Genetic control of corticosteroid side-chain isomerase activity in the mouse

The corticosteroid side-chain isomerases of mammalian liver catalyze the interconversion of the ketol and aldol side chains. In the mouse, isomerase was low in C57BL/6 (B6) mice (130 pmol/mg protein . 2 h) and high in BALB/c (C) mice (230 pmol/mg protein . 2 h). From analysis of hybrids between B6 and C and of backcrosses of these hybrids to B6, it was concluded that isomerase levels are controlled by a single autosomal gene dominant for high activity. The distribution of high and low isomerase levels in a series of CXB/By recombinant inbred strains of mice was consistent with linkage of the isomerase gene to H-2. Congenic BALB.B mice (H-2b haplotype from C57BL/10) had low isomerase activities corresponding to C57BL/10, not the high activity of the background strain BALB/c(H-2d). Similarly, BN10.D2 congenic mice (H-2d haplotype from the DBA/2 strain) had high activity characteristic of DBA/2. In the (C X B6)F1, (C X BALB.B)F1 and (B10 X B10.D2)F1 hybrids, all of which are H-2d/H-2d heterozygotes, isomerase activity was high. The association of isomerase levels with H-2 type was further confirmed in mice of the following backcrosses: (C X BALB.B)F1 X BALB.B, (C X B6)F1 X B6 and (B10 X B10.D2)F1 X B10. H-2b/H-2b homozygous segregants had consistently low activity and H-2b/H-2d heterozygous segregants had consistently high activity. It was concluded that the level of corticosteroid side-chain isomerase activity in mouse liver is controlled by a gene(s) in the region of the H-2 locus on chromosome 17.

Oxidative peptide (and amide) formation from Schiff base complexes

One hypothesis of the origin of pre-modern forms of life is that the original replicating molecules were specific polypeptides which acted as templates for the assembly of poly-Schiff bases complementary to the template, and that these polymers were then oxidized to peptide linkages, probably by photo-produced oxidants. A double cycle of such anti-parallel complementary replication would yield the original peptide polymer. If this model were valid, the Schiff base between an N-acyl alpha amino aldehyde and an amino acid should yield a dipeptide in aqueous solution in the presence of an appropriate oxidant. In the present study it is shown that the substituted dipeptide, N-acetyl-tyrosyl-tyrosine, is produced in high yield in aqueous solution at pH 9 through the action of H2O2 on the Schiff-base complex between N-acetyl-tyrosinal and tyrosine and that a great variety of N-acyl amino acids are formed from amino acids and aliphatic aldehydes under similar conditions.

The distribution and fate of 14C-chloramphenicol in the new-born pig

The distribution of 14C-chloramphenicol has been studied in new-born pigs with the aid of whole-body autoradiography. In the lung, liver, adrenal cortex, kidney, myocardium, pancreas, thyroid, spleen and skeletal muscle the amounts of radioactivity were higher than that of the blood short time after injection and remained higher than the blood up to 8 hrs. After 4 and 8 hrs the brain concentration of 14C was also higher than that of the blood. In the bone marrow, however, the concentration did not reach that of the blood during the whole experiment. In the organs more than 90% of the radioactivity was represented by chloramphenicol: the excretory organs, thyroids, and adrenals being exceptions.

Urinary excretion of arterial blood prostaglandins and thromboxanes in man

To determine the fraction of the arterial prostaglandin E2 (PGE2), 6-ketoprostaglandin F1 alpha (6-keto-PGF1 alpha), and thromboxane B2 (TXB2) that is excreted unmetabolized into human urine, the 3H-labeled compounds were separately infused into the renal artery or brachial vein of 23 subjects. Urine extracts were subjected to sequential chromatography on thin-layer plates, Sephadex LH-20, and reverse-phase high-pressure liquid chromatography to isolate the unmetabolized fraction. Dual isotope ratio techniques were used to identify peak fractions, to assess purity, and to calculate recovery. Following renal artery infusions, 32.2% of 6-keto-PGF1 alpha, 13.5% of TXB2, and 3.9% of PGE2 were excreted unmetabolized. Calculated fractional excretion of these compounds on a single transit through the kidney are approximately 30, 13, and 3.9%, respectively. Following brachial vein infusion of [3H]prostaglandin I2, 2.7% of the infusate was excreted as 6-keto-PGF1 alpha, suggesting that circulating prostaglandin I2 may contribute to urinary 6-keto-PGF1 alpha. When combined with published measurements of urinary PGE2, 6-keto-PGF1 alpha, and TXB2, these data can be used to calculate the maximum arterial blood concentration of these substances. The results indicate that arterial blood concentration of PGE2, TXB2, and 6-keto-PGF1 alpha in man are only a few picograms per milliliter or less.

Evidence for a dual action of converting enzyme inhibitor on blood pressure in normal man

We studied the effect of a converting enzyme inhibitor (CEI), Captopril SQ 14,225 50 mg p.o. in eight supine normal subjects under a high sodium (150 mEq/d) and low sodium (25 mEq/d) diet. On high sodium, plasma renin (PRA) and aldosterone were basal and Saralasin did not lower mean blood pressure. However, CEI induced an 11.4 +/- 3.2 mm fall in blood pressure (p less than 0.02) and either indomethacin 50 mg or ibuprofen 800 mg (PI), when given simultaneously on another day abolished the blood pressure response (2.5 +/- 0.9 mm Hg, p greater than 0.5). In contrast, on a low salt diet where renin was increased, CEI induced a drop in blood pressure which was not significantly altered by PI (12.8 +/- 1.1 vs. 10.0 +/- 3.1 mm Hg, p greater than 0.5). CEI increased plasma renin on both diets (1.7 +/- 0.5 to 3.5 +/- 0.8 and 2.8 +/- 0.6 to 12.5 +/- 3.1 ng/ml/hr respectively both p less than 0.05). Aldosterone did not change (high Na+) or fell (low Na+). Inhibition of Prostaglandin synthesis did not significantly block the renin rise from CEI suggesting that the direct angiotensin II negative feedback is relatively independent of acute prostaglandin release. Our studies suggest that CEI has a dual hypotensive action. In a low renin state, the hypotensive action appears to be mediated through vascular prostaglandins.

Peripheral metabolism of intact parathyroid hormone. Role of liver and kidney and the effect of chronic renal failure

The plasma disappearance rate (metabolic clearance rate) of administered intact parathyroid hormone (intact PTH) was analyzed in awake dogs with indwelling hepatic and renal vein catheters. The metabolic clearance rate (MCR) of intact PTH was found to be very rapid, 21.6 +/- 3.1 ml/min per kg in 11 normal dogs. The liver accounted for the greatest fraction of the MCR of intact PTH (61 +/- 4%) by virtue of an arterial minus venous (a - v) difference across the liver of 45 +/- 3%. The renal uptake of intact PTH accounted for 31 +/- 3% of the MCR of intact PTH. The renal a - v difference for intact PTH of 29 +/- 2% was significantly greater than the filtration fraction indicating renal uptake of intact PTH at sites independent of glomerular filtration. Together, the hepatic and renal clearances of intact PTH accounted for all but a small fraction of the MCR of intact PTH. The MCR of intact PTH, rendered biologically inactive by oxidation, was markedly decreased to 8.8 +/- 1 ml/min per kg. The a - v difference of oxidized intact PTH was reduced both in the liver and kidney. These data suggested that the high uptake rates of intact PTH are dependent, at least in part, upon sites recognizing only biologically active PTH. Chronic renal failure (CRF) decreased the MCR of intact PTH to 11.3 +/- 1.3 ml/min per kg (n = 10). Both the hepatic and renal a - v differences of intact PTH were reduced in dogs with CRF. This resulted in reductions in the hepatic and renal clearances of intact PTH. These studies identify the liver as a major extrarenal site of PTH metabolism affected by CRF. They suggest that CRF impairs the function of the major uptake sites involved in intact PTH metabolism.

Borderline personality disorder: interrater reliability of the diagnostic interview for borderlines

Three interviewers, working in pairs and using the Diagnostic Interview for Borderlines (DIB), interviewed three samples of 10 adult psychiatric inpatients. The two members of each interviewer pair alternated in the role of interviewer. Each member of the interviewer pairs completed the interview schedule and scored the protocol according to the instructions provided by the authors of the DIB. Interrater reliability was determined for each interviewer pair using the Kappa statistic. Reliability values were at about the level reported recently by Spitzer, Forman, and Nee (1979) for DSM-III axis I diagnoses in general. Additional statistical analyses were performed to determine whether there were patient sex differences on DIB scores, whether the two male interviewers differed from the female interviewer in their ratings of male or female patients, and whether experience differences among the three interviewers were reflected in their rating of patients. Among the latter analyses, the only significant finding was that in the interviewer pair consisting of a very experienced male psychiatrist and a male first year psychology graduate student, the former rated male patients as less borderline than did the latter. No other difference was found among raters, or between sex of patient and interviewer sex or amount of clinical experience. It was concluded that the DIB is sufficiently reliable for use in clinical research.

Lack of a direct effect of 1,25-dihydroxycholecalciferol on parathyroid hormone secretion by normal bovine parathyroid glands

Because of differing reports of an effect of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on parathyroid hormone (PTH) secretion, the present studies were performed in vitro using bovine parathyroid gland slices and isolated parathyroid cells. Both COOH-terminal and NH2-terminal RIAs for PTH were employed. No effect of 1,25(OH)2D3 on PTH secretion was found during a 4-h incubation of parathyroid slices in variable external calcium concentrations. The results from dual RIA measurements also showed no effect of 1,25(OH)2D3 on PTH secretion by isolated parathyroid cells during 90- to 150-min incubations with variable calcium concentrations. In addition, extensive analysis by polyacrylamide gel electrophoresis showed no effect of 1,25(OH)2D3 on cAMP generation. Whereas calcium inhibited and isoproterenol stimulated the production of cAMP, 1,25(OH)2D3 had no effect. We conclude that 1,25(OH)2D3 does not affect parathyroid gland function acutely in vitro.

Parathyroid hormone metabolism and its potential as a uremic toxin

Secondary hyperparathyroidism is a universal complication of chronic renal failure. It has been proposed that the markedly elevated levels of immunoreactive parathyroid hormone (i-PTH) in uremia may represent a "uremic toxin" responsible for many of the abnormalities of the uremic state. Plasma i-PTH consists of a mixture of intact hormone, a single-chain polypeptide of 84 amino acids, and smaller molecular weight hormonal fragments from both the carboxy- and amino-terminal portion of the PTH molecule. The hormonal fragments arise from metabolism of intact PTH by peripheral organs as well as from secretion of fragments from the parathyroid glands. The structural requirements for the known biological actions of PTH reside in the amino-terminal portion of the PTH molecule. Carboxy-terminal fragments, biologically inactive at least in terms of adenylate cyclase activation, hypercalcemia, or phosphaturia, depend on the kidney for their removal from plasma, and thus accumulate in the circulation in chronic renal failure. It is unknown at the present time if other biological effects of these carboxy-terminal fragments may contribute to some of the biochemical alterations observed in uremia. The most significant consequence of increased PTH levels in uremia is the development of bone disease characterized by osteitis fibrosa. In addition, it would appear that PTH plays an important role in some of the abnormal electroencephalographic patterns observed in uremia. This may be due to a potential role of PTH in increasing calcium content of brain. Parathyroid hormone also has been implicated as a pathogenetic factor in many other alterations present in uremia, i.e., peripheral neuropathy, carbohydrate intolerance, hyperlipidemia, and other alterations. Unfortunately, outstanding clinical research is lacking in this field and conclusive experimental data are practically nonexistent. Further studies are necessary if one is to accept the concept of PTH being a significant "uremic toxin."

Long-term effect of lithium on the uptake of 5-hydroxytryptamine by human platelets

1 The content, uptake and storage of 5-hydroxytryptamine (5-HT) in platelets were determined in eight manic-depressive patients not on lithium (Li); in ten manic-depressive patients on Li; and in ten apparently normal persons as controls. 2 Platelets from the patients, whether or not on Li, contained less 5-HT than platelets from normal people. 3 5-HT uptake and storage by platelets from untreated patients were significantly lower than those of control subjects. 4 When patients had been on Li for 3 months or longer the diminished uptake and storage of 5-HT by their platelets were more than fully reversed. 5 Li added to platelet-rich plasma in vitro had no effect on the uptake of 5-HT by platelets.

Effect of intact parathyroid hormone on hepatic glucose release in the dog

The liver has been shown to remove parathyroid hormone (PTH) from its arterial circulation by a mechanism that is selective for the intact form of the peptide (PTH 1-84). The present studies demonstrate that PTH has biologic effects on the liver in vivo. Bovine PTH 1-84 stimulated hepatic glucose release in dogs with indwelling hepatic vein catheters from basal values of 31+/-8 to 68+/-9 mg/min per kg after bolus injections of PTH. The effect on hepatic glucose release was apparent by 5 min and persisted for the 80 min of observation. The NH(2)-terminal PTH fragment (syn b-PTH 1-34) had no effect. Bovine PTH 1-84 administered in doses designed to produce circulating levels of immunoreactive PTH similar to the endogenous levels observed in uremic dogs also increased the incorporation of (14)C from infused [(14)C]alanine into glucose, and increased estimated hepatic uptake of both chemical and [(14)C]alanine, while increasing hepatic glucose release. Thus, administration of "physiologic levels" of b-PTH 1-84 stimulated hepatic glucose release in part through increased gluconeogenesis in vivo, whereas syn b-PTH 1-34 had no demonstrable effect. Circulating levels of insulin rose after PTH administration, an increase which presumably represents a secondary response to the rise in glucose release. These results suggest that the liver is a target organ of PTH, and that PTH might potentially alter carbohydrate metabolism during hypersecretion. They also suggest that hepatic uptake of PTH may be related in part to production of a specific biologic effect rather than just simple peptide degradation.

Degenerate perturbations of protein structure as the mechanism of anaesthetic action

The interaction of the n-alkanols with lipid bilayers and excitable membranes shows that there is no simple correlation between conduction block and any of the perturbations of bilayer structure currently proposed as unitary mechanisms of local anaesthetic action. We propose instead that the n-alkanols act by direct interaction with target proteins to cause perturbations which depend directly on the precise structure of the alcohol.

Hypomagnesemia and impaired parathyroid hormone secretion in chronic renal disease

Severe hypocalcemia secondary to magnesium depletion has been described in numerous patients with gastrointestinal disorders. The development of profound hypomagnesemia in chronic renal disease is a rare finding. We studied three patients with advanced renal failure and magnesium depletion. Severe hypocalcemia also was present in these patients. Despite hyperplasia of the parathyroid glands, the levels of immunoreactive parathyroid hormone (PTH) in blood were inappropriately low for the degree of renal insufficiency. After the administration of magnesium there was a significant increase in the levels of circulating i-PTH in serum with a concomitant improvement in the hypocalcemia.

[A new and simple method for determining the position of the venous angle on the lateral angiogram (author's transl)]

The authors describe a new and very simple method for the localisation of the venous angle on the lateral view of carotid angiography: the venous angle projects exactly on the midpoint of a line between the endobregma and the base of the external auditory meatus.

Degradation of parathyroid hormone and fragment production by the isolated perfused dog kidney. The effect of glomerular filtration rate and perfusate CA++ concentrations

The renal degradation of intact bovine parathyroid hormone (b-PTH 1-84) was studied with the isolated perfused dog kidney. Disappearance of b-PTH 1-84 from the perfusate occurred concomitantly with the appearance of smaller molecular weight forms of immunoreactive parathyroid hormone (PTH). These smaller molecular weight PTH fragments included both carboxyl and amino terminal regions of the PTH peptide. Perfusate from kidneys with lower glomerular filtration rates (GFR) contained b-PTH 1-84 for longer periods of time than kidneys with higher GFRs, and perfusate from kidneys with lower GFRs demonstrated greater accumulation of carboxyl terminal PTH fragments. Perfusate containing high Ca++ concentrations retarded, and perfusate with low Ca++ concentrations accelerated the rate of degradation of b-PTH 1-84 by the kidney. These studies, therefore document the production of PTH fragments during the course of intact hormone degradation by the kidney. They also demonstrate renal clearance of the PTH fragments produced and define the effects of glomerular filtration rate and calcium concentrations on degradation of intact hormone and the clearance of PTH fragments.

Hyperphosphatemia

Serum phosphorus concentrations are maintained within narrow limits in humans. In the extracellular fluid most of the phosphorus is present in the inorganic form and at the level of the glomerulus greater than 90% of PO4 is ultrafilterable. The kidney plays a key role in PO4 homeostasis. Micropuncture experiments have demonstrated that 60 to 70% of the filtered PO4 is reabsorbed in the proximal tubule; however, there is evidence that a significant amount of PO4 is reabsorbed in the distal tubule. Phosphate secretion probably plays a minor role in the overall renal regulation of phosphate. In normal individuals the amount of PO4 ingested plays a key role in the amount that ultimately will be excreted in the urine. The reabsorption of PO4 along the nephron is regulated by a series of factors of which parathyroid hormone is the most important one. Hyperphosphatemia is seen frequently in clinical medicine and by far, the most common cause is a decrease in urinary PO4 excretion secondary to renal failure. From the practical point of view, the most effective way to treat hyperphosphatemia is to decrease PO4 absorption in the GI tract by the use of PO4 binders.

[Diastematomyelia--its importance in the treatment of congenital scoliosis]

The risk of neurologic complications following corrective surgery in congenital scoliosis is ten times greater than in idiopathic scoliosis, the main reasons being transfixation of the spinal cord by diastematomyelia or by other adhesions of the spinal cord. Therefore preoperative myelography is advisable in congenital scoliosis. The typical findings from 3 cases of diastematomyelia, as shown by myelography and by operation, are presented. The clinical and x-ray features are shown as well as neurological signs, which are easily overlooked.

Selective uptake of intact parathyroid hormone by the liver: differences between hepatic and renal uptake

Hepatic and renal extraction of immunoreactive parathyroid hormone (i-PTH) was studied in awake dogs with explanted kidneys and chronic indwelling hepatic vein catheters. After a single injection of bovine PTH 1-84 (b-PTH 1-84), hepatic arteriovenous (A-V) differences for immunoreactive PTH (i-PTH) was 39% at 2 min after injection but decreased to 0% by 25 min, despite high levels of i-PTH in the arterial circulation. Gel filtration of arterila and hepatic venous samples obtained when hepatic A-V differences for i-PTH were demonstrable revealed hepatic uptake of the intact hormone and addition of a smaller COOH-terminal fragment, eluting just after the intact hormone, to the hepatic venous blood. Gel filtration of samples obtained 20-30 min after injection of b-PTH was demonstrable) revealed no detectable intact hormone in the circulation. Levels of COOH-terminal fragments of the hormone at the time were identical in arterial and hepatic venous samples. In additional experiemtns no hepatic A-V difference was observed after the injection of the synthetic bovine PTH 1-34 (syn b-PTH 1-34). By comparison there was a demonstrable A-V difference of 20% across the kidney for both intact PTH and COOH-terminal fragments that persisted until i-PTH disappeared from the circulation. The kidney also demonstrated an A-V difference of 22% after injection of syn b-PTH 1-34. These studies demonstrate selective extraction of intact PTH but not of its fragments by the liver. The kidney, on the other hand, extracted the intact hormone and both COOH and NH2 terminal fragments. The studies demonstrate that the kidney was the only organ of those examined that detectably removed the fragments of PTH from the circulation.

An irreversible effect of lithium administration to patients

1 Lithium administration to patients leads to a pronounced inhibition (about 90%) of the choline transport system in erythrocytes. The transport system does not recover when ghosts are prepared from the erythrocytes, thereby removing intracellular as well as extracellular lithium. 2 When a patient is taken off lithium, the choline transport in erythrocytes recovers only very slowly over a period of three months, i.e. at about the same rate at which the erythrocytes that had been exposed to lithium are replaced by new cells. 3 It is concluded that therapeutic concentrations of lithium produce an irreversible inhibition of the choline transport system in human erythrocytes.

[Parinaud's syndrome in non-tumorous hydrocephalic intracranial hypertension]

Four cases (3 children and one adolescent) are presented in which Parinaud's syndrome developed in the course of progressive non-tumorous hydrocephalus. The vertical gaze palsy completely disappeared in all cases some days after raised intracranial pressure had been successfully treated. Neuroradiological findings indicate that Parinaud's syndrome can be elicited by a dorsal midbrain compression due to a markedly dilated suprapineal recess. Other contributing factors as distortion and compression of distal branches of the posterior cerebral artery in the cisterna ambiens region and an axial caudal displacement of the oral brain stem may be involved. According to the few cases published in the literature, the vertical gaze palsy seems to occur predominantly in benign connatal aqueduct stenosis and may then be regarded as a relatively early symptom of decompensating hydrocephalic intracranial pressure.

Extracellular cations and the movement of choline across the erythrocyte membrane

1. The ability of human erythrocytes to accumulate choline is abolished when external Na is replaced by Cs, Rb, K or Li but is increased when the external cation is Mg or Ca.2. The unidirectional influx of choline is reduced when external Na is replaced by other monovalent cations but is not changed when Na is replaced by Mg or Ca.3. The unidirectional efflux of choline into a choline-free medium is increased when external Na is replaced by other monovalent cations and markedly reduced when Na is replaced by Mg or Ca. When the external medium contains 1 mM choline, changing the external cation has virtually no effect on the rate of choline efflux.4. When the extracellular concentrations of K and Na are similar to that found in the intracellular water, choline appears to become passively distributed across the cell membrane; when the extracellular K is then replaced by Cs a net efflux of choline against a concentration gradient results.5. It is concluded that the choline carrier may be described as a cation carrier with a high affinity for choline and affinities for Cs > Rb > K > Li > Na and that these monovalent cations can cross the membrane on the choline transport system.

Some properties of an SH group essential for choline transport in human erythrocytes

1. The choline transport system in human erythrocytes is inhibited by N-ethylmaleimide (NEM), cystamine and p-chloromercuribenzene sulphonic acid (PCMBS).2. External choline increases the rate of inhibition by NEM and cystamine but decreases the rate of inhibition by PCMBS. Intracellular choline has the opposite effect.3. Competitive inhibitors of choline transport that are not themselves transported protect the carrier against all three thiol reagents.4. Some thiol reagents with a very low lipid solubility do not inhibit choline transport.5. The transport inhibition by cystamine is reversed by various reducing agents.6. Cystamine protects the transport system against NEM and PCMBS.7. It is suggested that NEM and cystamine react with an SH group of the transport system and that this SH group is more reactive when the carrier is facing inside. PCMBS penetrates erythrocytes only very slowly and is assumed to react preferentially with the outward facing carrier.8. The reactive SH group seems to be located in a lipophilic environment.