Epidemiology of the vascular assessment and correlation of the WIfI Classification in lower limb amputee patients at Martinique university hospital in 2018.

BACKGROUND: The precise epidemiological evaluation of amputations is difficult. It is a serious public health and economic problem with a high death rate. The proportion of amputees with pre-amputation vascular status remains unknown. The main objective of our study was to evaluate the proportion of patients with lower limb amputation who had a pre-procedural vascular assessment. The secondary objectives were to evaluate the risk of amputation at the admission of these patients, estimate the incidence of amputations in Martinique, and to collect epidemiological data on this category of patients. MATERIAL AND METHODS: We conducted an epidemiological, retrospective, and observational study, over the year 2018 between January 01 and December 31, including all adults' patients who underwent an amputation of the lower limb at the university hospital center of Martinique. RESULTS: Among the 170 included patients, 79 (46%) patients had a major lower limb amputation. The incidence of amputations in 2018 was estimated at 48.9/100,000 inhabitants. The vascular assessment was performed for 110 (65%) patients. For the other 60 (35%) patients who did not have a vascular assessment, 53 (88%) had a severe infection. This assessment was significantly related to the amputation level: a vascular assessment was performed in 97 (70%) patients with below the knee amputation versus 13 (41%) patients with above the knee amputation (P<0.01). The WIfI classification system found a high risk of amputation for 152 (89%) of patients but also a benefit of revascularization ranked high for 138 (81%) of them. The origin of amputation was limb ischemia for 125 (68%) patients. CONCLUSION: A significant number of patients who underwent lower limb amputation did not have a pre-procedural vascular assessment. Many improvements in the health care are therefore to be implemented. The upcoming M@diCICAT project in Martinique will contribute in the improvement of patient management. The incidence of amputation in Martinique is considered high compared to other countries (French national incidence in 2003=24.8/100,000 inhabitants), and it seems to have remained stable since 2008. Our population is considered to be at high risk of amputation by the SVS-WIfI classification. This score seems adapted to anticipate the evolution of these patients and could be useful in daily practice.

Localization and overall structure of a mannose-rich glycopeptide from a pathologic immunoglobulin.

The structure of a mannose-rich glycopeptide from a human pathological IgM has been investigated. It belongs to the group I (simple) glycopeptides and contains only mannose and N-acetylglucosamine residues in a molar ratio of 10:2. The structures of its oligosaccharide moiety and peptide chain have been determined: its molecular localization is specified and the relation between its biosynthesis and the oligosaccharide structure determine is discussed. Based on the alpha- and beta-mannosidase digestions and permethylation studies for the oligosaccharide moiety, and on the results obtained after sequential analysis of the peptide chain, the following structure is proposed for the mannose-rich IgM Du glycopeptide: (Formula: see text). The recovery of one molecule of this glycopeptide per molecule of heavy chain and the determination of the amino acid sequence have led us to locate this glycopeptide on asparagine 402 of the Fc portion of the heavy chain mu of IgM Du.

[Studies on the cell wall of yeast of the genus Rhodotorula. X. Isolation and purification of cell-wall glycoproteins from Rhodotorula rubra (author's transl)]. / Etudes des parois de levures du genre Rhodotorula. X. Isolement et purification de glycoprotéines de la paroi de Rhodotorula rubra

Following ethylene diamine treatment of the cell wall of Rhodotorula rubra, a water soluble fraction has been isolated. This fraction can be resolved into three glycoproteins and one protein. The major part is a glycoprotein, purified to homogeneity which has a molecular weight of 64 000. The glyco-part of this protein contains mannose, glucose and one residue of glucosamine. After pronase treatment, the presence of an ""Asparaginyl-N-acetylglucosamine" linkage is established by the existence of one aspartic acid residue and one glucosamine residue. After permethylation, the initial data give some evidence that the branching points in the molecule were the carbon atoms 3 and (or) 6 of the mannose moiety and that some glucose moieties are bound to the non-reducing terminal end.

Cow kappa-casein: structure of the carbohydrate portion.

The detailed sugar sequences of the two main carbohydrate portions of cow kappa-casein were established by enzymic and chemical methods and by mass spectrometry. The sugar sequences correspond to widespread sugar parts occurring in many glycoproteins.

Alterations in the carbohydrate moiety of alpha-1-acid glycoprotein purified from human cirrhotic ascitic fluid.

The carbohydrate analysis of alpha 1-AGPc purified from cirrhotic ascitic fluid was performed by immunoaffinity chromatography. It showed a large increase in the fucosyl molar ratio and sugar content (47%). The molar ratio of the oligosaccharides which were released by hydrazinolysis and fractionated by high-performance liquid chromatography confirms the marked increase in fucosyl residues in each fraction. A shift towards fractions with a high degree of branching was also observed. Moreover, the studies of sugar molar ratios and methylation of the tetrasialylated fraction indicated the simultaneous presence of sialyl and fucosyl residues on one of the outer branches.

The primary structure of the asialo-carbohydrate units of the first glycosylation site of human plasma alpha 1-acid glycoprotein.

The elucidation of the structures of the carbohydrate units linked to glycosylation site I of human plasma alpha 1-acid glycoprotein is described. These carbohydrate units can be grouped into compounds with bi- (class A) and triantennary (class B) structures and the triantennary structure with a fucose residue (class BF) (Fig. 1). The structural variability of the carbohydrate units of glycosylation site I and also of glycosylation sites II to V (Fournet, B., Montreuil, J., Strecker, G., Dorland, L., Haverkamp, J., Vliegenthart, J.F.G., Binette, J.P. and Schmid, K. (1978) Biochemistry 17, 5206--5214) accounts largely for the microheterogeneity of alpha 1-acid glycoprotein.

Effect of phenobarbital on the oligosaccharide structure of rat alpha-acid glycoprotein.

We have recently shown that the administration of phenobarbital to rats leads to an increased serum alpha 1-acid glycoprotein content with alterations in the relative proportion of the sugar moiety. Therefore, alpha 1-acid glycoprotein was purified from normal (alpha 1-acid glycoproteine N) and phenobarbital-treated rats (alpha 1-acid glycoprotein PB) Glycans were separated by AX-10 chromatography and analysed by gas chromatography. It appears that, compared to alpha 1-acid glycoprotein N, alpha 1-acid glycoprotein PB had a higher carbohydrate content (31.7% compared to 26%) and a non-negligible amount of neutral oligosaccharide (12.2% compared to 1.3%). No tetrasialyl oligosaccharides in alpha 1-acid glycoprotein PB were detected, whereas their relative proportion in alpha 1-acid glycoprotein N was 27%.

Structure determination of the polymorphism of acylgalactosylceramide in rat brain by gas chromatography/mass spectrometry and proton magnetic resonance.

This paper describes the structure of acylcerebrosides isolated from rat brains. Three fractions (acylglycosylceramides I, II, III) were resolved according to their decreasing RF values on TLC. GLC analysis of acylglycosylceramides II and III indicates that their ester-linked fatty acids are short and rather unsaturated, while amide-linked fatty acids are longer and hydroxylated. Sugar GLC analysis indicates that acylglycosylceramides II and III contain only galactose. To determine the substitution position of the acyl group on the galactose moiety, the free hydroxyl groups of acylglycosylceramide were protected with dihydropyran, deacylated and subjected to permethylation. The methylated galactoside acetates obtained after hydrolysis and reduction were then analyzed by gas chromatography/mass spectrometry. Acylglycosylceramides II and III turned out to be complex mixtures of 2-O-acyl-, 3-O-acyl-, 4-O-acyl- and 6-O-acylgalactosylceramides. Moreover, the abundance of alpha-methylgalactoside reveals the existence of unsubstituted galactose, suggesting that some ester-linked fatty acids could be esterified to the hydroxyl group of hydroxy fatty acids linked to sphingosine. NMR spectrometry was used to confirm this ester linkage. The key spectral feature of the fatty acid-galactose linkage (4.45 ppm) did move to 4.15 ppm after saponification of acylglycosylceramide II; on the other hand, acylglycosylceramide III contained only the spectral feature 4.15 ppm, corresponding to a high percentage of unsubstituted galactose and consistent with the presence in the molecule of a fatty acid esterified by the omega-OH group of the hydroxy fatty acid (3.95 ppm).

N-terminal sequence extension in the glycosylated forms of human pancreatic stone protein. The 5-oxoproline N-terminal chain is O-glycosylated on the 5th amino acid residue.

The pancreatic stone protein isolated from human calculi (PSP) derives from the immunoreactive protein forms detected in human pancreatic juice (PSP S2-5) through the tryptic cleavage of the Arg-11-Ile-12 bond. Among the eleven amino acids of the PSP S2-5 N-terminal extension Z-E-A-Q-T-E-L-P-Q-A-R, the first residue is an oxoproline and the fifth, a threonine, bears the single carbohydrate chain of the protein molecules. Variations in the glycan chain composition account for the differences in the Mr of PSP S2-5. The PSP S2-5 forms are very soluble in aqueous solutions between the pH values 5.0-9.0, whereas the proteolysated form is scarcely soluble.

Structure of the three major sialyl-oligosaccharides excreted in the urine of five patients with three distinct inborn diseases: "I cell disease" and two new types of mucolipidosis.

The urine of five patients with three distinct diseases ("I Cell disease" and two new types of mucolipidosis) contains sialic acid-rich oligosaccharides in a high amount: 50- to 500-fold the normal. The structure of the major components are as follows: alphaAcNeu(2 leads to 6)betaGal(1 leads to 4)betaGlcNac(1 leads to 2)alphaMan(1 leads to 3)betaMan(1 leads to 4)GlcNac,[alphaAcNeu(2 leads to 6)]betaGal(1 leads to 4)betaGlcNAc(1 leads to 2)alphaMan(1 leads to 3)[betaGal(1 leads to 4)betaGlcNac(1 leads to 2)alphaMan(1 leads to 6)]betaMan(1 leads to 4)GlcNAc and alphaAcNeu(2 leads to 6)betaGal(1 leads to 4)betaGlcNAc(1 leads to 2)alphaMan(1 leads to 3)[alphaAcNeu(2 leads to 6)betaGal(1 leads to 4)betaGlcNAc(1 leads to 2)alphaMan(1 leads to 6)]betaMan(1 leads to 4)GlcNAc. These results suggest that a deficit in alpha-neuraminidase is associated to these three different disorders and that an endo-beta-D-N-acetylglucosaminidase is able to release sialyoligosaccharides by splitting the sialylglycans of glycoproteins.

Isolation and characterization of methylated sugars from the tube of the hydrothermal vent tubiculous annelid worm Alvinella pompejana.

The tube of Alvinella pompejana contains in its carbohydrate fraction, 3 methylated monosaccharides: 2-mono-O-methyl-L-fucose, 3-mono-O-methyl-L-fucose and 2,4-di-O-methyl-L-fucose. The present work appears to be the first report of the occurrence of 2-mono-O-methyl-L-fucose and 3-mono-O-methyl-L-fucose in the animal kingdom. Moreover, it is the first time that 2,4-di-O-methyl-L-fucose is found in nature.

400-MHz 1H-NMR spectroscopy of fucosylated tetrasialyl oligosaccharides isolated from normal and cirrhotic alpha 1-acid glycoprotein.

The comparative study of fucosylated tetrasialyl-oligosaccharides isolated from normal and cirrhotic alpha 1-AGP was performed using permethylation and 400-MHz 1H-NMR spectroscopy. These results clearly show the tetraantennary structure of these two oligosaccharides with hyperfucosylation for the tetrasialylated fraction from cirrhotic alpha 1-AGP. In the latter oligosaccharide the simultaneous presence on two antennae (7 and 7') of the sialosyl Lewis X determinant NeuAc-(alpha 2-3) Gal(beta 1-4) [Fuc(alpha 1-3)] GlcNAc has been observed. Moreover the 5 and 5' antennae were alpha 2-6 sialylated but without fucose.

Carbohydrate structures of hen ovomucoid. A mass spectrometric analysis.

The apparently homogenous N-glycosidically-linked glycans 1, 7, 11 and 14 released by hydrazinolysis from hen ovomucoid were analysed by fast atom bombardment and electron-impact mass spectrometry after reduction and permethylation. The spectra support the primary structures established independently [FEBS Letters (1983) 152, 145-152] using methylation analysis, partial acid hydrolysis and 500 MHz 1H NMR spectroscopy. In addition to the major constituents present in fractions 1, 7, 11 and 14, four minor components not detected by other methods could be characterized with the aid of the mass spectrometry data as: Man2GlcNAcGlcNAc-o1, GlcNAc4Man3GlcNAc-o1, GlcNAc6Man3GlcNAc-o1 and GalGlcNAc6-Man3GlcNAc-o1. Our results show that the physical techniques used provide valuable data on the structure of complex glycans. In addition they can be employed to ascertain the homogeneity of the compounds examined as well as to detect trace amounts of homologs that might not be noticed by other methods.

Primary structure of a novel N-glycosidic carbohydrate unit, derived from hen ovomucoid. A 500-MHz 1H-NMR study.

The N-glycosidic carbohydrate chains of hen beta-ovomucoid were released from the protein by hydrazinolysis, and separated by HPLC. Primary structural analysis of 3 major fractions was conducted by applying 500-MHz 1H-NMR spectroscopy in combination with methylation analysis. One of the fractions investigated appeared to consist of an intersected penta-antennary structure extended with one Gal residue. The location of the latter in a certain branch could be established unambiguously by NMR. This structure is a novel member of the family of N-glycosidic carbohydrates of glycoproteins.

Structure of the three major fucosyl-glycoasparagines accumulating in the urine of a patient with fucosidosis.

Fifteen fucosyl-oligosaccharides and fucosyl-glycoasparagines have been isolated from the urine of a patient with fucosidosis. The structure of the three most abundant glycoasparagines are as follows: alpha-Fuc-(1 lead to 6)-beta-GlcNAc-Asn; alpha-Man-(1 leads to 6)-beta-Man-(1 leads to 4)-beta-GlcNAc-(1 lead to 4) [alpha-Fuc-(1 leads to 6)]-belta-GlcNAc-Asn; beta-Gal-(1 leads to 4) [alpha-Fuc-(1 lead to 3)] beta-GlcNAc-(1 leads to 2)-alpha-Man-(1 lead to 6)-beta-Man-(1 leads to 4)-beta-GlcNAc-(1 leads to 4) [alpha-Fuc-(1 leads to 6)] beta-GlcNAc-Asn. The structures are related to the class of fucosyl-glycoproteins (e.g.: IgG immunoglobulin, lactotransferrin and alpha 1-acid glycoprotein). The terminal sequence: beta-Gal-(1 leads to 4) [alph-Fuc-(1 leads to 3)] beta-GlcNAc-(1 leads to 2)-a-Man leads to R is novel for carbohydrate moieties in glycoproteins.

[Complete structure of glycopeptides isolated from IgG immunoglobulins of cow colostrum]. / Structure complète de glycopeptides isolés des immunoglobulines IgG1 du colostrum de vache

Bovine immunoglobulins (IgG1 type) have been isolated from colostral whey. Hydrolysis by pronase, trypsin and (or) chymotrypsin yield several glycopeptides structural studies of which lead to the following results. 1. IgG1 colostral immunoglobulins possess two glycan moieties which are linked to the peptidic chain by an N-(beta-aspartyl)-N-acetylglucosaminylamine bound. 2. The peptidic sequence around the linkage region has been determined by classical methods and is as follows: Thr-Lys-Pro-Arg-Glu-Glu-Gln-Phe-Asn(Glycan)-Ser-Thr-Tyr-Arg. 3. The following procedures: partial acidic hydrolysis, periodic oxidation, hydrazinolysis-nitrous deamination, methylation and use of specific glycosidases allowed us to determine the structure of the glycan moieties which fit with the general following scheme: (see article) Thus they could be related to the general glycan structure so-called of "N-acetyllactosamine type" because they possess the pentasaccharidic core common to numerous glycoproteins Man alpha 1 leads to [Man alpha 1 leads to 6] Man beta 1 leads to 4 GlcNAc beta 1 leads to 4 GlcNAc beta 1 leads to Asn on which are conjugated 2 N-acetyllactosamine residues. Besides they present a microheterogeneity which is due to the varying number of additional N-acetylneuraminic acid and fucose residues. 4. These structures are compared to various immunoglobulin structures proposed by others: bovine serum IgG and human serum IgG, IgE and IgA.

The sugar part of kappa-caseins from cow milk and colostrum and its microheterogeneity.

Cow kappa-casein contains only three different sugars (Gal, GalNAc, NeuNAc). However detailed analyses achieved mainly by gas liquid chromatography suggested a microheterogeneity at the sugar level. After alkaline borohydride treatment, filtration on Bio-Gel P4 and paper chromatography, different carbohydrate parts were obtained. The two main compounds had the following molar compositions: GalNAc (1), Gal(1) and NeuNAc (1) and GalNAc (1), Gal(1) and NeuNAc (2). From these data and our previous sequence studies, some formulae of the polysaccharide part were proposed. One of them was closely related to the sugar sequence of a glycopeptide with MN activity which was in agreement with our observation concerning a cross antigenic reactivity between the N blood group substances and the caseinoglycopeptides. All the polysaccharide parts isolated from colostrum caseinoglycopeptide were much more complex than those obtained from the normal glycopeptide, confirming an evolution of the sugar part as a function of time after parturition.

[Structure and immunochemical properties of the urinary oligosaccharides excreted during induced galactosuria]. / Structure et propriétés immunochimiques des oligosaccharides urinaires excrétés au cours de la galactosurie provoquée

Induced galactosuria is characterized by the excretion in urine of large amounts of new oligosaccharides, the structure of which are in connection with blood-group phenotypes ABH, Lewis and Secretor: O group : O-alpha-L fucopyranosyl-(1 leads to 2)-D galactopyranose et O-alpha-L fucopyranosyl-(1 leads to 2)-O-beta-D galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 4)]-O-beta-D 2-deoxy-2 acetamido-glucopyranosyl-(1 leads to 4)-[O-alpha-L fucopyranosyl-(1 leads to 6)]-D-galactopyranose. A group: O-alpha-D-2-deoxy-2 acetamido-galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 2)]-D galactopyranose et O-alpha-D-2-deoxy-2 acetamido-galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 2)]-O-beta-D galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 4)]-O-beta-D-2-deoxy-2 acetamido-glucopyranosyl-(1 leads to)-[O-alpha-L fucopyranosyl-(1 leads to 6)]-D galactopyranose. B group : O-alpha-D galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 2)]-D galactopyranose et O-alpha-D galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 2)]-O-beta-D galactopyranosyl-(1 leads to 3)-[O-alpha-L fucopyranosyl-(1 leads to 4)]-O-beta-D-2-deoxy-2 acetamido-glucopyranosyl-(1 leads to 4)-[O-alpha-L fucopyranosyl-(1 leads to 6)]-D-galactopyranose.

[Chemistry of urinary mannosides excreted in mannosidosis]. / Etude chimique des 'mannosides urinaires excrétés au cours de la mannosidose

Mannose-rich oligosaccharides have been isolated from urines of 5 patients with mannosidosis. Their compositon and structure were determined. Three of them have been previously described by Norden et al: alpha p-Manp-(1 leads to 3) beta-d-Manp-(1 leads to 4) d-GlcNAcp; alpha-p-Manp-(1 leads to 2), alpha-d-Manp-(1 leads to 3) beta-d-Manp-(1 leads to 4) d-GlcNAc and alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 3) beta-d-Manp-(1 leads to 4) d-GlcNAcp, but the four others are new entities: alpha-d-Manp-(1 leads to 3) (alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 6) beta-d-Manp-(1 leads to 4) GlcNAcp; alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 3) (alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 6) beta-d-Manp-(1 leads to 4) GlcNAcp; alpha-d-Manp-(1 leads to 2), alpha-d-Man-(1 leads to 3) (alpha-d-Manp-(1 leads to 6) beta-d-Manp-(1 leads to 4) GlcNAp and alpha-d-Manp-(1 leads to 2) alpha-d-Manp-(1 leads to 3) (alpha-d-Manp-(1 leads to 6) beta-d-Manp-(1 leads to 4) GlcNAcp. These structures are related to the glycans of "oligomannosidic type" present in numerous glycoproteins. All possess a N-acetylglucosamine residue in terminal reducing position and reinforce the hypothesis of Kobata et al. and Montreuil et al. that catabolism of glycans N-glucosidically linked to the protein moiety begins by the aciton of a beta-endo-N-acetylglucosaminidase.

[Isolation and structure of an external glycoprotein of the cell wall of Torulopsis candida]. / Isolement et structure dune glycoprotéine superficielle de la paroi de Torulopsis candida.

The treatment with ethylenediamine of Torulopsis candida yeast cell walls has permitted to isolate a mannoprotein. It has been possible to collect this glycoprotein in a pure state after separation of the different hydrosoluble products by gel filtrations and paper electrophoresis. This compound contains 62 per cent of mannose, 3 per cent of N-acetylglucosamine and 31 per cent of amino acids. The mannose units are attached by 1 leads to 2 linkage, short oligosaccharides are bound to serine of the peptide chain by O-glycosidic linkages while polysaccharides are attached to asparagine of this peptide chain by a N glycosidic linkages probably through the intermediate of chitobiose.