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Biomedical subjects

A D Roses

Publications and source records attributed to A D Roses.

At least 271 records · Page 15Linked to original sources
PubMed1985

Gel chromatography on a Sepharose 4B column: earlier elution of protein-sodium dodecyl sulfate complexes of low Stokes radii.

A procedure is described for the determination of the Stokes radius of a detergent micelle by gel chromatography. It was observed that different lots of Sepharose 4B can exhibit a wide variation in the permeation of their gel pores. It is shown that this variation is due to differences in their pore size distribution. It has been observed that protein-sodium dodecyl sulfate (SDS) complexes of high Stokes radii eluted on a Sepharose 4B column with Stokes radii lower than the theoretical, as it has been previously reported but that protein-SDS complexes of low Stokes radii (less than 70 A), contrary to what might have been expected, eluted with Stokes radii higher than the theoretical. Evidence was obtained that their anomalous elution is due to an interaction of the detergent SDS with the gel pores of small diameter.

Chemical Phenomena↗
PubMed1985

Cardiac involvement in myotonic muscular dystrophy.

Cardiac illness in myotonic muscular dystrophy (MyD) is infrequent, but subclinical cardiac involvement in MyD is very common (found in 42 of 46 subjects) and may be responsible for sudden death. In this series, we found ECG abnormalities in 72%, left ventricular dysfunction in 70%, mitral valve prolapse in 37%, and sudden death in 4%. Four deaths during the study period were due to acute left ventricular failure, one to sepsis and respiratory insufficiency, and one was unexplained. We did not find ominous bradyarrhythmias or atrioventricular block, evidence of congestive heart failure, noninvasive evidence of coronary artery disease, or any correlation of type or amount of cardiac involvement with any clinical parameter such as age, sex, or severity of systemic dystrophy. We feel tachyarrhythmias may play as important a role in sudden death of myotonic muscular dystrophy subjects as bradyarrhythmias, and coronary artery disease in addition to cardiac dystrophy may produce arrhythmias and myocardial dysfunction in myotonic muscular dystrophy. In addition, some subjects have an unusual form of resting left ventricular dysfunction which improves with exercise. The most important problem in the clinical management of myotonic muscular dystrophy subjects is sudden death, and the solution does not appear to be empiric ventricular pacing. Our recommendations for prophylaxis of sudden death in myotonic muscular dystrophy are noninvasive investigation of coronary artery disease in subjects with significant risk factors, with angiography and surgery if indicated: detailed evaluation of syncopal and presyncopal events, including electrophysiologic testing, with pacemaker or antiarrhythmic drug therapy if indicated; and consideration of ventricular pacing of asymptomatic subjects if severe bradycardia or marked intraventricular conduction delay develops during follow-up, serial 12-lead ECGs. The documentation of tachyarrhythmias during sudden death and syncopal episodes in myotonic muscular dystrophy subjects makes ventricular pacing alone an uncertain modality for prevention of sudden death in subjects with only mildly lengthened PR or QRS intervals, and suggests a combination of pacemaker and antiarrhythmic drug therapy for the myotonic muscular dystrophy subject with syncope of no apparent cause.

Adult↗
PubMed1985

Localization of cloned unique DNA to three different regions of chromosome 19: screen for linkage probes for myotonic dystrophy.

Screening polymorphic DNA probes for linkage to myotonic dystrophy (DM) and to other reported chromosome 19 (CH19) genes will develop a linkage map for human CH19. We report here the assignment of 3 cloned unique DNA sequences to 3 distinct regions of CH19. The novel use of 35S-labeled probes facilitated the rapid localization of the gene for the third complement factor (C3) to 19p13.2 by in situ hybridization. Metaphase chromosomes were from normal peripheral lymphocytes as well as from a fibroblast line containing a 15;19 translocation which permitted clear identification of CH19 regions of localization. Two random clones isolated from a plasmid library of human F-group enriched chromosomal DNA (D19S5 and D19S6) were in like manner assigned to 19p1.2 and 19q13.2 to 19qter, respectively.

Chromosome Mapping↗
PubMed1984

Vesicles with transport capability isolated from cultured fibroblasts.

Plasmalemmas from cultured human skin fibroblasts, isolated by a simple and reproducible method, can be converted to vesicles which are capable of active transport of aminoacid when glutathione is included within the vesicles. In the isolation, the plasmalemmas are stabilized with a Ricinus lectin, with preservation of the classic plasmalemma enzymes. The procedure has been applied successfully to a number of normal and abnormal human skin fibroblasts including those of myotonia dystrophica and progeria victims, and to the lung fibroblast WI-38. As part of a study of the characteristics of transport enzymes related to aging and to the muscular dystrophies in cultured fibroblasts, it was desirable to simplify the system by the use of vesicles prepared from the fibroblast plasmalemmas. The procedure described below is similar in some respects to that applied to another membranous system in the use of a lectin to stabilize the plasmalemma structure. The use of other stabilizing agents such as heavy metals and surfactant polymers which react with the membranes, but could compromise the reliability of the enzyme assays, was avoided. Since the focus of this study was on the enzymic systems of transport, the examination of facilitated diffusion or exchange was excluded. The well defined glutathione-dependent mechanism of aminoacid transport was examined to verify the competence of the vesicles for active transport and to confirm their sidedness. Other enzymes of transport, the ATPases, and membrane marker enzymes were also determined.

Adenosine Triphosphatases↗
PubMed1984

Autologous mixed lymphocyte reaction in patients with myasthenia gravis: correlation with disease activity.

Enriched subpopulations of peripheral blood mononuclear cells from patients with myasthenia gravis and from normal control individuals were tested for proliferative ability in the autologous mixed lymphocyte reactions. Myasthenia gravis patients were studied at various phases of therapy. Longitudinal patient populations were studied. Purified T cells from untreated patients with active myasthenia gravis demonstrated enhanced proliferative responses when co-cultured with nonmodified autologous non-T cells. Furthermore, treatment by thymectomy with or without prior plasmapheresis was associated with a consequent normalization of the autologous reaction. The enhanced autologous mixed lymphocyte reaction in the pre-treatment group of myasthenia gravis patients was significantly different from the post-treatment and normal control groups (Stimulation Index, p less than 0.01 and p less than 0.02, respectively). This difference in activity was also confirmed in a longitudinal study of 10 patients followed pre- and post-treatment (Stimulation Index, p less than 0.02). There was no difference between the responses of post-treatment patients and normal control individuals. There was no evidence of altered T cell responsiveness or non-T cell stimulation, as measured by the allogeneic mixed lymphocyte reaction or by mitogen-induced lymphocyte proliferation, between pretreatment and post-treatment patients as compared to controls. The responses were not affected by serum substitution experiments whereby myasthenic responder T cells were co-cultured with pooled normal human sera. Other parameters studied included clinical status, anti-acetylcholine receptor antibody levels, and thymic pathology. An intriguing connection between abnormalities in the thymic cell populations and the autoaggressive state in myasthenia may be reflected by the in vitro autologous mixed lymphocyte reaction.

Adolescent↗
PubMed1983

Recombinant DNA strategies in genetic neurological diseases.

The application of recombinant DNA techniques applied to the study of genetic neurological diseases will play a major role in the practice of neurology in upcoming years. Strategies are now available to develop useful and relatively simple biochemical diagnostic tests for heterozygous individuals with diseases inherited as autosomal dominant traits. In addition, molecular genetic methods will lead to the delineation of the genomic mutations responsible for these diseases. This review will update the current status of research in several neurological genetic diseases including myotonic muscular dystrophy, Huntington's disease, Charcot-Marie-Tooth disease and Duchenne muscular dystrophy (X-linked). An introduction and overview of the methodology is provided. Specific research strategies including random screening of libraries, chromosome walking, messenger RNA selection, and messenger RNA translation are described. These strategies are designed to provide heterozygote identification, prenatal diagnosis and gestational management, the development of rational therapies, and the understanding of the molecular basis of disease expression.

Charcot-Marie-Tooth Disease↗
PubMed1983

The genetic status of mothers of isolated cases of Duchenne muscular dystrophy.

Classical genetic theory, based on assumed equal mutation rates in males and females, predicts that one-third of all cases of Duchenne muscular dystrophy (DMD) in a generation are born as new mutants to non-carrier mothers. Furthermore, less than half the mothers of apparently isolated cases appear to be carriers on the basis of raised serum creatine kinase levels. We have analysed the pedigrees of 61 families of DMD boys seen in the Duke Neuromuscular Research Clinic and 45 DMD families followed at the University of Virginia. The frequency of affected boys among the next born male sibs of 37 initially isolated DMD cases in two clinic populations was significantly greater than predicted by Haldane's theory (p = 0.029) and the estimated proportion of new mutant cases in the combined clinic population of 106 families was 0.127 (SE 0.111). The absence of affected males in earlier generations in families of isolated cases may be explained in part by a high ratio of male to female stillbirths and infant deaths, which was more than three times that of the normal population in this study. These data suggest that new mutant cases are less common than expected and current predictions may underestimate genetic risks in mothers of isolated cases.

Adult↗
PubMed1983

Radionuclide angiocardiographic analysis of myocardial function in myotonic muscular dystrophy.

Using radionuclide angiocardiography, we studied cardiac function in 10 men with myotonic muscular dystrophy who had no cardiac symptoms and were less than 50 years of age, comparing resting and exercise performance of the heart. Nine of 10 patients had an abnormality of myocardial function. The interaction of exercise-induced cardiomyopathy with conduction system abnormalities may be important in sudden cardiac dysfunction in patients with myotonic dystrophy.

Adult↗
PubMed1983

Effect of thymectomy on peripheral lymphocyte subsets in myasthenia gravis: selective effect on T-cells in patients with thymic atrophy.

Myasthenia gravis (MG) is an autoimmune disease affecting nicotinic acetylcholine receptors. The clinical improvement that follows thymectomy in some myasthenic patients implicates thymic factors as well in the pathogenesis of MG. We have studied circulating immunoregulatory T cell subsets before and after thymectomy in 11 adult patients with MG. Six patients had thymic hyperplasia and five patients had atrophic thymus at the time of thymectomy. Before thymectomy, patients who subsequently were shown to have an atrophic thymus, had lower lymphocyte counts than either patients later shown to have a hyperplastic thymus (1315 +/- 143 lymphocytes/mm3 vs. 2434 +/- 350 lymphocytes/mm3, p less than 0.01), or age-matched controls (1315 +/- 143 lymphocytes/mm3 vs. 2636 +/- 589 lymphocytes/mm3, p less than 0.02). Moreover, after thymectomy, in MG patients with an atrophic thymus, there was a significant rise in lymphocyte count (from 1315 +/- 143 lymphocytes/mm3 to 2279 +/- 292 lymphocytes/mm3, p less than 0.02) beginning 3 days postthymectomy and persisting for at least 6 weeks thereafter. In comparison, patients with a hyperplastic thymus showed no change in circulating lymphocyte counts (p greater than 0.1). Enumeration of lymphocyte subsets in MG patients with an atrophic thymus demonstrated normal B cell numbers before and after thymectomy (p greater than 0.1), whereas, T cells were significantly decreased before thymectomy compared with age-matched normal subjects (859 +/- 82 T cells/mm3 vs. 2215 +/- 545 T cells/mm3, p less than 0.05), and rose to near normal levels after thymectomy (1796 +/- 294 T cells/mm3, p less than 0.02 compared with prethymectomy levels). Using monoclonal anti-T cell antibodies 3A1, OKT4, and OKT8, we found that, before thymectomy in the atrophic thymus group, 3A 1+ T cells were significantly depressed compared with postthymectomy levels (620 +/- 173 cells/mm3 vs. 1627 +/- 331 cells/mm3, p less than 0.02) as were OKT4+ cells 436 +/- 88 cells/mm3 vs. 1112 +/- 63 cells/mm3, p less than 0.001), In contrast, no significant change was seen after thymectomy in the OKT8+ cell subset (p greater than 0.1). MG patients with an atrophic thymus had decreased plasma cortisol levels postthymectomy compared with prethymectomy levels, whereas thymectomy in MG patients with a hyperplastic thymus effected no change in plasma cortisol levels. These data demonstrate in MG patients with an atrophic thymus that thymectomy has an effect on the number of circulating T cells, and in particular, on those T cells expressing antigens 3A1 and OKT4. This effect may in part be mediated by changes in plasma adrenal corticosteroid levels after thymectomy or may be due to a factor produced by atrophic thymuses in MG.

Antigens, Differentiation, T-Lymphocyte↗
PubMed1982

Thymectomy in late-onset myasthenia gravis.

Between 1977 and 1979, 12 consecutive patients with myasthenia gravis who were over the age of 55 years were treated by thymectomy. In all, their conditions improved clinically; 11 of the 12 became free of the generalized features of myasthenia gravis. Nine patients required no further medication. Acetylcholine-receptor antibody titers did not change significantly. Although five patients had atrophic thymus glands, their conditions also improved. We conclude that (1) thymectomy is a safe and effective therapy for patients with myasthenia gravis who are over the age of 55 years; (2) steroids and anticholinesterase agents are not essential in the management of late-onset myasthenia gravis; and (3) reduction in acetylcholine-receptor antibody titer is not essential for beneficial clinical response.

Aged↗
PubMed1982

Myotonic muscular dystrophy. Calcium-dependent phosphatidate metabolism in the erythrocyte membrane.

It has been suggested that the erythrocytes of myotonic dystrophy (MyD) patients have a decreased calcium-stimulated phosphatidic acid (PA) accumulation. This could be the result of a defect in the calcium-stimulated hydrolysis of the polyphosphoinositides (calcium-dependent phosphodiesterase) or in the subsequent formation of PA from its precursors (diacylglycerol kinase). In vitro assays were established for both enzymes in erythrocyte membranes. Calcium-dependent phosphodiesterase activity was assayed with both endogenous 32P-labeled erythrocyte diphosphoinositide and triphosphoinositide and with the same phospholipids isolated from rat brain. No significant differences in activity were found between MyD patients and normal controls with either method of substrate preparation. No difference in diglyceride kinase activity was found between ghosts prepared from MyD patients and normal controls. Thus, there were no differences in either of the membrane-associated enzymes of phosphatidic acid metabolism.

Calcium↗
PubMed1982

Neonatal myasthenia gravis in the infant of an asymptomatic thymectomized mother.

A case of neonatal myasthenia gravis is reported in the infant of an asymptomatic thymectomized mother with comparably elevated acetylcholine receptor (AChR) antibody titers. The mother remained asymptomatic despite elevated antibody titers while the infant became asymptomatic in association with the disappearance of the AChR antibody. It is suggested that the AChR antibody plays an essential role in the development of neonatal myasthenia gravis. It is also suggested that a thymic factor is necessary for the development of clinical symptomatology accounting for the lack of correlation between the clinical state of the mother and infant.

Adult↗
PubMed1982

A prospective study of thymectomy and serum acetylcholine receptor antibodies in myasthenia gravis.

Forty-seven consecutively presenting myasthenia gravis (MG) patients with generalized weakness were treated according to a standardized prospective protocol. All patients underwent a sternal splitting "total" thymectomy. Medical status before surgery was optimized by plasmapheresis without immunosuppression. Medications were avoided or discontinued whenever possible. All patients were improved. At the time of latest follow-up 83% were free of generalized weakness and 61% were on no medications. There was no significant change in Acetylcholine Receptor Antibody (AChR-AB) titer. The following conclusions were made: (1) thymectomy is an effective therapy for MG, (2) additional medications are not necessary in the majority of patients, and (3) a reduction in the AChR-AB titer is not essential for clinical benefit.

Acetylcholine↗
PubMed1981

Variation of serum creatine kinase levels with age in normal females: implications for genetic counselling in Duchenne muscular dystrophy.

We have examined the variation of creatine kinase (CK) levels with age in 206 unrelated normal females. The subjects included 75 adult women aged 15-50, 11 post-menopausal women aged 50-70 and 120 girls under 15 years of age, comprising 84 girls with idiopathic epilepsy (65 pre-menarchal and 19 post-menarchal), well controlled on various anticonvulsant combinations, and 36 normal schoolgirl volunteers (28 pre-menarchal and 8 post-menarchal). Comparison of mean and variance values showed no significant difference between the CK levels in normal and epileptic girls and the data were subsequently combined. Creatine kinase levels were significantly higher in the pre-menarchal girls than in the post-menarchal girls and normal adult women. Levels were high in the first few months of life, fell during infancy and early childhood, rose rapidly in later childhood and then fell abruptly around the time of menarche. The levels then fell slowly throughout adult life but rose again after age 40. This phasic variation with age may be related to hormonal status. The use of age-specific CK ranges may have a significant effect on the carrier detection rate in Duchenne dystrophy.

Adolescent↗