Influence of intravenous n-3 lipid supplementation on fatty acid profiles and lipid mediator generation in a patient with severe ulcerative colitis

N-3 fatty acids were supplied to a 36-year-old female patient suffering from ulcerative colitis and severe steroid side-effects, in a sequence of parenteral and enteral administration. During a moderately active period of disease, 200 ml d-1 fish oil-derived lipid emulsion (eicosapentaenoic acid [EPA], 4.2 g; docosahexaenoic acid [DHA], 4.2 g) was infused for 9 days, in parallel with rapid tapering of the steroid dose. Disease activity declined rapidly, and the patient was subsequently provided with 16 fish oil capsules per day (EPA, 2.9 g; DHA, 1.9 g) for 2 months. At the end of this period of therapy, severe colitis recurred with intestinal and extraintestinal manifestations. The n-3 lipid emulsion was then used for intravenous alimentation (29 days, maximum dose 300 ml per day); during this time, marked improvement of the inflammatory bowel disease was noted. During both periods of parenteral n-3 lipid administration, total plasma EPA and DHA contents increased several-fold, surpassing that of arachidonic acid; this plasma n-3 fatty acid enrichment was only maintained to a minor extent during the intermediate period of dietary fish oil supplementation. The intravenously administered EPA-containing triglycerides were rapidly hydrolyzed, as evidenced by the appearance of substantial quantities of EPA in the plasma free fatty acid fraction. Platelet and neutrophil total membrane content of EPA and DHA as well as n-3 fatty acid/AA membrane ratios similarly increased during the periods of intravenous n-3 lipid administration and declined during oral fish oil uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

The efficacy of intravesical BCG in the treatment of patients with high risk superficial bladder cancer

Sixty-two patients with superficial bladder cancer stage T1 with or without dysplasia or carcinoma in situ and 34 patients with stage TA associated with dysplasia or carcinoma in situ were treated by TUR and TUR + BCG, respectively, and were followed up for an average of 46 months (6-192) and 32 months (6-72), respectively, after therapy. The recurrence rate (61%), progression (37%) and tumour death (19%) were unfavourably high in the group of patients treated by TUR only. On the contrary, the effect of intravesical BCG therapy was excellent. Recurrence rate was as low as 20.5%, and progression and tumour death were not detected in any patient. Intravesical BCG seems to be the best choice for treatment of high risk superficial bladder cancer. The authors recommend their effective modified treatment schedules.

Stochastic resonance in a single neuron model: theory and analog simulation

Here, we consider a noisy, bistable, single neuron model in the presence of periodic external modulation. The modulation induces a correlated switching between states driven by the noise. The information flow through the system, from the modulation, or signal, to the output switching events, leads to a succession of strong peaks in the power spectrum. The signal-to-noise ratio (SNR) obtained from this power spectrum is a measure of the information content in the neuron response. With increasing noise intensity, the SNR passes through a maximum: an effect which has been called stochastic resonance, and which was first advanced as a possible explanation of the observed periodicity in the recurrences of the Earth's ice ages. We treat the problem within the framework of a recently developed approximate theory, valid in the limits of weak noise intensity, weak periodic forcing and low forcing frequency, for both additive and multiplicative noise. Moreover, we have constructed an analog simulator of the neuron which demonstrates the stochastic resonance effect, and with which we have measured the SNRs for comparison with the theoretical results. Our model should be of interest in situations where a single inherently noisy neuron is the receptor of a periodic signal, which is itself noisy, either from the network or from an external source.

Developing nurse managers in Hungary

Success in the work of nursing administrators can be realized only if they have their own sphere of competency and authority. In the Hungarian management system, however, nursing administrators are only functional leaders; they do not have authority for decisionmaking nor do they have a major leadership role. Most hand in proposals and carry out decisions made by the general director/chief physician or other leaders of the hospital. Below, an overview of the present status of Hungarian nursing administrators and a suggested new structure of management that would provide nursing administrators with a full and independent right of decision, which would greatly improve the efficiency of nursing care.

[Urinary N-acetyl-beta-D-glucosaminidase activity in healthy, polycythemic and hypoxic newborn infants]

Urinary N-acetyl-beta-D-glucosaminidase (NAG) activity was assayed in 20 polycythemic newborns and prematures, together with 50 prematures suffering from hypoxia on the 1st, 2nd, 4th, 14th, and 28th day after birth. The enzyme was also assayed in 101 healthy newborns which provided normal reference values. NAG activity was factored by the creatinine concentration to given an index. There were significant difference in the NAG indices either between full-term and preterm babies or between appropriate for gestational age (AGA) and small for gestational age (SGA) neonates of the normal group. However, NAG excretion on the first day of life was significantly raised in the case of polycythemic newborns. Following partial plasma exchange, on the 14th day the NAG activity returned to the normal range. NAG activities of premature babies suffering from idiopathic respiratory distress syndrome (IRDS) were significantly elevated on the 1st, 2nd, 4th day but fell sharply to the 14th day. NAG activity fell to normal values by the 28th day. These results suggest that the urinary NAG index is a sensitive indicator of the renal tubular damage during the newborn period.

The effect of polycythemia and hypoxia on urinary N-acetyl-beta-D-glucosaminidase activity in newborns

Urinary N-acetyl-beta-D-glucosaminidase activity was assayed in fullterm and preterm polycythemic neonates, in preterm infants with hypoxia, and in healthy newborns. There were no significant differences between fullterm and preterm babies or between appropriate for gestational age and small for gestational age neonates in the normal group. N-acetyl-beta-D-glucosaminidase excretion on the first day of life was significantly raised in polycythemic newborns (P less than 0.01). Fourteen days after partial plasma exchange the enzyme activity returned to normal. N-acetyl-beta-D-glucosaminidase activities in preterm babies with respiratory distress syndrome were significantly (P less than 0.01) raised on the 1st, 2nd, 4th days and fell sharply to the 14th day. N-acetyl-beta-D-glucosaminidase isoenzyme studies revealed that urine samples taken from preterm babies with respiratory distress syndrome in the first week after birth contained increased amounts of intermediate and B isoenzyme forms while there was a concomitant reduction in the amount of the A form present.

Study of the unidimensionality of the Bech-Rafaelsen Melancholia Scale using Rasch analysis in a French sample of major depressive disorders

In a French sample of 73 major depressive disorders (according to the DSM III definition), the unidimensionality of the Bech-Rafaelsen Melancholia Scale was studied; firstly by means of traditional but not really valid methods (i.e., factor analysis and Cronbach's alpha), and second, using the Rasch logistic model. These methods would seem to show that the B.R.M.E.S. provides a unidimensional measurement of depression.

[Results of BCG immunotherapy in the management of bladder tumors]

The authors reported their results of BCG immunotherapy in the treatment of the bladder cancer. between 1984-1989 60 superficial and 4 muscle infiltrative bladder tumors were treated. The results of 53 BCG treated superficial bladder cancer group were compared to control groups. The recurrence cases three-four times, the progressive cases eight-ten times were more in the control groups than it was found in the BCG group. They could not establish the value of BCG in the treatment of muscle infiltrative bladder cancer, because they had not appropriate number of patients and they could find only few articles in the literature. The authors surveied the last literature of BCG immuntherapy and verified that BCG had an important role in the treatment of the bladder cancer and searching the action of antitumor effect of BCG would add more useful information to cancer immunology.

[The role of hydroxyl groups of tyrosine residues in RNA-ligase]

The stability of the AMP-RNA-ligase complex was studied. The complex was found to be stable for at least two weeks upon storage at 0 degrees. Approximately 50% of the initial radioactivity was retained after storage at 9 degrees for 49 days. The formation of adenosine in the complex decomposition products suggested the possible involvement of the tyrosine hydroxyl group in the formation of AMP-RNA-ligase complexes. In order to study the structure of the enzyme active site, the hydroxyl groups of the RNA-ligase tyrosine residues were modified with N-acetyl-imidazole. It was found that four out of 25 tyrosine residues are exceptionally susceptible to chemical modification with resultant complete suppression of the enzyme ability to form a complex with ATP. The kinetic parameters (Km, V) of native and modified RNA-ligase were determined and compared. A hypothetical scheme of the tyrosine hydroxyl group participation in RNA-ligase-catalyzed reactions is proposed.

Studies on the N-acetyl-beta-D-hexosaminidase B from germinating Lupinus luteus L. seeds. II. Mechanism and inhibition with some 2-acetamido-2-deoxyaldono(1----4)lactones

The N-acetyl-beta-D-hexosaminidase B of germinating yellow lupin seeds catalyzed the hydrolysis of both p-nitrophenyl-N-acetyl-beta-D-glucosaminide and -galactosaminide substrates. The investigation of the pH dependence of the kinetic parameters (Vmax and Vmax/Km) demonstrated that two common ionizable groups (probably two carboxyl groups) play an essential role in the catalysis. That is, the enzyme has a lysozyme-like splitting mechanism, and the possibility of an anchimeric assistance provided by the acetamido group seems to be negligible. The presence of a deprotonated carboxyl group near the glycosidic linkage was also supported by inhibition with 1-thio substrate analogues. On the other hand, some 2-acetamido-2-deoxyaldono(1----4)lactones proved to be effective inhibitors of the hexosaminidase with the exception of the D-arabinose derivative, which can be explained by high stereospecificity in the binding.

Studies on the N-acetyl-beta-D-hexosaminidase B from germinating Lupinus luteus L. seeds. I. Purification and characterization

The N-acetyl-beta-D-hexosaminidase B of germinating Lupinus luteus L. seeds (McFarlane et al. (1984) Phytochemistry 23, 2431-2433) was partially purified with a six-step purification procedure following extraction. This enzyme consists of one protein chain (Mr 69,000, as determined by SDS-PAGE and 62,500, as obtained by gel filtration on Bio-Gel P-60 Gel) and has a neutral isoelectric point (pI = 7.05, as determined by chromatofocusing). Moreover, it was found to be very sensitive to low ionic strength, especially in the presence of different gels based on Sephadex. Considering the substrate specificity, the enzyme splits both p-nitrophenyl-2-acetamido-2-deoxy-beta-D-glucosaminide and -galactosaminide substrates, but lacks N,N'-diacetylchitobiase activity. A new mixed-substrate procedure was developed and is presented here to demonstrate that a common active site is responsible for the splitting of both synthetic substrates.

In vitro investigation of BK-218, a new oral and parenteral cephalosporin

The antibacterial activity of BK-218 was similar to that of cefamandole when it was tested against several laboratory strains. The inhibiting effect of BK-218 was greater than that of cephalexin and cefoxitin on penicillin-binding proteins of Escherichia coli HB101. This result was in close correlation with the relative inhibition of radiolabeled glucosamine incorporation (greatest with BK-218) and with the lytic effect (most intensive with BK-218). BK-218 proved to be a good inhibitor for all five of the beta-lactamases that were investigated, although two enzymes (Enterobacter cloacae P99 and Pseudomonas aeruginosa Cilote) hydrolyzed it to some extent.

Kinetic investigation of the substrate specificity of the cyanogenic beta-D-glucosidase (linamarase) of white clover

Partially purified linamarase from Trifolium repens (genotype Lili acac) plants was kinetically characterized. Kinetic evidence was found to support the assumption that this cyanogenic beta-D-glucosidase has a broad substrate spectrum. p-Nitrophenyl-beta-D-xylopyranoside and p-nitrophenyl-alpha-L-arabinopyranoside substrates bound almost as tightly to the active center of the enzyme as the glucono(1----5)lactone transition-state analog inhibitor. Substrate specificity investigation also indicated that positions C-4 and C-6 on the pyranoside ring play an essential role in both substrate orientation and splitting. Recently very similar kinetic characteristics were reported on some mammalian cytosolic beta-D-glucosidases and a possible physiological interpretation of this coincidence is discussed. Inhibition studies with glucono(1----5)lactone revealed that the carbohydrate moiety of each substrate attached to the same binding site in the active center. Inhibition experiments with 1-thio substrate analogs demonstrated that the aglycon and the angular arrangement around the glycosidic linkage were the major determinants in the observed substrate specificity.

Kinetic studies on the broad-specificity beta-D-glucosidase from pig kidney

A broad-specificity beta-D-glucosidase from pig kidney cortex was isolated and purified to homogeneity by a rapid purification procedure. The pI (5.14 +/- 0.05), Mr (59,000 +/- 2000) and specific activities with several p-nitrophenyl glycosides (galactopyranoside, glucopyranoside, arabinopyranoside, xylopyranoside) were comparable with those published previously for cytoplasmic beta-D-glucosidase from other sources and organs. Mixed-substrate experiments and inhibition studies with glucono-(1----5)-lactone revealed that a single active centre, containing one catalytic site and one saccharide-binding site, was responsible for the splitting of all four synthetic substrates. Inhibition experiments with substrate analogues demonstrated that (i) the major binding determinant of the glycosides was the aglycone moiety, (ii) an anionic side chain of the enzyme (probably a carboxy group) interacted with the glycosidic linkages and (iii) the properties of the aglycone significantly influenced the binding of the carbohydrate moiety. The inhibition constants of the p-nitrothiophenyl derivatives were in good agreement with the Km values of the corresponding substrates. Therefore the Michaelis constants could be regarded as true equilibrium constants (Ks). The 'three-point-attachment model' of the substrate splitting, proposed by Daniels [(1983) Ph.D. Dissertation, University of Pittsburgh] for the analogous liver enzyme, was applicable for beta-D-glucosidase from pig kidney too. The possible nature of the 'attachments' is discussed.

[French adaptation, concurrent validation and factorial analysis of the Bech and Rafaelsen melancholia scale]

33 depressive patients diagnosed major depressive episode (DSM III) have been assessed by the French translation of the melancholia scale of Bech and Rafaelsen and the following scales: scale of depressive retardation (ERD) (Widlocher), Hamilton depression rating scale with 26 items (HDS 26), Montgomery and Asberg depression rating scale (MADRS). A concurrent validation shows that Bech-Rafaelsen melancholia scale is valid. A principal components analysis with VARIMAX rotation found 4 principal components: retardation and blunted affect, asthenia, anxiety, suicidal impulses.

Modified general affinity adsorbent for large-scale purification of penicillinases

N-Acetyl-D-(-)-penicillamine as a stable second-generation biospecific affinity ligand has previously been suggested for purification of Bacillus cereus 569/H beta-lactamase I. A complex spacer arm is coupled with the matrix by using epichlorohydrin and phloroglucinol doubly activated with divinyl sulphone in the meta position. Coupling of D-(-)-penicillamine ligand resulted in an active affigel. However, we found that two affinity ligands in close proximity prevents simultaneous binding of two penicillinase molecules, therefore one ligand is superfluous. Our results show that: (1) shortening the spacer arm by direct activation of the matrix with divinyl sulphone is satisfactory to produce the affinity material with N-acetyl-D-(-)-penicillamine; (2) incorporation of 15 mumol of N-acetyl-D-(-)-penicillamine per ml of wet Sepharose 4B satisfies the maximum binding capacity requirements of the affigel (about half of the originally incorporated amount of ligand); (3) our simplified affinity adsorbent is generally applicable for large-scale purification of penicillinases to homogeneity from various bacterial sources by the convenient batch method without prior concentration of these enzymes; (4) reacetylation for four/five times can regenerate the original binding capacity of the affigel.

Use of chromatofocusing for separation of beta-lactamases. VIII. Analytical chromatofocusing of chromosomal cephalosporinases from four Klebsiella strains

Although still there are Klebsiella strains which do not harbour plasmids and produce constitutive chromosomal beta-lactamases, recently clinical isolates were found in ever increasing numbers carrying mainly TEM-, CARB- and OXA type R-factors. We selected four chromosomal cephalosporinase producing Klebsiella strains to study the pI values of the enzymes and their simultaneous separability from accompanying proteins by chromatofocusing techniques. We compared pI values of the pure and the crude preparations: K. pneumoniae K1 SC 10436: pIpure = 6.4, pIcrude = 6.42; K. aerogenes K1 1082 E: pIpure = 6.5, pIcrude = 6.5; K. oxytoca 1082 E: pIpure = 6.42, pIcrude = 6.4; K. oxytoca 20: pIpure = 7.62, pIcrude = 7.6. Excellent agreement of the pI values among each other, but occasional differences with those obtained by analytical isoelectrofocusing are attributed to methodological diversities and to the presence of satellite enzymes, known to exist in Klebsiella.