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Biomedical subjects

J R McCormick

Publications and source records attributed to J R McCormick.

At least 55 records · Page 3Linked to original sources
PubMed1982

Elevation of serum chemotactic factor inactivator activity in rabbits induced by inflammation and chemotactic factor.

Inflammatory mediators such as the vasoactive and chemotactic factors, which are formed during the activation of serum complement, are extremely potent biologic peptides and are thought to be under the rigid control of specific serum-derived regulators or inactivators, including the anaphylatoxin inactivator (AI) and the chemotactic factor inactivator (CFI). Our understanding of the biologic importance and implication of these regulators in inflammatory reactions is primarily based on in vitro observations, and there is only limited data on their in vivo importance. Previously, alterations in CFI and AI levels were detected in chronic inflammatory disease states, but no data on their activity or role during acute inflammatory reactions have been demonstrated. Here we demonstrate the elevation of serum CFI activity during acute inflammatory reactions in rabbits. Specifically, inflammatory reactions were induced in rabbits by intraperitoneal injections of 0.1% oyster glycogen. Rabbit serum CFI levels rose rapidly over the first 4 hours after glycogen injection, reaching levels 4-8 times higher than the preglycogen serum CFI levels. Additional studies demonstrated that acute elevations of serum CFI levels could also be induced in rabbits by intravenous infusion of activated rabbit serum or C5-derived chemotactic factors. Infusion of saline, albumin, or the synthetic chemotactic peptide f-Met-Leu-Phe did not cause elevation of the serum CFI levels in rabbits. Thus, we take these data to support our hypothesis that 1) CFI is a "hyperacute phase reactant" that is elevated during inflammatory reactions, and 2) that this elevation of serum CFI activity is probably triggered by the appearance of specific C5-derived chemotactic factors within the vasculature. These studies not only provide exciting new insights into the regulatory mechanisms involved in acute inflammatory reactions but suggest that novel approaches to antiinflammatory therapy may be forthcoming.

Acute Disease↗
PubMed1982

Alterations in activities of anaphylatoxin inactivator and chemotactic factor inactivator during hemodialysis.

The systemic infusion of complement-derived anaphylatoxin ane chemotaxins during hemodialysis results in profound transient neutropenia and may be associated with subtle pulmonary dysfunction. The fact that these potent inflammatory peptides do not usually produce serious ill effects may be due in part to their rapid inactivation by the serum regulatory proteins anaphylatoxin inactivator (AI) and chemotactic factor inactivator (CFI). Accordingly, the authors investigated the effect of hemodialysis on circulating neutrophil counts and serum levels of AI and CFI activity in 10 patients. In all patients, circulating neutrophil counts plummeted by more than 50% within 5 minutes of the onset of dialysis and rose beyond control levels by 1 hour. AI activity significantly fell from 65 +/- 16 mU/ml before dialysis to 18.7 +/- 7.8 mU/ml within 5 minutes of its initiation; levels remained depressed throughout the procedure. In contrast, CFI gradually increased, achieving a level significantly different from the predialysis value by 15 minutes. These events contrasted with the observation that activation of the complement system in vitro results in a significant decline in both CFI and AI activities. We suggest that the maintenance of or increase in CFI activity in patients undergoing hemodialysis enhances the clearance of circulating chemotactins, preventing the persistent activation of neutrophils during the procedure and subsequent organ dysfunction.

Adult↗
PubMed1981

Serum angiotensin-converting enzyme levels in patients with pigeon-breeder's disease.

The serum concentration of angiotensin-converting enzyme is frequently elevated in individuals with active sarcoidosis. The enzyme is presumably actively synthesized by the epithelioid and giant cells of the granuloma. Hypersensitivity pneumonitis, resulting from the inhalation of antigens from pigeons by susceptible individuals, is associated with the development of a granulomatous interstitial and alveolar infiltrate in the pulmonary parenchyma. Because the clinical and pathologic presentation may mimic that of sarcoidosis, we compared the serum levels of angiotensin-converting enzyme in these two diseases. The concentration of angiotensin-converting enzyme is not elevated in individuals with active hypersensitivity pneumonitis, in contrast to its frequent elevation in sarcoidosis. We suggest that the granulomatous response in hypersensitivity pneumonitis may differ at a biochemical level from that of sarcoidosis, since the synthesis of angiotensin-converting enzyme does not appear to be increased.

Allergens↗
PubMed1981

The development of bleomycin-induced pulmonary fibrosis in neutrophil-depleted and complement-depleted rats.

The development of bleomycin-induced pulmonary fibrosis was studied in rats depleted of neutrophils for 1 week and in rats depleted of complement for 1 week. Lung injury was assessed by histologic evaluation and by the biochemical measurement of total lung collagen. Qualitatively, histologic evidence of damage induced by bleomycin showed that damage progressed in a similar manner in neutropenic and complement-depleted animals when compared with normal animals. However, analysis of total lung collagen at 1 week after bleomycin administration revealed that collagen deposition was increased in neutropenic animals and decreased in animals depleted of complement when compared with untreated animals that received bleomycin. There were no significant differences in lung collagen levels at 1 month after bleomycin treatment in neutrophil-depleted or complement-depleted animals when compared with animals that received bleomycin alone.

Animals↗
PubMed1981

Suppression by superoxide dismutase of immune-complex--induced pulmonary alveolitis and dermal inflammation.

The possible role of oxygen metabolic products in immune-complex--induced injury of rat lung and of dermal blood vessels has been probed with the use of two inhibitors, superoxide dismutase (SOD) and catalase. With the use of the reversed passive Arthus reaction in the skin, local administration of SOD, but not of catalase, blocked the early phase of the tissue injury, as quantitated by the leakage of homologous albumin. The early phases of immune-complex--induced injury of the lung were completely blocked by the parenteral (intraperitoneal) administration of SOD. Except at very high doses, SOD did not interfere with chemotactic-factor--induced release of lysosomal enzymes from rat neutrophils. These data suggest that oxygen metabolic products such as O(2-) may play an important role in the early phases of damage produced in rat alveolar walls and dermal vasculature by the deposition of immune complexes.

Animals↗
PubMed1981

Infection in remnant of left ventricular assist device after successful separation from assisted circulation.

There have been two long-term and two short-term survivors among 10 patients in our hospital in whom the left ventricular assist device (LVAD) was implanted for cardiogenic shock after cardiac operations. Two of these four patients developed graft infection in the LVAD remnants left attached to the ascending aorta and left ventricle; one died of sepsis and the other required repeat operations for a chronic draining sinus and hemorrhage from a left ventricular--cutaneous fistula. This experience with infection and demonstration of the feasibility of total removal of both limbs of the LVAD without cardiopulmonary bypass lead us to recommend complete removal of the LVAD conduits in patients weaned from assisted circulation.

Aorta↗
PubMed1981

Oleic-acid-induced lung injury in the rat. Failure of indomethacin treatment or complement depletion to ablate lung injury.

The purpose of this study was to establish a rat animal model of acute respiratory distress syndrome using the intravenous injection of oleic acid. Further, we attempted to inhibit the development of lung injury by pretreatment of the rats with indomethacin or cobra venom factor. Histologic evidence of lung injury was apparent within hours after the administration of a single intravenous injection of oleic acid. By 24 hours, interstitial and intraalveolar edema and hemorrhage were noted with vascular congestion and an extensive interstitial infiltrate. The lungs appeared virtually normal by 12 days, with no evidence of chronic lung injury. Multiple injections of oleic acid also did not progress into chronic pulmonary inflammation. Treatment of the rats with indomethacin or cobra venom factor had no effect on ablating acute lung injury. An animal model of adult respiratory distress syndrome is presented which does not progress to chronic lung injury.

Animals↗
PubMed1980

Successful use of a paracorporeal left ventricular assist device in man.

A paracorporeal left ventricular assist device (LVAD) with a capacity to pump 8 L/min of blood was employed in a clinical trial, and this report details the first survivor. A 60-year-old man could not be separated from the pump oxygenator following coronary artery bypass grafting, and, therefore, an LVAD was employed. Almost the entire left ventricular workload was assumed by the mechanical pump so that the myocardium was allowed to rest and recover. The LVAD support was continued for 105 hours. It provided satisfactory total body perfusion with maintenance of good hemodynamics--without serious deleterious effects on hematologic factors. The patient is alive and active without cardiac symptoms 16 months after his operation. The total experience with 13 LVAD implantations warrants continuation of the clinical trials in selected patients.

Angina Pectoris↗
PubMed1980

Unusual effects of metrizamide lumbar myelography. Constellation of aseptic meningitis, arachnoiditis, communicating hydrocephalus, and Guillaine-Barré syndrome.

A clinical constellation of aseptic meningitis, arachnoiditis, communicating hydrocephalus, and a Guillain-Barré syndrome occurred following lumbar myelography with metrizamide. To our knowledge, Guillain-Barré syndrome has not been previously described following myelography with any contrast agent. Meningeal reactions and hydrocephalus have been reported with other agents, but this is the first instance with metrizamide.

Aged↗
PubMed1979

Left ventricular false aneurysm after coronary bypass surgery: radionuclide diagnosis and surgical resection.

A patient with left ventricular pseudoaneurysm formation resulting from myocardial infarction 4 years after coronary bypass surgery is described. The pseudoaneurysm was diagnosed with gated cardiac blood pool imaging and was subsequently successfully surgically repaired. Postoperative pericardial abnormalities predisposing to the possible development of a false aneurysm are discussed. Also, clinical situations in which pseudoaneurysm should be suspected are described, and appropriate diagnostic approaches are outlined.

Coronary Artery Bypass↗
PubMed1979

Temporary left ventricular bypass: factors affecting patient survival.

Circulatory support (range, 2 hours-8 days) was undertaken in eight cardiac surgical patients (with two survivors) exhibiting intractable cardiogenic shock. A paracorporeal, pneumatic, xenograft-valve pump was interposed between the left ventricular apex and ascending aorta. Pumping lowered left atrial and ventricular pressure while maintaining cardiac output (1.8--2.6 l/min/m2). Following implantation, plasma hemoglobin and erythrocyte mechanical fragility values were elevated but decreased to normal when renal function was not impaired. Mild thrombocytopenia was noted in three patients and was severe in five others with persistent hemorrhage. Anticoagulation agents were used during tapering of pump flow (three patients) after 100, 105 and 120 hours of bypass. Otherwise, for the major portion of the interval of mechanical circulatory support, anticoagulants were not administered. Despite this fact, no systemic embolization was detected in any of the patients. It appears that assist pump support can be life-saving in acute left ventricular failure in patients following cardiac surgery.

Adult↗
PubMed1979

Suppression of immune complex vasculitis in rats by prostaglandin.

Immune complex-induced vascular damage can be markedly suppressed by treatment of rats with either prostaglandin (PG)E1 or its stable derivative, 15-(S)-15-methyl PGE1, but not with PGF2 alpha. In addition, PGD2 and PGE2 also show suppressive effects. The PGE1 derivative is considerably more effective than PGE1 and shows potent anti-inflammatory activity even after oral administration. Suppression of the vasculitis reaction is reflected by a greatly diminished increase in vasopermeability, indicating little or no vascular damage. In suppressed animals, the infiltration of neutrophils is greatly reduced, and those leukocytes that have appeared at tissue sites fail to show phagocytic uptake of immune complexes. In suppressed animals, the skin sites nevertheless show deposits of immune complexes and C3 fixation in vascular walls. Neutrophils harvested from the blood of rats treated with PGE1 show depressed responsiveness in chemotaxis and in enzyme secretion after incubation with chemotactic peptide. These studies indicate that certain PG have potent anti-inflammatory activity, which may be related to their effects on leukocytes.

Administration, Oral↗
PubMed1979

Simple method for measurement of cardiac output by thermodilution after cardiac operation.

Cardiac output by the thermodilution technique was measured by a new No. 2 Fr. transthoracic (2F-TT) thermistor catheter placed at cardiac operation into the pulmonary artery directly through the right ventricular outflow tract. Cold (0 degree C) 5% dextrose in water (D5W) was used as indicator and injected through a percutaneously placed central venous pressure (CVP) catheter in the jugular vein. Comparison to the No. 7 Fr. Swan-Ganz (7F-SG) catheter demonstrated a close correlation (r = 0.87) and almost identical mean thermodilution cardiac output values during 530 determinations in 10 patients. No difficulty was experienced in insertion or removal of the 2F-TT catheter and no bleeding complications were noted. Experiments in six dogs showed that variation in position of the tip of the CVP catheter within the superior vena caval venous system and right atrium was not a critical factor in measurement of thermodilution cardiac output. The thermodilution cardiac output technique in general and the ease of insertion, as well as the small size of the 2F-TT catheter, should make this method especially advantageous in infants and small children.

Cardiac Output↗
PubMed1979

Bleomycin-induced pulmonary fibrosis in the rat: inhibition by indomethacin.

A model for pulmonary fibrosis in the rat has been developed using intratracheal administration of bleomycin. The histopathologic features of the reaction are similar to those reported in the hamster model. Increases in vascular permeability are seen in the lung within 24 hours and persist over a 2-month period. Extractable collagen, as measured by hydroxyproline, increases during this time by a factor greater than 1.5 times the reference control values of normal lung. During this same period, a prominent eosinophilia develops. The continued treatment of bleomycin-injected rats with indomethacin markedly diminishes the amount of extractable lung collagen at 60 days and the histopathologic evidence of pulmonary fibrosis. The eosinophilia over the first 3 weeks is also markedly suppressed. Less dramatic effects were seen with the permeability changes. These findings indicate that the rat is a reliable and useful model for the study of blemoycin-induced pulmonary fibrosis and that treatment with indomethacin ameliorates the lung changes.

Animals↗