the binding site of 2,3-diphosphoglycerate to carbonmonoxyhemoglobin contains the same (or at least some of the same) amino acid residues responsible for binding in the deoxy form. As a result of the specific interactions with 2,3-diphosphoglycerate, the beta 2-histidyl residues make a significant contribution to the alkaline Bohr effect under these experimental conditions (up to 0.5 proton/Hb tetramer). 2,3-Diphosphoglycerate also affects the individual hydrogen ion equilibria of several histidyl residues located away from the binding site on the surface of the hemoglobin molecule, and, possibly, in the heme pockets. These results give the first experimental demonstration that long-range electrostatic and/or conformational effects of the binding could play an important role in the allosteric effect of 2,3-diphosphoglycerate on hemoglobin.(ABSTRACT TRUNCATED AT 250 WORDS)

A proton nuclear magnetic resonance investigation of the anion Bohr effect of human normal adult hemoglobin

High-resolution proton nuclear magnetic resonance spectroscopy has been used to investigate the molecular mechanism of the Bohr effect of human normal adult hemoglobin in the presence of two allosteric effectors, i.e., chloride and inorganic phosphate ions. The individual hydrogen ion equilibria of 22-26 histidyl residues of hemoglobin have been measured in anion-free 0.1 M HEPES buffer and in the presence of 0.18 M chloride or 0.1 M inorganic phosphate ions in both deoxy and carbonmonoxy forms. The results indicate that the beta 2-histidyl residues are strong binding sites for chloride and inorganic phosphate ions in hemoglobin. The affinity of the beta 2-histidyl residues for these anions is larger in the deoxy than in the carbonmonoxy form. Nevertheless, the contribution of these histidyl residues to the anion Bohr effect is small due to their low pK value in deoxyhemoglobin in anion-free solvents. The interactions of chloride and inorganic phosphate ions with the hemoglobin molecule also result in lower pK values and/or changes in the shapes of the hydrogen ion binding curves for several other surface histidyl residues. These results suggest that long-range electrostatic interactions between individual ionizable sites in hemoglobin could play an important role in the molecular mechanism of the anion Bohr effect.

The Sendai virus nucleocapsid exists in at least four different helical states

Sendai virus nucleocapsids have been observed by electron microscopy to coexist in three different helical pitch conformations, 5.3, 6.8, and 37.5 nm. The 5.3- and 6.8-nm conformations are present both in uranyl acetate negatively stained preparations and in tantalum-tungsten metal-shadowed preparations, whereas the 37.5-nm conformation, which has not been previously reported, is present only in the shadowed preparations. The 5.3-nm pitch conformation appears to be a mixture of two discrete structural states, with a small difference in the twist of the structure between the two. We have used image reconstruction techniques on an averaged data set from eight negatively stained nucleocapsids to produce a three-dimensional reconstruction at 2.4-nm resolution of the structure in one of the 5.3-nm pitch states. There are 13.07 nucleocapsid protein (NP) subunits in each turn of the helix in this state. The helical repeat is 79.5 nm, containing 196 subunits in 15 turns of the left-handed 5.3-nm helix. The arrangement of subunits produces a 5.0-nm-diameter hollow core which forms an internal helical groove. The RNA accounts for about 3% of the mass of the nucleocapsid, and so its location is not conspicuous in the reconstruction. Because of the RNA remains associated with the NP subunits during mRNA transcription and genome replication, structural transitions in the nucleocapsid may determine the accessibility of the genome to polymerases. Alternatively, the large hollow core and internal helical groove we have reconstructed may allow access to the RNA even in the tightly coiled 5.3-nm pitch conformation.

Fluoride in cerebrospinal fluid of patients with fluorosis

The CSF fluoride level of individuals drinking water with normal fluoride content and of patients with endemic fluorosis were studied. For the purpose of studying the relationship between the dynamic equilibrium of the CSF fluoride and other body fluids, urine and blood fluoride were examined simultaneously. Fluoride was revealed in every CSF sample of the control group and its mean value was lower than that of the blood. The CSF fluoride concentration of patients with fluorosis was slightly higher than that of the control group, although there was no statistically significant difference. The results suggests that fluoride is a normal component of CSF. In severe cases of fluorosis or breakdown of the blood-brain in some diseases of the central nervous system, the CSF fluoride value might be increased.

Beneficial effects of verapamil during metabolic acidosis in isolated perfused rat hearts

Metabolic acidosis was produced in two groups of isolated, glucose-perfused beating rat hearts. The first group (control) was untreated whereas the second group was pretreated for 48 h by the addition of verapamil (1.2 g/L) to the drinking water. Untreated hearts all developed asystole during a 30 min perfusion with an acidotic substrate (pH = 6.8) or during subsequent reequilibration with physiologic substrate (pH = 7.4). Prior to asystole, all untreated hearts showed evidence of severe mechanical and biochemical deterioration evaluated by 31 P NMR spectroscopy. In contrast, hearts of treated rats showed less mechanical and metabolic deterioration, and all recovered during reequilibration. The mechanism of protection of verapamil against the effects of metabolic acidosis is unclear but appears to be related to preserved mitochondrial function by the drug and not to a reduced demand for energy.

Structure of a new hexasaccharide from the coaggregation polysaccharide of Streptococcus sanguis 34

The major constituent of a coaggregation polysaccharide from Streptococcus sanguis 34 is a hexasaccharide, isolated as the alditol. The proposed structure is alpha-D-GalpNAc-(1----3)-beta-L-Rhap-(1----4)-beta-D-Glcp-(1----6) -beta-D-Galf- (1----6)-beta-D-GalpNAc-(1----3)-D-Galol, based upon g.l.c.-m.s. of alditol acetates and partially methylated alditol acetates, f.a.b.-m.s., 1H-n.m.r. spectroscopy, g.l.c.-m.s. of trimethylsilylated (+)- and (-)-2-butyl glycosides, and cleavage by alpha-N-acetylgalactosaminidase. The structural deduction was facilitated by cleavage of the hexasaccharide at the furanoside linkage by 48% hydrogen fluoride, and reduction of the product, to yield alpha-D-GalpNAc-(1----3)-beta-L-Rhap-(1----4)-beta-D-Glcp-(1----6) -D-Galol.

Isolation of a novel O-linked, sulfated polysaccharide of high molecular weight from an ovarian cyst glycoprotein having blood group "A" activity

Treatment of a blood group A-active ovarian cyst mucin glycoprotein with alkaline borohydride under conditions expected to cleave O-glycosidic linkages between carbohydrate and peptide releases a sulfated polysaccharide of average molecular weight 20,000. Its peptide and mannose content is less than 1%, and carbohydrate analysis gives Fuc/GalNAc/Gal/GlcNAc in the ratio of 1:1:2.2:2.2. Galactosaminitol is recovered at the level of one residue per 112-residue average polysaccharide chain. The 13C- and 1H-NMR spectra show that the polysaccharide has side chains whose non-reducing terminals have the blood group A structure on a type 1 chain: (Formula: see text). Methylation analysis confirms the presence of these blood group A type 1 sidechains as well as 4-substituted GlcNAc, 3-substituted galactose and 3,6-substituted galactose branch points. Periodate oxidation removes all the fucose and GalNAc from the non-reducing terminal but leaves intact the backbone composed of beta-linked Gal and GlcNAc, as would be expected for a polylactosamine. Although the native polysaccharide is resistant to endo-beta-galactosidase digestion, the product of periodate degradation is partially digested, giving a 30% yield of a trisaccharide shown by 1H-NMR spectroscopy to be: Gal(beta 1----3)GlcNAc(beta 1----3)Gal We conclude that this is a high molecular weight sulfated polysaccharide which is related to the asparagine-linked polylactosamine chains of cell surface glycoproteins which have been implicated in cell differentiation. However, the blood group A polysaccharide from the ovarian cyst mucin is unique in several respects. It is linked to the protein by an O-glycosidic bond rather than the N-asparagine linkage of the previously known polylactosamines which have a trimannosyl core, and its blood group A side chains are on a type 1 core rather than type 2 which is found on other polylactosamines.

Evaluation of the hereditary Syrian hamster cardiomyopathy by 31P nuclear magnetic resonance spectroscopy: improvement after acute verapamil therapy

The relation between metabolic and functional derangement in various cardiomyopathies has not been well characterized. This information was specifically sought in a spontaneous cardiomyopathic model. Metabolic and hemodynamic parameters were obtained in glucose-perfused beating hearts of 180-200-day-old cardiomyopathic Syrian hamsters and age-matched healthy animals. This period in the cardiomyopathic hamster lifetime is intermediary between the necrotic phase and the appearance of heart failure. We used 31P nuclear magnetic resonance spectroscopy to analyze energy metabolites and intracellular pH. Cardiomyopathic hamsters had significantly higher mole fraction values for inorganic phosphate, lower phosphocreatine mole fraction as well as lower phosphocreatine/inorganic phosphate and adenosine triphosphate/inorganic phosphate ratios. Analysis of pH indicated the presence of regions of increased acidity within the heart of myopathic hamsters. Cardiomyopathic hamsters also had significantly lower left ventricular pressure, coronary flow, and myocardial oxygen consumption. Separate groups of normal and myopathic hamsters were given verapamil for 24 hours (one injection of 4 mg/kg s.c. followed by 1.2 g/l in drinking water). Verapamil-treated myopathic hamsters had evidence of markedly improved mitochondrial function when compared with untreated animals. Left ventricular pressure and coronary flow rose to normal levels. Replacing glucose by pyruvate in the perfusate of myopathic hamsters results in a marked increase in left ventricular pressure, coronary flow, and oxygen consumption with a moderate rise in phosphocreatine. Thus, 180-200-day-old cardiomyopathic hamster heart is characterized by evidence of decreased mitochondrial function, by areas of increased acidity within the heart, and by reduced left ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)

Mutagenicities of nitrosated carboline derivatives

Food-borne amines have been considered as the potential precursors of endogenous carcinogenic N-nitroso compounds in humans. A compound which yields a direct mutagen after nitrite treatment was isolated from soy sauce and was identified as 1-methyl-1,2,3,4-tetrahydro-2-carboline-3-carboxylic acid (MTCA) (Wakabayashi, et al., 1983). The mutagenicities of other carboline derivatives such as harman, norharman, harmaline, harmalol, harmine, and harmol were studied. Like MTCA, the nitrosated carboline derivatives showed higher mutagenic activity as compared to their corresponding parent compounds. The demethylated analogue of MTCA, 1,2,3,4-tetrahydro-2-carboline-3-carboxylic acid was synthesized and its nitrosated products were shown to be mutagenic to Salmonella typhimurium TA 100 and TA 98. The potent mutagen Trp-P-2 is a typical 3-carboline derivative. The mutagenicity of Trp-P-2 was suppressed remarkably after nitrosation. Several 3-carboline derivatives also showed the similar property. Nitrosation of MTCA gave several derivatives which were isolated and showed direct mutagenicity to Salmonella typhimurium TA 98. Further characterization of these new carboline derivatives is in progress.

Characterization of the oligosaccharide alditols from ovarian cyst mucin glycoproteins of blood group A using high pressure liquid chromatography (HPLC) and high field 1H NMR spectroscopy

A combination of reverse phase and normal phase high pressure liquid chromatography has been used to separate the reduced oligosaccharides produced by alkaline borohydride degradation of a blood group A ovarian cyst mucin glycoproteins. Fourteen compounds, ranging in size from a monosaccharide to a decasaccharide, have been isolated preparatively using a Zorbax C-18 reverse phase column eluted with water and a MicroPak AX-5 normal phase column eluted with aqueous acetonitrile. The purity of the products and their structures were determined from the fully assigned high field proton NMR spectra. The resonances of exchangeable amide protons, observed by the Redfield selective pulse sequence in H2O, were assigned by decoupling to the resonances of H2 of the 2-acetamido sugars. Nuclear Overhauser effects were used to establish the relationship of the anomeric protons and those of the aglycone. In exception to earlier proposals that nuclear Overhauser effect on irradiation of the anomeric proton should always be observed at the proton attached to the aglycone carbon, we find that for the linkage of GalNAcp(1----3)Gal, nuclear Overhauser effect on irradiation of the alpha-anomeric proton resonance is observed not at H3 but at H4 of galactose. A combination of NMR methods and enzymatic degradation was employed to determine the structures of 13 different oligosaccharides of which seven have not previously been reported. These oligosaccharides, which terminate with beta-Gal, alpha-Fuc, beta-GlcNAc, and alpha-GalNAc, account for 75% of the total glycoprotein carbohydrate, the remainder being isolated as a mixture of glycopeptides and a high molecular weight polysaccharide whose NMR spectrum implies a simple repeating subunit structure closely related to that of the oligosaccharides.

Discovery and epidemiology of PCB poisoning in Taiwan: a four-year followup

An outbreak of polychlorinated biphenyl (PCB) poisoning from the consumption of contaminated rice oil, covering four counties in central Taiwan, was investigated. There were 1843 cases by the end of 1980. The highest frequency of incidence occurred during the period from March to July 1979. The severity of clinical manifestations varied. Most patients showed symptoms of mild or moderate severity. The major age group affected was between 11 and 20 years old. Most of the victims were students and factory workers. The amount of PCB intake in each victim was estimated to be 0.7 to 1.84 g and the latent period from the time of intake to the onset of clinical manifestations was approximately 3 to 4 months. The patients' blood PCB concentrations ranged from 3 ppb to 1156 ppb; 44.27% of 613 patients had levels of 51 to 100 ppb and 27.6% PCB blood levels over 100 ppb. In the course of 3.5 years, 2061 persons were determined to be PCB poisoning victims. Now, except for a few severe cases, their skin symptoms are very much improved. Thirty-nine babies showing hyperpigmentation were born from PCB-poisoned mothers. The fatality rate was high: eight of them died. Another 24 deaths were reported among the PCB-poisoned group, almost half of them (12) from hepatoma, liver cirrhosis or liver diseases with hepatomegaly.