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Biomedical subjects

G Cooper

Publications and source records attributed to G Cooper.

At least 199 records · Page 11Linked to original sources

Contractile function, myosin ATPase activity and isozymes in the hypertrophied pig left ventricle after a chronic progressive pressure overload.

Experimental right ventricular pressure-overload hypertrophy in small mammals is associated with early muscle dysfunction, even before the onset of overt pump failure. Experimental results are quite heterogeneous regarding muscle function of the pressure hypertrophied left ventricle. Muscle dysfunction of the right or left ventricle, when found, may be causally related to alterations of myosin ATPase activity and isozyme type. However, the effect of a gradual pressure overload, analogous to that which occurs in human aortic stenosis, on myocardial contractile function and myosin ATPase activity has not been studied in a large animal whose normal myosin isozyme pattern resembles that of man. We therefore studied pump performance, myocardial contractile function, and myosin ATPase activity and isozyme pattern in pigs with severe, gradually applied left ventricular pressure overload. Thirteen weeks after supravalvular aortic banding, 10 pigs grew more than 7-fold in body weight and were found to have an aortic stenosis area of 0.5 +/- 0.1 cm2 with a gradient of 93 +/- 12 mm Hg. Compared with nine control animals, the banded animals had a 67% increase in left ventricular mass relative to body weight without overt pump failure as measured by cardiac index and pulmonary artery wedge pressure. Left ventricular ejection performance, measured as shortening fraction, was maintained except in three animals with extreme hypertrophy, in which depressed ejection performance may have been due to an afterload mismatch, myocardial dysfunction, or both. Myocardial contractile function, determined from the end-systolic stress-diameter relationship, was normal except in two pigs in which ejection performance was depressed and left ventricular mass was more than doubled. Only the slow V3 isozyme of myosin ATPase was found in both normal and hypertrophied pig myocardium, and the ATPase activity was normal in pigs with all degrees of hypertrophy. Thus, in a large animal model of severe, gradual left ventricular pressure overload, in which myosin isozyme pattern remains apparently unaltered, moderate hypertrophy can be associated with normal myosin ATPase activity and contractile function that is normal by current methods of evaluation.

Adenosine Triphosphatases↗

Combined antrectomy and Roux-en-Y anastomosis in the surgical treatment of recurrent peptic ulceration.

The results of antrectomy performed for recurrent peptic ulceration after vagotomy and drainage are frequently marred by bilious vomiting. Consequently, there has been interest in combining antrectomy with Roux-en-Y drainage to prevent this complication. The experience of one surgeon in revisional gastric surgery has been studied retrospectively. Thirty-six patients have been reviewed in detail, 24 of whom had a combined antrectomy and Roux-en-Y anastomosis: 16 for recurrent peptic ulceration, 2 for non-ulcer dyspepsia and 6 for bile reflux gastritis. None of these has required reoperation, and 12 of the 16 with recurrent ulcers have had a good result. Four of 12 who underwent antrectomy alone subsequently required biliary diversion. Combining antrectomy with a Roux-en-Y anastomosis prevents postoperative bile reflux gastritis and thereby the need for further revision on this account. The results of this approach compare well with those of other procedures used in the treatment of recurrent peptic ulceration.

Adult↗

Staphylococcus aureus bacteremia in diabetic patients. Endocarditis and mortality.

The presentation and course of Staphylococcus aureus bacteremia in 27 diabetic patients (18 insulin-dependent) were compared with those in 34 nondiabetic patients. The groups were comparable in age, proportion with pre-existing cardiac valvular disease, community-acquired bacteremia, fever, and leukocytosis. Endocarditis (vegetation or new regurgitant murmur) was present in eight (30 percent) diabetics and four (12 percent) nondiabetics (p = 0.16). A primary focus of infection was present in 67 percent of diabetics and 65 percent of nondiabetics. Among those with a focus, six of 18 diabetics and none of 22 nondiabetics had endocarditis (p less than 0.005). Fifteen of 54 (28 percent) patients who received appropriate antibiotic therapy died. After stratificaton for underlying illness, there was no mortality difference between those with and without endocarditis (three endocarditis deaths versus 1.78 expected), or between those with and without diabetes (four diabetic deaths versus 4.8 expected). Diabetics with staphylococcal bacteremia were more likely than nondiabetics to have endocarditis in the presence of a primary focus. They had no increase in mortality.

Adult↗

Vocational rehabilitation of multiple sclerosis (MS) patients. I. Analysis of clinical and demographic factors.

The vocational status of 299 multiple sclerosis (MS) patients in Israel, aged 17 to 50 years, was examined. This represents 30 per cent of the MS patients in Israel. It was found that 58 per cent of the patients continued working. Of the remaining 42 per cent, 24 per cent were severely disabled, but 18 per cent had working potential. A comparison was made between patients located up to 1971, and those located between 1971 and 1974. The latter series benefited from earlier follow-up, yielding a population with more recent onset of the illness. They were also younger, and differed from the first series in a number of other social and demographic aspects. The shorter duration and younger age of onset did not affect the percentage working, but did provide a higher percentage with working potential. Higher educational level was associated with continuation of work. Neither type of occupation nor work history had influence in this regard. The severity of the disease, and of some aspects in particular, had a deleterious influence.

Adult↗

Morphological changes in the mechanically unloaded myocardial cell.

The role of stretch and/or tension in maintaining the structural integrity of the myocardial cell was investigated in 16 cats. Right ventricular papillary muscles were studied 1-28 days after transection of the chordae tendinae and compared to adjacent intact papillary muscles. A progressive atrophy, as shown by decreased mean cell cross-sectional area, occurred; by the 28th day mean cardiocyte area was only 28% of the control value. The earliest ultrastructural changes (one day after surgery) were primarily focal and included disorientation of contractile filaments and loss of Z-line substance. During the first week, vacuolation, loss of contractile filaments and infiltration of macrophages and fibroblasts were characteristic. By the second week a massive loss of contractile substance, disappearance of the sarcoplasmic reticulum, and a marked increase in connective tissue occurred. Leptomere structures, membrane alterations, and phagocytosis were the most typical changes between the second and fourth week. Hydroxyproline assays on papillary muscles unloaded for three days showed a 38% increase in connective tissue, indicating an early increase in connective tissue/muscle mass associated with mechanical unloading. It is concluded that the cardiocyte is extremely dependent upon mechanical loading, i.e., stretch and/or tension. Mechanical unloading (tenotomy) results in rapid and marked cellular degeneration which exceeds that observed in skeletal muscle following either disuse or denervation.

Animals↗

Ability of antibody-bound human sperm to penetrate zona-free hamster ova in vitro.

Sera from men and women at risk for immunologic causes of infertility were screened for sperm-specific antibodies by a new test devised to assess directly the presence of immunoglobulins bound to the sperm plasma membrane. Passive antibody transfers to antibody-negative sperm of a fertile donor were performed with the use of sera that possessed iso- or auto-antibodies directed against the sperm head, including the acrosome and postacrosomal regions. The ability of these antibody-bound sperm to penetrate the zona-free hamster egg in vitro, a prerequisite for fertilization, was enhanced, as compared with the penetrating ability of antibody-free sperm of the same donor. These results indicate that the sperm-specific antibodies studied in these experiments, although bound to the sperm head, do not cause infertility by interfering with the acrosome reaction or gamete membrane fusion.

Animals↗

Chronic progressive pressure overload of the cat right ventricle.

When an abrupt, fixed increase in afterload induces hypertrophy, the myocardium exhibits normal pump function in vivo, depressed muscle function in vitro, and paradoxically increased oxygen consumption. Such abnormalities may be either a transient response to a reversible myocardial injury or instead may be a persistent characteristic of hypertrophy contributing to eventual heart failure. To distinguish between these alternatives, we developed a model of chronic progressive pressure overload. Kittens had either a sham operation or pulmonary banding for 25 (group I) or 60 (group II) weeks. Banding produced a gradually increasing pressure overload with growth, maximum at 16 weeks after operation. The ratio of right ventricular to body weight increase from 0.54 +/- 0.03 to 0.82 +/0.04 g/kg (P less than 0.01) in group I and from 0.50 +/- 0.03 to 0.72 +/- 0.03 (P less than 0.01) in group II. In vivo right ventricular pump function (cardiac output and ejection fraction) was normal in both groups. In vitro contractile function and metabolism were measured in papillary muscles from the same right ventricles. Both experimental groups showed marked contractile abnormalities: preloaded shortening velocity was reduced from 0.80 +/- 0.05 to 0.53 +/- 0.05 muscle length/sec (P less than 0.01) in group I and from 0.84 +/- 0.04 to 0.60 +/- 0.06 (P less than ).01) in group II. Maximum isometric active tension was reduced from 60 +/- 7 to 35 +/- 5 mN/mm2 (P less than 0.01) in group I and from 56 +/- 5 to 27 +/- 4 (P less than 0.01) in group II. Metabolism was normal in both experimental groups. Thus, under conditions relevant to the study of clinical cardiac hypertrophy that are unlikely to cause acute injury, hypertrophy produces persistently abnormal intrinsic contractile function

Animals↗

Male pseudohermaphroditism secondary to an abnormality in Leydig cell differentiation.

We present the first case of a prepubertal male with an abnormality in Leydig cell differentiation resulting in male pseudohermaphroditism. There was no plasma androgen response to im administration of hCG. Leydig cells were not apparently by either light or electron microscopy in tissue obtained from a biopsy of the right testis 96 h after the last dose of hCG. In addition, LH-hCG saturation analyses performed on membrane preparations from the testicular tissue revealed no binding. An expanded classification for male pseudohermaphroditism is presented.

Cell Differentiation↗

Apolipoprotein A-I, A-II and C-II in black and white residents of Evans County.

Plasma levels of lipids, lipoprotein-cholesterol and three major apolipoproteins (ApoA-I, A-II and C-II) were studied in 318 black and white males and females randomly sampled in Evans County, Georgia. Black-white differences in lipid and lipoprotein-cholesterol concentrations were observed, with low-density fractions higher in whites and high-density fractions higher in blacks. Plasma levels of ApoA-I but not ApoA-II were higher in blacks than in whites and in females than in males. ApoC-II concentrations were lower in black than in white men and women. Black-white differences in atherogenic lipoprotein fractions were statistically explained (in the sense of association, not necessarily of causal process) by the differences in ApoC-II concentrations between the race groups. Black-white differences in anti etherogenic high-density lipoprotein-cholesterol were greater than statistically predicted by differences in ApoA lipoprotein levels. The findings are indicative of black-white differences in lipoprotein composition.

Apolipoproteins↗

Steroid 5 alpha-reductase deficiency in a 65-year-old male pseudohermaphrodite: the natural history, ultrastructure of the testes, and evidence for inherited enzyme heterogeneity.

We report a 65-yr-old male pseudohermaphrodite with steroid 5 alpha-reductase deficiency in whom there was no medical intervention before, during, or after puberty, enabling us to observe the natural history of this condition. The affected subject has an android build, with more facial and body hair than in previously described affected adults. Although the subject was raised as a girl, a male gender identity evolved with the events of puberty, but social factors have delayed the complete expression of a male gender role. Plasma levels of dihydrotestosterone and the in vivo conversion of radiolabeled testosterone to dihydrotestosterone were decreased. There was an elevated urinary etiocholanolone to androsterone ratio, typical of the syndrome. Characterization of 5 alpha-reductase enzyme activity in cultured genital skin fibroblasts demonstrated a pattern of enzyme activity distinctly different from three previously described families with this condition. There was decreased enzyme affinity for testosterone and NADPH. Also, the stability of the enzyme to elevated temperature was not protected by NADPH, resulting in rapid disappearance of enzyme activity after inhibition of protein synthesis with cycloheximide. Electron microscopic evaluation of the testes was carried out.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗

Regional cerebral blood flow in patients with Parkinson's disease.

Regional cerebral blood flow (rCBF) was measured by the xenon 133 inhalation method in 60 patients with Parkinson's disease and compared with flow data obtained in 51 age-matched normal control subjects. Mean brain rCBF was significantly reduced in patients with parkinsonism (9.5%, P less than .001). The most marked and significant rCBF decreases were observed in the older patients (18.8%, P less than .001). There was no correlation between degree of rCBF reduction and duration of parkinsonism. Decreases in hemispheric mean rCBF values were similar in both hemispheres even in patients with unilateral signs. The present study provides additional evidence for involvement of the cerebral cortex in Parkinson's disease. The rCBF decline may be associated in part with high prevalence of mental impairment and cortical atrophy and with diminished cerebral metabolic rate due to brain dopamine deficiency in patients with parkinsonism.

Adult↗