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Biomedical subjects

A S Menon

Publications and source records attributed to A S Menon.

At least 19 recordsLinked to original sources
PubMed2025

Distinct phenotypic consequences of cholangiocarcinoma-associated FGFR2 alterations depend on biliary epithelial cell state.

Epithelial cancers disrupt tissue architecture and are often driven by mutations in genes that play important roles in normal epithelial morphogenesis. The intrahepatic biliary system is an epithelial tubular network that forms within the developing liver via the de novo initiation and expansion of apical lumens. Intrahepatic biliary tumors (intrahepatic cholangiocarcinoma) commonly harbor activating genomic alterations in the FGFR2 receptor tyrosine kinase, which plays important roles in epithelial morphogenesis in other developmental settings. Using a physiologic and quantitative 3D model we demonstrate that FGFR signaling is important for biliary morphogenesis and that oncogenic FGFR2 fusions and in-frame deletions disrupt biliary architecture. Importantly, we show that the trafficking of and signaling from the FGFR2 mutants, as well as their phenotypic impacts, are governed by the epithelial state of the cell. Unexpectedly, we also found that distinct tumor-driving FGFR2 mutants disrupt biliary morphogenesis in completely different and clinically relevant ways, informing our understanding of morphogenesis and tumorigenesis and highlighting the importance of convergent studies of both.

Journal Article↗
PubMed1994

The high prevalence of unsafe sexual behaviors among acute psychiatric inpatients. Implications for AIDS prevention.

We conducted a study to determine the prevalence and sociodemographic distribution of unsafe sexual behaviors among psychiatric inpatients and to investigate an association between crack cocaine use and these behaviors. Two hundred thirty-nine patients admitted to two Philadelphia hospitals during a 12-month period were interviewed to obtain a detailed sexual history and substance abuse history. A history of multiple sex partners was reported by 42.6% of male patients and 13.0% of female patients (p < .01). A history of receptive anal intercourse in the past 6 months was reported by 11.6% of females and 2.1% of males (p < .05). Only about half the study subjects who were sexually active reported ever using a condom during the past 6 months. Crack cocaine use among males and cocaine use among females was statistically significantly associated with a history of having sex with a high risk partner. This study draws attention to the role of crack cocaine and other types of cocaine in the spread of human immunodeficiency virus infection in this population and the need for intensive acquired immunodeficiency syndrome prevention programs on inpatient psychiatric units.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Tracheal perforation. A complication associated with transtracheal oxygen therapy.

A 73-year-old woman with a transtracheal oxygen catheter in place developed sudden onset of respiratory distress and subcutaneous emphysema. Bronchoscopy revealed the presence of three posterior tracheal wall perforations and a blind pouch arising from one of the perforations. Subsequent bronchoscopies revealed complete healing of the perforations. We believe that these perforations occurred during placement of the transtracheal catheter.

Aged↗
PubMed1992

Terminology for drug injection practices among intravenous drug users in Baltimore.

Terms for four discrete drug injection practices were obtained by presenting photographs and a brief description of practices to intravenous drug users who enrolled in a longitudinal study of HIV infection in Baltimore. The 2,921 respondents were predominantly male (81%) and Black (90%), the median age was 34 years (range: 18-68 years), and the median duration of intravenous drug use was 13 years (range 0-50 years). Forty-six different terms were used to characterize direct injection into a vein, 51 for the practice of repeatedly withdrawing and reinjecting one's own blood following injection of drug, 39 for subcutaneous injection, and 45 for transferring drug between different syringes. Terms tended to cluster by race and duration of drug use. These data indicate substantial variation in terminology for drug injection practices. Further, they augment prior research showing that photographs may be used as a useful aid in survey research on drug experiences in the population.

Adolescent↗
PubMed1991

Phrenic neural output during hypoxia in dogs: constant-flow ventilation vs. spontaneous breathing.

We studied the effects of removing cyclic pulmonary afferent neural information on respiratory pattern generation in anesthetized dogs. Phrenic neural output during spontaneous breathing (SB) was compared with that occurring during constant-flow ventilation (CFV) at several levels of eucapnic hypoxemia. Hypoxia caused an increase in both the frequency and the amplitude of the moving time average (MTA) phrenic neurogram during both SB and CFV. The change in frequency as arterial saturation was reduced from 90 to 60% during SB was significantly higher than that during CFV [SB, 32.3 +/- 10.9 (SD) breaths/min; CFV, 10.3 +/- 5.8 breaths/min; P = 0.001]. By contrast, the increase in the amplitude of the MTA phrenic neurogram was smaller (SB, 0.62 +/- 0.68 units; CFV, 1.35 +/- 0.81 units; P = 0.01). The changes in frequency with hypoxia during both modes of ventilation resulted primarily from a shortening of expiratory time. Both inspiratory time and expiratory time were greater during CFV than during SB, but their change in response to hypoxia was not significantly different. We conclude that the amplitude response of the MTA phrenic neurogram to hypoxia is similar to that seen during hypercapnia; in the presence of phasic afferent feedback the MTA amplitude response is decreased and the frequency response is increased relative to the response observed in the absence of phasic afferents.

Afferent Pathways↗
PubMed1991

Respiratory sinus arrhythmia in dogs. Effects of phasic afferents and chemostimulation.

We examined the hypothesis that respiratory sinus arrhythmia (RSA) is primarily a central phenomenon and thus that RSA is directly correlated with respiratory controller output. RSA was measured in nine anesthetized dogs, first during spontaneous breathing (SB) and then during constant flow ventilation (CFV), a technique whereby phasic chest wall movements and thoracic pressure swings are eliminated. Measurements of the heart rate and of the moving time averaged (MTA) phrenic neurogram during these two ventilatory modes were made during progressive hypercapnia and progressive hypoxia. RSA divided by the MTA phrenic amplitude (RSAa) showed a power-law relationship with both arterial carbon dioxide partial pressure (PaCO2) and oxygen saturation (SaO2), but with different exponents for different conditions. However, the power-law relation between RSAa and respiratory frequency had an exponent indistinguishable from -2 whether hypoxia or hypercapnia was the stimulus for increased respiratory drive, and during both CFV and spontaneous breathing (-1.9 +/- 0.4, hypoxia, SB; -1.8 +/- 0.7, hypoxia, CFV; -2.1 +/- 0.8, hypercapnia, SB; -1.9 +/- 0.7, hypercapnia, CFV). We conclude that respiratory sinus arrhythmia is centrally mediated and directly related to respiratory drive, and that changes in blood gases and phasic afferent signals affect RSA primarily by influencing respiratory drive.

Afferent Pathways↗
PubMed1990

Control of expiratory duration by arterial CO2 oscillations in vagotomized dogs.

The role of respiratory oscillations of PaCO2 (CO2 oscillations) in the regulation of expiratory duration (TE) was examined in eight anesthetized dogs by measuring instantaneous changes of arterial pH during the respiratory cycle with a catheter-tip ISFET (ion-sensitive field effect transistor) pH electrode. Steady-state changes in arterial pH oscillation were induced by vagotomy, which increased the amplitude of pH oscillation from 0.014 +/- 0.002 (mean +/- SEM) to 0.058 +/- 0.006 units (P less than 0.001), and prolonged TE from 5.12 +/- 0.56 to 9.99 +/- 1.11 sec (P less than 0.005) with little change in average pH (0.021 +/- 0.011 units, P = 0.12). Vagotomy also reversed the phase relationship between arterial pH oscillation at the carotid bodies and tidal ventilation, such that pH rose during early expiration, rather than falling as occurred in the intact state. When the within-breath oscillation of arterial pH was transiently reduced by having the vagotomized dogs inspire a single breath of CO2 enriched air, TE of the same breath was shortened in proportion to the reduction in amplitude of pH oscillation (r = 0.72, P less than 0.001), rather than in proportion to changes in the average pH of the test breath (r = 0.44). The results indicate that the profile of within-breath oscillation of PaCO2 (phase relationship and amplitude) can exert an important influence on TE, and may in part account for the prolongation of TE following vagotomy.

Animals↗
PubMed1990

Mechanisms of gas exchange with different gases during constant-flow ventilation.

To investigate the mechanisms responsible for the difference in gas exchange during constant-flow ventilation (CFV) when using gases with different physical properties, we used mixtures of 70% N2-30% O2 (N2-O2) and 70% He-30% O2 (He-O2) as the insufflating gases in 12 dogs. All dogs but one had higher arterial PCO2 (PaCO2) with He-O2 compared with N2-O2. At a flow of 0.37 +/- 0.12 l/s, the mean PaCO2's with N2-O2 and He-O2 were 41.3 +/- 13.9 and 53.7 +/- 20.3 Torr, respectively (P less than 0.01); at a flow rate of 0.84 +/- 0.17 l/s, the mean PaCO2's were 29.1 +/- 11.3 and 35.3 +/- 13.6 Torr, respectively (P less than 0.01). The chest was then opened to alter the apposition between heart and the lungs, thereby reducing the extent of cardiogenic oscillations by 58.4 +/- 18.4%. This intervention did not significantly alter the difference in PaCO2 between N2-O2 and He-O2 from that observed in the intact animals, although the individual PaCO2 values for each gas mixture did increase. When the PaCO2 was plotted against stagnation pressure (rho V2), the difference in PaCO2 between N2-O2 and He-O2 was nearly abolished in both the closed- and open-chest animals. These findings suggest that the different PaCO2's obtained by insufflating gases with different physical properties at a fixed flow rate, catheter position, and lung volume result mainly from a difference in the properties of the jet.

Animals↗
PubMed1988

Influence of phasic afferent information on phrenic neural output during hypercapnia.

We measured the moving time average (MTA) of the phrenic neurogram before and after removal of phasic afferent information from the lungs, chest wall, and oscillations in blood gases by using constant-flow ventilation (CFV). Anesthetized dogs were studied at various levels of steady-state and progressive hypercapnia during spontaneous breathing and during CFV. When steady-state and progressive hypercapnia were compared, the frequency and height of the MTA phrenic neurogram were independent of the rate of induction of hypercapnia during each mode of ventilation. During spontaneous ventilation, the response to hypercapnia comprised mainly an increase in frequency with only a slight increase in the amplitude of the MTA phrenic waveform. During muscular paralysis and CFV, the responses were similar to those observed after vagotomy with mainly an increase in the amplitude and only a small increase in frequency. For both spontaneous breathing and CFV, increases in frequency were achieved mainly by a shortening in expiratory time with the inspiratory time remaining relatively constant. Our data support the concept of a centrally patterned respiratory generator, whose inherent pattern is modified by phasic feedback from peripheral receptors mainly of vagal origin.

Afferent Pathways↗
PubMed1988

Mechanisms mediating the heart rate response to hypoxemia.

We studied the effect of phasic pulmonary afferent information on heart rate (HR) during a progressive reduction in oxygen saturation (SaO2). The Hering-Breuer reflex was evaluated with the use of the ratio of apnea duration after lung inflation to the preceding expiratory time (dT). Phasic afferent activity was stopped in anesthetized, paralyzed dogs by constant-flow ventilation (CFV), a technique that removes cyclic changes in lung volume. During normocapnic (PaCO2 = 36.4 +/- 1.1 mm Hg) spontaneous breathing, there was a wide variability in HR response, with a mean delta HR/delta SaO2 (+/- SE) of 0.62 +/- 0.27 beats/min/% (values greater than 0 indicate a tachycardiac response). There was a good correlation between delta HR/delta SaO2 and dT (r = .79). Mean delta HR/delta SaO2 for the combined normocapnic and hypercapnic studies during CFV was lower (-1.32 +/- 0.19 bpm/%) than that during spontaneous breathing (0.23 +/- 0.19, p less than .0001). We suggest that the HR response to hypoxemia is strongly related to the strength of the Hering-Breuer reflex, which may explain the large interdog variability in HR responses.

Animals↗
PubMed1988

Contribution of pulmonary receptors to the heart rate response to acute hypoxemia in rabbits.

We studied the effect of pulmonary afferent activity on the heart rate response to a progressive, isocapnic decrease in oxygen saturation (SaO2) in anesthetized rabbits. To abolish the effect of rapidly adapting receptors, we used inhaled bupivacaine aerosol, and to abolish the effect of slowly adapting stretch receptor activity, we used sulfur dioxide insufflation. The heart rate (HR) response (delta HR/delta SaO2) under control conditions was 0.39 +/- 1.29 beats/min/% (mean +/- SD, n = 11; values greater than 0 indicate a tachycardiac response to hypoxemia). After sulfur dioxide insufflation, all nine rabbits had a bradycardiac response (-2.02 +/- 1.13 beats/min/%), which was significantly less than control (p less than 0.0001). After bupivacaine inhalation, the heart rate response (0.27 +/- 1.04 beats/min/%) was unchanged from control. There were no significant differences in the percent increase of minute ventilation during hypoxemia in all runs. Our results indicate that in rabbits the receptors responsible for the increase in heart rate during progressive hypoxemia are the slowly adapting receptors.

Acute Disease↗
PubMed1988

Constant oxygen insufflation (COI) in a ventilatory failure model.

We examined the use of a constant insufflation of oxygen into the lungs to assist ventilation in a ventilatory failure model. The model consisted of 12 anesthetized dogs (17 to 32 kg) that were partially paralyzed using intermittent low doses of muscle relaxant; this produced a steady-state mean PaCO2 of 90 +/- 15.8 mm Hg (+/- SD). A catheter (1.5 mm ID) was inserted into each lung to the most distal position possible and withdrawn 1 to 2 cm. The effects of a constant insufflation of oxygen at rates of 5, 10, or 20 L/min were studied at this position (mean distance from the carina = 9 +/- 2 cm); at the carina; and using a single catheter located 2 cm above the carina. The changes in PaCO2 and minute ventilation (VE) due to the insufflation were calculated from the mean steady-state control values. Using the data for all catheter positions and flow rates, the insufflation was associated with a mean decrease in PaCO2 of 31 (+/- 7.6) mm Hg associated with a mean decrease in VE of 48 (+/- 12.9)%. The flow of 20 L/min caused a significantly greater drop in PaCO2 than the flow of 5 L/min (p = 0.02). This technique may prove beneficial for patients with various forms of ventilatory failure that are difficult to treat by conventional means.

Acute Disease↗
PubMed1987

Binding of nucleotides to the ATP-dependent protease La from Escherichia coli.

A critical enzyme in protein breakdown in Escherichia coli is the ATP-hydrolyzing protease La, the lon gene product. In order to clarify the role of ATP in proteolysis, we studied ATP and ADP binding to this enzyme using rapid gel filtration to separate free from bound ligands. In the presence of Mg2+ or Mn2+ and 10 microM ATP, two molecules of ATP were bound to the tetrameric enzyme, while at 100 microM ATP (or higher), four ATP molecules were bound, both at 0 and 37 degrees C. Protease La thus has two high affinity sites (S0.5 less than 10(-7) M) for ATP and two lower affinity sites (S0.5 = 12-15 microM). Binding was reversible. In the absence of a divalent ion, ATP bound to only two sites. However, much lower Mg2+ concentrations (50 microM) were required for maximal ATPase binding than for maximal proteolytic and ATPase activity (2 mM). Decavanadate, which is a potent inhibitor of proteolysis, also blocked ATP binding, but orthovanadate had neither effect. Different ATP analogs bind to these sites in distinct ways. Adenyl-5'-yl imidodiphosphate binds to only one high affinity site, while adenyl-5'-yl methylene monophosphonate binds to two. Nevertheless, both non-metabolizable analogs can activate oligopeptide hydrolysis as well as ATP. Although binding of a single nucleotide can activate peptide hydrolysis, occupancy of all four sites appears necessary for maximal protein breakdown. The ATP molecules on all four sites are hydrolyzed rapidly. The Pi is released, but ADP remains on the enzyme. ADP binds to the same four sites, but this process does not require divalent ions. Protease La shows higher affinity for ADP than for ATP. Therefore, in vivo, ADP should inhibit ATP binding and protease La function.

ATP-Dependent Proteases↗
PubMed1987

Protein substrates activate the ATP-dependent protease La by promoting nucleotide binding and release of bound ADP.

The interaction of protein substrates with protease La from Escherichia coli enhances its ability to hydrolyze ATP and peptide bonds. These studies were undertaken to clarify how unfolded proteins allosterically stimulate this ATPase activity. The tetrameric protease can bind four molecules of ATP, which activates proteolysis, or four molecules of ADP, which inhibits enzymatic activity. Protein substrates stimulate binding of the nonhydrolyzable ATP analog [3H] adenyl-5'yl imidodiphosphate, although they do not increase the net binding of [3H]ATP or [3H]ADP. Once bound, ATP is quickly hydrolyzed to ADP, which remains noncovalently associated with protease La even through repeated gel filtrations. Exposure to protein substrates (e.g. denatured bovine serum albumin at 37 degrees C) induces the release of all the bound ADP from the enzyme. Nonhydrolyzable ATP analogs bound to the enzyme were not released by these substrates. Proteins that are not degraded (e.g. native bovine serum albumin) and oligopeptides that only bind to the catalytic site do not induce ADP release. Thus, polypeptide substrates have to interact with an allosteric site to induce this effect. The protein-induced ADP release is inhibited by high concentrations of Mg2+ and is highly temperature-dependent. Protein substrates promoted [3H]ATP binding in the presence of ADP and Mg2+ (i.e. ATP-ADP exchange) and reduced the ability of ADP to inhibit the enzyme's peptidase and ATPase activities. These results indicate that: 1) ADP release is a rate-limiting step in protease La function; 2) bound ADP molecules inhibit protein and ATP hydrolysis in vivo; 3) denatured proteins interact with the enzyme's regulatory site and promote ADP release, ATP binding, and their own hydrolysis.

ATP-Dependent Proteases↗
PubMed1987

The energy utilized in protein breakdown by the ATP-dependent protease (La) from Escherichia coli.

A crucial enzyme in the pathway for protein degradation in Escherichia coli is protease La, an ATP-hydrolyzing protease encoded by the lon gene. This enzyme degrades various proteins to small polypeptides containing 10-20 amino acid residues. To learn more about its energy requirement, we determined the number of ATP molecules hydrolyzed by the purified protease for each peptide bond cleaved. The enzyme hydrolyzed about 2 molecules of ATP for each new amino group generated with casein, bovine serum albumin, glucagon, or guanidinated casein as substrates, even though these proteins differ up to 20-fold in size and 3-4 fold in rates of hydrolysis of peptide bonds. Similar values for the stoichiometry (from 1.9 to 2.4) were obtained using fluorescamine or 2,4,6-trinitrobenzene sulfonic acid to estimate the appearance of new amino groups. These values appeared lower at 1 mM than at 10 mM Mg2+. The coupling between ATP and peptide bond hydrolysis appeared very tight. However, when the protease was assayed under suboptimal conditions (e.g. at lower pH or with ADP present), many more ATP molecules (from 3.5 to 12) were consumed per peptide bond cleaved. Our data would indicate that the early steps in protein degradation consume almost as much energy (2 ATPs for each cleavage) as does the formation of peptide bonds during protein synthesis.

ATP-Dependent Proteases↗
PubMed1987

Catheter position and blood gases during constant-flow ventilation.

We studied the effect of catheter position and flow rate on gas exchange during constant-flow ventilation (CFV) in eight anesthetized, paralyzed dogs. The distal tips of the insufflation catheters were positioned 0.5, 2.0, 3.5, and 5.0 cm from the tracheal carina. Flow rates were varied between 10 and 55 l/min and steady-state arterial blood gases were measured. At a given flow rate, arterial CO2 pressure (PaCO2) decreased as CFV was administered further into the lung up to a distance of 3.5 cm from the carina; there were no significant differences in PaCO2 at 3.5 and 5.0 cm. For a given catheter position, PaCO2 decreased with increasing flow rate up to a flow rate of 40 l/min. Further increases in flow rate had no significant effect on PaCO2. Arterial O2 pressure (PaO2) was relatively constant at all flow rates and catheter positions. We conclude that, up to a point, CO2 elimination can be improved by positioning the catheters further into the lung; advancing the catheters further than 3.5 cm from the carina may cause over-ventilation of specific lung regions resulting in a relative plateau in CO2 elimination and relatively constant PaO2's. Positioning the catheters further into the lung permits the use of lower flow rates, thus potentially minimizing the risk of barotrauma.

Animals↗
PubMed1987

Contribution of cardiogenic oscillations to gas exchange in constant-flow ventilation.

The contribution of cardiogenic oscillations to gas exchange during constant-flow ventilation was examined in 11 dogs. With the use of two variations of cardiopulmonary bypass to maintain the systemic and pulmonary circulation, the influence of cardiogenic oscillations was removed by arresting the heart. Cardiac arrest by ventricular fibrillation was associated with a mean decrease in alveolar ventilation of 43% in five dogs on right and left heart bypass. However, successful defibrillation and return of the prearrest level of alveolar ventilation could not be achieved; thus we studied six dogs on left heart bypass. Alveolar ventilation decreased an average of 37% with cardiac arrest, and defibrillation resulted in a return of alveolar ventilation to 81% of the prearrest value. These results are consistent with previous predictions that cardiogenic oscillations are an important mechanism of gas transport during constant-flow ventilation.

Animals↗