425 research outputs found
A new representation of acid-base disturbances
The acid-base status of intensive care patients is monitored on the basis of three quantities. The graphical representation which may be of help for the monitoring task is therefore cumbersome. The classical Siggaard-Andersen acid-base chart is such a representation, but it is only suited for evaluating one acid-base status at a time and not for representing acid-base paths. A new representation, obtained after a principal components transformation is presented. It is shown that the representation is characteristic for the laboratory instrument used. Its most attractive feature is that it is distortionless with respect to the three-dimensional configuration
Transcobalamin II-mediated uptake of vitamin B12 by rat liver cells
Vitamin B12 plays a unique role in mammalian metabolism
not only because, as a coenzyme, it is involved in two
completely different and unrelated biochemical pathways, -
the synthesis of nucleic acid precursors and the catabolism
of some fatty acids -, but even more because it gives an
excellent example how different groups of living organisms
work together and depend on each other for the supply of
vital nutrients. Vitamin B12 is almost exclusively found in
animal products. However, it is not synthesized by the
animals themselves but, they are able in one or the other
way to absorb vitamin B12 which is produced bv microorganisms.
For instance in ruminants the bacteria in the
rumen are the source of the vitamin, which is taken up by
the gut, distributed over the tissues and which is
subsequently consumed by man with the meat or with the milk.
However, the quantity of vitamin B12 , which is available in
the food. is so low, that it would be lost if not an
elaborate system of carrier proteins and cellular receotor
mechanisms selectively collected it from the food and
delivered it to the tissues. Intrinsic factor, produced and
secreted by the qastric mucosa, binds the vitamin, which
enters the body with the food, and hands it over to the
ileal mucosa cells, which carry specific receptors for this
protein. When the vitamin enters the blood, the plasma
transport proteins, the transcobalamins, take it up
immediately and deliver it to the tissues
Effect of nitrous oxide on folate coenzyme distribution and de novo synthesis of thymidylate in human bone marrow cells
Abstract
The effect of nitrous oxide on intracellular folate metabolism of the human bone marrow was studied in vitro. Bone marrow cells, obtained from healthy volunteers, were incubated with 5 Ă 10â8m-[3H]5-formyltetrahydrofolate (5-formylTHF) for 18 hr to label intracellular folate pools. Subsequently the cells were exposed to nitrous oxide for up to 10 hr, and the intracellular folate coenzyme levels were quantitated by HPLC. The dU suppression test was carried out on part of the bone marrow samples in order to measure folate-dependent synthesis of the DNA precursor thymidylate (dTMP). After 5 hr exposure to nitrous oxide the de novo dTMP synthesis of the bone marrow cells was significantly decreased (P < 0.05), and this reduced synthesis persisted at 10 hr. After both 5 and 10 hr of exposure to nitrous oxide the amount of 10-formylTHF was reduced (P < 0.05) while that of 5-methylTHF was increased (P < 0.05). At 10 hr the level of THF was also decreased (P < 0.05). This study shows that nitrous oxide exposure of human bone marrow cells causes a redistribution of the various folate coenzymes which supports the idea of âfunctional cobalamin deficiencyâ. Moreover it seems probable that following prolonged exposure to nitrous oxide, not only folate-dependent dTMP synthesis but also de novo purine synthesis is reduced
Significance of various parameters derived from biological variability of lipoprotein(a), homocysteine, cysteine, and total antioxidant status
Analytical and biological components of variability and various derived
indices have been determined for lipoprotein(a) [Lp(a)], homocysteine
(Hcy), cysteine (Cys), and total antioxidant status (TAOS) in ostensibly
healthy adult Caucasians and in stable outpatients with an increased serum
Lp(a). In healthy Caucasians, average intraindividual biological CVs (CVb)
were 20.0% for Lp(a), 9.4% for Hcy, 5.9% for Cys, and 2.8% for TAOS, CVbs
being similar in men and women. In the outpatient group, CVbs were
comparable for Hcy, Cys, and TAOS, but significantly lower for Lp(a) (7.5%
vs 20.0%; P <0.0001). Moreover, a significant inverse relation between
both biological and analytical CVs (CVa) and serum Lp(a) concentrations
was demonstrated. We conclude that average CVa and CVb values, and hence
average derived indices, are adequate for Hcy, Cys, and TAOS, whereas
individual values should be used for Lp(a)
Development of a clinical prediction model for an international normalised ratio >= 4.5 in hospitalised patients using vitamin K antagonists
Portable blood gas and electrolyte analyzer evaluated in a multiinstitutional study
A recently introduced blood gas/electrolyte analyzer (SenDx 100((R)),
renamed ABL70) intended for point-of-care, near-patient, or stat
laboratory use was evaluated simultaneously in four different institutions
and compared with three different laboratory bench analyzers with respect
to imprecision, inaccuracy (assessed by tonometry), and patient-sample
analyses. The analyzer is equipped with a sensor cassette and a reagent
cartridge for 50, 100, or 200 analyses and 100 or more traditional
quality-control measurements. One analysis requires 170 microL of whole
blood and takes <90 s. Statistically, the instrument performed somewhat
better (lower CVs) for PO2 and potassium and somewhat worse for pH, PCO2,
and ionized calcium than the respective comparison analyzers. However, the
overall performance (in terms of CV and accuracy) was satisfactory in
terms of clinical (e.g., CLIA '88) goals in all institutions. The mean
difference and the CV of that difference in some 400 patient-sample
comparisons were as follows: 0.010 (+/- 0.002%) for pH, -0.65 mmHg (+/-
4%) for PCO2, -0.49 mmHg (+/- 6%) for Po2, 0.44 mmol/L (+/- 1.2%) for
sodium, -0.013 mmol/L (+/- 2.9%) for potassium, -0.016 mmol/L (+/- 2.6%)
for ionized calcium, and -0.016 L/L (+/- 7. 1%) for the hematocrit. Its
acceptable analytical performance and ease of operation make the SenDx 100
suitable for the analysis of blood gases and electrolytes
Relation between cytokines and routine laboratory data in children with septic shock and purpura
Objective
To establish the relation between routine laboratory data (lactate, fibrinogen, CRP) and cytokines (TNF,IL-1 and-6) and to estimate their prognostic value in pediatric patients with severe infectious purpura on admission.
Design
Prospective study.
Setting
Pediatric intensive care unit (PICU).
Patients
17 children aged 5â172 months (median 46) were hospitalized in our PICU in 1989â90 with severe infectious purpura.Neisseria meningitidis was isolated in 15 children andHaemophilus influenzae in two. The patients were divided into 3 groups: non-shock, shock and severe shock leading to death. Shock was defined by standard criteria.
Measurements
Arterial blood was sampled for lactate, CRP, fibrinogen, TNF, and IL-1 and-6 on admission. The PRISM (pediatric risk of morality)-score was recorded.
Methods
Statistical analysis was performed with the Student'st-test using the logarithmic values of the cytokine concentration, and Spearman correlation analysis.
Results
According to the shock criteria, 9 patients were in shock of whom 4 did not survive. Significant differences existed between the 3 groups concerning lactate, TNF, and IL-6. Fibrinogen, CRP, IL-1, and PRISM-score discriminated only between survivors and non-survivors. A highly significant correlation existed between cytokines, the PRISM-score and lactate (TNF:r=0.69, IL-1:r=0.56, IL-6:r=0.65, PRISM:r=0.65). A significant inverse correlation existed between cytokines and CRP (TNF:r=â0.55, IL-1:r=â0.64, and IL-6:r=â0.56), and IL-6 and fibrinogen (r=â0.65).
Conclusion
These results show a significant correlation between cytokines and lactate, and lactate, TNF and IL-6 are closely associated with the severity of septic shock with purpura in children
Anti-leukemic potential of methyl-cobalamin inactivation by nitrous oxide
Myeloâcytotoxicity of extended nitrous oxide (N2O) inhalation was described almost forty years ago and then incidentally applied already with temporary success for suppressing leukemia. In 1948 the accompanying megaloblastic maturation arrest was explained by inactivation of the methylcobalamin coenzyme and subsequent folate deficiency. We studied the antiâleukemic effect of N2O on a transplantable acute leukemia in B(rown) N(orway) rats. Progression of this B,N,M(yelocytic)L(eukemia) was measured as spleen and liver weights, and leukemic blood cell counts. The deoxyuridine (dU)âsuppression test provided in vitro indication of the functional folate activity of leukemic cells. Breathing of N2Oâoxygen considerably reduced but did not eradicate, BNMLâproliferation. Addition of antiâmetabolites, interfering with some enzyme in the folate metabolism beyond the methylcobalamin coâenzyme dependent methionine synthase step, acted at least synergistically. The antiâleukemic effect of cycloleucine, which reduces Sâadenosylâmethionine synthesis by inactivation of methionine adenosyltransferase, was moderate but became much stronger with N2O inhalation. Methotrexate, a potent antiâleukemic agent by inhibiting tetrahydrofolate (THF) generation through inactivation of diâHF reductase, became highly antiâBNML, even in low dosage when combined with or preceded by N2O. 5âFluorouracil, which inhibits methyleneâTHF dependent thymidilate synthase, itself was surprisingly antiâBNML, but also became much more potent with previous or concomittant N2O exposure. Preliminary dUâsuppression test results with human acute leukemia cells, exposed to N2O and/or folate antagonists in vitro, correlated well with the in vivo BNMLâexperiments. Combining the anticobalamin activity of N2O with an antiâfolate therefore seems to be a promising chemotherapeutic approach. Copyrigh
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