[Perirenal hematoma diagnostic of periarteritis nodosa. Apropos of a case]

Hematoma of the renal space may be of various causes. Polyarteritis nodosa can be revealed by a perirenal hematoma as in the case reported but this is a rare complication of the disease. A case of a young man with a previous history of hepatitis Hbs+ is reported.

Amino acid sequence of human histidine-rich glycoprotein derived from the nucleotide sequence of its cDNA

A lambda gt 11 library containing cDNA inserts prepared from human liver mRNA has been screened with an affinity-purified antibody to human histidine-rich glycoprotein (HRG) and then with a restriction fragment isolated from the 5' end of the largest cDNA insert obtained by antibody screening. A number of positive clones were identified and shown to code for HRG by DNA sequence analysis. A total of 2067 nucleotides were determined by sequencing 3 overlapping cDNA clones, which included 121 nucleotides of 5'-noncoding sequence, 54 nucleotides coding for a leader sequence of 18 amino acids, 1521 nucleotides coding for the mature protein of 507 amino acids, a stop codon of TAA, and 352 nucleotides of 3'-noncoding sequence followed by a poly(A) tail of 16 nucleotides. The length of the noncoding sequence of the 3' end differed in several clones, but each contained a polyadenylylation or processing sequence of AATAAA followed by a poly(A) tail. More than half of the amino acid sequence of HRG consisted of five different types of internal repeats. Within the last 3 internal repeats (type V), there were 12 tandem repetitions of a 5 amino acid segment with a consensus sequence of Gly-His-His-Pro-His. This repeated portion, referred to as a "histidine-rich region", contained 53% histidine and showed a high degree of similarity to a histidine-rich region of high molecular weight kininogen.

Improvement in organically disturbed behavior with trazodone treatment

Four elderly patients with severe organic brain syndromes and disturbed behavior were treated with trazodone after therapy with neuroleptics had been ineffective. The behavior of all four patients improved substantially. In each case, the clinical presentation did not suggest a depressive illness, and many of the disturbed behaviors, such as hypersexuality, are not generally considered characteristic of depression. The improvement in behavior may be related to the taming effect of trazodone in animal models of aggression. This effect is not shared by other antidepressants; thus, trazodone may have unique value as an alternative to neuroleptics for the treatment of organically disturbed behavior.

The heparin-binding site(s) of histidine-rich glycoprotein as suggested by sequence homology with antithrombin III

A high degree of sequence homology has been found between the N-terminal region of histidine-rich glycoprotein (HRG) and that of antithrombin III (AT III) where the putative heparin-binding site of AT III is located. The amino acid residue at the position corresponding to Arg-47 of AT III that is essential for the heparin-binding was also arginine (Arg 23 and 78) in the homologous sequences of HRG. These observations strongly suggest that the heparin-binding sites of HRG and AT III are evolutionarily related. There was no apparent sequence similarity between the remaining about 70% portions of the two proteins.

Characterization of a cDNA coding for human protein C

Protein C is a precursor to a serine protease that is present in mammalian plasma. In its activated form, it readily inactivates factor Va and factor VIIIa, two proteins that participate as cofactors in the blood coagulation cascade. In the present studies, a lambda gt11 library containing cDNA inserts prepared from human liver mRNA has been screened with an antibody to human protein C. Seven positive clones were isolated from 2 X 10(6) phage and were plaque-purified. The cDNA inserts of two of these phage were sequenced and shown to code for human protein C. Each cDNA insert coded for a portion of the light chain of the molecule, a connecting region, the heavy chain, a stop codon, a 3'-noncoding region, and a poly(A) tail. The length of the noncoding sequence on the 3' end differed in the two clones, but each contained a processing or polyadenylylation signal followed by a poly(A) tail. The amino acid sequence as determined from the cDNA indicates that protein C is synthesized as a single-chain polypeptide containing the light chain and the heavy chain connected by a dipeptide of Lys-Arg. The single-chain molecule is then converted to the light and heavy chains by cleavage of two or more internal peptide bonds. In plasma, the heavy and light chains of protein C are linked together by a disulfide bond. The amino acid sequence of human protein C shows a high degree of homology with that of the bovine molecule. The DNA sequence coding for the catalytic region near the active site serine in human protein C also showed a high degree of DNA and amino acid sequence identity with prothrombin, factor IX, and factor X, three of the other vitamin K-dependent serine proteases that are present in plasma.

In vivo stimulation of low-density lipoprotein degradation by insulin

The effect of insulin on low-density lipoprotein (LDL) metabolism in vivo was evaluated using the euglycemic insulin clamp technique. In seven subjects, mononuclear cells isolated after a 4-h insulin infusion degraded more 125I-labeled LDL than cells isolated after a saline infusion in six control subjects. In addition, insulin caused the accelerated disappearance of 125I-labeled LDL from plasma in subjects previously injected with autologous 125I-LDL. Infusion of saline had no such effect. These data suggest that insulin, in vivo, stimulates LDL catabolism and could thereby influence LDL cholesterol levels. Insulin-induced stimulation of LDL catabolism could account for the reduction of LDL-cholesterol levels observed in intensively treated type I diabetic patients.

Male longevity and age differences between spouses

Analysis of mortality estimates and adjusted census data showed that men aged 70 to 79 married to younger women tended to live longer than men married to older women. The standard mortality ratio for 50-year-old husbands with younger wives was 90, whereas it was 112 for husbands with older wives. For 70-year-old men the comparable values were 80 and 133. Thus the mortality risk associated with marriage to a younger woman was clearly less than that associated with marriage to an older woman. Two possible explanations were advanced for this relationship: (a) premarital selection factors may be related to longevity, and (b) psychological, physiological, or social factors associated with longevity may be enhanced by marriage to a younger woman.

Kinetics of amyloid deposition. II. The effects of dimethylsulfoxide and colchicine therapy

Amyloid (AA) protein, when deposition begins, is deposited in two stages--a rapid deposition period of 2 weeks and a plateau stage. The effect of dimethylsulfoxide (DMSO) and colchicine therapy on the kinetics of amyloid deposition was dependent on the stage of the disease at which therapy began. If given during the rapid deposition period, colchicine delayed the increase in amyloid but did not abolish it. Eventually, splenic and liver amyloid reached the level seen in untreated animals. On the other hand, DMSO given during the rapid deposition period led to significant resorption of both splenic and liver amyloid. By contrast, colchicine and DMSO given after the rapid deposition period were essentially without effect in promoting amyloid resorption. These results correlated well with the serum levels of SAA, the putative AA precursor. Colchicine given during the period of rapid AA deposition caused a transient decline in SAA levels, which eventually returned to levels seen in untreated animals. DMSO given during the rapid deposition period rapidly abolished the high SAA levels and maintained it at a level seen in normal animals. Both colchicine and DMSO therapy, if instituted after the rapid amyloid deposition period, failed to reduce SAA levels significantly below that of untreated controls.

Solvent effects on ouabain binding to the (Na+,K+)-ATPase of rat brain

The effects of the solvents deuterated water (2H2O) and dimethyl sulfoxide (Me2SO) on [3H]ouabain binding to (Na+,K+)-ATPase under different ligand conditions were examined. These solvents inhibited the type I ouabain binding to the enzyme (i.e., in the presence of Mg2+ + ATP + Na+). In contrast, both solvents stimulated type II (i.e., Mg2+ + Pi-, Mg2+-, or Mn2+-dependent) binding of the drug. The solvent effects were not due to pH changes in the reaction. However, pH did influence ouabain binding in a differential manner, depending on the ligands present. For example, changes in pH from 7.05 to 7.86 caused a drop in the rate of binding by about 15% in the presence of Mg2+ + Na+ + ATP, 75% in the Mg2+ + Pi system, and in the presence of Mn2+ an increase by 24% under similar conditions. Inhibitory or stimulatory effects of solvents were modified as various ligands, and their order of addition, were altered. Thus 2H2O inhibition of type I ouabain binding was dependent on Na+ concentration in the reaction and was reduced as Na+ was elevated. Contact of the enzyme with the Me2SO, prior to ligands for type I binding, resulted in a greater inhibition of ouabain binding than that when enzyme was exposed to Na+ + ATP first and then to Me2SO. Likewise, the stimulation of type II binding was greater when appropriate ligands acted on enzyme prior to addition of the solvent. Since Me2SO and 2H2O inhibit type I ouabain binding, it is proposed that this reaction is favored under conditions which promote loss of H2O, and E1 enzyme conformation; the stimulation of type II ouabain binding in the presence of the solvents suggests that this type of binding is favored under conditions which promote the presence of H2O at the active enzyme center and E2 enzyme conformation. This postulation of a role of H2O in modulating enzyme conformations and ouabain interaction with them is in concordance with previous observations.

Acceleration of low-density lipoprotein catabolism in man by total parenteral nutrition

Since insulin enhances the catabolism of low-density lipoprotein (LDL) by cultured human cells, a potential role of insulin in the regulation of plasma LDL levels in man is suggested. To evaluate the possible effect of insulin on LDL catabolism in vivo, the disappearance rates of injected 125I-labeled autologous LDL were determined before and after endogenous hyperinsulinemia was evoked by total parenteral nutrition. Multicompartmental analysis of plasma decay curves showed a 26% increase in the fractional catabolic rate of LDL after total parenteral nutrition was started. An associated reduction of plasma cholesterol levels resulted from changes in both LDl and high-density lipoprotein. These results suggest that the reduction of LDL levels during total parenteral nutrition is at least partly accounted for by enhanced LDL catabolism. It is postulated that the enhanced LDL catabolism may result from the hyperinsulinemia that accompanies total parenteral nutrition, via insulin stimulation of receptor-mediated LDL catabolism.

Visible physical impairment and psychological adjustment among pediatric cancer survivors

Because psychological and psychiatric assessments of childhood cancer survivors have revealed a high rate of psychiatric sequelae, the authors investigated the relationship between the degree of physical unpairment resulting from cancer treatment and the psychosocial adjustment problems of survivors. Ratings of physical impairment were based on the visibility of physical residua as well as the functional limitations they imposed. The results indicated that the psychosocial adjustment of survivors is not significantly related to the severity of physical impairment.

Effects of behavioral and pharmacological weight loss programs on nutrient intake

Behavior therapy is a widely used method for short-term weight control. Formal nutrition counseling is not included in many behavioral programs. To determine what types of diets were self-selected by patients and to see how they compared with individuals participating in a relaxation group with anorectic medication, the eating diaries compiled by participants in such a program were analyzed for 20 different nutrients. In general, pretreatment intakes were nutritious and typical for Americans. Both the behavioral and a relaxation-medication treatment produced weight loss and reduction in calorie intake. Both treatments were associated with the consumption of a fairly nutritious diet not much different from the pretreatment intake except for a reduction in the amount eaten.

Zinc metabolism in humans after oral and intravenous administration of Zn-69m

Seventeen patients were studied after separate oral and intravenous administration of 50 muCi Zn-69m to determine if Zn-69m is suitable for studying zinc metabolism in humans and to determine if the route of administration affects kinetics. Patients stayed on a metabolic ward for each study. Activity was measured in the total body, urine, feces, blood, plasma, red blood cells, and by detectors over liver and thigh. Five day urine to fecal ratios were 0.44 (intravenous), 0.018 (oral). Most activity went rapidly to liver, then followed two component exponential loss patterns in both cases. Thigh area doubling time was 5.7 days whether the zinc was given orally or intravenously. Plasma activity decreased to less than 2% of that injected by 24 hr after intravenous administration and decreased from a maximum of 1.2% of that ingested, 3 hr after oral administration to 0.7% by 24 hr. Red blood cell activity increased through the 5-day study period to maximum values of 6.4% of that injected after intravenous administration and 2.4% of that ingested after oral administration. Similar metabolic patterns were observed regardless of whether Zn-69m was administered intravenously or orally, suggesting that these patterns were not affected by the mode of administration for the cases studied.

Effects of polyamines on partial reactions of membrane (Na+ + K+)-ATPase

Spermine and spermidine inhibit the (Na+ + K+)-ATPase (ATP phosphohydrolase, EC 3.6.1.3) reaction so that the effect increases as the ionic content due to Na+ and K+ in the reaction is reduced. Several other amines inhibit (Na+ + K+)-ATPase to varying degress and methylglyoxal-bis-(guanylhydrazone) was the most potent inhibitor among those tested. The inhibition by polyamines of the ATPase is uncompetitive with respect to Mg2+ and ATP activation of the reaction. Various naturally occurring polyamines and other amines inhibited Na+ activation of (Na+ + K+)-ATPase as well as Na+-dependent phosphoenzyme formation in an apparently competitive manner with respect to Na+. Likewise, K+-activation of (Na+ + K+)-ATPase as well as K+-p-nitrophenyl phosphatase was inhibited in an apparently competitive manner with respect to K+. Both the cation charge and structure (e.g., aliphatic chain length) may contribute to the inhibitory effects of the amines; however, Na+ sites appear to be more sensitive to cation charge than the aliphatic chain length of the amine, whereas the opposite appears to be true for K+ sites. The results do not indicate a specific effect of polyamines on (Na+ + K+)-ATPase or its partial reactions.

The influence of design on the transmission of torque across knee prostheses

Knee prostheses of eight different designs were tested experimentally to determine the axial torque necessary to rotate the tibial component relative to the femoral component with the prosthesis positioned at or near full extension. The results represent transmitted torque as a function of axial rotation. For six designs, the transmitted torque was 11.3 newton-meters (100 inch-pounds) or greater at 6 degrees of rotation, with an axial load of 1556.8 newtons (350 pounds). These prostheses either had close conformation between femoral and tibial components, or were mechanically linked. In these prostheses, the geometry of the articulating surfaces was the primary determinant of torque. For the other two types, under similar loading conditions the transmitted torques were 2.5 newton-meters (twenty-two inch-pounds) at 6 degrees of rotation. These prostheses were designed to allow greater freedom for rotation, and hence for them the primary determinant of torque was friction between the articulating surfaces. The predictive value of this torque characteristic relative to the incidence of loosening will have to be determined by comparison with clinical experience.

Herbert total knee prosthesis: combined laboratory and clinical assessment

We tested the Herbert knee prosthesis, which was designed to restore intrinsic stability with limited degrees of freedom for rotation to severely damaged or deformed knees, in a knee simulator. These tests indicated a tendency for the prosthesis to fracture through the medial femoral housing after cycling for the equivalent of one to three years of normal use. In a clinical series of thirty-five knees treated with the prosthesis, there were five failures similar to those produced by laboratory testing. On the basis of this combined study, the Herbert prosthesis appears to have design characteristics that seriously limit its usefulness for long-term knee replacement. Testing in a knee simulator in this case appeared to be a valid predictor of clinical failure.

Na+-dependent phosphorylation of the rat brain (Na+ + K+)-ATPase. Possible non-equivalent activation sites for Na+

The steady state levels of Na+-dependent phosphoenzyme (E-P) in the (Na+ + K+)-ATPase (EC 3.6.1.3) of rat brain, obtained from a time course study of phosphoenzyme formation at 4 degrees C, were dependent on the concentration of Na+ in the reaction and were maximal in the presence of 64 mM Na+. The plot of phosphoenzyme vs. Na+ concentration gave a curve which on conversion to a double reciprocal plot (1/E-P vs. 1/Na+) gave a line with two breaks, yielding apparently three linear segments. This may be taken to indicate the presence of multiple Na+ sites for the formation of the phosphoenzyme. To test this hypothesis further, the following approach was taken. By making the assumption that the phosphoenzyme may represent bound Na+, it was possible to subject the data to rigorous multiple-site analysis by utilizing steady-state binding equations described by Klotz and Hunston (1971) (Biochemistry 10, 3065-3069), and by Scatchard (1949) (Ann. N.Y. Acad. Sci. 51, 660-672). The analysis of the data by these methods suggests that there may be three non-equivalent Na+ activation sites for the formation of Na+-dependent phosphoenzyme in the (Na+ + K+)-ATPase. The estimated intrinsic association constants (Ka) for activation by Na+ at each of the three sites were 3.4, 0.295, and 0.025 mM-1, respectively.

Death anxiety in normal children and adolescents

Instruments devised to measure death anxiety, depression, and manifest anxiety in adults were administered to 75 junior high-school students, 111 senior high-school students, and 38 adults in an effort ot determine the nature of any developmental differences among these groups. A number of significant differences were noted, with the senior high-school students showing greater anxiety, depression, and death anxiety than the other groups. These results are discussed in the context of tasks of adolescent development, and an item analysis of the death anziety questionnaire is presented. Developmental differences in the origin of death anxiety are related to previous studies of death anxiety in adults.

The psychological differentiation of male myopes and nonmyopes

A comparison of 140 male myopes and 118 male nonmyopes of the entering class of Virginia Military Institute cadets in 1968 demonstrated that there are a number of Strong Vocational Interest Inventory test items which will clearly differentiate myopes from nonmyopes so that it is possible to identify 76% of the individuals falling into either class on the basis of a stepwise discriminant analysis based almost entirely on the Strong Vocational Interest Blank. The items which discriminate in favor of the myopes are essentially those which require academic achievement and individual creative performance, whereas the items which are in favor of the nonmyopes are those which require business and selling skills as well as outdoor types of activities. Further, the myopes are significantly more likely to achieve officer status and win more academic awards than the nonmyopes.

Circadian rhythms in human heart homograft

The electrocardiogram and cardiotachogram of a patient with a human heart transplant has been recorded for 72 hours. Within the donor P-QRS-T complex, one can identify the P waves emanating from residual sinoatrial heart tissue of the recipient. The recipient P waves are independent of the donor complexes. A clear circadian rhythm (23.4 hours) in heart rate is maintained for both donor and recipient tissue, the donor complexes preceding by a phase shift of 135 minutes the complexes of the recipient heart tissue. Both tissues display clear morning and evening minimum and maximum rates paralleling activity and lighting cycles.