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Biomedical subjects

D Chiu

Publications and source records attributed to D Chiu.

At least 55 records · Page 3Linked to original sources

Chromosome anomalies as predictors of recurrence risk for spontaneous abortion.

Reproductive histories and chromosomes of spontaneous abortions were studied by segregation analysis in 1890 sibships ascertained through a cytogenetically studied abortion. Normal karyotypes are associated with recurrent abortion. Among abnormal karyotypes, trisomy has an elevated recurrence risk even after adjustment through a liability indicator for maternal age. Possible mechanisms and conflicting evidence in the literature on trisomy are discussed. None of these differences in recurrence risk is large enough to play a significant numerical role in genetic counseling.

Abortion, Spontaneous↗

The molecular species composition of phosphatidylcholine affects cellular properties in normal and sickle erythrocytes.

The phosphatidylcholine specific transfer protein (PCTP) from bovine liver was used to retailor the molecular species composition of phosphatidylcholine (PC) in the membrane of normal (AA) and sickleable (SS) human erythrocytes. Changes in molecular species composition of PC altered morphology as well as cellular deformability and stability as measured with ektacytometry. In normal cells, replacement of native PC with 1-palmitoyl,2-arachidonoyl PC (PAPC) resulted in a decrease in osmotic fragility with no change in hydration, whereas replacement with 1,2-dipalmitoyl PC (DPPC) led to an increased osmotic fragility and cellular hydration. Replacement of native PC by 1-palmitoyl,2-oleoyl PC (POPC) in normal cells had no apparent effect on these parameters. In contrast, replacement of native PC in sickle cells with either PAPC, DPPC or POPC led to cellular hydration. Facilitation of PC exchange between subpopulations of SS cells separated on buoyant density also led to cellular hydration. These observations suggest that the state of hydration of sickle cells can be modified by the fatty acyl composition of PC and illustrate a a role for the lipid core in the observed permeability changes in sickle erythrocytes. They also raise the interesting possibility that the state of cellular hydration of sickle cells may be modulated by altering the molecular species composition of the membrane phospholipids.

Anemia, Sickle Cell↗

Neutrophil-induced K+ leak in human red cells: a potential mechanism for infection-mediated hemolysis.

Activated neutrophils (AN) when incubated with red blood cells (RBCs) at a ratio of 1:100 were shown to damage RBCs as reflected by an increase in passive potassium (K+) permeability. Oxygenated sickle cells were more susceptible to this injury than normal (AA) RBCs. In both normal and sickle cells, the degree of K+ leak was found to be linearly related to the amount of AN in the incubation mixture. Pretreatment of AA RBCs with low-dose H2O2 resulted in an increased K+ leak after exposure to AN. Compared with patients with stable sickle cell anemia, those who were observed while infected or in crisis had notably more K+ leak from their RBCs after AN exposure. Addition of activated neutrophils from a patient with chronic granulomatous disease resulted in K+ leak from normal RBCs, despite a deficiency in production of toxic oxygen species. Cell-free supernatants from AN also mediated K+ leak. Sickle cells were, again, leakier after exposure to these preparations. Scavengers of toxic oxygen species inhibited up to 40% of the leak, whereas the maximal inhibition obtained by using protease inhibitors was 60%. Addition of autologous plasma in low concentrations inhibited the leak but also resulted in hemolysis, probably via a different mechanism. These studies demonstrate that measurement of passive K+ loss from RBCs allows discrimination between two separate mechanisms of AN-induced damage, an oxidant mechanism, as has been previously described, and a new pathway that appears to be mediated by granule-associated enzymes released from AN. The increased susceptibility of sickle RBCs, especially during periods of increased physiologic stress, suggests that previous membrane damage in vivo may render these RBCs more sensitive to the action of either oxidants or granules released from neutrophils.

Anemia, Sickle Cell↗

The aging process of human neonatal erythrocytes.

The red blood cell population of the human newborn is more heterogeneous than that of adults. To characterize this heterogeneity, red cells were separated on Stractan gradients into populations according to their density and, therefore, generally according to their age. Lipid content, phospholipid asymmetry, osmotic fragility, and deformability were measured. With increasing density, osmotic resistance and deformability decreased to a greater extent in the neonatal than the adult red cell. There was a marked loss of surface area throughout the life span of the neonatal red cell which was not accompanied by a parallel loss of membrane lipid. This apparent discrepancy could be explained at least in part by internalization of membrane lipid as a result of endocytosis, a process shown to be present in even the densest neonatal red cells.

Adult↗

Growth retardation in sickle-cell disease treated by nutritional support.

The effect of increased nutritional intake was evaluated in 5 growth-retarded children with sickle-cell disease. Growth on recommended daily calorie and protein intakes had been inadequate in all 5. Fat absorption and intestinal mucosal morphology were normal in all 5. 2 children were given nutritional supplementation by nasogastric intubation, 1 received nightly oral formula supplements, and 2 were supplemented with zinc, iron, folate, and vitamin E only. Nutritional supplementation by the nasogastric route produced a rapid sustained increase in growth rate, associated with striking reductions in pain crises and infections which had previously necessitated many hospital admissions. Oral supplementation improved the clinical course but had no effect on growth rate. Mineral and vitamin supplements influenced neither the growth rate nor the clinical course. The observations indicate that nasogastric nutritional supplementation may accelerate growth and reduce the incidence and severity of complications in growth-retarded children with sickle-cell disease.

Adolescent↗

Maternal age-specific rates of numerical chromosome abnormalities with special reference to trisomy.

The effect of maternal age on the incidence of chromosomally normal spontaneous abortion and different categories of chromosome abnormality among all clinically recognized human pregnancies was evaluated. The results provide no evidence for a significant association of age with sex chromosome monosomy or polyploidy, but clearly demonstrate an effect of age on the frequency of trisomy and chromosomally normal spontaneous abortions. Estimated maternal age-specific rates of trisomy among all recognized pregnancies were calculated and suggest that a majority of oocytes of women aged 40 years and older may be aneuploid.

Abortion, Spontaneous↗

Clinical superiority of a new nonionic contrast agent (iopamidol) for cardiac angiography.

The hemodynamic and electrophysiologic alterations induced by ionic contrast agents during cardiac angiography are well described. Recently nonionic contrast agents have become available for cardiac angiography. To evaluate the safety of these new agents, a double-blind randomized study was performed comparing a new nonionic agent (iopamidol) with a commonly used ionic contrast agent (Renografin-76). Eighty-one patients undergoing left ventriculography and coronary angiography were included; 41 received iopamidol and 40 received sodium meglumine diatrizoate (Renografin-76). After left ventriculography, there was a decrease in the arterial pressure with both contrast agents. However, the severity and the duration of hypotension were both significantly greater with Renografin-76 compared with the new nonionic agent (p less than 0.001). After selective injections of the coronary arteries, electrocardiographic analysis demonstrated that the increase in the QT interval (p less than 0.0002) and the changes in both the ST segment and T wave amplitude (p less than 0.001) were significantly greater in the Renografin-76 group compared with the iopamidol group. During coronary angiography, 8 of the 40 patients receiving Renografin-76 required temporary pacing for sinus pauses of 2.5 seconds or more, and 2 of the 40 also developed ventricular fibrillation. None of the 41 patients receiving iopamidol had these complications. This report demonstrates that the electrocardiographic changes, the severity and duration of hypotension and the incidence of serious arrhythmias are significantly greater with Renografin-76 than with iopamidol. Thus, this new nonionic agent appears to enhance the safety of cardiac angiography.

Aged↗

Effect of hydrogen peroxide exposure on normal human erythrocyte deformability, morphology, surface characteristics, and spectrin-hemoglobin cross-linking.

To further define the conditions for forming spectrin-hemoglobin cross-linking in human erythrocyte membranes and to examine its possible effects on membrane function, we incubated normal human erythrocytes for up to 3 h in concentrations of H2O2, varying from 45 to 180 microM, in an azide phosphate buffer, pH 7.4. The chemical changes observed indicated that methemoglobin formation occurred early and at a low concentration (45 microM). Morphologic changes characterized by increased echinocyte formation occurred in a dose-dependent fashion. In addition, decreased cell deformability commensurate with increased membrane rigidity was found. Finally, an increase in cell recognition as determined by monocyte phagocytosis and adherence in vitro, as well as decreased phosphatidylcholine accessibility to bee venom phospholipase A2, was found in H2O2-treated erythrocytes compared with controls. Both of these latter changes were closely correlated with the extent of spectrin-hemoglobin cross-linking. In addition to these protein-mediated interactions, lipid peroxidation also occurred after H2O2 exposure, as shown by generation of fluorescent amino propene derivatives. The addition of the antioxidant, butylated hydroxytoluene, decreased the fluorescent derivatives, but did not prevent the effects on membrane function. This suggests that lipid peroxidation, though present, was not necessary for the membrane changes found. In contrast, spectrin-hemoglobin aggregation and the alterations in membrane function were completely prevented by prior exposure of the erythrocytes to carbon monoxide.

Carbon Monoxide↗

Complete hydatidiform mole in Hawaii: an epidemiological study.

An analysis of hydatidiform moles occurring in Hawaii over a 14-year period (1968-1981) was undertaken. The pathology of all 278 reported molar pregnancies was reviewed and showed 69.4% to be complete, 24.5% to be partial, and 6.1% to be nonmolar. A case-control epidemiological investigation of the complete moles showed maternal age and race to be important, moles being significantly more prevalent in women under 20 and over 40 yr of age and also in women of Japanese, Filipino, and other Oriental ancestry. However no difference was seen in the prevalence of moles between Oriental women born in the Orient and those born and raised in Hawaii. No significant difference was found in paternal age, paternal race, socioeconomic status, or reproductive history, suggesting that these factors do not play an important role in the etiology of complete hydatidiform mole. Incidence rates for complete moles were calculated taking age and race into consideration and ranged from a high of 1 in 150 to a low of 1 in 2,000 naturally terminating pregnancies.

Adolescent↗

Parental origin of autosomal trisomies.

Chromosome heteromorphisms of parents and their trisomic spontaneous abortions were compared in an attempt to determine the parental origin of 204 single trisomies, including cases of trisomy 3, 4, 9, 13, 14, 15, 16, 21 and 22, nine mosaic trisomies and nine double trisomies. Non-disjunction at maternal meiosis I was the most likely source of the additional chromosome for all trisomies studied, including the mosaics, and this was the case at all maternal ages. However, trisomy 21 had a significantly increased proportion of paternally derived cases by comparison with all other trisomies. Consideration of the sex ratio in cases of trisomy 21 of known parental origin suggests that there is an excess of males associated with paternal first meiotic division non-disjunction. The fact that this mechanism of origin is more prevalent in trisomy 21 may well explain why there is an excess of males associated with this abnormality but not with other autosomal trisomies.

Abortion, Spontaneous↗

Peroxidation, vitamin E, and sickle-cell anemia.

In summary, we propose the following scheme (Figure 5) to describe the role of peroxidation in the pathophysiology of SCA. Sickle erythrocytes are more susceptible to peroxidation than are normal erythrocytes. This increased susceptibility to peroxidation is, in part, due to decreased blood vitamin E levels and abnormal membrane phospholipid organization induced by sickling. The peroxidative damage of sickle erythrocytes may accelerate or contribute to loss of cell deformability and to chronic hemolysis. Peroxidative damage can produce abnormal cellular properties, such as potassium leak and reduced filterability, and contribute to formation of ISCs. Increased red cell rigidity can initiate episodes of capillary obstruction, leading to vasoocclusive painful crises and to tissue infarction. Liver dysfunction as well as increased production of bilirubin secondary to hemolysis could result in bile sludging and decreased secretion of bile salts into the intestinal lumen. Reduced bile salt secretion leads to partial fat and vitamin E malabsorption. Vitamin E deficiency enhances red cell susceptibility to peroxidation and promotes a vicious cycle in SCA. Although we have not studied factors that might initiate peroxidative damage, sickle hemoglobin and excess body iron should be considered as potential sources. Our studies suggest that vitamin E supplementation to sickle-cell patients could be of clinical benefit.

Anemia, Sickle Cell↗

Properties of vitamin E-deficient erythrocytes following peroxidant injury.

Several membrane properties of vitamin E-deficient and normal erythrocytes were studied after incubation of these cells with hydrogen peroxide. Measurements of mean corpuscular volume, cation permeability, membrane Na+, K+ ATPase activity, red cell filterability through 5 mu millipore filters, and membrane protein pattern on sodium dodecyle sulfate-gel electrophoresis revealed marked alterations before lysis. Vitamin E sufficient cells were unaffected by a similar incubation with hydrogen peroxide. We speculate that the changes in membrane function, which follow peroxidant injury, contribute to the shortened red cell survival in the vitamin E deficient state.

Cell Membrane Permeability↗

Sexual development of patients with isochromosomes for the long arm of the X chromosome.

The sexual development of 14 girls with non-mosaic monocentric 46,X,iXq karyotype was studied. Seven out of eight girls were found to have immature secondary sexual characteristics and amenorrhoea, a finding greatly contrasting with that in Triplo-X girls. The relative ineffectiveness of the isochromosome Xq in maintaining fertility may be due to the absence of one short arm, which probably also carries a gonadal determinant. Alternatively, the presence of two inactivation sites on one isochromosome may render the gonadal determinants inactive at an important stage in gonadal development.

Adolescent↗

Abnormalities in membrane phospholipid organization in sickled erythrocytes.

In contrast to the wealth of information concerning membrane phospholipid asymmetry in normal human erythrocytes, very little is known about membrane phospholipid organization in pathologic erythrocytes. Since the spectrin-actin lattice, which has been suggested to play an important role in stabilizing membrane phospholipid asymmetry, is abnormal in sickled erythrocytes, we determined the effects of sickling on membrane phospholipid organization. We used two enzymatic probes: been venom phospholipase A2 and Staphylococcus aureus sphingomyelinase C, which do not penetrate the membrane and react only with phospholipids located in the outer leaflet of the bilayer. Our results suggest that the distribution of glycerophospholipids within the membrane of sickled cells is different from that in nonsickled cells. Compared with the normal erythrocyte, the outer membrane leaflet of the deoxygenated, reversibly sickled cells (RSC) and irreversibly sickled cells (ISC) was enriched in phosphatidyl ethanolamine in addition to containing phosphatidyl serine. These changes were compensated for by a decrease in phosphatidyl choline in that layer. The distribution of sphingomyelin over the two halves of the bilayer was unaffected by sickling. In contrast to ICS, where the organization of phospholipids was abnormal under both oxy and deoxy conditions, reoxygenation of RSC almost completely restored the organization of membrane phospholipids to normal. These results indicate that the process of sickling induces an abnormality in the organization of membrane phospholipids to normal. These results indicate that the process of sickling induces an abnormality in the organization of membrane lipids in RSC which become permanent in ISC.

Anemia, Sickle Cell↗

Sickled erythrocytes accelerate clotting in vitro: an effect of abnormal membrane lipid asymmetry.

A membrane lipid abnormality induced by sickling and found as a permanent alteration in the irreversibly sickled cell (ISC) is the rearrangement of phosphatidyl ethanolamine (PE) and phosphatidyl serine (PS) from the inner to the exterior side of the lipid bilayer. Since PS can provide a catalytic surface for the binding of blood coagulation factors and thus can exhibit procoagulant activity, we investigated the influence of oxy and deoxy reversibly sickled cells (RSC) ass well as ISC on clotting in vitro. Red blood cells (RBC), as the source of phospholipid, were added to platelet-poor citrated plasma containing Russell's viper venom (RVV) and clotting time was measured after recalcification. The clotting time after addition of normal RBC and oxy-RSC was similar to the saline blank (100 sec). In contrast, both oxy-ISC and deoxy completely sickled RSC shortened clotting time by 30%. Using liposomes prepared with identical phospholipid composition to the outer lipid leaflet of either normal RBC, RSC or ISC clotting times similar to those with intact cells were achieved. Since the liposomes did not contain protein, accentuation of clotting appears to be related to abnormal phospholipid organization, in particular to the abnormal exposure to aminophospholipids on the outer surface of the membrane. This abnormality may contribute to the pathogenesis of the vaso-occlusive episode in sickle cell anemia.

Anemia, Sickle Cell↗

Erythrocyte membrane lipid reorganization during the sickling process.

In order to study possible alterations in membrane lipids during sickling, we have measured the difference in susceptibility to lipid peroxidation, binding of trinitrobenzenesulfonic acid (TNBS) to aminophospholipids, and fatty acid uptake in cells containing sickle haemoglobin under aerobic and anaerobic conditions. We have also examined TNBS binding in irreversibly sickled cells in an attempt to evaluate the permanent effects of any such alterations. We found that when erythrocytes were sickled by deoxygenation, the susceptibility to lipid peroxidation and binding of TNBS to aminophospholipids was markedly increased, while normal control cells showed no change. These effects appeared to be specific for the sickled state rather than a nonspecific consequence of cell age or the concentration of sickle haemoglobin within the cell. In contrast, fatty acid incorporation into membrane phospholipids, representing potential lipid renewal, was decreased in the sickled state. Cell fractions enriched in irreversibly sickled cells showed increased TNBS labelling in air and only modest rises with anoxia. Taken together, these data imply a rearrangement of membrane lipids during the sickling process and suggest a permanent reorganization of membrane lipids in the irreversibly sickled cell.

Aerobiosis↗