Attachment of community nurses to general practice.
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Biomedical subjects
Publications and source records attributed to J Fisher.
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Circular DNA was isolated from mitochondrial fractions of ram spermatozoa by SDS treatment followed by convex sucrose gradient centrifugation. The DNA had a contour length of 5.0 micron. Its buoyant density was 1.6983 g cm-3, which was smaller than two nuclear DNA components with buoyant densities of 1.6999 and 1.7156 g cm-3, found in ram spermatozoa. The Tm of the mitochondrial DNA was 69.7 degrees C. The mole fraction G+C calculated from the buoyant density and melting temperature was 39.1% and 38.6%, respectively.
Serum ferritin concentration has been measured during the course of pregnancy in 154 women. There was a rapid decrease in iron stores during early pregnancy irrespective of any iron therapy. Oral iron did, however, prevent the stores reaching iron deficient levels during the second half of pregnancy. The results suggest that maternal erythroid activity starts early in pregnancy and may exhaust the iron stores before the fetal demands for iron can be met.
Ventricular irritability and ventricular fibrillation developed in an alcoholic patient who had withdrawal seizures and delirium tremens; he was successfully resuscitated. Potassium and magnesium level were low; therefore replacement of these electrolytes was carried out, as well as intravenous administration of lidocaine hydrochloride; however, ventricular tachycardia developed again and required countershock. No further arrhythmias occurred after additional potassium chloride and procainamide hydrochloride therapy was given. Hypokalemia and possibly hypomagnesemia are implicated as important factors in the development of ventricular ectopy. Delirium tremens is a potential medical emergency, and in the presence of low potassium and/or magnesium levels, or ventricular irritability, patients with this condition should be treated expectantly in an intensive care unit, with close monitoring and aggressive therapy for life-threatening arrhythmias.
In order to facilitate interpretation of the deazaisoalloxazine system as a valid mechanistic probe of flavoenzyme catalysis, we have examined some of the fundamental chemical properties of this system. The enzymatic synthesis, on a micromole scale, of the flavin coenzyme analogues 5-deazariboflavin 5'-phosphate (deazaFMN) and 5-deazariboflavin 5'-diphosphate, 5' leads to 5'adenosine ester (deazaFAD) has been achieved. This latter synthesis is accomplished with a partially purified FAD synthetase complex (from Brevibacterium ammoniagenes), containing both phosphorylating and adenylylating activities, allowing direct conversion of the riboflavin analogue to the flavin adenine dinucleotide level. The structure of the reduced deazaflavin resulting from enzymatic and chemical reduction is established as the 1,5-dihydrodeazaflavin by proton magnetic resonance. Similarly, the C-5 position of the deazaflavins is demonstrated to be the locus for hydrogen transfer in deazaflavin redox reactions. Preparation of 1,5-dihydrodeazaflavins by sodium borohydride reduction stabilized them to autoxidation (t 1/2 approximately 40 h, 22 degrees C) although dihydrodeazaflavins are rapidly oxidized by other electron acceptors, including riboflavin, phenazine methosulfate, methylene blue, and dichlorophenolindophenol. Mixtures of oxidized and reduced deazaflavins undergo a rapid two-electron disproportionation (k = 22 M-1 S-1 0 degrees C), and oxidized deazaflavins form transient covalent adducts with nitroalkane anions at pH less than 5. Generalized methods for the synthesis of isotopically labeled flavin and deazaflavin coenzymes and their purification by adsorptive chromatography are given.
The ability of 5-deazaisoalloxazines to substitute for the isoalloxazine (flavin) coenzyme has been examined with several flavoenzymes. Without exception, the deazaflavin is recognized at the active site and undergoes a redox change in the presence of the specific enzyme substrate. Thus, deazariboflavin is reduced catalytically by NADH in the presence of the Beneckea harveyi NAD(P)H:(flavin) oxidoreductase, the reaction proceeding to an equilibrium with an equilibrium constant near unity. This implies an E0 of -0.310 V for the deazariboflavindihydrodeazariboflavin couple, much lower than that for isoalloxazines. With this enzyme, both riboflavin and deazariboflavin show the same stereospecificity with respect to the pyridine nucleotide, and despite a large difference in Vmax for the two, both have the same rate-determining step (hydrogen transfer). Direct transfer of the hydrogen is seen between the nicotinamide and deazariboflavin in both reaction directions. DeazaFMN reconstituted yeast NADPH: (acceptor) oxidoreductase (Old Yellow Enzyme), and deazaFAD reconstituted D-amino acid:O2 oxidoreductase and Aspergillus niger D-glucose O2 oxidoreductase are all reduced by substrate at approximately 10(-5) the rate of holoenzyme; none are reoxidized by oxygen or any of the tested artificial electron acceptors, though deazaFADH-bound to D-amino acid:O2 oxidoreductase is rapidly oxidized by the imino acid product. Direct hydrogen transfer from substrate to deazaflavin has been demonstrated for both deazaFAD-reconstituted oxidases. These data implicate deazaflavins as a unique probe of flavin catalysis, in that any mechanism for the flavin catalysis must account for the deazaflavin reactivity as well.
Three cases of acute, free perforation of the colon in Crohn's disease are described and their clinical and pathological features are detailed. Colonic perforation in Crohn's disease bears no definite relationship to obstruction or adrenocorticosteroid therapy. It may occur with or without toxic megacolon, and pathological study has not thus far suggested a common pathogenetic mechanism. Although free perforation has been considered to be extremely rare in Crohn's colitis, it is likely that this complication is more common than previously believed.
A 24-year-old woman with Marfan's syndrome and mitral regurgitation had clinical features suggestive of infective endocarditis. The causative organism was Streptococcus viridans. Initial therapy with penicillin G, in a dose that should have been bactericidal and hence curative according to the results of the initial quantitative antimicrobial studies, became inadequate. The strain of S. viridans displayed considerable variation in both growth properties and antimicrobial sensitivity during the course of therapy. In addition, a different strain of S. viridans was cultured 1 month after treatment had begun. It is therefore important to repeat cultures and antimicrobial sensitivity testing during treatment of infective endocarditis.
When S. mansoni adults were cultured in vitro for 12 days in a diphasic medium, their gross morphology, motor activity, frequency of sexual pairings, rates of glucose utilization and of lactic acid production were the same in the presence (90% N2/5% O2/5% CO2) or absence (95% N2/5% CO2) of oxygen. Therefore, no Pasteur effect, nor any reduction in lactic acid formation, was demonstrable under aerobic conditions. While aerobic conditions did not affect the rate of glycolysis, they had a marked effect on egg production. In the presence of oxygen, the rate of egg-laying reached a maximum between days 4 and 6. The average number of viable eggs produced per worm pair during this period was 118 (Sx equals 2.2), which is within the overall range (68 to 248) recorded by others for this same strain in vivo. Conversely, under anaerobic conditions in vitro, virtually no eggs were laid. It remains to be determined whether oxidative metabolism actually is required for energy to produce eggs, or whether some reaction yielding no ATP is essential for completion of their developmental process, such as tanning of the eggshall brought about by the oxidation of some phenolic compounds.
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Transport of vinylglycolate (2-hydroxy-3-butenoic acid) via the lactate transport system is the limiting step for covalent labeling of membrane vesicles prepared from E. coli ML 308-225. Thus, the rate and extent of vinylglycolate labeling is stimulated about 10-fold by ascorbate-phenazine methosulfate, and stimulation is abolished by 2,4-dinitrophenol and by phospholipase treatment, neither of which affect the rate of vinylglycolate oxidation. [(3)H]Vinylglycolate of high specific activity has been prepared, and vesicles have been labeled with this compound in the presence of ascorbate-phenazine methosulfate. Examination of these preparations by high resolution radioautography in the electron microscope demonstrates that virtually all of the vesicles are labeled. The experiments provide a strong indication that most, if not all, of the membrane vesicles in these preparations catalyze active transport.
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