Elevation of Cardiac Troponins in Prolonged Status Epilepticus: A Retrospective Chart Analysis

INTRODUCTION

To determine the clinical significance of elevation of Troponin-I [cTn-I] during prolonged status epilepticus [pSE] SE is known to be accompanied by an increase in sympathetic outflow. Elevation of cTn-I has been linked to myocardial stress. We hypothesize that in patients with risk factors for coronary artery disease[CAD], pSE may lead to myocardial stress and an elevation of cTn-I.

METHODS

This is a retrospective study of patients over the age of 18 years who were presented to Virginia Commonwealth University with SE between 2005 and 2010. Data was evaluated using the 30-minute definition for SE and 30 day mortality. Risk factors for CAD and cTn-I levels within the first 24 hours of diagnosis of pSE were analyzed.

KEY FINDINGS

There were a total of 435 patients with a confirmed diagnosis of pSE, of which 266 had cTn-I concentrations reported. Statistical analysis showed a significant association between CAD risk factors and cTn-I elevation (χ² =12.87, p-value <0.01), with Crude Odds Ratio of 4.7. In patients with a CAD risk factor, an elevation of cTn-I is associated with a significantly increased risk of mortality, with an Odds ratio of 8.0, (χ² =40, [95% CI 4.1-15.9] p-value < 0.01). Mortality was higher in those with an elevation of cTn-I [54.65%] as opposed to those who did not have an elevation [15.08%], irrespective of CAD risk factors. OR=6.7, (χ² =45, [95% CI=3.7-12.2] p-value < 0.01).

CONCLUSIONS

In patients with pSE values, elevated cTn-I values are seen four to five time more often in those with CAD risk factors, as opposed to those without the risks. An elevation of cTn-I in this subgroup of patients with CAD risk factors was associated with an eight to nine fold increase in their 30 day mortality as compared to patients with pSE, who did not have an elevation of cTn-I.

Effect of different forms of methionine on lactational performance of dairy cows

Methionine is one of the first limiting AA in dairy cows. The use of rumen-protected Met to correct deficient diets is limited by the lack of a product that could be incorporated into a pelleted concentrate. The main objective of this trial was to test, at practical doses (approximately 10 g of absorbable Met), the efficacy of 2 forms of pelletable Met hydroxy analogs, D,L-2-hydroxy-4-(methylthio)-butanoic acid (HMB) and the isopropyl ester of HMB (HMBi), to provide Met to cows, especially for milk protein synthesis, compared with a negative control and to Smartamine M (SmM). These treatments were tested according to a 4 x 4 Latin square in 16 Holstein cows. Plasma Met concentrations were increased by 110 and 65% that of the control value after HMBi and SmM treatments, respectively. Milk protein yield increased by 32 and 41 g/d for HMBi and SmM, respectively. D,L-2-hydroxy-4-(methylthio)-butanoic acid supplementation did not improve Met availability to the cows for milk protein synthesis. The HMBi treatment induced an increase in 15:0 in milk at the expense of a general reduction in even-numbered short-and medium-chain fatty acids. Moreover, HMBi and SmM supplements led to an increase in the saturation level of C18 fatty acids consistent with the improvement of Met supply. It was concluded that HMBi is a new "rumen-protected" form of Met that can be supplied to cows integrated into pellets.

Methionine Availability in Plasma of Dairy Cows Supplemented with Methionine Hydroxy Analog Isopropyl Ester

Adequate Met supply is especially important in the dairy cow for milk protein synthesis. Because of insufficient Met contents in the most frequently used feed-stuffs, Met becomes limiting in the diet of the dairy cow. To restore the amino acid balance of the diet and consequently to optimize lactation performance, Met must be supplied in a protected form because of its high degradability as a free amino acid by rumen microorganisms. A new chemical derivative of Met, the isopropyl ester of the 2-hydroxy-4-(methylthio)-butanoic acid (HMBi) was tested for its metabolic fate by following the evolution of plasma concentrations of its metabolites (2-hydroxy-4-(methylthio)-butanoic acid (HMB), Met, isopropyl alcohol, and acetone) after spot-dose supplementation (50 g Met equivalent) to 15 cows. Results indicated that HMBi would be quickly absorbed and hydrolyzed into HMB and isopropyl alcohol, and then converted to Met and acetone, respectively. In our experimental conditions, the Met availability for cows was estimated to be 48.34 +/- 2.05% using a calibration curve established by modeling the area under the curve response to increasing doses of Met supplied as Smartamine M, whose bioavailability (80%) is considered the reference value. Plasma kinetics and bioavailability of Met were compared between HMBi and Smartamine M in the same cows. Comparison of the kinetics suggests that HMBi would be absorbed through the rumen wall providing good protection against rumen microorganisms. It can thus be concluded that HMBi is a new source of Met for ruminants with an acceptable bioavailability.

Improving intestinal amino acid supply of pre- and postpartum dairy cows with rumen-protected methionine and lysine

Eighty-four Holstein cows were assigned to a randomized block experiment to determine effects of supplementing pre- and postpartum diets containing highLys protein supplements with rumen-protected Met and Lys. Before parturition, cows received a basal diet with 1) no rumen-protected amino acids (AA), 2) 10.5 g/d of Met from rumen-protected Met, or 3) 10.2 g/d of Met and 16.0 g/d of Lys from rumen-protected Met plus Lys. After parturition, cows continued to receive AA treatments but switched to diets balanced for 16.0 or 18.5% crude protein (CP). Diets were corn-based; supplemental protein was provided by soybean products and blood meal. Cows received treatments through d 105 of lactation. Compared with basal and Met-supplemented diets, Met + Lys supplementation increased yield of energy-corrected milk, fat, and protein, and tended to increase production of 3.5% fat-corrected milk. Significant CP x AA interactions were observed only for milk protein and fat content. Supplementation of the 16% CP diet with Met and Met + Lys had no effect on milk true protein and fat content. However, Met and Met + Lys supplementation of the 18.5% CP diet increased milk protein content by 0.21 and 0.14 percentage units, respectively, and Met supplementation increased fat content by 0.26 percentage units. Results of this study indicate that early-lactation cows fed corn-based diets are responsive to increased intestinal supplies of Lys and Met and that the responses depend on dietary CP concentration, supply of metabolizable protein, and intestinal digestibility of the rumen-undegradable fraction of supplemental proteins.

Interaction between the N-terminal domain of gastric H,K-ATPase and the spectrin binding domain of ankyrin III

We screened a cDNA bank of rabbit gastric fundic mucosa by two-hybrid assays looking for binding partners of the N-terminal domain of the rabbit gastric H,K-ATPase. We extracted five clones sharing more than 90% sequence identity. The longest clone codes for a protein sharing a high identity (96 and 96.8%, respectively) with a fragment of the membrane domain, from Arg-835 to Ser-873, plus the major part of the "spectrin binding domain" going from Glu-874 to Leu-1455 of human and mouse ankyrin III. We conclude that the membrane and spectrin binding domains of the rabbit ankyrin III are candidates for the binding partner of the N-terminal domain of the rabbit gastric H,K-ATPase. To validate the ankyrin-ATPase interaction and to test its specificity, we produced both domains in yeast and bacteria, coimmunoprecipitated them with an anti-ATPase antibody, and copurified them by affinity chromatography. The sequence of rabbit ankyrin III was not known, and this is the first report demonstrating that the ankyrin III and the H,K-ATPase interact with no intermediate. The interaction involves the N-terminal domain of the ATPase on one hand and the spectrin binding domain of the ankyrin on the other.

Gastric proton pump is expressed in the inner ear and choroid plexus of the rat

Inner ear fluids and cerebrospinal fluid show remarkably stable ionic concentrations, particularly that of K(+) and H(+), but the mechanisms which control the homeostasis of these media are not well understood. We investigated a possible role of the gastric H, K-ATPase (gH,K-ATPase) pump in this control since this pump is known to be expressed in other tissues than gastric parietal cells. Here, we show by reverse transcription-polymerase chain reaction that the rat gH,K-ATPase alpha- and beta-subunits are expressed in the inner ear (lateral wall, organ of Corti and spiral ganglion cells), while only the alpha-subunit is expressed in the choroid plexus (CP). The presence of the alpha-subunit in the inner ear and CP was confirmed by immunoblotting. Immunohistochemistry localized this protein in the intermediate cells of the stria vascularis, in the spiral ligament and the spiral ganglion. gH,K-ATPase could be involved in the maintenance of H(+) and K(+) equilibria in cerebrospinal and labyrinthine fluids.

Efficient solubilization and purification of the gastric H+, K+-ATPase for functional and structural studies

When gastric H(+),K(+)-ATPase-containing microsomes are solubilized by detergents, a rapid loss of ATPase activity is generally observed. In this article, SDS/PAGE of octa(ethylene glycol)dodecyl monoether (C(12)E(8))- and n-dodecyl beta-d-maltoside-solubilized microsomes and their purifications by affinity chromatography on Reactive Red column reveal that inactivation is due to two main effects. (i) Solubilization activates an aspartic protease that cleaves down the alpha-subunit of the H(+),K(+)-ATPase. Addition of pepstatin A at slightly acidic pH and at low temperature prevents the proteolysis. (ii) A too-harsh delipidation inactivates the ATPase. When n-dodecyl-beta-d-maltoside is the detergent, the soluble H(+), K(+)-ATPase is highly active (2.5 micromol/mg per h at pH 6.0 and 5 degrees C) as long as ATP is added. When C(12)E(8) is used, the detergent induces an inactivation due to delipidation, since addition of lipids restores activity. The two subunits of the H(+), K(+)-ATPase are present in equimolar ratio in the n-dodecyl beta-d-maltoside-purified complex. Moreover, two main types of complex (330 and 660 kDa) were resolved in non-denaturing gels and should be the dimeric (alphabeta)(2) and tetrameric (alphabeta)(4) heterodimers respectively. In conclusion, purification of active, stable, soluble complexes of H(+),K(+)-ATPase with few lipids (a lipid/protein ratio of 0.25, w/w) has been achieved. This material should be useful for further structural studies.

Prediction of epitopes and production of monoclonal antibodies against gastric H,K-ATPase

Monoclonal antibodies (mAbs) were produced against gastric H,K-ATPase using a theoretical and experimental strategy based on prediction of linear epitopes by molecular modelling followed by production of anti-peptide antibodies. By analysing the alpha subunit sequence, we predicted several epitopes corresponding to amino acids K519-L533, E543-Y553 and S786-L798 and produced monoclonal antibodies HK519, HK543 and HK786. All three react against gastric H,K-ATPase in RaLISA, immunohistochemistry and Western blots demonstrating that they recognize the native and the SDS-denatured ionic pump and that the epitopes are located at the surface of the native ATPase. Antibody Kd are in the range 6-10x10(-8) M. Monoclonal antibody HK519 is a competitive inhibitor of ATP, in agreement with ATP binding to K519. Neither mAb 543, nor mAb 786 inhibit the ATPase activity. Monoclonal antibody 95111, whose epitope is mapped between residues C529 and E561, competes with mAb HK543 but not with the other two. We suggest that the 95111 epitope is overlapping or very close to the HK543-553 sequence. Induction of E1 conformer by binding FITC to K519 increases the number of mAb 95111 and mAb HK543 epitopes but not that of mAb 786, supporting the fact that the fragment E543-Y553 changes accessibility, maybe during the E1-E2 transconformation.

1-anilino-8-naphtalene sulfonate probes a gastric HK-ATPase potassium site whose access requires ionophores

1-anilino-8-naphtalenesulfonate (ANS) is a hydrophobic dipole previously used to demonstrate that the proton for potassium exchange by the gastric HK-ATPase is electroneutral. In this paper, we demonstrate that ANS binds to gastric membranes and probes conformational changes of the HK-ATPase independently of any active H for K exchange. Conformational changes require the presence of potassium-valinomycin and are not triggered by sodium. Potassium effect is enhanced by ATP, in the presence and in the absence of magnesium and, by ADP, in the presence of magnesium. Labeling of the pig HK-ATPase K518 by fluorescein-5-isothiocyanate inhibits the enzyme activity and knocks out the ATP effect on ANS fluorescence. Scherring 28080 and the monoclonal antibody 95-111, two competitive inhibitors of K-activated ATPase dephosphorylation, do not modify K-effect on ANS fluorescence but inhibit ATP effects. This supports that ANS does not probe K-site between the H1-H2 loop. Treatment of gastric membranes with trypsin does not inhibit the ANS response to potassium but does inhibit the response to ATP. This suggests that the ATP site inducing the ANS response is cytoplasmic and the potassium site is intramembranous. Titration reveals that one mole of ANS interacts with one mole of ATPase. We suggest that ANS probes a hydrophobic potassium site of gastric ATPase and that addition of ATP and ADP-Mg embed that site.

Loss of deciduous teeth and germs of permanent incisors in a 4-year-old child. An atypic prepubertal periodontitis? A clinical, microbiological, immunological and ultrastructural study

A 4-year-old child was referred, in April 1988, to Rennes Dental School (France) for deciduous tooth mobility with premature loss of 4 deciduous teeth and germs of 2 permanent incisors. Microbiological examinations by culture revealed the presence of the periodontal pathogen Actinobacillus actinomycetemcomitans. Immunofluorescence of plaque samples revealed the presence of Porphyromonas gingivalis that had not been isolated by culture. Neutrophil functions were within normal ranges. Transmission electron microscopy of gingiva showed a disorganised epithelium. The connective tissue was infiltrated by inflammatory cells. The basement membranes were normal, but the connective tissue-epithelium interface was mainly composed of short rete pegs. Scanning electron microscopy of extracted deciduous teeth revealed lack of cementum, lacunae in the cementum and lack of fibrillar insertion on the middle part of the root. Skin lesions, mainly situated on face, were observed. Treatment was by extraction of mobile deciduous teeth combined with 3-week courses of metronidazole. Clinical and microbiological follow-up was continued over a 7-year period. No periodontal lesions have been detected since eruption of the permanent teeth. The present subgingival and lingual microflora (December 1995) is composed of bacteria associated with periodontal health. However, the future appearance of a hitherto undetected systemic disease is still possible.

Interactions of ruminally protected methionine and lysine with protein source or energy level in the diets of cows

Interactions between supplementation with ruminally protected Met and Lys and the nature of protein or energy concentration of the diet were studied using 16 and 12 multiparous lactating dairy cows in two trials of 8 and 12 wk, respectively, commencing on approximately d 40 of lactation. In trial 1, cows received a semicomplete diet plus concentrates. The diet consisted of 62 to 63% corn silage, 2.2% corn gluten meal, .4% urea, 11% soybean meal (untreated or treated with formaldehyde), and 23 to 24% barley. In trial 2, cows received a complete diet with corn silage, untreated and formaldehyde-treated soybean meal, and barley in the ratio 78:12:9:0 or 49:13:4:33. All treatments were replicated in a 4 x 4 Latin square design. In both trials, Met plus Lys (10 g/d of intestinally available Met and 30 g/d of Lys) has no significant effect on DMI, milk yield, fat content, casein as a percentage of true protein, or urea content of the milk. Mean increase of milk protein yield was 46 g/d with Met plus Lys, and mean increase of true protein content was 1.1 g/kg of milk. The increase in content of milk true protein was greater for cows receiving the low energy diet. Protein source had no effect on milk yield or composition. Glucose, urea, NEFA, BHBA, and total free AA in plasma were unaffected by supplementation of ruminally protected Met plus Lys. However, concentrations of Met and Lys in blood were slightly, but not significantly, higher in supplemented cows.

Effects of dietary fat and L-methionine on the hepatic metabolism of very low density lipoproteins in the preruminant calf, Bos spp

The effects of triglycerides (TG) from tallow (1.21 and 2.13 g TG/kg of body weight (BW) per meal, diets R and B respectively) and from tallow plus cream (2.50 g TG/kg of BW per meal, diet L) with or without L-methionine (2.6 g/kg dry matter) on hepatic apparent secretion of very low density lipoproteins (VLDL) were investigated in 3 groups of 4 preruminant calves fitted with chronic catheters and with electromagnetic blood-flow probes implanted in their hepatic vessels. Increasing TG concentrations stimulated the apparent VLDL secretion by the liver (1.02, -0.36 and -1.51 mg VLDL mass/min per kg of BW in diets L, B and R, respectively). L-Methionine increased this secretion when associated with the lipid-restricted (diet R; 0.25 and -1.51 mg VLDL/min per kg of BW) and basal (diet B; 0.35 and -0.36 mg VLDL/min per kg of BW) diets (non-significant). However, the VLDL apparent secretion decreased with the lipid-enriched diet (diet L), which suggests an insufficient dose of L-methionine compared with the level of TG intake, and a possible competition between liver and intestine for utilization of L-methionine for the synthesis of TG-rich lipoproteins.

Lipoprotein metabolism in the preruminant calf: effect of a high fat diet supplemented with L-methionine

The effects of dietary lipid and L-Met supplementation on plasma lipids and lipoproteins were investigated in 16-wk-old preruminant calves. Four calves received the basal milk diet (2.0 g of lipid/kg of BW per meal) for 8 d followed by the same diet supplemented with L-Met (2.6 g/kg of dietary DM) for 5 d. Similarly, seven calves received successively the basal diet supplemented with cream (2.7 g of lipid/kg of BW per meal) and the same diet supplemented with L-Met. The diet with cream induced higher triglyceridemia than the basal diet because of a marked increase in chylomicra and in very low density lipoproteins, which suggested stimulation of intestinal lipoprotein secretion. Moreover, this lipid-enriched diet stimulated the formation of very light high density lipoproteins to the detriment of heavy high density lipoproteins. These particles, the bovine counterpart of mammalian high density lipoproteins of type 1, were distributed within the density range of low density lipoproteins. Addition of L-Met in the diets increased plasma concentrations of chylomicra and very low density lipoproteins, suggesting direct stimulation of the intestinal secretion of both of these lipoproteins and of the hepatic very low density lipoproteins. No effect of L-Met was observed on the concentrations and the physicochemical properties of low and light high density lipoproteins.

Gastric acid secretion in the chicken: effect of histamine H2 antagonists and H+/K(+)-ATPase inhibitors on gastro-intestinal pH and of sexual maturity calcium carbonate level and particle size on proventricular H+/K+ ATPase activity

1. Cimetidine was more potent 4 hr after a single injection of 25 or 100 mg/kg body wt in increasing gastric pH than other H2 receptor antagonists, ranitidine and famotidine but was less efficient than H+/K(+)-ATPase inhibitors. Omeprazole rose proventricular and gizzard pH at a lower dose than SCH 28080 and Ro 18-5364 (30, 50 and 200 mg/kg body wt, respectively). 2. Proventricular and gizzard pH values were maximal 1 and 4 hr after a single injection of 7.5 mumol/kg body wt omeprazole. Inhibition of acid secretion was maintained for 24 hr after an injection of 100 mumol/kg. 3. H+/K(+)-ATPase activity in vitro was 10 mumol Pi/hr/mg protein in the microsomal fractions of the proventriculus. It was doubled by nigericine and inhibited by SCH 28080. However, western blots by high specific H+/K(+)-ATPase monoclonal antibody 95-A3 and 95-111 recognized a 42 kDa band but hardly exhibited the specific 95 kDa band recognition. 4. Chickens and immature pullets showed a higher H+/K(+)-ATPase activity than laying hens. Calcium level of the diet did not affect the enzyme activity but coarse particles of calcium fed to pullets or laying hens enhanced the H+/K(+)-ATPase activity when compared with ground particles.

Location of the cytoplasmic epitope for a K(+)-competitive antibody of the (H+,K+)-ATPase

The monoclonal antibody (mAb) 95-111 binds the alpha subunit of (H+,K+)-ATPase and inhibits the K(+)-ATPase activity. To map the epitope, all of the partial sequences of the alpha subunit were expressed in Escherichia coli HB101 using rabbit alpha subunit cDNA restriction fragments ligated into PuEx vector. Bacterial recombinant lysates were separated by sodium dodecyl sulfate-gel electrophoresis, and the epitope was detected by Western blotting. The antibody site was mapped between Cys529 and Glu561. This is close to the Lys517 that binds fluorescein isothiocyanate (FITC) and is considered to be between M4 and M5 close to the ATP binding domain. However, the mAb inhibition of ATPase is not ATP-competitive but is K(+)-competitive with a KI of 2 x 10(-9) M. The mAb also inhibits K+ quench of FITC fluorescence competitively with a KI of 8 x 10(-9) M. The K+ activation of ATPase activity and quench of FITC fluorescence are dependent on K+ binding to an E2 form of the enzyme from the extracytoplasmic surface. The mAb epitope is cytoplasmic since the K(+)-ATPase activity of ion-tight gastric vesicles is inhibited. The 125I-mAb 95-111 binds to a single class of sites with an apparent KD of 2.3 +/- 0.8 x 10(-9) M and K+ does not displace bound mAb. Hence, antibody binding to a cytoplasmic Cys529-Glu561 epitope allosterically competes with K(+)-dependent reactions at extracytoplasmic sites.

Immunopurification of gastric parietal cell tubulovesicles

1. The tubulovesicles of hog and rabbit gastric parietal cells were immunopurified from microsomes using monoclonal antibodies against the (H+, K+)-ATPase. 2. The best yields of immunoprecipitation were obtained with an ATPase/mAb molar ratio of 0.3: the immunoprecipitate contained 79 and 90% of the hog and rabbit microsomal PNPPase activity respectively and K(+)-stimulated ATPase specific activity was 221 +/- 29 mumoles Pi per hr and per mg of membrane protein. 3. The immunoprecipitate contained vesicles that were 85% cytoplasmic-side out, like tubulovesicles in vivo, demonstrating that the epitopes were cytoplasmic. 4. The alpha-beta protomer of (H+, K+)-ATPase accounted for 80 +/- 12% of the immunopurified proteins. 5. The major other proteins ran at 80, 75, 69, 57, 47, 44, 39, 34 and 32 kDa on the SDS-PAGE. 6. Comparative analysis between sucrose-gradient purified fractions and immunopurified tubulovesicles demonstrated that carbonic anhydrase and actin were contaminants and that the 53 kDa and presumably the 50 kDa bands of the gradient fraction were alpha and beta subunits of F1 ATPase.

[Münchhausen syndrome]

Münchhausen's syndrome is characterized by fictitious illnesses associated with hospital peregrination, pseudologia fantastica with a mythomanic discourse that includes strongly structured medical elements, passivity and dependance at examinations, and aggressiveness. The whole picture is so typical that the syndrome can easily be recognized. Cases of Münchhausen's syndrome by proxy (Meadow's syndrome) have been reported during the last few years; the condition concerns children suffering from diseases which are entirely due to their parents and can be compared with the battered child syndrome. In terms of nosology, among pathomimias Münchhausen's syndrome figures as a borderline state. Since it is impossible to establish positive relations with these patients, treatment fails in almost every case.

[Bacterial periodontal plaque in childhood. Literature review]

Bacterial colonization is investigated: before eruption, in primary dentition, mixed dentition and permanent dentition, with and without gingival inflammation. Microorganisms such as spirochetes and Black pigmented Bacteroides are implicated in the periodontal disease. These germs arrive later than teeth and their importance grows with age and gingival inflammation. Different reviews have emphasised the potential role of specific pathogens in the aetiology of periodontitis. The plaque composition of necrotizing ulcerative gingivitis and periodontitis in their pre and post pubertal forms, localized and generalized is investigated. A actinomycetemcomitans, B. intermedius and spirochetes can be isolated from children having destructive periodontal disease. Changes in flora can then be explained.

[Types of interbacterial coaggregation in dental plaque]

Scanning electron microscopic observations of teeth-gingiva fragments removed among children or dogs made an important contribution to our knowledge of the composition of the microbial flora in gingival crevice. It was possible to appreciate special relationships between forms as "corn-cob" or "bristle brush" arrangements. The development of these formations were observed: coccal form apposition preceded corn-cob organization; abundant extra-cellular amorphous material preceded bristle brush arrangement. Inter or/intra bacterial calcification models are proposed to explain calculus formation.

Use of scanning electron microscopy to investigate dental calculus in dogs

The formation of dental calculus in dogs is a major problem. Scanning electron microscopy of tartar specimens from dogs revealed on the outer surface of the plaque polymorphic configurations, more or less arranged as free filaments, corn-cobs or swab-like structures. Uninhabited bacterial recesses were found on the inner surface of the calculus. Calcification may occur between or within the bacteria. Elucidating the mechanisms of calculus formation should help in the development of prophylactic measures.

[A comparison of culture and immunofluorescence technics in the study of Bacteroides with black pigmentation]

The aim of that study was to compare culture and immunofluorescence (IF) methods to determine whether B. gingivalis and other B.P.B. can be detected in subgingival plaque of children. Samples were collected from the lingual sulcus of mandibular incisors, dispersed and diluted from 1 to 10(-5); 15 microliters of each dilution were plated on Trypticase soja agar and Todd-Hewitt agar supplemented with blood, Vit K 1 and hemin. The same dilutions were smeared on glass slides for indirect IF using an species-specific polyclonal rabbit whole cell antiserum to B. gingivalis ATCC 33 277. Representative colonies producing brown-to-black pigment were isolated, purified and further characterized. Using culture, BPB were detected in 46% of children (19/41). B. gingivalis was cultured from 6 children. Using immunofluorescence test (Fluotec*), 90% of 309 children 3 years old and more harbour detectable B.P.B., but B. gingivalis don't react with that test. B. gingivalis were detected by immunofluorescence in 72% of children (30/41) in the incisor plaque.

H+/K(+)-ATPase contents of human, rabbit, hog and rat gastric mucosa

A monoclonal antibody (mAb 95-111) was used to titrate the amounts of H+/K(+)-ATPase in subcellular fractions of the fundus of rats, pigs, rabbits and humans. All four had similar amounts of H+/K(+)-ATPase: 2.1 +/- 0.5 (human), 1.9 +/- 0.4 (rabbit), 4.4 +/- 0.5 (rat) and 4.2 +/- 0.8 (hog) mg ATPase/g wet tissue. The antigen concentrations and H+/K(+)-ATPase enzymatic activities of subcellular fractions were linearly correlated in all species but rat suggesting that human, rabbit and hog H+/K(+)-ATPases have similar rates of catalysis (223 mumol Pi/h per mg ATPase). The non-correlation of rat data probably reflects the known lability of the rat enzyme. Hence, immuno-titration promises to be a more reliable method of estimating rat ATPase than the currently used enzymatic assay. The H+/K(+)-ATPase content of human biopsies was 20-fold higher than previously-published (Smolka, A. and Weinstein, W.M. (1986) Gastroenterology 90, 532-539) suggesting that the previous immuno-titration underestimated the H+/K(+)-ATPase content of the human fundus.

A monoclonal antibody which inhibits H+/K(+)-ATPase activity but not chloride conductance

A mouse monoclonal antibody was raised against hog gastric membranes. This antibody (95-111 mAb) has a very high affinity for the 95 kDalton band of H+/K(+)-ATPase-enriched membranes, and does not react with Na+/K(+)-ATPase. The epitope is located on the tubulovesicles and canaliculi of the parietal cells. The 95-111 mAb also inhibits the ATP hydrolytic activity, decreases the steady-state phosphorylation level and inhibits the phosphatase activity of H+/K(+)-ATPase, strongly suggesting that the epitope is on the catalytic subunit of H+/K(+)-ATPase. The 95-111 mAb also recognizes rat, rabbit and human gastric H+/K(+)-ATPase. This mAb differs from the H+/K(+)-ATPase-inhibiting mAb previously described (Asano et al. (1987) J. Biol. Chem. 262, 13263-13268), in that it does not inhibit the chloride conductance opened by Cu-o-phenanthroline in gastric vesicles.

The ontogeny of rat gastric H+/K+-ATPase

The ontogeny of rat H+/K+-ATPase was studied between foetal day 18 and neonatal day 18, using a specific monoclonal antibody (95-111 mAb). The H+/K+-ATPase content of gastric subcellular membranes was assayed and the ATPase subunits were characterized by Western blot. The epithelium density in parietal cells was measured by immunohistochemistry. H+/K+-ATPase was present in the 18-day-old foetuses and parietal cells were detected on foetal day 19. The H+/K+-ATPase concentration remained stable from foetal day 18 to neonatal day 1, while the parietal cell density increased 2.5-fold. The H+/K+-ATPase concentration increased by 2.5-fold on day 6, then remained constant up to day 18. The parietal cell density remained unchanged during this period, suggesting that the concentration increase on day 6 was due to an increase in parietal cell ATPase content. The 95-111 mAb recognized a 95 kDa single band on foetal day 18 and a doublet at all the other stages of development. Previous studies had demonstrated that acid secretion drops critically at day 12 post partum in the rat and that H+/K+-ATPase activity is lost. The present study demonstrates that the H+/K+-ATPase is, however, present on day 12.

[Pharmacokinetics and antibiotic therapy of the child]

Pharmacokinetics is too often unknown while ordering antibiotics, particularly to children. The aim of that paper is to recall the pharmacokinetic characteristics of the most ordered families in pediatric dentistry: penicillin A and macrolides, as well as the modifications peculiar to children, due to pathology, or subsequent to drug interactions.

Thiophosphorylation of hog gastric (H+ + K+)-ATPase membranes by endogenous protein kinases

(H+ + K+)-ATPase-enriched membranes from hog stomachs were tested for their capacity to autophosphorylate using [gamma-32P]ATP or [gamma-35S]ATP[S] as phosphate donors. The radioactive polypeptides were characterized by SDS-PAGE. In the presence of Mg2+ and 5 microM [gamma-32P]ATP, rapid and transient incorporation of 32P occurred at 0 degrees C. Radioactivity was essentially found in the major polypeptide of the material, the 95 kDa subunit of (H+ + K+)-ATPase. Under the same experimental conditions, thiophosphorylation was slower and reached a plateau within 1 h. Incorporation levels were higher with manganese than with magnesium. After one hour at 0 degrees C, and in the presence of 10 mM manganese and 5 microM ATP[S], 0.58 +/- 0.06 nmoles of thiophosphate were incorporated per mg of protein. Twenty seven percent of the thiophosphorylated amino acids were acylphosphates i.e. likely to be the ATPase thiophosphointermediate. The remaining thiophosphorylated amino acids (73%) were thought to be produced by protein kinases. This was supported by the autoradiographies of membrane SDS-PAGE which indicated that, in addition to the 95 kDa ATPase subunit, other polypeptides were thiophosphorylated especially at 108, 58, 47, 45 and 36-40 kDa. A previous study had provided strong evidence that chloride transport in gastric microsomes, is modulated by a protein kinase-dependent phosphorylation (Soumarmon, A., Abastado, M., Bonfils, S. and Lewin M.J.M. (1980) J. Biol. Chem. 255, 11682-11687). In the present work, we demonstrate that the peptidic inhibitor of cAMP-dependent protein kinases decreased thiophosphorylation of a 45 kDa polypeptide. We suggest that this polypeptide could be regarded as a candidate for the role of chloride transporter or chloride transport regulator.

Depolymerization of solubilized gastric (H+ + K+)-ATPase by n-octylglucoside or cholate

We have previously shown that an active (H+ + K+)-ATPase can be extracted from gastric apical membranes using n-octylglucoside (Soumarmon, A., Grelac, F. and Lewin, M.J.M. (1983) Biochim. Biophys. Acta 732, 579-585). This extract contained an holomeric enzyme of 390-420 kDa and contained 68% of the K+-stimulated ATPase specific activity originally present. We demonstrate here that inactivation, induced during a more classically designed protocol, is associated with the appearance of smaller, polymorphic structures with molecular mass of 330-360 and 240-250 kDa estimated using molecular sieve chromatography and glycerol gradients. This suggests that (H+ + K+)-ATPase solubilization by n-octylglucoside is a complex process involving first extraction of the enzyme as an active polymer, with subsequent depolymerication and inactivation of this polymer. Depolymerization was specifically studied by treating the large holomeric n-octylglucoside-extracted (H+ + K+)-ATPase with increasing concentrations of either n-octylglucoside or cholate. Detergent-induced changes were characterized by centrifugation on glycerol gradients. Progressive displacement of ATPase activity into three different peaks at 32%, 26% and 20% glycerol was found with increasing detergent concentrations. n-Octylglucoside inhibited enzyme activities and was more deleterious for phosphatase than for ATPase activity. Moreover, it induced the dissociation of phosphatase and ATPase distribution profiles. At concentrations of 0.2 to 1.15%, cholate induced the displacement of the glycerol gradient profiles but no loss of activities and no dissociation of phosphatase and ATPase profiles. Higher concentrations of this detergent (2.5%) also inactivated the ATPase concomitantly with the appearance of a protein peak with no related activity at 16-18% glycerol. From this study we suggest that solubilization of gastric (H+ + K+)-ATPase can be achieved through the extraction of a polymer by n-octylglucoside and through subsequent depolymerization using cholate. We suggest that the different sizes correspond to monomers, dimers, trimers and perhaps tetramers. The monomers were apparently inactive under present test conditions.

Gastric microsomal NADH-cytochrome b5 reductase: characterization and solubilization

NADH-cytochrome b5 reductase from hog gastric microsomes was studied with respect to substrate dependence, optimum pH, thermal denaturation as well as anti-cytochrome b5 antibodies and different ions. The reduction of potassium ferricyanide by the enzyme was specific for NADH. Using potassium ferricyanide or trypsin-solubilized liver cytochrome b5 (Tb5) as substrates, enzyme activity was inhibited by ADP and to a lesser extent by ATP. Tb5- (but not ferricyanide-) reductase was activated by ionic strength up to 0.05 ion equivalent per liter and inhibited at higher strengths whatever the ion used (Cl-, Na+, Ca2+, Mg2+). Enzyme solubilization occurred with Triton X100. The solubilization increased the Tb5- (but not the ferricyanide-) reductase activity up to a Triton:protein ratio of 15. We therefore suggest that gastric microsomes contain a Triton soluble membrane-bound NADH cytochrome b5 reductase which is in many respects similar to the liver and red cell enzymes.

Gastric acid secretion results from antagonistic effects of antral histamine (Antramine) and somatostatin on gastrin

Gastric acid secretion, whole blood histamine concentration and serum gastrin were measured in dogs, equipped with Heidenhain pouch, in response to feeding alone and in combination with antral histamine (AH)--Antramine--or with somatostatin. Feeding stimulated acid secretion, histamine and gastrin responses in a dose-related manner. Addition of antramine to feeding resulted in a potentiated acid and gastrin responses while histamine response corresponded to sum of individual responses to antramine and to feeding. Somatostatin reduced markedly acid and histamine responses, while gastrin response was unchanged. Serum gastrin and whole blood histamine appear to be agonistic factors responsible together for acid secretion. Somatostatin suppresses histamine response and would inhibit gastrin activity on acid secreting cells by this mean. Somatostatin and histamine might act antagonistically on gastrin which would be their common substrate, and thus they could intervene in a regulation process of acid secretion. In regard to synthetic histamine, native antral histamine--antramine--appears to be a better candidate for a physiological histamine regulation of acid secretion.

Determination of 3 methyl-L-histidine in human urine by ion exchange high performance liquid chromatography. Applications to patients in post-operative surgical care

A new chromatographic procedure is proposed for measuring 3 methyl-L-histidine (3 MH) in human urine. The sample was purified on a cation-exchange resin (AGR 50W-X4) and analysed by ion exchange high performance liquid chromatography on a PARTISIL 10 SCX Whatman column in UV light at 210 nm within 16 min. This procedure gave similar outputs of 3 MH to those described in human normal urine (mean +/- SEM = 213 +/- 15 mumol X 24 h-1, n = 19). It was used to measure the urinary outputs of 3 MH of five patients admitted to an intensive surgical care unit, for 48, 28, 25, 15 and 10 days, respectively. The urinary outputs of 3 MH were normal or lower than normal. The 10(3) urinary 3 MH/creatinine molar ratios were also calculated; this new 3 MH analysis could help the reanimator to prescribe an adequate nutritional assessment.

Cytochrome b5-dependent delta 9 desaturation of fatty acids in gastric microsomes

Stearyl-CoA was shown to stimulate the reoxidation rate of cytochrome b5 of gastric microsomes and to decrease the reduction rate of trypsin-purified hog liver cytochrome b5 by the NADH-cytochrome b5 reductase of these microsomes. This latter effect was (1) proportional to microsome concentration and to stearyl-CoA concentration with an apparent Km of 3.3 . 10(-6) M and a Vmax of 71 nmol per min and per mg microsomal protein, (2) insensitive to ATP and inhibited by 1.4 mM KCN, (3) mimicked by palmityl-CoA but not by stearic nor palmitic acid. Direct assays carried out using [14C]stearyl- and [14C]palmityl-CoA as substrates showed a production of 0.12 nmol of oleic and palmitoleic acid, respectively, per min per mg of microsomal protein. In the presence of Tb5 antibodies the reaction was inhibited by 40%. These results support the occurrence of cytochrome b5-dependent fatty acid delta 9 desaturation in gastric microsomes.

Determination of histamine, methylhistamines and histamine-o-phthaldialdehyde complexes by two high-performance liquid chromatographic procedures. Application to biological samples

Two high-performance liquid chromatographic procedures were proposed to measure histamine. The first, with UV detection and a strong acid cation exchanger (Partisil 10, SCX Whatman), made it possible to isolate histamine and some methylated derivatives. The second, with a C18 sorbent (mu Bondapak, Waters, 10 microns particle size) eluted with ion-pairing phases, made it possible to isolate the histamine-o-phthaldialdehyde complexes. This last procedure allied with a chromatographic purification step gave lower or identical amounts of histamine than those described in human urine (16 +/- 7 micrograms per 24 h), canine whole blood (1.5 +/- 1 ng/ml) and human gastric juice (2.3 +/- 1.4 ng/ml). The two procedures gave the concentration of a histamine-like compound isolated from the antral mucosa.

Histamine is able to suppress the inhibitory effect of somatostatin on exogenous gastrin: comparison between extractive antral histamine and synthetic histamine

In view of examining inhibition by somatostatin of gastrin-induced gastric secretion, antral histamine (AH) and synthetic histamine (SH) were comparatively studied in dogs. Both AH and SH were able to antagonize somatostatin: their potencies did not differ significantly as regards acid secretion, but AH is more potent than SH on pepsin secretion. The dose-dependent activity of AH was limited for the period of infusion. The denervated pouch is more sensitive than the innervated stomach. We suggest that antral histamine might intervene in the complex regulation of gastric secretion where somatostatin and gastrin act antagonistically and where the stimulatory as well as inhibitory fibers of the vagus intervene.