Showing papers by "Icahn School of Medicine at Mount Sinai published in 1985"

Depression and immunity: Lymphocyte function in ambulatory depressed patients, hospitalized schizophrenic patients, and patients hospitalized for herniorrhaphy.

Abstract: • Mitogen-induced lymphocyte stimulation responses in ambulatory patients with major depressive disorder did not differ from those of matched controls. Lymphocyte responses in hospitalized schizophrenic patients and in patients hospitalized for elective herniorrhaphy similarly did not differ from responses of controls. The number of peripheral-blood T cells was decreased among the ambulatory depressed patients but not in the schizophrenic patients. These findings, together with previously reported decreased lymphocyte function in hospitalized depressed patients, suggest that decreased lymphocyte function is associated specifically with depression and not related to hospital effects or nonspecifically to other psychiatric disorders. The results also suggest that altered immunity in depression may be related to severity of depressive symptoms.

Plasma Homovanillic Acid Concentration and the Severity of Schizophrenic Illness

Abstract: Concentrations of plasma homovanillic acid before treatment were highly correlated with global severity of illness in schizophrenic patients, both before and after treatment. In contrast, a fixed dose of haloperidol did not affect those concentrations. Thus, in patients with a diagnosis of schizophrenia, plasma homovanillic acid may reflect the severity of illness, but not be influenced by short-term pharmacological perturbations by neuroleptics.

Compulsive Sexual Behavior: Definition of a Problem and an Approach to Treatment

Abstract: Sexual compulsivity is defined as a lack of control over one's sexual behavior. Data were collected on 30 gay and bisexual men in New York City who defined themselves as sexually compulsive and who sought treatment for the problem, in order to determine: 1) whether they differed in psychological profile and sexual behavior from a matched control group of men seeking general psychotherapy; and 2) what the effect is of group psychotherapy for sexual compulsivity on the sexual behavior of group participants. It was found that men who are sexually compulsive differ from controls primarily in terms of the frequency and type of their sexual behavior. They do not display more neurotic symptoms. Further, it was found that group psychotherapy helps participants reduce the frequency of their sexual encounters with different partners. An objective measure of the sense of control one has over his/her sexual behavior is needed for further research on this subject.

American Opiophobia:: Customary Underutilization of Opioid Analgesics

Abstract: American physician markedly undertreat severe pain based on an irrational and undocumented fear that appropriate use will lead patients to become addicts. Such irrational fear-opiophobia-resists educational intervention as phobic fears resist rational explanation and exploration. Because this phobia has become fixed in the customary behavior of physicians, it is particularly resistant to change. Re-education might better be directed to the changing of mistaken attitudes about drug use and abuse that are part of the American culture and which are not amenable to alteration by medical education.

Relation of acute myocardial infarction to cocaine abuse.

Abstract: It is estimated that 10 million Americans have used cocaine and that 5 million use it regular1y.l Although cocaine was first introduced in 1884 as a local anesthetic, little information appeared on the cardiovascular effects of cocaine use until recently. Cocaine abuse has been associated with tachycardia, systemic hypertension, ventricular arrhythmias, acute myocardial infarction (AMI) and sudden death.2-7 Coleman et al2 reported the first case of AM1 associated with illicit use of cocaine; however, the patient was presumed to have underlying coronary artery disease, although he did not undergo coronary angiography. Kossowsky and Lyon3 described 6 patients with AMI attributed to cocaine abuse. Four of their patients had some degree of atherosclerotic narrowing of the coronary arteries by angiography or autopsy and 2 did not have cardiac catheterization. Schachne et al4 described another patient whose coronary arteries were normal. We describe another cocaine user who had AMI.

Complications in Vascular Surgery

Abstract: Pitfalls of Noninvasive Vascular Testing Dennis F. Bandyk Cardiopulmonary Complications Related to Vascular Surgery W. Darrin Clouse and David C. Brewster Renal Failure and Fluid Shifts Following Vascular Surgery Gregory J. Cherr and Kimberly J. Hansen Intimal Hyperplasia: The Mechanisms and Treatment of the Response to Arterial Injury Michael J. Englesbe and Alexander W. Clowes The Healing Characteristics, Durability, and Long-Term Complications of Vascular Prostheses Glenn C. Hunter and David A. Bull Anastomatic Aneurysyms Gary M. Jacobs and Alexander D. Shepard Hypercoaguable States and Unexplained Vascular Graft Thrombosis Jonathan B. Towne Complications and Failures of Anticoagulant and Antithrombotic Therapy John R. Hoch Gastrointestinal and Visceral Ischemic Complications of Aortic Reconstruction Daniel J. Reddy and Hector Dourron Spinal Cord Ischemia Alfio Carroccio, Nicholas J. Morrissey, and Larry H. Hollier Impotence Following Aortic Surgery Richard Kempczinski Complications Following Reconstructions of the Pararenal Aorta and Its Branches Kenneth J. Cherry Complications of Modern Renal Revascularization Jeffery D. Cardneau and Louis M. Messina The Diagnosis and Management of Aortic Bifurcation Graft Limb Occlusions Mark T. Eginton and Robert A. Cambria Problems Related to Extra-Anatomic Bypass Including Axillofemoral, Femorofemoral, Obturator, and Thoracofemoral Bypasses Kyle Mueller and William H. Pearce

Structure and macromolecular organization of type VI collagen.

Abstract: Collagen VI is a large, disulfide-bonded protein complex which is widely distributed in connective tissue The constituent polypeptide chains (Mr = 110,000-140,000) consist of collagenous and noncollagenous segments, are degraded to chains of about half the size when collagen VI is solubilized by pepsin, and assemble to a unique pattern of oligomers As revealed by electron microscopy, the triple-stranded protomer consists of a triple helix 105 nm in length flanked on each side by globular domains of similar size (diameter about 7 nm) Protomers are assembled to dimers by an antiparallel staggered alignment of triple-helical segments This leads to inner regions, 75 nm in length, of two slightly supercoiled triple helices flanked by globular domains At both sides 30-nm-long outer triple-helical segments emerge that are terminated by globules Tetramers are formed from laterally aligned dimers that cross with their outer triple-helical segments in a scissors-like fashion The same structures, except with much smaller globular domains, are found in pepsin-treated collagen VI Disulfide-linked collagen VI produced by cultured fibroblasts has a size similar to that of genuine collagen VI found in tissue extracts Larger forms of collagen VI are assembled from tetramers by end-to-end aggregation which because of an overlap of the outer segments brings all globular domains close together This arrangement predicts microfibrillar structures in tissues with a periodicity of 100-110 nm and a diameter of 5-10 nm Structures consistent with this proposal were indeed found by immunoelectron microscopy of placenta and aorta using the ferritin technique Large, lateral aggregates of collagen VI microfibrils may in addition exist in cell cultures and tissues ("zebra collagen," "Luse bodies") and are presumably maintained by contacts between globular domains

Detection of benzo(a)pyrene:DNA adducts in human white blood cells.

Abstract: Metabolic activation of benzo(a)pyrene (BP) to its ultimate carcinogenic form, 7β,8α-diol-9α,10α-benzo(a)pyrene epoxide (BPDE), and the binding of BPDE to DNA are important steps in BP carcinogenicity in experimental animals. Since people of certain occupations are exposed to high concentrations of BP, we have used enzyme-linked immunosorbent assay and ultrasensitive enzymatic radioimmunoassay to measure BPDE:DNA adducts in white blood cells from 2 of these occupational groups. Seven of 28 samples from roofers and 7 of 20 samples from foundry workers were positive for BPDE:DNA adducts (range, 2 to 120 fmol BPDE/50 μg DNA). In a group of nine volunteers without these industrial exposures to BP, the two positive DNA samples were from cigarette smokers. Control DNA obtained from human lymphocyte cell line RPMI 4265 was negative. These results indicate that the metabolic activation of BP and formation of BPDE:DNA adducts occurs in humans.

Unraveling the effects of compensation, litigation, and employment on treatment response in chronic pain

Abstract: Although it has often been suggested that chronic pain patients who are receiving workmen's compensation or who have litigation pending are less likely to benefit from treatment, the results of outcome studies of this question conducted by various pain clinics have been inconsistent. We hypothesized that poorer outcome in such patients may be related to the fact that they are less likely to be working and that the inconsistent results in the literature may therefore be explained by variability among studies in the percentages of patients who are receiving compensation (or who have litigation pending) who are also working. We examined the relationships among compensation, litigation, employment, and short- and long-term treatment response in a series of 454 chronic pain patients. Compensation benefits and employment status both predicted poorer short-term outcome in univariate analyses; however, when employment and compensation were jointly used to predict outcome in multiple regression analyses, only employment was significant. In additional analyses, only employment significantly predicted long-term outcome, whereas compensation and litigation did not. Our results suggest that it would be valuable to redirect attention away from the deleterious effects of the ‘compensation neurosis’ and toward the roles of activity and employment in the treatment and rehabilitation of chronic pain patients.

Vasodilator therapy for primary pulmonary hypertension. Limitations and hazards.

Abstract: Vasodilator drugs were initially administered to patients with primary pulmonary hypertension based on the unproven hypothesis that pulmonary vasoconstriction played an important role in the pathogenesis of the disease. There were early reports of hemodynamic and clinical improvement after treatment with various vasodilating agents, but subsequent experience did not confirm these uncontrolled observations, and emphasized the limitations and hazards of this approach. Vasodilator therapy generally fails to reduce pulmonary vascular resistance selectively during long-term administration and frequently leads to systemic hypotension, exacerbation of the pulmonary hypertensive state, worsening of right ventricular failure, and systemic arterial desaturation. Beneficial hemodynamic responses are seen in only 15% to 25% of patients. Vasodilator therapy should not be considered an established treatment of patients with primary pulmonary hypertension.

Deprenyl protects dopamine neurons from the neurotoxic effect of 1-methyl-4-phenylpyridinium ion.

Abstract: 1-Methyl-4-phenylpyridinium ion (MPP+) is the product of the metabolic oxidation of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) by monoamine oxidase (MAO). MPP+ is toxic to 3,4-dihydroxyphenylethylamine (dopamine, DA) neurons in explant cultures of rat embryonic midbrain. Addition of 2.5 microM MPP+ to the feeding medium for 6 days results in significant reduction of the DA levels in the cultures (to 19% of control) as well as in the uptake of [3H]DA (to 32% of control). When the cultures are treated with the MAO inhibitor deprenyl (10 microM) 24 h prior to and during exposure to MPP+, the DA neurons are protected from the toxicity of the drug. In the combined deprenyl plus MPP+ treatment, the levels of DA in the cultures remain at the control range and the [3H]DA uptake is reduced to only 73% of control. These results indicate that MAO is involved in the toxicity of MPP+ on DA neurons.

Collagen fibrillogenesis in human skin.

Abstract: Although considerable progress has been made with respect to our understanding of the biosynthesis and structure of interstitial collagens, the actual events involved in collagen fibril formation remain poorly understood. Numerous questions remain unsolved: What is the monomeric unit for fibril formation? Does fibril formation involve the polymerization of individual monomeric units or larger molecular aggregates? Does fibril formation initiate at or near the cell surface or away from cells in the extracellular matrix? Does fibrillogenesis require the participation of other connective tissue components such as fibronectin and proteoglycans? There is some evidence that procollagen molecules are packed intracellularly within secretory vacuoles and then released into the extracellular matrix.' It is assumed that following the cleavage of the aminoand carboxylpropeptides by specific proteases, collagen molecules spontaneously polymerize to form collagen fibrils. The sequence and the rate of removal of extension propeptides appears to vary with tissues and with the type of procollagen. Organ culture studies showed that the aminopropeptide of type 111 procollagen was released more slowly than the carboxylpropeptide, whereas the opposite sequence was demonstrated for type I procollagen in cultured fibroblasts? In embryonic chick calvaria the aminopropeptide of type I procollagen is removed before the carboxylpropeptide while in smooth muscle cell cultures the carboxylpropeptide is removed before the aminopropeptide? However, regardless of the sequence for removal of the propeptides, it is generally accepted that both propeptides have to be cleaved for normal fibrillogenesis to proceed. The hypothesis that collagen molecules polymerize spontaneously in the extracellular matrix is based on in vitro data: These studies showed that collagen molecules in solution interact and form fibrils when the temperature is raised to 37°C. Recent studies on chick embryogenesis of skin showed that the aminopropeptides of type I and type I11 collagens participate in fibrillogenesis and may regulate fibril diameter.' The purpose of this study is to present additional data on the role of the aminopropeptide of type I and type I11 collagen during fibrillogenesis of embryonic and adult human skin and to discuss current hypotheses on the mechanism of collagen fibrillogenesis.

Cocultures of human thyroid monolayer cells and autologous T cells: impact of HLA class II antigen expression

Abstract: Normal human thyroid cells in monolayer culture were induced to express surface HLA class II antigens (DR and DQ) by lectin stimulation. HLA class II positive thyroid cells caused proliferation of autologous T cells, a phenomenon not found in the absence of detectable HLA class II antigen expression. Autologous T cell proliferation was further stimulated by the presence of lectin-free interleukin-2, a known stimulator of activated T cells, and inhibited by monoclonal antibody to HLA-DR antigen. These data demonstrated that normal human thyroid cells, following HLA class II antigen expression, have the capacity to stimulate the immune system. Since over 90% of the monolayer cells were thyrocytes, based on staining with antithyroid microsomal serum, and cells of the monocyte⁄ macrophage series were absent, it is suggested that HLA class II antigen positive human thyroid cells were the principal activators of autologous T cells. Such a mechanism may be important in the target site amplification of human auto...

Histologic correlates and virulence implications of endometrial carcinoma associated with adenomatous hyperplasia

Abstract: The association of endometrial carcinoma (EC) with endocrinopathies manifested by obesity, nulliparity, and/or increased estrogen levels of exogenous or endogenous estrogens is now well-known EC is also seen in patients without these findings Are these different cancers ? Seventy-four cases of EC were reviewed and classified into two groups: group I, with associated adenomatous hyperplasia (AH), 31 cases; and group II, without associated AH, 43 cases Group I included more well-differentiated and less invasive carcinomas; histologically, the pattern was glandular in all cases In Group II, the EC were less well-differentiated, more invasive, and included, besides adenocarcinomas, clear-cell, papillary, and anaplastic carcinomas with giant tumor cells Squamoid features were found in both groups The possible existence of two types of EC, a hormonal-dependent EC associated with AH (which is believed to result from hyperestrogenism, and to have a better clinical prognosis), and an "independent" EC, not associated with AH, is discussed

In vivo treatment of rats with monoclonal anti-T-cell antibodies. Immunohistochemical and functional analysis in normal rats and in experimental allergic neuritis.

Abstract: The effects of intraperitoneal injection of monoclonal anti-rat T-lymphocyte antibodies were evaluated immunohistochemically and functionally in normal rats and in rats with experimental allergic neuritis. In the normal animals a single injection of OX8 antibodies, reactive with suppressor/cytotoxic T cells, completely eliminated OX8-reactive cells from peripheral lymphoid organs and from circulation, whereas the ‘pan’ T-cell-reactive W3/13 antibodies and the helper T-cell-reactive W3/25 antibodies only caused a partial elimination of their respective target cells. Injection of the W3/13 and W3/25 antibodies but not of OX8 antibodies led to a diminished responsiveness to allogeneic stimulation in vitro for spleen cells obtained from the treated rats, whereas the OX8 injection caused a complete elimination of the in vitro cytotoxic response to allogeneic cells in the mixed lymphocyte reaction-activated spleen cell population. When Lewis rats were injected with peripheral nerve myelin and Freund's adjuvant for the induction of EAN, treatment with W3/13 antibodies completely prevented the onset of disease, whereas treatment with the OX8 antibodies exaggerated the disease symptoms.

Induced expression of the glucocorticoid receptor in the rat intermediate pituitary lobe.

Abstract: Synthesis and release of pro-opiomelanocortin-derived peptides are under differential regulation in the anterior and intermediate lobes of the pituitary. Glucocorticoids inhibit synthesis of pro-opiomelanocortin-related peptides in the anterior lobe but not in the intermediate lobe. These two lobes are also characterized by differences in neural innervation and blood flow, both of which may represent routes of access for regulatory factors (the intermediate lobe is avascular). Immunoreactive glucocorticoid receptor, which can be demonstrated in many tissues, is absent from the intermediate lobe. Immunocytochemistry was used to demonstrate the presence of immunoreactive glucocorticoid receptor in the intermediate lobe after pituitary stalk transection, neurointermediate lobe grafts to kidney capsule, or monolayer culture of neurointermediate pituitary cells. This appearance of the glucocorticoid receptor is presumably a consequence of removal of intermediate pituitary cells from neural influences that may be responsible for inhibiting their expression under normal conditions in vivo.