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Biomedical subjects

N Baker

Publications and source records attributed to N Baker.

At least 37 records · Page 2Linked to original sources

Andersen's syndrome: a distinct periodic paralysis.

A previous study of 4 patients defined Andersen's syndrome (AS) as a triad of potassium-sensitive periodic paralysis, ventricular dysrhythmias, and dysmorphic features. AS appears to be distinct in terms of its genetic defect from the alpha-subunit of skeletal muscle sodium channel and the cardiac potassium channel responsible for most long QT syndromes (LQT1). We studied 11 additional patients with AS from 5 kindreds. Spontaneous attacks of paralysis were associated with hypokalemia, normokalemia, or hyperkalemia. All 11 patients had similar dysmorphic features. The QT interval was prolonged in all patients although only 4 were symptomatic. Genetic linkage studies excluded linkage to the alpha-subunit of the skeletal muscle sodium channel and to four distinct LQT loci. In addition, none of the common dihydropyridine receptor mutations responsible for hypokalemic periodic paralysis were present. We conclude that (1) AS is a genetically unique channelopathy affecting both cardiac and skeletal membrane excitability, (2) attacks of paralysis may be either hypokalemic or hyperkalemic, (3) a prolonged QT interval is an integral feature of this syndrome, and (4) a prolonged QT interval may be the only sign in an individual from an otherwise typical AS kindred. This may be confused with more common, potentially lethal LQT syndromes.

Adolescent↗

Molecular recognition by cholesterol esterase of active site ligands: structure-reactivity effects for inhibition by aryl carbamates and subsequent carbamylenzyme turnover.

Interactions of mammalian pancreatic cholesterol esterases from pig and rat with a family of aryl carbamates CnH2n+1NHCOOAr [n = 4-9; Ar = phenyl, p-X-phenyl (X = acetamido, bromo, fluoro, nitro, trifluoromethyl), 2-naphthyl, 2-tetrahydronaphthyl, estronyl] have been investigated, with an aim of delineating the ligand structural features which lead to effective molecular recognition by the active site of the enzyme. These carbamates inhibit the catalytic activity of CEase by rapid carbamylation of the active site, a process that shows saturation kinetics. Subsequent slow decarbamylation usually leads to full restoration of activity, and therefore aryl carbamates are transient inhibitors, or pseudo-substrates, of CEase. Structural variation of carbamate inhibitors allowed molecular recognition in the fatty acid binding and steroid binding loci of the extended active site to be probed, and the electronic nature of the carbamylation transition state to be characterized. Optimal inhibitory activity is observed when the length of the carbamyl function is n = 6 and n = 7 for porcine and rat cholesterol esterases, respectively, equivalent to eight- and nine-carbon fatty acyl chains. In contrast, inhibitory activity increases progressively as the partial molecular volume of the aromatic fragment increases. Hammett plots for p-substituted phenyl-N-hexyl carbamates indicate that the rate-determining step for carbamate inhibition is phenolate anion expulsion. Effects of the bile salt activator taurocholate on the kinetically resolved phases of the pseudo-substrate turnover of aryl carbamates were also studied. Taurocholate increases the affinity of the carbamate for the active site of cholesterol esterase in the reversible, noncovalent complex that precedes carbamylation and increases the rate constants of the serial carbamylation and decarbamylation steps. Structural variation of the N-alkyl chain and of the aryl fused-ring system provides an accounting of bile salt modulation of the fatty acid and steroid binding sites, respectively. In that pseudo-substrate turnover of aryl carbamates proceeds by a three-step mechanism that is analogous to that for rapid turnover of lipid ester substrates, these investigations illuminate details of ligand recognition by the extended active site of cholesterol esterase that are prominent determinants of the substrate specificity and catalytic power of the enzyme.

Animals↗

Resolution of the neutropenia of Felty's syndrome by longterm administration of recombinant granulocyte colony stimulating factor.

Felty's syndrome is characterized by neutropenia, splenomegaly, and recurrent infection in patients with rheumatoid arthritis. We used recombinant granulocyte colony stimulating factor (rGCSF) in a patient with Felty's syndrome and recurrent sepsis. rGCSF induced a statistically significant increase in the patient's absolute neutrophil and total white blood cell counts. During 14 months of followup taking rGCSF, disseminated varicella zoster was the only infectious complication. Except mild thrombocytopenia and a transient flare of arthritis, no serious adverse effects occurred. rGCSF may be a safe and effective therapy for Felty's syndrome in selected patients.

Aged↗

Auditory sensory gating, hippocampal volume, and catecholamine metabolism in schizophrenics and their siblings.

Schizophrenia may result from the concerted action of several pathophysiological factors. This pilot study compared the distribution of measurements of three such putative factors in 11 schizophrenics and their siblings: a neurophysiological deficit in auditory sensory gating, diminished hippocampal volume, and increased catecholamine metabolism. Abnormal auditory sensory gating was found in all schizophrenics in the 11 families studied and in 8 of their 20 siblings. Compared with the schizophrenics, the clinically unaffected siblings with abnormal auditory gating had larger hippocampal volume. There was no similar difference for the siblings with normal gating. The siblings with abnormal auditory gating also had lower homovanillic acid levels than the other siblings. The data suggest that a familial neuronal deficit, identified by diminished sensory gating, may be a necessary, but not sufficient factor in the pathogenesis of schizophrenia. Individuals with this deficit are generally clinically unaffected, except for schizophrenics, who also have other abnormalities, such as diminished hippocampal volume and increased catecholamine metabolism.

Acoustic Stimulation↗

The effects of drug therapy on radiographic progression of rheumatoid arthritis. Results of a 36-week randomized trial comparing methotrexate and auranofin.

OBJECTIVE: To determine the effects of drug therapy (methotrexate [MTX] versus auranofin [AUR]) on radiographic progression in patients with active rheumatoid arthritis (RA). METHODS: We conducted a 9-month randomized, multicenter, double-blind trial comparing MTX and AUR. Standardized radiographs of the hands and wrists were obtained at baseline and at completion of the study. Four experienced bone radiologists graded the radiographs for erosions, joint space narrowing, erosion healing, and reparative bone formation. RESULTS: Two hundred eighty-one patients were enrolled in the study. Radiographs were available on 167 of the 183 who completed the trial. After 9 months of therapy, there was a significantly greater worsening of the erosion score in the AUR group (mean +/- SEM change of 1.67 +/- 0.4) compared with the change in the MTX group (0.60 +/- 0.3) (P = 0.040). There was also a significantly greater worsening of the joint space narrowing score in the AUR group compared with the MTX group (1.36 +/- 0.3 versus 0.42 +/- 0.2) (P = 0.007). There was no difference demonstrated between groups in healing of erosions or in reparative bone formation. CONCLUSION: The rate of radiographic progression in patients with RA, as measured by erosion score and joint space narrowing score, was demonstrated to be lower in those treated with MTX, as compared with AUR, over a 36-week period.

Adult↗

Musculoskeletal manifestations in beta 2-microglobulin amyloidosis. Case discussion.

The cases presented illustrate some of the typical (case 1) and less common (case 2) clinical features of beta 2m amyloidosis. The accumulation of beta 2m amyloid in tissues is a potentially severe complication of dialysis-treated chronic renal failure. Beta 2m amyloidosis has been shown to have distinct clinical, radiologic, and pathologic features. The pathogenesis of this condition is not yet clearly understood, and recommendations for the clinical management of these patients at present are limited to recognition of the disease and symptomatic treatment. Further insights into the biology of this disease should lead to new strategies for prevention and treatment.

Aged↗

Anorexic contribution to increased linoleate mobilization and oxidation in lymphoma-bearing mice.

To test for a regulatory defect in adipose triacylglycerol (essential) fatty acid mobilization in lymphoma-bearing mice, free [1-14C]linoleic acid/mouse serum albumin was injected iv into lymphoma-bearing and control mice, adapted to a reversed light cycle, and studied in three dietary states in the dark period. Mean daily food intake decreased in mice with small and large tumor burdens. Plasma free fatty acid (FFA) oxidation rates, which approximate FFA mobilization rates, were estimated by multicompartmental analysis (CONSAM). Oxidation of linoleate to CO2 was reduced significantly (85%) in ad libitum fed as compared to briefly fasted control mice but not in fed vs. fasted mice with large or small tumor burdens. However, plasma FFA oxidation rates to CO2 did not differ in briefly fasted tumor-bearing and pair-fed control mice. When re-fed a 250-mg test meal, briefly fasted mice with small tumors suppressed plasma free linoleic acid oxidation, as did controls. During simulated night, mildly anorexic, tumor-bearing mice with small tumor burdens mobilized essential fatty acids much faster than controls. This could explain body fat loss. The abnormally rapid rates of FFA (free linoleic acid) mobilization at night probably result from anorexia rather than from inability of food to suppress fat mobilization.

Animals↗

Effect of human mammary MX-1 tumor on plasma free fatty acids in fasted and fasted-refed nude mice.

We hypothesized that tumor-bearing (TB) nude mice, because they are reported to have no detectable, circulating tumor necrosis factor (TNF)/cachectin, would regulate their plasma free fatty acid (FFA) levels normally when fasted and refed. We compared levels of individual plasma FFA in response to fasting (24 hr) and to refeeding (for 20 hr after fasting) a fat-free, 65% sucrose diet in control, nude mice and in mice bearing 1.3 +/- 0.4 g MX-1 tumors. Total plasma FFA levels were typically high in 24-hr fasted mice [mean concentrations in microM +/- SE (n); controls 515 +/- 63 (6); TB, 625 +/- 63 (6)]. FFA levels were reduced by 65% in each group in response to refeeding. Each major plasma FFA species fell in response to refeeding, except arachidonate, which did not change significantly (fasted vs. fasted-refed concentrations) in either controls or TB mice. In refed mice, the molar FFA ratio of oleate to linoleate rose; however, that of oleate to arachidonate fell markedly. TB nude mice had normal appetites. We conclude that all species of FFA were mobilized from adipose tissue in a normal manner in TB nude mice; therefore, regulation of adipose triacylglycerol fatty acid mobilization (as plasma FFA) by dietary sugar is probably not affected by MX-1 tumor growth in these mice. Our findings are consistent with the hypothesis that nude mice may be unable to secrete TNF/cachectin in response to tumor growth, but they do not establish whether or not endogenous, circulating TNF/cachectin increases FFA mobilization in any TB animal.

Adipose Tissue↗

Auditory sensory gating and catecholamine metabolism in schizophrenic and normal subjects.

Diminished neuronal response to repeated sensory input is a sensory-gating phenomenon that has been found to be deficient in schizophrenic patients. For example, schizophrenic patients fail to decrease the amplitude of the P50 wave of the auditory evoked potential to the second of paired click stimuli. In some studies, however, normal subjects have also failed to decrease their P50 responses. The aim of this study was to determine if accommodation to the recording situation over time would affect the gating of the P50 response. The gating of the P50 wave is measured as the ratio of the amplitude of the second response to the amplitude of the first. Three successive auditory evoked potentials were compiled, each from trains of 32 pairs of stimuli. Twelve normal subjects and 12 schizophrenic patients were studied. Unconjugated catecholamine metabolites were measured from venous samples drawn before and after the electrophysiological recording. Between the first and third trials, the normal subjects significantly increased their gating of P50. This increase in gating of P50 was related to decreased levels of the noradrenergic metabolite 3-methoxy-4-hydroxyphenylglycol. No similar phenomenon was observed in the schizophrenic patients, a number of whom had a further decrease in P50 gating over the three trials. Transient failure to observe gating of P50 in normal subjects may be related to increased state-dependent noradrenergic activity, which is known to disrupt sensory gating. This mechanism does not seem to account for the more persistent failure of sensory gating in schizophrenia.

Acoustic Stimulation↗

Renal epithelium: reversal of cytotoxic damage by addition of anti-thymocyte globulin.

A novel in vitro assay of renal epithelium tight junction function was used to assess the efficacy with which rabbit anti-thymocyte globulin (ATG) blocks epithelium damage mediated by lymphokine-activated killer (LAK) cells. It was found that LAK cells lysed renal epithelial cells poorly in standard chromium-release assays but that they caused a rapid, and almost total, reduction in trans-epithelium monolayer resistance, indicating tight junction failure and, hence, loss of tissue function. LAK cell-mediated cytolysis of the sensitive K562 cell line was completely blocked in the presence of ATG at a concentration of 200 micrograms/ml. Addition of ATG at this concentration to damaged renal cell monolayers in the presence of LAK cells allowed the trans-monolayer resistance to recover rapidly to levels approaching the values recorded before initial addition of LAK cells. On this basis it seems likely that the rapid restoration of renal function frequently observed after appropriate "rescue" therapy during episodes of acute rejection may reflect subtle changes in tissue function rather than recovery from widespread graft cell cytolysis.

Animals↗

Evidence of extensive phospholipid fatty acid methylation during the assumed selective methylation of plasma free fatty acids by diazomethane.

We compared a conventional method (Method I) for measuring plasma free fatty acid (FFA) concentrations with two more rapid procedures (Method II and Method III). Method I required total lipid extraction, separation of FFA by thin-layer chromatography, methylation, and gas-liquid chromatographic analysis of the fatty acid (FA) methyl esters. Method II was a colorimetric procedure. Method III relied upon diazomethane's presumed ability to selectively methylate FFA even in the presence of FA esters. The three methods were compared using plasma from fasted and from fed nude mice, tumor-bearing mice (MX-1 and ZR-75-1 human mammary carcinomas), and controls. Method II, was less reliable than Method I, but both gave similar mean values for plasma FFA levels in fasted mice. Both Methods I and II also showed similar lowering of plasma FFA levels after feeding previously fasted mice. Method III consistently gave values that were far greater than those obtained using Methods I and II. Moreover, highly significant differences between fasted and fed mice were obscured by direct methylation of plasma FFA with diazomethane (Method III). The excess FA methyl esters formed in Method III were derived from plasma phospholipids, but not from plasma triacylglycerols. After feeding fasted mice, plasma free palmitic acid and oleic acid levels fell (Method I); by contrast, the excess "FFA" formed by methylation of plasma phospholipid FA increased two-fold and fourteen-fold, respectively. Caution is therefore advised in the use of direct methylating agents when measuring total and individual plasma FFA levels.

Animals↗

Model development to describe the heterogeneous kinetics of apolipoprotein B and triglyceride in hypertriglyceridemic subjects.

The heterogeneous nature of very low density lipoprotein (VLDL) metabolism in hypertriglyceridemia gives rise to complex kinetics when labeled VLDL are traced. Analysis of such systems benefits from the simultaneous study of several metabolically discrete subfractions which are then integrated. We have studied the kinetics of VLDL and intermediate density lipoprotein (IDL) apoprotein B and triglyceride simultaneously by injecting homologous 125I-labeled VLDL1 and 131I-labeled VLDL2 and [2-3H]glycerol intravenously in three diverse type IV hyperlipoproteinemic subjects. An additional type IV subject received only [2-3H]glycerol. Specific radioactivities were measured in: VLDL1-triglyceride and -apoB, VLDL2-triglyceride and -apoB, and in each corresponding subfraction after further separation into heparin-Sepharose-bound and -unbound fractions. ApoB and triglyceride specific radioactivities were also measured in IDL. Analysis of the kinetics of apoB in the unbound fractions in VLDL1 and VLDL2 showed the presence of two pools of particles, one of which turned over rapidly. The kinetics of apoB in the bound fractions in VLDL1 and VLDL2 were, in contrast, dominated by a large slowly turning over pool of particles that resembled the kinetics of whole VLDL. Evidence of a partial precursor-product relationship between the unbound and bound fractions suggested that the former was richer in nascent-like particles, while the latter contained more remnant particles. However, triglyceride specific radioactivity curves for both unbound and bound fractions showed initial rapid rises and broad peaks, indicating that the bound fraction also contained a substantial proportion of nascent-like particles. Using multicompartmental analysis, a model was constructed to account for the kinetics of both apoB and triglyceride in all fractions of VLDL and in IDL. The model comprises two parallel delipidation pathways that supply a common remnant pool with these features: 1) multiple direct inputs of particles into plasma at VLDL2 and IDL levels; 2) heterogeneous triglyceride precursor pools leading to different rates of labeling of VLDL1 and VLDL2; 3) very substantial delipidation of VLDL2 particles prior to conversion to IDL and; 5) triglyceride production rates somewhat higher than previously reported. The inclusion in the model of the rapidly turning over pool of triglyceride-rich particles, identified in the heparin-unbound fraction, suggests that values for triglyceride production in man have been underestimated.

Aged↗

Reduced suppression of plasma saturated fatty acid mobilization and oxidation by feeding in lymphoma-bearing mice.

Lymphoma-bearing mice have a circulating lipid-mobilizing factor, but increased plasma free fatty acid (FFA) turnover has not been demonstrable in earlier studies using postabsorptive tumor-bearing mice. We hypothesized that FFA mobilization in lymphoma-bearing mice is only elevated in fed mice and may best be observed at night (dark, reversed light cycle). AKR mice with early and advanced tumors (10(6) SL-3 lymphoma cells, i.p.) and controls were fed ad libitum (reversed light cycle, dark) or fasted 4 h (daylight, regular cycle), given injections of [14C]bicarbonate of [1-14C]palmitate-mouse serum albumin, i.v., and plasma [14C]FFA disappearance and/or breath 14CO2 were monitored. Plasma FFA mobilization, estimated by multicompartmental analysis (SAAM) of the oxidation rate was lower in fasted mice with advanced tumors [tumor, 9.5 +/- 6.0% (%SE); controls, 14 +/- 4.4% micrograms-atoms fatty acid-carbon/min/30 g body weight, n = 3 to 6 mice/time point/group]. Feeding reduced these rates 90% in control mice and 53% in mice with early tumors, but only 14% in mice with advanced tumors. Plasma FFA fractional catabolic rates were 2.5 times faster in fed mice with advanced tumors than in controls. Diminished suppression of fatty acid mobilization in fed tumor-bearing mice (at night) probably accounts partially for the body fat loss.

Adipose Tissue↗