Biomedical subjects

B S Wilson

Publications and source records attributed to B S Wilson.

At least 37 records · Page 2Linked to original sources

PubMed1998

The identification and characterization of umbilical cord blood-derived human basophils.

Cross-linking allergen-specific immunoglobin E on human peripheral blood basophils results in the release of histamine and other inflammatory mediators that initiate allergy and asthma. The signaling pathways leading from IgE binding to mediator release have not been well established, mainly due to the difficulty in obtaining adequate numbers of highly purified basophils. It was the goal of this study to easily obtain Fc epsilonRI-positive human basophils in high yield and purity for studies of signal transduction pathways. We describe an in vitro culture system in which pulsing normal human cord blood leukocytes with interleukin-3 (IL-3) for 3-4 h followed by incubation in medium with fetal bovine serum generates a cell population that is predominately Fc epsilonRI positive between 14 and 28 days of culture. These cells resemble peripheral blood basophils when examined by light and electron microscopy. Like normal blood basophils, they express the integrins, CD11b, CD18, CD29, and CD49d. A majority of the IL-3-pulsed cells also express a marker recognized by the basophil-specific antibody, 2D7. Fc epsilonRI cross-linking results in a time and dose-dependent release of histamine. Fc epsilonRI cross-linking also stimulates protein-tyrosine phosphorylation, thought to be the first event leading to the IgE-mediated activation of peripheral blood basophils. These studies establish cord blood as an accessible source from which basophil-like cells can be developed to examine Fc epsilonRI-mediated signal transduction.

Allergens↗

PubMed1998

Identification of the Fc epsilonRI-activated tyrosine kinases Lyn, Syk, and Zap-70 in human basophils.

BACKGROUND: In human blood basophils, cross-linking the high-affinity IgE receptor Fc epsilonRI with multivalent antigen activates a signaling pathway leading to Ca2+ mobilization, actin polymerization, shape changes, secretion, and cytokine production. METHODS AND RESULTS: The role of tyrosine kinases in human Fc epsilonRI signaling was explored by using human basophils isolated by Percoll gradient centrifugation followed by negative and/or positive selection with antibody-coated magnetic beads. Fc epsilonRI cross-linking of more than 95% pure basophil preparations activates the protein-tyrosine kinases Lyn and Syk, previously linked to Fc epsilonRI-coupled rodent mast cell activation, as well as Zap-70, previously implicated in T-cell receptor signaling, and causes the tyrosine phosphorylation of multiple proteins. The presence of Lyn, Syk, and Zap-70 in basophils was confirmed by Western blotting in lysates of highly purified basophils and independently by confocal fluorescence microscopy in cells labeled simultaneously with kinase-specific antibodies and with the basophil-specific antibody 2D7. Comparable amounts of Lyn and Syk were found in basophils and B cells, whereas T cells appear to have greater amounts of Zap-70 than basophils. The tyrosine kinase inhibitor piceatannol spares IgE-mediated Lyn activation but inhibits IgE-induced Syk and Zap-70 activation as well as overall protein tyrosine phosphorylation and secretion. Overall protein-tyrosine phosphorylation increases steadily over a range of anti-IgE concentrations that are low to optimal for secretion. However, tyrosine phosphorylation continues to increase at high anti-IgE concentrations that elicit very little secretion (the characteristic high-dose inhibition of secretion). CONCLUSIONS: Our data demonstrate the association of anti-IgE-stimulated, protein-tyrosine phosphorylation by a cascade of tyrosine kinases, including Zap-70 as well as Lyn and Syk, with the initiation of Fc epsilonRI-mediated signaling in human basophils.

Basophil Degranulation Test↗

PubMed1998

Design for an inexpensive but effective cochlear implant.

Widespread application of cochlear implants is limited by cost, especially in developing countries. In this article we present a design for a low-cost but effective cochlear implant system. The system includes a speech processor, four pairs of transmitting and receiving coils, and an electrode array with four monopolar electrodes. All implanted components are passive, reducing to a minimum the complexity of manufacture and allowing high reliability. A four-channel continuous interleaved sampling strategy is used for the speech processor. The processor and transmission link have been evaluated in tests with a subject previously implanted with the Ineraid electrode array and percutaneous connector. A prototype of the link, consisting of four pairs of transmitting and external receiving coils, was used, with the outputs of the receiving coils directed to four intracochlear electrodes through the percutaneous connector. The subject achieved speech reception scores with the prototype system that were equivalent to those achieved with a standard laboratory implementation of a continuous interleaved sampling processor with current-controlled stimuli.

Cochlear Implantation↗

PubMed1998

Wortmannin-sensitive phosphorylation, translocation, and activation of PLCgamma1, but not PLCgamma2, in antigen-stimulated RBL-2H3 mast cells.

In RBL-2H3 tumor mast cells, cross-linking the high affinity IgE receptor (FcepsilonRI) with antigen activates cytosolic tyrosine kinases and stimulates Ins(1,4,5)P3 production. Using immune complex phospholipase assays, we show that FcepsilonRI cross-linking activates both PLCgamma1 and PLCgamma2. Activation is accompanied by the increased phosphorylation of both PLCgamma isoforms on serine and tyrosine in antigen-treated cells. We also show that the two PLCgamma isoforms have distinct subcellular localizations. PLCgamma1 is primarily cytosolic in resting RBL-2H3 cells, with low levels of plasma membrane association. After antigen stimulation, PLCgamma1 translocates to the plasma membrane where it associates preferentially with membrane ruffles. In contrast, PLCgamma2 is concentrated in a perinuclear region near the Golgi and adjacent to the plasma membrane in resting cells and does not redistribute appreciably after FcepsilonRI cross-linking. The activation of PLCgamma1, but not of PLCgamma2, is blocked by wortmannin, a PI 3-kinase inhibitor previously shown to block antigen-stimulated ruffling and to inhibit Ins(1,4,5)P3 synthesis. In addition, wortmannin strongly inhibits the antigen-stimulated phosphorylation of both serine and tyrosine residues on PLCgamma1 with little inhibition of PLCgamma2 phosphorylation. Wortmannin also blocks the antigen-stimulated translocation of PLCgamma1 to the plasma membrane. Our results implicate PI 3-kinase in the phosphorylation, translocation, and activation of PLCgamma1. Although less abundant than PLCgamma2, activated PLCgamma1 may be responsible for the bulk of antigen-stimulated Ins(1,4,5)P3 production in RBL-2H3 cells.

Androstadienes↗

PubMed1998

Calcium-dependent clustering of inositol 1,4,5-trisphosphate receptors.

Rat basophilic leukemia (RBL-2H3) cells predominantly express the type II receptor for inositol 1,4,5-trisphosphate (InsP3), which operates as an InsP3-gated calcium channel. In these cells, cross-linking the high-affinity immunoglobulin E receptor (FcepsilonR1) leads to activation of phospholipase C gamma isoforms via tyrosine kinase- and phosphatidylinositol 3-kinase-dependent pathways, release of InsP3-sensitive intracellular Ca2+ stores, and a sustained phase of Ca2+ influx. These events are accompanied by a redistribution of type II InsP3 receptors within the endoplasmic reticulum and nuclear envelope, from a diffuse pattern with a few small aggregates in resting cells to large isolated clusters after antigen stimulation. Redistribution of type II InsP3 receptors is also seen after treatment of RBL-2H3 cells with ionomycin or thapsigargin. InsP3 receptor clustering occurs within 5-10 min of stimulus and persists for up to 1 h in the presence of antigen. Receptor clustering is independent of endoplasmic reticulum vesiculation, which occurs only at ionomycin concentrations >1 microM, and maximal clustering responses are dependent on the presence of extracellular calcium. InsP3 receptor aggregation may be a characteristic cellular response to Ca2+-mobilizing ligands, because similar results are seen after activation of phospholipase C-linked G-protein-coupled receptors; cholecystokinin causes type II receptor redistribution in rat pancreatoma AR4-2J cells, and carbachol causes type III receptor redistribution in muscarinic receptor-expressing hamster lung fibroblast E36(M3R) cells. Stimulation of these three cell types leads to a reduction in InsP3 receptor levels only in AR4-2J cells, indicating that receptor clustering does not correlate with receptor down-regulation. The calcium-dependent aggregation of InsP3 receptors may contribute to the previously observed changes in affinity for InsP3 in the presence of elevated Ca2+ and/or may establish discrete regions within refilled stores with varying capacity to release Ca2+ when a subsequent stimulus results in production of InsP3.

Animals↗

PubMed1998

Repeatability and agreement of two corneal-curvature assessments in keratoconus: keratometry and the first definite apical clearance lens (FDACL). CLEK Study Group. Collaborative Longitudinal Evaluation of Keratoconus.

PURPOSE: This study was conducted to determine the agreement and test-retest repeatability of two methods for measuring corneal curvature in keratoconus: keratometry and the First Definite Apical Clearance Lens (FDACL). Our interest in the FDACL procedure stems from the important contact lens-fitting information and documentation of disease progression provided by the FDACL trial lenses and observation of fluorescein patterns. METHODS: The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study is an observational study that has enrolled 1,209 keratoconus patients to characterize the progression of keratoconus, to determine factors associated with its progression, and to assess its impact on quality of life. Ten percent of the patients were randomly selected at baseline for a retest examination. The baseline examination, which included keratometry and FDACL, was repeated in this sample. The FDACL is the flattest lens in the standardized CLEK trial lens set that vaults the apex of the cone. FDACL provides an estimate of the sagittal height of the cone. RESULTS: The correlation of FDACL with the steep keratometric reading (r = 0.89; p = 0.0001) and the flat keratometric reading (r = 0.83; p = 0.0001) were high. Test-retest repeatability as measured by the intraclass correlation coefficient (ICC) was high: FDACL ICC, 0.97; steep keratometric reading ICC, 0.96; and flat keratometric reading ICC, 0.95. Test-retest repeatability of FDACL remained high in advanced disease. CONCLUSION: FDACL provides a repeatable new procedure for determining disease severity in keratoconus.

Adult↗

PubMed1998

Bilateral cochlear implants controlled by a single speech processor.

OBJECTIVE: This study aimed to assess, in one profoundly hearing impaired subject, potential benefits and limitations in placing bilaterally implanted scala tympani electrode arrays under control of a single speech processor. STUDY DESIGN: All available stimulation sites in both ears were compared in studies of pitch discrimination and pitch ranking, identifying three bilateral pairs capable of supporting interaural comparisons with no perceptible difference in pitch. Using those pairs, the subject's ability to lateralize sound was studied as a function of interaural time delay and interaural amplitude difference. Consonant identification scores were obtained for continuous interleaved sampling processors using various unilateral and bilateral combinations of electrodes. RESULTS: For loudness-matched stimuli composed of 50-msec bursts of 80-microsec/phase pulses at 480 pulses/sec, the subject was able to identify the ear receiving the earlier onset for interaural delays at least as brief as 150 microsec for all three matched pairs. For similar simultaneous stimuli, the subject could identify the ear receiving the louder signal for the smallest deviations from loudness-matched amplitudes available from the implanted electronics. The consonant studies found no evidence that bilateral stimulation per se degrades speech processor performance, even for arbitrary divisions of information between the two ears. Additional contralateral as well as ipsilateral channels were observed to improve speech processor performance. CONCLUSIONS: The ability of this subject to lateralize sounds on the basis of interaural delay or loudness difference, combined with the consonant identification results, supports further use of coordinated binaural stimulation to improve cochlear implant users' ability to understand speech, especially in the presence of competing speech noise.

Adult↗

PubMed1997

Cooperation between the Fc epsilonR1 and formyl peptide receptor signaling pathways in RBL(FPR) cells: the contribution of receptor-specific Ca2+ mobilization responses.

RBL(FPR) mast cells express the tyrosine kinase-coupled IgE receptor, Fc epsilonR1, and the G-protein-coupled formyl peptide receptor, FPR. Fc epsilonR1 crosslinking causes Ca2+ stores release, Ca2+ influx, Ins(1,4,5)P3 production and secretion. FPR ligation also mobilizes Ca2+, but without measurable Ins(1,4,5)P3 production or secretion. Co-stimulating the FPR and Fc epsilonR1 induces more Ins(1,4,5)P3 production and secretion than Fc epsilonR1 cross-linking alone. Costimulation also produces more rapid and sustained Ca2+ responses than are generated by Fc epsilonR1 activation alone. We identified multiple differences between the FPR- and Fc epsilonR1-coupled Ca2+ responses, including a more rapid Ca2+ spike response to FPR ligation; intracellular Ca2+ stores that are empty following Fc epsilonR1 crosslinking but partially full following FPR activation; a more sustained Ca2+ influx response to Fc epsilonR1 crosslinking; and the immediate inhibition of stimulated Ca2+ influx by FPR antagonists but not by monovalent ligand that terminates Fc epsilonR1 crosslinking. We hypothesize that the interaction of receptor-specific Ca2+ mobilization pathways contributes to the FPR-mediated potentiation of Fc epsilonR1-coupled secretion.

Animals↗

PubMed1997

Relationship of ligand-receptor dynamics to actin polymerization in RBL-2H3 cells transfected with the human formyl peptide receptor.

The human formyl peptide receptor (FPR) expressed in RBL-2H3 transfectants (RBL[FPR]) behaves qualitatively like the FPR expressed by neutrophils except that it causes sustained F-actin accumulation and cell shape change responses on formyl peptide stimulation. These sustained responses were not accounted for by changes in the transfected receptor's ability to interact with ligand or by receptor density. Signal transduction pathways of transfected and neutrophil FPRs are apparently similar. In transfected cells, dissociation of ligand is sensitive to guanine nucleotide, the G protein is pertussis toxin-sensitive, FPR and G protein appear to be precoupled, the F-actin response is stimulated with the same dose-response profile as in neutrophils, and the F-actin accumulation response is directly regulated by the FPR, even long after initial stimulation. Potentially significant differences between neutrophil and transfected FPR were found when receptor processing was measured. In neutrophils, practically 100% of the FPR is converted to forms that dissociate slowly from ligand and are inactive in signal transduction within 2 min of ligand stimulation. By contrast, 20% or more of transfected FPR remains rapidly dissociating even 5 min after stimulation. Although 80% of neutrophil FPR is internalized by 5 min after stimulation, transfected FPR appears to plateau at 50-60% internalized. Because actin responses in neutrophils are regulated by a small number of active receptors, the inefficiency of receptor inactivation in RBL(FPR) transfectants may account for the prolonged F-actin accumulation response.

Actins↗

PubMed1997

The future of cochlear implants.

Remarkable progress has been made in recent years in the design and application of processing strategies for cochlear implants. Most notably, use of the new spectral peak (SPEAK) and continuous interleaved sampling (CIS) strategies have provided large improvements in speech reception performance compared with prior strategies (NIH Consensus Statement, 1995; Skinner et al., 1994a; Wilson et al., 1991). All major manufacturers of multichannel implant systems, including Advanced Bionics Corp., Bionic Systems, Cochlear Pty. Ltd., and Med El, now offer CIS or CIS-like strategies in their speech processors. The SPEAK strategy was developed by Cochlear Pty. Ltd and continues to be one of the options available in that company's devices. The principal purpose of this editorial is to present some of the many possibilities for further improvements in performance. To the extent that such possibilities are realized, implant systems of the future may be quite different from present systems, with different processing strategies, electrode designs, telemetry features, and fitting procedures.

Cochlear Implants↗

PubMed1997

Cochlear implant studies at Research Triangle Institute and Duke University Medical Center.

Examples from several areas of cochlear implant research are presented, with emphasis on the continuous interleaved sampling (CIS) approach to speech processor design. Within-subject comparisons of such processors with the compressed analog (CA) approach of the clinical Ineraid device are reviewed, and ongoing similar comparisons with the clinical Nucleus spectral peak (SPEAK) strategy are outlined. Correlations between chronic performance levels with clinical CA processors and initial performance levels with CIS, data on further improvements in performance with chronic use of CIS, and instances of substantial benefit from custom fitting of CIS parameters are presented as examples of findings with immediate clinical implications. New studies are described, involving the measurement of intracochlear evoked potentials in response to cochlear implant stimulation, and the integration of such work with computer modeling studies.

Cochlear Implants↗

PubMed1997

Temporal representations with cochlear implants.

OBJECTIVE: To record and characterize intracochlear evoked potentials (EPs) for a variety of electrical stimuli in studies with cochlear implant patients. METHODS: Recordings were made with patients having direct percutaneous access to their implanted electrodes. Intracochlear voltages were recorded via unstimulated electrodes. The stimuli included trains of identical pulses, with pulse rates ranging from 100 to 4065/s, and a modulated pulse train produced by a single-channel speech processor, with the pulse rate of 824/s. RESULTS: Magnitudes of EPs for each pulse in trains of identical pulses were uniform for pulse rates below about 200/s. For rates between about 400 and 1000/s, an alternating pattern of EP magnitudes was observed, with relatively large EPs following the odd-numbered pulses. For rates between about 1000 and 3000/s, more complex patterns were observed. After the first millisecond of each train at even higher rates, uniform EPs again were observed across pulses, although the absolute magnitude of the EPs was much lower than that observed for low rates of stimulation. The approximate rates corresponding to boundaries between these different regions varied among subjects and among electrodes within subjects. EP magnitudes for the modulated pulse train reflected the gross periodicity of the modulation waveform but did not reflect temporal details within the periods. CONCLUSIONS: Population responses of the human auditory nerve, as indicated by EP magnitudes, reflect the amplitudes of electrical pulses for pulse rates below about 200/s and above about 3000/s. Use of intermediate rates may introduce distortions in the transmission of stimulus information with cochlear implants.

Cochlear Implantation↗

PubMed1995

Distinct functions of the Fc epsilon R1 gamma and beta subunits in the control of Fc epsilon R1-mediated tyrosine kinase activation and signaling responses in RBL-2H3 mast cells.

In RBL-2H3 rat tumor mast cells, cross-linking the high affinity IgE receptor, Fc epsilon R1, activates the protein-tyrosine kinases Lyn and Syk and initiates a series of responses including protein-tyrosine phosphorylation, inositol 1,4,5-trisphosphate synthesis, Ca2+ mobilization, secretion, membrane ruffling, and actin plaque assembly. The development of chimeric receptors containing cytoplasmic domains of individual subunits of the heterotrimeric (alpha beta gamma 2) Fc epsilon R1 has simplified analyses of early signaling events in RBL-2H3 cells. Here, RBL-2H3 cells were transfected with cDNAs encoding the extracellular and transmembrane domains of the interleukin-2 receptor alpha subunit (the Tac antigen) joined to the C-terminal cytoplasmic domains of the Fc epsilon R1 gamma and beta subunits (TT gamma and TT beta). Both sequences contain tyrosine activation motifs implicated in antigen receptor signal transduction. TT gamma and TT beta are expressed independently of the native Fc epsilon R1, as demonstrated by the ability of Tac cross-linking agents to trigger the clustering and internalization through coated pits of both chimeric receptors without co-clustering the Fc epsilon R1. A full range of signaling activities is induced by TT gamma cross-linking; the TT gamma-induced responses are slower and, except for Lyn activation, smaller than the Fc epsilon R1-induced responses. In striking contrast, TT beta cross-linking elicits no tyrosine phosphorylation or signaling responses, it impairs basal activities measured in secretion and anti-PY (anti-phosphotyrosine antibody) immune complex kinase assays, and it antagonizes Fc epsilon R1-induced Lyn and Syk activation, protein-tyrosine phosphorylation, and signaling responses. We hypothesize that the isolated beta subunit binds a specific kinase or coupling protein(s) required for signaling activity, sequestering it from the signal-transducing gamma subunit. Binding the same kinase or coupling protein to the beta subunit of the intact Fc epsilon R1 may serve instead to present it to the adjacent gamma subunit, resulting in enhanced kinase activation and signaling responses.

Animals↗

PubMed1995

Wortmannin blocks lipid and protein kinase activities associated with PI 3-kinase and inhibits a subset of responses induced by Fc epsilon R1 cross-linking.

We have investigated the effects of wortmannin, an inhibitor of phosphatidylinositol 3-kinase (PI 3-kinase), on antigen-mediated signaling in the RBL-2H3 mast cell model. In RBL-2H3 cells, the cross-linking of high affinity IgE receptors (Fc epsilon R1) activates at least two cytoplasmic protein tyrosine kinases, Lyn and Syk, and stimulates secretion, membrane ruffling, spreading, pinocytosis, and the formation of actin plaques implicated in increased cell-substrate adhesion. In addition, Fc epsilon R1 cross-linking activates PI 3-kinase. It was previously shown that wortmannin causes a dose-dependent inhibition of PI 3-kinase activity and also inhibits antigen-stimulated degranulation. We report that the antigen-induced synthesis of inositol(1,4,5)P3 is also markedly inhibited by wortmannin. Consistent with evidence in other cell systems implicating phosphatidylinositol(3,4,5)P3 in ruffling, pretreatment of RBL-2H3 cells with wortmannin inhibits membrane ruffling and fluid pinocytosis in response to Fc epsilon R1 cross-linking. However, wortmannin does not inhibit antigen-induced actin polymerization, receptor internalization, or the actin-dependent processes of spreading and adhesion plaque formation that follow antigen stimulation in adherent cells. Wortmannin also fails to inhibit either of the Fc epsilon R1-coupled tyrosine kinases, Lyn or Syk, or the activation of mitogen-activated protein kinase as measured by in vitro kinase assays. Strikingly, there is substantial in vitro serine/threonine kinase activity in immunoprecipitates prepared from Fc epsilon R1-activated cells using antisera to the p85 subunit of PI 3-kinase. This activity is inhibited by pretreatment of the cells with wortmannin or by the direct addition of wortmannin to the kinase assay, suggesting that PI 3-kinase itself is capable of acting as a protein kinase. We conclude that Fc epsilon R1 cross-linking activates both lipid and protein kinase activities of PI 3-kinase and that inhibiting these activities with wortmannin results in the selective block of a subset of Fc epsilon R1-mediated signaling responses.

Actins↗

PubMed1995

New processing strategies in cochlear implantation.

New strategies for representing acoustic information with multichannel cochlear implants have produced substantial improvements in speech recognition for implant users. This report reviews within-subject comparison of a new continuous interleaved sampling (CIS) strategy with a compressed analog (CA) strategy used in a standard clinical device. In general, the comparison show higher levels of open-set speech recognition with CIS for each of the 11 subjects studied. Data on the importance of the patients variable in determining outcomes with cochlear implants are presented. A brief description of another new strategy, the spectral maxima sound processor (SMSP) strategy is given as well as information on the availability of CIS in various implant systems.

Cochlear Implants↗

PubMed1994

Inhibition of mast cell Fc epsilon R1-mediated signaling and effector function by the Syk-selective inhibitor, piceatannol.

In RBL-2H3 rat tumor mast cells, antigens that cross-link the high affinity cell surface IgE receptor, Fc epsilon R1, activate at least two receptor-associated protein-tyrosine kinases, Lyn and Syk, and cause the tyrosine phosphorylation of the receptor beta and gamma subunits, PLC gamma 1, Vav, and other proteins. Cross-linking antigens also induce increased phosphatidylinositol turnover, Ca2+ mobilization, secretion, actin polymerization, spreading, and membrane ruffling. We have used the protein-tyrosine kinase inhibitor, piceatannol (3,4,3',5'-tetrahydroxy-trans-stilbene), to explore the coupling of specific kinases to cellular responses. Piceatannol preferentially inhibits the activity of Syk as compared with Lyn when added to in vitro assays with isolated enzymes. Treatment of RBL-2H3 cells with piceatannol strongly inhibits the antigen-stimulated activation of Syk measured in anti-Syk and anti-phosphotyrosine immune complex kinase assays at concentrations that have no effect on receptor subunit phosphorylation and maintain or increase the activity of Lyn in anti-phosphotyrosine immune complex kinase assays. In cells metabolically labeled with [32P]orthophosphate, piceatannol inhibits the antigen-stimulated tyrosine phosphorylation of Syk and most other proteins. However, receptor subunit phosphorylation is unchanged. Selective inhibition of Syk in this manner blocks receptor-mediated down-stream cellular responses (inositol 1,4,5-trisphosphate production, secretion, ruffling, and spreading) while having only minor effects when these responses are induced with drugs that bypass the receptor complex. These results reveal receptor-mediated Lyn activation as a relatively piceatannol-insensitive event that may contribute to receptor subunit phosphorylation and Syk activation but does not per se elicit cellular responses. Receptor-mediated Syk activation on the other hand is highly sensitive to piceatannol, is essential to Fc epsilon R1-mediated cellular responses, and, based on the increased phosphorylation of Lyn in piceatannol-treated cells, may be involved in terminating Lyn activity.

Animals↗

PubMed1994

Transperitoneal nephrectomy for benign disease of the kidney: a comparison of laparoscopic and open surgical techniques.

OBJECTIVE: The objective of this study was to compare the results of laparoscopic nephrectomy for benign disease to open surgical nephrectomy for benign disease. METHODS: Twenty consecutive patients undergoing laparoscopic nephrectomy for benign disease were compared with 23 patients undergoing open surgical nephrectomy for benign disease and with 29 patients undergoing a donor nephrectomy. Data were collected in the following areas: patient age, anesthetic risk, operative time, estimated blood loss, postoperative time to resume oral intake, parenteral analgesics, oral analgesics, hospital stay, complications, and convalescence. Information was obtained through chart review, telephone interviews, and mailed questionnaires. RESULTS: Compared with open surgical nephrectomy, laparoscopic nephrectomy resulted in a statistically significant longer operative time; however, it afforded a statistically significant decrease in postoperative ileus (open group), hospital stay (both groups), oral analgesics (donor group), and convalescence (both groups). The incidence of complications was 15 percent in the laparoscopic group and 0 percent in the two open surgical groups; the majority of complications occurred during the initial seven laparoscopic procedures. CONCLUSIONS: Laparoscopic nephrectomy is a more time-consuming procedure than open surgical nephrectomy. Also, early in one's experience with this technique, the complication rate is higher than with open surgery. However, despite the newness of the technique, it results in significant benefits to the patient: decreased postoperative pain, shorter hospitalization, and more rapid convalescence.

Adult↗

PubMed1994

A Rab1 mutant affecting guanine nucleotide exchange promotes disassembly of the Golgi apparatus.

The Golgi apparatus is a dynamic organelle whose structure is sensitive to vesicular traffic and to cell cycle control. We have examined the potential role for rab1a, a GTPase previously associated with ER to Golgi and intra-Golgi transport, in the formation and maintenance of Golgi structure. Bacterially expressed, recombinant rab1a protein was microinjected into rat embryonic fibroblasts, followed by analysis of Golgi morphology by fluorescence and electron microscopy. Three recombinant proteins were tested: wild-type rab, mutant rab1a(S25N), a constitutively GDP-bound form (Nuoffer, C., H. W. Davidson, J. Matteson, J. Meinkoth, and W. E. Balch, 1994. J. Cell Biol. 125: 225-237), and mutant rab1a(N124I) defective in guanine nucleotide binding. Microinjection of wild-type rab1a protein or a variety of negative controls (injection buffer alone or activated ras protein) did not affect the appearance of the Golgi, as visualized by immunofluorescence of alpha-mannosidase II (Man II), used as a Golgi marker. In contrast, microinjection of the mutant forms promoted the disassembly of the Golgi stacks into dispersed vesicular structures visualized by immunofluorescence. When S25N-injected cells were analyzed by EM after immunoperoxidase labeling, Man II was found in isolated ministacks and large vesicular elements that were often surrounded by numerous smaller unlabeled vesicles resembling carrier vesicles. Golgi disassembly caused by rab1a mutants differs from BFA-induced disruption, since beta-COP remains membrane associated, and Man II does not redistribute to the ER. BFA can still cause these residual Golgi elements to fuse and disperse, albeit at a slower rate. Moreover, BFA recovery is incomplete in the presence of rab1 mutants or GTP gamma S. We conclude that GTP exchange and hydrolysis by GTPases, specifically rab1a, are required to form and maintain normal Golgi stacks. The similarity of Golgi disassembly seen with rab1a mutants to that occurring during mitosis, may point to a molecular basis involving rab1a for fragmentation of the Golgi apparatus during cell division.

Animals↗