Gene/Protein Disease Symptom Drug Enzyme Compound
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Two boys with congenital diarrhea, steatorrhea, and growth failure were studied. Preliminary investigations indicated that the enterohepatic circulation of bile acids was interrupted. Radiographically, ileal structure was normal; ileal function was normal when assessed by vitamin B12 absorption. To confirm our clinical suspicion that the patients had an isolated defect of ileal active bile acid transport, peroral terminal ileal biopsies were performed. Ileal mucosa was incubated in vitro in oxygenated Krebs-Ringer bicarbonate buffer containing 10 mM glucose and 0.1, 1.0, or 10.0 mM taurocholic acid at 37 degrees C. Ileal uptake from the patients was 0.10 and 0.34 mumol/g dry wt . min in 0.1 mM taurocholic acid, 1.20 and 2.39 mumol/g dry wt . min in 1.0 mM taurocholic acid, and 21.19 and 11.14 mumol/g dry wt . min in 10.0 mM taurocholic acid. At every concentration, significant (p less than 0.05) reductions were present compared with ileum from 7 ileostomy controls, 0.5 to 27 yr old whose uptake was 1.40 +/- 0.28 mumol/g dry wt . min (mean +/- SEM) at 0.1 mM; 6.36 +/- 1.33 mumol/g dry wt . min at 1.0 mM, and 76.20 +/- 19.30 mumol/g dry wt . min at 10.0 mM taurocholic acid. Ultrastructural examination of the ileal mucosa failed to demonstrate a significant structural abnormality. Significant reduction in ileal uptake of taurocholic acid accompanying clinical and biochemical findings of interruption of the enterohepatic circulation in the absence of mucosal disease suggests that these children have a previously undescribed, congenital transport defect that includes absence of active ileal bile acid transport presenting as diarrhea in infancy.
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PMID:Primary bile acid malabsorption: defective in vitro ileal active bile acid transport. 710 11

There has been a movement in the dialysis community towards higher blood pump flow rates (QB) during dialysis. However, the effects of increased QB on recirculation and consequently the impact on clearances have not been well quantified for clinically relevant QBS. We studied the effect of QB on recirculation in 16 patients in a prospective fashion. Blood pump speeds of 200, 250, 300, 350, 400, 450, and 500 cc/min were studied in a randomized order. For QBS of 350 cc/min and greater, 14-gauge needles were used; at lower QBS, 16-gauge needles were used. The needles were positioned at least 5 cm apart. Recirculation studies were done after stabilization of QB during the first 15 minutes of dialysis with a dialysate temperature of 37 degrees C and minimal transmembrane pressure. Recirculation was calculated using the three-needle technique. All patients had an angiogram performed upon completion of the study. Effective clearances were calculated to demonstrate the effect of QB on Recirculation rates increased with increased QB (r = 0.43). Recirculation was 12.1% +/- 1.2 (Mean +/- SEM) at a QB of 200 cc/min versus 23.8% +/- 3.0 at a QB of 500 cc/min (p < 0.05). Venous pressures increased with increasing QBS, 120.0 mmHg +/- 7.3 at a QB of 200 cc/min to 204.2 mmHg +/- 9.1 at a QB of 500 cc/min. Bleeding from needle puncture sites only occurred with use of the 14-gauge needles (p = 0.02). Effective dialyzer urea and B12 clearances for six different dialyzers increased at a considerably lower rate beyond a QB of 300 cc/min.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Variable blood pump flow rates and the effect on recirculation. 785 Oct 34

To evaluate the effects of erythropoietin (EPO) therapy on the lipid profile in end-stage renal failure, we undertook a prospective study in patients on both hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD). One hundred and twelve patients (81 HD, 31 CAPD) were enrolled into the study. Lipid parameters [that is, total cholesterol and the LDL and HDL subfractions, triglycerides, lipoprotein (a), apoproteins A and B], full blood count, iron studies, B12, folate, blood urea, aluminium and serum parathyroid hormone were measured prior to commencement of EPO therapy. Ninety-five patients were reassessed 5.2 +/- 0.3 (mean +/- SEM) months later and 53 patients underwent a further assessment 13.1 +/- 0.6 months after the commencement of EPO, giving an overall follow-up of 10.0 +/- 0.6 months in 95 patients. As expected, EPO treatment was associated with an increase in hemoglobin (7.7 +/- 0.1 vs. 9.9 +/- 0.2 g/dl; P < 0.001) and a decrease in ferritin (687 +/- 99 vs. 399 +/- 69 micrograms/liter; P < 0.01). A significant fall in total cholesterol occurred (5.8 +/- 0.1 vs. 5.4 +/- 0.2 mmol/liter; P < 0.05) in association with a fall in apoprotein B (1.15 +/- 0.04 vs. 1.04 +/- 0.06; P < 0.05) and serum triglycerides (2.26 +/- 0.14 vs. 1.99 +/- 0.21; P < 0.05) during the course of the study. Other lipid parameters did not change, although there was a trend towards improvement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Effects of erythropoietin therapy on the lipid profile in end-stage renal failure. 819 94

Findings reported are for a subset of African American subjects, residing in the urban area of Washington, D. C., who participated in a Program Project designed to study nutrition, other factors, and the outcome of pregnancy. Fasting blood samples, drawn during each trimester of pregnancy and at delivery, were screened for concentrations of cocaine, phencyclidine (PCP) and marijuana. Since substance abusers are expected to consume inadequate diets, these samples were also analyzed for serum folate, vitamin B12, ferritin and ascorbic acid. Data for these biochemical variables were compared for subjects whose serum values for drugs were either above or below the drug screening threshold concentrations established by ADAMHA/NIDA. Pearson's correlations were used to determine relationships between pregnancy outcome variables and maternal serum drug concentrations. Blood samples drawn at delivery showed higher maternal: cord ratios (mean +/- SEM) for marijuana (3.3 +/- 2.2) and PCP (2.9 +/- 1.0) than for cocaine (1.0 +/- 0.2). The subjects whose serum values were above the ADAMHA/NIDA ranges for marijuana, PCP and cocaine had concentrations of folate and ferritin that were significantly less than those of subjects with lower serum drug levels (P < or = 0.05). High maternal serum concentrations of illicit drugs were accompanied by a significant increase in leukocyte count (P < or = 0.05). The level of maternal cocaine during the third trimester was inversely correlated with birthweight (r = -0.29; n = 52; P = 0.038) and head circumference (r = -0.28; n = 52; P = 0.047).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Relationships of serum illicit drug concentrations during pregnancy to maternal nutritional status. 820 48

The maintenance of endothelial barrier function is important in the regulation of fluid and solute balance between the vascular space and the surrounding tissue. Since fluid flow across endothelial cells stimulates a wide variety of endothelial responses, the effect of shear stress on barrier function was investigated. Bovine pulmonary artery endothelial cells were cultured on permeable microcarrier beads, placed in a chromatography column, and perfused. Indicator-dilution techniques were used to estimate the permeability of the cell-covered beads to low molecular weight tracers (sodium fluorescein-NaFlsc; cyanocobalamin-B12) as a function of flow rate through the column. Permeability values for both tracers were significantly increased (9.3 +/- 0.6 to 19.3 +/- 1.7 for NaFlsc; 8.2 +/- 0.5 to 20.4 +/- 3.1 for B12; mean+/-SEM, x 10(-5) cm/s, P < .05) when the flow rate was increased from 0.9 ml/min to 3.2 ml/min (corresponding to average shear stresses of 4.7 and 16.8 dynes/cm2). The permeability increase occurred within minutes of the flow increase, and was reversed by decreasing the flow rate to 0.9 ml/min. In the presence of cytochalasin D, the flow-induced permeability increase was not reversible. Neither inhibition of nitric oxide synthase (with NG-monomethyl-L-arginine) nor inhibition of cyclooxygenase (with indomethacin) was capable of blocking the flow-induced permeability increase. These results indicate that the rapid modulation of endothelial barrier by flow in vitro is probably not due to prostacyclin or nitric oxide.
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PMID:Flow-induced modulation of the permeability of endothelial cells cultured on microcarrier beads. 870 76

Increased permeability is an early and universal response of the vasculature to radiation injury, yet the biological basis of this reaction is poorly understood. The present study determined the time course and the dose-response relationship of radiation-induced hyperpermeability in cultured bovine pulmonary artery endothelial (BPAE) cells. BPAE cells were grown to a confluent monolayer on microcarrier beads, and column chromatography methods were used to evaluate permeability to two low molecular weight compounds: sodium fluorescein (NaFlsc, mol. wt. = 342) and cyanocobalamin (B12, mol. wt. = 1355). This is a novel in vitro model to study mechanisms and modifiers of radiation-induced permeability of endothelial cells under flow conditions using nonradioactive tracers. Cell-covered beads were exposed to a single dose of 10 Gy Of 137Cs gamma rays and placed in the column, and permeability was measured every 30 min for 3 h. There was a time-dependent increase in permeability to both tracers, reaching significance by 2 h. Increased permeability was accompanied by perturbations in F-actin distribution in the BPAE cells as determined by rhodamine-phalloidin fluorescence microscopy. Neither catalase nor captopril ameliorated this hyperpermeability, but dibutyryl cAMP partially prevented it. At 3 h after 0, 1, 2, 5 and 10 Gy irradiation, permeability values of 11.8 +/- 2.1, 13.9 +/- 2.2, 20.9 +/- 3.6, 24.8 +/- 2.8 and 27.2 +/- 3.3 (10(-5) cm/s, +/- SEM), respectively, were observed using NaFlsc. The increase was significant (P < 0.05) at 2 Gy or higher. Permeability to B12 was significantly elevated after 5 or 10 Gy. These results suggest that permeability of endothelial cells to low molecular weight solutes increases within 3 h after therapeutic doses of radiation, and that cAMP ameliorates this response.
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PMID:Dose-response effects of radiation on the permeability of endothelial cells in culture. 875 11

We investigated the effect of theophylline administration on circulating vitamin levels in children with asthma. Twenty-three asthmatic children, ranging in age from 7 to 15 with a mean of 10.8 years and including 16 patients who were treated with slow-release theophylline and 7 patients not receiving any type of theophylline preparation, were enrolled in this study. They all were inpatients who had been hospitalized for the control of asthma. Steady-state serum theophylline and vitamin A, B1, B2, B6, B12 and C levels were evaluated in these patients. Circulating vitamin B1 and B6 levels were depressed in asthmatic children treated with theophylline compared to those not receiving the agent (38.4 +/- 1.6 (mean +/- SEM) vs. 46.4 +/- 3.5 ng/ml and 7.1 +/- 0.5 vs. 11.8 +/- 2.1 ng/ml, respectively, p < 0.05). A significant negative correlation between theophylline and circulating levels of vitamin B6 was demonstrated in the subjects of this study (rs = -0.657, p < 0.001). In contrast, no relationship was noted between theophylline and circulating vitamin B1 levels. Theophylline did not affect circulating vitamin A, B2, B12 or C levels. We conclude that theophylline induces depression of circulating vitamin B1 and B6 levels in asthmatic children, although a dose-dependent interaction between theophylline and vitamin B1 would be unlikely.
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PMID:Relation between theophylline and circulating vitamin levels in children with asthma. 903 3

Erythropoietin (Epo) is a glycoprotein hormone produced in the kidney in response to hypoxia or anaemia. In acute renal failure (ARF) anaemia also occurs and current opinion is that Epo production is depressed with inappropriately low plasma levels throughout the uraemic phase. Our study was designed to determine the excretion of Epo in patients with ARF. Fifty-nine ventilated patients were studied, 39 with ARF and continuous veno-venous haemofiltration therapy (group 1) and 13 patients with normal renal function who served as a control group (group 2). All patients with ARF were anaemic and needed a mean transfusion of 0.6 units/day. Values for vitamin B12, folic acid, serum iron and ferritin were normal. While patients with normal renal function had Epo values within the normal range, patients with ARF had significantly higher values at the onset of haemofiltration therapy. Mean Epo (mean +/- SEM) values on days 0-2 were 92.6 +/- 11.7 mU/ml in group 1 and 16.5 +/- 6.4 mU/ml in group 2 (p < 0.0002). Epo levels declined in group 1 to 49 +/- 10.5 mU/ml on days 9 and 10 compared to 23 +/- 9.1 mU/ml in group 2 (ns). These values were maintained until the end of the observation period. No differences were seen between oliguric and non-oliguric patients. Our data show that patients with ARF have increased Epo levels at the beginning of the disease with a strong tendency to decrease, suggesting that there might be inadequate Epo levels during the course of acute renal failure.
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PMID:Erythropoietin in patients with acute renal failure and continuous veno-venous haemofiltration. 924 56

Total body water (TBW) is reduced in adult GH deficiency (GHD) largely due to a reduction of extracellular water. It is unknown whether total blood volume (TBV) contributes to the reduced extracellular water in GHD. GH and insulin-like growth factor I (IGF-I) have been demonstrated to stimulate erythropoiesis in vitro, in animal models, and in growing children. Whether GH has a regulatory effect on red cell mass (RCM) in adults is not known. We analyzed body composition by bioelectrical impedance and used standard radionuclide dilution methods to measure RCM and plasma volume (PV) along with measuring full blood count, ferritin, vitamin B12, red cell folate, IGF-I, IGF-binding protein-3, and erythropoietin in 13 adult patients with GHD as part of a 3-month, double blind, placebo-controlled trial of GH (0.036 U/kg.day). TBW and lean body mass significantly increased by 2.5 +/- 0.53 kg (mean +/- SEM; P < 0.004) and 3.4 +/- 0.73 kg (P < 0.004), respectively, and fat mass significantly decreased by 2.4 +/- 0.32 kg (P < 0.001) in the GH-treated group. The baseline RCM of all patients with GHD was lower than the predicted normal values (1635 +/- 108 vs. 1850 +/- 104 mL; P < 0.002). GH significantly increased RCM, PV, and TBV by 183 +/- 43 (P < 0.006), 350 +/- 117 (P < 0.03), and 515 +/- 109 (P < 0.004) mL, respectively. The red cell count increased by 0.36 +/- 0.116 x 10(12)/L (P < 0.03) with a decrease in ferritin levels by 39.1 +/- 4.84 micrograms/L (P < 0.001) after GH treatment. Serum IGF-I and IGF-binding protein-3 concentrations increased by 3.0 +/- 0.43 (P < 0.001) and 1.3 +/- 0.15 (P < 0.001) SD, respectively, but the erythropoietin concentration was unchanged after GH treatment. No significant changes in body composition or blood volume were recorded in the placebo group. Significant positive correlations could be established between changes in TBW and TBV, lean body mass and TBV (r = 0.78; P < 0.04 and r = 0.77; P < 0.04, respectively), and a significant negative correlation existed between changes in fat mass and changes in TBV in the GH-treated group (r = -0.95; P < 0.02). We conclude that 1) erythropoiesis is impaired in GHD; 2) GH stimulates erythropoiesis in adult GHD; and 3) GH increases PV and TBV, which may contribute to the increased exercise performance seen in these patients.
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PMID:The importance of growth hormone in the regulation of erythropoiesis, red cell mass, and plasma volume in adults with growth hormone deficiency. 928 31

The edible purple laver, Porphyra yezoensis, contained 51.49+/-1.51 microg of vitamin B12 compounds per 100 g dry weight of the laver (mean +/- SEM, n = 4). A vitamin B12 compound was purified from the lyophilized purple laver and partially characterized. The silica gel 60 TLC and reversed-phase HPLC patterns of the purified pink-colored compound were identical to those of authentic vitamin B12, but not to those of vitamin B12 analogues inactive for humans.
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PMID:Characterization of a vitamin B12 compound in the edible purple laver, Porphyra yezoensis. 1121 Jan 44


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