Biomedical subjects
Publications and source records attributed to R Roth.
Sixteen cases of endovascular treatment of aneurysms and pseudoaneurysms were reported; five patients had true aneurysms, 11 presented pseudoaneurysms of splanchnic arteries. In all cases embolization was performed with coils; in one case we used coils in combination with Ethibloc. In 14 of 16 patients definite occlusion of the aneurysms was achieved without further surgical intervention.
Purified human hemoglobin is being developed as an alternative to transfusions of homologous erythrocytes. However, toxicity associated with infusion of hemoglobin has limited the development of this resuscitation fluid. Some observed toxicities, including activation of the complement cascade, have been associated with contamination of hemoglobin solutions by bacterial endotoxin. Recent studies have demonstrated complex formation between hemoglobin and endotoxin, and have documented a resultant increase in the ability of endotoxin to activate coagulation, stimulate tissue factor production by human peripheral blood mononuclear cells, and stimulate tissue factor activity and protein synthesis in cultured human endothelial cells. The process of hemoglobin enhancement of endotoxin toxicity suggests a possible mechanism by which the consequences of endotoxin contamination of hemoglobin solutions, including complement activation, could be magnified. Therefore, we studied the potential of hemoglobin to either fix complement directly, or modify the ability of endotoxin to fix complement. Human crosslinked and native hemoglobins, at concentrations between 0.2 mg/ml and 3 mg/ml, were shown to fix complement. Complement fixation by hemoglobin was identical in normal human serum or in factor B-depleted serum, suggesting that fixation occurred via the classical pathway of complement activation. Complement fixation then was examined with a battery of smooth and rough endotoxins tested in the absence and presence of hemoglobin. Addition of hemoglobin to a solution of a rough Salmonella endotoxin partial structure, from which a single fatty acid had been hydrolyzed from the lipid A portion of the macromolecule, resulted in decreased efficiency of complement fixation. However, addition of hemoglobin had little or no effect on the intrinsic complement fixing abilities of eight other smooth endotoxins, rough endotoxins, or endotoxin partial structures. Our results demonstrated the ability of hemoglobin to fix complement at hemoglobin concentrations which would be achieved during infusion for resuscitation, but failed to demonstrate a reproducible effect of hemoglobin on the activation of complement by endotoxin.
Type 1 pili are heteropolymeric mannosebinding fibers produced by all members of the Enterobacteriaceae family. The bulk of the fiber is composed of FimA. Two macromolecular complexes responsible for mediating an interaction with mannose-containing receptors were purified from fimA- Escherichia coli by mannose affinity chromatography and ion-exchange chromatography. One complex contained only the mannose-binding adhesin, FimH, associated with FimG, a minor component of the type 1 pilus. In the other complex the FimG-FimH moiety was loosely associated with a chaperone-minor subunit complex (FimC-FimF), possibly representing an intermediate in tip fibrilla assembly. The FimC chaperone has also been shown to form a preassembly complex with FimH that has been purified and characterized previously. Purified FimC did not bind to the FimG-FimH complex but did recognize FimH dissociated from the FimG-FimH complex. Quick-freeze deep-etch electron microscopy revealed that the FimG-FimH complex had a thin fibrillar architecture. High-resolution electron microscopy of type 1 pili revealed that a 16-nm fibrillar tip structure with an architecture identical to that of the FimG-FimH complex was joined end-to-end to the pilus rod. In a fimH- deletion mutant, the tip fibrillae joined to pilus rods were approximately 3 nm in length. The full-length tip fibrilla was restored by complementation with the fimH gene in trans. The bipartite nature of the type 1 pilus was also demonstrated on pili purified from clinical isolates of members of the Enterobacteriaceae family arguing that it is a conserved feature of the type 1 pilus.
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Previously the toxicity of 45 heterogeneous environmental chemicals on growth and membrane functions in Saccharomyces cerevisiae and Chinese hamster ovary (CHO) cells (Cascorbi et al., 1993) was examined. In this study the inhibitory effects of the same set of chemicals on yeast RNA synthesis rate, measuring [2-14C]uracil uptake during cell proliferation are presented. The sensitivity of this test system was three to six times higher than that of the proliferation rate assay. In addition, the range of the EC20 values were similar to the range from the mammalian CHO cell proliferation test. The relatively good correlation with the yeast cell growth rate (r = 0.78, P = 0.0001) suggests that yeast RNA synthesis is a simple and rapid method of detecting a wide range of toxic compounds without the disadvantage of the insensitivity of the growth rate assay.
Pregnant CD rats were exposed dermally to 0.05, 1, 10, 50, and 250 mg/kg/day of Clarified Slurry Oil (CSO) on Days 0-19 of gestation to determine its potential developmental toxicity. Untreated and vehicle controls were included in the study. Day 20 of gestation Caesarean-derived fetuses were examined for gross, external, and visceral or skeletal alterations. Dosages of 1 mg/kg/day and higher significantly decreased maternal body weight, body weight gain, feed consumption, gravid uterine weight, and live litter size and significantly increased resorption rate. These dosages also significantly reduced fetal weights and retarded development of the brain, kidney, thoracic and caudal vertebrae, metacarpals, and hindpaw phalanges in dosage groups with live fetuses (high dosage group dams resorbed all conceptuses). The 50- and 250-mg/kg/day dosage group dams had only placentas and/or dark red viscous fluid in the uterus or vagina and significant body weight loss (associated with resorption). The highest dosage also caused emaciation, slight dehydration, and swollen dark anogenital areas. These results indicate that CSO produces adverse developmental effects at maternally toxic dosages. The maternal and developmental NOAELs (no observed adverse effect levels) were 0.05 mg/kg/day. In a second study, groups of 10 mated female rats were exposed to "pulse" exposures and dosages of 1, 50, or 250 mg/kg/day of CSO applied dermally for 2- or 3-day intervals that spanned the gestation period. All dosages reduced maternal feed consumption and body weight gain during the treatment period. Dosages of 50 and 250 mg/kg/day also produced early resorptions when administered on Days 6 through 8 and 9 through 11 of gestation. However, no increase in fetal alterations occurred, indicating that the effects on embryo-fetal development were due to early death and not to the death of malformed conceptuses.
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ATPase and inorganic pyrophosphatase (PPase) activities have been detected in several methanogenic bacteria. These activities are believed to play a crucial role in energy metabolism. In the present study we have investigated some characteristics of the ATPase and the inorganic PPase activities of Methanobacterium thermoautotrophicum. Although these proteins migrate identically on non-dissociating gels, they are catalyzed by distinct enzymes which are separable by biochemical purification methods. The partially purified enzymes are composed of at least two subunits. The ATPase subunits have molecular masses of about 43 and 33 kDa and the inorganic PPase such of about 31 and 25 kDa. After purification, the PPase and the ATPase did not hydrolyze ATP and PP(i), respectively. The membrane-bound ATPase and PPase activities are distinguished in response to sodium fluoride, by the effects of divalent cations, by the temperature ranges for activities and the solubilization behaviour by different extractants. Most investigated catalytic and structural properties of the ATPase do not suit the current criteria for classifying this enzyme under either the F-, V- or P-ATPases.
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We used high resolution three-dimensional electron microscopy to visualize Golgi cisternal structure and analyze morphological transitions induced by various in vitro incubations. Our images show that Golgi cisternae have two distinct surface coatings with different distributions and apparent functions. The first type, probably a coatomer coat, consists of tightly packed approximately 10 nm surface particles. These are localized exclusively to sites of membrane budding and are as intimately involved in bud formation as clathrin or caveolin coats. When this coating is exaggerated by GTP gamma S, the periphery of all cisternae is partitioned into coated vesicles that remain attached at their sites of formation. A second, much finer coating is evenly distributed over the periphery of cisternae, including tubules enclosing the fenestrae. It appears to stabilize the membrane curvature associated with tubules and edges. These different coatings must be considered in further attempts to unravel Golgi membrane trafficking mechanisms.
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The acute hemodynamic response of the liver to portal endotoxemia was measured in six isoflurane anesthetized pigs in which volume support was used to maintain normal cardiac output. After baseline monitoring, bacterial endotoxin (LPS) was infused over 1 hr into a mesenteric vein at a rate of 1 microgram.kg-1.hr-1, and monitoring was continued for 1 hr postinfusion. Peak vasoconstriction occurred during LPS infusion in both the hepatic artery (resistance increases 349% of baseline, P < 0.05) and the liver's portal circulation (resistance increases 159% of baseline, P < 0.05). Increased vascular resistance was also detected in lung (increases 433% of baseline) and intestine (increases 130% of baseline) at the midpoint of the LPS infusion. The non-splanchnic circulation, defined for our analysis as all of the peripheral circulation except the portal and hepatic arterial circulation, generally exhibited little change in vascular resistance during LPS infusion. LPS was incompletely cleared by the liver, but secondary clearance by the lung prevented large increases in the LPS concentration of arterial blood. During the first hour postinfusion, the systemic vascular resistance subsequently decreased to near normal in all vascular beds, with the exception of the liver's portal circulation. A sustained and secondary increase in vascular resistance of the liver's portal circulation and portal vein pressure occurred during the first hour after LPS infusion. We conclude that most of the vasoconstriction in the acute response to portal endotoxemia occurs in the liver and lung, organs directly exposed to elevated levels of endotoxins.
This animal study was designed to assess the tolerance of the normal bile duct to a single intraluminal high-dose-rate afterloading irradiation. This information is essential for treatment recommendations in irradiation therapy of malignant bile duct stenoses. In 16 pigs bile duct catheters were inserted surgically. Over these devices single intraductal doses of 7.5 Gy and 15 Gy were applied using an iridium-192 source. After a period of two to three months the bile ducts and the surrounding structures were investigated by means of cholangiography, angiography, and macropathological and histological investigations. A single intraductal dose of 7.5 Gy leads to a slightly scarred shrinkage of the bile duct with sclerosis and obliteration of the capillary vessels. Vasculitis and necrosis of the bile duct wall are still evident three months after irradiation. A single dose of 15 Gy leads to severe lesions with widespread necroses of the bile duct wall which tend to bleed, and result in a high degree of shrinkage of the bile duct. The radiation damage is most prevalent near the papilla and in the narrow segments near the liver. Single intraluminal high-dose-rate afterloading doses of 7.5 and 15 Gy cause significant lesions and complications at the bile ducts. As the intact bile duct is the Achilles heel of intraductal therapy, considerably lower single doses are recommended for a fractioned treatment.
The long-term tolerance to and effectiveness of heparin-induced extracorporeal LDL precipitation (HELP) in combination with lipid reducing drugs and diet was tested in six patient (5 males, 1 female; mean age 48 +/- 4 years). Follow-up period was over 50 months, in one patient over 24 months, while one man had a sudden cardiac death 57 weeks after starting treatment. The study was divided into three phases. In phase I (24 months) treatment consisted of HELP and conventional lipid-reducing drugs; in phase II (12 months) of lovastatin (80 mg daily) and cholestyramine (12-24 g daily); and phase III (14 months) of HELP, lovastatin and cholestyramine. In phase I it was possible to lower the pre-treatment level of LDL-cholesterol from 306 +/- 18 mg/dl to 173 +/- 13 mg/dl (43.5%). A similar effect (from 307 +/- 21 mg/dl to 155 +/- 17 mg/dl [-49.5%]) was obtained in phase II. The resumption of HELP reduced the pre-treatment LDL concentration to 136 +/- 9 mg/dl (-55.7%). The various treatment regimens were well tolerated. Biochemical data remained unchanged except for iron loss requiring substitution. Thus combined HELP, lovastatin and ion exchange offer for the first time an effective and reliable means in familial hypercholesterolaemia of clearly reducing long-term the mean LDL cholesterol level below the atherosclerosis threshold of 120 mg/dl.
We evaluated a new hemostasis device to maintain focused pressure over the femoral artery puncture site for 2-6 hours in 330 cases after diagnostic catheterization or coronary angioplasty. No patient developed later hematoma or vascular complications. The initial favorable experience suggests that this hemostasis device has advantageous features of stability and site visualization and is a suitable adjunct to current methods of maintaining puncture site pressure after brief manual compression following arterial catheterization.
Symptoms of depression in the majority of patients immediately following acute myocardial infarctions (AMI) resolve rapidly; they are an adjustment reaction. However, in a group of 552 male patients there were 80 (14.5%) patients with persistent major depressive symptoms during a finite period after AMI. Infarction size was assessed by maximum creatine kinase levels, the QRS-complex and the occurrence of late potentials. These measures did not correlate with the degree of depressed moods in these groups. An arrhythmic event in the early hospitalization phase, a recurrent infarction, dyspnoea, and persistent angina pectoris before the AMI were significantly related to more profound degrees of depression. Patients who reported serious life-events in the last 2 yr before AMI, or who suffered from exhaustion and fatigue in the prehospital phase were subject to significantly higher levels of depression. A prodromal phase prior to hospitalization free of bodily symptoms and the use of denial were related to low levels of depression. The logistic regression model incorporating all univariate significant variables revealed that symptoms of exhaustion and fatigue prior to AMI had the strongest independent correlation with post AMI depression.