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Biomedical subjects

C Wagner

Publications and source records attributed to C Wagner.

At least 109 records · Page 6Linked to original sources
PubMed1999

[Interval between initial symptoms and first treatment in patients with head-neck tumors].

We investigated the kinds of first symptoms and their delay in diagnosis by patients and physicians until the beginning of therapy in 92 patients with carcinomas of the head and neck. We were interested in the time from onset of first symptoms to the first consultation with a physician, the first contact with an ENT specialist and to admission to our hospital. We found no difference in the time of delay for first symptoms had by patients who consulted the family doctor first and those patients who were seen by an ENT specialist first. This may be due to almost all family doctors in Thuringia being specialists for general medicine. The patient was the decisive factor in delaying medical evaluation of first symptoms. Patients with laryngeal cancers had a twice as long interval between the first symptom and the initial consultation with a physician than patients with other cancers of the head and neck, since these latter tumors had clinically concerning symptoms in most cases. In patients with better education we found a longer interval between the onset of the first symptoms and the first consultation with a doctor. We think that better knowledge by patients about the first symptoms of a cancer of the head and neck and improved training in ENT diseases for specialists of general medicine will improve the overall rate for early detection of these tumors.

Adult↗
PubMed1999

Changes in the cerebrospinal-fluid monoamines in rats with an immunoneutralization of the subcommissural organ-Reissner's fiber complex by maternal delivery of antibodies.

The subcommissural organ (SCO) is a brain gland secreting glycoproteins into the cerebrospinal fluid (CSF), where they aggregate forming the Reissner's fiber (RF). By the continuous addition of newly released glycoproteins, RF grows along the cerebral aqueduct, fourth ventricle, and central canal of the spinal cord. At the filum, RF-glycoproteins escape from the central canal and reach the local blood vessels. Despite a century of research, the function of the SCO remains elusive. The aim of the present investigation was to test the hypothesis that RF-glycoproteins, by binding and transporting monoamines out of the CSF, participate in the clearance of these compounds. A protocol was designed that led to the permanent immunoneutralization of the SCO through the maternal delivery of antibodies. This was achieved by transplacental transfer to the fetuses, and through the milk to the pups, of specific antibodies against SCO secretory proteins. The antibodies reached the CSF of the fetuses and pups and blocked the RF formation during the first months of life. Some of these animals died during the first postnatal weeks; those who survived displayed a rise in the CSF concentration of several monoamines, l-DOPA being the one with the highest rise. Adult rats transiently deprived of RF by a single injection of anti-RF antibodies into the CSF showed a transient rise in the CSF concentration of l-DOPA. All these results support the hypotheses that the SCO-RF complex participates in the clearance of monoamines from the CSF.

Animals↗
PubMed1999

Expression of major histocompatibility class II antigens on polymorphonuclear neutrophils in patients with Wegener's granulomatosis.

BACKGROUND: Wegener's granulomatosis is a systemic inflammatory disease of unknown etiology. Many studies suggest that autoimmune reactions are involved, and there is good evidence for the participation of immunocompetent cells. In that context, we examined the activation of polymorphonuclear neutrophils (PMNs) of patients with Wegener's granulomatosis. METHODS: In a prospective study, the expression on the surface of PMNs of CD64 and of the major histocompatibility class II (MHC II) antigen was measured by cytofluorometry in whole blood. The expression of those antigens was correlated to disease activity. RESULTS: Up to 15% of the peripheral PMNs of patients with active disease expressed MHC II. Follow-up studies showed that expression correlated closely with disease activity and that it decreased rapidly under immunosuppressive therapy. Expression of CD64 was seen in approximately 50% of the patients, regardless of disease activity. CONCLUSION: MHC II expression on PMNs might serve as a novel diagnostic marker for active disease and appears to be suitable for monitoring immunotherapy. Moreover, our data provide evidence that PMNs, which are normally MHC II negative, acquire MHC II antigens in the course of disease and may be an unrecognized function within the afferent limb of the immune response.

Anti-Inflammatory Agents↗
PubMed1999

Mutations in the SLC3A1 gene in cystinuric patients: frequencies and identification of a novel mutation.

Cystinuria is a frequent autosomal recessive transport disorder characterized by defective renal resorption of cystine and other dibasic amino acids. Biochemically, three types of cystinuria can be defined. Here we present our results of screening for mutations in the SLC3A1 gene, which codes for a dibasic amino acid transporter protein and appears to be involved in the pathogenesis of cystinuria type I. Our study population consists of 5 Italian cystinuria type I patients and 10 cystinuric patients as yet unclassified as to clinical type. The latter were of different ethnic origin. In total, we found 13 point mutations and 8 genomic rearrangements in 15 cystinuric patients, i.e., our detection rate was 70% (23/30 chromosomes). Remarkably, in patients known to be suffering from cystinuria type I, the mutation detection rate was only 50%, whereas in patients unselected as to cystinuria type, we found 80% of mutations. Additionally, our results, as with those published in the literature, indicate a possible population specific distribution of mutations: Each of the 4 Greek patients analyzed here showed homozygosity for mutation T216M in exon 3. Analysis of a Yugoslavian patient showed homozygosity for a novel mutation, R365L, in exon 6 (nt1094G > T). Findings from molecular genetic studies, as well as physiological investigations, suggest that there are further genes that play a role in the etiology of cystinuria. Nevertheless, our results show that screening for mutations in the SLC3A1 gene can be a meaningful step toward molecular genetic diagnosis of cystinuria in patients without biochemical classification. As with cystic fibrosis, the finding of specific mutations in particular ethnic populations, suggest that the diagnostic approach should take into consideration a patient's ethnic origins.

Amino Acid Transport Systems, Basic↗
PubMed1999

A measuring instrument for evaluation of quality systems.

OBJECTIVE: To develop an instrument for provider organizations, consumers, purchasers, and policy makers to measure and compare the development of quality systems in provider organizations. DESIGN: Cross-sectional study of provider organizations using a structured questionnaire to survey managers. SETTING: The Netherlands. STUDY PARTICIPANTS: Provider organizations of six health care fields: primary health care, care for the disabled, mental health care, care for the elderly, hospital care and welfare care. MAIN MEASURES: Existence of quality assurance and quality improvement activities. RESULTS: The study presents a survey instrument for assessing the quality assurance and improvement activities of health care provider organizations and the developmental stage of quality systems. The survey instrument distinguishes five focal areas for quality improvement activities and four developmental stages. The study also reports data on the reliability and validity of the survey instrument. CONCLUSION: The instrument is reliable, easy to administer, and useful across health care fields as well as different kinds of organizations. Developing quality systems provide a common language across all parts of the health care sector. By assigning the activities to focal areas and developmental stages the instrument gives insight into the implementation of quality systems in health care. Comparable information on quality assurance activities increases the accountability of providers. Because of the efficient (not time consuming) approach, the instrument complements existing accreditation reviews.

Cross-Sectional Studies↗
PubMed1999

Thermostating by deterministic scattering: heat and shear flow.

We apply a recently proposed thermostating mechanism to an interacting many-particle system where the bulk particles are moving according to Hamiltonian dynamics. At the boundaries the system is thermalized by deterministic and time-reversible scattering. We first show how this scattering mechanism can be related to stochastic boundary conditions. We subsequently simulate thermal conduction and shear flow for a hard disk fluid. By comparing the transport coefficients obtained from computer simulations to theoretical results we find that this thermostating mechanism yields well-defined nonequilibrium steady states in the range of linear response. Furthermore, the conjectured identity between thermodynamic entropy production and exponential phase-space contraction rates is investigated from the standpoint of our formalism. We find that, in general, these quantities do not agree.

Journal Article↗
PubMed1999

Role of renal nerves in the stimulation of the renin system by reduced renal arterial pressure.

The aim of this study was to determine the role of renal innervation in the prolonged stimulation of renin secretion and renin synthesis accompanying renal artery stenosis. Male Sprague-Dawley rats, in which the left kidney had been denervated or sham denervated 4 days earlier, received a left renal artery clip (ID 0.2 mm). Plasma renin activity and renin mRNA were assayed 1, 2, or 4 days after clipping. The stimulation of both plasma renin activity and renin mRNA was blunted markedly in the rats with the denervated clipped kidney. The typical suppression of renin mRNA in the intact right kidney, however, was not different between rats with sham-denervated or denervated left kidneys, nor was the increase of blood pressure in response to renal artery clipping different between the experimental groups. To test whether the suppression of renin mRNA in the contralateral kidney was related to the increase of blood pressure, another group of rats with denervated clipped left kidneys was treated additionally with the T-type calcium channel blocker mibefradil (15 mg. kg(-1). d(-1)). Despite blood pressure normalization by mibefradil, plasma renin activities and renin mRNA levels in the clipped denervated kidneys and in the intact right kidneys remained unchanged. These findings suggest that renal nerves are responsible for marked background stimulation of both renin secretion and renin mRNA expression, which is normally masked by the inhibitory effect of renal perfusion pressure on the renin system. Renal nerve activity is therefore an important determinant of the gain of renin stimulation during reduced renal arterial pressure.

Animals↗
PubMed1999

Cellular control of renin secretion.

Renin secretion at the level of renal juxtaglomerular cells appears to be controlled mainly by classic second messengers such as Ca2+, cyclic AMP and cyclic GMP, which in turn exert their effects through oppositely acting protein kinases and probably also by affecting the activity of ion channels in the plasma membrane. Thus, protein kinase A stimulates renin secretion, whilst protein kinase C and protein kinase G II inhibit renin secretion. Moreover, Cl- channels could be involved in the mediation of the inhibitory action of Ca2+ on renin secretion. This review summarizes our present knowledge about the possible actions of these kinases in renal juxtaglomerular cells and considers pathways in the organ control of renin secretion.

Animals↗
PubMed1999

Regulation of renin secretion by angiotensin II-AT1 receptors.

Angiotensin II (AngII) resulting as the end product of a proteolytic cascade initiated by renin inhibits the secretion of renin in the sense of a negative feedback. A direct effect of AngII on renal juxtaglomerular epithelioid cells as the main source of renin secretion is mediated via AngII-AT1 receptors and involves calcium-dependent reactions. These reactions may comprise activation of protein kinase C and activation of chloride channels.

Angiotensin II↗
PubMed1999

Effects of candesartan on the renin system in conscious rats.

This study aimed to assess and to compare the effects of cadesartan cilexetil on the renin system in rats. Male Sprague Dawley rats were orally treated either with the angiotensin-converting enzyme inhibitor ramipril (7.5 mg/kg per d), with the established AngII-AT1 receptor blocker losartan (40 mg/kg per d), or with candesartan cilexetil (1 mg/kg per d) for 3 d, and the effects of these treatments on plasma renin activity, renal renin mRNA levels, and adrenal levels of AngII-AT1a and AngII-AT1b receptor mRNA were determined. It was found that all drugs led to very similar increases in plasma renin activity and renin mRNA levels and to rather similar decreases in adrenal AngII-AT1b receptor mRNA levels. It is concluded therefore that the effects of candesartan on the renin system in vivo are not different from those obtained with angiotensin-converting enzyme inhibition or with the AngII-AT1 receptor blocker losartan.

Adrenal Glands↗
PubMed1998

Measurement of plasma S-adenosylmethionine and S-adenosylhomocysteine as their fluorescent isoindoles.

The low levels of S-adenosylmethionine (AdoMet) and S-adenosylhomocysteine (AdoHcy) in plasma can be measured by formation of the fluorescent isoindole derivatives of these compounds. The procedure involves an initial separation of AdoMet and AdoHcy in deproteinized plasma by HPLC on a C-8 column followed by derivatization with naphthalenedialdehyde and cyanide for 10 min at pH 9.0. The fluorescent derivatives of AdoMet and AdoHcy are then chromatographed by HPLC on a C-18 column monitored with a fluorescence monitor. The formation of the isoindole goes to 85% completion and the overall recovery of standards added to plasma is about 65%. Correction for recovery is made by addition of known quantities of AdoMet and AdoHcy to plasma. Normal values (+/- SE) for AdoMet were 102.7 nM +/- 9.9 and for AdoHcy were 22.7 +/- 3.1.

Administration, Oral↗
PubMed1998

Role of cGMP-kinase II in the control of renin secretion and renin expression.

To investigate the roles of the cGMP-dependent protein kinases (cGKs) in the control of the renin system, we studied the regulation of renin in cGKI- or cGKII-deficient mice in vivo and in vitro. Renal renin mRNA levels both under stimulatory (low-salt diet plus ramipril) and inhibitory (high-salt diet) conditions were not different between wild-type and cGKI-/- mice, but were significantly elevated in cGKII-/- mice under all experimental conditions. In primary cultures of renal juxtaglomerular cells (JG) established from wild-type, cGKI-/-, and cGKII-/- mice, the adenylate cyclase activator forskolin stimulated renin secretion similarly in all genotypes tested. 8-bromo-cGMP attenuated basal and forskolin-stimulated renin secretion in cultures from wild-type and cGKI-/-, but had no effect in cells isolated from cGKII-/- mice. Activation of cGKs by 8-bromo-cGMP decreased renin secretion from the isolated perfused rat kidney, independent of prestimulation by beta-adrenoreceptor activation, macula densa inhibition, reduced perfusion pressure, or by a nominally calcium-free perfusate. Taken together, these findings suggest that activation of cGKII has a general inhibitory effect on renin secretion from renal JG cells.

Animals↗
PubMed1998

A novel phosphopantetheine:protein transferase activating yeast mitochondrial acyl carrier protein.

In Saccharomyces cerevisiae, the low molecular weight acyl carrier protein (ACP) of mitochondrial type II fatty acid synthase (FAS) and the cytoplasmic type I FAS multienzyme contain 4'-phosphopantetheine as a prosthetic group. Sequence alignment studies with the recently isolated phosphopantetheine:protein transferase (PPTase), Ppt1p, from Brevibacterium ammoniagenes revealed the yeast open reading frame, YPL148C, as a potential PPTase gene (25% identical and 43% conserved amino acids). In accordance with this similarity, pantetheinylation of mitochondrial ACP was lost upon disruption of YPL148C. In contrast, biosynthesis of cytoplasmic holo-FAS remained unaffected by this mutation. According to these characteristics, the newly identified gene was designated as PPT2. Similar to ACP null mutants, cellular lipoic acid synthesis and, hence, respiration were abolished in PPT2 deletants. ACP pantetheinylation, lipoic acid synthesis, and respiratory competence were restored upon transformation of PPT2 mutants with cloned PPT2 DNA. In vitro, holo-ACP synthesis was achieved by incubating apo-ACP with coenzyme A in the presence of purified Ppt2p. The homologous yeast enzyme could be replaced, in this assay, by the ACP synthase (EC 2.7.8.7) of Escherichia coli but not by the type I FAS-specific PPTase of B. ammoniagenes, Ppt1p. These results conform with the inability of Ppt2p to activate the cytoplasmic type I FAS complex of yeast.

Acyl Carrier Protein↗
PubMed1998

Endogenous or overexpressed cGMP-dependent protein kinases inhibit cAMP-dependent renin release from rat isolated perfused kidney, microdissected glomeruli, and isolated juxtaglomerular cells.

An overactive renin-angiotensin-aldosterone system (RAAS) has a central role in the pathogenesis of hypertension and cardiac hypertrophy, precursors of cardiac failure. Natriuretic peptides and NO acting through their second messenger, cGMP, increase natriuresis and diuresis, and inhibit renin release; however the mechanism by which this inhibition of the RAAS system functions is obscure. We recently reported cloning of the cDNA for type II cGMP-dependent protein kinase (cGK II), elucidated its first known function of inhibiting the cystic fibrosis transmembrane conductance regulator in rat intestine, and initially described its location in rat kidney juxtaglomerular (JG) cells, the ascending thin limb, and the brush border of proximal tubules. Here, we demonstrate inhibition of isoproterenol- or forskolin-stimulated renin release by 8-para-chlorophenylthio-cGMP (8-pCPT-cGMP), a selective activator of cGK, and prevention of this inhibition by a selective inhibitor of cGK, Rp-8-pCPT-cGMPS. In systems of differing complexity, inhibition by 8-pCPT-cGMP was nearly complete in isolated perfused kidney and microdissected afferent arterioles but only approximately 25% in isolated JG cells. Expression of either cGK II or cGK I in JG cells by using adenoviral vectors enhanced the inhibition of forskolin-stimulated renin release by 8-pCPT-cGMP to 50%. Our results indicate that cGK II, and possibly cGK I, can mediate cGMP inhibitory effects on renin release and are physiological components of the cGMP signal transduction system which opposes the RAAS.

Animals↗
PubMed1998

Stimulation of renin secretion by nitric oxide is mediated by phosphodiesterase 3.

This study aimed to characterize the cellular pathways along which nitric oxide (NO) stimulates renin secretion from the kidney. Using the isolated perfused rat kidney model we found that renin secretion stimulated 4- to 8-fold by low perfusion pressure (40 mmHg), by macula densa inhibition (100 micromol/liter of bumetanide), and by adenylate cyclase activation (3 nmol/liter of isoproterenol) was markedly attenuated by the NO synthase inhibitor nitro-L-arginine methyl ester (L-Name) (1 mM) and that the inhibition by L-Name was compensated by the NO-donor sodium nitroprusside (SNP) (10 micromol/liter). Similarly, inhibition of cAMP degradation by blockade of phosphodiesterase 1 (PDE-1) (20 micromol/liter of 8-methoxymethyl-1-methyl-3-(2-methylpropyl)xanthine) or of PDE-4 (20 micromol/liter of rolipram) caused a 3- to 4-fold stimulation of renin secretion that was attenuated by L-Name and that was even overcompensated by sodium nitroprusside. Inhibition of PDE-3 by 20 micromol/liter of milrinone or by 200 nmol/liter of trequinsin caused a 5- to 6-fold stimulation of renin secretion that was slightly enhanced by NO synthase inhibition and moderately attenuated by NO donation. Because PDE-3 is a cGMP-inhibited cAMP-PDE the role of endogenous cGMP for the effects of NO was examined by the use of the specific guanylate cyclase inhibitor 1-H-(1,2,4)oxodiazolo(4,3a)quinoxalin-1-one (20 micromol). In the presence of 1H-[1,2,4]oxodiazolo[4,3-a]quinoxalin-1-one the effect of NO on renin secretion was abolished, whereas PDE-3 inhibitors exerted their normal effects. These findings suggest that PDE-3 plays a major role for the cAMP control of renin secretion. Our findings are compatible with the idea that the stimulatory effects of endogenous and exogenous NO on renin secretion are mediated by a cGMP-induced inhibition of cAMP degradation.

1-Methyl-3-isobutylxanthine↗
PubMed1998

Crystal structure of apo-glycine N-methyltransferase (GNMT).

The crystal structure of the recombinant apo-form of glycine N-methyltransferase (GNMT) has been determined at 2.5 A resolution. GNMT is a tetrameric enzyme (monomer Mr = 32,423Da, 292 amino acids) that catalyzes the transfer of a methyl group from S-adenosylmethionine (AdoMet) to glycine with the formation of S-adenosylhomocysteine (AdoHcy) and sarcosine (N-methylglycine). GNMT is a regulatory enzyme, which is inhibited by 5-methyltetrahydrofolate pentaglutamate and believed to control the ratio of AdoMet to AdoHcy in tissues. The crystals belong to the orthorhombic space group P2(1)2(1)2 (a = 85.39, b = 174.21, c = 44.71 A) and contain one dimer per asymmetric unit. The AdoMet-GNMT structure served as the starting model. The structure was refined to an R-factor of 21.9%. Each monomer is a three-domain structure with a large cavity enclosed by the three domains. The tetramer resembles a square with a central channel about which N-terminal domains are intertwined. Only localized changes of the residues involved in the binding pocket are observed for the apo-GNMT structure when compared to that determined in the presence of substrate and substrate analog.

Animals↗