Biomedical subjects

A Novotny

Publications and source records attributed to A Novotny.

17 recordsLinked to original sources

PubMed2005

[Indicators for early prediction of outcome in sepsis].

Sepsis is still a major cause of postoperative morbidity and mortality. Numerous biochemical indicators have been evaluated regarding their potential in predicting prognosis in sepsis. Generally, one must differentiate between indicators: those for preoperative detection of patients at risk for lethal sepsis and those for early prediction of lethal outcome of septic complications. The first include the analysis of mononuclear phagocyte interleukin (IL)-12-synthesizing capability. Reduced IL-12 levels were associated with higher lethality. Cytokine-associated gene polymorphisms such as the loss of monocyte HLA-DR expression and homozygotism for the tumor necrosis factor B2 allele have a place in preoperative risk evaluation, as they were associated with worse prognosis in sepsis. Among the most important biochemical indicators for early prediction of lethal outcome in sepsis are decreased L-selectin and elevated IL-18, IL-6, and PCT plasma concentrations. Increased nuclear factor kappaB activity in mononuclear phagocytes and elevated calcitonin gene-related protein plasma concentrations were associated with unfavourable prognosis.

Calcitonin↗

PubMed2003

Transport of 5-aminolevulinic acid between blood and brain.

Little is known about the movement of 5-aminolevulinic acid (delta-aminolevulinic acid; ALA) between blood and brain. This is despite the fact that increases in brain ALA may be involved in generating the neuropsychiatric symptoms in porphyrias and that systemic administration of ALA is currently being used to delineate the borders of malignant gliomas. The current study examines the mechanisms involved in the movement of [(14)C]ALA across the blood-brain and blood-CSF barriers in the rat. In the adult rat, the influx rate constant (K(i)) for [(14)C]ALA movement into brain was low ( approximately 0.2 microl/g per min), was unaffected by increasing plasma concentrations of non-radioactive ALA or probenecid (an organic anion transport inhibitor) and, therefore, appears to be a diffusional process. The K(i) for [(14)C]ALA was 3-fold less than that for [(14)C]mannitol, a molecule of similar size. This difference appears to result from a lower lipid solubility rather than saturable [(14)C]ALA transport from brain to blood. The K(i) for [(14)C]ALA for uptake into the neonatal brain was 7-fold higher than in the adult. However, again, this was unaffected by increasing plasma ALA concentrations suggesting a diffusional process. In contrast, at the blood-CSF barrier, there was evidence of carrier-mediated [(14)C]ALA transport from blood to choroid plexus and blood to CSF. Both processes were inhibited by administration of non-radioactive ALA and probenecid. However, experiments in choroid plexus epithelial cell primary cultures indicated that transport in these cells was polarized with [(14)C]ALA uptake from the apical (CSF) side being about 7-fold greater than uptake from the basolateral (blood) side. In total, these results suggest that the brain is normally fairly well protected from changes in plasma ALA concentration by the very low blood-brain barrier permeability of this compound and by a saturable efflux mechanism present at the choroid plexus.

Aminolevulinic Acid↗

PubMed2003

Fluorescence-guided resections of malignant gliomas--an overview.

Radical resections of contrast-enhancing tumour in patients with malignant gliomas may be pertinent for survival but are often difficult to achieve due to uncertainties in distinguishing tumour margins intra-operatively. In this respect a number of novel methods are being examined which aim at enhancing resections. Among these methods, resections that exploit the accumulation of fluorescent porphyrins within malignant glioma tissue in response to exogenous administration of a metabolic percursor, 5-aminolevulinic acid, may offer particular advantages. This article summarises the clinical background and current status of 5-ALA drug development for fluorescence-guided resections of malignant gliomas and analyses the available literature with regard to possible mechanisms that govern the highly specific accumulation of fluorescent porphyrins in malignant glioma tissue in response to 5-ALA administration.

Aminolevulinic Acid↗

PubMed2000

Mechanisms of 5-aminolevulinic acid uptake at the choroid plexus.

5-Aminolevulinic acid (5-ALA) is a precursor of porphyrins and heme that has been implicated in the neuropsychiatric symptoms associated with porphyrias. It is also being used clinically to delineate malignant gliomas. The blood-CSF barrier may be an important interface for 5-ALA transport between blood and brain as in vivo studies have indicated 5-ALA is taken up by the choroid plexuses whereas the normal blood-brain barrier appears to be relatively impermeable. This study examines the mechanisms of 5-[(3)H]ALA uptake into isolated rat lateral ventricle choroid plexuses. Results suggest that there are two uptake mechanisms. The first was a Na(+)-independent uptake system that was pH dependent (being stimulated at low pH). Uptake was inhibited by the dipeptide Gly-Gly and by cefadroxil, an alpha-amino-containing cephalosporin. These properties are the same as the proton-dependent peptide transporters PEPT1 and PEPT2, which have recently been shown to transport 5-ALA in frog oocyte expression experiments. Choroid plexus uptake was not inhibited by captopril, a PEPT1 inhibitor, suggesting PEPT2-mediated uptake. The presence of PEPT2 and absence of PEPT1 in the choroid plexus were confirmed by western blotting. The second potential mechanism was both Na(+) and HCO(3)(-) dependent and appears to be an organic anion transporter, although it is possible that removal of Na(+) and HCO(3)(-) may indirectly affect PEPT2 by affecting intracellular pH. The presence of PEPT2 and a putative Na(+)/HCO(3)(-)-dependent organic anion transporter is important not only for an understanding of 5-ALA movement between blood and brain but also because these transporters may affect the distribution of a number of drugs between blood and CSF.

Aminolevulinic Acid↗

PubMed2000

Fluorescence-guided resection of glioblastoma multiforme by using 5-aminolevulinic acid-induced porphyrins: a prospective study in 52 consecutive patients.

OBJECT: It has been established that 5-aminolevulinic acid (5-ALA) induces the accumulation of fluorescent porphyrins in glioblastoma multiforme (GBM), a phenomenon potentially exploitable to guide tumor resection. In this study the authors analyze the influence of fluorescence-guided resection on postoperative magnetic resonance (MR) imaging and survival in a series of patients who underwent surgery in the authors' department. METHODS: Fifty-two consecutive patients with GBM received oral doses of 5-ALA (20 mg/kg body weight) 3 hours before induction of anesthesia. Intraoperatively, tumor fluorescence was visualized using a modified operating microscope. Fluorescing tissue was removed whenever it was considered safely possible. Residual enhancement on early postoperative MR imaging was quantified and related to each patient's characteristics to determine which factors influenced resection. Survival was analyzed using the Kaplan-Meier method and multivariate analysis was performed in which the Karnofsky Performance Scale (KPS) score, residual fluorescence, patient age, and residual enhancement on MR images were considered. Intraoperatively, two fluorescence qualities were perceived: solid fluorescence generally reflected coalescent tumor, whereas vague fluorescence mostly corresponded to infiltrative tumor. Complete resection of contrast-enhancing tumor was accomplished in 33 patients (63%). Residual intraoperative tissue fluorescence left unresected for safety reasons predicted residual enhancement on MR images in 18 of the 19 remaining patients. Age, residual solid fluorescence, and absence of contrast enhancement in MR imaging were independent explanatory factors for survival, whereas the KPS score was significant only in univariate analysis. No perioperative deaths and one case of permanent morbidity were encountered. CONCLUSIONS: The observations in this study indicate the usefulness of 5-ALA-induced tumor fluorescence for guiding tumor resection. The completeness of resection, as determined intraoperatively from residual tissue fluorescence, was related to postoperative MR imaging findings and to survival in patients suffering from GBM.

Adult↗

PubMed2000

Functional evidence for presence of PEPT2 in rat choroid plexus: studies with glycylsarcosine.

PEPT2 expression has been established in brain and, in particular, mRNA transcripts and PEPT2 protein have been identified in choroid plexus. However, there is little evidence for the functional presence of this peptide transporter in choroid plexus tissue. In this study, we examined the in vitro uptake of a model dipeptide, glycylsarcosine (GlySar), with whole tissue rat choroid plexus in artificial cerebrospinal fluid. Our findings are consistent with the known transport properties of PEPT2, including its proton dependence, lack of sodium effect, specificity, and high substrate affinity for dipeptides. Kinetic analysis showed saturable transport of GlySar with a Michaelis constant (K(m)) of 129 +/- 32 microM and a maximum velocity (V(max)) of 52.8 +/- 3.6 pmol/mg/min. GlySar uptake (1.88 microM) was not inhibited by 1.0 mM concentrations of amino acids (glycine, sarcosine, L-histidine), organic acids and bases (4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid, tetraethylammonium), or non-alpha-amino cephalosporins (cephaloridine, cephalothin). In contrast, di- and tripeptides (GlySar, glycylproline, glycylglycylhistidine), neuropeptides (carnosine), and alpha-amino cephalosporins (cefadroxil, cephalexin) inhibited the uptake of GlySar by 85 to 90% at 1.0 mM. These findings indicate that PEPT2 is functionally active in choroid plexus and that it might play a role in neuropeptide homeostasis of cerebrospinal fluid. The ability of PEPT2 to transport drugs at the choroid plexus also may be important for future drug design, delivery, and tissue-targeting considerations.

Animals↗

PubMed1998

In vitro and in vivo porphyrin accumulation by C6 glioma cells after exposure to 5-aminolevulinic acid.

Several malignant tissues synthesize endogenous porphyrins after exposure to 5-aminolevulinic acid (5-ALA). The present experiments have been designed to elucidate whether the C6 glioma cell, a model cell for human malignant glioma, similarly synthesizes porphyrins when exposed to 5-ALA, and whether specific synthesis occurs when C6 cells are inoculated into rat brains to form a tumor. In this situation the blood-brain barrier may interfere with 5-ALA availability, and spreading of porphyrins with edema outside the tumor may occur. Flow cytometry is used to determine the course of cell volume and porphyrin fluorescence intensities in cultured C6 cells which are incubated in 1 mM 5-ALA. For the induction of experimental brain tumors, 10(4) untreated C6 cells are inoculated into the brains of rats. After 9 days animals receive 100 mg 5-ALA/kg body weight. Brains are removed after 3, 6, or 9 h and frozen coronal sections obtained for H/E staining or fluorescence spectography. Cultured C6 cells show a linear increase of protoporphyrin IX fluorescence after exposure to 5-ALA, which begins to plateau after 85 min. Marked fluorescence is also observed in solid and infiltrating experimental tumor. However, faint fluorescence also occurs in normal tissue, basal pia, choroid plexus, and, more obviously, in white-matter tracts bordering the tumor (maximal distance: 1.5 +/- 0.7 mm). The observations demonstrate that C6 cells synthesize protoporphyrin IX after exposure to 5-ALA in vitro and in vivo. However, when utilizing 5-ALA for fluorescence detection or photodynamic therapy of brain tumors, attention should be paid to the possibility of protoporphyrin IX occurring outside the tumor.

Aminolevulinic Acid↗

PubMed1993

[Modification of pediatric lung function measurement by antibacterial filters].

The risk of cross-infection by contaminated lung function equipment can be reduced by the use of antibacterial filters. These filters, however, should have no significant influence on flow measurements. We investigated the effect of a new filter (Pall PF 30) on lung function measurements in 92 children and adolescents with bronchial asthma and cystic fibrosis. In randomized sequence, flow-volume curves and spirometry were registered in the whole body plethysmograph. Values measured with filter correlated closely to those registered without; individual values remained close to the line of identity. With high flow rates, however, there was a minimal tendency towards lower measurements with filter; this damping effect was flow-dependent and remained of a clinically insignificant dimension.

Adolescent↗

PubMed1992

[Modification of pediatric lung function measurement by antibacterial filters].

Adolescent↗

PubMed1991

Immunosuppressive substances from blue-green algae.

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Animals↗

PubMed1987

Metabolism of benzo[a]pyrene in primary cultures of human hepatocytes: dose-response over a four-log range.

Cultures of isolated human hepatocytes from three different human liver specimens were exposed for 24 h to media containing [3H]benzo[a]pyrene (BP) (0.1, 1.0, 10, 100 microM). The cells and media were harvested and extracted. Subsequent incubations of the aqueous phase with beta-glucuronidase and aryl sulfatase, followed by acetone/ethyl acetate extraction, were utilized to determine specific conjugation. Separation of the BP and its metabolites in the residues of the extracts was achieved by h.p.l.c. The capacity of human hepatocytes to metabolize BP was not saturated at up to 100 microM of BP, and the predominant metabolites produced were eluted in the void volume and were a mixture of highly polar BP forms. The next four most prevalent forms of BP metabolites were the 3-hydroxy BP, BP-4,5-dihydrodiol, BP-9,10-dihydrodiol, and BP-7,8-dihydrodiol. These metabolites all increased nearly linearly with dose. Conjugation varied for each different case, ranging from 31 to 91%, but a general trend clearly appeared; if beta-glucuronidation decreased, then sulfation increased and vice versa. BP metabolite binding to DNA was associated with the amount of unconjugated BP-7,8-dihydrodiol metabolite. BP metabolite binding to DNA was nearly linear from 0.1 to 10 microM BP; however, binding to DNA at 100 microM increased 64- to 844-fold over the binding occurring at 10 microM. Thus, human hepatocytes have a strong tendency to form highly polar BP metabolites, and total binding of BP to DNA over a four-log dose range is much less at 0.1-10 microM than one would predict from extrapolation from the high concentration (100 microM).

Benzo(a)pyrene↗

PubMed1986

Differential effect of growth factors on growth stimulation and phenotypic stability of glutamine-synthetase-positive and -negative hepatocytes in primary culture.

In rat liver parenchyma, two subpopulations of hepatocytes can be distinguished by the absence or presence of the marker enzyme, glutamine synthetase (GS). Hepatocytes in the perivenous zone immediately adjacent to the hepatic venules in the liver acinus are positive for GS. Using autoradiography in combination with immunocytochemistry, the response of these two hepatocyte populations (GS positive and GS negative) to a variety of growth factors (defined compounds or complex stimuli) was investigated in vitro. Irrespective of the individual growth-promoting activity (which varied considerably), all stimuli led to much higher labeling indices in GS-negative cells as compared to GS-positive cells. In GS-negative cells, the strongest effect was exerted by serum obtained from partially hepatectomized rats (labeling index, 67%) and the conditioned media of JM1 and JM2 hepatoma cells (63%-82%), followed by a combination of insulin and either norepinephrine (46%) or epidermal growth factor (EGF; 42%). In contrast, serum had the weakest influence on GS-positive cells (0.3%), while the other potent stimuli enhanced the labeling index of these cells by between 6% and 15% within 48 h. The percentage of labeled nuclei was higher in mononucleated than in binucleated GS-positive hepatocytes. The time course of thymidine incorporation was also different for the two subpopulations. Under all growth-promoting conditions, the stimulation of GS-negative cells peaked between 72 and 96 h, while it increased continuously in GS-positive cells for at least 120 h, particularly in the case of serum. In proliferating cultures, both the absolute and the relative number of GS-positive hepatocytes decreased, while no such effect was found in various nonproliferating control cultures maintained at low and high cell density. Similar results were found for GS activity. In contrast, the hormonal induction of tyrosine aminotransferase (TAT) was not affected. It is suggested that these differences in the growth response of GS-positive and -negative cells contribute to the acinar gradient in hepatocyte proliferation that occurs during liver regeneration. Furthermore, the striking phenotypic instability of GS-positive cells that have undergone DNA synthesis and mitosis supports the hypothesis that cellular reprogramming depends on passage through the cell cycle.

Animals↗

PubMed1985

Promoting effect of nicotinamide on the development of renal tubular cell tumors in rats initiated with diethylnitrosamine.

Nicotinamide administered in the drinking water of male Fischer 344 rats increased the number of renal tubular cell tumors of rats treated with an i.p. injection of diethylnitrosamine (DEN) (25-mg/kg body weight). The incidence of kidneys with tumors in rats treated with DEN alone was 5%. In rats which received DEN and then were promoted with either 30 or 6.7 mM nicotinamide in their drinking water, the incidence of kidneys with tumors rose to 59 and 28%, respectively. Rats which were on 30 mM nicotinamide but did not receive DEN had no kidney tumors present. These results show that nicotinamide promoted DEN-induced renal tubular cell tumorigenesis.

Animals↗

PubMed1983

Human hepatocyte-mediated mutagenesis and DNA repair activity.

Combined cultures of human hepatocytes and human fibroblasts constitute a system composed entirely of normal human cells that can be used to investigate the mutagenicity of chemicals requiring metabolic activation. Addition of diethylnitrosamine (DEN) to this system resulted in mutations at the hypoxanthine-guanine phosphoribosyltransferase locus of the human fibroblasts. In separate experiments with cultures of hepatocytes alone, DEN induced unscheduled DNA synthesis (UDS) in the human hepatocytes. A comparative analysis of UDS and hepatocyte-mediated mutagensis indicates a great degree of similarity between the human and previously studied rat hepatocytes in their response to DEN in vitro.

Animals↗

PubMed1982

Isolation, culture, and transplantation of human hepatocytes.

The in situ two-step collagenase perfusion technique used for the isolation of hepatocytes from rat liver was adapted into a procedure applicable to pieces of human liver obtainable from surgical procedures. Human hepatocytes obtained by this method were maintained in primary culture for 10 days. The cellular changes observed at the light microscopic and electron microscopic levels are described. The changes in microsomal enzymes as a function of the age of the cultures were also measured. Exposure of the human hepatocytes to procarcinogens known to be metabolized by rodent liver resulted in unscheduled DNA synthesis. The isolated hepatocytes were also transplanted into two-thirds partially hepatectomized athymic nude mice. The transplanted cells formed nodules with characteristic hepatic architecture. These studies demonstrate that hepatocytes obtained from human liver by the described modified collagenase technique can be used for in vitro studies in chemical carcinogenesis.

Adolescent↗

PubMed1977

Private industry health insurance plans: employment requirements for coverage in 1974.

In 1974, approximately 28.4 million active workers participating in almost 52,000 health plans on their jobs were covered by in-hospital health insurance benefits. A survey of these plans, conducted for the Social Security Administration by the Bureau of Labor Statistics, revealed that not all workers are automatically entitled to benefits on the first day they report for work. More than three-fifths had to fulfill at least one job-related requirement before their hospital coverage was effective. The extent and variety of employment requirements in private industry are discussed here along with data that show how plans that have such requirements differ from those that do not.

Collective Bargaining↗

PubMed1977

Federal civil-service annuitants and social security, December 1975.

This article examines personal and work-related characteristics of a sample of the nearly 1 million Federal civil-service retirees who were receiving annuities based on their own wage records as of December 31, 1975. Employment patterns and subsequent annuities in civil-service careers have been related to corresponding experience in jobs covered under the old-age, survivors, disability, and health insurance (OASDIHI) program. With some exceptions, the review uncovered patterns generally similar to those found in a study of 1967 annuitants. About 2 out of 5 annuitants were entitled to OASDHI cash benefits in 1975. Most of these dual beneficiaries received benefits on the basis of their own OASDHI-covered earnings, but 11 percent were entitled as dependents or survivors of other workers. About two-thirds of the annuitants not currently receiving benefits had some OASDHI-covered employment during their work careers. In general, those with the shortest civil-service careers and lowest annuities were most likely to be entitled to OASDHI cash benefits.

Aged↗