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Biomedical subjects

S Einzig

Publications and source records attributed to S Einzig.

At least 19 recordsLinked to original sources
PubMed2000

Increased susceptibility to gingival colonization by specific HACEK microbes in children with congenital heart disease.

It is well established that infective endocarditis (IE) involving the HACEK (Hemophilus, Actinobacillus, Cardiobacter, Eikenella, Kingella) group of microbes occurs in patients with congenital heart defects (CHD) and in those with prosthetic grafts. Dental caries and gingival disease have been presumed to be the focus of microbial shedding. The purpose of this study was to determine if children with CHD had a more severe gingival inflammatory condition and harbored the HACEK group of microbes to a greater extent than normal children. Two groups of 12 age and sex matched children were selected for this study. The experimental group consisted of twelve children with CHD, 1-1/2 to 8 years of age. The control group consisted of 12 healthy children 2 to 8 years of age. Each child had a gingival index score recorded as described by Massler. Subgingival cultures were obtained. Gingival samples were cultured for HACEK microbes and total Streptococcus (spp) using standard techniques. Fisher's exact test was performed with significance defined at P < 0.05. Children with CHD had more severe gingival inflammatory index than the control group (P < 0.05). 8/12 CHD patient had Actinobacillus actinomycetemcomitans (A.a.) as compared with 2/12 controls (P < 0.05). Furthermore, all cyanotic CHD patients (4/4) had A.a. whereas, only 2/12 controls did (P < 0.05). 4/12 CHD patients harbored Eikenella corrodens (E.c.) compared to 1/12 controls (N.S.). There was no significant difference in colonization with E.c. or A.a. between cyanotic and acyanotic patients. No significant difference in total Streptococcus (spp) was found between the two groups. This study suggests that children with CHD have a more severe gingival inflammatory index and are colonized with specific HACEK microbes more so than normal children.

Actinobacillus↗
PubMed1999

Comparative study of clinical evaluation of heart murmurs by general pediatricians and pediatric cardiologists.

In a study to compare the clinical diagnostic skills of academic general pediatricians and academic pediatric cardiologists in the evaluation of heart murmurs, a total of 128 patients (aged 1 month to 18 years) newly referred to a university pediatric cardiology clinic were evaluated by one of three general pediatricians and one of four pediatric cardiologists. The murmurs were clinically classified as innocent, pathologic, or possibly pathologic. The classification was revised after the review of electrocardiogram (EKG) and chest radiograph (CXR), if indicated. The definitive diagnosis was ascertained by echocardiography (94 normal, 34 abnormal). The general pediatricians identified as many pathologic heart murmurs as the pediatric cardiologists (27/34 vs. 29/34), with no difference in sensitivity, 79% vs. 85% (p = 0.53). The similarity in sensitivity could be because the general pediatricians were more cautious in the classification of heart murmurs and had classified more innocent heart murmurs as pathologic than the pediatric cardiologists (13/39 vs. 3/23), 41% vs. 13% (p = 0.02). The pediatric cardiologists correctly identified more innocent murmurs than general pediatricians (52/94 vs. 72/94), with a better specificity, 55% vs. 76% (p = 0.001); however, the accuracy of prediction of innocence was similar for both groups (52/59 vs. 72/77), 88% vs. 93% (p = 0.36). The revision of diagnosis with review of EKG and CXR was more often misleading than helpful for either group. Academic general pediatricians would identify most of the pathologic murmurs and are no more likely than an academic pediatric cardiologist to misclassify a pathologic heart murmur as innocent.

Adolescent↗
PubMed1998

Caffeine and Nicotine: Effects on Human Placental Vascular Tone In Vitro

>Objective: To investigate if the adverse effects caffeine and nicotine have on the fetus are mediated by placental vascular tone alterations.Study Design: Isolated human placental arteries and veins at resting tone in the presence and absence of endothelium were exposed to cumulative doses of caffeine (0.1 nm-0.1 mm), nicotine, and cotinine (1.0 nm-1.0 mm). Some of the vessels were submaximally precontracted with U44619 prior to exposure to cumulative doses of the drugs. Dose-response curves to serotonin, KCl, U46619, and prostaglandin F2alpha were also obtained in the presence or absence of caffeine, nicotine, and cotinine (0.1 mm).Results: Caffeine did not alter vascular tone in human placental arteries and veins at resting tone (n = 10). Modest relaxations (15-30% of maximal tone) were noted with the addition of the drug to precontracted placental blood vessels. Similarly, nicotine and cotinine had no effect on resting tone in placental blood vessels, whereas small relaxations (6-10% of maximal tone) occurred in vessels precontracted with U46619 (n = 7-10). Additionally caffeine (n = 6-10), nicotine, and cotinine failed to alter the dose-response curves to other contractile agents (n = 7-10).Conclusions: Based on these results caffeine, nicotine, and the nicotine metabolite cotinine do not appear to alter human placental vascular tone in vitro. These results suggest that the adverse effects of these drugs on the fetus during pregnancy are unlikely to be due to changes in placental vascular tone.

Journal Article↗
PubMed1998

In Vitro Vascular Relaxation to Progesterone and Its Metabolites in Human Umbilical and Placental Blood Vessels

> Background: We have recently reported that progesterone caused a receptor-mediated, cAMP-dependent relaxation in isolated placental arteries and veins from normal term pregnancies that may be important in maintaining adequate blood flow in the placental circulation. Objective: To further investigate the activity of progesterone and some of its metabolites in both placental and umbilical vessels. Study design: Isolated human placental and umbilical arteries and veins from normal term pregnancies, incubated in Krebs-bicarbonate buffer and submaximally precontracted with potassium chloride, were exposed to cumulative concentrations (0.01-30 µm) of progesterone, 5beta-pregnane-3,20-dione, 5alpha-pregnane-3,20-dione, or 5alpha-pregnane-3beta-ol-20-one. Results: All experimental progestins produced concentration-dependent relaxations in precontracted human placental and umbilical arteries and veins. These relaxations were endothelium-independent. Progesterone and 5beta-pregnane-3,20-dione appeared to be the most potent and efficient of the tested progestins, whereas 5alpha-pregnane-3beta-ol-20-one produced the least relaxation in the same vessels. Conclusions: These results suggest that not only progesterone, but also its metabolites, may be of physiological importance in the regulation of umbilico-placental vascular tone. Additionally, it appears that the umbilical blood vessels possess the same relaxation to progesterone as placental arteries and veins. Taken together, these results indicate a potential role for progesterone and its metabolites in maintaining adequate blood flow in the umbilico-placental circulation.

Journal Article↗
PubMed1996

Alteration of human placental vascular tone by antiarrhythmic medications in vitro.

INTRODUCTION: Antiarrhythmic medications are commonly used during pregnancy for treatment of maternal or fetal arrhythmias, but little is known about their effect on human placental vascular tone and, consequently, placental blood flow. The objective of this study was to evaluate the tone responses caused by antiarrhythmic medications in human placental vessels from normal term pregnancies in vitro. METHODS AND RESULTS: Isolated human placental arteries and veins from uncomplicated term pregnancies incubated in Krebs'-bicarbonate under 5% oxygen/5% carbon dioxide/balance nitrogen (PO2 35 to 38 torr) were exposed to cumulative doses of quinidine, procainamide, lidocaine, flecainide, propranolol, amiodarone, verapamil, digoxin, and adenosine after submaximal contraction with 5-hydroxytryptamine. The study was conducted both in the presence and absence of endothelium. The addition of the tested medications caused a significant, dose-dependent relaxation of human placental arteries and veins except for adenosine, which induced a sustained, dose-dependent contraction of human placental vessels regardless of the presence or absence of tone. Removal of the endothelium did not alter these responses. CONCLUSIONS: Based on these results, the medications tested should have no decremental effect on placental blood flow, with the possible exception of adenosine, which causes significant, dose-dependent contraction of human placental vessels in vitro. Should similar contraction be present in vivo, it may have an adverse effect on the fetus when administering adenosine to pregnant women at term or during labor.

Anti-Arrhythmia Agents↗
PubMed1995

Plasma antioxidant depletion after cardiopulmonary bypass in operations for congenital heart disease.

We describe the use of two in vitro tests to characterize plasma antioxidant capacity at the time of cardiac bypass in operations for congenital heart disease in 30 patients aged 3 days to 16 years (average 4.4 +/- 0.9 years [standard error]). Bypass and crossclamp time, circuit volume, and type of operation were recorded for each patient. First, a test of plasma radical antioxidant power measured chain breaking (secondary) antioxidant capacity of plasma to prevent oxidation of linoleic acid in vitro. Second, overall ability of plasma to prevent lipid peroxidation was assessed by a classic test of plasma inhibition of malondialdehyde formation in a beef brain homogenate. Plasma total radical antioxidant power level at baseline was 0.74 +/- 0.03 mumol/ml plasma, which decreased to 0.15 +/- 0.05 mumol/ml plasma after bypass (p < 0.001) and 0.26 +/- 0.08 mumol/ml plasma with recovery (n = 18, p < 0.001). Analysis of variance of postbypass total radical antioxidant power value showed age (p = 0.0002, r = 0.63) and bypass time (p = 0.009, r = 0.4677) to be significant factors. Pump prime volume in milliliters per kilogram and preoperative hemoglobin value were not significant factors. Beef brain malondialdehyde formation in vitro was limited 92% +/- 3% by normal plasma before operation versus 53% +/- 5% after operation (p < 0.001) and 51% +/- 5% at recovery after arrival in the pediatric intensive care unit (p < 0.001). Analysis of variance of the changes from before to after operation showed age p = 0.0015, r = 0.55) and bypass time (p = 0.033, r = 0.39) to be significant factors. Thus antioxidant capacity of plasma is significantly diminished after cardiopulmonary bypass in children. Young patient age and long duration of cardiopulmonary bypass are identified as factors that correlate positively with depletion of antioxidant capacity with bypass.

Adolescent↗
PubMed1994

Myocardial lipid composition in turkeys with dilated cardiomyopathy.

OBJECTIVE: The aim was to determine if reduced heart lipid peroxidation in turkeys with two forms of dilated cardiomyopathy, previously reported, was related to an alteration in the lipid composition of the ventricle. METHODS: Myocardial lipid composition was measured in turkeys with two types of dilated cardiomyopathy. Twenty six turkeys with naturally occurring dilated cardiomyopathy, six with furazolidone induced dilated cardiomyopathy, and 18 age matched control birds were used at 1 day, 9-10 days, and 38-78 days of age. Left ventricular fatty acid composition of the phospholipid, triglyceride, free fatty acid, and cholesterol ester fractions was analysed using gas chromatography. RESULTS: Significant age related changes were identified in the fatty acid composition of the heart. In the phospholipid fraction, linoleic acid (18:2 omega 6) values increased with age, while arachidonic acid values decreased. The saturated to unsaturated fatty acid ratio in control hearts was unchanged as a function of age in the phospholipid fraction. In the triglyceride fraction, however, this ratio decreased substantially between newly hatched and nine day old birds and then markedly increased in two month old controls. There was a striking alteration in the saturated to unsaturated fatty acid ratio in the triglyceride fraction of 2 month old cardiomyopathic birds; this ratio was markedly increased in the furazolidone induced cardiomyopathic turkey hearts (5.14 v 2.79 in controls) and markedly diminished (ie, 0.97 to 1.21) in the spontaneously cardiomyopathic turkeys. A significant increase in myristic (14:0) and decrease in linoleic (18:2 omega 6) acid concentration in the furazolidone group v control and a marked decrease in myristic and increase in linoleic acid concentrations in the spontaneously cardiomyopathic group v controls was present. CONCLUSIONS: (1) There is an age related alteration in the fatty acid composition of control turkey hearts. (2) Previously identified reduced lipid peroxidation in furazolidone induced and spontaneous cardiomyopathy in turkeys does not appear to be related to reduced concentration of polyunsaturated fatty acids. (3) The two forms of dilated cardiomyopathy are associated with markedly disparate alterations in the concentration of polyunsaturated fatty acids in the triglyceride fraction of 1-2 month old turkey hearts. The changes may be related, in part, to the pathogenesis in these two different forms of dilated cardiomyopathy.

Aging↗
PubMed1993

Spectrophotometric measurement of plasma 2-thiobarbituric acid-reactive substances in the presence of hemoglobin and bilirubin interference.

The 2-thiobarbituric acid reaction with malondialdehyde has been used to assess lipid peroxidation in a variety of biologic systems. However, in an attempt to measure plasma thiobarbituric acid-reactive substances (TBARS) during extracorporeal membrane oxygenation, a form of sustained cardiopulmonary bypass, it became apparent that the absorbance signal at the 532-nm wavelength was composed not only of the peak absorbance of TBARS, but also of interfering substances from heme pigments and bilirubin. A method of subtracting interfering substances was developed and applied to normal human plasma. The method was tested by adding varying amounts of red blood cell hemolysate, bilirubin, and 1,1,3,3-tetramethoxypropane (TMP) standard to plasma and determining TBARS in the resulting mixture. In addition, varying the amount of added desferoxamine was investigated to determine the effects of iron chelation on the assay. This was important because the different samples would have varying amounts of free iron from hemoglobin to catalyze the reaction. It was found that the following equation could be used in this system to determine that amount of 532-nm absorption due to TBARS: MDA532 = 1.22[(A532) - (0.56)(A510) + (0.44)(A560)]. Regression analysis revealed an 86.6% recovery of the TMP spike. Analysis of variance showed that the variability in the model could be explained mainly by the additive increments of TMP spike (94.6%).

Bilirubin↗
PubMed1992

Catecholamines in turkeys with alcohol-induced cardiomyopathy.

Although alcoholic cardiomyopathy has been difficult to reproduce in animals, turkeys fed 5% ethanol develop a dilated congestive cardiomyopathy. We therefore used this model to examine the adrenergic response to left ventricular dysfunction induced by alcohol. In normal turkeys, norepinephrine in kidneys decreased markedly with age from 1 day to 2 mo, with a similar but less dramatic decrease in cardiac norepinephrine. By 2 mo, chronic alcohol ingestion depleted cardiac norepinephrine compared with controls (217 +/- 22 vs. 316 +/- 41 ng/g, P < 0.05), even though cardiac norepinephrine is relatively low in turkeys compared with many other animals and humans. Norepinephrine in aorta was also decreased with alcohol administration, but kidney norepinephrine was unaffected. Dopamine was unaltered in any of the organs studied. Plasma norepinephrine is normally high in turkeys with arterial levels greater than venous (2,898 +/- 746 vs. 1,987 +/- 531 pg/ml at 2 mo). Venous plasma norepinephrine did not differ from control (2,595 +/- 547 pg/ml) after 2 mo of alcohol. Thus, as in humans, cardiomyopathy in alcohol-fed turkeys is associated with reduced cardiac norepinephrine, but unlike humans with cardiomyopathy, circulating norepinephrine remains normal.

Aging↗
PubMed1991

Newborn cardiorenal dynamics: a state of atrial natriuretic peptide unresponsiveness.

The newborn has an attenuated response to saline fluid challenge. We studied the response of endogenous atrial natriuretic peptides (ANF) to 10% body weight graded isotonic saline volume expansion (VE) in 14 anesthetized neonatal lambs which were either 1 day old or 7 days old. Plasma ANF values were unchanged at 3.3% and 10% VE compared with control values (56 +/- 28 vs. 66 +/- 17 and 66 +/- 37 pg/ml, not significant) in the 1-day-old lambs, whereas values increased significantly at both 3.3% and 10% VE (47 +/- 40 vs. 99 +/- 57 and 96 +/- 73, P = 0.022 and P = 0.018, respectively) in the 7-day-old lambs. No relationship existed between right atrial (RAP) or pulmonary capillary wedge pressures (PCWP) and plasma ANF in the 1-day-old lambs; however, a significant correlation existed (RAP, P = 0.015; PCWP, P = 0.022) in the 7-day-old lambs. In general, renal function was improved in the 7-day-old lambs compared with the 1-day-old lambs, but only changes in fractional sodium excretion were significantly different (P = 0.017). We speculate that ANF unresponsiveness in the 1-day-old lamb is related to physiological transitions during the birth process and that the maturation of the renal response to VE may require maturation of the atrial mechanism which permits ANF secretion.

Aging↗
PubMed1990

Anisodamine increases blood flow to the retina-choroid and protects retinal and pancreatic cells against lipid peroxidation.

This study investigated the effect of anisodamine (2 and 5 mg/kg i.v.) on ocular and systemic blood flow distribution in awake lambs using the radioactive microsphere technique. In separate in vitro studies, the effects of anisodamine (at final concentrations of 0.01 to 2.5 mg/ml) were determined on arachidonic acid, alloxan and ultraviolet radiation-induced lipid peroxidation of isolated retinal cells from rabbits and on alloxan-induced lipid peroxidation of hamster pancreatic islet beta cells. Malondialdehyde production was used as an index of lipid peroxidation and measured by the thiobarbituric acid method. Anisodamine preferentially increased blood flow and oxygen delivery to the retina-choroid and iris-ciliary body of the eye by 50-100%. Anisodamine significantly attenuated lipid peroxidation in retinal cells induced by ultraviolet radiation, alloxan and arachidonic acid by 17-50% and protected pancreatic beta cells against alloxan-induced lipid peroxidation. These properties may, in part, account for the beneficial effect of anisodamine in certain patients with diabetes.

Alloxan↗
PubMed1990

Reduced heart lipid peroxidation precedes cardiac dilatation in turkeys with naturally occurring cardiomyopathy.

STUDY OBJECTIVE: The aim of the study was to determine if reduced heart lipid peroxidation in 1-2 month old turkeys with furazolidone induced dilated cardiomyopathy is drug related and model dependent, a non-specific characteristic of the dilated turkey heart, or if alterations of heart lipid peroxidation can occur prior to onset of cardiac dilatation, and therefore may be involved in its pathogenesis. DESIGN: Ventricular lipid peroxidation capacity and superoxide dismutase activity were measured in controls and in turkeys with spontaneous cardiomyopathy at various ages (newly hatched, 7-10 d, and 1-2 months) and stages of the disease. SUBJECTS: 46 turkeys with naturally occurring dilated cardiomyopathy and 29 age matched controls were used at hatch, 7-10 d, and 1-2 months of age. MEASUREMENTS AND MAIN RESULTS: Heart lipid peroxidation, measured by thiobarbituric acid reactive substances (malondialdehyde), was found to be reduced not only in the dilated hearts of 1-2 months old cardiomyopathic turkeys [114(SEM 10) v 176(21) nmol.100 mg-1 protein, p = 0.023] but also in the non-dilated hearts of 9-10 day old cardiomyopathic turkeys [135(17) v 274(35) nmol.100 mg-1 protein, p = 0.004]. Ventricular superoxide dismutase activity was similar in control and cardiomyopathic turkeys at all stages and there was the expected increase with age. In control turkeys ventricular superoxide dismutase activity in 1-2 month old birds, at 718(52) nitrite units.100 mg-1 protein, was significantly higher than values in 7-10 day old turkeys [398(31) nitrite units.100 mg-1 protein, p = 0.001]. CONCLUSIONS: Decreased lipid peroxidation capacity is present in the dilated hearts of spontaneously cardiomyopathic turkeys. However, it is also decreased in cardiomyopathic turkeys at 9-10 d (the time of highest mortality) prior to the onset of cardiac dilatation. Therefore, alterations in heart lipid composition may be involved in the pathogenesis of this cardiomyopathy and not simply a result of the cardiac dilatation/hypertrophy process.

Aging↗
PubMed1989

Enhanced high energy phosphate recovery with ribose infusion after global myocardial ischemia in a canine model.

High energy phosphate levels are depressed following global ischemia and require several days to completely recover. Short-term methods to enhance ATP recovery have included infusion of ATP precursors, inhibition of enzymes that catabolize AMP, and membrane transport stabilization. Several precursors have been used to augment adenine nucleotide synthesis including adenosine, inosine, adenine, and ribose. Because of the short-term nature of previous experiments, recovery had been incomplete and the effects in the intact animal unknown. The purpose of this study was to determine the effects of ribose infusion in a long-term model of global ischemia and attempt to identify the precursor which limits myocardial ATP regeneration in the intact animal. Global myocardial ischemia (20 min, 37 degrees C) was produced in dogs on cardiopulmonary bypass. With reperfusion either ribose (80 mM) in normal saline or normal saline alone was infused at 1 ml/min into the right atrium and the animals were followed for 24 hr. Ventricular biopsies were obtained through an indwelling ventricular cannula prior to ischemia, at the end of ischemia, and 4 and 24 hr postischemia and analyzed for adenine nucleotides and creatine phosphate levels. Radiolabeled microspheres were used to measure myocardial and renal blood flows and no significant difference was found between ribose-treated control groups. In both groups, myocardial ATP levels fell by at least 50% at the end of ischemia. No significant ATP recovery occurred after 24 hr in the control dogs, but in the ribose-treated animals, ATP levels rebounded to 85% of control by 24 hr.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMed1989

Prostaglandin catabolism in fetal and maternal tissues--a study of 15-hydroxyprostaglandin dehydrogenase and delta 13 reductase with specific assay methods.

Recent studies have demonstrated that extraductal tissues such as lung are important sources of prostaglandin E2 which maintains the patency of ductus arteriosus in fetuses and prematurely-born infants. Also, organs such as lung are known to be active in the catabolism of PGE2. Earlier studies of enzymes involved in the catabolism of PGE2 such as 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and delta 13 reductase all used non-specific methods. In the present report, we studied 15-PGDH in fetal and maternal rat lung, kidney, and fetal lamb lung, kidney and ductus arteriosus with the use of a specific substrate (15-S)-[15(3)H-PGE2]. In addition, we measured the activity of delta 13 reductase in these tissues by measuring the conversion of [1-14C]-15-keto PGE2 to [1-14C]-15-keto-13,14-dihydro PGE2. The results from these studies demonstrated that in fetal rat lung and kidney, 15-PGDH activities increased rapidly while delta 13 reductase remained unchanged during late gestation. Ductus arteriosus possessed little 15-PGDH activities. These results strongly suggest that extraductal regulation of PGE2 metabolism is important in determining ductal caliber in fetuses and prematurely delivered neonates.

15-Oxoprostaglandin 13-Reductase↗
PubMed1989

Physical and mechanical effects of cardioplegic injection on flow distribution and myocardial damage in hearts with normal coronary arteries.

The physical and mechanical effects of injecting crystalloid cardioplegic solution under various pressures and flows was studied (in canine hearts) to establish a safe method for administering it in the presence of normal coronary arteries. A constant pressure system (300 mm Hg = 15 psi) was maintained in the solution reservoir, and flows and pressures were varied with the use of cannulas of different inner diameters: 0.8, 1.35, 1.6, 2.3, 2.58, and 2.80 mm. Cardioplegia distribution was measured by 15 microns radioactive microspheres. Peak flow rate, total flow, and mean flow rate per infusion were measured by an inline electromagnetic flowmeter probe. Direct aortic root pressure, time to standstill, and myocardial temperatures were recorded by continuous monitoring. Cardiac isoenzymes were measured in the coronary sinus, peripheral blood, and directly in the myocardial tissue. Histologic changes in the left ventricle were examined by light microscopy. The results showed that the higher the flow and pressure, the shorter the prearrest period, the better the flow distribution, and the faster the myocardial temperature drop. Mean aortic root pressures higher than 110 mm Hg and peak flow rates greater than 1500 ml/min caused a higher incidence of mechanical-physical trauma to the vascular endothelium and the endocardium, but cellular protection was good. Low pressure (less than 30 mm Hg) and peak flows (less than 125 ml/min) showed a higher incidence of cellular (myocardial) ischemia, focal necrosis, and uneven flow distribution. An aortic root pressure of 61 +/- 5 mm Hg, a mean peak flow rate of 622 +/- 52 ml/min, and a total flow of 600 ml for the first injection seem to offer the best cellular protection with minimal physical injury to the endothelium and endocardium for a mean canine heart weight of 236 gm.

Animals↗