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Biomedical subjects

D M Larson

Publications and source records attributed to D M Larson.

At least 37 records · Page 2Linked to original sources

Effect of acute and chronic arecoline treatment on cerebral metabolism and blood flow in the conscious rat.

Treatment with the muscarinic agonist arecoline improves memory retention in patients with Alzheimer's disease (AD). In animal models, arecoline selectively increases local cerebral glucose utilization (LCGU). We examined (1) whether these focal increases in metabolism were coupled to local cerebral blood flow (LCBF) and (2) whether the effect of arecoline on LCGU and LCBF was dependent upon duration of drug administration. In groups of young Fischer-344 rats, LCGU and LCBF were determined in 59 brain regions by the [14C]2-deoxyglucose and the [14C]iodoantipyrine autoradiographic methods following either the acute administration of arecoline (2 mg/kg and 15 mg/kg) or the chronic three week administration of arecoline (50 mg/kg/day). In general, LCBF correlated closely with LCGU following arecoline 2 mg/kg administration, but heterogeneous regions were present. Following treatment with arecoline 15 mg/kg, the two parameters became uncoupled with LCBF increasing disproportionately in relation to LCGU. Coupling between LCBF and LCGU was preserved during chronic arecoline treatment (50 mg/kg/day) but some regions, such as the hippocampus, were uncoupled with LCGU increasing to a greater extent than LCBF. Thus, we demonstrate that acute and chronic administration of arecoline can differentially modulate LCBF and LCGU. Since clinical administration of arecoline can improve cognitive function in patients with AD, understanding the ability of arecoline to selectively alter LCBF and LCGU in regions such as the hippocampus may offer insight into the pathophysiology of AD and provide direction for the development of definitive therapy for neurodegenerative disorders.

Animals↗

Comparison of the Z-sampler and Novak endometrial biopsy instruments for in-office diagnosis of endometrial cancer.

The purpose of this study was to compare the diagnostic accuracy and specimen adequacy of in-office endometrial biopsies taken with the Novak curette and with a disposable flexible polypropylene biopsy device, the Z-sampler, in patients with endometrial cancer. Eighty women with endometrial cancer had in-office endometrial biopsies performed with the Z-sampler and the Novak curette prior to hysterectomy. The Z-sampler diagnosed 66 (82.5%) with endometrial cancer compared to 68 (85%) with the Novak curette (P = 0.724). The Z-sampler biopsies included 10 specimens (12.5%) pathologically inadequate for diagnosis, compared to 5 (6.3%) Novak curette biopsies inadequate for diagnosis (P = 0.074). When both endometrial biopsies were adequate for pathologic evaluation, the Z-sampler diagnosed 66 of 70 women (94.3%) with endometrial cancer, compared to 64 of 70 (91.4%) diagnosed with the Novak curette (P = 0.617). We did not demonstrate a significant difference in diagnostic accuracy or specimen adequacy between in-office biopsies taken with the Novak curette and those taken with the Z-sampler in patients with endometrial cancer.

Adenocarcinoma↗

Histopathologic adequacy of office endometrial biopsies taken with the Z-sampler and Novak curette in premenopausal and postmenopausal women.

This study compared the adequacy of office endometrial biopsies taken with the Novak curette and a disposable, flexible polypropylene biopsy device, the Z-sampler, in premenopausal and postmenopausal women. Between September 1988 and November 1991, 407 women had paired office endometrial biopsies with the Z-sampler followed by the Novak curette. Overall, 83.0% of endometrial biopsies obtained with the Z-sampler were adequate for histopathologic diagnosis as compared to 84.5% obtained with the Novak curette (P = .53). In 181 (44.5%) premenopausal women, 94.5% of Z-sampler biopsies were adequate as compared to 95.6% of Novak curette biopsies (P = .80). In 226 (55.6%) post-menopausal women, 73.9% of Z-sampler biopsies were adequate as compared to 75.7% of Novak curette biopsies (P = .66). The Z-sampler biopsies were adequate in 94.5% of premenopausal women as compared to 73.9% of postmenopausal women (P < .0001). The Novak curette biopsies were adequate in 95.6% of premenopausal women as compared to 75.7% of post-menopausal women (P < .001). While we did not demonstrate a significant difference in the adequacy of endometrial samples taken with the Z-sampler and Novak curette in premenopausal and postmenopausal women, postmenopausal women had a significantly lower rate of adequate samples obtained with either device as compared to premenopausal women.

Adult↗

Prognostic significance of malignant cervical cytology in patients with endometrial cancer.

OBJECTIVE: To determine the prognostic importance of malignant cervical cytology before surgical stating in patients with endometrial cancer. METHODS: Between September 1987 and August 1993, 164 patients with endometrial cancer had preoperative cervical cytology examined before surgical staging, which included pelvic and para-aortic lymphadenectomy. RESULTS: Ninety-four patients (57.3%) had normal cervical cytology, 21 (12.8%) had atypical cytology suspicious for malignancy, and 49 (29.9%) had malignant cytology on preoperative cervical cytology. Statistically significant associations were found between cervical cytology and histopathology (P = .017), tumor grade (P = .001), cervical metastases (P < .001), surgical stage (P = .035), pelvic lymph node metastases (P = .016), and para-aortic lymph node metastases (P = .006). Patients with malignant cytology were more likely to have non-endometrioid histology, poorly differentiated malignancies, higher surgical stage, and cervical, pelvic lymph node, and para-aortic lymph node metastases. Patients with malignant cervical cytology had a 3.5 times higher prevalence of pelvic lymph node metastases and a five times higher prevalence of para-aortic lymph node metastases than patients with normal cytology. No association was found between preoperative cervical cytology and the depth of myometrial invasion, adnexal metastases, omental metastases, or malignant pelvic peritoneal cytology. CONCLUSIONS: Patients with endometrial cancer and malignant preoperative cervical cytology are at marked risk for extrauterine metastases, including pelvic and para-aortic lymph node metastases. Such patients should be considered for primary surgical staging, including pelvic and para-aortic lymphadenectomy.

Adenocarcinoma↗

Pelvic and para-aortic lymphadenectomy for surgical staging of high-risk endometrioid adenocarcinoma of the endometrium.

The objective of this study was to analyze the results of pelvic and para-aortic lymphadenectomy in high-risk patients with endometrioid adenocarcinoma of the endometrium and no clinical or gross surgical evidence of extrauterine metastases. From August 1987 to October 1992, 50 patients with high-risk endometrioid adenocarcinoma of the endometrium had pelvic and para-aortic lymphadenectomy performed. The median number of lymph nodes removed was 18. No preoperative radiotherapy was administered. Pelvic lymph node metastases (20.0%) and para-aortic lymph node metastases (16.0%) were the most common sites of extrauterine metastases diagnosed. Eight patients (80.0%) with pelvic lymph node metastases also had para-aortic metastases. All 8 patients with para-aortic lymph node metastases had pelvic lymph node metastases. Pelvic lymphadenopathy was diagnosed on surgical exploration in 30% of patients with pelvic lymph node metastases, and para-aortic lymphadenopathy was present in 50% with para-aortic metastases. Six of 46 patients (13.0%) without pelvic or para-aortic lymphadenopathy had microscopic lymph node metastases. Palpation of the pelvic and para-aortic lymph node areas alone is inadequate in identifying patients with lymph node metastases. The addition of routine pelvic and para-aortic lymphadenectomy to TAH/BSO will identify subclinical lymph node metastases in a significant number of patients who may benefit from individualized postoperative therapy.

Adenocarcinoma↗

Triangulating stapling technique: an alternative approach to colorectal anastomosis.

The triangulating stapling technique was employed to perform colorectal anastomosis in 259 patients. In 220 patients, the anastomosis was performed between the colon and nonperitonealized rectum. This anastomotic technique is safe and reliable and is an effective alternative to a circular stapling device, with minimal morbidity. The incidence of leak rate is comparable to anastomoses created by a circular stapling device. The main advantage seems to be the very low incidence of anastomotic stenosis.

Aged↗

Cerebral metabolic responses to meta-chlorophenylpiperazine are reduced during its chronic administration to young and aged rats.

The effects of the 5-HT agonist meta-chlorophenylpiperazine (MCPP) on regional cerebral metabolic rates for glucose (rCMRglc) were measured in 3- and 24-month-old rats that were not pretreated or were pretreated for 2 weeks with continuous infusion of saline or MCPP. rCMRglc were measured using the quantitative autoradiographic [14C]2-deoxy-D-glucose technique in 71 brain regions at 15 min after acute administration of MCPP 2.5 mg/kg. In the absence of chronic pretreatment, intraperitoneal MCPP 2.5 mg/kg produced widespread rCMRglc reductions (41 brain areas) in 3-month-old rats and more limited rCMRglc decreases (8 brain areas) in 24-month-old rats. After chronic treatment, MCPP failed to reduce rCMRglc in any region of either group of rats. These findings indicate that mechanisms of downregulation of response to MCPP are functional in young and aged rats and suggest that the age-related reduction in rCMRglc responses to acute MCPP in non-pretreated animals may be due to compensation for age-related losses of 5-HT terminals.

Aging↗

Molecular cloning and functional expression of human connexin37, an endothelial cell gap junction protein.

Gap junctions allow direct intercellular coupling between many cells including those in the blood vessel wall. They are formed by a group of related proteins called connexins, containing conserved transmembrane and extracellular domains, but unique cytoplasmic regions that may confer connexin-specific physiological properties. We used polymerase chain reaction amplification and cDNA library screening to clone DNA encoding a human gap junction protein, connexin37 (Cx37). The derived human Cx37 polypeptide contains 333 amino acids, with a predicted molecular mass of 37,238 D. RNA blots demonstrate that Cx37 is expressed in multiple organs and tissues (including heart, uterus, ovary, and blood vessel endothelium) and in primary cultures of vascular endothelial cells. Cx37 mRNA is coexpressed with connexin43 at similar levels in some endothelial cells, but at much lower levels in others. To demonstrate that Cx37 could form functional channels, we stably transfected communication-deficient Neuro2A cells with the Cx37 cDNA. The induced intercellular channels were studied by the double whole cell patch clamp technique. These channels were reversibly inhibited by the uncoupling agent, heptanol (2 mM). The expressed Cx37 channels exhibited multiple conductance levels and showed a pronounced voltage dependence. These electrophysiological characteristics are similar to, but distinct from, those of previously characterized connexins.

Alcohols↗

Molecular cloning and expression of rat connexin40, a gap junction protein expressed in vascular smooth muscle.

Gap junctions contain intercellular channels which are formed by members of a group of related proteins called connexins. Connexins contain conserved transmembrane and extracellular domains, but unique cytoplasmic regions which may provide connexin-specific physiologic properties. We used polymerase chain reaction (PCR) amplification and cDNA library screening to clone DNA encoding a novel member of this gene family, rat connexin40 (Cx40). The derived rat Cx40 polypeptide contains 356 amino acids, with a predicted molecular mass of 40,233 Da. Sequence comparisons suggest that Cx40 is the mammalian homologue of chick connexin42, but it has predicted cytoplasmic regions that differ from previously described mammalian connexins. Southern blots of rat genomic DNA suggest that Cx40 is encoded by a single copy gene containing no introns within its coding region. Northern blots demonstrate that Cx40 is expressed in multiple tissues (including lung, heart, uterus, ovary, and blood vessels) and in primary cultures and established lines of vascular smooth muscle cells. Cx40 is coexpressed with connexin43 in several cell types, including A7r5 cells, which contain two physiologically distinct gap junctional channels. To demonstrate that Cx40 could form functional channels, we stably transfected communication-deficient Neuro2A cells with Cx40 DNA. These Cx40-transfected cells showed intercellular passage of microinjected Lucifer yellow CH. The expression of multiple connexins (such as Cx40 and Cx43) by a single cell may provide a mechanism by which cells regulate intercellular coupling through the formation of multiple channels.

Amino Acid Sequence↗

Two-dimensional coupling by gap junctions in cultured gastric smooth muscle monolayers.

We studied intercellular transfer in cultured rabbit gastric smooth muscle cell monolayers after microinjection of electrotonic current or the fluorescent probe Lucifer yellow CH. Because cultured gastric muscle cells proliferate in vitro and form regular arrays of parallel spindle-shaped cells, we sought to assess the role of cell shape and orientation in determining two-dimensional coupling properties. With the use of electron microscopy, gap junctions were identified between adjacent cells. Northern blot analyses using specific cDNA probes demonstrated expression of mRNA for the gap junction protein connexin43. Dye injection of Lucifer yellow resulted in 97% transfer to at least one adjacent cell, and 88% of adjacent cells received dye. Electrophysiological studies were performed using two intracellular microelectrodes to measure electrotonic current flow between cells at varying interelectrode distances. Current flow in the monolayers was modeled using a modified two-dimensional analysis. Initial assessment showed that the ratio of calculated space constants (longitudinal axis/perpendicular axis) was 4.4, indicating anisotropic conditions. However, when a geometric transform was used to normalize the spindle-shaped cells to regular hexagons, the space constants became statistically equivalent (200 microns longitudinal, 256 microns perpendicular). These results suggest that anisotropy of current flow in the monolayer of gastric smooth muscle cells was due primarily to the shape of the cells and not to intrinsic membrane properties or the distribution of gap junctions.

Animals↗

Role of epicardial mesothelial cells in the modification of phenotype and function of adult rat ventricular myocytes in primary coculture.

Adult rat ventricular myocytes undergo a well-documented sequence of phenotypic changes during adaptation to primary culture. However, we observed that coculture of myocytes with a specific subset of nonmyocyte cardiac cells could slow and even reverse the process of adaptation. These nonmyocyte cells were isolated and identified by immunohistochemical and ultrastructural criteria as being of epicardial mesothelial origin. When added to long-term primary cultures of adult ventricular myocytes, epicardial mesothelial cells appeared to induce myofibrillar arrays that were more organized than those seen in noncocultured myocytes; these changes that occurred were concurrent with the appearance of large amplitude contractions and multicellular synchronous beating that was facilitated by gap junctions between myocytes and epicardial mesothelial cells. The changes in morphology and function were accompanied by a marked increase in beta-myosin heavy chain isoform transcription in cocultured myocytes, a return to the ratio of cardiac to skeletal alpha-actin expected in adult rat myocardium, and a much reduced expression of smooth muscle alpha-actin. These changes in myocyte phenotype and function appeared to require epicardial cell-myocyte contact, or close apposition, because media conditioned by epicardial mesothelial cells alone or in coculture had no effect. Thus, these rapid and reversible changes in myocyte ultrastructure, function, and gene expression may provide a useful in vitro model with which to study the mechanism responsible for regulating the plasticity of ventricular myocyte phenotype and the role of specific cell-cell interactions.

Animals↗

Pelvic and para-aortic lymphadenectomy for surgical staging of endometrial cancer: morbidity and mortality.

This analysis compared retrospectively the morbidity and mortality of patients with endometrial cancer who had total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAH/BSO) alone or with pelvic and para-aortic lymphadenectomy performed by the same surgeon at one private institution. Between August 1987 and March 1991, 77 women with endometrial cancer were staged surgically by a standard protocol without preoperative radiotherapy. Thirty-five patients (45%) had TAH/BSO alone and 42 (55%) had TAH/BSO with pelvic and para-aortic lymphadenectomy. The median number of lymph nodes removed was 18. Patients having lymphadenectomy had an increased mean (+/- standard deviation) operative time (129 +/- 29 versus 87 +/- 26 minutes; P less than .0001), increased mean estimated blood loss (391 +/- 192 versus 272 +/- 219 mL; P = .013), and a longer postoperative hospital stay (P = .017) compared with patients having TAH/BSO alone. However, there was no difference in transfusion rate, febrile morbidity, postoperative complications, or mortality. We conclude that pelvic and para-aortic lymphadenectomy can be added to TAH/BSO in patients with endometrial cancer without a clinically significant increase in morbidity or mortality.

Adult↗

Parachloroamphetamine selectively alters regional cerebral metabolic responses to the serotonergic agonist metachlorophenylpiperazine in rats.

To determine if reported reductions of regional cerebral metabolic rates for glucose (rCMRglc) induced by the 5-HT agent metachlorophenylpiperazine (MCPP) (2.5 mg/kg) are due to a presynaptic action, 3-month old Fischer-344 rats were given parachloroamphetamine (PCA), a serotonin neurotoxin, and rCMRglc was measured 1 or 3 weeks later with the quantitative autoradiographic [14C]2-deoxyglucose procedure in 74 brain regions after administering saline, MCPP or other drugs. PCA alone increased rCMRglc significantly only in the raphe nuclei and in visual structures (visual cortex, lateral geniculate, superior colliculus). MCPP alone reduced rCMRglc in 75% of the regions studied. In PCA-lesioned rats, metabolic responses to MCPP 2.5 mg/kg were virtually abolished and rCMRglc was increased in interanteromedial and centrolateral thalamic nuclei. rCMRglc responses to quipazine, a postsynaptic serotonin agonist, and to arecoline and bromocriptine, cholinergic and dopaminergic agonists, were unchanged by PCA-pretreatment. Selective abolition by PCA of the metabolic response to MCPP confirms that MCPP, at the dose studied, reduces rCMRglc in the forebrain via a presynaptic mechanism and that postsynaptic serotonergic function is not altered by PCA.

Animals↗

Time courses of behavioral and regional cerebral metabolic responses to different doses of meta-chlorophenylpiperazine in awake rats.

The time course and relation to dose of regional cerebral metabolic rates for glucose (rCMRglc) and of motor behavior were measured in awake male adult Fischer-344 rats after administration of meta-chlorophenylpiperazine (MCPP), a serotonin-1B receptor agonist. rCMRglc was determined, using the quantitative autoradiographic [14C]deoxyglucose technique, in 71 brain regions at 5, 15, 30 and 60 min after administration of MCPP 2.5 mg/kg i.p., and at 15 min after MCPP 25 and 40 mg/kg. The time course of performance on a rotating rod was measured periodically for 60 min after MCPP 2.5 mg/kg, a dose which impaired locomotion and reduced rCMRglc maximally at 15-30 min after its administration. At 15 min, rCMRglc declined significantly in 28 (40%) of the areas studied (mean decline 16%). Most regions affected were telencephalic or diencephalic, corresponding to the projection areas of serotonergic fibers arising from the raphe nuclei. After higher doses of MCPP, a behavioral serotonin syndrome was observed with both rCMRglc increases and decreases (25 mg/kg) or only rCMRglc increases (40 mg/kg). Whereas behavioral and metabolic activation induced by high doses of MCPP may result from stimulation at postsynaptic serotonin receptors, rCMRglc reductions and hypomotility produced by MCPP 2.5 mg/kg resemble the effects of serotonin receptor antagonists and suggest that, at this low dose, MCPP acts at modulatory serotonin autoreceptors to reduce endogenous serotonin release.

Animals↗

Preferential metabolic activation of subcortical brain areas by acute administration of nicotine to rats.

Cerebral metabolic and behavioral effects of acutely administered nicotine were measured in rats in relation to dose. Nicotine 0.1, 1, or 10 mg/kg or vehicle was administered intraperitoneally to 3-month-old male Fischer-344 rats that had been pretreated with hexamethonium bromide 5 mg/kg i.p. to reduce peripheral autonomic effects. Regional CMRglc (rCMRglc) values were measured, using the quantitative autoradiographic [14C]-2-deoxy-D-glucose method, in 71 brain regions, beginning 3 min after nicotine or vehicle administration. Intensity of body tremor, scored by a blinded rater, was dose related and peaked at 3 min after nicotine injection. rCMRglc rose in a dose-related manner: Nicotine 0.1 mg/kg had no significant effect in any region, whereas 1 mg/kg elevated rCMRglc significantly in 21 regions (mean rise 20%) and 10 mg/kg produced generalized (56 regions) and greater (mean rise 50%) increases in rCMRglc. Nicotine 1 mg/kg activated thalamic nuclei, cerebellum, geniculate nuclei, superior colliculus, median raphe, reticular formation, and the habenulointerpeduncular pathway, but was without effect in the telencephalon. Effects of nicotine in the hindbrain were related anatomically to reported distributions of [3H]nicotine and [3H]acetylcholine but not [125I]alpha-bungarotoxin binding sites, implying that the former ligands label functional nicotine receptors. The pattern of change in rCMRglc after nicotine administration suggests that its cognitive effects in humans are due to augmented arousal/attention and visual processing rather than to direct neocortical or hippocampal activation.

Animals↗

Gap junction messenger RNA expression by vascular wall cells.

Gap junctions between vessel wall cells provide a pathway for the intercellular exchange of ions and small molecules. Pure cultures of microvascular and macrovascular endothelial and smooth muscle cells, vascular pericytes, and several nonvascular cell lines were tested for junctional communication by fluorescent dye transfer. All of the vascular wall cells were capable of dye transfer. Since gap junctions are formed by a family of related proteins (connexins) whose unique domains may confer physiological regulatory properties, we tested total RNA from these cultures by Northern blot analysis for expression of the currently available, characterized, and cloned mammalian gap junction proteins: connexin26, connexin32, and connexin43. All of the vascular wall cells expressed connexin43 messenger RNA. Connexin43 was expressed in vascular cells from bovine, porcine, rat, and human sources. Several nonvascular cell lines of mesenchymal origin also expressed connexin43 messenger RNA. When high stringency Northern blots were used, messenger RNAs for connexin32 or connexin26 were not detected in any of the vascular wall cells but were expressed in several cell lines of epithelial origin. Freshly isolated and purified aortic endothelial and smooth muscle RNA preparations similarly contained only connexin43 messenger RNA, excluding the possibility of culture-induced alterations in gene expression. The expression of connexin43 by all vascular wall cells may provide a mechanism for the functional integration of the vessel wall by gap junctions.

Animals↗

Anorectal complications of vaginal delivery.

The incidence of anorectal complications following vaginal delivery was studied in 20,500 women. One thousand forty (5 percent) of all normal vaginal deliveries resulted in episiotomy with third- and fourth-degree extension or a fourth-degree perineal tear. Of these fourth-degree lacerations, 101 patients (10 percent) experienced wound disruption after primary repair. Sixty-seven patients (66 percent) experienced wound disruption that required surgical correction. Anorectal complications were anal ulcer, anorectal abscess, sphincteric disruption, and rectovaginal fistula. Surgical correction of these complications resulted in satisfactory outcome.

Adult↗