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Biomedical subjects

B Lee

Publications and source records attributed to B Lee.

At least 217 records · Page 12Linked to original sources
PubMed1998

Evaluation of gene therapy for citrullinaemia using murine and bovine models.

Citrullinaemia is an autosomal recessive disorder caused by the deficiency of argininosuccinate synthase. The deficiency of this enzyme results in an interruption in the urea cycle and the inability to dispose of excess ammonia derived from the metabolism of protein. The only treatment for this disorder has been dietary restriction of protein and supplementation with medications allowing for alternative excretion of excess nitrogen. Gene therapy offers the possibility of a long-term cure for disorders like citrullinaemia by expressing the deficient gene in the target organ. We have explored the use of adenoviral vectors as a treatment modality for citrullinaemia in two animal models, a naturally occurring bovine model and a murine model created by molecular mutagenesis. Mice treated with adenoviral vectors expressing argininosuccinate synthase lived significantly longer than untreated animals (11 days vs 1 day; however, the animals did not exhibit normal weight gain during the experiment, indicating that the therapeutic effectiveness of the transducing virus was suboptimal. It is speculated that part of the failure to observe better clinical outcome might be due to the deficiency of arginine. In the bovine model, the use of adenoviral vectors did not result in any change in the clinical condition of the animals or in the level of plasma ammonia. However, the use of 15N isotopic ammonia allowed us to assess the flux of nitrogen through the urea cycle during the experiment. These studies revealed a significant increase in the flux through the urea cycle following administration of adenoviral vectors expressing argininosuccinate synthase. We conclude that the use of adenoviral vectors in the treatment of citrullinaemia is a viable approach to therapy but that it will be necessary to increase the level of transduction and to increase the level of enzyme produced from the recombinant viral vector. Future experiments will be designed to address these issues.

Adenoviruses, Human↗
PubMed1998

Mutations in LMX1B cause abnormal skeletal patterning and renal dysplasia in nail patella syndrome.

The LIM-homeodomain protein Lmx1b plays a central role in dorso-ventral patterning of the vertebrate limb. Targeted disruption of Lmx1b results in skeletal defects including hypoplastic nails, absent patellae and a unique form of renal dysplasia (see accompanying manuscript by H. Chen et al.; ref. 2). These features are reminiscent of the dominantly inherited skeletal malformation nail patella syndrome (NPS). We show that LMX1B maps to the NPS locus and that three independent NPS patients carry de novo heterozygous mutations in this gene. Functional studies show that one of these mutations disrupts sequence-specific DNA binding, while the other two mutations result in premature termination of translation. These data demonstrate a unique role for LMX1B in renal development and in patterning of the skeletal system, and suggest that alteration of Lmx1b/LMX1B function in mice and humans results in similar phenotypes. Furthermore, we provide evidence for the first described mutations in a LIM-homeodomain protein which account for an inherited form of abnormal skeletal patterning and renal failure.

Amino Acid Sequence↗
PubMed1998

Limb and kidney defects in Lmx1b mutant mice suggest an involvement of LMX1B in human nail patella syndrome.

Dorsal-ventral limb patterning in vertebrates is thought to be controlled by the LIM-homeodomain protein Lmx1b which is expressed in a spatially and temporally restricted manner along the dorsal-ventral limb axis. Here we describe the phenotype resulting from targeted disruption of Lmx1b. Our results demonstrate that Lmx1b is essential for the specification of dorsal limb fates at both the zeugopodal and autopodal level with prominent phenotypes including an absence of nails and patellae. These features are similar to those present in a dominantly inherited human condition called nail patella syndrome (NPS), which also has renal involvement. Mouse Lmx1b maps to a region syntenic to that of the NPS gene, and kidneys of Lmx1b mutant mice exhibit pathological changes similar to that observed in NPS (refs 5,6). Our results demonstrate an essential function for Lmx1b in mouse limb and kidney development and suggest that NPS might result from mutations in the human LMX1B gene.

Animals↗
PubMed1998

Continuous ambulatory haemodynamic monitoring with an implantable system. The feasibility of a new technique.

AIMS: This study evaluates the feasibility and safety of a completely implantable system for long-term ambulatory monitoring of important haemodynamic parameters in patients with severe cardiopulmonary disease. METHODS: The design of the implantable monitoring system is similar to a conventional single lead pacemaker. A lead with incorporated biosensors for the continuous recording of pressure and oxygen saturation signals is positioned in the right ventricle and connected to a monitor and memory device subcutaneously implanted like an ordinary pacemaker can. RESULTS: Five patients with implanted haemodynamic monitoring systems have been followed for from 7 to 16 months. Continuous measurements of activity, heart rate, mixed venous oxygen saturation and estimated pulmonary artery diastolic pressure were registered with variable resolution during daily living and predefined provocations. The memory covered a maximum of 3 weeks at low resolution. The monitored parameters showed an adequate and significant response to various haemodynamic situations. Except for the demand of recalibration of two oxygen sensors, there were no technical problems and the quality of data were excellent. CONCLUSION: Long-term ambulatory haemodynamic monitoring is feasible and potentially useful for the management of patients with severe cardiopulmonary disease.

Activities of Daily Living↗
PubMed1998

Mutation analysis of LMX1B gene in nail-patella syndrome patients.

Nail-patella syndrome (NPS), a pleiotropic disorder exhibiting autosomal dominant inheritance, has been studied for >100 years. Recent evidence shows that NPS is the result of mutations in the LIM-homeodomain gene LMX1B. To determine whether specific LMX1B mutations are associated with different aspects of the NPS phenotype, we screened a cohort of 41 NPS families for LMX1B mutations. A total of 25 mutations were identified in 37 families. The nature of the mutations supports the hypothesis that NPS is the result of haploinsufficiency for LMX1B. There was no evidence of correlation between aspects of the NPS phenotype and specific mutations.

Animals↗
PubMed1998

Effects of balanced vasodilator, flosequinan, on aortic impedance in failing heart.

An arteriovenous vasodilator, flosequinan, has been shown to be effective for the treatment of acute heart failure. However, little is known as to its effect on aortic impedance, which is known to be a proper and precise expression of left ventricular (LV) afterload. To evaluate the acute cardiovascular effect of flosequinan in failing heart, we administered flosequinan intravenously to seven dogs with cardiac failure produced by an infusion of carbon powder (20-50 microm in diameter) into left main trunks of coronary artery. The LV-pump function was severely impaired after intracoronary injection of carbon powder, as evidenced by the findings that cardiac output, circumferential shortening velocity (mean Vcf), and peak +dP/dt of LV pressure were all decreased, associated with a significant increase in LV end-diastolic pressure. Flosequinan (0.9 mg/kg, i.v.) increased cardiac output by 28%, mean Vcf by 44%, and peak +dP/dt by 24%, whereas it decreased total systemic resistance by 32%, time constant of LV pressure decay by 22%, and LV end-diastolic pressure by 18%. Moreover, flosequinan substantially decreased the pulsatile components of LV afterload (i.e., characteristic impedance by 11% and arterial wave reflection coefficient by 45%). Thus flosequinan exerted not only positive inotropic but also positive lusitropic effects, in association with a significant reduction of both pulsatile and steady components of LV afterload, contributing to an improvement of LV-pump function in acute cardiac failure.

Animals↗
PubMed1998

The long and the short of it: developmental genetics of the skeletal dysplasias.

The skeletal dysplasias are a large heterogeneous group of genetic conditions characterized by abnormal shape, growth, or integrity of bones. Often, there may be prominent features associated with other organ systems as part of a more encompassing skeletal malformation syndrome. Tremendous advances have been made in the clinical and molecular delineation of these conditions over the past 20-30 years. We have progressed from initial broad clinical classifications of these conditions in the first two-thirds of this century, to extensive delineation based on radiographic features in the 1970s and 1980s, to the present reconsideration and grouping of these conditions according to their molecular pathogenesis. This has in part been spurred on by advances in the understanding of the developmental pathways which govern skeletal development, as well as by the human genome sequencing effort, which has provided a plethora of positional candidate genes for many of these conditions. The pathogenetic correlations derived from such studies are often based on parallels between the human phenotype and mouse models of the human condition, and have sometimes revealed novel developmental functions.

Animals↗
PubMed1998

An orphan seven-transmembrane domain receptor expressed widely in the brain functions as a coreceptor for human immunodeficiency virus type 1 and simian immunodeficiency virus.

Both CD4 and an appropriate coreceptor are necessary for infection of cells by human immunodeficiency virus type 1 (HIV-1) and most strains of HIV-2. The chemokine receptors CCR5 and CXCR4 are the major HIV-1 coreceptors, although some virus strains can also utilize alternative coreceptors such as CCR3 to infect cells. In contrast, most if not all simian immunodeficiency virus (SIV) strains use CCR5 as a coreceptor, and many SIV strains can use CCR5 independently of CD4. In addition, several orphan seven-transmembrane receptors which can serve as HIV-1 and SIV coreceptors have been identified. Here we report that APJ, an orphan seven-transmembrane domain receptor with homology to the angiotensin receptor family, functions as a coreceptor for a number of HIV-1 and SIV strains. APJ was expressed widely in the human brain and in NT2N neurons. APJ transcripts were also detected by reverse transcription-PCR in the CD4-positive T-cell line C8166, but not in peripheral blood leukocytes, microglia, phytohemagglutinin (PHA)- or PHA/interleukin-2-stimulated peripheral blood mononuclear cells, monocytes, or monocyte-derived macrophages. The widespread distribution of APJ in the central nervous system coupled with its use as a coreceptor by some HIV-1 strains indicates that it may play a role in neuropathogenesis.

Animals↗
PubMed1998

Influence of the CCR2-V64I polymorphism on human immunodeficiency virus type 1 coreceptor activity and on chemokine receptor function of CCR2b, CCR3, CCR5, and CXCR4.

The chemokine receptors CCR5 and CXCR4 are used by human immunodeficiency virus type 1 (HIV-1) in conjunction with CD4 to infect cells. In addition, some virus strains can use alternative chemokine receptors, including CCR2b and CCR3, for infection. A polymorphism in CCR2 (CCR2-V64I) is associated with a 2- to 4-year delay in the progression to AIDS. To investigate the mechanism of this protective effect, we studied the expression of CCR2b and CCR2b-V64I, their chemokine and HIV-1 coreceptor activities, and their effects on the expression and receptor activities of the major HIV-1 coreceptors. CCR2b and CCR2b-V64I were expressed at similar levels, and neither molecule affected the expression or coreceptor activity of CCR3, CCR5, or CXCR4 in cotransfected cell lines. Peripheral blood mononuclear cells (PBMCs) from CCR2-V64I heterozygotes had normal levels of CCR2b and CCR5 but slightly reduced levels of CXCR4. CCR2b and CCR2b-V64I functioned equally well as HIV-1 coreceptors, and CCR2-V64I PBMCs were permissive for HIV-1 infection regardless of viral tropism. The MCP-1-induced calcium mobilization mediated by CCR2b signaling was unaffected by the polymorphism, but MCP-1 signaling mediated by either CCR2b- or CCR2-V64I-encoded receptors resulted in heterologous desensitization (i.e., limiting the signal response of other receptors) of both CCR5 and CXCR4. The heterologous desensitization of CCR5 and CXCR4 signaling by both CCR2 allele receptor types provides a mechanistic link that might help explain the in vivo effects of CCR2 gene variants on progression to AIDS as well as the reported antiviral activity of natural CCR2 ligands.

Cell Line, Transformed↗
PubMed1998

Sequence-specific protein interaction with a transcriptional enhancer involved in the autoregulated expression of cAMP receptor 1 in Dictyostelium.

Major stages of Dictyostelium development are regulated by secreted, extracellular cAMP through activation of a serpentine receptor family. During early development, oscillations of extracellular cAMP mobilize cells for aggregation; later, continuous exposure to higher extracellular cAMP concentrations downregulates early gene expression and promotes cytodifferentiation and cell-specific gene expression. The cAMP receptor 1 gene CAR1 has two promoters that are differentially responsive to these extracellular cAMP stimuli. The early CAR1 promoter is induced by nM pulses of cAMP, which in turn are generated by CAR1-dependent activation of adenylyl cyclase (AC). Higher, non-fluctuating concentrations of cAMP will adapt this AC stimulus-response, repress the activated early promoter and induce the dormant late promoter. We now identify a critical element of the pulse-induced CAR1 promoter and a nuclear factor with sequence-specific interaction. Mutation of four nucleotides within the element prevents both in vitro protein binding and in vivo expression of an otherwise fully active early CAR1 promoter and multimerization of the wild-type, but not mutant, sequence will confer cAMP regulation to a quiescent heterologous promoter. These cis and trans elements, thus, constitute a part of the molecular response to the cAMP transmembrane signal cascade that regulates early development of Dictyostelium.

Animals↗
PubMed1998

Congenital myotonic dystrophy requiring prolonged endotracheal and noninvasive assisted ventilation: not a uniformly fatal condition.

In this report we present two infants with congenital myotonic dystrophy (CMD) who were successfully weaned from prolonged ventilatory support using nasal continuous positive airway pressure (N-CPAP). The first infant received 127 days of endotracheal mechanical ventilation as part of 141 days of total ventilatory support, including N-CPAP; the second infant received 27 days of endotracheal mechanical ventilation as part of 84 days of total ventilatory support. Noninvasive N-CPAP facilitated weaning these two infants from ventilatory support, thereby minimizing the morbidity associated with prolonged intubation. The developmental outcomes of our two infants were comparable to infants not requiring prolonged endotracheal mechanical ventilation. We suggest that this noninvasive modality of ventilatory support may be advantageous in the management and beneficial to the outcome of infants with CMD who are respirator-dependent >30 days.

Adult↗
PubMed1998

Characterization of inositol 1,4,5-trisphosphate receptor isoform mRNA expression and regulation in rat pancreatic islets, RINm5F cells and betaHC9 cells.

The inositol 1,4,5-trisphosphate receptor (InsP3R) is an intracellular Ca2+ channel that plays a role in the regulation of insulin secretion. In rat isolated pancreatic islets the expression of types I, II and III InsP3R mRNA was identified by reverse transcriptase-polymerase chain reaction and confirmed by cDNA cloning and sequencing. The islet ratios of types I, II and III InsP3R mRNA to beta-actin mRNA were 0.08 +/- 0.02, 0.08 +/- 0.03 and 0.25 +/- 0.04 respectively. Types I, II and III InsP3R mRNA were also expressed in rat (RINm5F) and mouse (betaHC9) pancreatic beta-cell lines, and rat cerebellum. Type III InsP3R mRNA was quantitatively the most abundant form in rat islets and RINm5F cells. In betaHC9 cells, types II and III InsP3R mRNA were expressed at similar levels, and in much greater abundance than type I mRNA. Type III was the least abundant InsP3R mRNA in cerebellum. Culture of betaHC9 cells for 5 days at 2.8 and 25 mM glucose, or RINm5F cells for 7 days at 5.5 and 20 mM glucose, resulted in significantly enhanced expression of type III, but not types I and II, InsP3R mRNA in the cells at the higher glucose concentrations. During short-term (0.5-2 h) incubations, betaHC9 cell type III InsP3R mRNA levels increased in response to glucose in a time- and concentration-dependent manner. Actinomycin D inhibited the glucose response. Alpha-ketoisocaproic acid also stimulated betaHC9 cell type III InsP3R mRNA expression in a concentration-dependent manner, whereas 2-deoxyglucose and 3-O-methylglucose were without effect. The different levels of expression of mRNA for three InsP3R isoforms in islets and insulinoma cells, and the influence of glucose and alpha-ketoisocaproic acid on the expression of type III mRNA, suggests that nutrient metabolism plays a role in the regulation of this gene and that the function of InsP3R subtypes may be unique with each playing a distinct role in beta-cell signal transduction and insulin secretion.

Animals↗
PubMed1998

Searching for the meaning of the Category Test and the Wisconsin Card Sort Test: a comparative analysis.

The Category Test (CT) and the Wisconsin Card Sort Test (WCST) have long been the major instruments used for the assessment of "frontal lobe" brain damage. These tests have often been used interchangeably by clinicians. However, research to date has disagreed on the extent to which these tests can be interpreted in a similar manner. The current paper examined the interrelationships between the tests in 112 mixed brain injured clients. The results showed relatively small correlations between the tests in the range of .4 to .6 which were eliminated when age, education, premorbid IQ (Vocabulary) and spatial skills (Block Design) were used as covariates. Regression analyses showed clear differences in which WAIS-R tests predicted each test, while factor analysis revealed little overlap between the tests except for a small relationship between the number of WCST categories completed and CT errors. The CT appeared to reflect spatial and spatial analysis skills while the WCST reflected verbal analysis and sequential skills. The results clearly indicate that the tests are not interchangeable and do not reflect the same underlying cognitive skills nor can they be interpreted in the same manner for neuropsychological purposes.

Adolescent↗
PubMed1998

Secured medical imaging over the Internet.

The Internet has established itself as an affordable, extremely viable and ubiquitous communications network that can be easily accessed from virtually any point in the world. This makes it ideally suited for medical image communications. Issues regarding security and confidentiality of information on the Internet, however, need to be addressed for both occasional, individual users and consistent enterprise-wide users. In addition, the limited bandwidth of most Internet connections must be factored into the development of a realistic usermodel and resulting protocol. Open architecture issues must also be considered so that images can be communicated to recipients who do not have similar programs. Further, application-specific software is required to integrate image acquisition, encryption and transmission into a single, streamlined process. Using Photomailer software provided by PhysiTel Inc., the authors investigated the use of sending secured still images over the Internet. The scope of their investigation covered the use of the Internet for communicating images for consultation, referral, mentoring and education. Photomailer software was used at several local and remote sites. The program was used for both sending and receiving images. It was also used for sending images to recipients who did not have Photomailer, but instead relied on conventional email programs. The results of the investigation demonstrated that using products such as Photomailer, images could be quickly and easily communicated from one location to another via the Internet. In addition, the investigators were able to retrieve images off of their existing email accounts, thereby providing greater flexibility and convenience than other systems which require scheduled transmission of information on dedicated systems. We conclude that Photomailer and similar products may provide a significant benefit and improve communications among colleagues, providing an inexpensive means of sending secured images on the Internet.

Computer Communication Networks↗
PubMed1998

Prevalence of influenza A virus (H1N1) antibodies in bovine sera.

An H1 subtype-specific indirect ELISA was used to determine the prevalence of influenza A virus antibodies in a retrospective study of 2,345 bovine sera in Minnesota. Twenty-seven percent of the samples tested were positive, 31% were low-positive and 42% were negative. The prevalence of antibody appeared to peak during the months of September to November and then again from February to March. A subset of the above samples was examined by hemagglutination-inhibition (HI) to confirm the ELISA results. A 92% correlation was found between the ELISA and hemagglutination-inhibition assay. Western blot analysis on a subset of ELISA positive sera (n = 50) confirmed the presence of antibodies to the nucleoprotein and H1 hemagglutinin protein of influenza A virus.

Animals↗
PubMed1998

Prospective study on factors delaying surgery in ruptured abdominal aortic aneurysms.

Delays between rupture, eventual diagnosis and the repair of abdominal aortic aneurysms (AAAs) can significantly affect outcome, but the reasons for such delays in management are not always clear. A prospective study was, therefore, performed on 30 patients with ruptured AAAs. Twenty-three male and seven female patients, mean age 71.3 years, were studied. The general practitioner had made the correct diagnosis in only 38% of cases and the most common misdiagnosis was renal colic (24%). Non-vascular hospital doctors made the correct diagnosis in 55% of cases, but patients with back pain were the most frequently misdiagnosed by both types of doctor. The performance of an ultrasound scan significantly delayed referral to the vascular unit from a median of 0.75 to 2.50 hours and was of little benefit in aiding the diagnosis. In conclusion, the most striking delay factors in the management of ruptured AAAs are the high incidence of misdiagnosis and the lack of benefit of ultrasound scanning.

Aged↗