The activation of red blood cell transketolase in groups of patients especially at risk from thiamin deficiency

Erythrocyte transketolase activation by thiamin diphosphate has been studied in elderly patients with moderate or severe chronic dementia, acute alcoholic admissions and chronic alcoholics with evidence of brain damage, mostly of the Wernicke-Korsakoff type. Significantly more patients in each group than controls showed abnormal activation of transketolase, not only by 0.3 mM thiamin diphosphate (TDP) but also in further activation by increase to 3 mM. This indicated the presence in a proportion of the alcoholic and the demented patients of an abnormal enzyme variant, similar to that previously found in vitro. The modified transketolase activation test may warn not only of marginal thiamin deficiency but also independently, of susceptibility to brain damage in patients at risk.

Amoxapine-induced cognitive impairment in two patients

Two patients are described in whom subtle cognitive impairments are associated with therapeutic doses of amoxapine. The implications of this observation for the management of depression, particularly in patients with coexisting dementing illnesses, are discussed.

The effects of pregnancy in multiple sclerosis: a retrospective study

We reviewed the medical records of 178 women with multiple sclerosis to evaluate the number of completed pregnancies, current disability status, and relationship of pregnancy to onset of MS symptoms. We found no differences in the long-term disability of women with no pregnancies, one pregnancy, or two or more pregnancies. Women who had initial symptom onset in pregnancy experienced less subsequent disability than women whose symptoms began before or after pregnancy. Therefore, pregnancy per se or number of pregnancies has no effect on subsequent disability.

Self-assessment: a personalized approach to nursing during pregnancy

A Prenatal Self-Assessment questionnaire was developed to aid in personalizing nursing care in a large medical center prenatal clinic. The questionnaire complements the standard prenatal record, which is intended primarily to document medical findings and treatment. The tool was used with more than 100 mothers who were receptive to this approach. The women's responses to questions about their feelings and thoughts concerning their pregnancies facilitated identification of potential problems and provided a basis for individualized and comprehensive care.

Closed wound suction drainage

Closed wound suction drainage may have application to certain podiatric surgical procedures. It can be used to reduce postoperative edema and hematoma formation, decrease the possibility of infection, and minimize the chance of external contamination of the surgical site. Certain conditions that may occur after podiatric surgical procedures and that are detrimental to the healing and rehabilitation of the patient but can be obviated by the use of closed suction drainage are illustrated. Drains should be considered in any podiatric surgical procedure that results in the creation of large voids or causes substantial bleeding as occurs in large resections of bone. Included in this would be any plastic surgical procedures or amputations of the foot.

Complex formation and O2 sensitivity of Azotobacter vinelandii nitrogenase and its component proteins

The O2 stability of the MoFe protein, the Fe protein, a 1:1 mixture of these proteins, and a 1:1 mixture in the presence of the Azotobacter vinelandii FeS-II protein has been studied as a function of time under controlled O2 partial pressures. The Fe protein is much more sensitive to O2 exposure than is the MoFe protein. The presence of the FeS-II protein at a 1:1 ratio with the component proteins measurably increases the O2 stability of the MoFe and Fe proteins. O2 inactivation of the MoFe protein was studied in some detail and found to be quite complex. At least three partially overlapping reactions are suggested. The first is the reversible oxidation of the metal clusters of the MoFe protein to the combined extent of 12 electrons with full retention of activity. The second phase consists primarily of activity loss with little increase in the extent of reversible oxidation. The third phase continues to decrease the protein activity but is also accompanied by formation of a g = 2.0 EPR signal and more extensive oxidation. Ultracentrifugation studies of the FeS-II protein at a 1:1:1 ratio with the Fe and MoFe proteins do not support the formation of the Bulen complex. The formation of other O2-stable complexes is discussed.

Extreme metabolic alkalosis with fludrocortisone therapy

We present an unusual case of extreme metabolic alkalosis resulting from severe hypokalaemia caused by unmonitored fludrocortisone therapy. Biochemical aspects of the disorder are discussed, as is the successful treatment with diuretics and potassium replacement. Some dangers of this therapy and necessary precautions are emphasized.

High Performance Liquid Chromatographic Analysis of Rotenone Formulations: Collaborative Study

A collaborative study was conducted on a high performance liquid chromatographic (HPLC) method for determining rotenone in formulations. One liquid and 4 dust samples, containing other rotenoids and pesticides, with rotenone guarantees ranging from 0.75% to 20% were analyzed by 16 laboratories. Peak height measurements were used by 14 laboratories while 8 laboratories used integrator area measurements. Samples were extracted on a rotary shaker for 1% h with dioxane. An aliquot was analyzed using reverse phase HPLC and UV detection at 280 nm. Coefficients of variation ranged from 2.47 to 3.19% for peak height determinations and from 2.56 to 6.00% for peak area determinations. One collaborator analyzed the samples by the official infrared method for a comparison. The HPLC method has been adopted official first action.

Stoichiometry and spectral properties of the MoFe cofactor and noncofactor redox centers in the MoFe protein of nitrogenase from Azotobacter vinelandii

Reductive EPR and optical titrations of oxidized MoFe protein using reduced methyl viologen as reductant were used to quantitate the stoichiometry of the various spectroscopically and electrochemically distinct redox centers in the oxidized MoFe protein. Three centers were found to correlate with the EPR signal development (MoFe cofactor centers), and three centers were found to be independent of the EPR signal (P clusters) but to demonstrate distinct optical and kinetic properties. Oxidative EPR and optical titrations of reduced MoFe protein are reported which support the presence of three P-cluster centers. The optical titrations show a distinct change in kinetic behavior between the MoFe cofactor and P-cluster centers. Controlled potential coulometry demonstrates that incremental oxidation of reduced protein by methylene blue, thionine, or indigodisulfonate occurs specifically at three P-cluster sites. Subsequent oxidation by methylene blue and thionine (but not indigodisulfonate) causes the EPR signal to disappear. Three P-cluster sites, two EPR sites, and one presently uncharacterized site are suggested by the results of this study.

Redox and spectroscopic properties of oxidized MoFe protein from Azotobacter vinelandii

The MoFe protein from Azotobacter vinelandii undergoes a six-electron oxidation by various organic dye oxidants with full retention of initial activity. Reduction of the oxidized protein by S2O42- and by controlled potential electrolysis indicates the presence of two reduction regions at -290 and -480 mV, each requiring three electrons for complete reaction. Control of the oxidation conditions provides a means for preparing two distinct MoFe protein species selectively oxidized by three electrons. Selective reduction of the redox region at -290 mV causes development of the EPR signal associated with fully reduced MoFe protein while reduction at -480 mV produces a change in the visible spectrum but has no effect on the EPR signal intensity. Kinetic differences for reduction of the two redox regions indicate that the cofactor region undergoes a more rapid reaction with reductant than the other metal redox sites.

Kinetics of dithionite ion utilization and ATP hydrolysis for reactions catalyzed by the nitrogenase complex from Azotobacter vinelandii

The kinetics of S2O42-utilization and ATP hydrolysis during the nitrogenase-catalyzed H2 evolution and acetylene and nitrogen-reducing reactions were studied using a polarographic technique to monitor-S2O42-concentration. Rate constants for both S2O42-utilization and ATP hydrolysis were determined as a function of temperature and corresponding activation energies determined. The activation energy for ATP hydrolysis differs from that for product formation or S2O42-utilization by 5 kcal/mol above 20 degrees C and by 25 kcal/mol below 20 degrees C. The rate law for S2O42-utilization was determined and describes the enzyme catalyzed rate over a 1000-fold variation in S2O42-concentration and at least a 100-fold change in ATP concentration. The rate law for S2O42-utilization under N2-reducing conditions at 25 degrees C is given by -d([S2O42-]/dt = (2.3 x 10(-3) ET[S2O42-]1/2-[ATP]2)/([ATP]2 + K1[ATP] + K2), where ET is total enzyme concentration in mg/ml and K1 and K2 are equilibrium constants for ATP binding to nitrogenase. The half-order dependence of the rate on S2O42-concentration in interpreted in terms of the equilibrium S2O42- = 2SO2-, in which SO2- is the actual electron donor to nitrogenase. A partial mechanism incorporating these results is presented.

The thermochemical characterization of sodium dithionite, flavin mononucleotide, flavin-adenine dinucleotide and methyl and benzyl viologens as low-potential reductants for biological systems

The heat of reaction (deltaH) of Fe(CN)63-, Methyl Viologen, FMN and FAD with S2O42- in aqueous buffer solutions was measured calorimetrically. In addition deltaH values for reduction of Fe(CN)63-, FMN and FAD by reduced Methyl Viologen were determined. The resulting calorimetric data and corresponding E0 values were combined to yield thermodynamic data for these simple reducing agents in a form useful for applications to biological reactions. Thermodynamic data for the reduction of spinach ferredoxin are also presented.

Stoichiometry, ATP/2e values, and energy requirements for reactions catalyzed by nitrogenase from Azotobacter vinelandii

The stoichiometry of the nitrogenase ATP-dependent H2 evolution and ecetylene reduction reactions using S2O4(2-) as an electron source was studied by various techniques. For each mole of S2O4(2-) oxidized to 2SO3(2-) by the enzyme-catalyzed reactions at 25 degrees and pH 8, 1 mol of H2 (1 mol of ethylene for acetylene reduction) and two protons are produced. Under these conditions, 4.5 mol of ATP was hydrolyzed to ADP and inorganic phosphate for each S2O4(2-) oxidized. ATP/S2O4(2-) (ATP/2e) values determined at 5 degree intervals from 10 to 35 degrees were found to go through a minimum at 20 degrees. This effect is explained in terms of possible enzyme structure modifications. Calorimetric measurements for the enzyme-catalyzed H2 evolution and acetylene reduction reactions gave deltaH values of -32.4 and -75.1 kcal/mol of S2O4(2-), respectively.

Directional effects of cyclic AMP on platelets

1. Platelets undergo a spreading reaction in a microscope slide—coverslip preparation.

2. If a gradient of cyclic AMP is generated in such a preparation a large fraction of the spread platelets are oriented with their veils into the gradient.

Disseminated intravascular coagulation complicating infectious mononucleosis

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