At pH 2, ovalbumin retains native-like secondary structure as seen by far-UV CD and FTIR, but lacks well-defined tertiary structure as seen by the fluorescence and near-UV CD spectra. Addition of 20 mM Trifluoroacetic acid (TFA) or 30 mM Trichloroacetic acid (TCA) on acid-induced state results in protein aggregation. This aggregated state possesses extensive β-sheet structure as revealed by far-UV CD and FTIR spectroscopy. Furthermore, the aggregates exhibit decreased ANS fluorescence and increased thioflavin T fluorescence. The presence of aggregates was confirmed by size exclusion chromatography. Such a formation of β-sheet structure is found in the amyloid of a number of neurological diseases such as Alzheimer's and scrapie. Ovalbumin at low pH, in the presence of K(2)SO(4), exists in partially folded state characterized by native-like secondary structure and tertiary folds.
Male albino rats were fed different dietary brans at 20% level for two months to study their effect on lipid metabolism. Wheat and corn brans significantly (P less than 0.05) decreased the serum cholesterol level while chickpea bran significantly (P less than 0.05) lowered the liver and heart cholesterol concentrations. Significant (P less than 0.05) reduction was observed in liver and heart triglyceride with all brans. Wheat, corn and chickpea brans fed at 20% level had no significant effect on serum triglyceride concentration.
INTRODUCTION: Esophageal variceal bleeding is one of the leading causes of death in patients with cirrhosis, requiring rapid endoscopic intervention and vasoactive medication administration. When this fails, balloon tamponade using Sengstaken–Blakemore (SB) tube is an effective temporizing measure in up to 90% of patients. However, it can result in esophageal perforation, with potentially fatal septic mediastinitis. Mediastinitis from esophageal perforation carries mortality rates as high as 40-67%, with mortality rate increasing as time to perforation detection increases. Hence a high level of suspicion and rapid identification are key. CASE DESCRIPTION/METHODS: A 56 year old male with history of decompensated Hepatitis C related cirrhosis, recurrent variceal bleeds and portal vein thrombosis (on warfarin), presented with massive hematemesis due to variceal bleed. Despite endoscopy (EGD) with banding, re-bleeding occurred, with rapid drop in hemoglobin from 9 to 5 g/dl. Despite multiple attempts, SB tube was unsuccessful due to resistance. Therefore, the patient was emergently transferred to a tertiary care center for specialist management. Upon presentation, he was found to be in fluid/blood unresponsive shock, requiring high dose vasopressor support. An emergent EGD revealed a 1 cm esophageal perforation above the gastroesophageal junction. CT chest revealed pneumomediastinum. He underwent esophageal stent placement 24 hours later, and was concomitantly treated with antibiotics, antifungals, vasopressors and chest tube insertion for mediastinitis. He slowly stabilized following these interventions, and within 1 week was transferred out of the ICU. DISCUSSION: In patients with fluid/blood unresponsive shock following esophageal manipulation with an SB tube, a high level of suspicion for esophageal perforation and mediastinitis should be maintained. In the past, Xray and esophagogram were thought to be helpful in establishing the diagnosis, however, it is now recognized that going straight to contrast-enhanced CT thorax has the highest yield and will establish diagnosis expediently. This is a necessity, as studies have shown a dramatic reduction in mortality if the diagnosis is made within the first 24 hours, with subsequent initiation of antibiotics and antifungals. Lastly, early consideration for esophageal stenting has also shown to reduce mortality, by tamponading the bleeding varices as well as the perforation.
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