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Biomedical subjects

J H Stevenson

Publications and source records attributed to J H Stevenson.

At least 19 recordsLinked to original sources

The metabolism of malate by cultured rat brain astrocytes.

Since malate is known to play an important role in a variety of functions in the brain including energy metabolism, the transfer of reducing equivalents and possibly metabolic trafficking between different cell types; a series of biochemical determinations were initiated to evaluate the rate of 14CO2 production from L-[U-14C]malate in primary cultures of rat brain astrocytes. The 14CO2 production from labeled malate was almost totally suppressed by the metabolic inhibitors rotenone and antimycin A suggesting that most of malate metabolism was coupled to the electron transport system. A double reciprocal plot of the 14CO2 production from the metabolism of labeled malate revealed biphasic kinetics with two apparent Km and Vmax values suggesting the presence of more than one mechanism of malate metabolism in these cells. Subsequent experiments were carried out using 0.01 mM and 0.5 mM malate to determine whether the addition of effectors would differentially alter the metabolism of high and low concentrations of malate. Effectors studied included compounds which could be endogenous regulators of malate metabolism and metabolic inhibitors which would provide information regarding the mechanisms regulating malate metabolism. Both lactate and aspartate decreased 14CO2 production from 0.01 mM and 0.5 mM malate equally. However, a number of effectors were identified which selectively altered the metabolism of 0.01 mM malate including aminooxyacetate, furosemide, N-acetylaspartate, oxaloacetate, pyruvate and glucose, but had little or no effect on the metabolism of 0.5 mM malate. In addition, alpha-ketoglutarate and succinate decreased 14CO2 production from 0.01 mM malate much more than from 0.5 mM malate. In contrast, a number of effectors altered the metabolism of 0.5 mM malate more than 0.01 mM. These included methionine sulfoximine, glutamate, malonate, alpha-cyano-4-hydroxycinnamate and ouabain. Both the biphasic kinetics and the differential action of many of the effectors on the 14CO2 production from 0.01 mM and 0.5 mM malate provide evidence for the presence of more than one pool of malate metabolism in cultured rat brain astrocytes.

Animals

Intractable digital neuroma pain; the ultimate solution?

A case is presented in which, following the failure of several surgical and non-surgical procedures to control the increasingly severe pain in an amputation thumb stump, a toe transfer was carried out, successfully relieving the symptoms without transfer of the pain to the donor site. The patient has remained pain-free for 3 years.

Adult

Experience with the free "inverted" groin flap in facial soft tissue contouring; a report on 6 flaps.

Reconstruction of the soft tissue facial contour defect in Romberg's disease and facial lipodystrophy using a free groin flap has been previously reported. However, controversy exists over the optimum placing of this flap within the cheek, i.e. whether it is better to have the dermis or subcutaneous fat side next to the muscle. Our experience with 6 flaps, 3 of which have been followed up for 3 1/2 years, is presented. In all cases the flaps were placed with the dermis side down, i.e. next to muscle. Although not a comparative study, our impression is that in the long term this technique reduces gravitational migration. Our experience with 2 flaps suggests that, in the early postoperative period at least, secure fixation by suturing to the muscle and periosteum is important. We believe that, in addition, this method gives a smoother contour and allows easy and safe secondary adjustments to be made where necessary.

Adolescent

Proximal upper limb replantation in children.

Proximal upper limb amputation not only leads to serious local disability but carries with it substantial systemic implications. The replantation of an avulsed limb is all too frequently followed by disappointing functional results. In children, however, with secure bony stability, vascular reconstruction and immediate appropriate nerve repair the results of replantation can be most gratifying. Two such cases have been seen at The Hospital for Sick Children and are reported in detail. The late functional results as illustrated make this complex procedure a very worthwhile undertaking.

Activities of Daily Living

Serum effects on substrate oxidation by dissociated brain cells: possible sites of action.

This report is an extension of recent studies indicating the presence of a factor in serum that preferentially inhibits 14CO2 production from labeled glucose. Experiments with dissociated cells revealed that the inhibitory effects of serum were only slightly changed over more than a 50-fold range in initial glucose concentration. Serum had no effect on the rate of glucose transport (uptake of 1,3[3H]2-deoxyglucose). The inhibitory effect of serum was greater on 14CO2 production from [6-14C]glucose than [1-14C]glucose. Other studies revealed that 14CO2 production from [1-14C]pyruvate was more than 5 times the rate obtained using [3-14C]pyruvate; however, the inhibitory effect of serum was much greater on the latter (20% vs 60% inhibition respectively) at 2 mM pyruvate and in the presence of 1% fetal bovine serum. Attempts to characterize the factor using Amicon filtration showed the highest inhibitory activity in a 10,000 mol. wt. fraction, although some inhibitory activity was found in commercial preparations of bovine serum albumin. Delipidation of serum had no effect. Based on these results, we postulate that the observed decrease in labeled CO2 production reflects the regulation of substrate utilization at the pyruvate carboxylase step by one or more factors in serum (with a mol. wt. of approximately 10,000).

Animals

Upper limb motor and sensory recovery after multiple proximal nerve injury in children: a long term review in five patients.

Five children who had sustained multiple proximal upper limb nerve injury were reviewed at 18 months to 3 1/2 years after primary repair had been carried out. The findings show that nerve regeneration occurred significantly more rapidly than in adults, with good return of motor and sensory function to the hand, resulting in each of the patients having a useful, painfree and functionally capable upper limb. In two of the cases, the limb had been completely severed. The findings support the view that primary repair of severed proximal nerves in this age group--even in avulsion type injuries--can give good results.

Arm Injuries

Functional, mechanical, and biochemical assessment of ultrasound therapy on tendon healing in the chicken toe.

We studied the therapeutic effect of ultrasound treatment on the functional recovery of surgically repaired profundus tendon in the right third toe of mature White Leghorn hens. Ultrasound treatment was given daily for 5 minutes for a total of 20 treatment days, starting immediately after 4 weeks immobilization. Ultrasound (frequency 3.0 mHz; intensity 0.75 W/cm2) was delivered to the right leg by a 5-cm2 probe through distilled water in a bath kept at 35 degrees C. The flexion of the toe was measured preoperatively for 4 consecutive days and daily for 6 weeks after the start of ultrasound treatment for the calculation of percent of functional recovery of the flexor tendon. The non-ultrasound-treated group of birds went through the same manipulations except that no ultrasound was given when the right leg was immersed in the water bath. Ultrasound treatment significantly (p less than 0.01) improved the functional recovery of the repaired tendons (less than 5-mm gap) starting on the third week of treatment (94 +/- 2 percent) compared with the non-ultrasound-treated group (79 +/- 4 percent). Ultrasound treatment had no effect on gap formation or breaking (tensile) strength of the repaired tendons. It is concluded that ultrasound enhanced functional return of repaired flexor tendons in the hen, and the clinical implication is discussed.

Animals

Substrate oxidation by isolated rat brain mitochondria and synaptosomes.

The rates of [6-14C]-glucose oxidation by reconstituted systems of cytosol and mitochondria or cytosol and synaptosomes were essentially the same as the rate of oxidation of [3-14C]-3-hydroxybutyrate. However, the rate of [U-14C]-glutamine oxidation by mitochondria was 2.5 times that by synaptosomes. The addition of glutamine (5 mM) caused a reduction in the rates of oxidation [6-14C]-glucose of 20% and 40% by mitochondria and synaptosomes, respectively. Conversely, the addition of glucose (5 mM) had little or no effect on the rate of [U-14C]-glutamine oxidation by either organelle. Amino-oxyacetate decreased [U-14C]-glutamine oxidation by mitochondria more than 35% but had little or no effect on the rate of glutamine oxidation by synaptosomes. When glucose (5 mM) was added to [3-14C]-3-hydroxybutyrate, the rates of oxidation by the mitochondria and synaptosomes were increased by 65% and 77%, respectively. However, in the reverse situation the addition of 3-hydroxybutyrate decreased [6-14C]-glucose oxidation by synaptosomes (35%) but did not decrease the rate by mitochondria. These results suggest that differences in the rates of substrate utilization by mitochondria and synaptosomes and differences in substrate interactions in these two subcellular organelles may contribute to metabolic compartmentation in the brain.

Animals

Competition among oxidizable substrates in brains of young and adult rats. Whole homogenates.

The rates of conversion into 14CO2 of D-(-)-3-hydroxy[3-14C]butyrate, [3-14C]acetoacetate, [6-14C]glucose and [U-14C]glutamine were measured in the presence and absence of unlabelled alternative oxidizable substrates in whole homogenates from the brains of young and adult rats. The addition of unlabelled glutamine resulted in decreased 14CO2 production from [6-14C]glucose in brain homogenates from both young and adult rats. In contrast, glucose had no effect on [U-14C]glutamine oxidation. In suckling animals, both 3-hydroxybutyrate and acetoacetate decreased the rate of oxidation of [6-14C]glucose, but in adults only 3-hydroxybutyrate had an effect, and to a lesser degree. The addition of unlabelled glucose markedly enhanced the rates of oxidation of both ketone bodies in adult brain tissue and had little or no effect in the young. The rate of production of 14CO2 from [U-14C]glutamine was increased by the addition of unlabelled ketone bodies in brain homogenates from young, but not from adult rats. In the converse situation, unlabelled glutamine added to 14C-labelled ketone bodies diminished 14CO2 production in young rats, but had no effect in adult animals. These results revealed a complex age-dependent pattern of interaction in which certain substrates apparently competed with each other, whereas an enhanced rate of 14CO2 production was found with others.

3-Hydroxybutyric Acid

Burn injury to the face with associated fracture caused by a flare gun: a case report.

A case is presented of a child who sustained a full-thickness burn to the glabella and nose area, associated with an underlying fracture and cerebrospinal fluid leakage. This first reported case of a flare gun injury illustrates some important principles of facial management and soft tissue cover, in both the acute and the reconstructive phases.

Blast Injuries

Effect of L-alanine infusion on gluconeogenesis and ketogenesis in the rat in vivo.

1. In 48 h-starved 6-week-old rats the 14C incorporation in vivo into blood glucose from a constant-specific-radioactivity pool of circulating [14c]actateconfirmed that lactate is the preferred gluconeogenic substrate. 2. Increasing the blood [alanine] to that occurrring in the fed state increased 14C incorporation into blood glucose 2.3-fold from [14c]alanine and 1.7-fold from [14c]lactate. 3. When the blood [alanine] was increased to that in the fed state, the 14C incorporation into liver glycogen from circulating [14c]alanine or [14c]lactate increased 13.5- and 1.7-fold respectively. 4. The incorporation of 14C into blood acetoacetate and 3-hydroxybutyrate from a constant-specific-radioactivity pool of circulating [14c]oleate was virtually abolished by increasing the blood [alanine] to that existing in the fed state. However, the [acetoacetate] remained unchanged, whereas [3-hydroxybutyrate] decreased, although less rapidly than did its radiochemical concentration. 5. It is concluded that during starvation in 6-week-old rats, the blood [alanine] appears to influence ketogenesis for circulating unesterfied fatty acids and inversely affects gluconeogenesis from either lactate or alanine. A different pattern of gluconeogenesis may exist for alanine and lactate as evidenced by comparative 14C incorporation into liver glycogen and blood glucose.

Acetoacetates

Mitochondrial glycerol kinase activity in rat brain.

Glycerol kinase activity was found in the particulate fraction of rat brain homogenates predominantly associated with mitochondria. The enzyme remained bound to the particulate fraction after treatment with a variety of solubilizing agents.

Animals

Ability of exogenous alanine to lower blood beta-hydroxybutyrate during development in rats.

The intraperitoneal injection of L-alanine into 10- and 21-day-old fed Wistar rats resulted in blood alanine levels of 3-5 mM and in a rapid, significant decrease in the concentration of beta-hydroxybutyrate (betaOHB) in blood. The drop in betaOHB was unrelated to changes in the concentrations of pyruvate, lactate, or glucose. The intraperitoneal injection of glutamate at the same age had no effect on betaOHB values. In 2-day-old pups and in older weaned animals, the injection of alanine had either no effect or increased the levels of betaOHB in blood. The most rapid disappearance of exogenous alanine occurred in 35-day-old and not in 10- and 21-day-old rats. These data suggest that alanine has a depressant effect on the level of circulating betaOHB at a specific stage in the animal's maturation.

Alanine