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Biomedical subjects

R A Stone

Publications and source records attributed to R A Stone.

At least 19 recordsLinked to original sources

Lung cancer mortality among industrial workers exposed to formaldehyde: a Poisson regression analysis of the National Cancer Institute Study.

The Formaldehyde Institute (FI) sponsored additional Poisson regression analysis of lung cancer mortality data from the joint National Cancer Institute (NCI)/FI cohort study of workers exposed to formaldehyde to investigate the previously reported effects of plant and latency period and to assess the impact of short-term workers (under 1 yr employment) on the results. There were 242 lung cancer deaths in this cohort of 20,067 white male workers. With OCMAP software, lung cancer death rates for the white males in this cohort were computed by plant, age, calendar time, and job type for several time-dependent formaldehyde exposures, including formaldehyde exposure in the presence of 12 selected co-exposures: ammonia (AM), antioxidants (AN), asbestos (AS), carbon black (CB), dyes/inks/pigments (DY), hexamethylenetetramine (HX), melamine (ME), particulates (PT), phenol (PH), plasticizers (PL), urea/urea compounds (UR), wood dust (WD), and a composite co-exposure (X5) involving AN, HX, ME, PH, and UR.A 1.6-fold increase in lung cancer risk was found, beginning approximately 16-20 yr after first employment in the study plants with no evidence of a differential effect of latency between hourly and salaried workers or among the various categories of formaldehyde exposure as measured by cumulative average intensity or length of exposure. The statistically significant heterogeneity in lung cancer risk among the 10 plants could not be explained by interplant differences in cumulative or average intensity of exposure to formaldehyde, either without regard to co-exposures or in the presence of any of the 12 co-exposures considered individually. Plant was not a statistically significant predictor of lung cancer risk when cumulative exposure to the composite X5 was included in the model, suggesting that some component of X5, or a correlate, could at least partly account for the overall heterogeneity. No significant associations were found for cumulative, average, or length of exposure to formaldehyde without regard to co-exposure, but positive associations were found for cumulative exposure to formaldehyde in the presence of several co-exposures (AN, HX, ME, PH, and UR). For workers who were never exposed to any of 10 co-exposures associated with an increased lung cancer risk, there was a decreasing pattern of estimated lung cancer risk ratios relative to cumulative formaldehyde exposure. Similar patterns were seen when the analysis was restricted to the long-term workers. Analysis of the internal cohort rates corroborates previous analyses of NCI/FI cohort data in that significant positive associations were found between the risk of lung cancer and cumulative exposure to formaldehyde in the presence of several of the same co-exposures. No such associations were found in the absence of these co-exposures.

Adult

Reduced renovascular resistance by clonidine.

The antihypertensive effect of clonidine has been attributed to acute inhibition of sympathetic outflow from the central nervous system. This conclusion is derived from experiments with single doses of clonidine. The mechanism of the long-term blood pressure-lowering effect of clonidine has been less well characterized. Antihypertensive therapy may alter renal hemodynamics and these changes may ultimately affect systemic blood pressure. We studied the effect of long-term clonidine therapy on intrarenal hemodynamics, the renin-angiotensin system, and selected indices of sympathetic nervous system activity in 13 patients with essential hypertension to further elucidate its action. Long-term clonidine therapy resulted in decreased MAP and RVR associated with the suppression of supine but not upright PRA. RPF, RBF, FF, and WBV did not change. UKA, on index of the the putative vasodilating renal kallikrein-kinin system, was also not changed. Our findings suggest a role for PRA in modulating RVR during long-term clonidine therapy. This was associated with the reduction observed in MAP.

Adult

Plasma dopamine-beta-hydroxylase activity and blood pressure variability in hypertensive man.

It has been proposed that measurements of plasma dopamine-beta-hydroxylase (DBH) may allow for assessmetn of adrenergic tone and may elucidate a possible neurogenic contribution to essential hypertension. We performed a series of measurements of DBH in fifty-seven normotensive and fifty hypertensive black and white men in order (1) to compare DBH to selected blood pressure patterns and (2) to evalutate the influence of salt intake, posture and race on plasma DBH. Plasma DBH, measured on unrestricted salt intake with subjects supine, was 42 +/- 4 Units/L in white normotensives, greater (P less than 0.05) than black normotensives (26 +/- 6 Units/L). White hypertensives had greater plasma concentrations of DBH than black (35 +/- 3 VS. 24 +/- 5, P less than 0.05). Normotensives did not differ from hypertensives. Dietary salt restriction and upright ambulation increased plasma DBH activity in hypertensives. Although DBH did not correlate directly with blood pressure, high DBH values were associated with lability of blood pressure in hypertensives but not in normotensives. There are two possible explanations for our results: (1) multiple factors influence plasma DBH activity and plasma levels reflect more than adrenergic function, or (2) essential hypertension is a multifactorial disease and excess sympathetic neuronal activity alone is not sufficient to produce sustained hypertension.

Adult

The transport of para-aminohippuric acid by the ciliary body and by the iris of the primate eye.

Para-aminohippuric acid (PAH) accumulates against a concentration gradient in the ciliary body and independently in the iris of the rhesus monkey eye. This accumulation is inhibited by incubation of 0 degrees C and shows saturation kinetics in both tissues. Cyanide, ouabain, dinitrophenol, iodopyracet, and probenecid effectively depress PAH uptake in both tissues, but anaerobic incubation conditions have little effect on uptake in either tissue. The washout of preaccumulated PAH occurs 2.5 times faster from the iris than from the ciliary body. The effects on washout of 10(-4)M PAH, 0 degrees C, and 10(-5)M dinitrophenol are consistent with washout occurring by a diffusional mechanism in both tissues, with some reaccumulation occurring in the ciliary body only. In addition, nonsaturable uptake of PAH, studied in both tissues under high PAH concentrations, also occurs significantly faster in the iris than in the ciliary body. The kinetic analysis of active PAH uptake in both tissues is discussed in terms of initial uptake and in terms of a steady-state model. This steady-state model compensates for some technical problems in applying in vitro incubation techniques to primate tissues and also includes a correction for the additional exchange processes that affect the two tissues differently. Results of the kinetic analysis suggest that, at least to an order of magnitude, iris uptake is significant with respect to ciliary body uptake.

Aminohippuric Acids

Cholic acid accumulation by the ciliary body and by the iris of the primate eye.

Cholic acid accumulates in both the ciliary body and the iris of the primate eye during in vitro incubations at 37 degrees C for 1 hr. Incubation at 0 degrees C depresses uptake in both tissues. The washout of preaccumulated cholic acid occurs some 3.4 times faster from the iris than from the ciliary body. The mechanism of cholic acid accumulation in both tissues is less sensitive to inhibition by high iodipamide concentrations and also is less sensitive to inhibition by high hippurate concentrations than the mechanism of p-aminohippurate (PAH) accumulation. Therefore, although overlap may exist, the cholic acid--uptake mechanism differs from the PAH-uptake mechanism in both the primate ciliary body and the primate iris.

Animals

Racial analysis of the volume-renin relationship in human hypertension.

We studied 29 normotensive men (14 black, 15 white) and 36 hypertensive men (27 white, nine black) to examine the association of race with blood pressure, blood volume, and peripheral renin activity (pra). Blood volume was lower in white hypertensive men than in white normotensive men, but was similar in all blacks. When subjects were tested in the supine position, PRA was lower in black normotensive subjects than white normotensive subjects. The PRA did not differ among groups tested in an upright posture, while furosemide-stimulated PRA was lower in hypertensive than normotensive subjects of both races despite lower blood volumes in white hypertensive subjects. Differences of volume and renin measurements appear to reflect basic differences between whites and blacks with essential hypertension. We emphasize the need to consider race in the investigation of human hypertension.

Adult

Human plasma dopamine beta-hydroxylase. Purification and properties.

Dopamine beta-hydroxylase was isolated from normal human plasma. The major form of the active enxyme in plasma was purified to apparent homogeneity and is a 300,000-dalton tetramer containing 4 atoms of tightly bound copper. About 20% of the enzyme activity in plasma was isolated as a dimeric form of this enzyme. Sodium dodecyl sulfate gel electrophoresis of the purified form gave a polypeptide subunit molecular weight of 72,000 and disulfide-linked dimers of this component were observed. Both forms of the enzyme are apparently glycoproteins and interact with immobilized concanavalin A. Furthermore, the enzyme is capable of binding to alkyl-substituted agarose by hydrophobic interaction. Advantage was taken of these properties to purify the enzyme. Both purified tetramer and partially purified dimer were further characterized by kinetic analysis and the Stokes radii and S20,W of these species were compared. Rabbit antiserum to the purified tetramer revealed no immunochemical differences between the two enzyme forms by using a method of immunotitration.

Animals

Urinary kallikrein activity in the hypertension of renal parenchymal disease.

To learn more about the regulation of blood pressure in renal parenchymal disease, 57 subjects (18 normal controls, 25 patients with essential hypertension and 14 with renal parenchymal disease and hypertension) were evaluated for peripheral renin activity, 24-hour urinary kallikrein activity and whole-blood volume. Blood volumes were significantly lower in patients with essential hypertension (P less than 0.001) and those with renal disease and hypertension (P less than 0.001) than in normotensive subjects. Renin activities (measured after the subjects were standing) were also lower in patients with essential hypertension and hypertension due to renal disease (P less than 0.01 and P less than 0.02, respectively). Kallikrein activity was similar in subjects with renal disease and those with hypertension (P less than 0.05) but markedly diminished in both groups as compared with normotensive subjects (P less than 0.001 and P less than 0.01, respectively) when glomerular filtration rates were taken into account. The kallikrein-kinin system may be involved in the hypertension associated with renal parenchymal disease.

Adult

The relationship of urinary kallikrein activity to renal salt and water excretion.

1. We measured urinary kallikrein (kininogenin) excretion in black and white normotensive subjects during a variety of manipulations of salt and water balance. 2. A large intravenous saline load administered while the subjects were on an unrestricted sodium diet did not significantly change urinary kallikrein activity in either racial group. 3. After several days of dietary sodium restriction both racial groups increased their urinary kallikrein activity. An intravenous water load given then further increased urinary kallikrein activity. White subjects were studied for an additional 24 h period, and urinary kallikrein activity returned to pre-water load values, indicating that the excretion of a water load in sodium-depleted subjects is associated with an increase in kallikrein excretion. 4. Black subjects excreted less kallikrein in the urine than white subjects during the initial 24 h periods of unrestricted dietary sodium intake, but there were no other significant racial differences during the other experimental conditions.

Adult

Hypertension in renal insufficiency: a major therapeutic problem.

Hypertension and a high incidence of cardiovascular morbidity and mortality often accompany end-stage renal disease. Causes of the hypertension include abnormalities of extracellular fluid volume, increased activity of the renin-angiotensin system, dysfunction of the autonomic nervous system, and deficiency of vasodilator substances. Treatment is not detrimental to residual renal function and may enhance the quality of survival. Several types of therapy are available that may be used sequentially or in combination. New antihypertensive drugs and improved blood-cleansing devices allow a more optimistic outlook on long-term survival in end-stage renal disease.

Antihypertensive Agents

The prostaglandin and kallikrein-kinin systems in mineralocorticoid escape.

To evaluate the interactions of the renal prostaglandin and kallikrein-kinin systems during mineralocorticoid escape, we administered desoxycorticosterone acetate (DOCA; 20 mg im daily for 10 days) to five normal men and then repeated the study 2-16 weeks later with simultaneous indomethacin (200 mg/day) or ibuprofen (1600 mg/day) for prostaglandin inhibition (PI). Plasma aldosterone, PRA, and urinary prostaglandin E (PGE) were measured by immunoassay; urinary kallikrein activity was measured by esterase activity. With DOCA, subjects gained 2.0 +/- 0.1 (SE) kg and retained 485 +/- 125 milliequivalents (meg) sodium; serum potassium fell from 4.6 +/- 0.2 to 3.2 +/- 0.1 meq/liter, aldosterone fell from 3.8 to 2.2 ng/dl, and PRA fell from 0.9 to 0.1 ng/ml . h (all P less than 0.05). Kallikrein increased from 6.4 +/- 1.6 to 65.3 +/- 18.8 esterase U (P less than 0.01), but PGE (820 +/- 110 vs. 780 +/- 80 ng/day) did not change. With DOCA and PI, PGE fell by 80%. Subjects again gained 2.0 kg and retained 530 +/- 106 meq sodium; aldosterone fell to 1.1, PRA fell to 0.2, and potassium fell to 3.3 (all P less than 0.05 from basal, but P less than 0.4 from DOCA alone). Kallikrein again rose to 56.0 +/- 19.2 (P less than 0.01). However, the rate of sodium retention was enhanced slightly but significantly. These studies demonstrate that with DOCA, urinary kallikrein activity increases but PGE is unaltered. The minimal effects of prostaglandin inhibition and the lack of change in PGE excretion suggest that prostaglandins do not play an important role in mineralocorticoid escape. There is no apparent interaction of prostaglandins with the kallikrein system in this model; however, the kallikrein-kinin system may still play a direct role in the escape phenomena.

Adult

Furosemide-augmented intravenous urography: results in essential hypertension.

Giving an intravenous diuretic during urography (furosemide-augmented urography, vasodilated urography) causes renal swelling which is easily measured. Several investigators have used this observation as the basis of a screening test for renovascular hypertension. They found that normal kidneys enlarge in area by more than 10%, while kidneys with renal artery stenosis show a blunted size response, usually less than 5%. We used the technique in 46 patients with proven essential hypertension in order to further examine its potential usefulness in the hypertensive population. The 92 kidneys showed an average area increase of only 7.0% +/- 3.6% SD, and only 15% of the kidneys enlarged by more than 10%. Based on these observations we doubt that vasodilated urography will be valuable as a screening test for renovascular hypertension because of the high incidence of false positive and indeterminate results in patients without renal artery stenosis.

Adult

Renal vasculature in essential hypertension: racial differences.

In an attempt to explain the greater morbidity from essential hypertension in the black as compared with the white race, we evaluated the intrarenal vasculature of 27 patients with hypertension (19 white and 8 black). All patients had mild-to-moderate hypertension (mean arterial pressure, 110 to 125 mm Hg), normal renal function, and minimal target-organ damage. All patients had selective renal angiograms, which were evaluated for arterial nephrosclerosis. Additionally, renal blood flow was estimated by the clearance of para-aminohippurate. Patient age, blood pressure, and plasma renin activity did not differ between the two races. Black hypertensives had significantly (P less 0.01) more severe nephrosclerosis than the white patients. Renal blood flow was lower (P less than 0.05) in black patients (390 +/- 35 ml/min - m2 body surface area) than white patients (473 +/- 19 ml/min - m2 body surface area). These findings may help to explain racial differences in morbidity and mortality from essential hypertension.

Adult