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Examines the influence of distal Gly-21 residue on the chemical step of hydride transfer in dihydrofolate reductase catalysis. Use of sequence conservation information and kinetic data on site-directed mutants; Selection of region spanning position for the mutagenesis and kinetic studies; Enhancement of chemical reaction barrier by motion of distal.

Arterioenteric fistulas are uncommon, particularly when involving the colon and rectum, and death often ensues from multisystem failure.A seventy-eight-year-old man was admitted to the hospital within a few hours after the onset of profuse rectal bleeding. The preoperative diagnosis was perfo rated diverticulitis, but exploratory laparotomy uncovered a ruptured right iliac artery aneurysm that had eroded into the rectum. A diverting sigmoid colosto my and cross femoral grafting were performed, and the patient recovered. Ear ly, aggressive surgical intervention and medical management were essential to the successful outcome of this case. [ABSTRACT FROM PUBLISHER]