Water-soluble upper GI based on clinical findings is reliable to detect anastomotic leaks after laparoscopic gastric bypass.

Anastomotic leak after laparoscopic Roux-en-Y gastric bypass (LGB) is a major complication that must be recognized and treated early for best results. There is controversy in the literature regarding the reliability of upper GI series (UGI) in diagnosing leaks. LGB was performed in patients meeting NIH criteria for the surgical treatment of morbid obesity. All leaks identified at the time of surgery were repaired with suture and retested. Drains were placed at the surgeon's discretion. Postoperatively, UGI was performed by an experienced radiologist if there was a clinical suspicion of leak. From September 2001 until October 2004, a total of 553 patients (age 40.4 +/- 9.2 years, BMI 48.6 +/- 7.2) underwent LGB at UAB. Seventy-eight per cent (431 of 553) of patients had no clinical evidence suggesting anastomotic leak and were managed expectantly. Twenty-two per cent (122 of 553) of patients met at least one inclusion criteria for leak and underwent UGI. Four of 122 patients (3.2%) had a leak, two from anastomosis and two from the perforation of the stapled end of the Roux limb. No patient returned to the operating room without a positive UGI. High clinical suspicion and selectively performed UGI based on clinical evidence is reliable in detecting leaks.

Study on early intervention with ACE inhibitor in myocardical infarction and short term outcome.

The present study was carried out on 100 patients with acute myocardial infarction (AMI) being treated with angiotensin converting enzyme (ACE) inhibitor and another 80 patients with conventional treatment but without ACE inhibitor during the period from May 1, 1995 to August 7, 1996 in Medical College, Calcutta. Clinical and other laboratory investigations including echocardiographic parameters were noted and recorded meticulously within 24-48 hours after AMI and repeated at 4th week. The present study based on non-invasive methods other than haemodynamic methods has shown that the echocardiographic assessment of left ventricular functional parameters after 4 weeks of ACE inhibitor therapy (n = 100) were better in treated group in comparison to control group without ACE inhibitor (n = 80) and the difference was statistically significant at 99% level of confidence. Overall mortality was 4% in ACE inhibitor group and 8.75% in the control group. This short term study with early intervention with ACE inhibitor within 48 hours of AMI has shown statistically significant evidence of beneficial effect of ACE inhibitor in improving the ventricular functional parameters and also reducing short term mortality from cardiac cause within 4 weeks compared to the group not receiving ACE inhibitors.

Purification and Characterization of Cellobiose Dehydrogenases from the White Rot Fungus Trametes versicolor.

The white rot fungus Trametes versicolor degrades lignocellulosic material at least in part by oxidizing the lignin via a number of secreted oxidative and peroxidative enzymes. An extracellular reductive enzyme, cellobiose dehydrogenase (CDH), oxidizes cellobiose and reduces insoluble Mn(IV)O(inf2), commonly found as dark deposits in decaying wood, to form Mn(III), a powerful lignin-oxidizing agent. CDH also reduces ortho-quinones and produces sugar acids which can promote manganese peroxidase and therefore ligninolytic activity. To better understand the role of CDH in lignin degradation, proteins exhibiting cellobiose-dependent quinone-reducing activity were isolated and purified from cultures of T. versicolor. Two distinct proteins were isolated; the proteins had apparent molecular weights of 97,000 and 81,000 and isoelectric points of 4.2 and 6.4, respectively. The larger CDH (CDH 4.2) contained both flavin and heme cofactors, whereas the smaller contained only a flavin (CDH 6.4). These CDH enzymes were rapidly reduced by cellobiose and lactose and somewhat more slowly by cellulose and certain cello-oligosaccharides. Both glycoproteins were able to reduce a very wide range of quinones and organic radical species but differed in their ability to reduce metal ion complexes. Temperature and pH optima for CDH 4.2 were affected by the reduced substrate. Although CDH 4.2 showed rather high substrate specificity among the ortho-quinones, it could also rapidly reduce a structurally very diverse collection of other species, from negatively charged triiodide ions to positively charged hexaquo ferric ions. CDH 6.4 showed a higher K(infm) and a lower V(infmax) and turnover number than did CDH 4.2 for all substrates tested. Furthermore, CDH 6.4 did not reduce the transition metals Fe(III), Cu(II), and Mn(III) at concentrations likely to be physiologically relevant, while CDH 4.2 was able to rapidly reduce even very low concentrations of these ions. The reduction of Fe(III) and Cu(II) by CDH 4.2 may be important in sustaining a Fenton's-type reaction, which produces hydroxyl radicals that can cleave both lignin and cellulose. Unlike the CDH proteins from Phanerochaete chrysosporium, CDH 4.2 and CDH 6.4 are unable to produce hydrogen peroxide.

Creation of metal-complexing agents, reduction of manganese dioxide, and promotion of manganese peroxidase-mediated Mn(III) production by cellobiose:quinone oxidoreductase from Trametes versicolor.

Culture supernatants of the white-rot fungus Trametes versicolor were found to contain Mn(III)-complexing agents able to effectively promote manganese-dependent peroxidase (MnP)-mediated oxidation of phenol red. The high molecular weight fractions of these supernatants contained carbohydrate polymers that functioned as effective Mn(III)-complexing agents. Gluconic and glucuronic acids were also found to be effective Mn(III)-complexing ligands capable of supporting MnP-mediated phenol red oxidation, as was the cellobionic acid formed from cellobiose by cellobiose:quinone oxidoreductase (CBQase) (EC 1.1.5.1). The formation of cellulose-derived sugar acid manganese-complexing agents by CBQase increased in the presence of wood pulp and cellulolytic enzymes. CBQase, while oxidizing cellobiose, reduced insoluble Mn(IV)O2 to Mn(II) or Mn(III) by a reaction whose rate is determined by the nature of the manganese-complexing agents present. A model is proposed to explain how oxidation of carbohydrate and reduction of MnO2 and quinones by CBQase may complement oxidation by MnP, thus promoting lignin biodegradation.

An indirect free radical-based assay for the enzyme cellobiose:quinone oxidoreductase.

A sensitive and quantitative assay for the detection of cellobiose:quinone oxidoreductase (CBQase) is described. The assay is based on the ability of CBQase to reduce the cation radicals formed by the laccase-mediated oxidation of chlorpromazine (CPZ). Formation of the CPZ radical cation is readily followed at 530 nm, and the net rate of its formation is decreased in proportion to the amount of CBQase activity present. Advantages of this assay are its increased sensitivity due to the high extinction coefficient of the CPZ radical, the high solubility of the substrate in water, and the assay's ability to detect reductive activity in the presence of laccase and other oxidative enzymes. The assay also detects other enzymes, such as glucose oxidase, which have CPZ radical-reducing activity.

Effects of Kraft Pulp and Lignin on Trametes versicolor Carbon Metabolism.

The white rot basidiomycete Trametes (Coriolus) versicolor can substantially increase the brightness and decrease the lignin content of washed, unbleached hardwood kraft pulp (HWKP). Monokaryotic strain 52J was used to study how HWKP and the lignin in HWKP affect the carbon metabolism and secretions of T. versicolor. Earlier work indicated that a biobleaching culture supernatant contained all components necessary for HWKP biobleaching and delignification, but the supernatant needed frequent contact with the fungus to maintain these activities. Thus, labile small fungal metabolites may be the vital biobleaching system components renewed or replaced by the fungus. Nearly all of the CO(2) evolved by HWKP-containing cultures came from the added glucose, indicating that HWKP is not an important source of carbon or energy during biobleaching. Carbon dioxide appeared somewhat earlier in the absence of HWKP, but the culture partial O(2) pressure was little affected by the presence of pulp. The presence of HWKP in a culture markedly increased the culture's production of a number of acidic metabolites, including 2-phenyllactate, oxalate, adipate, glyoxylate, fumarate, mandelate, and glycolate. Although the total concentration of these pulp-induced metabolites was only 4.3 mM, these compounds functioned as effective manganese-complexing agents for the manganese peroxidase-mediated oxidation of phenol red, propelling the reaction at 2.4 times the rate of 50 mM sodium malonate, the standard chelator-buffer. The presence of HWKP in a culture also markedly stimulated fungal secretion of the enzymes manganese peroxidase, cellulase, and cellobiose-quinone oxidoreductase, but not laccase (phenol oxidase) or lignin peroxidase.

Biotinylated RNA probes for the detection of potato spindle tuber viroid (PSTV) in plants.

Diseases caused by potato spindle tuber viroid (PSTV) are of significant agronomic importance, and early detection is vital. The objective of this paper was to synthesize biotinylated RNA probes in order to develop a specific, sensitive, and reliable assay system for detection of PSTV in infected plants. RNA probes were prepared by in vitro transcription of cloned PSTV, and were labelled with either biotin-11-UTP or [32P]UTP. Partially purified total RNAs from healthy and from PSTV-infected plants were spotted onto nitrocellulose filters and hybridized with either biotin-labelled or 32P-labelled probes. Our results showed that the sensitivity of biotinylated probes was similar to that for the 32P-labelled probes.

Synaptic mechanism of methionine-enkephalin uptake.

The actions of classical neurotransmitters at the synapse are rapidly terminated either by re-uptake or by enzymatic degradation. Enkephalins, like other neurotransmitters, have been demonstrated to be degraded by active proteinases present in the brain. However, it has been generally assumed that an uptake process is not operant for met-enkephalin. To confirm or disprove this assumption, we examined the problem of met-enkephalin uptake in rat brain synaptosomes. Male rat brains were collected in ice-cold sucrose (0.32M) and homogenized, and by differential centrifugation we prepared P2 pellet. The pellet was then incubated with 3H-met-enkephalin, the reaction terminated by dilution, and the reaction mixture filtered under vacuum. (1) Lysing the synaptosomes in ice cold water before or after incubation with met-enkephalin separates out the synaptic vesicles. The post-incubation lysis showed a market amount of radioactivity in the supernatant which contained the vesicles. The vesicles may thus be the sites of accumulation of met-enkephalin. Pre-incubation lysis produced markedly less accumulation of radioactivity. (2) Ca++ at various concentrations was found to be an activator of met-enkephalin uptake. (3) The rate of accumulation of met-enkephalin was found to be temperature sensitive; 37 degrees greater than 25 degrees greater than 0 degrees. (4) The degree of uptake varied with different concentrations of met-enkephalin and with time. That it is the met-enkephalin taken up and not the degraded fraction was confirmed by RIA of the material extracted from the synaptosomes. The evidence provided here suggests that there is an uptake system for met-enkephalin.

The amino acid sequence of the peptide containing the thiol group of creatine kinase from normal and dystrophic chicken breast muscle. Comparison of some of the immunological properties of the antibodies developed in rabbits against these enzymes.

The major (14)C-labelled peptides from creatine kinase from normal and dystrophic chicken muscle obtained by carboxymethylating the reactive thiol groups with iodo[2-(14)C]acetic acid and digestion with trypsin were purified by ion-exchange chromatography on Dowex-50 (X2) and by paper electrophoresis. The chromatographic characteristics of the (14)C-labelled peptides, their electrophoretic mobilities at pH6.5, and their amino acid compositions were identical for the two enzymes. The sequence of amino acids around the essential thiol groups of creatine kinase from normal and dystrophic chicken muscle was shown to be Ile-Leu-Thr-CmCys-Pro-Ser-Asn-Leu-Gly-Thr-Gly-Leu-Arg (CmCys, carboxymethylcysteine). This sequence is almost identical with that for the creatine kinases in human and ox muscle and bovine brain and is very similar to that of arginine kinase from lobster muscle. Antibodies to the enzymes were raised in rabbits and their reaction with the creatine kinase from normal and dystrophic muscles in interfacial, immunodiffusion and immunoelectrophoretic experiments was studied. The cross-reaction between normal muscle creatine kinase and antisera against the dystrophic muscle enzyme (or vice versa) observed by immunodiffusion and by immunoelectrophoretic experiments further suggests that the enzymes from normal and dystrophic chicken muscle are similar in structure. The results of the present study, the identical amino acid sequence of the peptides containing the reactive thiol group from both the normal and dystrophic chicken muscle enzymes and the immunological similarities of the two enzymes are in accord with the similarity of the two enzymes observed by Roy et al. (1970).

Preparation and properties of creatine kinase from the breast muscle of normal and dystrophic chicken (Gallus domesticus).

1. The purification of creatine kinase from normal and genetically dystrophic chicken breast muscle is described. Enzyme recovery was significantly lower from dystrophic muscle. 2. Both enzymes had the same number of reactive and total thiol groups and had similar specific activities and similar amino acid compositions. 3. No significant differences were observed in sedimentation, electrophoretic or kinetic properties. 4. Peptide ;maps' showed no significant differences, and electrophoresis of partial acid hydrolysates of the labelled enzymes suggested that corresponding amino acid sequences around all the thiol groups were very similar. 5. The enzymes showed identical temperature stabilities. 6. No significant differences between the enzymes from normal and dystrophic muscle were observed.