What is the latest thinking about the environmental causes of sarcoidosis?
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Biomedical subjects
Publications and source records attributed to D Moller.
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(1) The hypothesis that inhalational anesthetics affect G-protein linked alpha2 adrenergic signaling pathway was investigated using human platelets as a model system. (2) Alpha2 receptor stimulation by UK-14304, a potent and selective agonist, inhibits cAMP production induced by prostaglandin I2 (PGI2). (3) Brief stimulation (30 s) with PGI2 raised cAMP levels in platelets by 25-fold; UK-14304 suppressed the PGI2 stimulus by 80%. (4) Halothane at fractional minimum alveolar concentration (MAC) through super physiological levels (16 MAC) had no effect on basal or prostacyclin stimulated levels of cAMP, nor did it have any effect on the inhibition of cAMP production by UK-14304. Moreover, isoflurane, enflurane and sevoflurane had no significant effect on cAMP production at 1.5 or 8 MAC. The results suggest alpha2 and PGI2 signaling pathways are not sensitive to volatile anesthetics including the alpha2 or PGI2 receptor/G-protein complex, G-protein/adenylyl cyclase complex and adenylyl cyclase itself. (5) The possibility that halothane and related anesthetics act more distally in the pathway, on cAMP-dependent protein kinase (PKA), was investigated by measuring the phosphorylation pattern of endogenous platelet proteins by PKA. (6) An increase in the [32P]phosphate incorporation was observed in platelets exposed to either, low doses of PGI2 or isobutylmethylxanthine (IBMX). Halothane, isoflurane, enflurane or sevoflurane further increased the level of [32P]-incorporation. The apparent increase in PKA activity suggests that at least in platelets, volatile anesthetics activate PKA-dependent pathways which should antagonize alpha2 adrenergic signaling.
BACKGROUND: This study was done to determine survival rates in subpopulations of severely neurologically disabled children who reside in pediatric skilled nursing facilities and to compare these survival rates with those in previously published studies. METHODS: Data were collected at three pediatric skilled nursing facilities over the 1986 to 1996 decade. The total study population numbered 447. We studied in detail six groups of the most severely disabled children and correlated their survival rates with clinical parameters and the presence of other significant diseases. RESULTS: The survival rates in our six groups of severely disabled children were significantly better than those previously reported. In group 1, our 8-year survival rate was 66%, as compared with 5% in the previous study. In group 2, our 8-year survival rate was 89%, versus 22% in the previous study. We obtained better survival rates in all six groups studied, irrespective of the analysis including children less than 1 year old, between 1 year and 15 years old, or more than 15 years old. The most significant determinant for reduced survival was the presence of other significant diseases. Those with other significant diseases had a 10-year survival rate of 45%, whereas those who were relatively healthy had a survival rate of 90%. Patients who received gastrostomy tube feedings had a better 10-year survival rate than those fed by nasogastric tube (78% vs 41%). This difference was independent of the presence of other significant medical diseases. CONCLUSIONS: Our results show substantially better survival rates than those previously reported. These improved results are most likely related to much more intense medical management of severely disabled children in skilled nursing facilities than at home or in other residential settings. Our study also showed a significantly better survival rate for those fed by gastrostomy tube as compared with nasogastric tube.
To optimize glucose utilization, double transgenic mice were created by crossing mice overexpressing glucose transporter GLUT4 with mice overexpressing hexokinase (HKII) in muscle. Transgenic mice overexpressing GLUT4 alone have exhibited improvements in glucose tolerance and insulin action. In vitro studies of hexose uptake in soleus muscle from transgenic mice suggested that GLUT4 was limiting the glucose flux except at high glucose concentration, where hexokinase became the limiting step. In vivo, glucose tolerance was similar in GLUT4 and GLUT4/HKII mice, although stimulated plasma insulin values were significantly lower in the latter group. Insulin tolerance tests performed in diabetic GLUT4 vs. diabetic GLUT4/HKII transgenic mice yielded identical results. Again, endogenous insulin in GLUT4/HKII mice during a mild hyperglycemic clamp was stimulated by only two- vs. fourfold in GLUT4 mice. Although the overexpression of HKII alone resulted in increased glucose utilization in several muscles, the overexpression of GLUT4 plus HKII did not augment basal or stimulated in vivo glucose utilization compared to GLUT4 overexpression. In conclusion, GLUT4 is rate limiting for muscle glucose utilization but HKII might be important under hyperglycemia. The addition of HKII to GLUT4 overexpression is not sufficient to further augment glucose tolerance or insulin action. In GLUT4/HKII double transgenic mice, glucose clearance is tempered by a low insulin stimulated level.
Eight monoclonal antibodies of different classes and isotypes and rabbit IgG were oxidized under a variety of conditions with 5-50 mM periodate. The number of aldehyde groups generated per immunoglobulin were measured by reduction with tritiated sodium borohydride or coupling of fluoresceinthiosemicarbazide. There were up to 25.5 aldehyde groups detected on the periodate-oxidized antibody 96.5, measured by borohydride reduction whereas the same conditions led to only 9.6 aldehydes per IgG on the antibody L6 of the same IgG2A isotype. Fluoresceinthiosemicarbazide bound to oxidized antibodies but not to the same extent as tritium. On mildly oxidized IgMs it was possible to generate more than 200 aldehyde groups per antibody molecule. Depending on the conditions and the antibody used periodate oxidation could lead to antibody crosslinking. The avidities of the modified antibodies were determined by Scatchard analyses and inhibition assays. A new mathematical method to evaluate the immunoreactivities of modified antibodies relative to the unlabeled native antibody from inhibition binding data was established. Periodate concentrations higher than 50 mM decreased the avidities and immunoreactivities of all IgGs tested. This effect is more pronounced if the oxidation is performed at pH 5.6 and 25 degrees C instead of pH 4.6 and 0 degree C. The BR96 antibody is inactivated even under mild oxidation conditions.
The extrapancreatic actions of sulfonylureas on the glucose transport system were studied in the L6 line of cultured rat skeletal muscle cells. Insulin (10(-7) M) increased 2-deoxyglucose uptake in differentiated L6 myotubes by 30-40% after 8 h of incubation. The sulfonylurea tolazamide (0.6 mg/ml, 22 h) had no effect on glucose uptake in the absence of insulin, but increased insulin-stimulated 2-deoxyglucose uptake twofold. The total cellular content of glucose transporters was assessed with a monoclonal anti-transporter antibody by a solid-phase ELISA method. Insulin (8 h) increased the quantity of glucose transporters, with a maximal twofold increase at 10(-7) M and a dose-response curve similar to that for insulin stimulation of glucose uptake. In spite of its lack of effect on glucose uptake, tolazamide alone (0.6 mg/ml) increased the cellular content of transporters by 70%. The effects of insulin and tolazamide on transporter gene expression were studied with probes derived from Hep G2 glucose transporter cDNA. Insulin increased the transporter mRNA level 1.7-fold, tolazamide increased it 1.5-fold, and the combination of insulin and tolazamide increased transporter mRNA 3-fold. It is concluded that sulfonylureas, together with insulin, enhance glucose uptake in L6 skeletal muscle cells by increasing the number of functioning glucose transport molecules. The long-term regulation of the glucose transport system in skeletal muscle by insulin and sulfonylureas in vivo may involve similar changes in transporter function, number, and gene expression.
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