The use of percutaneous endoscopic gastrostomy (PEG) in 161 consecutive elderly patients.

Over the period 1 April 1990 to 31 December 1992, a total of 179 PEG procedures were performed on 161 elderly patients, mean age 79 years (range 53-99). In most (141) patients, the indication was neurological dysphagia (usually stroke), but in 20 the tube was inserted to attain adequate nutritional support. Thirty-day fatality was 20% overall, but in those who underwent PEG only for nutritional support, survival was poor--only 20% at 30 days. Almost all deaths were a result of progression of the original illness. Only one procedure-related death occurred. Fifty-six complicating episodes occurred in 20 (12%) patients, the majority being minor. The commonest adverse event was PEG site infection. PEG is a useful and in general well tolerated procedure in geriatric practice, but careful patient selection is essential; in particular its use as a nutritional adjunct in frail patients needs careful evaluation.

Effect of n-3 and n-6 fatty acids on hepatic microsomal lipid metabolism: a time course study.

The present study examines the time dependent effects of n-6 and n-3 polyunsaturated fatty acids on liver microsomal lipid metabolism in FVB mice fed a diet supplemented with a mixture of free fatty acids (mainly 18:3n-6 and 20:5n-3) at 25 mg/g diet. Significant changes in the fatty acid composition of total liver and microsomal lipids were observed after 7 days on the diets. Thereafter, some animals remained on the same diet while others were fed a diet supplemented with hydrogenated coconut oil (HCO). With the exception of 20:5n-3 which showed a slower recovery, establishment of the HCO pattern was rapid indicating that the diet-induced changes could be easily reversed. The unsaturation index, the cholesterol/phospholipid ratio and the microviscosity of the microsomal membranes were not affected by these dietary manipulations. Unsaturated fatty acid supplementation reduced the activity of delta 9 desaturase by 50%. Feeding the HCO diet to mice previously fed the EPA/GLA diet led to a progressive increase in delta 9 desaturase activity, reaching 80% of the day zero values after 14 days. The monoene content of hepatic total lipids reflected, in most cases, the changes in enzyme activity. This study shows that a low dose of a n-3 and n-6 free fatty acid mixture increases the quantities of members of the n-3 family, without loss of n-6 fatty acids in microsomal membranes and modifies the activity of delta 9 desaturase without altering the microsome physicochemical parameters.

The effect of n-6 fatty acids on normal and v-Ki ras transformed NIH-3T3 cells.

The effect of exogenous gamma-linolenic acid (18:3n-6) was examined on NIH-3T3 and a subclone expressing the v-Ki-ras oncogene (DT). 18:3n-6 inhibited DT cell growth more readily than NIH-3T3 cell growth. In comparison, linoleic acid (18:2n-6) had no effect on the growth of either cell line. DT cells elongated and desaturated both 18:2n-6 and 18:3n-6 to dihomo-gamma-linolenic acid (20:3n-6) and arachidonic acid (20:4n-6) to a much greater extent than NIH-3T3 cells and had a much higher membrane fluidity. The presence of the ras gene or its product appears to increase the metabolism of polyunsaturated fatty acids and potentiate the cytostatic actions of 18:3n-6.

Induction and regulation of alpha-amylase synthesis in a cellulolytic thermophilic fungus Myceliophthora thermophila D14 (ATCC 48104).

The alpha-amylase enzyme synthesis was higher when M. thermophila D-14 (ATCC 48104) was grown in culture medium incorporated with starch or other carbohydrates containing maltose units. Maximum enzyme production was attained with 1% starch followed by a gradual decrease with increasing concentration. Marked decrease in alpha-amylase synthesis occurred with the addition of glucose to the culture medium and this decreasing activity was proportional to the concentration of glucose. The enzyme synthesis was resumed as soon as the glucose concentration fell below a critical level. The addition of cAMP did not eliminate the repressive activity of glucose. The findings suggest that extracellular alpha-amylase synthesis in M. thermophila D-14 was inducible and subject to catabolite repression.

Purification and characterization of extracellular ß-glucosidase from Myceliophthora thermophila.

The extracellular ß-glucosidase has been purified from culture broth of Myceliophthora thermophila ATCC 48104 grown on crystalline cellulose. The enzyme was purified approximately 30-fold by (NH4)2SO4 precipitation and column chromatography on DEAE-Sephadex A-50, Sephadex G-200 and DEAE-Sephadex A-50. The molecular mass of the enzyme was estimated to be about 120 kD by both sodium dodecyl sulphate gel electrophoresis and gel filtration chromatography. It displayed optimal activity at pH 4.8 and 60°C. The purified enzyme in the absence of substrate was stable up to 60°C and pH between 4.5 and 5.5. The enzyme hydrolysed p-nitrophenyl-ß-D-glucoside, cellobiose and salicin but not carboxymethyl cellulose or crystalline cellulose. The K m of the enzyme was 1.6MM for p-nitrophenyl-ß-D-glucoside and 8.0MM for cellobiose. D-Glucose was a competitive inhibitor of the enzyme with a K of 22.5MM. Enzyme K activity was inhibited by HgCl2, FeSO4, CuSO4, EDTA, sodium dodecyl sulphate, p-chloromercurobenzoate and iodoacetamide and was stimulated by 2-mercaptoethanol, dithiothreitol and glutathione. Ethanol up to 1.7 M had no effect on the enzyme activity.

Purification and properties of an extracellular endoglucanase from Myceliophthora thermophila D-14 (ATCC 48104).

An extracellular endoglucanase (1,4-beta-glucanohydrolase, EC 3.2.1.4) produced by Myceliophthora thermophila D-14 (ATCC 48104) has been purified to homogeneity by ammonium sulphate precipitation and two consecutive ion-exchange chromatographic steps on DEAE-Sephadex A-50 columns. The enzyme was purified 13.8-fold and was homogeneous by analytical PAGE and SDS-PAGE. It has a high apparent Mr, of about 100,000. The pH and temperature optima for its activity were 4.8 and 65 degrees C respectively. The Km of the purified enzyme for CMC (sodium salt) was 3 mg ml-1. The enzyme displayed low activity toward salicin and p-nitrophenyl beta-D-glucoside. The activity was enhanced in the presence of Na+, K+ and Ca2+ but effectively inhibited by Hg2+, Fe2+, Mg2+, Cu2+ and NH4+. Inhibition studies indicated that the enzyme may be a metalloprotein and/or that it requires metal ions for its optimum activity.

Effects of linoleic and gamma-linolenic acids (efamol evening primrose oil) on fatty acid-binding proteins of rat liver.

We have studied the effects of Efamol evening primrose oil (EPO) on fatty acid-binding proteins (L-FABP) of rat liver. EPO contains 72% cis-linoleic acid and 9% cis-gamma linolenic acid. EPO has been clinically used for treatment of a number of diseases in humans and animals. EPO is also known to lower cholesterol level in humans and animals. Feeding of an EPO supplemented diet to rats (n = 9) for 2 months decreases the oleate binding capacity of purified L-FABP of rat liver whereas the palmitate binding activity was increased by 38%. However, EPO feeding did not alter the L-FABP concentrations significantly as measured by using the fluorescence fatty acid probe, dansylamino undecanoic acid. Endogenous fatty acid analysis of L-FABPs revealed significant qualitative and quantitative changes in fatty acid pattern after EPO feeding. EPO feeding decreased the endogenous palmitate level by 53% and oleate level by 64% in L-FABPs and also EPO feeding decreased the total endogenous fatty acid content from 62 nanomole per mg of protein to 42 nanomole per mg of L-FABP (n = 3).

Antitumor activity of L-asparaginase from Cylindrocarpon obtusisporum MB-10 and its effect on the immune system.

L-Asparaginase from Cylindrocarpon obtusisporum MB-10 inhibits the growth of Ascites Fibrosarcoma and Dalton's Lymphoma tumor cells in vivo and significantly increases the survival rate of tumor bearing mice. The enzyme-treated normal mice become more healthy and survive longer than their usual life span. The spleen size of normal animals treated with L-asparaginase become larger, and the number of their rosetting T-lymphocytes along with the capacity of SRBC constellation gets increased. The surface topography of splenic T-lymphocytes of enzyme-treated mice exhibits some extensions of different parts of the membrane with ruffling of surface and formation of innumerable blebs, foldings, microvilli, etc. The adherence of leukocytes of peritoneal exudate cells of these mice is also enhanced. All results suggest that C. obtusisporum MB-10 L-asparaginase is active against tumors and non-immunosuppressive, and it deserves to be an immunotherapeutic agent.

Purification and properties of an L-asparaginase from Cylindrocarpon obtusisporum MB-10.

An L-asparaginase producing mesophilic fungus Cylindrocarpon obtusisporum MB-10 was isolated from soil. The constitutive intracellular L-asparaginase from the organism was purified. The enzyme after 65-fold purification with an overall yield of 11% and specific activity of 100 unit.mg-1 seemed to be homogeneous in native, SDS-PAGE and thin layer isoelectric focusing gel. The apparent Mr of the enzyme was 216,000, and it constituted four identical subunits. The pI of the enzyme was 5.5. It was a conjugate protein with 37.3% (w/w) carbohydrate. The enzyme was stable to storage at -20 degrees C and to repeated freezing and thawing. The L-asparaginase from the organism was very much specific for L-asparagine and did not hydrolyze D-asparagine and L-glutamine. The pH and temperature optima for the enzyme activity were 7.4 and 37 degrees C, respectively. The Km of the L-asparaginase was found to be 1 x 10(-3)M. Metal ions, such as Zn2+, Fe2+, Cu2+, Hg2+ and Ni2+ potentially inhibited the enzyme activity, while metal chelators like EDTA, CN-, cysteine, etc., enhanced the activity indicating that the enzyme was not a metalloprotein. Its activity was also enhanced in the presence of reduced glutathione but not with dithiothreitol and 2-mercaptoethanol. Differential inhibition of the enzyme activity was observed with iodoacetamide and p-chloromercuribenzoate, thus indicating possible involvement of free-SH group in the enzyme catalysis.

Induction and Catabolite Repression of beta-Glucosidase Synthesis in Myceliophthora thermophila D-14 (= ATCC 48104).

beta-Glucosidase activity in Myceliophthora thermophila D-14 (= ATCC 48104) was inducible and was produced in culture filtrate during growth with various inducers, of which PNPG (p-nitrophenyl-beta-d-glucoside) was the most efficient. Induction of beta-glucosidase also occurred when the organism was grown in medium supplemented with different carbon sources. Carboxymethyl cellulose, cellobiose, and Solka-Floc were found effective for induction of enzyme biosynthesis. The addition of glucose to the culture medium severely repressed beta-glucosidase synthesis, which could not be reversed by exogenous cyclic AMP or dibutyryl cyclic AMP.