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Biomedical subjects

B T Hyman

Publications and source records attributed to B T Hyman.

At least 235 records · Page 13Linked to original sources

Warfarin-related purple toes syndrome and cholesterol microembolization.

The "purple toes syndrome" is a rare complication of oral anticoagulant therapy. Four patients who presented with "purple toes syndrome" several weeks after warfarin therapy was initiated are described. The diagnosis of cholesterol microembolization was made by biopsy in three cases. Malignant hypertension and renal failure developed in two patients who died within three to six months of onset of purple toes. Postmortem examination in one of these patients showed widespread cholesterol microembolization. Renal failure has not developed in the other two patients, who are doing well. These biopsy and autopsy results suggest that the warfarin-related "purple toes syndrome" is due to cholesterol microembolization.

Aged↗

Multiple myeloma with polyneuropathy and coagulopathy. A case report of the polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin change (POEMS) syndrome.

A patient with the syndrome of polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) had multiple myeloma and IgA-kappa monoclonal gammopathy. To our knowledge, of over 50 cases in the literature, this is the only instance of kappa light chains noted in a patient with the complete syndrome. Sural nerve biopsy revealed increased immunofluorescence for IgA and kappa chains. Furthermore, this patient had a hemorrhagic diathesis characterized by a prolonged bleeding time and a prolonged thrombin time due to a qualitative platelet dysfunction and an apparent inhibition of fibrin monomer polymerization. In none of the other cases of POEMS syndrome was a coagulopathy reported. A short course of plasmapheresis improved the bleeding time but did not alter the polyneuropathy.

Blood Coagulation Disorders↗

Perforant pathway changes and the memory impairment of Alzheimer's disease.

The perforant pathway is a large neuronal projection that arises from layers II and III of the entorhinal cortex of the parahippocampal gyrus. It is the principal source of cortical input to the hippocampal formation. In 11 cases of Alzheimer's disease, we have found that neurofibrillary tangles develop in the cells of origin of the perforant pathway. In addition, the termination zone of the perforant pathway, in the outer two thirds of the molecular layer of the dentate gyrus, contains a distinct layer of neuritic plaques. None of the 8 control subjects had such changes. These profound alterations effectively disconnect the hippocampal formation from the association and limbic cortices. Because of the central role of the hippocampus and parahippocampal gyrus in learning, it is likely that pathological changes in the perforant pathway, by precluding normal hippocampal operation, account for some aspects of the memory impairment in Alzheimer's disease.

Aged↗

Effect of naltrexone on senile dementia of the Alzheimer type.

Some reports have suggested that naloxone, a short-acting opiate receptor blocker given intravenously, has a beneficial effect on the symptoms of senile dementia of the Alzheimer type. We have performed a double-blind, crossover trial of naltrexone, an orally active, long acting opiate antagonist, in 17 Alzheimer-type dementia patients. None showed any improvement in assessments of day-to-day living skills or on a battery of neuropsychological tests. No side effects were noted. In the dosage used, naltrexone appears not to be useful in Alzheimer-type dementia.

Administration, Oral↗

Alzheimer's disease: cell-specific pathology isolates the hippocampal formation.

Examination of temporal lobe structures from Alzheimer patients reveals a specific cellular pattern of pathology of the subiculum of the hippocampal formation and layers II and IV of the entorhinal cortex. The affected cells are precisely those that interconnect the hippocampal formation with the association cortices, basal forebrain, thalamus, and hypothalamus, structures crucial to memory. This focal pattern of pathology isolates the hippocampal formation from much of its input and output and probably contributes to the memory disorder in Alzheimer patients.

Aged↗

Glycine uptake by cultured human Y79 retinoblastoma cells: effect of changes in phospholipid fatty acid unsaturation.

Glycine uptake was investigated in cultured Y79 retinoblastoma cells containing different degrees of phospholipid fatty acid unsaturation. The modifications were produced by growing the retinoblastoma cells in medium supplemented with various unsaturated fatty acids. Glycine was taken up by the retinoblastoma cells through two kinetically distinguishable process. The high-affinity system is totally dependent upon extracellular Na+ and partially dependent upon Ca2+. Of the glycine taken up by retinoblastoma cells, 85-90% remains as free intracellular glycine and less than 30% is incorporated into cellular protein. When the cells are grown in a medium containing 10% fetal bovine serum as the only source of fatty acids, the phospholipids contained 23% polyunsaturated fatty acids. Under these conditions the high-affinity system has a K'm of 34.2 +/- 3.7 micrometers and a V'max of 91.2 +/- 16.2 pmol min-1 mg protein -1. The low-affinity system has a K'm of 2.7 +/- 0.4 mM and a V'max of 4.1 +/- 0.5 nmol min-1 mg protein-1. When the polyunsaturated fatty acid content of the phospholipids was increased by supplementing the medium with linolenic or docosahexaenoic acids (n-3 polyunsaturates) or linoleic or arachidonic acids (n-6 polyunsaturates), the K'm and V'max of the high-affinity glycine uptake system were increased three- to fourfold. By contrast, supplementing the medium with oleic acid, and n-9 monounsaturate, did not significantly alter the K'm or V'max for glycine uptake. The results with this model system suggest that one of the effects of the high polyunsaturated fatty acid content normally present in neural cell membranes may be a modulation of the high-affinity transport system so that it functions more efficiently in regulating glycine uptake.

Biological Transport↗

Prostaglandin production by 3T3-L1 cells in culture.

Rapidly growing cultures of 3T3-L1 preadipocytes produce large quantities of prostaglandins when they are either stimulated with the calcium ionophore A23187 or incubated with arachidonic acid. The main prostaglandin produced under all conditions was prostaglandin E2. Prostaglandin production in response to ionophore stimulation or incubation with arachidonic acid decreased markedly, however, as the cultures approached confluence, were maintained in the confluent state, or were stimulated to differentiate. Enrichment of confluent, differentiated cultures with arachidonic acid did not enhance prostaglandin production. Recovery of prostaglandin production occurred when logarithmic growth was reinstituted by reseeding confluent cultures at low cell densities, but sparse cultures maintained in a low-growth phase did not recover the ability to produce large amounts of prostaglandin E2. Therefore, the decline in prostaglandin synthetic capacity appears to be associated with the decrease in growth rate as the cells approach confluence. Media conditioned by confluent cells reduced prostaglandin E2 production when added to rapidly growing cells, suggesting that an inhibitor of prostaglandin synthesis may be formed by the confluent cultures. Nondifferentiating 3T3 fibroblasts, which similarly release mainly prostaglandin E2, also exhibited a decrease in prostaglandin production as the cultures became confluent. The amounts of prostaglandins produced by 3T3 cells in the confluent state were much greater, however, than those produced by confluent or differentiated 3T3-L1 cultures. These findings suggest that the low capacity to produce prostaglandins may be involved in either the induction or maintenance of differentiation in 3T3-L1 cells.

Adipose Tissue↗

Choline uptake in cultured human Y79 retinoblastoma cells: effect of polyunsaturated fatty acid compositional modifications.

Choline uptake in Y79 human retinoblastoma cells occurs through two kinetically distinguishable processes. The high-affinity system shows little sodium or energy dependence, and it does not appear to be linked to acetyl CoA; choline O-acetyltransferase. When the cells are grown in a culture medium containing 10% fetal bovine serum, the high-affinity system has a K'm= 2.16 +/- 0.13 microM and V'max = 27.0 +/- 2.9 pmol min-1 mg-1, whereas the low-affinity system has a k'm = 20.4 +/- 1.3 microM and V'max = 402 +/- 49 pmol min-1 mg-1. Under these conditions, the polyunsaturated fatty acid content of the cell membranes is relatively low. When the polyunsaturated fatty acid content of the microsomal membrane fraction was increased by supplementing the culture medium with linolenic or docosahexaenoic acids (n-3 polyunsaturated fatty acids) or arachidonic acid (n-6 polyunsaturated fatty acid), the K'm of the high-affinity choline transport system was reduced by 40--60%. The V'max also was reduced by 20--40%. Supplementation with oleic acid, the most prevalent monounsaturated fatty acid, did not affect either kinetic parameter. The results suggest that one functional effect of the high unsaturated fatty acid content of neural cell membranes is to facilitate the capacity of the high-affinity choline uptake system to transport low concentrations of choline. This effect appears to be specific for polyunsaturated fatty acids but not for a single type, for it is produced by members of both the n-3 and n-6 classes of polyunsaturated fatty acids.

Biological Transport↗

Accumulation of (n-9)-eicosatrienoic acid in confluent 3T3-L1 and 3T3 cells.

The 3T3-L1 preadipocyte cultured cell line accumulates the n-9 class of eicosatrienoic acid (20:3 n-9) after becoming confluent when the medium contains 10% fetal bovine serum. Accumulation of 20:3 n-9 also occurred in confluent, nondifferentiating 3T3 cells but not in eight other cultured cell lines that were tested. Radioisotope experiments indicate that confluent 3T3-L1 cells synthesized 20:3 n-9 from [1-14C]oleic acid. 20:3 n-9 comprised 9.8% of the cell phospholipid fatty acids, and its accumulation was associated with a 40% reduction in the phospholipid arachidonic acid content. The highest percentage of 20:3 n-9 was present in the ethanolamine and inositol glycerophospholipid fractions. Eicosatrienoic acid also accumulated in 3T3-L1 cells that were treated with dexamethasone, methylisobutylxanthine, and insulin to achieve adipocyte morphology. Supplementation of the culture medium with 0.03 mumol/ml of either linoleic or arachidonic acid prevented 20:3 n-9 accumulation. Partial reversal of the 20:3 n-9 accumulation occurred when confluent cells were either replated at a low density to initiate logarithmic growth or supplemented with 0.03 mumol/ml of arachidonic acid. The accumulation of 20:3 n-9, a polyunsaturate that ordinarily is found only in essential fatty acid deficiency, may be an important variable in studies involving 3T3-L1 and 3T3 cells.

8,11,14-Eicosatrienoic Acid↗

Accumulation of N-3 polyunsaturated fatty acids cultured human Y79 retinoblastoma cells.

The metabolism of the n-3 class of polyunsaturated fatty acids, which occur in relatively high quantities in neural tissues, was studied in human Y79 retinoblastoma cells. These cells contained low levels of n-3 polyunsaturates when grown in culture media supplemented with fetal bovine serum. The cells readily incorporated performed docosahexaenoic acid (22.6 n-3) into phospholipids, but human skin fibroblasts did this to a similar extent. When 10 to 30 mumol/ml linolenic acid (18:3 n-3) was added, the cell also accumulated 22:6 in phospholipids. The capacity to convert appreciable amounts of 18:3 to 22:6 appears to be a unique property of the retinoblastoma cells as compared with other continuously cultured cell lines. More 18:3 than linoleic acid (18:2 n-6) was incorporated into phospholipids by the retinoblastoma cultures, and 18:3 was channeled to a larger extent into the ethanolamine glycerophospholipid fraction. These findings indicate that retinoblastoma cells handle n-3 polyunsaturated fatty acids in a manner very similar to neural tissue in vivo. Based on the results obtained with this model system, it appears that three processes may contribute to the accumulation of 22:6 in retina and neural tissue: increased ability to incorporate 18:3, the capacity to convert 18:3 to 22:6, and channeling of 18:3 and its metabolites into ethanolamine glycerophospholipids.

Cell Division↗

Fatty acid and lipid composition of the monkey retina in diet-induced hypercholesterolemia.

We determined the fatty acid composition of the lipids of cynomolgus monkey retina in animals fed commercial chow or a saturated fat, cholesterol-enriched atherogenic diet for 100 days. Doxosahexaenoic acid (22 : 6) accounted for 25.8% of the ethanolamine phosphoglyceride fatty acids, 17.6% of the serine plus inositol phosphoglyceride fatty acids, 8.4% of the choline phosphoglyceride fatty acids and 5.8% of the neutral lipid fatty acids in the retinas of the chow-fed animals. Therefore, monkey retinas, like those of other mammalian species, ordinarily contain large amounts of 22 : 6. Retinas from the monkeys fed the atherogenic diet contained less 22 : 6 as well as other polyunsaturates in each of the phospholipid classes. The decrease in polyunsaturates was compensated for by increases in palmitic, stearic, and oleic acids. There was no difference in the amount of phospholipid, the distribution of phospholipid classes, or the amount of cholesterol in the retinas of the monkeys fed the atherogenic diet. These results indicate that the single type of lipid alteration produced in the retina by a diet enriched in saturated fat and cholesterol is a decrease in the polyunsaturation of the retinal phospholipids. The reduction in retinal 22 : 6 content might have significance for photoreceptor function.

Animals↗

Neuron numbers in Alzheimer's disease: cell-specific pathology.

The significance of the particular neurons lost in Alzheimer's disease is discussed in the context of their likely anatomic role as projection neurons. The location and function of affected neurons is emphasized, rather than absolute number.

Aged↗

Alteration in the pattern of nerve terminal protein immunoreactivity in the perforant pathway in Alzheimer's disease and in rats after entorhinal lesions.

Neurons in layer II of the entorhinal cortex consistently develop neurofibrillary tangles in Alzheimer's disease (AD). Experimental neuroanatomical studies have shown that these neurons give rise to the perforant pathway, a major excitatory projection to the hippocampal formation, which terminates in a discrete pattern in the outer portion of the molecular layer of the dentate gyrus. The distribution of two nerve terminal associated proteins, synaptophysin and NT75, was studied in the molecular layer of the dentate gyrus in AD and control cases to determine whether Alzheimer neuronal pathology is associated with loss of synaptic markers. In parallel studies, the effect of ablation of the entorhinal cortex in rats was evaluated. In AD as compared to controls, a decrease in synaptophysin immunostaining was evident in the terminal zone of the perforant pathway. NT75 nerve terminal immunostaining was too weak to interpret in the human hippocampal formation. Both synaptophysin and NT75 immunoreactivity were found in association with some neuritic plaques. In rats, entorhinal lesions resulted in diminished immunoreactivity for both synaptophysin and NT75 in the perforant pathway terminal zone. These results suggest that nerve terminal protein loss is a concomitant feature of neuronal pathology in AD.

Aged↗

Blockade of 1-methyl-4-phenylpyridinium ion (MPP+) nigral toxicity in the rat by prior decortication or MK-801 treatment: a stereological estimate of neuronal loss.

1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, (MPTP), produces a parkinsonian syndrome both in man and in experimental animals. Its toxicity is mediated by a metabolite, the 1-methyl-4-phenylpyridinium ion (MPP+). When injected into the striatum, MPP+ is accumulated by dopaminergic nerve terminals and retrogradely transported to the substantia nigra pars compacta (SNc) where it causes neuronal degeneration. MPP+ accumulates in mitochondria and blocks complex I of the electron transport chain. A proposed mechanism of neurotoxicity is excitotoxic neuronal degeneration induced by this energy depletion. We examined whether either prior decortication or administration of the N-methyl-D-aspartate (NMDA) receptor antagonist, (+)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine maleate (MK-801) could prevent or diminish the selective nigral neuronal degeneration that follows unilateral intrastriatal injection of MPP+. We quantified the extent of neuronal death in the SNc ipsilateral and contralateral to the injections on Nissl-stained sections with unbiased stereological techniques. One week after injection of MPP+, approximately 75% of the SNc neurons were lost on the side of the injection. The loss was a consequence of the reduction in both SNc volume and neuronal density. Both prior decortication or the administration of MK-801 for 2 days nearly completely prevented MPP(+)-induced neuronal loss in the ipsilateral SNc. These results are consistent with an NMDA receptor mediated excitotoxic mechanism for MPP(+)-induced nigral toxicity.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗