Magnetic resonance imaging and quantitative analysis of intracranial cystic lesions: surgical implication.

The authors evaluated a series of proven intracranial cystic lesions prospectively. The relative signal intensities of these lesions on both T1- and T2-weighted sequences were correlated with the composition and viscosity of the cystic contents. Specimens were collected from 51 patients by cyst aspiration or at the time of surgery. Once a specimen was obtained, it was immediately sent for quantitative analysis of proteins, cholesterol, triglyceride, calcium, and blood by-products. In 30 patients, the cystic lesion was hypointense on T1 and hyperintense on T2 relative to white matter. The cystic content in this group of patients was a watery fluid that could be easily aspirated. In another 14 patients, the cystic lesion was either isointense or hyperintense on T1 and hyperintense on T2-weighted sequences. In this group of patients, the cystic contents were mild to moderately viscous and a wide bore needle or cannula was required for aspiration. In the remaining seven patients, the cystic contents were hyperintense (n = 4), isointense (n = 2), or hypointense (n = 1) on T1 but all were markedly hypointense on T2-weighted sequences. The contents of the cystic lesions in these seven patients ranged from pastelike to solid and had to be removed surgically. This study concludes that the observed T1- and T2-weighted signal intensities can predict the relative viscosity and the composition of intracranial cystic contents. This information is found to be quite useful in planning surgery and using appropriate instrumentation in the management of intracranial cystic masses.

Interaction of creatine kinase and adenylate kinase systems in muscle cells.

Elsewhere in this book the important role of creatine kinase and its metabolites in high energy phosphate metabolism and transport in muscle cells has been reviewed. The emphasis of this review article is mainly on the compartmentalized catalytic activity of adenylate kinase in relation to creatine kinase isoenzymes, and other enzymes of energy production and utilization processes in muscle cells. At present the role of adenylate kinase is considered simply to equilibrate the stores of adenine nucleotides. Recent studies by us and others, however, suggest an entirely new view of the metabolic importance of adenylate kinase in muscle function. This view offers a closer interaction between adenylate kinase and creatine kinase, in the process of energy production (at mitochondrial and glycolytic sites), and energy utilization (at myofibrillar sites and perhaps other sites such as sarcoplasmic reticular, sarcolemmal membrane, etc.), thus being an integral part of the high energy phosphate transport system. This review article opens up the opportunity to further examine the metabolism of adenine nucleotides and their fluxes through the adenylate kinase system in intact muscle cells. Using an intact system, having a preserved integrity of their compartmentalized enzymes and substrates, is essential in clarifying the exact role of adenylate kinase in high energy phosphate metabolism in muscle cells.

Effect of food restriction on the phosphocreatine energy shuttle components in rat heart.

Malnutrition has been associated with changes in cardiac metabolism and performance. We have previously reported a diabetic-type cardiomyopathy associated with chronic food restriction and weight loss. Because the creatine-phosphocreatine-creatine kinase system is important in the contractile process, we studied the components of this system in rats fed a food-restricted diet (33% of control animal intake). After 4 weeks of food restriction, total creatine kinase (CK) activities were reduced by 28% in ventricles and by 38% in atria. The CK isoenzymes in the heart were not equally affected. The BB isoenzyme was decreased by 77% and 78%, the MB isoenzyme by 45% and 43%, the MM isoenzyme by 22% and 19% and CKmito by 16% and 15% in ventricles and atria, respectively. In contrast, brain CK activity which is predominantly the BB isoenzyme, was slightly higher in the food-restricted than in control rats. Further studies on ventricular tissue from food-restricted rats revealed a 27% decline in myofibrillar CR activity and a 58% decline in myofibrillar ATPase activity. Phosphocreatine and creatine concentrations were not changed by food restriction, however, ATP was decreased by 23% in ventricles from rats on the restricted diet. Cardiac mitochondrial oxidative phosphorylation was also impaired. State 3 respiration with alpha-ketoglutarate was reduced 20% in the food-restricted heart. These changes are compared to those which we previously observed in the diabetic rat heart and the significance of these findings is discussed.

Diabetic type of cardiomyopathy in food-restricted rats.

We have demonstrated that food restriction that is associated with weight loss can produce a type of cardiac dysfunction similar to that produced by diabetes. As in diabetic atria, the food-restricted atria had a 2-fold increase in contraction force, rate of force development, and rate of force decline compared with controls. Both food-restricted and diabetic atria could tolerate anoxia better than controls. The contractile function of the whole perfused heart from the food-restricted rat was reduced, as in the case of the diabetic heart. As the left ventricular volume was increased, the left ventricular developed pressure and the rate of rise and fall in pressure were significantly reduced in both food-restricted and diabetic hearts, compared with those of age- and weight-matched controls. The positive inotropic responses of atria and whole perfused heart to increasing concentrations of extracellular calcium were similarly altered in food-restricted and diabetic hearts. The possible molecular mechanisms of these findings and some of the differences observed between food-restricted and diabetic hearts are discussed.

Alteration of the phosphocreatine energy shuttle components in diabetic rat heart.

Considering the important role of the phosphocreatine energy shuttle in contractile function of the heart we decided to study the different components of this shuttle in STZ-induced diabetic rat heart with a known diabetic related cardiomyopathy. Diabetes produced a gradual decline in total CK activity, reaching a maximum of 35-40% decrease after 4 weeks of diabetes, in both atria and ventricles. All of the CK isoenzymes including the mitochondrial CK (CKm) were reduced but to a different extent in these two tissues. The percentage reduction in diabetic ventricles was BB greater than MB greater than CKm greater than MM and in atria was CKm greater than BB greater than MB greater than MM. A major difference between atrium and ventricle was the greater loss of CKm in diabetic atria than diabetic ventricle (75% in atria vs 32% in ventricle). The B subunit seemed to be the one that was affected the most followed by CKm isoenzyme and then the M subunit. The bound myofibrillar CK isoenzyme, expressed as units of activity/mg of myofibrillar protein, was not affected by 4 weeks of diabetes. The high energy phosphates were also reduced in diabetic heart with a greater reduction in phosphocreatine (43-45%) and a smaller change in ATP (27%). Mitochondrial oxidative phosphorylation with alpha-ketoglutarate was reduced (55%) in diabetic heart, whereas, there was no difference when succinate was used as substrate. These changes were reversible by 4 weeks of insulin treatment. The loss of CKm, phosphocreatine and the reduction in mitochondrial oxidative phosphorylation, could result in an inefficient phosphocreatine energy shuttle which could contribute to the cardiac functional defects associated with diabetes.

Altered functional activity and anoxic tolerance in diabetic rat isolated atria.

Functional activities of isolated atria from 4-week diabetic rats and their anoxic tolerance and recovery were compared to those of control rats. The present study showed a two-fold increase in maximum developed contraction force (CF), the rate of force development, and the rate of relaxation in isolated atria from diabetic rat heart over that of the control. The rate of the sinoatrial node was lower in the diabetic. However, this lower rate was not responsible for higher CF of the diabetic isolated atria since the twofold difference was still present when both diabetic and control atria were electrically paced at identical rates. Although the high energy phosphate content of the diabetic isolated atria was lower than that of control (50% lower phosphocreatine and 15% lower ATP), diabetic atria exhibited improved short term anoxic tolerance and recovery compared to that of the control. The recovery from long term anoxia, however, was better in control than in diabetic atria, considering the higher original CF in diabetic atria. The present observations are compatible with better ischemic tolerance and higher basal force development observed by some investigators on diabetic isolated heart preparations but not with impaired contractility reported by others. Possible mechanisms responsible for the observed changes are discussed.

Long-acting contraceptive agents: testosterone esters of unsaturated acids.

The synthesis of 13 new esters of testosterone is described, with the esterifying acids bearing acetylenic, olefinic, or polyunsaturated functions in the chain, for evaluation as long-acting androgens.

PIP: A program of the World Health Organization for developing long-acting esters of testosterone that would exhibit a more constant release rate and maintain testosterone levels in the normal range longer than testosterone enanthate found that these esters had a role in fertility, and gerontology. The synthesis of 13 new esters of testosterone is described, with the esterifying acids bearing acetylenic, olefinic or polyunsaturated functions in the chain, for evaluation as long-acting androgens. The nuclear magnetic resonance (NMR) images were recorded on a spectrometer. The samples were recorded in tubes using CDC13 as solvent. The NMR spectra were recorded with Perkin-Elmer instrument in CDC13, with tetramethylsilane as internal reference. Infrared spectra were measured on the same spectrometer. Mass spectra were also recorded. Thin-layer chromatography was performed on Merck silica gel and the spray reagent was iodine or vanillin. To a solution of testosterone the corresponding acid chloride was added yielding the pure ester after the usual work-up. E-5-methylhexa-2,4-dienoic (IXb), 5- phenylpenta-2-,4-dienoic (Xb), 5-phenyl-4-yn-pent-2-enoic (XIb), and non-4-en-6-ynoic acid (XIIb), were required for the synthesis. Esterification of testosterone with each of the first 12 unsaturated acids was performed by reaction with the corresponding acid chlorides in pyridine. Although the nona-2,3-dienoic acid ethyl ester was easily obtained, this compound could not be hydrolyzed to the acid (XIIIb). Hence, an alternative procedure was tried for the synthesis of the ester XIIIa, by reaction of bromoacetate of testosterone (XIVa) with triphenylphosphine to give the phosphorane (XVa). Reaction of this phosphorane (XVa) with 1-diazoheptan-2-one (XVI) led to the allenic ester (XIIIa).

The polysome as a terminal for the creatine phosphate energy shuttle.

The role of the creatine phosphate shuttle in the energetics of muscle protein synthesis in isolated polysomes, from rat hindlimb muscle, was studied. Triton X-100-treated polysomes, following their centrifugation through a 1 M sucrose gradient, contained 38 mU/mg RNA of bound creatine kinase. In the presence of pH 5 enzyme (obtained from rat liver), 0.5 mM ATP, and 1 microM GTP, amino acid (leucine) incorporation by polysomes in the presence of 8 mM creatine phosphate was twice that in the presence of an exogenous ATP regenerating system of 10 mM phospho(enol)pyruvate and 10 U/ml pyruvate kinase. Since added creatine kinase had no effect on incorporation supported by creatine phosphate it is clear that endogenous creatine kinase allows sufficient regeneration of ATP. These data also suggest that nucleoside diphosphokinase must have been associated with the polysome for phosphate was transferred to GTP from [33P]creatine phosphate, and the specific activities of ATP and GTP increased at equal rates, reaching the specific activity of creatine phosphate at 8 min. We conclude that skeletal muscle polysomes have bound creatine kinase activity and they act as terminals for the creatine phosphate energy shuttle. Creatine phosphate regenerates GTP, probably through an intermediate reaction catalyzed by nucleoside diphosphokinase. This provided an added support for the hypothesis of compartmentation of enzymes and substrates and that the transport form of energy between the mitochondria and energy utilizing sites in muscle is creatine phosphate rather than ATP, which extends the general role of the creatine phosphate energy shuttle.

Free creatine available to the creatine phosphate energy shuttle in isolated rat atria.

To measure the actual percentage of intracellular free creatine participating in the process of energy transport, the incorporation of [1-14C]creatine into the "free" creatine and phosphocreatine (PCr) pools in spontaneously beating isolated rat atria, under various conditions, was examined. The atria were subjected to three consecutive periods, control, anoxia, and postanoxic recovery, in medium containing tracers of [1-14C]creatine. The tissue content and specific activity of creatine and PCr were determined at the end of each period. The higher specific activity found for tissue PCr (1.87 times) than creatine, independent of the percentage of total intracellular creatine that was present as free creatine, provides evidence for the existence of two separate pools of free creatine. Analysis of the data shows that in the normal oxygenated state approximately equal to 9% of the total intracellular creatine is actually free to participate in the process of energy transport (shuttle pool). About 36% of the total creatine is bound to unknown intracellular components and the rest exists as PCr. The creatine that was taken up and the creatine that was released from the breakdown of PCr have much greater access to the site of phosphorylation than the rest of the intracellular creatine. A sharp increase in the specific activity of residual PCr on prolongation of anoxic time was also observed. This provides evidence for a nonhomogeneous pool of PCr, for the most recently formed (radioactive) PCr appeared to be hydrolyzed last.

Mitochondrial creatine phosphokinase deficiency in diabetic rat heart.

The role of the mitochondrial end of the phosphocreatine energy shuttle was studied in the streptozotocin diabetic rat heart. Diabetic rats had 45 +/- 5% lower body weight and yielded 46 +/- 6% less mitochondria gm of protein than normals. Diabetic heart mitochondria had 32 +/- 7% lower creatine phosphokinase (CPK) activity and 59 +/- 10% lower oxygen consumption rate than normal heart mitochondria. Creatine (25 mM) did not stimulate oxygen uptake by diabetic heart although control (normal) heart mitochondria were stimulated. Inadequate mitochondrial energy production in the form of phosphocreatine could result in lower energy delivery to the myofibrillar contraction sites and might be an important factor in diabetic cardiomyopathy and weight loss.

Effects of magnesium depletion on myocardial high-energy phosphates and contractility.

The effect of prolonged magnesium depletion on contractility, phosphorylating activity, and organic phosphates of spontaneously beating isolated rat atria was studied. Rats were fed a Mg-deficient diet for 8 weeks, during which serum Mg fell from 1.85 +/- 0.02 to 0.52 +/- 0.10 mg/dl. Atrial contractile activity was measured for 1 hr and at the end of this period tissue samples were taken for the determination of the phosphorylated intermediates. Mg depletion was associated with (a) reduced intracellular inorganic phosphorus and adenine nucleotides; (b) elevated creatine phosphate; (c) reduction in contractile force (CF) with no change in atrial beat rate (BR). There were no significant differences in the activities of creatine phosphokinase and adenylate kinase in control and Mg-depleted rat atrial homogenates determined in the presence of 5 mM MgCl2. Addition of various concentrations of MgCl2 to the medium resulted in an immediate reduction in both CF and BR of normal and Mg-depleted rat atria. Intraperitoneal administration of MgCl2 to Mg-depleted rats resulted in complete recovery of CF of isolated atria. This improvement in CF occurred without changes in the levels of inorganic phosphate and adenine nucleotides. The reduced intracellular level of high-energy phosphate or inorganic phosphate cannot therefore be responsible for the impaired contractility seen in Mg-depleted heart muscle. On the other hand, the fact that the creatine phosphate levels were higher in magnesium depletion suggests that myofibrillar utilization of creatine phosphate is more impaired than production, analogous to phenomena seen in postanoxic recovery.

Recovery of isolated rat atrial function related to ATP under different anoxic conditions.

Spontaneously beating isolated rat atria were subjected to 1 h of anoxia at 37 degrees C in various cardioplegic solutions. Contraction continued for different times upon initiation of anoxia, depending on the nature of the cardioplegic solution. Two hundred micromolar P1,P5-di(adenosine-5')pentaphosphate (Ap5A) stopped atrial function in less than 30 s of anoxia in contrast to 50 s in the case of Hearse's cardioplegic solution (16 mM MgCl2, 16 mM KCl, 1 mM Procaine), and 20 min in the case of controls. The stopping time was also prolonged from 30 to approximately 50-55 seconds if a lower concentration of Ap5A (100 microM) was used. Function, adenine nucleotides (AN), and phosphocreatine (PCr) were then measured 20 min after reoxygenation. The recovery of both function and AN was most rapid and complete with 200 microM Ap5A (97% recovery in ATP and 100% in function) and least complete in control (50% recovery in ATP and 78% in function). A positive correlation between recovery of ATP, or total adenine nucleotides, and recovery of function was observed in all cases. The higher the level of ATP remaining at the end of 1 h of anoxia and the more recovered after 20 min of reoxygenation, the more complete the recovery of function. The PCr returned to normal or even higher than normal values in all cases, even though function returned only in proportion to ATP. Since PCr is mitochondrial in origin, it appears that loss of a portion of the AN localized at the energy-utilizing sites occurred before serious mitochondrial damage and was responsible for the incomplete postanoxic functional recovery.

Postanoxic recovery of spontaneously beating isolated atria: pH related role of adenylate kinase.

The functional activity, adenine nucleotides, and creatine phosphate content of spontaneously beating isolated rabbit atria were measured prior to anoxia, after 1 hr anoxia, and at the end of 1 hr reoxygenation at pH 6.7 and 7.2 During anoxia at pH 7.2 there was 13.3% loss of adenine nucleotides pool, 35.2% loss of ATP, 36.2% increase in ADP, 200% increase in AMP, and a decrease to 8.8% of CP assayed to the beating atria in oxygen. At pH 6.7 there was almost the same decrease in CP, about 10% decrease in ATP, no change in total adenine nucleotides, no change in AMP and a higher increase in ADP (88.7%). The postanoxic recovery was much more complete when the pH was 6.7 during anoxia, and the first 40 min of reoxygenation. The extent of recovery of functional activity correlated well with the level of ATP in all cases not CP. Since the adenylate kinase and ATPase activity both decrease at acidic pH, their combined diminution would tend to preserve the adenine nucleotide pool and thus the better recovery at pH 6.7, because of a decrease in energy demand and unavailability of AMP for the degradation process. This study also supports the notion of compartmented adenine nucleotides connected by the creatine phosphate-creatine energy shuttle.

Myokinase and contractile function of glycerinated muscle fibers.

Glycerinated rabbit psoas muscle fibers containing native CPK, ATPase, and myokinase activities were used and isometric contraction and relaxation responses to either ADP or ATP + CP or to ATP alone in the presence and absence of P1, P5-di(adenosine-5'-pentaphosphate), a myokinase inhibitor, were compared. In previous (14) work it was shown that CP generated more efficient and faster contraction and relaxation of glycerinated muscle fibers than ATP. The present work deals with the role of myokinase in the differential response of fibers to CP and ATP. Inhibition of the myokinase activity of these fibers caused slight diminution of the rate of contraction at physiological concentrations of ATP. Uninhibited fibers were not able to reach maximum contraction, because the tension began to drop gradually even in the presence of Ca2+. Addition of Ap5A permitted maximum contraction and the ability to stay at the contracted state. In the case of CP + adenosine nucleotides (ATP or ADP), myokinase activity decreased the rate of tension development which was statistically significant after 5-7 sec of contraction. Thus, a higher tension was obtainable when myokinase was inhibited. At high concentration of adenine nucleotides (greater than 2 mM) and in the absence of Ap5A, not only the maximum tension never was reached, but a spontaneous drop in tension was observed before addition of EGTA, as was seen with ATP alone. Relaxation was faster and more complete in the presence of uninhibited myokinase activity except that the ADP was low (125 mM). These observations provide further evidence for a close functional interaction of these three enzymes in the mechanism of contraction and relaxation, giving further support to the notion of the creatine-phosphocreatine energy shuttle.

Myofibrillar end of the creatine phosphate energy shuttle.

Isometric contraction and relaxation of glycerinated rabbit psoas muscle fibers containing native creatine kinase (CK) and ATPase activities were studied. Energy for contraction and relaxation was provided either by ADP + creatine phosphate (CP) or ATP alone, and the effectiveness of these additions on rate and maximum force of contraction and relaxation were compared. In the presence of 250 microM ADP, physiological concentration of CP (10 mM) produced faster and stronger contraction and faster and more complete relaxation than equimolar or even higher concentrations of ATP. When contraction was initiated by addition of ADP to fibers preincubated with 10 mM CP, the apparent Km for ADP was 1.18 +/- 0.24 mM. If the fibers were preincubated with ADP and contraction initiated by addition of 10 mM CP, the apparent Km for ADP was more than an order of magnitude smaller (76.0 +/- 4 microM). The observed Km for ADP for contraction was about half the Km for CP in solution (151.5 microM). The apparent Km for CP for rate of contraction was 2.67 +/- .046 mM independent of sequence of addition of ADP. Since these experiments were done in the presence of P1,P5-diadenosine 5'-pentaphosphate, a powerful inhibitor of adenylate kinase, the role of this enzyme in the process was not significant. These observations support the idea of compartmentation of myofibrillar CK in close function with myosin ATPase as part of the phosphoryl creatine energy shuttle.

Three-step preparation and purification of phosphorus-33-labeled creatine phosphate of high specific activity.

Rabbit heart mitochondria were used as a source of enzymes for the synthesis of phosphorus-labeled creatine phosphate. This method is based on the coupled reaction between mitochondrial oxidative phosphorylation and mitochondrial-bound creatine kinase. It is possible to convert more than 90% of the inorganic phosphate (Pi) to creatine phosphate. The method used only small amounts of adenine nucleotides which led to a product with only slight nucleotide contamination. This could be removed by activated charcoal extraction. For further purification, a method for the removal of residual Pi is described.

Kinetic properties and functional role of creatine phosphokinase in glycerinated muscle fibers--further evidence for compartmentation.

The following phenomena were observed when relative contraction and relaxation effects of ATP and creatine phosphate (CP) were studied in rabbit psoas muscle glycerinated fiber bundles containing native creatine phosphokinase (CPK) and ATPase activities: (1) nucleotide was absolutely necessary for contraction; (2) in the presence of a small amount of ADP (250 microM), physiological concentration of CP (10 mM) produced faster and stronger contraction and faster, more complete, relaxation than equimolar or higher concentrations of ATP; (3) if the nucleotide was in the form of ATP, the nucleotide Km for contraction was about 1.5 mM; (4) if the nucleotide was in the form of ADP, the nucleotide Km for contraction at physiological concentration of CP (10 mM) was 0.076 to 1.18 mM depending upon the order of addition of ADP and CP; (5) the apparent Km for CP for contraction was 2.67 mM independent of sequence of addition of ADP and CP.

Long-acting contraceptive agents: aliphatic and alicyclic carboxylic esters of levonorgestrel.

Esters of levonorgestrel (13 beta-ethyl-17 alpha-ethynyl-17 beta-hydroxygon-4-en-3-one) with a variety of aliphatic and alicyclic carboxylic acids have been prepared and characterised. In tests for the suppression of estrus in rats, esters with short-chain aliphatic acids and with cyclobutane-carboxylic acid were considerably more active than the standard, norethisterone enanthate (17 alpha-ethynyl-17 beta-hydroxyestr-4-en-3-one). Such esters show great promise for development as long-acting progestogens.

Long-acting contraceptive agents: esters of norethisterone with alpha- and/or beta-chain branching.

The synthesis of eighteen esters of norethisterone (17 alpha-ethynyl-17 beta-hydroxyestr-4-en-3-one) is described. These all possess some form of alpha- and/or beta-substitution in the ester side-chain. The work was undertaken in order to evaluate any long-acting fertility control effect intrinsic in such compounds. A pentamethyl disiloxy ether was also included in the group of substances prepared for testing because of its similar substitution pattern.

Long-acting contraceptive agents: cyclopropyl and cyclobutyl esters of norethisterone.

Several esters of norethisterone (17 alpha-ethynyl-17 beta-hydroxyestr-4-en-3-one) with carboxylic acids containing a cyclopropyl or cyclobutyl ring have been synthesized and the stereochemistries of the side-chains determined.