Showing papers by "Medical University of South Carolina published in 1986"
TL;DR: Using a laser-Doppler flowmeter, it was found that the relative surface blood flow in cerebral cortex decreased to 62, 48, and 18% of baseline respectively after successive ligation of the right middle cerebral artery, and the right and left common carotid arteries.
Abstract: In the search for a more reproducible focal ischemic stroke model in the rat, we systematically interrupted blood flow to the right middle cerebral artery territory by ligating the right middle cerebral artery, and the right and left common carotid arteries in succession. Using a laser-Doppler flowmeter, we found that the relative surface blood flow in cerebral cortex supplied by the right middle cerebral artery decreased to 62, 48, and 18% of baseline respectively after successive ligation of the right middle cerebral artery, and the right and left common carotid arteries. A focal infarct in the cerebral cortex supplied by the right middle cerebral artery was consistently noted after ligation of the right middle cerebral and the right common carotid arteries and temporary clip occlusion of the left common carotid artery for 60 min. The surface areas of infarction measured 100 +/- 6 mm2 and the maximal cross-sectional area of infarction was 10.4 +/- 1.1 mm2 (N = 10). The mortality rate was 7% (N = 70). The characteristic changes of ischemic necrosis were limited to the cortex with sparing of subcortical structures. No motor deficits occurred. Occlusion of the right middle cerebral artery alone or together with the right common carotid artery did not consistently cause gross infarction and the maximal cross-sectional area of infarction was smaller (the right middle cerebral artery, 1.7 +/- 0.8 mm2, N = 10; the right middle cerebral artery plus the right common carotid artery, 4.8 +/- 1.9 mm2, N = 10). Permanent ligation of the right middle cerebral artery and both common carotid arteries had a high mortality (60% in 3 days, N = 10).(ABSTRACT TRUNCATED AT 250 WORDS)
620 citations
TL;DR: It is demonstrated here that activated human blood monocyte, but not resting monocytes, release a mediator that attracts smooth muscle cells and cooperates with other mediators to stimulate fibroblast proliferation.
Abstract: Activated human monocytes express the c-sis proto-oncogene and release a mediator showing PDGF-like activity
364 citations
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TL;DR: It can be concluded that many recurrent basal cell carcinomas are aggressive from the beginning, and this often can be predicted from the histologic picture.
Abstract: The pathologic specimens from forty-seven patients with fifty-one recurrent basal cell carcinomas referred for Mohs' surgery were studied. Specimens from the original tumor and from each subsequent recurrence were reviewed. Of the original tumors, 65% demonstrated an aggressive* histologic picture characterized by poor palisading and an infiltrating and/or micronodular pattern. In twelve cases the recurrent tumor developed a more aggressive histologic picture, but in seven cases the histologic picture became more benign. Electrodesiccation and curettage was the initial treatment for forty-one basal cell carcinomas. Ten tumors had been excised previously, with routine pathologic examination indicating tumor-free margins in six of these lesions. It can be concluded that many recurrent basal cell carcinomas are aggressive from the beginning, and this often can be predicted from the histologic picture. Lesions with an aggressive pathologic picture should not be managed by blind technics such as electrodesiccation and curettage and may defy routine pathologic examination of conventional excision specimens. Mohs' surgery appears to be the treatment of choice for such lesions.
163 citations
TL;DR: In this article, the peroxisomal β-oxidation system for very long chain fatty acids is defective in X-linked childhood adrenoleukodystrophy (ALD).
149 citations
TL;DR: Findings provide evidence for the presence in certain sensory cells of a characteristic galactosylconjugate which may prove to be of significance in nerve function.
133 citations
TL;DR: The hypothesis that TxA2 exerts a pathophysiologic effect in shock following bolus endotoxin is supported and the results suggest that some other cyclooxygenase product(s) is involved in septic shock due to fecal peritonitis or cecal ligation.
Abstract: Intravenous bolus endotoxin elicits a marked but transient increase in plasma TxB2 and 6-keto-PGF1 alpha in a large number of species. A smaller, delayed and more prolonged increase in TxB2 and 6-keto-PGF1 alpha are reported in animals with septic shock, i.e., those with fecal peritonitis or cecal ligation. Thromboxane synthetase inhibitors or antagonists attenuate endotoxin-induced acute cardiopulmonary changes, the delayed increase in serum lysosomal enzymes, fibrin/fibrinogen degradation products and the thrombocytopenia in a number of species. While these drugs increase survival of rats or mice following endotoxin they do not alter survival of rats in septic shock. These results support the hypothesis that TxA2 exerts a pathophysiologic effect in shock following bolus endotoxin. In contrast, nonsteroidal antiinflammatory drugs (NSAID) and dietary essential fatty acid deficiency increase survival of rats subjected to endotoxin shock, and survival time in models of septic shock. These results also suggest that some other cyclooxygenase product(s) is involved in septic shock due to fecal peritonitis or cecal ligation. Preliminary experimental studies indicate salutary effects of leukotriene inhibitors and antagonists in endotoxin shock and in models of acute pulmonary injury. Clinical studies have demonstrated elevated plasma TxB2 and 6-keo-PGF1 alpha concentrations in patients with septic shock, and elevated LTD4 in pulmonary edema fluid of patients with the adult respiratory distress syndrome. In view of these clinical and experimental results, clinical trials of NSAID and/or leukotriene inhibitors/antagonists should be considered.
130 citations
TL;DR: The capacity of the internal mammary artery to produce prostacyclin in both a basal and a stimulated state is greater than that of the saphenous vein, which is a possible biochemical explanation for the clinically observed better patency rate of internal Mammary artery grafts.
129 citations
TL;DR: Though the results of this thrust are still preliminary, the exploration of these therapeutic strategies in cerebrovascular disorders based on further understanding of the pathophysiologic roles of TXA2, PGI2, LTs and probably other AA metabolites is anticipated with some optimism.
Abstract: Our understanding of the biochemistry and biologic actions of AA metabolites has been greatly expanded in recent years. The discoveries of TXA2, PGI2, and LTs have fostered new concepts of the pathophysiology of cerebral ischemia. New approaches to treatment of ischemia include seeking an optimal dose of aspirin, developing drugs that selectively inhibit or antagonize TXA2 or LTs, and administering PGI2 or its analogues. Altering the dietary content of essential fatty acids for prophylaxis is also being studied. Though the results of this thrust are still preliminary, the exploration of these therapeutic strategies in cerebrovascular disorders based on further understanding of the pathophysiologic roles of TXA2, PGI2, LTs and probably other AA metabolites is anticipated with some optimism.
123 citations
TL;DR: The effect of diabetes on the structure and function of insulin receptors was studied in rats 7 d after streptozotocin injection, using solubilized, partially purified receptors from rat hindlimb muscles to study peripheral insulin resistance associated with insulinopenic diabetes.
Abstract: The effect of diabetes on the structure and function of insulin receptors was studied in rats 7 d after streptozotocin injection, using solubilized, partially purified receptors from rat hindlimb muscles. Diabetes increased the number of insulin receptors per gram of muscle 60-70% without apparent change in insulin binding affinity. Incubation of receptors at 4 degrees C with [gamma-32P]ATP and insulin resulted in dose-dependent autophosphorylation of the beta-subunit on tyrosine residues; receptors from diabetic rats showed decreased base-line phosphorylation, as well as a decrease in autophosphorylation at maximally stimulating insulin concentrations. These receptors also showed diminished exogenous substrate kinase activity using histone H2b and angiotensin II as phosphoacceptors. The electrophoretic mobility (sodium dodecyl sulfate-polyacrylamide gel electrophoresis) of a subpopulation of beta-subunits derived from diabetics was slightly decreased; differences in electrophoretic mobility between control- and diabetic-derived beta-subunits were enhanced by generating fragments by partial Staphylococcus aureus V8 protease digestion. Endoglycosidase-H or neuraminidase treatment increased the electrophoretic mobility of beta-subunits in both groups, but only neuraminidase appeared to decrease or abolish differences in electrophoretic mobility between controls and diabetics, suggesting that excess sialilation may account, in part, for the altered mobility of diabetic derived beta-subunits. All structural and functional alterations in insulin receptors were prevented by treating diabetic rats with insulin for 60 h. Peripheral insulin resistance associated with insulinopenic diabetes may be related to modifications in insulin receptor structure, resulting in impaired signal transmission.
TL;DR: The effects of a standardized mixed meal, a self-selected meal and a sham meal on heart rate, arterial pressure, cardiac output, total systemic resistance and echocardiographic indexes of left ventricular performance were examined in normal volunteers.
Abstract: The effects of a standardized mixed meal, a self-selected meal and a sham meal on heart rate, arterial pressure, cardiac output, total systemic resistance and echocardiographic indexes of left ventricular performance were examined in normal volunteers. Supine heart rate and cardiac output increased after the meals (p less than 0.07 to 0.001), but not after the sham meal. Supine diastolic blood pressure and total systemic resistance decreased after the meals but not after the sham meal (p less than 0.05 to 0.001). Ejection fraction and mean velocity of circumferential fiber shortening increased after the standard meal (p less than 0.01) and tended to increase after the self-selected meal, but did not increase after the sham meal. Meals of normal size may induce splanchnic vasodilation and a decrease in total systemic resistance. Ingestion of food also significantly affects heart rate, blood pressure, cardiac output and echocardiographic indexes of left ventricular performance. Patients should not eat during short-term evaluation of cardiovascular interventions because the cardiovascular effects of a meal may compromise interpretation of the cardiovascular effects of the primary intervention. The hemodynamic effects of food may also interact with the effects of cardiovascular disease processes.
TL;DR: Examination of the frontal cortex of human and canine brains showed a similar distribution of nonpyramidal neurons with affinity for GalNAc‐binding lectins, and the periodic character of the neuronal surface staining suggested a location for the reactive glycoconjugate in or between the synapses.
Abstract: Paraffin embedded sections of rat, mouse, dog, and human brain were stained with a battery of lectin-horseradish perioxidase conjugates to localize and characterize glycoconjugates. In the rat and mouse cerebral cortex, a subpopulation of nonpyramidal neurons stained selectively with three lectins with specific affinity for terminal N-acetylgalactosamine (GalNAc). These and only these lectins stained the surface of the cell body, dendritic shafts, and proximal parts of the dendritic arborization. Most reactive, nonpyramidal neurons revealed a multipolar dendritic pattern, but some possibly belonged to the bitufted and bipolar types of neuron. The GalNAc-containing neurons appeared widely distributed in layers II-VI with relatively greater abundance in layers IV and V. In the cortex of rats and mice the stained neurons occurred in moderate numbers in the frontal, frontoparietal, striate, retrosplenial, and entorhinal regions, but were less numerous in the hippocampal gyrus, dentate gyrus, and olfactory area. Other neurons in the basal ganglia and brain stem stained weakly for GalNAc. Examination of the frontal cortex of human and canine brains showed a similar distribution of nonpyramidal neurons with affinity for GalNAc-binding lectins. At high magnification, the surface staining of neurons in the cerebral cortex, deep cerebellar nucleus, and other sites appeared periodic rather than continuous. The periodic character of the neuronal surface staining suggested a location for the reactive glycoconjugate in or between the synapses. The GalNAc-containing glycoconjugate occurred in a selected cell type, failed to bind the other lectin conjugates, and differed from biochemically detected glycoconjugates. It is, therefore, considered a newly recognized entity of possible physiologic significance for a population of cortical neurons.
TL;DR: Estimates of the prevalence of Raynaud phenomenon were obtained using the following criteria: cold sensitive subjects reporting white and/or blue color changes; cold sensitivity leading to medical consultation; combination of the two criteria above: 1.9%.
TL;DR: It is concluded that atriopeptin secretion by the atrial myocyte is stimulated by activation of the α-1 adrenergic receptor, which suggests an involvement of the sympathetic nervous system in the physiologic regulation of the secretion of this hormone.
TL;DR: In this article, the authors found that patients with underlying risk factors for upper airway obstruction, such as a forme fruste of sleep apnea or nasopharyngeal abnormalities, appear to be at increased risk for the development of pulmonary edema in the setting of intubation and anesthesia.
TL;DR: In this article, the authors treated seven patients with chronic renal failure and bleeding gastrointestinal telangiectasias with systemic estrogen or estrogen-progesterone in an uncontrolled trial.
Abstract: Gastrointestinal telangiectasias cause hemorrhage in patients with chronic renal failure. Therapies using vasoconstrictors, endoscopic application of heat, and surgery have had limited efficacy. Because several reports have suggested that estrogen or estrogen-progesterone therapy may control mucosal bleeding from telangiectasias in patients with hereditary hemorrhagic telangiectasia, we treated seven patients with chronic renal failure and bleeding gastrointestinal telangiectasias with systemic estrogen or estrogen-progesterone in an uncontrolled trial. Bleeding ceased in all patients. Blood transfusion requirements decreased from a mean of 1.2 U/month before treatment to 0.21 U/month after treatment. No significant side effects were noted. Results of this trial indicate the need for controlled investigations of this type of hormonal therapy.
TL;DR: The data indicate that serum prolactin levels always rise after complex partial seizures involving the temporal lobes, and rise after certain simplepartial seizures involving limbic structures, which may depend upon spread of the seizure to subcortical structures.
Abstract: A study was performed to evaluate changes in serum prolactin levels after simple and complex partial seizures, and to identify which specific anatomical structures must be involved in seizures for postictal elevation of prolactin levels to occur. Seventy-eight seizures were studied in patients with electrodes implanted bilaterally into amygdala, hippocampus, hippocampal gyrus, and frontal sites. All 38 complex partial seizures had bilateral limbic ictal discharges, and each was followed by a significant increase in prolactin concentration (mean peak, 50.8 ng/ml; range, 16.0 to 150.0 ng/ml). Eight of 10 simple partial seizures with unilateral high-frequency regional limbic discharges were followed by prolactin elevation (mean peak, 28.2 ng/ml; range, 13.4 to 44 ng/ml). Thirty simple partial seizures with other ictal limbic discharges or without limbic discharges were not followed by an elevated prolactin level. The data indicate that serum prolactin levels always rise after complex partial seizures involving the temporal lobes, and rise after certain simple partial seizures involving limbic structures. Thus, measurement of the prolactin level can help identify which simple partial seizures involve mesial temporal lobe structures. Limbic structures serve to trigger prolactin release, which may depend upon spread of the seizure to subcortical structures.
TL;DR: Hospital epidemiologists and clinical microbiologists will likely have an ever-increasing need to determine the plasmid content of gram-negative bacilli producing endemic and epidemic nosocomial infections.
Abstract: Bacterial plasmids have become valuable markers for the comparison of strains of nosocomial gram-negative bacilli. The importance of plasmids in nosocomial infections is primarily due to their transferable antibiotic resistance genes (R plasmids), but other plasmid-mediated traits may eventually serve as potential markers. Stable cryptic plasmids have also served to relate outbreak strains, particularly nonfermenting strains of gram-negative bacteria. Klebsiella pneumoniae and Serratia marcescens have been the major plasmid-containing species in outbreaks involving single or multiple species. Outbreaks of single species with common plasmid patterns have included the Enterobacteriaceae, Pseudomonas aeruginosa, Pseudomonas cepacia, Ewingella americana, and Legionella pneumophila. Intrageneric spread of the same or similar R plasmids has nearly always occurred within the Enterobacteriaceae in large medical centers or Veterans Administration hospitals. High-risk nurseries and burn units have been conspicuous foci for R plasmid evolution. Hospital epidemiologists and clinical microbiologists will likely have an ever-increasing need to determine the plasmid content of gram-negative bacilli producing endemic and epidemic nosocomial infections.
TL;DR: The results indicate that plasma fibronectin levels can be abnormally increased long before the onset of clinical symptoms and that abnormalities of this glycoprotein may be an early indication of this pathologic process.
TL;DR: In this article, the sperm swimming speed and motility index of 35 fertile men and husbands of 32 infertile couples were evaluated with the use of a rapid computerized sperm motion analysis (CSA).
TL;DR: Stimulation of peripheral-blood B-lymphocytes with phorbol ester or anti-immunoglobulin demonstrated intracellular translocation of phospholipid/Ca2+-dependent protein kinase (C-kinase) activity from cytosol to membrane fractions, suggesting that C-kinased protein phosphorylation may be related to membrane receptor occupation and may therefore be important in B-LYmphocyte responses.
Abstract: Stimulation of peripheral-blood B-lymphocytes with phorbol ester or anti-immunoglobulin demonstrated intracellular translocation of phospholipid/Ca2+-dependent protein kinase (C-kinase) activity from cytosol to membrane fractions. This phenomenon, which was dose- and time-dependent, was found in both normal and chronic-lymphocytic-leukemia B-cells. This suggests that C-kinase-dependent protein phosphorylation may be related to membrane receptor occupation and may therefore be important in B-lymphocyte responses.
TL;DR: Data support the concept that some of the macrophage colony- forming cells that respond to IL 3 are more primitive than those that are sensitive to CSF-1, and result in significant increases in the size of both macrophages and neutrophil-macrophage colonies.
TL;DR: It is critically important to realize that blood concentrations and pharmacokinetics of racemates often do not reflect those of the active enantiomers, as Thomas Walle and Kristina Walle point out.
TL;DR: Changes in propranolol disposition, as the result of a high‐protein meal, are consistent with a transient increase in hepatic blood flow, as measured by indocyanine green clearance.
Abstract: The influence of a high-protein meal as compared to fasting on the disposition of simultaneous intravenous and oral doses of propranolol, as well as on indocyanine green clearance, was examined in six normal subjects. The intravenous dose (0.1 mg/kg) was unlabeled propranolol and the oral dose (80 mg) was a stereospecifically deuterium-labeled pseudoracemate of propranolol. Systemic clearance of propranolol increased 38%, from 1005 +/- 57 to 1384 +/- 115 ml/min (mean +/- SE; P less than 0.05) as a result of the meal, with no change in t1/2 or apparent volume of distribution. A 12% decrease in oral clearance occurred with the meal but was not statistically significant (3717 +/- 185 ml/min, fasting; 3245 +/- 498 after meal), whereas bioavailability increased 67% (27.2% +/- 1.7% fasting; 45.5% +/- 4.3% after meal; P less than 0.01). Estimated hepatic blood flow, as measured by indocyanine green clearance, rose 34% 60 minutes after the meal (1719 +/- 155 ml/min fasting; 2304 +/- 218 ml/min after meal; P less than 0.02). A difference was observed in the oral clearance of the propranolol enantiomers in the fasting state, but this difference was unaffected by the meal. These alterations in propranolol disposition, as the result of a high-protein meal, are consistent with a transient increase in hepatic blood flow.
TL;DR: Platelet size and the distribution of platelet sizes are both increased in preeclamptic patients with normal platelet counts, and these changes suggest that accelerated platelet production and consumption are both widespread in preeClampsia.
TL;DR: The existence of defective cellular immune functions in both elderly Down's patients and Alzheimer's patients is demonstrated by the significantly decreased levels of peripheral blood lymphocytes from Alzheimer's disease patients relative to healthy controls.
TL;DR: Observations show that some but not other populations of GABAergic neurons possess binding capacity for VVA on their surface, and some neurons with surface glycoconjugate containing terminal GalNAc are therefore not GABAergic.
Abstract: Sections of fixed, paraffin-embedded brain from mice and rats were stained with agglutinin fromVicia villosa conjugated to horseradish peroxidase (VVA-HRP) to localize glycoconjugate containing terminalN-acetylgalactosamine (GalNAc). VVA-HRP binding sites were localized in periodic foci at the surface of a selective population of non-pyramidal interneurons in layers II through VI of the rodent cerebral cortex. These multipolar interneurons were shown to utilize γ-aminobutyric acid (GABA) as a transmitter and thus to be GABAergic by their immunostaining for glutamic acid decarboxylase (GAD) throughout the cytoplasm in serial sections. Pyramidal and other non-pyramidal cortical neurons received GABAergic input as evidenced by punctate immunostaining for GAD on their soma and proximal dendritic aborizations, but these cells failed to show VVA affinity or cytosolic GAD reactivity. Most neurons in the thalamic reticular nucleus stained for the presence of glycoconjugate with terminal GalNAc on their surface and for GAD in the cytosol. In contrast, cerebellar Purkinje cells showed strong cytosolic reactivity with anti-GAD but lacked surface staining with VVA-HRP. These observations show that some but not other populations of GABAergic neurons possess binding capacity for VVA on their surface. The surface of neurons in the deep cerebellar nucleus stained heavily with VVA but failed to show clear cytosolic reactivity for GAD. Some neurons with surface glycoconjugate containing terminal GalNAc are therefore not GABAergic.
TL;DR: Compared to controls, children who received the program showed an overall increase in knowledge of correct actions to take in the event of potential or actual abuse.
TL;DR: Data suggest that even in the low-risk patient, an early cervical examination could be beneficial, suggesting that a baseline late second-trimester examination could assist in the early but accurate diagnosis of preterm labor should it be suspected later in gestation.