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Biomedical subjects

R D Reynolds

Publications and source records attributed to R D Reynolds.

At least 19 recordsLinked to original sources

Altitude retinopathy on Mount Everest, 1989.

The authors studied prospectively the incidence of and risk factors for high altitude retinal hemorrhages among 14 members of the 1989 American Everest Expedition. All subjects had comprehensive eye examinations and fundus photography performed at sea level before the expedition and again at the Mt. Everest Base Camp after 6 weeks of exposure to altitudes between 5300 and 8200 meters. Asymptomatic intraretinal hemorrhages were found in five eyes of four climbers. An additional eye of one of these climbers had a central retinal vein occlusion with vitreous hemorrhage, which reduced visual acuity to counting fingers. Higher baseline intraocular pressure and use of nonsteroidal anti-inflammatory drugs were found to be significant risk factors for development of altitude retinopathy.

Acclimatization

Effects of ascorbic acid and pyridoxine supplementation on oxalate metabolism in peritoneal dialysis patients.

We studied the effect of vitamin C and B6 supplementation on oxalate metabolism in seven patients receiving chronic peritoneal dialysis therapy. The study was divided into three phases, each lasting 4 weeks. Plasma oxalate, total ascorbic acid, and pyridoxal-5'-phosphate (PLP) were measured at the end of each phase. Twenty-four-hour urinary excretion and dialysate removal rates of oxalate were also obtained. At the end of phase I (supplement-free period), plasma oxalate levels were markedly elevated at 47.6 +/- 7.1 mumol/L (437 +/- 66 micrograms/dL) (normal, 3.4 +/- 0.4 mumol/L [30.3 +/- 1.6 micrograms/dL]). Plasma total ascorbic acid levels were 62 +/- 6 mumol/L (1.0 +/- 0.1 mg/dL) (normal, 45 to 57 mumol/L [0.8 to 1.0 mg/dL]), while plasma PLP levels were markedly reduced to 24 +/- 5 nmol/L (normal, 40 to 80 nmol/L). Daily supplements of 0.57 mmol (100 mg) ascorbic acid orally (phase II) resulted in a 19% increase in the plasma oxalate levels to 57.8 +/- 6.1 mumol/L (520 +/- 55 micrograms/dL) (P less than 0.03), with a concomitant 60% increase in the plasma ascorbate levels (91 +/- 6 mumol/L [1.6 +/- 0.1 mg/dL], P less than 0.01). Plasma PLP values remained low. Finally, during phase III (0.57 mmol or 100 mg ascorbic acid plus 59.6 mumol or 10 mg pyridoxine HCI orally daily), plasma oxalate levels declined by 17% to 47.9 +/- 5.2 mumol/L (431 +/- 47 micrograms/dL) (P greater than 0.05 v phase II).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Consumption of a dehydrated ration for 31 days at moderate altitudes: status of zinc, copper, and vitamin B-6.

Intake of energy zinc, copper, and vitamin B-6 and indexes of zinc, copper and vitamin B-6 status were determined for eight men who consumed a high-carbohydrate dehydrated ration for 31 days of high activity at moderate altitudes (2,400 to 4,300 m). Data were collected 2 months before exposure (PRE), four times during the month at moderate altitudes (ALT), and 1 month after return (RET). Mean (+/- standard error) energy intake was 2,725 +/- 215, 3,430 +/- 79, and 3,370 +/- 215 kcal/day during PRE, ALT, and RET, respectively. Zinc and copper intakes averaged 10.6 +/- 1.6 and 1.0 +/- 0.1 mg/day during PRE and increased significantly to 16.9 +/- 0.7 and 3.5 +/- 0.1 mg/day during ALT; zinc and copper intakes were 15.5 +/- 1.6 and 1.9 +/- 0.3 mg/day for RET, respectively. Similarly, vitamin B-6 intake was significantly higher during ALT (PRE = 2.2 +/- 0.5 mg/day; ALT = 4.2 +/- 0.4 mg/day; and RET = 2.6 +/- 0.4 mg/day) as compared with PRE and RET. No significant changes were noted for plasma zinc, copper, or their related proteins or plasma or erythrocyte pyridoxal-5'-phosphate. Finally, no changes in urinary excretion of zinc were observed. The results indicate that dehydrated rations provide zinc, copper, and vitamin B-6 in amounts above the Recommended Dietary Allowances. Such diets may be consumed for at least 1 month without compromising status for these nutrients.

Adult

Ascorbic acid supplements in patients receiving chronic peritoneal dialysis.

Ascorbic acid supplements are commonly prescribed to patients with end-stage renal disease receiving peritoneal dialysis. To establish the need for ascorbic acid supplements, we evaluated seven chronic peritoneal dialysis patients during a supplement-free (phase I) period, and while receiving oral ascorbic acid (0.57 mmol/d [100 mg/d]) (phase II). Because of a proposed interaction with vitamin B6, patients were additionally supplemented with pyridoxine HCl (59.6 mumol/d [10 mg/d]) (phase III). Plasma levels and dialysate removal rates of total ascorbic acid and plasma pyridoxal-5-phosphate (PLP) were measured at the end of each phase. During phase I, plasma ascorbic acid levels (normal, 45 to 57 mumol/L [0.8 to 1.0 mg/dL]) declined slightly from 74 +/- 11 mumol/L (1.3 +/- 0.2 mg/dL) to 62 +/- 11 mumol/L (1.1 +/- 0.2 mg/dL) (P less than 0.02) at the end of the third week, and then remained stable to the end of the fourth week. Plasma ascorbic acid levels were no different in patients with or without residual renal function. With the addition of vitamin C supplements, plasma ascorbic acid levels increased by 45% of the baseline value at the end of phases II (P less than 0.001). The dialysate removal rate of ascorbic acid was 0.28 +/- 0.03 mmol/d (50 +/- 6 mg/d) at the end of phase I, and increased by 57% of the baseline value at the end of phases II (P less than 0.001). However, the peritoneal clearance of ascorbic acid remained unchanged during all phases the study. Pyridoxine depletion or repletion had no effect on plasma ascorbic acid levels (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged

Vitamin B-6 metabolism in premature infants.

The response of premature infants to intravenous pyridoxine or pyridoxal was studied by measuring serum and erythrocyte pyridoxal 5'-phosphate (PLP). In the first study serum PLP was measured in 28 infants periodically through day 28. Infants less than 30 wk gestational age (GA) had no serum PLP response to the administration of pyridoxine. Infants greater than or equal to 30 wk GA had significantly greater concentrations of PLP by day 3. In the second study there was a negligible response of serum PLP in nine infants less than or equal to 28 wk GA to supplementation of pyridoxine or pyridoxal. However, erythrocyte PLP and whole-blood total vitamin B-6 concentrations increased in both groups, indicating the presence of a substantial amount of the vitamin in the circulation of the infants. Whereas the functional significance of these observations is not known, it appears that in premature infants, serum PLP may not be an appropriate indicator of vitamin B-6 status.

Erythrocytes

Plasma pyridoxal and pyridoxal 5'-phosphate concentrations in response to ingestion of water or glucose polymer during a 2-h run.

The effects of ingesting a glucose polymer solution (GP) or water (W) on plasma pyridoxal 5'-phosphate (PLP) and pyridoxal (PL) concentrations were compared in six men (age: 30 +/- 2 y; VO2max: 57.4 +/- 3.2 mL.kg-1.min-1) under running (R) and control (C) conditions. Subjects ran for 2 h at 60-65% of VO2max for R and remained standing for C. For both R and C, 200 mL W or GP was ingested before (0-time) and every 30 min while running (30, 60, and 90 min). Plasma PLP decreased to 95% and 87% of 0-time at 180 min for WC and GPC and increased to 126% and 119% at 90 min and to 124% and 119% at 120 min for WR and GPR. By 60 min postrun, plasma PLP was 98% (WR) and 101% (GPR) of 0-time. There were no significant differences between W and GP conditions. Changes in PLP were not related to plasma volume or blood glucose, free fatty acids, lactate, alkaline phosphatase, aspartate aminotransferase, or alanine aminotransferase. No significant changes in plasma PL were noted. Exercise induces an increase in plasma PLP, perhaps due to transfer of B-6 vitamers from liver to skeletal muscle.

Adult

Extremely low serum pyridoxal 5'-phosphate in children with familial hypophosphatemic rickets.

The apparent vitamin B-6 status of 31 children with familial hypophosphatemic rickets (FHR) was determined. All children had alkaline phosphatase activity that was high-normal to elevated for their ages. A sensitive assay for pyridoxal 5'-phosphate (PLP) indicated that 15 of the 31 children had an undetectable (less than 0.2 nmol/L) concentration of the vitamer--the lowest values yet reported in human serum. The 16 remaining children had concentrations of the vitamer so low that they indicated a potential severe vitamin B-6 deficiency. However, none of the children had ever presented with any of the classical vitamin B-6-deficiency symptoms. Treatment of three additional FHR children with 100 mg pyridoxine.HCl/d resulted in a moderate and transient elevation of their serum PLP concentrations, a dramatic elevation of their erythrocyte PLP concentrations, and no improvement in clinical condition. Serum or plasma PLP concentrations are an inappropriate index for determining vitamin B-6 status in people with FHR and perhaps in others with elevated alkaline phosphatase activity.

Adolescent

Consumption of a dehydrated ration for 31 days at moderate altitudes: energy intakes and physical performance.

Energy intake, body weight, maximal work capacity, and measures of muscle strength and endurance were obtained from eight men who consumed a high-carbohydrate (CHO) dehydrated ration during a 31-day period of high activity at moderate altitudes. Data were collected 2 months before exposure to moderate altitudes (PRE), multiple times during the month's expedition at moderate altitudes (ALT), and after return from the expedition (RET). Work capacity per kilogram of body weight increased significantly from the PRE phase to the ALT phase. Mean energy intake averaged 2,354 +/- 71, 3,430 +/- 79, and 3,384 +/- 117 kcal/day during PRE, ALT, and RET, respectively; mean CHO intake during ALT was 595 +/- 13 g/day. Mean weight loss and reduction in body fat were significant: 1.9 +/- 0.9 kg and 18.9 +/- 10.1%, respectively. Energy deficits calculated from changes in body weight and composition during ALT ranged from 473 to 963 kcal/day, whereas the energy deficit estimated from the Harris-Benedict equation was only 194 kcal/day. The rigorous physical activity and exposure to moderate altitudes necessitated a high energy intake, approximating 3,800 kcal/day. The results indicate that physical performance and nutritional status are maintained when a high-CHO diet, consisting primarily of commercially available dehydrated foods, is consumed over a 31-day period of rigorous activity. However, weight loss and gastrointestinal distress were noted. These events might be minimized when a dehydrated ration is consumed, if dietary fat is substituted for some of the CHO.

Adipose Tissue

Nystagmus in Down's syndrome.

The incidence and characteristics of nystagmus in Down's syndrome are unclear. In 188 consecutive patients, 56 had nystagmus. Most had no clinically recognizable ocular pathology to account for the nystagmus. Twenty-nine had fine rapid horizontal nystagmus, 14 had a dissociated nystagmus which appeared pendular, whereas 9 had a form of latent or manifest latent nystagmus. Of the total patients with nystagmus, 41 had esotropia. Our findings suggest that fine rapid horizontal nystagmus, sometimes dissociated, occurs frequently in patients with Down's syndrome.

Adolescent

A longitudinal study of pyridoxine and zinc supplementation of lactating women.

Forty lactating women were randomly assigned to four treatment groups. Beginning at 1-d postpartum the women in each group received a daily vitamin-mineral supplement for 9 mo. The treatments differed only in the amount of vitamin B-6 (0.5 or 4.0 mg pyridoxine) and zinc (0 or 25 mg) included in the supplements. The 4.0-mg pyridoxine supplements significantly increased plasma total vitamin B-6, plasma pyridoxal phosphate (PLP), and milk total vitamin B-6, thus showing that maternal intake exerts a significant effect on vitamin B-6 concentration in milk. There was no effect of vitamin B-6 intake on plasma, erythrocyte, or milk zinc concentration. The 25-mg zinc supplement also had no effect on plasma, erythrocyte, or milk zinc concentration, suggesting that maternal zinc intake is not a major regulator of milk zinc concentration.

Adult