Lactate metabolism.

Lactate is the end product of the anaerobic metabolism of glucose, and its accumulation in the blood signals an increase in production or a decrease in utilization, or both. The most common etiology of lactic acidosis is hypoperfusion, which represents an imbalance between systemic oxygen demand and oxygen availability with resultant tissue hypoxia. A wide variety of other etiologies of hyperlactatemia have been identified or implicated.

The spherically averaged structure of a DNA isometric plant virus: cauliflower mosaic virus.

The organization of cauliflower mosaic virus was reinvestigated by neutron small-angle scattering in buffers containing various amounts of D2O. The molecular weight of the virions and their DNA content were determined and found to agree well with the known primary structure of the nucleic acid. The capsid probably possesses a T = 7 icosahedral organization.

Significance of blood lactate levels in critically ill patients with liver disease.

Lactic acidosis unrelated to tissue hypoxia has been described in patients with liver disease. This raises questions regarding the utility of the arterial lactate level as an indicator of tissue hypoperfusion in critically ill patients with hepatic dysfunction. The incidence of hyperlactatemia in a group of critically ill patients with liver disease and its association with clinical indicators of circulatory shock as well as hospital mortality were examined.

Selection of infant feeding method: a population-based study in a rural area.

The selection of infant feeding method was studied in a rural area. At discharge from the hospital, 70 percent of women were breast feeding, with 47 percent still breast feeding at three months. The decision regarding feeding method was made early, with the majority of women deciding before the pregnancy.

Selection of a physician for prenatal care.

The selection of a physician for prenatal care was studied as a model of the generic process of choosing a physician. The results suggest that factors important in this process are similar to those relating to satisfaction with care: physician competence, cost and convenience, and personal qualities. Women selecting obstetricians for prenatal care placed a higher emphasis on physician competence, whereas those selecting family physicians placed a greater emphasis on cost and convenience.

Oxytocin: pharmacology and clinical application.

Oxytocin is a potent uterine stimulant that is used for the induction and augmentation of labor, antenatal fetal assessment, and control of postpartum hemorrhage. If used improperly, oxytocin can lead to such complications as uterine hypercontractility with fetal distress, uterine rupture, maternal hypotension, water intoxication, and iatrogenic prematurity. These complications can almost always be avoided if oxytocin is given in proper dosages and with careful fetal and maternal monitoring.

Patient satisfaction with obstetric care.

Patient satisfaction with obstetric care was studied in a cohort of postpartum women from a rural midwestern county. Birth certificate data defined the population, and satisfaction data were acquired through a mailed questionnaire. An indirect measure (satisfaction scale) was derived with acceptable construct validity and internal consistency.

Changes in smoking and alcohol consumption during pregnancy: a population-based study in a rural area.

Changes in smoking and drinking behavior during pregnancy and factors influencing these changes were studied in a typical rural county. Using birth certificates and mailed questionnaires, information was obtained from 255 married women residents of Callaway County, Missouri, who gave birth in a one-year period. The women were much more likely to drink alcohol than to smoke before pregnancy (48.

Nosocomial infection among patients in different types of intensive care units at a city hospital.

Available data on the characteristics of infections in different types of ICUs are limited. Between May and July 1984, overall infection rates of patients in the ICUs and in the general wards at the Detroit Receiving Hospital were 19.2% and 9.

Molecular specialization of astrocyte processes at nodes of Ranvier in rat optic nerve.

The HNK-1 and L2 monoclonal antibodies are thought to recognize identical or closely associated carbohydrate epitopes on a family of neural plasma membrane glycoproteins, including myelin-associated glycoprotein, the neural cell adhesion molecule, and the L1 and J1 glycoproteins, all of which have been postulated to play a part in mediating cell-cell interactions in the nervous system. We have used these two antibodies in immunofluorescence and immunogold-electron microscopic studies of semithin and ultrathin frozen sections of adult rat optic nerve, respectively, and we show that they bind mainly to astrocyte processes around nodes of Ranvier. Most other elements of the nerve, including astrocyte cell bodies and large astrocytic processes, are not labeled by the antibodies.

The J1 glycoprotein--a novel nervous system cell adhesion molecule of the L2/HNK-1 family.

The neural cell adhesion molecules L1 and N-CAM share a common carbohydrate epitope that is recognized by the monoclonal antibodies L2 and HNK-1. The L2/HNK-1 epitope is also present on the myelin-associated glycoprotein (MAG) which is thought to mediate surface interactions between the axon and myelinating cell. Other, as yet unidentified, cell-surface glycoproteins are recognized by the two antibodies and are believed to belong to a family of neural cell adhesion molecules.

Genetic heterogeneity in Gaucher disease: physicokinetic and immunologic studies of the residual enzyme in cultured fibroblasts from non-neuronopathic and neuronopathic patients.

To elucidate the genetic heterogeneity in the three major phenotypic subtypes of Gaucher disease, the residual acid beta-glucosidase in fibroblasts from patients with all three subtypes from different ethnic and demographic groups was investigated by comparative kinetic, thermostability, and immunotitration studies. The kinetic studies delineated three distinct groups (designated A, B, and C) of residual activities with characteristic responses to the enzyme modifiers, taurocholate (or phosphatidylserine), and glucosyl sphingosine (or N-hexyl glucosyl sphingosine); Group A residual enzymes responded normally to these modifiers. All neuronopathic patients (types 2 and 3) and most non-Jewish, non-neuronopathic patients (type 1) had group A residual activities and thus could not be distinguished by their kinetic properties.

Gaucher disease types 1, 2, and 3: differential mutations of the acid beta-glucosidase active site identified with conduritol B epoxide derivatives and sphingosine.

To elucidate the genetic heterogeneity in Gaucher disease, the residual beta-glucosidase in cultured fibroblasts from affected patients with each of the major phenotypes was investigated in vitro and/or in viable cells by inhibitor studies using the covalent catalytic site inhibitors, conduritol B epoxide or its bromo derivative, and the reversible cationic inhibitor, sphingosine. These studies delineated three distinct groups (designated A, B, and C) of residual activities with characteristic responses to these inhibitors. Group A residual enzymes had normal I50 values (i.

Intra-arterial monitoring during cardiopulmonary resuscitation.

Because arterial cannulation assists in management of critically ill patients (pts), we assessed the utility of extending intra-arterial monitoring to hospitalized patients suffering in-hospital cardiopulmonary arrest outside of intensive care wards. A totally self-contained, readily portable system for rapid insertion of emergency intra-arterial lines was evaluated in 16 pts from 53 to 89 years old (mean = 66.5 years) undergoing cardiopulmonary resuscitation.

First-trimester prenatal diagnosis of Tay-Sachs disease.

The prenatal diagnosis of Tay-Sachs disease was made in two at-risk fetuses by the analysis of chorionic villi obtained at 9 and 11 menstrual weeks, respectively. The diagnoses were based on the absence of beta-hexosaminidase A activity as determined by: (1) specific enzyme assays, (2) anion-exchange chromatography, and (3) cellulose acetate gel electrophoresis. The enzymatic diagnoses were confirmed on fetal tissue as well as by ultrastructural demonstration of the first-trimester fetal neuropathology.

Neural cell adhesion molecules and myelin-associated glycoprotein share a common carbohydrate moiety recognized by monoclonal antibodies L2 and HNK-1.

Cell surface molecules have been implicated in cell interactions which underlie formation of the nervous system. The analysis of the functional properties of such molecules has profited from the combined use of antibodies and cell culture systems. It has been suggested that the interplay between these molecules modulates cell-to-cell interaction at critical developmental stages.

Expression of neural cell adhesion molecule L1 during development, in neurological mutants and in the peripheral nervous system.

Neural cell adhesion molecule L1 consists of two glycoprotein bands of 140 and 200 kdaltons at all developmental stages studied (from birth to adulthood in murine cerebellum and cerebral hemispheres) and in the 4 neurological mouse mutants reeler, weaver, staggerer and Purkinje cell degeneration. In histological sections L1 antigen is detectable at birth in the Purkinje cell layer and fiber tracts in the prospective white matter, but not in the external granular layer. From postnatal day 4 onwards L1 antigen additionally appears in the inner part of the external granular layer, the zone of postmitotic premigratory granule cell neurons.

Human lysosomal beta-glucosidase: kinetic characterization of the catalytic, aglycon, and hydrophobic binding sites.

Three binding sites on highly purified lysosomal beta-glucosidase from human placenta were identified by studies of the effects of interactions of various enzyme modifiers. The negatively charged lipids, taurocholate and phosphatidylserine, were shown to be noncompetitive, nonessential activators of 4-methylumbelliferyl-beta-D-glucoside hydrolysis. Similar results were observed using the natural substrate, glucosyl ceramide, and low concentrations of taurocholate (less than 1.

Alcohol use during pregnancy.

Heavy alcohol intake during pregnancy is associated with numerous adverse effects on the fetus, including low birth weight, congenital anomalies, mental retardation, and behavioral and learning disabilities. There is increasing evidence that moderate drinking also may cause these problems, but to a lesser degree. Less is known about the effects of a single drink or a single alcoholic binge, but no absolutely safe level of alcohol consumption has been determined for pregnant women.

Long-term reactions of women to electronic fetal monitoring during labor.

The long-term reactions of women to electronic fetal monitoring during labor were studied by mailing a questionnaire to a random sample of 110 women two to five months postpartum. Of the 75 women who responded and in whom the fetal monitor had been used, 74 gave an overall positive response to fetal monitoring. Four important factors underlying the responses of the women were identified.

The neural cell adhesion molecule L1 is distinct from the N-CAM related group of surface antigens BSP-2 and D2.

The neural cell adhesion molecule L1 and the group of N-CAM related molecules, BSP-2 and D2 antigen, are immunochemically distinct molecular species. The two groups of surface molecules are also functionally distinct entities, since inhibition of Ca2+-independent adhesion among early post-natal mouse cerebellar cells by Fab fragments of both antibodies are at least additive, when compared with equal concentrations of the individual antibodies.