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Biomedical subjects

J H Pratt

Publications and source records attributed to J H Pratt.

At least 55 records · Page 3Linked to original sources
PubMed1990

Obesity and vaginal hysterectomy.

A retrospective study was done of 471 consecutive vaginal hysterectomies done in a three-year period. Three groups of patients--239 normal to 9% overweight, 132 10-24% overweight and 100 greater than or equal to 25% overweight--were compared. Surgical difficulties were similar in all three groups. The more obese patient had a slightly greater incidence of febrile morbidity, stayed one day longer in the hospital and had a minimally greater loss of hemoglobin 48 hours postoperatively. However, obesity per se caused few problems during and after vaginal hysterectomy. The vaginal approach is the procedure of choice for hysterectomy in obese women.

Anemia↗
PubMed1989

Racial differences in aldosterone excretion and plasma aldosterone concentrations in children.

Blacks are more likely to have hypertension, have lower levels of plasma renin activity, and typically consume less potassium than whites. Whether blacks and whites secrete different amounts of aldosterone is less clear. We estimated aldosterone secretion indirectly in 715 children, 249 of whom were black, by measuring their nocturnal rates of urinary excretion of aldosterone. Dietary sodium and potassium intakes were estimated from their excretion rates. The mean (+/- SE) aldosterone-excretion rate was lower in the black children than in the white children (0.045 +/- 0.003 vs. 0.078 +/- 0.004 nmol per micromole of creatinine per kilogram of body weight; P less than 0.001). The potassium-excretion rate was also lower in the black children than in the white children (0.13 +/- 0.01 vs. 0.18 +/- 0.01 mmol per micromole of creatinine per kilogram; P less than 0.001). Aldosterone excretion was highly correlated with potassium excretion (P less than 0.001), but the lower aldosterone-excretion rate in blacks was explained only in part by their lower dietary intake of potassium. Systolic blood pressure was higher in black children (P less than 0.001), as was diastolic pressure (P = 0.037). In a second study of 99 children, the plasma aldosterone level was found to be significantly lower in black children than in white children (230 +/- 30 vs. 400 +/- 30 pmol per liter; P less than 0.001). Plasma renin activity and plasma cortisol levels were the same in both groups. In summary, we found that black children secrete about 40 percent less aldosterone than white children. The role of the lower aldosterone-secretion rate in the genesis of the higher blood pressures observed in black children is not known.

Aldosterone↗
PubMed1989

Beta-adrenergic enhancement of angiotensin II-stimulated aldosterone secretion.

Beta-adrenergic agonists have been shown to stimulate aldosterone secretion. Angiotensin II (AII) is one of the important stimuli of aldosterone secretion; conceivably beta-adrenergic influences affect the stimulatory potential of AII. Using cultured rat adrenal capsules, we found that 10(-7) M epinephrine and 10(-7) M isoproterenol enhanced 10(-7) M AII-stimulated aldosterone production. Propranolol (10(-7) M) completely inhibited the ability of epinephrine to augment the stimulatory actions of AII. In conclusion, beta-adrenergic agonists promote stimulation of aldosterone secretion by AII.

Aldosterone↗
PubMed1989

Evidence that angiotensin-II and potassium collaborate to increase cytosolic calcium and stimulate the secretion of aldosterone.

Angiotensin-II (AII) and potassium (K+) as stimuli of aldosterone secretion enhance each other's stimulatory potential. In the present study we looked for evidence that AII and K+ act through a common mechanism of signal transduction to affect secretion. Bovine adrenal glomerulosa cells were loaded with the calcium (Ca2+) probe aequorin to permit detection over prolonged time periods of the changes in cytosolic Ca2+ that occur in response to AII and K+. Perfusion fractions were collected for simultaneous measurement of aldosterone production rates. AII (10(-7) M) produced an immediate and transient increase in Ca2+, followed by a Ca2+ plateau that remained above baseline for as long as AII was present. An increase in K+ concentration (from 5 to 12 mM) produced a slow and eventually sustained increase in cytosolic Ca2+, which resembled the plateau produced by AII. Nitrendipine (10(-5) M) completely inhibited the secretory response to AII and K+ (during 60-min incubations) and inhibited the typical K+-induced increase in Ca2+. The sustained increase in Ca2+ with AII (the plateau) required extracellular Ca2+ and was proportional to the prevailing extracellular K+ concentration. When glomerulosa cells were incubated with AII, the aldosterone secretory response to K+ was substantially enhanced (P less than 0.001). In summary, stimulation by both AII and K+ resulted in a sustained increase in Ca2+ influx. AII-induced Ca2+ influx was dependent on the ambient K+ concentration. These results indicate that AII and K+ act together to determine the optimal rate of Ca2+ entry, which may then lead to the appropriate secretory rate of aldosterone.

Aldosterone↗
PubMed1988

The adrenal capsule alters the response of zona glomerulosa cells to atrial natriuretic peptide.

Atrial natriuretic peptide (ANP) is a potent inhibitor of potassium-stimulated aldosterone secretion. In the present study, we observed rat alpha ANP to inhibit aldosterone secretion stimulated by 10 mM potassium with an IC50 of 0.15 +/- 0.02 nM (mean +/- SE) in dispersed rat adrenal glomerulosa cells. However, when rat adrenal capsules, which contain the zona glomerulosa, were superfused in vitro, ANP had no effect on aldosterone secretion. Superfusion with 10 mM potassium increased aldosterone secretion 3- to 4-fold above baseline. Addition of 10 nM ANP to the superfusate did not lower potassium-stimulated aldosterone secretion. When this same ANP-containing superfusate was incubated with dispersed adrenal glomerulosa cells, potassium-stimulated aldosterone secretion was inhibited by 90%, proving sustained biological potency of the superfused ANP. Incubation of [125I]iodo-ANP with adrenal capsules for 60 min resulted in 83% degradation of [125I]iodo-ANP, whereas no detectable degradation was observed with dispersed adrenal glomerulosa cells. Removal of blood from the adrenal capsules or culturing the capsules for 48 h did not render them responsive to superfused ANP. In contrast, superfusion of 0.1 mM cycloheximide inhibited potassium-stimulated aldosterone secretion by 90%. These results suggest that the adrenal capsule contains an ANP-degrading enzyme(s). This enzyme may be produced by adrenal glomerulosa cells. The local existence of a degrading enzyme for ANP may allow the zone glomerulosa to regulate its response to ANP.

Adrenal Cortex↗
PubMed1987

Dopamine in rat adrenal glomerulosa.

There is increasing evidence that dopamine (DA) inhibits aldosterone production, but the source of DA for this dopaminergic influence is not known. In the present study we examined the adrenal's zona glomerulosa for the presence of DA. Rats maintained on an intake of regular food were killed by decapitation and the adrenal capsule (containing zona glomerulosa) and the remainder of the gland (containing both cortex and medulla) were examined for their content of DA and also for norepinephrine (NE) and epinephrine (E). DA was found in adrenal glomerulosa in substantial quantity, 1.92 +/- 0.17 (SEM) ng/mg wet weight, representing an approximate concentration of DA of 1-100 microM. DA in adrenal capsule represented 12.2% of the total adrenal content of DA. NE and E were also present in glomerulosa, 3.46 +/- 0.32 and 18.7 +/- 2.1 ng/mg respectively, but, unlike DA, about 98% of the total adrenal content of NE and E was contained in adrenal medulla. The NE/E ratio in capsule and medulla were similar, although slightly higher in adrenal medulla, suggesting that the medulla is the source of the NE and E found in glomerulosa. On the other hand, the DA/E ratio was several-fold higher in glomerulosa than medulla--suggesting that glomerulosa DA was derived at least partially from a source other than adrenal medulla. We also found that short-term culturing of the adrenal reduced DA levels to 1/3 that observed in fresh tissue. This could explain in part why cultured glomerulosa has been shown to be more responsive to administered stimuli. In summary, the findings indicate a significant concentration of DA in adrenal glomerulosa, and suggest that the effects of DA on aldosterone production are mediated locally within the adrenal.

Adrenal Glands↗
PubMed1987

Aldosterone production after short-term culture of rat adrenal capsule: responsiveness to angiotensin II, potassium and ACTH.

In vitro studies of aldosterone production have traditionally used freshly isolated adrenal glomerulosa tissue. In the present study we examined the effects of short-term culture of rat adrenal capsule on its secretory capacity by measuring both basal and stimulated aldosterone production. Capsules were maintained in culture for 24 h, and then responses to administered angiotensin II (1 X 10(-7) M), potassium (an increase of 2mM) and ACTH (1 X 10(-8) M) were determined during perifusion. Results were compared with responses by freshly isolated adrenal capsule. Although short-term culture reduced basal aldosterone production, responsiveness to administered stimuli was intact and often was greater than that observed with fresh capsular tissue. The results indicate that short-term culture of zona glomerulosa provides a suitable in vitro preparation for examining aldosterone secretory responsiveness to stimuli.

Adrenal Glands↗
PubMed1986

Carcase damage.

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Animals↗
PubMed1986

Aldosterone excretion rates in children and adults during sleep.

The present study undertook to examine aldosterone excretion during sleep as an integrated measurement of aldosterone production. A 24-hour urine collection was divided into awake and sleep fractions. Urinary aldosterone and electrolyte excretion were measured in 26 healthy children (mean age, 8.9 +/- 1.9 [SD] years) and 28 adults (mean age, 29.9 +/- 9.5 years). Aldosterone excretion in children was 5.6 +/- 3.9 (SD) micrograms/g creatinine during the awake period, which was significantly different from the 3.9 +/- 4.1 micrograms/g creatinine value recorded during sleep (p less than 0.002). In adults, awake aldosterone excretion was significantly greater than that during sleep; 4.9 +/- 2.7 versus 3.2 +/- 1.6 micrograms/g creatinine (p less than 0.001). Sleep aldosterone excretion values were highly correlated with the corresponding 24-hour aldosterone excretion values (r = 0.85, p less than 0.001) in children and in adults (r = 0.64, p less than 0.001). Sleep aldosterone excretion was correlated with 24-hour potassium excretion (p less than 0.02) only in children. Sleep aldosterone excretion correlated with neither sleep nor 24-hour sodium excretion in children or adults. Sleep electrolyte excretion rates were highly correlated with 24-hour excretion rates in both children and adults. Dexamethasone, 1 mg, administered the night before to suppress the normally high morning levels of endogenous adrenocorticotropic hormone, had no discernible effect on sleep aldosterone excretion. These results indicate that measurement of aldosterone excretion in an easily collected sleep urine sample provides a reliable index of aldosterone production in children and adults.

Adrenocorticotropic Hormone↗
PubMed1985

Decreases in renin and aldosterone secretion in alloxan diabetes: an effect of insulin deficiency.

The effect in the rat of alloxan diabetes (with and without insulin treatment) on renin and aldosterone secretion was examined. Rats with diabetes for 7 weeks were found to have lower PRA than nondiabetic controls. The decrease in PRA appeared to result from insulin deficiency since PRA was normal in diabetic rats given insulin. In a second set of animals, which were killed after 3 weeks, in vitro measurements of aldosterone production by perifused adrenal capsular tissue were carried out. Production of aldosterone was greatest by adrenal capsular tissue from insulin-treated diabetic rats where both basal and potassium-stimulated aldosterone production were higher than diabetic rats not given insulin. Although the reduced aldosterone production associated with untreated diabetes may have been a result of reduced in vivo exposure of adrenal tissue to angiotensin II, a chronic adrenotrophic influence of insulin could not be ruled out. In summary, insulin appears to be necessary for normal renin and aldosterone secretion in the diabetic rat.

Aldosterone↗
PubMed1985

Beta-adrenergic stimulation of aldosterone production by rat adrenal capsular explants.

Adrenal glomerulosa was examined for the presence of an adrenergic influence on aldosterone production. Cultured rat adrenal capsular explants were transferred to a perifusion system where the effect of exposure to catecholamines on aldosterone production was assessed. At 10(-6) M, isoproterenol greater than epinephrine greater than norepinephrine significantly stimulated aldosterone production, whereas at 10(-8) M only isoproterenol showed significant stimulation. Propranolol, a beta-adrenoreceptor antagonist, inhibited stimulation by epinephrine, and the phosphodiesterase inhibitor, 1-methyl-3-isobutylxanthine, enhanced stimulation by a submaximal dose of epinephrine. Epinephrine and norepinephrine were found by radioenzymatic assay to be present in fresh as well as cultured capsular tissue, although levels were considerably lower in tissue that had been in culture (about one tenth that of fresh tissue). The epinephrine-norepinephrine ratio was similar in capsule and medulla, suggesting a medullary source of capsular catecholamines. Whether catecholamines in the capsule arose from the in vitro manipulation of adrenal tissue or existed in vivo is unclear. In summary, beta-agonists stimulate aldosterone production in cultured rat capsular explants.

1-Methyl-3-isobutylxanthine↗
PubMed1984

Estrogen and androgen dynamics in liver disease.

Constant infusions of 3H-androgen/14C-estrogen were given to 18 men with increased serum bilirubin concentrations and biopsy proven hepatic cirrhosis. From data obtained from the infusions and the radioimmunoassay of circulating endogenous steroid levels metabolic clearance rates (MCR), blood production rates (PB), aromatization rates (fraction of androgen infused into and measured as estrogen in blood; [p]And, Est BB) and conversion ratios (ratio of concentration of radioactivity of infused precursor to product steroid in blood; CRPREC,PROD were calculated. These data were compared to normal data obtained from similar studies in a group of normal men similar in age and weight. The mean concentrations of testosterone (T), and dihydrotestosterone (DHT), were decreased but those of estrone (E1) and estradiol (E2) were increased, and the concentration of androstenedione, (A), was similar compared to the normal values. Compared to the values in normal men the mean MCR of T was decreased those of A and E2 were normal, and that of E1 was slightly increased. However, the PB's of both estrogens were increased while that of A was normal T was decreased. The increase in the PB's of the estrogens could be explained on the basis of a marked increase in [p]And, Est BB probably due to a shift in blood flow from the liver to peripheral tissue. These findings were noted in men with alcoholic cirrhosis as well as cardiac cirrhosis and in 1 subject with infectious hepatitis. Abnormalities in steroid metabolism occur in men with several types of liver disease and are not limited to those with alcoholic liver disease.

Adult↗
PubMed1984

The effect of captopril treatment on potassium-induced stimulation of aldosterone production in vitro.

Potassium and angiotensin (AII) show interdependence as stimuli of aldosterone production. However, potassium stimulates in vitro in the absence of AII. In the present study we examined for a contribution by AII to the in vitro stimulatory potential of potassium, an AII effect mediated on the adrenal before killing of the animal. Captopril, an angiotensin converting-enzyme inhibitor, was administered orally and by sc injection for 3 days so as to decrease levels of AII. Aldosterone secretory responses by adrenal capsules to graded increments in potassium were measured subsequently using a perifusion system. It was found that captopril pretreatment significantly reduced the magnitude of aldosterone secretory response to increments in potassium of 0.5 to 6.0 mM, from a baseline potassium concentration of 3.5 mM. Responses to the lowest increment in potassium, 0.5 and 1.0 mM, were virtually abolished by captopril treatment. The results suggest that AII sensitizes the adrenal glomerulosa such that very small changes in potassium concentration can affect aldosterone production.

Adrenal Glands↗
PubMed1983

Differing effects of metoclopramide and adrenocorticotropin on plasma aldosterone levels in glucocorticoid-suppressible hyperaldosteronism and other forms of hyperaldosteronism.

To investigate possible dopaminergic effects on aldosterone production, we administered the dopamine antagonist metoclopramide to 11 normal subjects, 8 patients with primary aldosteronism due to adenoma or hyperplasia, and 5 other patients with the glucocorticoid-suppressible form of hyperaldosteronism (GSH). All subjects except for those with GSH responded to metoclopramide with an increase in plasma aldosterone concentration even when endogenous ACTH was suppressed by dexamethasone pretreatment. This increase occurred without apparent mediation of other recognized stimuli for aldosterone secretion. In contrast, the patients with GSH failed to show any aldosterone response while receiving dexamethasone, but demonstrated a rise in plasma aldosterone concentration when dexamethasone was withheld. The responses in the patients with both forms of primary aldosteronism were greater in magnitude than in the normal subjects or in the subjects with GSH when not receiving dexamethasone. These studies, while demonstrating differences between the subtypes of hyperaldosteronism in their responsiveness to metoclopramide, indicate that ACTH or some other factor may exert a permissive effect in GSH for the aldosterone response to metoclopramide. A graded infusion of ACTH revealed a greater aldosterone response in GSH compared to that in the other groups, further suggesting the importance of ACTH in this disorder.

Adrenocorticotropic Hormone↗
PubMed1983

Unilateral hypersecretion of aldosterone associated with adrenal hyperplasia as a cause of primary aldosteronism.

In 3 patients with longstanding hypertension and spontaneous or diuretic-induced hypokalemia, the diagnosis of primary aldosteronism was established by the dual criteria of non-suppressible plasma aldosterone level and suppressed plasma renin activity. Preoperative studies of the etiology for the hyperaldosteronism using the postural plasma aldosterone test and adrenal venous steroid measurements gave conflicting results. On the basis of the differential adrenal venous steroid content, which suggested an unilateral adrenal source for the aldosterone hypersecretion, presumed to be adrenal adenoma, each patient was operated upon. In each case the excised adrenal revealed adenomatous or macronodular hyperplasia. Reinvestigation of the patients 3 to 12 months after the adrenalectomy showed that the dynamics of the renin-aldosterone axis was now restored to the normal state even though the patients remained hypertensive. These findings indicate that unilateral hypersecretion of aldosterone associated with adrenal hyperplasia can occur in some patients with primary aldosteronism simulating that due to an aldosteronoma. Such observations also raise questions about the pathogenesis of the adrenal hyperplasia and seem to add further complexity to the evaluation of patients with hyperaldosteronism.

Adrenal Cortex↗
PubMed1982

The blood pressure-raising effects of high dietary sodium intake: racial differences and the role of potassium.

Fourteen normotensive men (7 black, 7 white) were studied following equilibration during dietary sodium intake of 10, 300, 600, 800, 1200, and 1500 mEq sodium per day. Significant (p less than 0.05) increases in mean arterial blood pressure were seen after sodium intake of 800 mEq/d. Blood pressure increased at lower levels of sodium intake (800 mEq/d) and to a greater magnitude (21 mm Hg) in blacks than in whites (1200 mEq/d; 13 mm Hg). Sodium loading was associated with marked suppression of plasma renin activity, aldosterone and norepinephrine, and increases in cardiac index. At higher levels of sodium intake urinary potassium loss was seen. A subsequent experiment replacing urinary potassium losses as they occurred in six subjects demonstrated attenuation of the blood pressure increases seen in response to dietary sodium loading. These studies demonstrate a potential role for sodium and potassium in blood pressure regulation in normotensive man, and suggest that heterogeneity of response may be involved in the development of hypertension in individuals predisposed to avid sodium conservation.

Adolescent↗
PubMed1982

Role of angiotensin II in potassium-mediated stimulation of aldosterone secretion in the dog.

Potassium is known to enhance the aldosterone-stimulating action of angiotensin II. Such a synergistic interaction of potassium with angiotensin II could represent an action by angiotensin II to potentiate potassium as a stimulus. To examine for this effect of angiotensin II on potassium, plasma aldosterone levels were measured before and after an infusion of potassium chloride (15 meq i.v.) into dogs without and with prevention of angiotensin II formation by captopril, an angiotensin converting-enzyme inhibitor. In addition, responses to potassium were measured in a group of dogs receiving angiotensin II plus captopril. After potassium infusion, control dogs showed an increase of 7.7 +/- 1.9 (SEM) ng/dl (P less than 0.001) in the level of plasma aldosterone. In contrast, captopril-treated dogs showed no change in plasma aldosterone concentration in response to potassium. When angiotensin II was administered to captopril-treated dogs responsiveness to potassium administration was restored (plasma aldosterone concentration increased by 7.4 +/- 2.1 ng/dl, P less than 0.002). ACTH stimulated aldosterone secretion despite captopril treatment (P less than 0.001), however, ACTH produced a greater increase in the plasma aldosterone concentration in controls than in captopril-treated animals. It is evident from these results that stimulation of aldosterone secretion by potassium is considerably enhanced by angiotensin II. There appears to exist an important interdependence of these stimuli in the regulation of aldosterone secretion.

Adrenocorticotropic Hormone↗