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Biomedical subjects

G R Green

Publications and source records attributed to G R Green.

At least 37 records · Page 2Linked to original sources
PubMed1999

Potential mechanism of left ventricular outflow tract obstruction after mitral ring annuloplasty.

OBJECTIVES: The purpose of this study was to explore whether geometric changes that predispose to left ventricular outflow tract obstruction after mitral ring annuloplasty are coupled to subvalvular apparatus disturbances. METHODS: Radiopaque markers were implanted in sheep: 9 in the ventricle, 1 in the high interventricular septum, 1 on each papillary muscle tip, 8 around the mitral anulus, 4 on the anterior mitral leaflet, and 2 on the posterior leaflet. One group served as control (n = 5); the others were randomized to undergo annuloplasty with the Duran ring (n = 6; Medtronic, Inc, Minneapolis, Minn) or Carpentier-Edwards Physio ring (n = 6; Baxter Healthcare Corp, Irvine, Calif). After a 7- to 10-day recovery period, 3-dimensional marker coordinates were measured with biplane videofluoroscopy. RESULTS: At the beginning of ejection, (1) the anterior leaflet was displaced toward the left ventricular outflow tract; (2) the normal atrially flexed anterior anulus was flattened into the left ventricular outflow tract; (3) the posterior anulus was displaced toward the left ventricular outflow tract; (4) the anterior papillary muscle was displaced septally; and (5) the posterior papillary muscle was dislocated inwardly toward the anterior papillary muscle in the Physio ring group compared with the control group. During ejection, all these structures moved septally, encroaching further on the left ventricular outflow tract. In the Duran ring group, only the posterior anulus was displaced toward the left ventricular outflow tract; the anterior leaflet was not displaced toward the left ventricular outflow tract, and it did not move septally during ejection. CONCLUSIONS: The semirigid Physio ring was associated with perturbations in annular dynamics that caused changes in papillary muscle geometry. We propose an integrated valvular-subvalvular mechanism to explain displacement of the anterior leaflet into the left ventricular outflow tract after mitral ring annuloplasty.

Animals↗
PubMed1999

Mitral annular size and shape in sheep with annuloplasty rings.

BACKGROUND: Mitral annuloplasty is an important element of most mitral repairs, yet the effects of various types of annuloplasty rings on mitral annular dynamics are still debated. Recent studies suggest that flexible rings preserve physiologic mitral annular area change during the cardiac cycle, while rigid rings do not. METHODS: To clarify the effects of mitral ring annuloplasty on mitral annular dynamic geometry, we sutured 8 radiopaque markers equidistantly around the mitral anulus in 3 groups of sheep (n = 7 each: no ring, Carpentier-Edwards semi-rigid Physio-Ring [Baxter Healthcare Corp, Edwards Division, Santa Ana, Calif], and Duran flexible ring [Medtronic, Inc, Minneapolis, Minn]). Ring sizes were selected according to anterior leaflet area and inter-trigonal distance (Physio-Ring 28 mm, n = 7; Duran ring 31 mm, n = 5, and 29 mm, n = 2). After 8 +/- 1 days of recovery, the sheep were sedated and studied by means of biplane videofluoroscopy. Mitral annular area was calculated from 3-dimensional marker coordinates without assuming circular or planar geometry. RESULTS: In the no ring group, mitral annular area varied during the cardiac cycle by 11% +/- 2% (mean +/- SEM; maximum = 7.6 +/- 0.2, minimum = 6.8 +/- 0.2 cm2; P </=.001). Mitral annular area was fixed in the Physio-Ring group (4. 6 +/- 0.1 cm2) and, surprisingly, also static in the Duran ring group (4.8 +/- 0.1 cm2; P =.26 vs Physio-Ring). Furthermore, mitral annular 3-dimensional shape changed in the no-ring group during the cardiac cycle, but not in the Physio-Ring or Duran groups. CONCLUSIONS: Mitral annular area and shape did not change during the cardiac cycle after ring annuloplasty, regardless of ring type. Thus mitral annular area reduction, independent of intrinsic ring flexibility, is the chief mechanism responsible for the salutary effects of mitral ring annuloplasty.

Analysis of Variance↗
PubMed1998

Semirigid or flexible mitral annuloplasty rings do not affect global or basal regional left ventricular systolic function.

BACKGROUND: Previous studies have revealed that rigid mitral annuloplasty rings may be associated with left ventricular (LV) systolic dysfunction, but whether ring type affects regional systolic function at the base of the LV, in the region near the mitral annulus, is unclear. We tested the hypothesis that rigid fixation of the mitral annulus results in significant regional systolic dysfunction at the base of the LV. METHODS AND RESULTS: Twenty-six adult male sheep underwent placement of 13 miniature tantalum markers into the LV epicardium and around the mitral annulus to allow calculation of LV volume and regional epicardial area. Group I (n = 7) sheep served as controls; animals randomized to groups II (n = 11) and III (n = 8) underwent mitral annuloplasty with either a semirigid or flexible ring, respectively. After a 7- to 10-day recovery period, animals were studied in a closed-chest, sedated, autonomically blocked state. Global LV systolic function (end-systolic elastance and preload recruitable stroke work) were not significantly different among the 3 groups (P = 1.0, ANOVA). Regional systolic function at the base of the LV (fractional area shrinkage [FAS] of 4 epicardial areas) at comparable LV preload and afterload was similar in the 4 basal areas (P = 0.223, MANOVA). With the use of load-insensitive indexes (slope and area intercept of the end-systolic pressure-regional area relationship and regional stroke work-end-diastolic area relationship), regional systolic function also was not different between groups at baseline or with inotropic stimulation in any basal region (P > 0.05, MANOVA). Furthermore, neither annuloplasty ring perturbed the regional pattern of basal LV systolic function. CONCLUSIONS: Postoperative LV systolic function, both globally and in the region of the base of the LV (near the mitral annulus), was not altered with either semirigid or flexible ring fixation of the mitral annulus.

Animals↗
PubMed1998

Estimation of regional left ventricular wall stresses in intact canine hearts.

Left ventricular (LV) wall stress is an important element in the assessment of LV systolic function; however, a reproducible technique to determine instantaneous local or regional wall stress has not been developed. Fourteen dogs underwent placement of twenty-six myocardial markers into the ventricle and septum. One week later, marker images were obtained using high-speed biplane videofluoroscopy under awake, sedated, atrially paced baseline conditions and after inotropic stimulation (calcium). With a model taking into account LV pressure, regional wall thickness, and meridional and circumferential regional radii of curvature, we computed average midwall stress for each of nine LV sites. Regional end-systolic and maximal LV wall stress were heterogeneous and dependent on latitude (increasing from apex to base, P < 0.001) and specific wall (anterior > lateral and posterior wall stresses; P = 0. 002). Multivariate ANOVA demonstrated only a trend (P = 0.056) toward increased LV stress after calcium infusion; subsequent univariate analysis isolated significant increases in end-systolic LV wall stress with increased inotropic state at all sites except the equatorial regions. The model used in this analysis incorporates local geometric factors and provides a reasonable estimate of regional LV wall stress compared with previous studies. LV wall stress is heterogeneous and dependent on the particular LV site of interest. Variation in wall stress may be caused by anatomic differences and/or extrinsic interactions between LV sites, i.e., influences of the papillary muscles and the interventricular septum.

Animals↗
PubMed1998

Effects of partial left ventriculectomy on left ventricular geometry and wall stress in excised porcine hearts.

BACKGROUND AND AIMS OF THE STUDY: Partial left ventriculectomy (PLV, the "Batista procedure") has received recent attention as a surgical treatment for patients with dilated cardiomyopathy and end-stage congestive heart failure; however, the mechanisms responsible for the purported short-term improvement in left ventricular (LV) function are poorly characterized. This study examined the effects of PLV on three-dimensional (3-D) LV geometry, wall stress and passive LV mechanics in excised porcine hearts. METHODS: Thirty-three radio-opaque tantalum markers were placed into the LV wall of nine freshly excised, porcine hearts (arrested with cold crystalloid cardioplegia) to measure three dimensional LV geometry and volume. Simultaneous biplane video-fluoroscopic marker images and LV pressure (LVP) were obtained over a wide range of LV volumes generated with an intracavitary LV balloon. Measurements were repeated after excision of a diamond-shaped wedge of the lateral LV wall between the papillary muscles (mean: 8 x 3 x 2 cm; 10 +/- 2% of LV mass). RESULTS: Following PLV, the ventricle assumed a more elliptical shape (LV eccentricity rose from 0.71 +/- 0.15 to 0.81 +/- 0.09, p < 0.01). Circumferential radius of curvature fell in the anterior, lateral and posterior regions at the equatorial level (p < 0.01), while the posterior wall longitudinal radius of curvature increased at the basal, equatorial and apical levels (p < 0.01). No change in the longitudinal radius of curvature was observed in the other walls. These changes were associated with a fall in average equatorial LV wall stress from 176 +/- 34 to 159 +/- 30 kdyne/cm2 (p < 0.02). Myocardial stiffness (slope of the LV stress-strain relation) fell from 12.4 +/- 4.0 to 10.0 +/- 3.4 (p < 0.004), indicating lower global LV wall stress at any given LV size. CONCLUSIONS: In flaccid porcine hearts, the left ventricle became more elliptical and chamber size decreased after PLV, which resulted in lower regional LV wall stress and myocardial stiffness. LV ellipticalization may improve systolic LV performance by decreasing regional LV afterload (e.g., systolic wall stress), which would thereby lower myocardial oxygen consumption and improve LV pump efficiency.

Animals↗
PubMed1997

Continuing dilemmas concerning aortic valve replacement in patients with advanced left ventricular systolic dysfunction.

Aortic valve replacement in patients with aortic stenosis or aortic regurgitation who have severe left ventricular (LV) systolic dysfunction continues to be associated with a high mortality risk despite surgical, cardiological and anesthetic improvements over time. As a result of earlier surgical referral, however, fewer patients with aortic regurgitation (AR) and advanced LV failure present for operation today. Favorable operative and long-term results, and data demonstrating recovery of LV systolic function if patients are referred prior to the onset of systolic dysfunction have largely solved this problem in the context of AR. On the other hand, patients with critical aortic stenosis (AS) and severe LV systolic dysfunction constitute a more heterogeneous and even more challenging group. On one side of the continuum, patients with truly critical AS and low ejection fraction due to LV 'afterload mismatch' (depressed ejection performance resulting from excessively high systolic LV wall stress secondary to a very tight valve) generally respond well to aortic valve replacement, which immediately normalizes LV afterload. Conversely, patients with 'critical' aortic stenosis and advanced LV systolic dysfunction who present with a low transvalvular gradient and cardiac output constitute a subgroup at high operative risk, which also has a suboptimal prognosis after aortic valve replacement. This clinical situation has been termed the 'Gorlin Conundrum', and is punctuated by a low mean transvalvular gradient and low flow. The reason for the low transvalvular gradient is not always known, but can be secondary to some type of coexistent cardiomyopathy. Patients with only mild pathologic aortic valve sclerosis/stenosis and markedly depressed LV systolic function are frequently judged to have 'critical' aortic stenosis (AVA < 0.8 cm2 or AVAI < 0.4 cm2/m2) due to inherent flaws in the Gorlin equation and limitations of the Doppler continuity equation. Although alternative diagnostic techniques have been proposed, e.g. aortic valve resistance, stroke work loss, none has yet proven to be totally reliable. The suboptimal results of aortic valve replacement in low-gradient AS patients underscore our difficulty in currently predicting which patients will benefit from valve replacement. Newer diagnostic techniques, including dobutamine echocardiography, and novel new findings regarding the basic molecular mechanisms responsible for contractile dysfunction in pressure overload hypertrophy may ultimately improve the results of surgical treatment in these patients.

Aortic Valve Insufficiency↗
PubMed1996

Assessment tools: small area analysis.

Small area analysis, the examination of geographic variation in the medical care utilization of populations, provides a method for analyzing medical care resource use and can lead to improved medical care. Variations in rates of hospital admissions for most common causes of hospitalization are related to differences in the supply of medical care resources, such as hospital beds, and uncertainty in the outcomes of different diagnostic and therapeutic procedures. Introducing clinicians to practice variation can lead to process improvements. The article describes small area analysis and the limitations of this methodology.

Data Collection↗
PubMed1995

Histone phosphorylation during sea urchin development.

Studies on histone phosphorylation during transitions in chromatin structure occurring in vivo during spermatogenesis and early embryogenesis in sea urchins are reviewed and evaluated in the light of recent studies on histone phosphorylation occurring during chromatin synthesis in frog egg extracts in vitro and evidence that protein kinases and phosphatases play direct roles in the regulation of cellular structure. Sperm-specific histone variants Sp H1 and Sp H2B are maintained as phosphorylated derivatives N and O/P throughout spermatogenesis and early embryogenesis and egg specific histone variants CS H1 and CS H2A are phosphorylated during early embryogenesis. These developmental correlations provide clues about the roles of histone phosphorylation in control of chromatin structure in vivo and provide a basis for the interpretation of data obtained from in-vitro sperm chromatin remodeling in egg extracts and from biochemical studies on the effects of histone phosphorylation on DNA binding. The potential consequences for chromatin structure of the various histone phosphorylation events observed in sea urchins and frog egg extracts are discussed.

Animals↗
PubMed1994

Synthesis and processing of mammalian protamines and transition proteins.

Mouse and rat seminiferous tubule fragment cultures were used to examine synthesis and processing of mammalian protamines and transition proteins. The tubule fragments were incubated with [3H]-arginine, [3H]-histidine, [35S]-cysteine, or [32P]-PO4, and radiolabeled proteins were analyzed by acid/urea polyacrylamide gel electrophoresis and fluorography or autoradiography. Newly synthesized protamines were recovered from sonication-resistant nuclei (SRN) and could not be detected in cytoplasmic fractions, indicating that protamines are deposited into nuclei immediately after synthesis. Newly synthesized mouse protamine 1 (mP1) and the precursor to mouse protamine 2 (pre-mP2) migrated more slowly during electrophoresis than their predominant testicular forms, identified by staining with Coomassie blue R-250. Within 1 hour of synthesis, the electrophoretic mobilities of mP1 and pre-mP2 increased to match those of their predominant forms. These changes are consistent with initial charge-neutralizing modifications of the newly synthesized protamines, followed by removal of at least some of the modifying ligands, to unmask protamine basicity. Steady-state phosphorylation rates were high for rat protamine 1 (rP1) and were independent of phosphate content; both rP1 molecules of low and high phosphate content were rapidly phosphorylated. Pre-mP2-3, a major processing intermediate derived by proteolysis of pre-mP2, was also rapidly phosphorylated. Like the protamines, transition protein 2 (TP2) was rapidly phosphorylated and increased in electrophoretic mobility soon after synthesis. In contrast, transition protein 1 (TP1) was not phosphorylated and did not exhibit multiple electrophoretic forms.

Animals↗
PubMed1993

Phosphorylation weakens DNA binding by peptides containing multiple "SPKK" sequences.

Sea urchin testis-specific H1 and H2B histones (Sp H1 and Sp H2B) are characterized by reversibly phosphorylated N-terminal regions consisting largely of multiple clustered "SPKK" tetrapeptides (serine-proline adjacent to two basic amino acids). This report presents data showing differences in DNA affinities between peptides containing dephosphorylated and phosphorylated N-terminal regions. Sp H1 and its phosphorylated derivative (pSp H1) were purified by hydroxylapatite chromatography. Peptides containing the N-terminal regions of Sp H1 and pSp H1 (NP and pNP, respectively) were produced by digestion with Staphylococcus aureus protease. NP and two forms of pNP differing in phosphate content were purified by DNA-cellulose chromatography. The DNA affinities of the peptides were compared using several criteria. NP was bound more tightly by DNA-cellulose than pNPs. NP precipitated DNA under a broad range of NaCl concentrations; pNPs did not. Both NP and pNPs protected DNA against thermal denaturation, but NP created a more stable DNA-peptide complex. Thirty to sixty times more pNP than NP was required to obtain equivalent inhibition of Hoechst 33258 binding to DNA. NP did not behave as a competitive inhibitor of DNA binding by Hoechst 33258 binding to DNA. We conclude that during spermatogenesis, dephosphorylation of the Sp H1 N-terminal region increases its basicity and thus its affinity for DNA.

Amino Acid Sequence↗
PubMed1992

Packaging and unpackaging the sea urchin sperm genome.

Two species of histones in sea urchin sperm (Sp H1 and Sp H2B) are chimeric molecules whose highly basic amino-terminal domains are dephosphorylated at the last stage of sperm cell differentiation, and rephosphorylated immediately following fertilization. The phosphorylated regions consist largely of repeating tetrapeptides with two basic residues flanking Ser-Pro residues ('SPKK' motifs) and are predicted to have beta-turn secondary structures. Alteration of the charge and structure of the SPKK sites may play a role in the unusually dense DNA packaging of the mature sperm chromatin. The motif resembles the target site of cell-cycle-associated cdc2 kinases and is found in several other proteins whose nucleic acid affinities may be altered during the cell cycle.

Amino Acid Sequence↗
PubMed1991

A complex pattern of H2A phosphorylation in the mouse testis.

Phosphorylation of H2A histones in mouse testis was examined using testis tubule cultures labeled with 32PO4. Histones were analyzed by two systems of two-dimensional polyacrylamide gel electrophoresis, followed by autoradiography of the gels. Of the 32PO4 detected in histones, 95% was incorporated by certain modified forms of the H2A variants H2A.1 and H2A.X. Phosphorylation sites were mapped to N- and C-terminal regions of the modified variants by SDS gel electrophoresis and autoradiography of peptides generated by cleavage of in vitro-labeled proteins with N-bromosuccinimide. Incorporation rates differed for N- and C-terminal regions from different modified forms, demonstrating a complex pattern of H2A phosphorylation in the mouse testis.

Animals↗
PubMed1990

Sperm histones and chromatin structure of the "primitive" sea urchin Eucidaris tribuloides.

The "primitive" sea urchin Eucidaris tribuloides resembles the advanced sea urchins (euechinoids) in many respects, yet some features of its biochemistry and morphogenesis are more similar to other echinoderms such as starfish or sea cucumbers. Two unique characteristics of the sperm chromatin of all known euechinoids are an extremely long average nucleosomal repeat length and the presence of two male germ-line-specific histone variants, Sp H1 and Sp H2B. Histone composition and nucleosomal repeat length of the sperm chromatin of Eucidaris were compared to those of several euechinoids and a starfish. Eucidaris sperm chromatin contained large H1 and H2B histone variants typical of euechinoids. The H1 was about nine amino acids smaller than Sp H1 of the advanced urchin Strongylocentrotus purpuratus. Its Sp H2B molecules were the same size as in the euechinoids. Peptide maps showed that N-terminal regions of Sp H1 and Sp H2B contained repeating basic amino acid motifs characteristic of euechinoids. The smaller size of Eucidaris H1 is accounted for by a smaller C-terminal region. The repeat length of Eucidaris sperm chromatin was slightly shorter than that of two euechinoids, but significantly larger than starfish, which lacks a large H2B. The Sp H2B gene of Eucidaris was expressed during spermatogenesis in the same cell types as for S. purpuratus. Thus Sp histone subtype expression and chromatin structure in this distantly related echinoid closely resemble the euechinoids. The presence of an Sp H2B and a very long repeat length appear to be characteristic of the echinoids only.

Amino Acid Sequence↗
PubMed1990

6DMAP inhibits chromatin decondensation but not sperm histone kinase in sea urchin male pronuclei.

Treatment of sea urchin eggs for 10 min prior to fertilization with the kinase inhibitor 6DMAP (6-dimethylaminopurine) reversibly inhibits swelling and loss of conical morphology of the male pronucleus. Male pronuclei inhibited with 1 mM 6DMAP for 25 min undergo phosphorylation of Sp H1 and Sp H2B histones as fully as do control nuclei. Therefore, Sp histone kinase, whose target sequences resemble those of the M-phase histone kinase, is not inhibited by 6DMAP, and Sp histone phosphorylation, although it may be necessary, is not sufficient for chromatin decondensation.

Adenine↗
PubMed1990

Phosphorylation of Plant H2A Histones.

Phosphorylation of wheat (Triticum aestivum) and alfalfa (Medicago sativa) H2A histone variants was examined during early seedling growth. The C-terminal regions of wheat H2A variants contain multiple S-P tetrapeptides (serine-proline adjacent to a pair of basic amino acids) which resemble known phosphorylation sites in histones from other species. Phosphorylation of nucleosomal core histones was assessed by autoradiography of proteins labeled in vivo with (32)Pi and resolved by two-dimensional polyacrylamide gel electrophoresis, and phosphorylation sites were mapped by cleaving in vivo labeled H2A variants with N-bromosuccinimide. Essentially all phosphorylation of nucleosomal core histones in wheat and alfalfa seedlings occurred within the C-terminal peptides obtained from wheat and alfalfa H2A variants. A hypothesis accounting for the presence of large H2A and H2B histone variants in plants and phosphorylation of plant H2A C-terminal regions is proposed. The utility of S-P tetrapeptides for modulation of DNA-protein interactions is discussed.

Journal Article↗
PubMed1989

Phosphorylation of sea urchin histone CS H2A.

Phosphorylation of cleavage stage (CS) histones was studied during the first cell cycle in male pronuclei of the sea urchin. Histone CS H2A rapidly incorporated 32PO4 during the replication period, but not before. Peptide mapping and amino acid analysis of radiolabelled CS H2A showed that phosphorylation occurred mainly on serine residues located in the C-terminal region of the molecule. When DNA replication was inhibited with aphidicolin both CS H2A and CS H2B accumulated in male pronuclei at the same rate as in the control culture, whereas accumulation of H3 and H4 histones was reduced. Incorporation of 32PO4 by CS H2A doubled when DNA synthesis was inhibited with aphidicolin. Thus phosphorylation of CS H2A was correlated with transport of CS histones from the egg storage pool to the male pronucleus, but not with chromatin synthesis, indicating that this event precedes nucleosome formation. A role for phosphorylation and dephosphorylation of the CS H2A C-terminal region in modulating transport of stored CS histone dimers and their assembly into nucleosomes is discussed.

Amino Acid Sequence↗
PubMed1988

Interaction of sperm histone variants and linker DNA during spermiogenesis in the sea urchin.

Several physical properties of sea urchin spermatid chromatin, which contains phosphorylated Sp H1 and Sp H2B histone variants, and mature sperm chromatin, in which these histones are dephosphorylated, were compared. Density, thermal stability, average nucleosomal repeat length, and resistance to micrococcal nuclease digestion are all increased in mature sperm relative to spermatid chromatin. Since the chromatins are identical in histone variant subtypes, the altered physical properties are not a consequence of changes in histone primary structure during spermiogenesis. The data are interpreted to mean that dephosphorylation of the N-terminal regions of Sp H1 and Sp H2B in late spermatid nuclei permits strong ionic binding of these highly basic regions to the extended linker, stabilizing the highly condensed structure of sperm chromatin.

Animals↗