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Biomedical subjects

J A Myers

Publications and source records attributed to J A Myers.

At least 19 recordsLinked to original sources

An optical fiber transducer for single myofibril force measurement.

A force transducer has been developed for use in force measurement of skeletal muscle myofibrils. The transducer is suitable for measurement of passive and contractile forces in a range up to 200 micrograms, with 1 microgram resolution. It is based upon the operating principle of the deflection of an optical fiber of known compliance, sensed by the differential illumination of two phototransistors. Attractive features include ease of operation and specimen mounting, high bandwidth, adaptability for different force ranges, and simple and inexpensive construction.

Biomechanical Phenomena

Molten globule monomer to condensed dimer: role of disulfide bonds in platelet factor-4 folding and subunit association.

Platelet factor 4 (PF4) exhibits high affinity for heparin and exists as a tetramer in solution under physiologic conditions. Reduction of the two disulfide bridges in PF4 increases the protein's dissociation constant for heparin approximately 20-fold and shifts the highest apparent aggregation state from tetramer to dimer as evidenced by gel filtration, chemical cross-linking, and 1H-NMR studies. 1H-NMR spectra of reduced PF4 monomers generally show narrower, less dispersed, upfield-shifted NH and alpha H resonances, suggesting the presence of an unfolded monomer state. Reduced PF4 monomer folding, however, is evidenced by the presence of about 12 relatively long-lived backbone NHs and by CD spectra that indicate conservation of overall secondary structure. These data suggest the presence of a molten globule-type state. Urea denaturation shifts this apparent molten globule to a fully unfolded state characterized by more random coil-like resonance shifts. The reduced PF4 dimer state yields NMR and CD data consistent with preservation of tertiary structural folds found for the native species. In this regard, the reduced PF4 folding transition is thermodynamically linked with dimer formation which stabilizes tertiary structure. Monomer-dimer association equilibria for reduced PF4 essentially follow the same pH and salt titration trends as reported previously for native PF4 dimers [Mayo, K. H., & Chen, M. J. (1989) Biochemistry 28, 9469-9478], indicating that that dimer interface is generally conserved in the absence of disulfide constraints. Reduced PF4 tetramers are not apparent under any conditions investigated, suggesting that disulfides are necessary for efficient antiparallel beta-sheet alignment between dimer pairs.

Chromatography, Gel

Retroperitoneoscopy: foreign body retrieval.

Retroperitoneoscopy is a rarely indicated procedure for the urological surgeon. However, it can be a useful means to approach some types of ureteral pathology and foreign bodies. We describe a case in which a severed surgical drain was removed from deep within the retroperitoneum by using a percutaneous retroperitoneal approach.

Aged

Pupil diameter and the principal ray.

Placement of the surgical zone is critical in refractive procedures that alter a portion of the corneal curve. An improperly centered optical zone may produce glare, decrease best corrected visual acuity, and decrease contrast sensitivity. For proper placement, the new surface should be centered around the line of sight, which is the principal ray from the object of regard that passes through the image of the patient's pupil as projected on the cornea. This point is not necessarily at the geometric center of the cornea and is found by locating the center of the pupil while the patient is maintaining fixation coaxially with the surgeon. However, the pupil does not dilate concentrically and its geometric center moves as the pupil diameter changes. We have found a shift up to 0.7 mm in the geometric center of the pupil as it dilates. Therefore, centration of an ablated or a radial keratotomy zone is most efficiently done when the diameter of the modified corneal optical zone is centered around the line of sight and is superimposed upon the entrance pupil. This will minimize extension of the edge of the large pupil beyond the ablated zone and reduce unwanted secondary optical effects from degrading vision.

Adult

Platelet factor 4 efficiently reverses heparin anticoagulation in the rat without adverse effects of heparin-protamine complexes.

BACKGROUND: It has been observed that the reversal of heparin anticoagulation in humans by protamine sulfate (PS) results in various adverse reactions including leukopenia, thrombocytopenia, activation of complement, increased vascular permeability, systemic hypotension, pulmonary vasoconstriction, and pulmonary edema. The purpose of this study was to compare the efficacy and effects of native platelet factor 4 (PF4) and recombinant platelet factor 4 (rPF4) with those of PS in heparin neutralization in vivo, using a rat model. METHODS AND RESULTS: Sprague-Dawley rats were anesthetized with sodium pentobarbital, and the right femoral vein and carotid artery were cannulated. For determination of activated partial thromboplastin time, platelet count, white blood cell count, and complement titer, arterial blood samples were taken before and immediately after heparin (10 units/100 g) infusion and at several time points after the infusion of the neutralizing agent (PS, 0.1 mg/100 g; PF4, 0.5 mg/100 g). In separate groups of animals, mean arterial blood pressure was monitored throughout identical protocols and the lungs were prepared for histological examination. The anticoagulant activity of heparin was effectively reversed by all of the neutralizing agents (PS, PF4, and rPF4). Platelet count (48% of initial), white blood cell count (52% of initial), complement titer (60% of initial), and mean arterial pressure (20% decrease) decreased significantly in heparinized animals receiving PS but not in those receiving PF4 or rPF4. Lung interstitium appeared normal when heparin was followed by PF4; however, interstitial edema and hemorrhage were observed with heparin-PS. CONCLUSIONS: These results suggest that PF4 efficiently reverses heparin anticoagulation in the rat without the adverse effects of heparin-protamine complexes. Therefore, rPF4 may be an appropriate substitute for PS in patients undergoing cardiovascular surgery and other procedures that require heparin anticoagulation.

Animals

Effect of temporary occlusion of hypogastric arteries on blood loss during radical retropubic prostatectomy.

We report on a prospective, partially randomized study of 130 patients, examining the effect of temporary occlusion of the hypogastric arteries on intraoperative blood loss, perioperative blood replacement and change in preoperative to postoperative hematocrit. We observed no significant difference in any of these parameters when comparing patients who did and did not undergo intraoperative occlusion of the hypogastric arteries. These findings suggest that temporary occlusion of the hypogastric arteries during radical prostatectomy does not have a major effect on the blood loss associated with this operation. Extensive collateral circulation to the prostate and a substantial venous component of blood loss may explain these findings. Banking of 3 units of autologous blood preoperatively would have decreased the need for homologous transfusions in the majority of patients.

Adenocarcinoma

Long-term followup of patients treated with 1 or 2, 6-week courses of intravesical bacillus Calmette-Guerin: analysis of possible predictors of response free of tumor.

We report our long-term experience with 104 patients treated for recurrent superficial bladder tumors followed for a mean of 48 +/- 2 months (range 6 to 83 months). Patients received 6 weekly intravesical bacillus Calmette-Guerin instillations, and were followed for response with urinary cytology, cystoscopy and bladder biopsy. Patients were considered treatment failures if either urinary cytology or biopsy results were positive for tumor. Of 69 patients who failed the initial treatment course 60 were given an additional 6-week course of therapy. A 6-week course of bacillus Calmette-Guerin was successful in 19 of 55 patients (35%) treated for prophylaxis, 10 of 32 (31%) treated for carcinoma in situ and 6 of 17 (35%) treated for residual tumor. The response rate for the total patient population treated with 1, 6-week course was 34% (35 of 104). Another 6-week course was successful in 32 of 60 patients (53%). The over-all response rate free of tumor for patients treated with either 6 or 12 weeks of therapy was 64%. The mean interval free of tumor was 48 months. We evaluated tumor type, stage and grade in conjunction with muscle invasion to assess potential indicators of response to a second course of bacillus Calmette-Guerin. Of 13 patients with carcinoma in situ and 45 with papillary disease 5 (38%) and 26 (58%), respectively, responded to a second course of bacillus Calmette-Guerin (not significantly different). In contrast, 5 of 8 carcinoma in situ failures (63%) had muscle invasive disease, compared to only 3 of 19 papillary nonresponders (16%) (p less than 0.02). These results suggest that intravesical bacillus Calmette-Guerin for the treatment of superficial bladder tumors is an effective long-term therapy. One 6-week course may be ineffective for some patients and another 6-week course provides long-term survival free of tumor for many course 1 failures. Patients who present with carcinoma in situ after a single 6-week course of intravesical bacillus Calmette-Guerin have a significantly higher risk for muscle invasive disease than those with recurrent papillary tumors.

Administration, Intravesical

Changes in gene expression during nitrogen starvation in Anabaena variabilis ATCC 29413.

When the filamentous, nitrogen-fixing cyanobacterium Anabaena variabilis ATCC 29413 was subjected to nitrogen starvation under aerobic conditions, a complex series of events was initiated which resulted in heterocyst formation and derepression of the ability to fix dinitrogen. Using DNA-RNA hybridization techniques, we monitored the expression of several genes during nitrogen starvation and correlated changes in the mRNA levels with changes in enzyme activity, protein levels, and morphology. Nitrogenase mRNA was first observed after about 8.5 h of nitrogen starvation, as was nitrogenase activity. Late proheterocysts were present at that time. The level of nitrogenase mRNA increased for 5 to 6 h and then leveled off. Phycocyanin and allophycocyanin mRNA levels decreased rapidly within 1 h of nitrogen starvation; the levels increased later, as nitrogen starvation was alleviated, first by protein breakdown and then by nitrogen fixation. The average half-life of A. variabilis mRNA was determined by pulse-labeling techniques to be 16 to 18 min. Hybridization analysis showed that cpc and apc mRNAs also had half-lives of 16 to 18 min; the half-lives were not significantly different under nitrogen starvation conditions. Our results support the idea that the changes induced by nitrogen starvation are primarily the result of transcriptional regulation.

Aerobiosis

Cyanide-induced parkinsonism: clinical, MRI, and 6-fluorodopa PET studies.

A 46-year-old man ingested 1,500 mg of potassium cyanide in a suicide attempt. He survived, but later developed a severe parkinsonian syndrome. MRI revealed multiple areas of low-signal intensity in the globus pallidus and posterior putamen. A 6-fluorodopa PET study revealed bilateral decreased uptake in the basal ganglia. This evidence of functional impairment of dopaminergic nigrostriatal neurons is related either to direct toxicity of cyanide or to the effects of cerebral hypoxia secondary to cyanide intoxication.

Cyanides

In-vivo secondary structure analysis of the small nuclear RNA U1 using psoralen cross-linking.

Intramolecular base-pairing interactions have been probed in the small nuclear RNA U1 in vivo. HeLa cells were treated with the psoralen derivative aminomethyltrioxsalen, and cross-linking was carried out by irradiating the intact cells with light of 365 nm wavelength. Cross-linking resulted in a discrete shift in electrophoretic mobility of approximately 65 to 70% of the U1. This intramolecularly cross-linked U1 RNA, termed XU1, was purified and shown to co-migrate with uncross-linked U1 upon photo-reversal of psoralen cross-links with light of 254 nm wavelength. XU1 was also generated by the in-vitro cross-linking of deproteinized U1, suggesting that the secondary structure of U1 RNA in solution is similar to that of U1 ribonucleoprotein in the cell. A sequencing analysis was developed, based on partial enzymatic and alkaline cleavage of psoralen-treated RNA, to identify the position of psoralen cross-links and to distinguish between psoralen monoadducts and diadducts (cross-links). Sequencing of 3' and 5' end-labeled XU1 provided direct evidence for the presence of a unique intramolecular cross-link in XU1, located on uridine 116 (U116). This result is consistent with several secondary-structure models for U1 in which U116 is located in a base-paired stem. The proximity of uridine 96 (U96) to U116 on the opposite side of the base-paired stem suggested that U116 was cross-linked to U96. An additional U1 species having an electrophoretic mobility between those of U1 and XU1 was also generated by psoralen treatment. Analysis of this U1 species, termed U1M, revealed a psoralen monoadduct on U96. Further longwave (365 nm) irradiation of purified U1M resulted in its conversion to XU1 by completion of the U96-U116 cross-link. This suggested that cross-linking at the U96-U116 site occurred as a two-step process in which the psoralen first reacted with U96 and then with U116. Sequencing analysis also identified a psoralen monoadduct on uridine 45 (U45) of XU1. Efficient psoralen-adduct formation, which resulted in cross-linking at the U96-U116 site and monoaddition on U45, suggests that these regions are relatively accessible in the native U1 small nuclear ribonucleoprotein particle in vivo.

Base Sequence

Purification and characterization of the gene 1.2 protein of bacteriophage T7.

Gene 1.2 of bacteriophage T7, located near the primary origin of DNA replication at position 15.37 on the T7 chromosome, encodes a 10,059-dalton protein that is essential for growth on Escherichia coli optA1 strains (Saito, H., and Richardson, C. C. (1981) J. Virol. 37, 343-351). In the absence of the T7 1.2 and E. coli optA gene products, the degradation of E. coli DNA proceeds normally, and T7 DNA synthesis is initiated at the primary origin. However, T7 DNA synthesis ceases prematurely and the newly synthesized DNA is degraded; no viable phage particles are released. The gene 1.2 protein has been purified to apparent homogeneity from cells in which the cloned 1.2 gene is overexpressed. Purification of the [35S] methionine-labeled protein was followed by monitoring the radioactivity of the protein and by gel electrophoresis. The purified protein has been identified as the product of gene 1.2 on the basis of molecular weight and partial amino acid sequence. We have found that extracts of E. coli optA1 cells infected with T7 gene 1.2 mutants are defective in packaging exogenous T7 DNA when such extracts are prepared late in infection. Purified gene 1.2 protein restores packaging activity to these defective extracts, thus providing a biological assay for gene 1.2 protein. No specific enzymatic activity has been found associated with the purified gene 1.2 protein.

Amino Acid Sequence

Gene 1.2 protein of bacteriophage T7. Effect on deoxyribonucleotide pools.

The gene 1.2 protein of bacteriophage T7, a protein required for phage T7 growth on Escherichia coli optA1 strains, has been purified to apparent homogeneity and shown to restore DNA packaging activity of extracts prepared from E. coli optA1 cells infected with T7 gene 1.2 mutants (Myers, J. A., Beauchamp, B. B., White, J. H., and Richardson, C. C. (1987) J. Biol. Chem. 262, 5280-5287). After infection of E. coli optA1 by T7 gene 1.2 mutant phage, under conditions where phage DNA synthesis is blocked, the intracellular pools of dATP, dTTP, and dCTP increase 10-40-fold, similar to the increase observed in an infection with wild-type T7. However, the pool of dGTP remains unchanged in the mutant-infected cells as opposed to a 200-fold increase in the wild-type phage-infected cells. Uninfected E. coli optA+ strains contain severalfold higher levels of dGTP compared to E. coli optA1 cells. In agreement with this observation, dGTP can fully substitute for purified gene 1.2 protein in restoring DNA packaging activity to extracts prepared from E. coli optA1 cells infected with T7 gene 1.2 mutants. dGMP or polymers containing deoxyguanosine can also restore packaging activity while dGDP is considerably less effective. dATP, dTTP, dCTP, and ribonucleotides have no significant effect. The addition of dGTP or dGMP to packaging extracts restores DNA synthesis. Gene 1.2 protein elevates the level of dGTP in these packaging extracts and restores DNA synthesis, thus suggesting that depletion of a guanine deoxynucleotide pool in E. coli optA1 cells infected with T7 gene 1.2 mutants may account for the observed defects.

DNA Replication

Stepwise shortening of muscle fibre segments.

Shortening dynamics were measured in single fibres of frog skeletal muscle using a system that could track the spacing between hairs mounted on the fibre surface. Segment length changes were predominantly stepwise. The objective of the study was to identify potential artifacts and check their relevance. Several possible causes of artifactual steps were evaluated quantitatively and ruled out. In addition, the surface marker method and an independent length-detection method based on light diffraction were used simultaneously. The concurrence of results confirmed that it is highly unlikely that stepwise shortening could arise out of instrument artifact. Possible mechanisms underlying the phenomenon are considered.

Animals

Bupivacaine protein binding in the term parturient: effects of lactic acidosis.

The effects of lactic acidosis on bupivacaine serum protein binding was studied in a group of term parturients and a group of nonpregnant female control subjects. Groups were matched in age and health. Distribution characteristics of bupivacaine in pregnancy were determined. Bupivacaine protein binding was best characterized by the model for two classes of binding sites in all studies. The parturients exhibited a lower capacity for the high-affinity, low-capacity (alpha 1-acid glycoprotein) site and higher affinity for the low-affinity, high-capacity (albumin) site. Lactic acidosis decreased the affinity constant for the high-affinity, low-capacity site in the control group but did not change binding characteristics in the parturients. Free concentration of bupivacaine (Cu) was elevated at low total bupivacaine concentrations (Ct) (less than 10 micrograms/ml). No differences in Cu were detected at concentrations in the cardiotoxic range (greater than 20 micrograms/ml). The Cu values predicted by the estimated binding parameters from in vitro experiments were compared with actual Cu measured in nine parturients at delivery; they correlated significantly (r = 0.94). Distribution changes for bupivacaine in the parturients were consistent with known physiologic changes in body composition associated with pregnancy. Alterations that occur in serum protein binding during pregnancy should not result in increased risk of central nervous system or cardiovascular system toxicity since these alterations do not increase free tissue concentration.

Absorption

The influence of lactic acid on the serum protein binding of bupivacaine: species differences.

Various animal models have been used for studies of bupivacaine cardiovascular toxicity. These studies are difficult to relate to the clinical situation, since the disposition of bupivacaine in the various species is unknown. The serum protein binding of bupivacaine, therefore, was determined in human, sheep, monkey, dog, and rat at physiologic pH using ultrafiltration. Since a mixed acidosis results during a systemic toxicity reaction to bupivacaine, the influences of an acidic pH, resulting from the addition of lactic acid, also was examined. All sera exhibited two classes of binding sites, a high-affinity, low-capacity class (class 1) and a low-affinity, high-capacity class (class 2). When compared to human serum at physiologic pH, a significantly higher (P less than 0.05) affinity constant for the class 1 sites was observed for all species studied, with the exception of the rat. All species studied exhibited a significantly lower (P less than 0.05) capacity for the class 1 sites. The binding parameters of the class 2 sites displayed no significant difference. An acid pH resulted in a decrease in bupivacaine protein binding over the entire concentration range studied for all species, with the exception of the monkey. Monkey serum exhibited no change in bupivacaine binding with a decrease in pH. Since protein binding explains only a portion of the total disposition of bupivacaine, further delineation of each animal model under both acidotic and physiologic conditions needs to be accomplished before the animal studies currently under investigation can be extrapolated to the clinical situation.

Acidosis

Generalized seizures and cocaine abuse.

Cocaine is a commonly abused drug. We report three patients who had generalized seizures immediately following intravenous injection of cocaine. Previous experimental and clinical literature have documented a relationship between cocaine and convulsions. The rising incidence of cocaine use may be associated with a rising incidence of cocaine-associated seizures.

Adult

The influence of diazepam on the serum protein binding of bupivacaine at normal and acidic pH.

Since both bupivacaine and diazepam are highly protein bound, it is possible that a drug displacement interaction could occur, resulting in an increase in free bupivacaine concentration that could exacerbate systemic toxicity. This study was undertaken to characterize the serum binding of diazepam and to evaluate any drug displacement interaction between diazepam and bupivacaine. Human serum obtained from venous blood of normal male and female volunteers was used for measurements of protein binding using an Amicon Micropartition System. Bupivacaine protein binding in the presence of 0, 0.5 and 1.5 microgram/ml diazepam was best described by the model for two classes of binding sites. Neither concentration of diazepam significantly altered the capacity or affinity for either class of bupivacaine binding sites when compared to control. Free concentrations of bupivacaine were statistically identical in the presence of both diazepam concentrations. The complete diazepam binding profile in both serum and isolated human serum albumin was best described by a model describing two classes of binding sites. The effect of an acidic pH on bupivacaine was also independent of diazepam concentration. Diazepam protein binding was not affected by a reduction in pH from 7.4 to 7.0. The data reported here suggest no binding displacement interaction exists between bupivacaine and concomitantly administered diazepam. Thus, administration of diazepam during a toxic reaction associated with bupivacaine should not alter free bupivacaine concentration.

Acidosis

The clinical relevance of the drug displacement interaction between meperidine and bupivacaine.

The effect of meperidine at two clinically relevant concentrations (0.4 and 0.8 microgram/ml) on the serum protein binding of bupivacaine was studied. The serum protein binding profile for meperidine was characterized over a wide concentration range (0.5-100 micrograms/ml). All bupivacaine binding experiments were characterized by a two classes of binding sites model. Bupivacaine binding was independent of added meperidine. Meperidine binding was characterized by a one class of binding sites model and the unbound meperidine concentration was relatively constant over the entire range studied. The capacity and affinity of the meperidine binding site are suggestive of binding primarily to albumin. At clinically encountered meperidine concentrations, no increased toxicity due to an increase in unbound bupivacaine would be expected.

Binding, Competitive