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Biomedical subjects

C G Stephens

Publications and source records attributed to C G Stephens.

5 recordsLinked to original sources

Cyclic nucleotides regulate the morphologic alterations required for chemotaxis in monocytes.

The initial morphologic response of human monocytes to chemoattractants is a change in shape from round to a triangular "motile" configuration (polarization). At doses chemotactic in vitro, chemoattractants induced rapid (t 1/2 = 45 sec), sustained (greater than 40 min) polarization of monocytes in suspension. Extracellular Ca++ was not required for polarization induced by chemoattractants, but in the absence of Ca++ kinetics were slowed (t 1/2 = 6.5 min). Phenylephrine, carbamycholine, serotonin, and ascorbate also caused rapid polarization of monocytes. Unlike chemoattractants, polarization by the pharmacologic agents was unsustained (less than 15 min), absolutely required extracellular Ca++, and affected about 50% of the cells responsive to chemoattractants. Based on relative sensitivities to alpha 1- and alpha 2-adrenergic agonists and antagonists, polarization caused by adrenergic agents was mediated by alpha 2-receptors. Muscarinic and alpha 2-adrenergic agonists, serotonin, and ascorbate enhanced the rate and number of monocytes polarizing to suboptimal doses of chemoattractants. Thus, the initial morphologic changes induced by chemoattractants appear to utilize an activation pathway shared with a variety of agents that enhance cGMP levels and inhibit adenylate cyclase. In contrast, theophylline, histamine, and isoproterenol, all agents that activate adenylate cyclase and elevate cAMP levels, inhibited monocyte polarization to chemoattractants. As in PMN, pharmacologic agents that increase cAMP levels inhibited monocyte chemotaxis in vitro, whereas those that inhibit adenylate cyclase and increase cGMP enhanced monocyte chemotactic responses. Thus, the initial morphologic response of monocytes to chemoattractants as well as the processes required for sustained directional motility are modulated by cyclic nucleotides.

Adrenergic beta-Agonists

Cholelithiasis in sickle cell anemia: surgical or medical management.

Cholelithasis was diagnosed in 40 of 100 consecutive patients with sickle cell anemia treated in the emergency room. Incidence apparently was not related to sex or degree of reticulocytosis, but did increase with age and perhaps was greater in patients with lower percentage of hemoglobin F and more complications of their hemoglobinopathy. Cholelithiasis was not unusual in children less than 11 years old. No major surgical complications were noted during 29 elective cholecystectomies, but urgent cholecystectomy, performed for real or suspected acute cholecystitis in seven patients, resulted in multiple major postoperative problems. With the low morbidity of elective procedures, as well as simplification of subsequent abdominal pain crisis management, elective cholecystectomy in patients with stable sickle cell conditions is recommended. Surgery during sickle cell crises or acute cholecystitis, with the attendant increased morbidity, should be avoided.

Adult

Spontaneous peritonitis due to Hemophilus influenzae in an adult.

Hemophilus influenzae, usually pathogenic in the pediatric population, caused septicemia and peritonitis in the cirrhotic adult described here. Susceptibility to this unusual adult pathogen was perhaps related to liver disease or corticosteroid treatment. This organism has not previously been associated with the syndrome of spontaneous bacterial peritonitis in an adult.

Adult

Classical and alternative complement pathway activation by pneumococci.

Sixty-two strains of Streptococcus pneumoniae were studied for their abilities to consume selected components of classical and alternative complement pathways in human sera. The classical pathway was blocked by chelating calcium with ethyleneglycol-bios (beta-aminoethyl ether)-N,N-tetraacetic acid and by removing C4. The alternative pathway was blocked by removing factor B. Each strain's activation of the two pathways was compared with its nonimmune reactivity with the Fc region of immunoglobulin G (IgG). Activation of the classical complement pathway appeared to be independent of such Fc reactivity. Highly Fc-reactive strains, however, were shown to activate the alternative pathway more effectively than did less Fc-reactive strains. Since pneumococcal activation of the alternative pathway requires non-immunospecific IgG, these findings suggest that nonimmune binding of IgG on the pneumococcal surface endows it with complement-activating properties.

Complement System Proteins