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Biomedical subjects

H C Yang

Publications and source records attributed to H C Yang.

At least 55 records · Page 3Linked to original sources

Phospholipase A2 and its role in brain tissue.

Phospholipase A2 (PLA2) is the name for the class of lipolytic enzymes that hydrolyze the acyl group from the sn-2 position of glycerophospholipids, generating free fatty acids and lysophospholipids. The products of the PLA2-catalyzed reaction can potentially act as second messengers themselves, or be further metabolized to eicosanoids, platelet-activating factor, and lysophosphatidic acid. All of these are recognized as bioactive lipids that can potentially alter many ongoing cellular processes. The presence of PLA2 in the central nervous system, accompanied by the relatively large quantity of potential substrate, poses an interesting dilemma as to the role PLA2 has during both physiologic and pathologic states. Several different PLA2 enzymes exist in brain, some of which have been partially characterized. They are classified into two subtypes, Ca2+-dependent and Ca2+-independent, based on their catalytic dependence on Ca2+. Under physiologic conditions, PLA2 may be involved in phospholipid turnover, membrane remodeling, exocytosis, detoxification of phospholipid peroxides, and neurotransmitter release. However, under pathological situations, increased PLA2 activity may result in the loss of essential membrane glycerophospholipids, resulting in altered membrane permeability, ion homeostasis, increased free fatty acid release, and the accumulation of lipid peroxides. These processes, along with loss of ATP, may be responsible for the loss of membrane phospholipid and subsequent neuronal injury found in ischemia, spinal cord injury, and other neurodegenerative diseases. This review outlines the current knowledge of the PLA2 found in the central nervous system and attempts to define the role of PLA2 during both physiologic and pathologic conditions.

Animals↗

Recurrent type I membranoproliferative glomerulonephritis after renal transplantation and protective role of cyclosporine in acute crescentic transformation.

Almost all diseases affecting the native kidney may recur in the transplanted kidney, with one of the most frequent being recurrent glomerulonephritis. Among the glomerulonephritides, membranoproliferative glomerulonephritis (MPGN), immunoglobulin A nephropathy (IgA), and focal-segmental glomerulosclerosis (FSGS) have the highest rates of recurrence. Here we report a patient who, after living-related kidney transplantation, suffered allograft loss shortly after surgery due to recurrence of glomerulonephritis. Two weeks prior to transplant nephrectomy light microscopic examination of the allograft biopsy failed to show glomerulonephritis. Subsequent histopathology of the transplant nephrectomy specimen demonstrated a crescentic form of type I MPGN following withdrawal of cyclosporin A (CsA) and intense course or oral steroid therapy. The entity of recurrent type I MPGN in kidney transplantation is reviewed, and a possible protective role of CsA against rapidly progressive crescentic type I MPGN is explored.

Cyclosporine↗

Technetium-99m-MAG3 scintigraphy in acute renal failure after transplantation: a marker of viability and prognosis.

UNLABELLED: This study assessed 99mTc-mercaptoacetyltriglycine (MAG3) for determination of renal transplant prognosis for recovery in patients with early postoperative dysfunction. The postulate tested was that good tracer extraction may imply high likelihood of recovery, while poor extraction may confer a poor prognosis. METHODS: A 2-min image acquired 1 min after MAG3 administration, named a cortical uptake phase (CUP) image, was visually analyzed according to standardized semiquantitative guidelines. Interpretation was expressed in tubular injury severity scores (TISS) that ranged from 1 (a normally functioning renal transplant) to 6 (a photopenic defect in place of renal transplant). RESULTS: The study analyzed 64 patients (35 men, 29 women, age 45.9 +/- 14 yr). All five patients with TISS of 6 or 5 lost the transplant. Only 1 of 10 patients with TISS of 4 lost the transplant. All patients with TISS of less than 4 recovered renal transplant function. CONCLUSION: This study suggests that MAG3 scan (the CUP image specifically) is an accurate prognosticator in patients with early postoperative renal transplant dysfunction. Reproduction of these results in a larger population and other institutions is necessary before clinical implementation of this methodology.

Acute Kidney Injury↗

Successful reversal of acute vascular rejection in a renal allograft with combined mycophenolate mofetil and tacrolimus as primary immunotherapy.

Despite the use of newer immunosuppressive drugs, early allograft rejection is still a major cause of graft loss and diminished graft survival. The pathological picture of acute interstitial rejection usually responds to high dose steroids, whereas the treatment of acute vascular (AVR) rejection characterized by an intense vasculitis and/or endotheliolitis is more formidable. The use of newer monoclonal antibodies specific for T lymphocytes and their subsets has only been occasionally successful in reversing AVR. Here we report a case of successful reversal of acute vascular renal allograft rejection with mycophenolate mofetil (MMF) and tacrolimus as primary therapy.

Adult↗

Pure red cell aplasia due to parvovirus B19 infection in solid organ transplantation.

Human parvovirus B19 disease is an infrequent but recognized rare cause of anemia in immunocompromised patients. A few cases of parvovirus B19 infections have been reported in transplant recipients, of those only four patients underwent renal transplantation. The primary immunosuppressive therapy in these patients included prednisone with either cyclosporine or tacrolimus. In one patient the disease was self-limiting, while in three others the hematocrit improved following 10-15 d of treatment with commercial intravenous immunoglobulin (IVIG). Herein, we report the fifth case of pure red cell aplasia due to parvovirus B19 infection in a renal transplant recipient who responded to a 5-d course of IVIG. To our knowledge, this is the first case of parvovirus B19 infection in a patient with solid-organ transplantation whose immunosuppressive regimen included both mycophenolate mofetil and tacrolimus and in whom an excellent clinical response was achieved with a short course of IVIG infusion.

Adult↗

Efficacy of oral ganciclovir in prevention of cytomegalovirus infection in post-kidney transplant patients.

Unlike parenteral gancicovir, the efficacy of oral ganciclovir in the prevention and treatment of cytomegalovirus (CMV) infection in kidney transplantation has not been well documented. This study prospectively evaluated the episodes of CMV infection within the first nine months after transplantation in renal transplant recipients treated prophylactically with oral ganciclovir (750 mg twice a day) over a period of 3 months (oral ganciclovir, N = 22), compared with patients randomly assigned as controls (controls, N = 22) who did not receive any anti-viral prophylaxis. Diagnosis of CMV infection at presentation included serological determination of CMV-specific immunoglobulin M antibodies, CMV immunofluorescence assay [standard culture tube and shell vial] (blood) and virus isolation (urine and tissue). CMV infection occurred in one patient (5%) in the oral ganciclovir group and 6 patients (27%) in the control group (p < 0.05). The episodes of biopsy proven allograft rejections were 5% (1/21) and 18% (4/22) in the oral ganciclovir and control groups, respectively. Except for one, none of these patients developed CMV infection either before or after rejection(s). Controlling for the reason (induction or treatment of rejection) for using cytolytic antibody therapies, we found that prophylactic oral ganciclovir was protective against CMV infection (adjusted risk reduction 0.83; 95% confidence interval, 0.33-0.98; p < 0.05). Neither, the CMV status of donors and recipients nor the treatment for acute rejection had any significant impact on the occurrence of CMV infections. Our results show that oral ganciclovir is an effective and well tolerated therapy in the prevention of CMV infection in renal transplant patients.

Administration, Oral↗

Characterization of plasmalogen-selective phospholipase A2 from bovine brain.

Plasmalogens are hydrolyzed by a plasmalogen-selective phospholipase A2. This enzyme, purified from bovine brain, does not require Ca2+ and is localized in cytosol. It has a molecular mass of 39 kDa and is strongly inhibited by glycosaminoglycans, gangliosides, and sialoglycoproteins. These molecules may be involved in the regulation of its enzymic activity. Plasmalogen-selective phospholipase A2 plays an important role in the release of free fatty acids and platelet-activating factor during trauma.

Animals↗

Plasmalogen-selective phospholipase A2 and its role in signal transduction.

The breakdown of plasmalogens in neural membranes is a receptor-mediated process catalyzed by a plasmalogen-selective phospholipase A2. This enzyme has been isolated from bovine brain. It is localized in cytosol and does not require Ca2+ for its activity. It has a molecular weight of 39 kDa and is strongly inhibited by glycosaminoglycans, gangliosides and sialoglycoproteins. The interactions between plasmalogen-selective phospholipase A2 and glycoconjugates may be involved in the regulation of enzymic activity. Under normal conditions, plasmalogen-selective phospholipase A2 provides second messengers such as arachidonic acid and eicosanoids. However, under pathological conditions, this enzyme may be involved in a massive release of free fatty acids that may cause serious cell and tissue damage.

Animals↗

Adverse effect of donor vasopressor support on immediate and one-year kidney allograft function.

BACKGROUND: This purpose of this study was to determine if there was a significant difference between the rates of acute tubular necrosis (ATN) and long-term graft survival in renal allografts procured from donors requiring inotropic support (DRIS) and those from donors not requiring inotropic support. METHODS: Eighty-two consecutive cadaveric renal transplant patients were prospectively followed in our local procurement area, the Delaware Valley Transplant Program. Forty-eight patients received organs from DRIS (> 10 mcg/kg per minute of dopamine, dobutamine, epinephrine, and norepinephrine alone or in combination), and 34 did not. RESULTS: Allografts from the non-DRIS group had an immediate function rate of 82.4% and a 1-year function rate of 91.2%. In comparison, the DRIS grafts had an immediate function rate of 58.3% and a 1-year function rate of 72.9%. These differences were statistically significant. The mean serum creatinine in the non-DRIS group was 1.46 +/- 0.58 mg/dl, whereas in the DRIS cohort it was 1.89 +/- 0.93 mg/dl. CONCLUSIONS: Kidneys transplanted from DRIS had significantly (1) poorer immediate function, (2) worse 1-year survival rates, and (3) higher serum creatinine at 1 year. We conclude that recipients receiving organs from donors requiring inotropic support are at a higher risk of developing ATN after surgery and experience reduced 1-year function.

Adolescent↗

Effect of use of vasopressors in organ donors on immediate function of renal allografts.

The purpose of this study was to determine whether use of vasopressors in cadaveric donors of renal transplants was associated with an increased prevalence of acute tubular necrosis after kidney transplantation. We compared immediate allograft function in 26 consecutive renal allograft recipients whose donors had been given vasopressors with that in 26 recipients whose donors had nor. The donors treated with vasopressors had been given more than 10 micrograms/kg per minute of dopamine, norepinephrine, or epinephrine, alone or in combination. The groups were matched with respect to donors' age, recipients' disease, and cold ischemic time. The prevalence of immediate allograft function was significantly lower in recipients whose donors had required use of vasopressors (38.5%) than in recipients whose donors had not required vasopressors (65.4%). We conclude that use of vasopressors in kidney donors leads to an increased prevalence of acute tubular necrosis.

Adolescent↗

In situ expression of platelet-derived growth factor (PDGF-beta) during chronic rejection is abolished by retransplantation.

We have shown that Fischer 344-->Lewis renal allografts (ALLO) develop chronic rejection which is not detected in Lewis-->Lewis isografts (ISO). The progression of chronic rejection in ALLO can be reversed by retransplantation (RE-TX) of kidneys from ALLO back into syngeneic Fischer 344 recipients. The purpose of this study was to assess the in situ expression of PDGF-beta, a cytokine associated with wound injury, in ISO, ALLO, and RE-TX. In situ PDGF-beta mRNA expression in kidney sections was assessed early (8 weeks) and late (16 weeks) during the development of chronic rejection. Kidneys from ALLO were transplanted back into syngeneic Fischer recipients at 12 weeks and evaluated for PDGF-beta expression 12 weeks later. Differences in glomerular staining were graded quantitatively on a minimum of 25 glomeruli per section with grade 0, no positive cells in the glomerulus; grade 1, 1 or 2 positive cells; grade 2, 3 or more positive cells in a segmental distribution; and grade 3, > 4 positive cells of moderate intensity in a diffuse distribution. According to this grading system, glomerular PDGF-beta mRNA expression in isografts (N = 6) at 8 and 16 weeks after transplantation was 0.09 +/- 0.03 and 0.2 +/- 0.04, respectively. In allografts (N = 6), PDGF-beta mRNA was significantly higher (P < .001) for the same time periods, 1.28 +/- 0.6 and 1.89 +/- 0.08, respectively. In situ expression of PDGF in retransplants (N = 6) at 24 weeks, 0.07 +/- 0.02, was significantly diminished (P < .001) at 24 weeks compared to allografts at 8 or 16 weeks.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Plasmalogens, phospholipases A2 and signal transduction.

Several lines of evidence indicate that the breakdown of plasmalogens in neural membranes during neurodegenerative diseases is a receptor-mediated process catalyzed by a plasmalogen-selective phospholipase A2. This enzyme has recently been purified from bovine brain. It does not require Ca2+ and is localized in cytosol. It has a molecular mass of 39 kDa and is strongly inhibited by glycosaminoglycans, with the pattern of inhibition being heparan sulfate > hyaluronic acid > chondroitin sulfate > heparin. This plasmalogen-selective phospholipase A2 is also inhibited by gangliosides and sialoglycoproteins. Substrate specificity and the effects of metal ions, detergents and inhibitors suggest that this phospholipase A2 is different from the well-known 85 kDa Ca(2+)-dependent cytosolic phospholipase A2 that has recently been cloned and is not plasmalogen-selective. The plasmalogen-selective phospholipase A2 may be regulated by glycosaminoglycans and sialoglycoconjugates and may be involved in the regulation of K+ channels. This enzyme, which plays a major role in the release of fatty acids during ischemic injury and reperfusion, shows promise as a major target for drug therapy.

Animals↗

Purification of lipases, phospholipases and kinases by heparin-Sepharose chromatography.

Heparin interacts with lipases, phospholipases and kinases. Immobilized heparin can be used for the purification of diacylglycerol and triacylglycerol lipases, phospholipases A2 and C and protein and lipid kinases. The use of heparin-Sepharose is an important development in analytical and preparative techniques for the separation and isolation of lipases, phospholipases and kinases.

Animals↗

Effects of glycosaminoglycans and glycosphingolipids on cytosolic phospholipases A2 from bovine brain.

Two forms of Ca(2+)-independent cytosolic phospholipase A2 activity (110 kDa and 39 kDa) were found in bovine brain. They were separated by Sephadex G-75 column chromatography. The 110 kDa phospholipase A2 was much more active with phosphatidylethanolamine and was not affected by glycosaminoglycans, whereas the 39 kDa phospholipase A2 was much more active with ethanolamine plasmalogen and was markedly inhibited by glycosaminoglycans. Heparan sulphate was the most potent inhibitor, followed by chondroitin sulphate, hyaluronic acid and heparin. Gangliosides, especially the GM3 ganglioside, but not other glycosphingolipids, inhibited the activity of the 39 kDa phospholipase A2 in a dose-dependent manner. The heat-inactivation profiles of the 110 kDa and 39 kDa phospholipases A2 provide further evidence for the differences between these cytosolic enzymes. Interactions between glycosaminoglycans, gangliosides and phospholipases A2 may be involved in the maintenance of membrane function.

Animals↗

Effects of sialic acid and sialoglycoconjugates on cytosolic phospholipases A2 from bovine brain.

Two forms of Ca(2+)-independent cytosolic phospholipases A2 were separated by Sephadex G-75 column chromatography. N-Acetylneuraminic acid, gangliosides, and sialoglycoproteins inhibited both phospholipases A2 in a concentration dependent manner, but colominic acid, poly(2,8-N-acetylneuraminic acid), had no effect on enzymic activities. Interactions between phospholipases A2 and sialoglycoconjugates may be involved in the translocation of phospholipases A2 from cytosol to plasma membrane during receptor stimulation.

Animals↗

Calmodulin interaction with the skeletal muscle sarcoplasmic reticulum calcium channel protein.

Studies were initiated to define the equilibria of calmodulin binding to the skeletal muscle sarcoplasmic reticulum (SR) Ca(2+)-release channel protein in native SR vesicles. Calmodulin affinity-labeling experiments indicated that the major calmodulin receptor in heavy SR preparations was a protein of M(r) > 450,000, corresponding to the Ca(2+)-release channel protein. [3H]Ryanodine-binding assays indicated 10.6 +/- 0.9 pmol of high-affinity ryanodine binding per milligram of SR protein. Wheat germ calmodulin was derivatized with rhodamine-x-maleimide. The affinity and binding capacity of the channel protein in SR vesicles for the derivatized calmodulin (Rh-CaM) were determined by fluorescence anisotropy in the presence of (1) 1 mM EGTA, (2) 0.1 mM CaCl2, and (3) 0.1 mM CaCl2 plus 1 mM MgCl2. In the presence of EGTA, Rh-CaM bound to the channel protein with a Kd of 8.6 +/- 0.8 nM and a Bmax of 229 +/- 7 pmol/mg, suggesting that calmodulin binds to the channel protein at [Ca2+] comparable to that in resting muscle. In the presence of 0.1 mM CaCl2, the binding equilibrium shifted to a two-site ligand-binding model; the high-affinity class of sites had a Bmax1 of 54 +/- 7 pmol/mg and a Kd1 of 4.3 +/- 1.1 nM, while the lower affinity class of sites had a Bmax2 of 166 +/- 28 pmol/mg and a Kd2 of 239 +/- 102 nM. In the presence of both Ca2+ and Mg2+, there was a further change in the Rh-CaM/channel protein interaction.(ABSTRACT TRUNCATED AT 250 WORDS)

Affinity Labels↗

Successful identification of acute renal allograft rejection with duplex ultrasonography.

Duplex ultrasonography has met with variable accuracy in identifying acute renal allograft rejection. These published studies have focused on using mathematical indices. We have applied duplex ultrasonography differently by insonating the site of rejection, i.e. renal cortex, to identify by subjective analysis the changes of the velocity spectral patterns. This subjective analysis method was compared to the mathematical indices of diastolic/systolic ratio and pulsatility index in 126 episodes of clinical acute renal allograft rejection which all had biopsy correlation. This present study represents the largest published experience with duplex ultrasonography and renal transplant rejection. Subjective analysis of velocity spectral patterns (SUBJ) resulted in sensitivity of 87%, specificity of 94% and overall accuracy of 88%. This technique was statistically better than the diastolic/systolic ratio (DSR) sensitivity of 40%, specificity of 72% and overall accuracy of 49%, or the pulsatility index (PI) sensitivity of 47%, specificity of 75% and overall accuracy of 55%. The superior results of the subjective analysis technique of duplex ultrasonography to identify acute renal allograft rejection suggests that this diagnostic approach has sufficient accuracy to avoid invasive allograft biopsies.

Acute Disease↗

Photodisruption of deposits on intraocular lens by Nd: YAG laser a case report.

After cataract surgery with intraocular lens (IOL) implantation, there is usually inflammation with deposits on IOL. In rare cases, the deposit may be severe even after medical treatment and require removal by laser or surgery. The case is a 71-year-old woman who received cataract surgery 8 years ago. She had numerous inflammatory deposits on the anterior surface of IOL in the left eye. After photodisruption by Nd:YAG laser with Q-switched/fundamental mode/0.5 mJ/1 pulse per burst/0 defocus/65 bursts and focus on deposits with contact lens, the deposits were cleaned without any complication and the patient's vision improved.

Aged↗