RESUMO
As part of a project funded by the European Commission (EC) for the development and evaluation of multiresidue methods for analysis of drinking and related waters, 15 European laboratories evaluated a method using styrene-divinylbenzene co-polymer solid-phase extraction followed by gas chromatography/mass spectrometry. The main aim of the study was to evaluate whether the method meets the requirements of EC Directive 98/83 in terms of accuracy, precision, and detection limit for 22 pesticides according to the following requirements: limit of detection, < or = 0.025 microg/L; accuracy, expressed as recovery between 75 and 125%; and precision, expressed as repeatability relative standard deviation of the method of < 12.5% and as reproducibility relative standard deviation of the method of < 25%. Analyses for unknown concentrations were performed with fortified commercial bottled and tap waters. All laboratories were able to achieve detection limits of 0.01 microg/L for all pesticides except dimethoate and desisopropylatrazine (0.02 microg/L). The criteria for repeatability were met for all compounds except trifluralin, dimethoate, and lindane in bottled water and chlorpyrifos, dimethoate, and lindane in tap water. The criteria for reproducibility were met for all compounds except trifluralin, dimethoate, and lindane in bottled water and pendimethalin, chlorpyrifos, dimethoate, terbutryn, and lindane in tap water. In terms of accuracy, the method meets the requirements for all pesticides in both matrixes, except for lindane in bottled water and lindane and chlorpyrifos in tap water.
Assuntos
Resíduos de Praguicidas/análise , Abastecimento de Água/análise , Algoritmos , Cromatografia Gasosa-Espectrometria de Massas , Indicadores e Reagentes , Padrões de Referência , Reprodutibilidade dos Testes , Soluções , Solventes , Poluentes Químicos da Água/análiseRESUMO
Co-ordinated joint service planning by all stakeholders is widely accepted as a valuable principle in the development of community support services for persons with severe mental illness. Even so, relatively little is known of the views and priorities of the different parties with regard to the elements that should make up the care and support system. This paper reports on a Dutch study in which clients, mental health care workers and community service professionals offered their opinions on what constitutes a support system that enables individuals with long-term mental illness to participate in the community. The results show that the respondents regarded a stable base as an essential prerequisite for the realisation of this objective. Within this general consensus, the clients stressed the importance of advocacy and sheltered meeting places; the mental health professionals emphasised the rehabilitative elements and the representatives of the generic community services felt that the key components in any such system were crisis intervention services and co-ordination at client and system level.
Assuntos
Serviços Comunitários de Saúde Mental , Prioridades em Saúde , Humanos , Transtornos Mentais/terapia , Países Baixos , Recursos HumanosRESUMO
In urine of patients with propionyl-CoA carboxylase deficiency or with methylmalonic acidemia, carnitine esters of 2-methyl-branched fatty acids of all chain lengths between 4 and 9 atoms of carbon were identified during the acute phase of the diseases. The chemical structure of these compounds was obtained by gas chromatography-mass spectrometry analysis of their fatty acid moieties in their free and picolinyl ester forms. We suggest mechanisms for the biosynthesis of these branched fatty acids, and their accumulation in urine during episodes of caloric imbalance.
Assuntos
Carnitina/análogos & derivados , Ácido Metilmalônico/sangue , Propionatos/sangue , Adulto , Carboxiliases/deficiência , Carnitina/química , Carnitina/urina , Estudos de Casos e Controles , Cromatografia Gasosa-Espectrometria de Massas , Humanos , Lactente , Erros Inatos do Metabolismo Lipídico/sangue , Erros Inatos do Metabolismo Lipídico/urina , Masculino , Metilmalonil-CoA Descarboxilase , Espectrometria de Massas de Bombardeamento Rápido de ÁtomosRESUMO
UNLABELLED: We present the clinical, pathological, biochemical, and molecular results on an infant girl with long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency and data on her deceased elder brother for whom this condition was retrospectively diagnosed. Clinical signs were liver enlargement and elevated liver enzymes, failure to thrive, and neurological disease (coma, seizures) triggered by an infectious stress. In the second child hepatic failure and status epilepticus developed during the onset of a rotavirus gastroenteritis. A barbituric coma was induced, but hypotonia and lack of eye pursuit persisted after suppression of antiepileptic drugs. She ultimately died of heart failure. Unlike previously reported cases, both of these patients had early-onset cirrhosis, and severe neurological disease was observed in the second child. CONCLUSION: Liver cirrhosis and brain damage may be underestimated in cases of long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency and may occur early in life.
Assuntos
3-Hidroxiacil-CoA Desidrogenases/deficiência , Erros Inatos do Metabolismo Lipídico/enzimologia , Cirrose Hepática/enzimologia , Cirrose Hepática/genética , Idade de Início , Evolução Fatal , Feminino , Humanos , Lactente , Erros Inatos do Metabolismo Lipídico/genética , Erros Inatos do Metabolismo Lipídico/patologia , Fígado/patologia , Cirrose Hepática/patologia , MasculinoRESUMO
Previously undescribed medium-chain acylcarnitines were identified in a urine sample from a patient with medium-chain acyl-CoA dehydrogenase deficiency. These are the 4-methylvaleryl, 4- and 5-methylhexanoyl, 6-methylheptanoyl-, 6-methyloctanoyl-, 4,5-dimethylhexanoyl- and 4,7-decadienoylcarnitines. Their chemical structures were obtained by gas chromatographymass spectrometry analysis of their fatty acid moieties as picolinyl esters.
Assuntos
Acil-CoA Desidrogenases/deficiência , Carnitina/análogos & derivados , Acil-CoA Desidrogenase , Carnitina/urina , Pré-Escolar , Feminino , Glucuronatos/análise , Glicina/análise , HumanosRESUMO
We describe a boy with an early lethal hypertrophic vacuolar cardiomyopathy of neonatal onset. Abnormal intra- and extralysosomal glycogen storage disease was demonstrated in heart and skeletal muscles. Glycogen content was twice the normal in muscles and over 3-fold the normal in the heart. In this organ, over 50% of the intracellular space was occupied by glycogen and possibly oligosaccharides, as demonstrated by the quantitative morphometric analysis of electron micrographs. The activity of acid alpha-glucosidase was increased in the heart, skeletal muscles, and liver, but was normal in leukocytes. A review of the 11 previously published pedigrees of lysosomal glycogen storage disease with normal in vitro alpha-glucosidase activity allows the delineation of three clinical entities: juvenile and neonatal pseudo-Pompe diseases and partial Pompe disease. Partial Pompe disease, due to the tissue-specific absence of acid alpha-glucosidase, was observed in a single patient. The most common form is the late-onset pseudo-Pompe disease, which is characterized by severe cardiomyopathy and mild myopathy appearing in the second or third decade, prominent arrhythmia with Wolf-Parkinson-White syndrome, and sometimes mental retardation. Patients reported as suffering from Antopol disease probably belong to this group. Dominant inheritance (autosomal or X linked) is likely in most families. The present report appears to be the first one to describe a rapidly fatal neonatal form of lysosomal glycogenosis without acid maltase deficiency. The mode of inheritance of this form is not known. Differential diagosis includes Pompe disease (similar histology) and cardiac phosphorylase b kinase deficiency (similar clinical course). The delineation of neonatal pseudo-Pompe disease makes enzymatic confirmation mandatory in each case suspected of Pompe disease.
Assuntos
Doença de Depósito de Glicogênio Tipo II/genética , Doenças por Armazenamento dos Lisossomos/genética , Glucana 1,4-alfa-Glucosidase/deficiência , Doença de Depósito de Glicogênio Tipo II/enzimologia , Doença de Depósito de Glicogênio Tipo II/patologia , Humanos , Recém-Nascido , Doenças por Armazenamento dos Lisossomos/enzimologia , Doenças por Armazenamento dos Lisossomos/patologia , Masculino , Microscopia Eletrônica , Miocárdio/ultraestrutura , Linhagem , alfa-GlucosidasesRESUMO
Analysis of urinary medium-chain acylcarnitines extracted on C18 cartridges and gas chromatography mass spectrometry of their fatty acid moieties as picolinyl esters allowed the determination of the chemical structure of previously unidentified acylcarnitines in normal human urine. These are the 2,6-dimethylheptanoyl-, the 2,6-dimethyl-5-heptenoyl-, and the trans- and cis-3,4-methylene heptanoylcarnitines, also named 3-cyclopropane octanoylcarnitines. Assessment of the structure of these cyclopropane derivatives was obtained by 1H and 13C nuclear magnetic resonance spectroscopy. In addition, other acylcarnitines were tentatively identified.
Assuntos
Carnitina/urina , Cromatografia Gasosa-Espectrometria de Massas/métodos , Acilação , Carnitina/análogos & derivados , Humanos , Valores de Referência , Espectrometria de Massas de Bombardeamento Rápido de ÁtomosRESUMO
Methylumbelliferyl-tetra-N-acetylchitotetraoside hydrolase activity was increased 53- to 484-fold in plasma from Gaucher disease patients and no activator could be found. High activity was also measured in other lysosomal storage diseases including Krabbe disease, Wolman disease, GM1-gangliosidosis and to a lesser extent Niemann-Pick disease type B, but the activities were lower than the lowest values in Gaucher patients. Kinetic properties of the high activity in Gaucher plasma were similar to those of controls. It is not known whether the increased activity represents intrinsic enzyme activity or increased enzyme concentration. It is possible that this enzyme may help in the detection of Gaucher disease or in the assessment of enzyme therapy with beta-D-glucosidase (Ceredase).
Assuntos
Quitinases/sangue , Doença de Gaucher/enzimologia , Fosfatase Ácida/sangue , HumanosRESUMO
Two siblings presented with neonatal cholestasis and early liver insufficiency. The older was admitted for end-stage cirrhosis with severe hypoglycemia and had long-term successful liver transplant at the age of 15 months. The second child presented a similar neonatal history of cholestasis, hypoglycemia, hyperlactacidemia, liver insufficiency and progressive cirrhosis. Extensive work-up excluded all known causes of neonatal cholestasis. Gluconeogenesis was found normal following alanine and fructose infusion. Repeated hypoglycemia with early post-prandial hyperlactacidemia led us to investigate the mitochondrial respiratory chain enzyme activities. Selective defects of complexes I, III and IV, coded by mitochondrial DNA, were detected in liver tissue of this patient and on preserved frozen tissue from his sibling, whilst normal activities were found in liver tissue samples from control patients with end-stage liver diseases. No extrahepatic manifestations were found. We conclude that liver deficiency of mitochondrial respiratory chain enzymes may cause liver disease in neonates, associated with hypoglycemia and post-prandial hyperlactacidemia. The disease is cured by liver transplantation.
Assuntos
Colestase/metabolismo , Cirrose Hepática/metabolismo , Falência Hepática/etiologia , Mitocôndrias Hepáticas/metabolismo , Acidose Láctica/complicações , Acidose Láctica/metabolismo , Colestase/complicações , DNA Mitocondrial/análise , Transporte de Elétrons/fisiologia , Humanos , Hipoglicemia/complicações , Hipoglicemia/metabolismo , Lactente , Cirrose Hepática/complicações , Falência Hepática/metabolismo , Falência Hepática/cirurgia , Transplante de Fígado , Masculino , Mitocôndrias Hepáticas/genética , Núcleo FamiliarRESUMO
Fragmentation of negative ions produced by fast-atom bombardment (FAB) from 14 tauroconjugated bile acids and some of their deuterated analogs has been studied by mass spectrometry and by collision-induced dissociation (CED) tandem mass spectrometry at low energy.Low energy collision-induced dissociation of the deprotonated molecules [M - H](-) of these tauroconjugated bile acids leads to both charge-driven and charge-remote fragmentations (CRF). The former yields neutral loss from the side chain with charge migration during the fragmentation process. These fragments dominate the CID spectra, but are absent from the FAB spectra. Their relative abundances are dependent on the number and the positions of the hydroxyl groups in the steroid nucleus and thus permit distinction among some positional isomers.The CRF fragments correspond to cleavages in the side chain up to fragmentations across the steroid rings with charge retention on the sulfonate group. These CRF fragments, which also are useful for structural identification, are less intense in CID than in FAB spectra. It appears that these charge-remote fragments are favored by unsaturation in the steroid rings, either as keto groups or as endocyclic double bonds. Tandem mass spectrometry combined with the use of deuterated analogs demonstrates that the structures of the survivor pseudomolecular ions and of the CRF fragments are not rearranged.
RESUMO
To evaluate the role of dietary polyamines in maturation of the rat small intestine, spermine was given orally twice daily to suckling pups from day 10 to day 14 postpartum at different doses: 0, 0.2, 0.5, 1, 2.5, and 5 mumol/dose. Compared to saline treated controls, spermine (5 mumol) produced significant increases in mucosal mass parameters (+12 to +57%, P < 0.05), induced prematurely an adult pattern of microvillous enzymes, and enhanced, respectively, by 19- and 3.5-fold (P < 0.01 vs controls) the concentration of the secretory component of p-immunoglobulins in villous and crypt cells. The response of microvillous enzymes (lactase, sucrase, maltase, and aminopeptidase) to spermine was dose-dependent and -specific since oral administration of arginine (5 mumol) or ornithine (5 mumol) was without effect. Intestinal changes were found to be significant (P < 0.05) for doses of spermine exceeding 1 mumol/day, which is in the range of the amount of polyamines provided by solid pellets at weaning (0.4 mumol/g). However, intestinal changes were undetectable at the physiological amounts of polyamines consumed by pups from rat milk during the suckling period (less than 0.3 mumol/day). Consistent with a direct effect of spermine on the intestinal cell, the cytosolic activity of ornithine decarboxylase was depressed by 27-fold (P < 0.005 vs controls) in the jejunum, while inhibition of ornithine decarboxylase by alpha-difluoromethylornithine did markedly decrease but did not suppress the cell response to spermine. Alternately, plasma corticosteronemia, which was virtually absent by day 14 in controls, ranged between 1.4 and 4.6 micrograms/dl in 60% (N = 9) of the spermine-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Dieta , Mucosa Intestinal/efeitos dos fármacos , Intestino Delgado/efeitos dos fármacos , Poliaminas/farmacologia , Animais , Animais Lactentes , Relação Dose-Resposta a Droga , Mucosa Intestinal/enzimologia , Mucosa Intestinal/crescimento & desenvolvimento , Intestino Delgado/enzimologia , Intestino Delgado/crescimento & desenvolvimento , Microvilosidades/efeitos dos fármacos , Microvilosidades/enzimologia , Ornitina Descarboxilase/efeitos dos fármacos , Ornitina Descarboxilase/metabolismo , Ratos , Ratos Wistar , Componente Secretório/efeitos dos fármacos , Componente Secretório/metabolismo , Cloreto de Sódio/farmacologia , Espermina/farmacologia , DesmameRESUMO
To examine the effects of prenatal exposure to ethanol on postnatal development of small intestinal and liver functions, female rats were accustomed to increasing amounts of ethanol (10 to 25%, vol/vol) in tap water for 1 mo. During pregnancy, ethanol-fed dams had higher daily caloric intake and similar weight gain compared with controls. In ethanol offspring, neonatal mortality was 28.9% compared to 0% in controls. Although ethanol had been withdrawn at birth, pups issued from ethanol-treated mothers showed at 5 and 10 d postpartum decreased values of body weight, jejunal and ileal weights, and intestinal DNA concentration per unit of length, as well as lower specific and total activities in lactase and maltase, compared with controls. DNA synthesis rates, measured by the incorporation of [3H]thymidine into mucosal DNA, were also significantly (-20 to -34%, p < 0.01) depressed in the jejunum and ileum of ethanol pups at 5 and 10 d of age. All these parameters returned to control levels by d 15 postpartum. Electron microscopy of jejunal mucosal samples at 5, 10, and 15 d of age revealed that ethanol pups differed from controls by a fetal-like immature aspect of the enterocytes, which persisted up to d 15. The ontogenic upsurge in sucrase and the decline in lactase occurred at weaning with the same chronology in both groups, but the level reached by sucrase activity was about 50% lower in alcohol offspring than in controls. Except for moderate steatosis, the ultrastructure of hepatocytes was unaltered in sucklings.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Etanol/toxicidade , Intestino Delgado/efeitos dos fármacos , Fígado/efeitos dos fármacos , Troca Materno-Fetal , Alcoolismo/complicações , Animais , DNA/biossíntese , Feminino , Transtornos do Espectro Alcoólico Fetal/etiologia , Intestino Delgado/crescimento & desenvolvimento , Intestino Delgado/metabolismo , Fígado/crescimento & desenvolvimento , Fígado/metabolismo , Microscopia Eletrônica , Gravidez , Complicações na Gravidez , Ratos , Ratos WistarRESUMO
The inhibitory effects of valproate (VPA) and nine of its metabolites on mitochondrial oxidations have been investigated. Valproate, 4-ene-VPE, 2,4-diene-VPA and 2-propylglutaric acid inhibited the rate of oxygen consumption by rat liver mitochondrial fractions with long- and medium-chain fatty acids, glutamate (+/- malate), succinate, alpha-ketoglutarate (+ malate) and pyruvate (+ malate) as substrates. Sequestration of intramitochondrial free CoA by valproate and these three metabolites has been demonstrated and quantified. However, CoA trapping could not account for all the inhibitions observed. 2-ene-VPA and 3-oxo-VPA, metabolites formed during the beta-oxidation of valproate, were not capable of trapping intramitochondrial CoA although they were inhibitors of the beta-oxidation of decanoate, probably by inhibition of the medium-chain acyl-CoA synthetase.
Assuntos
Coenzima A/metabolismo , Mitocôndrias Hepáticas/efeitos dos fármacos , Proteínas Repressoras , Proteínas de Saccharomyces cerevisiae , Ácido Valproico/análogos & derivados , Ácido Valproico/farmacologia , Animais , Coenzima A Ligases/metabolismo , Ácidos Graxos/metabolismo , Masculino , Mitocôndrias Hepáticas/metabolismo , Modelos Químicos , Consumo de Oxigênio/efeitos dos fármacos , Ratos , Ratos Endogâmicos , Ácido Valproico/metabolismoRESUMO
Orthotopic liver transplantation (OLT) has been proposed to treat patients with type IV glycogenosis because of early progressive cirrhosis. Reports have shown absence of disease progression in other organs after OLT and even regression of cardiac amylopectin infiltration in one case. We describe a 15-month-old child in whom a liver transplant was performed for type IV glycogenosis. There were no clinical signs of extrahepatic disease before OLT. Nine months later, the patient developed progressive cardiac insufficiency and died from cardiac failure. Because of massive amylopectin deposits, decreased myofibrils in cardiac cells, and exclusion of other causes of cardiac failure, death was attributed to amylopectionosis. Our observation contrasts with the Pittsburgh experience and suggests that cardiac amylopectionosis may progress after OLT.
Assuntos
Cardiomiopatias/complicações , Cardiomiopatia Dilatada/etiologia , Doença de Depósito de Glicogênio Tipo IV/complicações , Transplante de Fígado , Amilopectina/análise , Biópsia , Cardiomiopatias/patologia , Cardiomiopatia Dilatada/patologia , Doença de Depósito de Glicogênio Tipo IV/patologia , Doença de Depósito de Glicogênio Tipo IV/cirurgia , Humanos , Lactente , Fígado/química , Fígado/patologia , Masculino , Microscopia Eletrônica , Miocárdio/química , Miocárdio/patologiaRESUMO
Liver mitochondria from rats fed 1% (w/w) valproic acid for 75 days displayed an approximate 30% decrease in coupled respiration rates with substrates entering the respiratory chain at complexes I and II. Uncoupling the respiration from proton-pumping, or measuring the respiration without complex IV removed this inhibition. The treatment induced a loss of activity of cytochrome oxidase consistent with a decrease in the mitochondrial content of cytochrome aa3. The inhibition induced by long lasting administration of valproate is apparently located at the site of the proton-pumping activity of complex IV. Furthermore, the capacity of electron transport through complex IV, being far in excess of that required for normal functioning in coupled mitochondria, seems to be controlled by the coupling to proton-pumping in which cytochrome aa3 appears to play a major role.