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Biomedical subjects

Y Weng

Publications and source records attributed to Y Weng.

At least 73 records · Page 4Linked to original sources

Capture of an early fusion-active conformation of HIV-1 gp41.

Using an inhibitory synthetic peptide (DP-178) from HIV-1 gp41, we have trapped HIV-1 envelope glycoprotein (Env) undergoing conformational changes during virus entry. Our data show that DP-178 binds gp41 and inhibits Env-mediated membrane fusion after gp120 interacts with cellular receptors, indicating that conformational changes involving the coiled coil domain of gp41 are required for entry. Capture of this fusion-active conformation of Env provides insights into the early events leading to Env-mediated membrane fusion.

3T3 Cells↗

Successful surgical treatment of a giant aneurysm of the right coronary artery.

We describe the case of a 46-year-old female patient, who was referred to us under the suspicion of an acute type-A aortic dissection. After perusal of the computer tomogram and subsequent transesophageal echocardiography, we decided to operate, albeit under the assumption of the existence of a pericardial cyst. Intraoperatively a strikingly large aneurysm of the right coronary artery presented itself, which was successfully treated through resection and end-to-end anastomosis.

Anastomosis, Surgical↗

Coronary angioplasty, bypass surgery, and retransplantation in cardiac transplant patients with graft coronary disease.

BACKGROUND: Graft coronary disease (GCD) remains the single greatest limitation to long-term survival of heart transplant recipients. Therapeutic strategies for the prevention or retardation of GCD in the cardiac allograft are limited; palliative coronary revascularization has been attempted. Because of the high mortality rate associated with advanced forms of GCD our institution offers the option of retransplantation in selected cases. The aim of this study was by analyzing retrospectively the outcomes of angioplasty, coronary bypass grafting, and retransplantation in cardiac transplant patients to attempt to identify subgroups of transplant recipients with graft coronary disease who may profit from myocardial revascularization. METHODS: Of the 989 patients undergoing 1016 heart transplantations (HTx) at our institution between 10/86 and 12/97, all were screened for the development of GCD. Analyzing routinely annual angiography, intracoronary ultrasound in defined study patients, and autopsy findings, GCD was diagnosed in 124 patients (110 male, 14 female) 2 to 107 months after HTx (mean 30 months). RESULTS: PTCA: Fourty-six out of 124 patients underwent 76 angioplasties at a mean of 50 +/- 30 months (range 4-91 mo) following cardiac transplantation. The primary success rate was 96% (73/76). The reason for the unsuccessful angioplasty attempts (n = 3) was failure to completely penetrate a stenosis of LAD in 2 patients and severe dissection of RCA, which required emergency surgery, in one. Angiographic restenosis occurred in 42% (31 of 76 lesions) and was diagnosed 11 +/- 11 months after the first angioplasty. There was no procedure-related death. CABG: Seven patients underwent bypass surgery at a mean of 67 months (range 6-128 months) after HTx. Elective surgery was performed in 2 patients with proximal severe triple-vessel disease (Type A lesion) and in 1 patient with severe tricuspid regurgitation who received a tricuspid valve replacement and concomitant single-vessel bypass surgery for proximal GCD (Type A lesion). One patient with combined Type A and B/C lesions required emergency surgery for dissection of RCA after an angioplasty procedure. Three patients with post-infarction unstable angina developed worsening congestive heart failure which required emergency surgery. Angiographically all these patients showed diffuse, distal arteriopathy (combined Type B/C lesions). The electively operated patients and the patient with dissection of RCA were successfully treated and survived beyond hospital discharge (overall survival for CABG in GCD patients 4/7 = 57%). After a mean follow-up of 10 months (range 2-32 months) all are in good clinical condition. All 3 patients with distal arteriopathy and emergency surgery died in hospital of left-ventricular failure (43%). Retransplantation: Eight patients underwent retransplantation at a mean of 54 months (range 6-96 months) after HTx. Six of 8 patients had successful operations and survived beyond hospital discharge with a one-year-survival rate of 75%. In a mean follow-up of 31 months (5-68 months) 3 of 6 retransplant recipients developed a recurrence of GCD. CONCLUSION: The presence of angiographic distal arteriopathy should be considered a significant factor in patient selection for coronary revascularization procedure. Coronary angioplasty is to be considered as a method of treatment for severe, local stenoses (Type A lesion). PTCA may be applied in these selected cardiac transplant recipients with primary success and complication rates comparable to routine angioplasty but with an increased rate of restenosis especially in small vessels (diameter < 2.5 mm). The distinction between Type A lesions in large (diameter > or = 2.5 mm) and small vessels may be important not only with respect to restenosis but also with respect to long-term benefit. The overall survival did not differ between GCD patients with and without PTCA, suggesting this treatment to be largely palliative. (ABSTR

Angioplasty, Balloon, Coronary↗

Mutational analysis of residues in the coiled-coil domain of human immunodeficiency virus type 1 transmembrane protein gp41.

The envelope glycoprotein (Env) of human immunodeficiency virus mediates virus entry into cells by undergoing conformational changes that lead to fusion between viral and cellular membranes. A six-helix bundle in gp41, consisting of an interior trimeric coiled-coil core with three exterior helices packed in the grooves (core structure), has been proposed to be part of a fusion-active structure of Env (D. C. Chan, D. Fass, J. M. Berger, and P. S. Kim, Cell 89:263-273, 1997; W. Weissenhorn, A. Dessen, S. C. Harrison, J. J. Skehel, and D. C. Wiley, Nature 387:426-430, 1997; and K. Tan, J. Liu, J. Wang, S. Shen, and M. Lu, Proc. Natl. Acad. Sci. USA 94:12303, 1997). We analyzed the effects of amino acid substitutions of arginine or glutamic acid in residues in the coiled-coil (heptad repeat) domain that line the interface between the helices in the gp41 core structure. We found that mutations of leucine to arginine or glutamic acid in position 556 and of alanine to arginine in position 558 resulted in undetectable levels of Env expression. Seven other mutations in six positions completely abolished fusion activity despite incorporation of the mutant Env into virions and normal gp160 processing. Single-residue substitutions of glutamic acid at position 570 or 577 resulted in the only viable mutants among the 16 mutants studied, although both viable mutants exhibited impaired fusion activity compared to that of the wild type. The glutamic acid 577 mutant was more sensitive than the wild type to inhibition by a gp41 coiled-coil peptide (DP-107) but not to that by another peptide corresponding to the C helix in the gp41 core structure (DP-178). These results provide insight into the gp41 fusion mechanism and suggest that the DP-107 peptide may inhibit fusion by binding to the homologous region in gp41, probably by forming a peptide-gp41 coiled-coil structure.

Amino Acid Sequence↗

Alterations of oncogenes, tumor suppressor genes and growth factors in hepatocellular carcinoma: with relation to tumor size and invasiveness.

OBJECTIVE: To make a better understanding of the molecular mechanisms involved in recurrence and metastasis of the hepatocellular carcinoma (HCC), some invasion related oncogenes, and growth factors have been investigated. METHODS: The studies were separately carried out, the results of which were summarized in this article with relation to tumor size and invasiveness of HCC. RESULTS: The aberration rates of p53 and CDKN2 in HCC were 45.9% and 36.4% respectively, which were higher in invasive HCC compared with non-invasive HCC. H-ras expression was positive in 29.3% of HCC, which was associated with recurrence and extrahepatic metastasis of HCC. Intralesional injection of H-ras antisense gene markedly inhibited the tumor growth and metastasis of HCC in nude mice. The positive rates of transforming growth factor (TGF)-alpha, epidermal growth factor receptor (EGFR) and c-erbB-2 were 45.7%, 47.1% and 92.3% respectively. The expression of EGFR was closely related to TGF-alpha, which was related to HCC recurrence. But no obvious difference of TGF-alpha or c-erbB-2 expression was found between HCC with and without recurrence, or with and without extrahepatic metastasis. Expression of nm23/tissue inhibitor of metalloproteinase (TIMP)-2 was positively associated with the prognosis of HCC patients (Log-rank, P < 0.001). The alterative rates of above-mentioned genes and growth factors in small HCC were slightly lower than that in large ones, but no significant difference was shown except the p53 mutation. CONCLUSIONS: The p53/CDKN2 mutation, over-expression of H-ras/EGFR, were associated with the invasiveness and recurrence of HCC. H-ras antisense gene might be of potential implication in the control of HCC recurrence and metastasis. Expression of nm23/TIMP-2 was closely related to the prognosis of HCC patients. Biological characteristics remained critical points to the prognosis even in small HCC.

Animals↗

[Determination of oil contents and fatty acids in seeds of Torreya Arn. in China].

OBJECTIVE: To analyze the oil contents and fatty acid composition in the seeds of Torrreya in China. METHOD: The contents and composition were determined by gravimetric analysis and GC respectively. RESULT: The oil contents in the seeds were 42.67%-54.39%. Among the fatty acids, linoleic acid and oleic acid were dominant. The unsaturated fatty acids accounted for 76.1%-82.0% of the whole fatty acids, and the major saturated fatty acids were behenic acid and palmitic acid. CONCLUSION: The oil in the seeds of Torreya is of high-quality, and the higher contents of bdhenic acid are characteristic for the oil. The development and utilization values of the seed oil in Torreya are evaluated.

Cycadopsida↗

[The influence of side-to-side portacaval shunt plus enhancement of perfusion of hepatic artery on cirrhotic liver: an experimental study].

OBJECTIVE: To for improving the perfusion of liver, we designed an operation of portacaval shunt (PCS) plus enhancement of perfusion of hepatic artery (EPHA). METHOD: 48 wistar rats were divided into 4 groups randomly. group I (normal control), group II (liver cirrhotic control), group III (PCS on liver cirrhosis), and group IV (PCS + EPHA on liver cirrhosis). The EPHA was performed by the ligation of the left gastric and splenic artery. Liver function tests, liver biopsy, and nuclide hepatobiliary dynamic imaging (NHDI) were performed on the 2nd week and the 6th month after operation. RESULT: In NHDI, the peak time was short (P < 0.05) and the excretive rate was high (P < 0.01). The liver function and the proliferative degree of the fibrotic tissue of the liver were perfected significantly (P < 0.05) in the group IV compared with the group III after operation. CONCLUSION: PCS + EPHA can increase the perfusion of the hepatic artery, maintain the liver function and delay liver cirrhosis, and overcome the side effects of PCS. It is a new surgical technique in treating portal hypertension.

Alanine Transaminase↗

ATP is a cofactor of the Upf1 protein that modulates its translation termination and RNA binding activities.

The nonsense-mediated mRNA decay pathway decreases the abundance of mRNAs that contain premature termination codons and prevents suppression of nonsense alleles. The UPF1 gene in the yeast Saccharomyces cerevisiae was shown to be a trans-acting factor in this decay pathway. The Upf1p demonstrates RNA-dependent ATPase, RNA helicase, and RNA binding activities. The results presented here investigate the binding affinity of the Upf1p for ATP and the consequences of ATP binding on its affinity for RNA. The results demonstrate that the Upf1p binds ATP in the absence of RNA. Consistent with this result, the TR800AA mutant form of the Upf1p still bound ATP, although it does not bind RNA. ATP binding also modulates the affinity of Upf1p for RNA. The RNA binding activity of the DE572AA mutant form of the Upf1p, which lacks ATPase activity, still bound ATP as efficiently as the wild-type Upf1p and destabilized the Upf1p-RNA complex. Similarly, ATPgammaS, a nonhydrolyzable analogue of ATP, interacted with Upf1p and promoted disassociation of the Upf1p-RNA complex. The conserved lysine residue (K436) in the helicase motif Ia in the Upf1p was shown to be critical for ATP binding. Taken together, these findings formally prove that ATP can bind Upf1p in the absence of RNA and that this interaction has consequences on the formation of the Upf1p-RNA complex. Further, the results support the genetic evidence indicating that ATP binding is important for the Upf1p to increase the translation termination efficiency at a nonsense codon. Based on these findings, a model describing how the Upf1p functions in modulating translation and turnover and the potential insights into the mechanism of the Upf1p helicase will be discussed.

Adenosine Triphosphate↗

Nitric oxide inhalation in the treatment of right ventricular dysfunction following left ventricular assist device implantation.

BACKGROUND: Following left ventricular assist device (LVAD) implantation in end-stage heart failure, the management of right ventricular dysfunction presents a therapeutic problem unresolved by conventional drug therapy (catecholamines, nitrates, and prostacyclin). This study was performed to investigate the effects of supplemental inhalation of nitric oxide (NO), a selective pulmonary vasodilator, postoperatively and prospectively. METHODS AND RESULTS: Intraindividual dose titration of NO was performed (0 to 40 ppm) according to a standardized protocol. Thereafter treatment was continued with the individually most effective dose of NO (25 to 40 ppm). In 8 consecutive male patients presenting with right ventricular dysfunction postoperatively, a significant dose-dependent improvement in hemodynamic function was observed: pulmonary vascular resistance decreased from 336+/-110 to 210+/-59 dynes x s x cm(-5) (P<.0001), cardiac index rose from 2.0+/-0.4 to 2.7+/-0.4 L x min(-1) x m(-2) (P<.003) at 40 ppm; doses of >20 ppm were effective in increasing cardiac index (P<.05). With continuous NO inhalation up to 48 hours, pulmonary vascular resistance decreased further to 155+/-33 dynes x s x cm(-5) (P<.0001) as the cardiac index increased to 3.3+/-0.6 L x min(-1) x m(-2) (P<.003). Pulmonary artery pressure decreased (P<.0001) as did systemic vascular resistance with hemodynamic improvement (P<.01). Central venous pressure and mean arterial pressure remained unchanged. Right ventricular ejection fraction at transesophageal echocardiography increased from 24+/-7% to 44+/-7% (P<.01) at the end of the study, and right ventricular end-diastolic volume decreased (P<.05). Weaning from NO therapy was successful at 2 to 8 days, and all patients were extubated. Right ventricular function remained stable thereafter. CONCLUSIONS: In the treatment of right ventricular dysfunction following LVAD implantation, inhalation of NO markedly decreased right ventricular afterload by its selective vasodilating effects on the pulmonary circulation without producing systemic hypotension; this merits further evaluation.

Administration, Inhalation↗

Risk factors for early degeneration of allografts in pulmonary circulation.

OBJECTIVE: The aim of this study was to define risk factors for early degeneration of allografts in pulmonary circulation and to recommend some guidelines to minimize them. METHODS: Between January 1988 and March 1995, 202 patients with various types of congenital heart disease received cryopreserved allograft conduits for reconstruction of their right ventricular outflow tract. We report on 63 patients receiving allografts ranging from 9-24 mm size within the first 2 years of life. RESULTS: Survivors have been followed for 4-67 months. Survival at 5 years, including hospital mortality, was 66%. Two patients died at reoperation. Of the patients 19.6% (9/46) had early structural deterioration (SD) of their vascular allografts at a mean of 15.2 months after implantation. Seven of these have already been reoperated with allograft exchange. Freedom of reoperation was 66% at 5 years. Infants showed 48% freedom of reoperation at 5 years compared to 90% in the 1-2 years age group, while freedom of SD was 59% in infants at 48 months compared to 87% in the 1-2 years age group. Of allografts with SD in the infant group 66% had an allograft size of < 14 mm. In aortic allografts freedom of SD was 62% compared to 93% in pulmonary allografts. Freedom of allograft wall calcification was 46% at 18 months in all patients. In the statistical analysis, only infant age (P = 0.03) and aortic allograft (P = 0.02) were shown to be significant risk factors for early SD. CONCLUSION: The use of pulmonary allografts, avoidance of relatively short and small conduits of < 14 mm in diameter, might improve the durability of allografts in infants and small children.

Bioprosthesis↗

Results of left atrioventricular valve reconstruction after previous correction of atrioventricular septal defects.

OBJECTIVE: The objective of this study was to determine causes of severe left atrioventricular (AV) incompetence and the factors leading to the success of valve repair later after correction of atrioventricular septal defects (AVSD). METHODS: A total of 28 patients aged 5 months to 38 years (mean age 6.7 years) were operated for significant (grade II-III) left AV valve incompetence (LAVVI), two months to twenty-five years (median 1.5 years) after correction of complete (11 patients) or partial atrioventricular septal defects. Fourteen patients had initially undergone surgery during infancy. RESULTS: At reoperation a completely open or partially sutured cleft was found in 16 patients combined with dysplastic valve tissue in four cases, with a fibrotic valve in three cases, with posterior leaflet prolapse in two cases, with a double orifice valve in three cases, and a parachute valve in two cases. Partial or complete reopening of a previously sutured cleft caused by suture dehiscence was found in 12 cases combined with a fibrotic valve in five cases, with a dysplastic valve in one case and with severe deformity of valve in one case. A combination of these anomalies was observed in seven patients in both groups. Left atrioventricular valve repair including cleft closure combined with annuloplasty and other surgical procedures resulted in the disappearance or significant diminishing of LAVI in 18 patients (64%). Severe SAVI persisted in six patients, five of them exhibiting a combination of several additional left AV valve anomalies (fibrotic or dysplastic valve, parachute valve). Five of these six patients underwent successful left AV valve replacement with a mechanical prosthesis 7 days to 2 years after reoperation. The presence of additional left AV valve anomalies was the single statistically significant factor for recurrent major LAVVI after reoperation (P = 0.0106). There were two postoperative deaths in patients with mild LAVVI after surgery, and no late deaths. CONCLUSION: An open cleft is the major factor of late severe SAVVI after correction of AVSD. Although suturing the cleft in conjunction with performing annuloplasty improved valvular function in most of the cases, the presence of severe left AV valve anomalies increased the risk of recurrent LAVVI and the need for valve replacement, thus playing a major role in determining the outcome of valve reconstruction in patients after reoperation.

Adolescent↗

Circulatory support with paracorporeal pneumatic ventricular assist device (VAD) in infants and children.

OBJECTIVE: The feasibility and efficacy of the pneumatic 'Berlin Heart' ventricular assist device (VAD) were evaluated in 14 pediatric patients with profound cardiogenic shock refractory to conventional therapy. METHODS: There were two patient groups. Eleven patients, aged 2 weeks 15 years and weighing 3.2-52 kg received a left ventricular assist device or a biventricular assist device as a bridge to cardiac transplantation (bridge group). Nine of them had liver, kidney, or lung dysfunction before device implantation. Three patients were supported with a biventricular assist device for myocardial recovery (recovery group): a 6-month-old girl for postcardiotomy shock, a 10-month-old girl for allograft failure after cardiac transplantation, and a 4-year-old boy with acute myocarditis. RESULTS: In the bridge group, eight patients were transplanted after a bridge duration of 6-98 days (mean, 32 days) with five long-term survivors. Organ functions were normalized during bridging in all of the transplant recipients. In the recovery group, the first patient was removed from support after 2 days because of irreversible brain damage. The second patient was weaned from biventricular support after 8 days, but suffered from recurrent allograft failure. The third patient received biventricular support for 21 days followed by extracorporeal membrane oxygenation and was subsequently discharged from the hospital. CONCLUSIONS: The 'Berlin Heart' VAD can keep selected infants and children with life-threatening heart failure for weeks or months.

Adolescent↗

Long-term mechanical circulatory support as a bridge to transplantation, for recovery from cardiomyopathy, and for permanent replacement.

Since 1988, 295 patients have undergone MCS at the German Heart Institute Berlin; 246 received biventricular support with the extracorporeal pneumatically-driven Berlin Heart Assist Device, 49 received left ventricular support with implantable assist devices (33 Novacor, 16 TCI). Longer waiting periods for heart transplantation has caused the mean duration of MCS to increase from 12 days in 1988 to 76 days in 1994. Of the 24 patients who underwent MCS for more than 90 days, nine were implanted with a biventricular device, 12 with a Novacor device, and 15 with a TCI device. Eight patients with uni-ventricular devices remain on support after 200 days (range 203-600 days). Six of the Novacor patients could be discharged to a nursing home or to their own residences. One patient still on NC support after more than 600 days currently resides at his home and has regained normal physical activity. Minor pocket infections occurred in two TCI and four Novacor patients; one patient died of sepsis. A total of four patients could be weaned from LVAD after 160-347 days of MCS. An initial high level of beta1 receptor antibodies disappeared completely during left ventricular support. This decline in auto-antibodies was paralleled by a dramatic improvement in cardiac function. LVEF remained unchanged up to 6 months after explantation. Long-term mechanical support has become a reality. Heart transplantation after prolonged MCS yields results comparable to primary HTx. Some patients exhibit immunological changes and a dramatic improvement in ventricular function under long-term MCS and can be weaned with extremely satisfying results.

Adolescent↗

Successful mechanical circulatory support for more than two years with a left ventricular assist device in a patient with dilated cardiomyopathy.

A 36-year-old man with dilated cardiomyopathy was supported with a left ventricular assist device for 795 days. During this support time gradual functional recovery was noted. The patient tolerated the device well, enjoyed a good quality of life, and experienced no technical device-related problems. When a suitable donor heart became available, the device was switched off, and native ventricular function was assessed. This was judged to be acceptable, and the left ventricular assist device was successfully explanted. Postexplantation function remained acceptable and improved over the following days. The patient was discharged on the twentieth postoperative day and remains well.

Adult↗

[Surgical therapy of chronic atrial fibrillation with the "Cox/Maze-III-operation"].

UNLABELLED: We examined the results of simultaneous surgical treatment of chronic atrial fibrillation using a Cox/Maze III operation during mitral valve surgery (n = 12), atrial secundum defect closure (n = 1), combined operation (mitral valve and atrial secundum; n = 1) and thrombectomy from the left atrium (n = 1). Mean preoperative atrial fibrillation was 5.1 years (range 0.5-12 years). In the mean follow-up period of 13.1 months (1-24 months), 14 patients (93%) had sinus rhythm. CONCLUSION: (1) The surgical treatment of chronic atrial fibrillation using a Cox/Maze III operation can be performed without increased perioperative or postoperative risks; (2) Cox/Maze III operation represents an effective surgical treatment of chronic atrial fibrillation.

Aged↗