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Biomedical subjects

S Pang

Publications and source records attributed to S Pang.

At least 91 records · Page 5Linked to original sources

HIV-1 env sequence variation in brain tissue of patients with AIDS-related neurologic disease.

We investigated sequence variation in the human immunodeficiency virus type 1 (HIV-1) env gene region that encodes the fourth disulfide-bonded domain of the external membrane glycoprotein, gp120, among three HIV-1 isolates from patients with AIDS-related neurologic disease. The sequences of HIV-1 isolated directly from brain tissue, blood cells, and in vitro cell cultures were compared. The results suggest that there may be many closely related HIV-1 genomes of several distinct subtypes in an HIV-1-infected individual. Differences were observed in the frequency distribution of sequence variants obtained from brain versus blood of the same individuals. Overall, the proportion of silent mutations is much lower than expected by random occurrence. Taken together, these results favor the possibility that selective forces may play a role in the tissue distribution of certain HIV-1 strains.

AIDS Dementia Complex↗

High levels of unintegrated HIV-1 DNA in brain tissue of AIDS dementia patients.

In the host cell, retroviral DNAs exist in three main forms: unintegrated linear, unintegrated circular, and integrated (the provirus). High levels of unintegrated forms of retroviral DNA often correlate with superinfection and accompanying cytopathic effects, as, for example, in the case of feline acquired immunodeficiency. In culture, HIV-1 infection also results in high levels of unintegrated viral DNA although direct correlations with cytopathicity have not been made. The low frequency of HIV-1-infected cells in patients has made it difficult to determine the structure of the viral DNA in fresh tissue samples from AIDS patients by standard methods such as Southern hybridization. The PCR technique however, which allows the detection of viral DNA at levels far below that possible by other hybridization methods is, in its conventional form, of limited use for quantitative analysis. To study the amount and form of HIV-1 DNA in primary tissue of AIDS patients we have therefore modified the PCR method. Our results indicate that each of the three species of viral DNA are detectable in blood and brain of AIDS patients, and that in autopsy samples from patients with HIV encephalitis there is a considerably higher proportion of unintegrated viral DNA.

AIDS Dementia Complex↗

The auditory P 300 correlates with specific cognitive deficits in Parkinson's disease.

An abnormally prolonged latency of the P 300 event-related potential has been reported in several types of dementing illnesses, including Parkinson's disease (PD). While some PD patients have dementia, a significant number of PD patients have less severe cognitive impairments. We examined the relationship between the auditory P 300 and a neuropsychological battery of 11 tasks in 43 PD patients. The quantitative relationship between the individual neuropsychological measures and the P 300 was examined using partial correlation and analysis of covariance techniques which controlled for age, education, and illness duration. The strongest correlations were between P 300 and both short-term memory and visual perception. Global cognitive deficits do not appear to relate to the abnormal P 300 responses in PD: instead, specific aspects of cognitive decline accounted for the electrophysiological abnormalities. An abnormally long or absent P 300 correlated with deficits on select cognitive tasks: those involving memory, visual perception, and abstract reasoning. The interactions between anatomical and neurochemical abnormalities in PD are discussed in light of the pattern of deficits seen in this study.

Adult↗

Human immunodeficiency virus type 1 T-cell tropism is determined by events prior to provirus formation.

Different strains of human immunodeficiency virus type 1 (HIV-1) vary in the ability to replicate in cells that bear the HIV-1 receptor, CD4. The mechanism responsible for these cell tropism differences is unknown. We examined different isolates of HIV-1 with regard to replication in specific tumor-derived CD4-positive T-cell lines and normal peripheral blood lymphocytes. To investigate early events in the virus life cycle at low multiplicities of infection, we used a modification of the polymerase chain reaction method. Use of a molecularly cloned primary HIV-1 isolate, HIV-1 JR-CSF, restricted for replication in T-cell lines, demonstrated that little or no viral DNA or RNA was synthesized in nonpermissive cells after infection. However, transfection of proviral DNA resulted in efficient transient virus production from these cells. Therefore, we conclude that at least one block to infection for HIV-1 strains in nonpermissive T cells occurs at a point in entry or uncoating before provirus formation.

Base Sequence↗

Swelling-induced release of glutamate, aspartate, and taurine from astrocyte cultures.

Swelling of primary astrocyte cultures by exposing them to hypotonic media caused release of label after the cells had been allowed to accumulate 3H-L-glutamate, 3H-D-aspartate, or 3H-taurine. Comparable release of endogenous L-glutamate or taurine, as measured by high-pressure liquid chromatography (HPLC), was also found. Release of label was not affected by treating the cells with cytochalasin B, indicating that microfilament polymerization was not significantly involved. Hypotonic-induced release did not appear to principally involve reversal of the Na(+)-dependent uptake system since increasing external K+ to depolarize the cells by replacement of external Na+, thus maintaining isotonic conditions, increased release to a lesser extent. Threo beta-hydroxyaspartate, a potent 3H-L-glutamate uptake blocker, added externally stimulated efflux of 3H-L-glutamate independently of the swelling-induced efflux. Upon restoration of swollen cells to isotonic medium they showed an unimpaired ability to take up 3H-L-glutamate. The swelling-induced release of label was inhibited by a number of anion transport inhibitors, one of which has been shown to significantly improve outcome in an experimental brain trauma/hypoxia model in which astrocyte swelling is an early event.

Amino Acids↗

[Research on the critical dose for antithrombotic effectiveness of aspirin in the Chinese].

We studied 345 cases taking aspirin due to increased platelet aggregation. 220 were male and 125 were female. They were divided into five groups (0, 30 mg, 50 mg, 300 mg, 500 mg, daily) with double-blind method. Platelet aggregation tests were performed before and after medication. The result shows that the response in male is good. For female, the benefit in menopausal women and contraceptive taker is more prominent than that in adolescent and middle aged women. From our clinical trial we suggest 50 mg of aspirin daily as the optimal dosage.

Adolescent↗

Selegiline use to prevent progression of Parkinson's disease. Experience in 22 de novo patients.

To test the hypothesis that selegiline (L-deprenyl), a selective inhibitor of B-type monoamine oxidase, can halt the natural progression of Parkinson's disease, its use in 22 naive patients (mean age, 58 years; mean Parkinson's disease duration, 2.3 years) in the early stages (1 to 2) of the disease was studied. Patients were started and maintained on a daily dose of 10 mg of selegiline, and they underwent neurologic examinations at 3-month intervals using our center's disease staging and total rated disability scores. The criterion set for disease progression was defined as either the appearance of a new objective sign and/or a definite, persistent worsening (greater than 25%) of existing signs after the initiation of the selegiline trial. Patients remained on a regimen of selegiline [corrected] for periods ranging from 7 to 84 months. At the time of their latest neurologic examination, 17 (77%) of the 22 patients had conditions that demonstrably worsened with selegiline alone at an average of 10.8 months from the start of the drug therapy. Six of these 17 patients with worsening conditions (or 27% of the original 22) eventually required the addition of levodopa with carbidopa (Sinemet) on average at 13 months from the start of selegiline therapy; they have continued, to date, taking this combination for an additional mean follow-up period of 20.7 months. Four of the original 22 patients had relatively unchanged, stable neurologic status at the time of their latest examination (average follow-up period, 11.6 months).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Selegiline as an adjunct to conventional levodopa therapy in Parkinson's disease. Experience with this type B monoamine oxidase inhibitor in 200 patients.

Two hundred patients at a median age of 63 years, receiving conventional levodopa therapy for 8 years, who had had Parkinson's disease for 10 years, tried a regimen of selegiline (L-deprenyl), a type B monoamine oxidase inhibitor, at a daily dose of 10 mg, for varying periods from less than 6 months to more than 24 months (28% over 24 months). Selegiline does improve parkinsonism during the initial 6 months to 12 to 24 months of combined therapy in one third to almost half of patients with an end-of-dose type of response to long-term levodopa therapy. However, even this particular class of patients is unable to maintain such an improvement by 36 months, much less by 48 months, from the start of the selegiline trial. About one quarter of poor responders to levodopa and those with random deterioration show improvement in their parkinsonian status in the first 6 months of the selegiline trial, but their conditions quickly deteriorate by 1 year. The predominant pattern of response to previous levodopa therapy and the severity of the total disability score at the initiation of the selegiline trial were the two variables that were predictive of risk of failure with the drug. No evidence suggested that selegiline decreases the excess mortality rate of Parkinson's disease above that achieved with the use of levodopa alone. Selegiline as an adjunctive agent to conventional levodopa therapy was not unduly impressive with regard to preventing progression of Parkinson's disease.

Clinical Trials as Topic↗

Excitatory amino acid-stimulated uptake of 22Na+ in primary astrocyte cultures.

In this study we have found that L-glutamic acid, as well as being taken up by a Na+-dependent mechanism, will stimulate the uptake of 22Na+ by primary astrocyte cultures from rat brain in the presence of ouabain. By simultaneously measuring the uptake of 22Na+ and L-3H-glutamate a stoichiometry of 2-3 Na+ per glutamate was measured, implying electrogenic uptake. Increasing the medium K+ concentration to depolarize the cells inhibited L-3H-glutamate uptake, while calculations of the energetics of the observed L-3H-glutamate accumulation also supported an electrogenic mechanism of at least 2 Na+:1 glutamate. In contrast, kinetic analysis of the Na+ dependence of L-3H-glutamate uptake indicated a stoichiometry of Na+ to glutamate of 1:1, but further analysis showed that the stoichiometry cannot be resolved by purely kinetic studies. Studies with glutamate analogs, however, showed that kainic acid was a very effective stimulant of 22Na+ uptake, but 3H-kainic acid showed no Na+ -dependent uptake. Furthermore, while L-3H-glutamate uptake was very sensitive to lowered temperatures, glutamate-stimulated 22Na+ uptake was relatively insensitive. These results indicate that glutamate-stimulated uptake of 22Na+ in primary astrocytes cultures cannot be explained solely by cotransport of Na+ with glutamate, and they suggest that direct kainic acid-type receptor induced stimulation of Na+ uptake also occurs. Since both receptor and uptake effects involve transport of Na+, accurate measurements of the Na+ :glutamate stoichiometry for uptake can only be done using completely specific inhibitors of these 2 systems.

Amino Acids↗

The hypothalamic-pituitary-adrenal axis in partial (late-onset) 21-hydroxylase deficiency.

Patients with late-onset congenital adrenal hyperplasia (LOCAH) due to partial 21-hydroxylase deficiency have no clinical or biochemical evidence of hypocortisolism. In contrast, patients with the classical forms of CAH frequently develop adrenal insufficiency, characterized by elevated plasma ACTH and low serum cortisol levels. To examine the various components of the hypothalamic-pituitary-adrenal axis in patients with LOCAH, we studied 12 patients with this disorder (10 females and 2 males; age range, 51/2-36 yr). Plasma ACTH and serum cortisol, 17-hydroxyprogesterone (17-OHP), and androstenedione (Adione) concentrations were measured after administration of ovine CRH (oCRH); 1 micrograms/kg at 2000 h) and in the unstimulated state (every 30-60 min for 24 h). The patients' oCRH-stimulated ACTH, cortisol, and Adione responses did not differ from those of normal subjects, whereas their serum 17-OHP concentrations were elevated both basally and after oCRH (P less than 0.05). The patients' unstimulated 24-h ACTH and cortisol levels were normal and exhibited normal diurnal variability. Cortisol pulse frequency was normal. The patients' unstimulated serum 17-OHP levels exceeded those in the normal subjects at all times (P less than 0.01) and exhibited diurnal variability paralleling that of ACTH and cortisol. Unstimulated serum Adione levels in 4 adult women were in the normal or low normal range, except between 0200-0730 h when they were moderately elevated (P less than 0.05). We conclude that the ACTH-cortisol component of the hypothalamic-pituitary-adrenal axis is in normal equilibrium in this group of patients with LOCAH. Because serum Adione levels were elevated only briefly, we suggest that peripheral tissue conversion of 17-OHP to androgens may be the primary cause of the hirsutism and acne in these patients.

17-alpha-Hydroxyprogesterone↗

Recurrence of Cushing's disease in childhood after radiotherapy-induced remission.

A 16-year-old female patient with recurrent Cushing's disease (CD) underwent successful treatment with pituitary irradiation. Within one year after radiotherapy, cortisol levels had returned to normal (but with continued absence of diurnal variation), growth velocity improved, and puberty ensued. Five years after treatment, the patient developed clinical and biochemical evidence of recurrent CD. The high baseline evening corticotropin level (9 pmol/L [40 pg/mL]) was unresponsive (maximum level, 10 pmol/L [46 pg/mL]) to stimulation with ovine corticotropin-releasing hormone (CRF). In patients with CD treated with radiotherapy, the corticotropin response to CRF stimulation may not be reliably compared with that of normal control values. After pituitary adenomectomy, the corticotropin concentration was still unresponsive to CRF. We suggest that the pituitary tumor was secondary to abnormal hypothalamic CRF regulation not corrected by pituitary irradiation; therefore, CD may recur despite pituitary irradiation.

Adenoma↗

Low plasma androgens in women with systemic lupus erythematosus.

The high ratio of women with systemic lupus erythematosus (SLE) has remained unexplained, despite the recent description of metabolic abnormalities of estrogen and androgen metabolism. Alterations of steroid metabolism in patients with SLE could be important in the pathogenesis of this disease, since it has been reported that gonadal steroids modulate the immune system. Moreover, research with inbred lupus mice has shown that estrogens have adverse effects on the disease in both sexes, whereas androgen therapy or oophorectomy is protective in females. Recently, the finding of elevated testosterone oxidation at C-17 in females with SLE suggested that plasma androgen levels in males and females with SLE should be examined more closely. We studied the varying degrees of clinical activity, with regard to plasma levels of 4 significant androgens: testosterone, androstenedione, dehydroepiandrosterone, and dehydroepiandrosterone sulfate in a series of 5 male and 42 female SLE patients. Decreased levels of all androgens were observed in women with SLE. The lowest levels of plasma androgens were found in female patients who had active disease, as determined by laboratory and clinical assessment. These data support the fact that specific abnormalities of androgen metabolism in the female are associated with SLE, and may contribute in some way to morbidity and mortality. More importantly, these data may have implications for future therapeutic regimens based on male hormone replacement.

Adolescent↗

Pitfalls of prenatal diagnosis of 21-hydroxylase deficiency congenital adrenal hyperplasia.

Hormonal measurements and HLA genotyping of amniotic fluid at midgestation correctly predicted the postnatal diagnosis of congenital adrenal hyperplasia (CAH) in 29 of 32 fetuses at risk. Of these 29, 7 were predicted to have prenatal-onset classical 21-hydroxylase deficiency (21-OH def) based on elevated amniotic fluid 17-hydroxyprogesterone (17-OHP) and delta 4-androstenedione (delta 4-A) levels. These 7 fetuses and their index cases were ultimately proven to have salt-wasting classical 21-OH def. Of 5 who were HLA typed, the genotype was identical to the index case in 4; in one, HLA prediction was not possible, because the parents shared identical HLA antigens. Normal amniotic fluid 17-OHP and delta 4-A levels in the remaining 22 fetuses predicted that they were not affected with classical CAH. These children have been clinically asymptomatic to date or proven biochemically not to have classical or nonclassical CAH. Of the 22 fetuses, 11 were predicted by HLA genotyping to be homozygous normal or heterozygous for 21-OH def. In 3 of the 32 fetuses, prenatal diagnosis was incorrect. In one, the fetus was predicted to have CAH based on HLA identity to the index case. However, amniotic fluid 17-OHP and delta 4-A were normal, and the fetus was normal. The index case of this family did not have CAH, but was a normal child. Thus, amniotic fluid hormone levels accurately predicted a normal fetus, while HLA genotyping was not relevant in prenatal diagnosis because the index case was unaffected. The second fetus was predicted to be affected on the basis of HLA genotyping and to be unaffected based on normal amniotic fluid 17-OHP and delta 4-A. During infancy, this female infant had postnatal-onset nonclassical CAH. The index case in this family, presumed to have classical simple virilizing CAH, was later diagnosed to have nonclassical CAH. Thus, in nonclassical CAH, hormonal measurement of 17-OHP and delta 4-A is not useful in prenatal diagnosis; only HLA genotyping of the fetus is valuable. In the third case, the fetus was predicted to be a heterozygote by HLA genotyping and to be unaffected by hormonal measurement. Postnatally, at age 2 7/12 yr, the male child was found to have classical simple virilizing CAH and to be HLA-B-DR identical to his brother (index case) who also has classical simple virilizing CAH.(ABSTRACT TRUNCATED AT 400 WORDS)

17-alpha-Hydroxyprogesterone↗