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Biomedical subjects

P Mancuso

Publications and source records attributed to P Mancuso.

At least 37 records · Page 2Linked to original sources

Modulation of alveolar macrophage phagocytosis by leukotrienes is Fc receptor-mediated and protein kinase C-dependent.

We have previously established an important role for leukotrienes (LTs) in augmenting rat alveolar macrophage (AM) phagocytosis of Klebsiella pneumoniae opsonized with complete immune serum (IS), which contains the two well-known opsonins, immunoglobulin (Ig) G and complement (C). In this report, the specific opsonin requirements for LT modulation of AM phagocytosis and the dependence of this response on protein kinase (PK) C activity were investigated. Phagocytosis of K. pneumoniae opsonized with IS, non-immune serum, or heat-inactivated immune serum and of inert targets (IgG-opsonized fluorescent microspheres or C-opsonized sheep red blood cells) was examined. Inhibition of endogenous LT synthesis or action attenuated, whereas the addition of exogenous LTs augmented, phagocytosis only of targets opsonized with IgG. LTs had no effect on phagocytosis of C-opsonized or unopsonized targets. LTs did not affect adherence of IgG-opsonized targets, implying instead an enhancement of internalization. Macrophage internalization of phagocytic targets has previously been shown to require PKC activity. Pretreatment of AMs with the PKC inhibitors staurosporine or calphostin C, or with phorbol 12-myristate 13-acetate to deplete PKC, completely inhibited the ability of LTB(4) and largely inhibited the ability of LTC(4) to augment phagocytosis of IgG-opsonized microspheres. These results demonstrate that LT enhancement is confined to Fc receptor (FcR)-mediated phagocytosis. Moreover, PKC activation represents an important mechanism by which LTs promote FcR-mediated phagocytosis.

Acetophenones↗

Lhermitte duclos disease and Cowden disease: clinical, pathological and neuroimaging study of a case.

The authors report the case of a 26-year-old female patient affected by Lhermitte Duclos disease and Cowden disease. Preoperative MRI allowed a correct diagnosis which was confirmed by pathological examination. The authors stress the possibility that Lhermitte Duclos and Cowden disease be a single phakomatosis; for this reason all the patients affected by Lhermitte-Duclos should be screened for the presence of multiple hamartomas or malignant neoplastic lesions typical of Cowden disease.

Adult↗

Cervical spinal epidural abscesses. A report on five cases.

The authors report a series of five cases of non tuberculous cervical spinal epidural abscesses. There were neither patients suffering from immunodeficiency syndromes nor drug addicts; all the patients were in their seventh decade; two patients were affected by diabetes mellitus refractory to medical treatment. Retropharyngeal abscess was the main etiological risk factor (two cases); Staphylococcus aureus was cultured in two cases. Gadolinium MRI was necessary for a preoperative diagnosis, planning surgical approach and postoperative prognosis. Surgical debridement was performed via an anterior approach in those cases where the collection was located lower than C4 and did not span more than three vertebral segments; posterior approach, via a laminectomy, was performed in a case of C1-C2 location of the lesion and in a case of involvement of the whole cervical spine. Surgical results were poor in those patients affected by diabetes mellitus, a lesion involving the high cervical segments (higher than C4) or a lesion spanning more than three levels. Medical treatment with MRI follow-up was not undertaken in any of the patients and we opted for surgical drainage in all the cases due to the possibility of a sudden neurological deterioration, caused both by spinal cord mechanical compression and vascular compromission.

Abscess↗

5-Lipoxygenase reaction products modulate alveolar macrophage phagocytosis of Klebsiella pneumoniae.

The leukotrienes are potent lipid mediators of inflammation formed by the 5-lipoxygenase-catalyzed oxidation of arachidonic acid. Although the effects of leukotrienes on neutrophil chemotaxis and activation have been established, their role in modulating innate host defense mechanisms is poorly understood. In a previous study (M. Bailie, T. Standiford, L. Laichalk, M. Coffey, R. Strieter, and M. Peters-Golden, J. Immunol. 157:5221-5224, 1996), we used 5-lipoxygenase knockout mice to establish a critical role for endogenous leukotrienes in pulmonary clearance and alveolar macrophage phagocytosis of Klebsiella pneumoniae. In the present study, we investigated the role of specific endogenous leukotrienes in phagocytosis of K. pneumoniae and explored the possibility that exogenous leukotrienes could restore phagocytosis in alveolar macrophages with endogenous leukotriene synthesis inhibition and enhance this process in leukotriene-competent cells. Rat alveolar macrophages produced leukotriene B4 (LTB4), LTC4, and 5-hydoxyeicosatetraenoic acid (5-HETE) during the process of phagocytosis, and the inhibition of endogenous leukotriene synthesis with zileuton and MK-886 dramatically attenuated phagocytosis. We also observed a reduction in phagocytosis when we treated alveolar macrophages with antagonists to the plasma membrane receptors for either LTB4, cysteinyl-leukotrienes, or both. In leukotriene-competent cells, LTC4 augmented phagocytosis to the greatest extent, followed by 5-HETE and LTB4. These 5-lipoxygenase reaction products demonstrated similar relative abilities to reconstitute phagocytosis in zileuton-treated rat alveolar macrophages and in alveolar macrophages from 5-lipoxygenase knockout mice. We conclude that endogenous synthesis of all major 5-lipoxygenase reaction products plays an essential role in phagocytosis. The restorative and pharmacologic effects of LTC4, LTB4, and 5-HETE may provide a basis for their exogenous administration as an adjunctive treatment for patients with gram-negative bacterial pneumonia.

Animals↗

Spinal malignant melanotic schwannoma. Case report.

The authors report a rare case of spinal cord compression syndrome due to a malignant melanotic schwannoma. Pathogenesis, diagnostic difficulty and therapeutical problems are discussed. The authors conclude that such tumours should be surgically treated due to the possibility of a benign clinical behaviour even in those cases showing malignant histological features.

Adult↗

New introducer technique for implanting pacemakers and defibrillator leads: percutaneous incannulation of the cephalic vein.

OBJECTIVES: This study was designed to assess the feasibility of percutaneous incannulation of cephalic vein for the implantation of pacemaker and defibrillator leads. BACKGROUND: The development of the subclavian vein puncture technique for pacemaker lead implantation has many advantages compared to surgical isolation of cephalic vein. However, initial enthusiasm has been dampened by reports of serious complications because of the anatomical relationships of the subclavian vein. METHODS AND RESULTS: Percutaneous incannulation of the right cephalic vein was attempted in 75 patients who were candidates for permanent pacemaker or ICD implantation. The technique was effective in 46 patients. It was shown to be ineffective in 18, despite the presence of a normal vein. In seven patients, the cephalic vein was found to be unusable for passing the electrocatheter and in four patients, the vein was absent. In the patients in whom the vein was present, the success rate was 46/71 (64%). The average implantation time was 7.2 minutes (range 5-10), while the average time for conventional surgical technique was 15.2 minutes (range 14-20) (p < 0.001). All patients remained free from complications during a mean follow-up period of 8.2 months (range 1 to 18). CONCLUSIONS: In our opinion, percutaneous incannulation of cephalic vein could be adopted as the first step in pacemaker or defibrillator implantation procedures, as it shows satisfactory success rates, simplicity of execution and absence of complications. Most importantly, in the event of failure, it does not compromise the use of a conventional technique.

Adult↗

Multiple primary cerebral hydatid cysts: case report.

The authors report the case of a patient with primary multiple cerebral hydatid cysts emphasizing the role played by MRI in planning the surgical approach. The indications for medical treatment of such lesions are also discussed.

Brain Diseases↗

Effects of eicosapentaenoic and gamma-linolenic acid on lung permeability and alveolar macrophage eicosanoid synthesis in endotoxic rats.

OBJECTIVES: Proinflammatory eicosanoids (cyclooxgenase and lipoxygenase metabolites of arachidonic acid) released by alveolar macrophages play an important role in endotoxin-induced acute lung injury. We investigated the effect of prefeeding rats for 21 days with enteral diets that provided the anti-inflammatory fatty acids, eicosapentaenoic acid and gamma-linolenic acid (derived from fish oil and borage oil, respectively), as compared with an n-6 fatty acid-enriched diet (corn oil) on the following: a) lung microvascular protein permeability, arterial blood pressure, and platelet and white blood cells in a model of endotoxin-induced acute lung injury; b) alveolar macrophage prostaglandin and leukotriene synthesis; and c) liver and alveolar macrophage phospholipid fatty acid composition. DESIGN: Prospective, randomized, controlled, double-blind study. SETTING: Research laboratory at a university medical center. SUBJECTS: Male Long-Evans rats, weighing 250 g. INTERVENTIONS: Rats were randomized into four dietary treatment groups and fed nutritionally complete diets (300 kcal/kg/day), containing 55.2% of the total calories from fat with either 97% corn oil, 20% fish oil, 20% fish and 5% borage oil, or 20% fish and 20% borage oil for 21 days. On day 22, lung microvascular protein permeability, mean arterial pressure, and platelet and white blood cell counts were determined for 2 hrs after an intravenous injection of Salmonella enteritidis endotoxin (10 mg/kg). In a second group of prefed rats, the phospholipid fatty acid composition was determined in liver and alveolar macrophages. Alveolar macrophages were harvested by bronchoalveolar lavage and stimulated in vitro with a calcium ionophore (A23187), and the concentrations of leukotrienes B4 and B5, thromboxane A2, prostaglandin E2, and 6-keto-prostaglandin F1 alpha were measured in a third group of prefed rats. MEASUREMENT AND MAIN RESULTS: Lung permeability was greatest with corn oil and was significantly attenuated with 20% fish oil and 20% fish and 5% borage oil, and this effect approached significance with 20% fish and 20% borage oil (p = .06). The early and late hypotensive effects of endotoxin were attenuated with 20% fish oil, 20% fish and 5% borage oil, and 20% fish and 20% borage oil, as compared with corn oil. Concentrations of leukotriene B4, prostaglandin E2, and thromboxane B2 released from A23187-stimulated alveolar macrophages were significantly lower with 20% fish oil and 20% fish and 20% borage oil, as compared with corn oil. The increase in lung microvascular protein permeability with 20% fish and 20% borage oil was not significantly different than the lung microvascular protein permeability that was found in animals receiving 20% fish oil (p = .20) and 20% fish and 5% borage oil (p = .31). Alveolar macrophage and liver phospholipid concentrations of arachidonic acid were lower, and the concentrations of eicosapentaenoic acid and docosahexaenic acid were higher, with 20% fish oil, and 5% borage oil, and 20% fish and 20% borage oil, as compared with corn oil. Dihomo-gamma-linolenic acid, the desaturated and elongated intermediate of gamma-linolenic acid, was increased with 20% fish and 20% borage oil, as compared with 20% fish oil and 20% fish and 5% borage oil. CONCLUSIONS: The severity of pulmonary microvascular protein permeability and the degree of hypotension were reduced with fish or fish and borage oil diets, as compared with corn oil, in endotoxic rats. The reduced synthesis of the proinflammatory arachidonic acid-derived mediators, leukotriene B4, thromboxane B2, and prostaglandin E2 from stimulated alveolar macrophages was indicative of a decrease in arachidonic acid and an increase in eicosapentaenoic acid and docosahexaenoic acid in cell membrane phospholipids.

Animals↗

Dietary fish oil and fish and borage oil suppress intrapulmonary proinflammatory eicosanoid biosynthesis and attenuate pulmonary neutrophil accumulation in endotoxic rats.

OBJECTIVE: Proinflammatory eicosanoids and cytokines are important mediators of local inflammation in acute lung injury. We determined if enteral nutrition with anti-inflammatory fatty acids, eicosapentaenoic acid, and gamma-linolenic acid would reduce the intrapulmonary synthesis of proinflammatory eicosanoids and cytokines and pulmonary neutrophil accumulation in a rat model of acute lung injury. DESIGN: Prospective, randomized, controlled, double-blind study. SETTING: Research laboratory at a university medical center. SUBJECTS: Male Long-Evans rats (250 g). INTERVENTIONS: Rats were randomly assigned to three dietary treatment groups and fed nutritionally complete diets (300 kcal/kg/day) containing 55.2% of the total calories from fat with either 97% corn oil, 20% fish oil, or 20% fish and 20% borage oil for 21 days. On day 22, bronchoalveolar lavage was performed 2 hrs after an intravenous injection of Salmonella enteritidis endotoxin (10 mg/kg) or saline. Bronchoalveolar lavage fluid was analyzed for leukotriene B4, leukotriene C4/D4, thromboxane B2, prostaglandin E2, 6 keto-prostaglandin F1alpha, tumor necrosis factor (TNF)-alpha, and macrophage inflammatory protein-2 (MIP-2). Lung myeloperoxidase activity (a marker for neutrophil accumulation) and phospholipid fatty acid composition were also determined. MEASUREMENTS AND MAIN RESULTS: Lung phospholipid concentrations of arachidonic acid were lower and the concentrations of eicosapentaenoic acid and docosahexaenoic acid were higher with fish oil and fish and borage oil as compared with corn oil. Dihomo-gamma-linolenic acid, the desaturated and elongated intermediate of gamma-linolenic acid, increased with fish and borage oil as compared with fish oil and corn oil. The levels of leukotriene B4, leukotriene C4/D4, 6-keto-prostaglandin F1alpha, and thromboxane B2 with corn oil were significantly increased with endotoxin as compared with saline. In contrast to the corn oil group, endotoxin did not significantly increase bronchoalveolar lavage levels of leukotriene B4, leukotriene C4/D4, and thromboxane B2 above those of saline-treated rats with fish oil and fish and borage oil. Lung myeloperoxidase activity was significantly increased in endotoxin-treated rats compared with those rats given saline in all dietary treatment groups. However, lung myeloperoxidase activity was significantly lower with either fish oil or fish and borage oil as compared with corn oil after endotoxin. Although endotoxin increased the levels of TNF-alpha and MIP-2 with all dietary treatment groups as compared with saline-treated rats, there were no significant differences in the levels of either cytokine between the dietary treatment groups. CONCLUSIONS: These results indicate that dietary fish oil and fish and borage oil as compared with corn oil may ameliorate endotoxin-induced acute lung injury by suppressing the levels of proinflammatory eicosanoids (but not TNF-alpha or MIP-2) in bronchoalveolar lavage fluid and reducing pulmonary neutrophil accumulation.

Animals↗

Reactivity of 62 Rh MAbs with weak and variant antigens.

We characterized serologically 5 anti-C (4 IgM and 1 IgG), 3 anti-c (2 IgM and 1 IgG), 4 anti-E (1 IgM and 3 IgG), 4 anti-e (3 IgM and 1 IgG) and 46 anti-D (16 IgM and 30 IgG) monoclonal antibodies, provided by the Rh Section of the Third International Workshop and Symposium on Monoclonal Antibodies against Human Red Blood Cells and Related Antigens (1996) for their ability to detect weak and variant antigens. The agglutination patterns were established using untreated and papain-treated red blood cells in a column agglutination technology system (BioVue, Ortho). Significant differences were found between the IgM and IgG antibodies. The papain treatment seemed to be important for IgM but not for IgG antibodies. Almost all of the IgM anti-D antibodies detected untreated DIV samples and almost all of the IgG anti-D antibodies detected untreated weak D samples. Both IgM and IgG anti-D antibodies showed the highest number of negative reactions with DVI and Rh 33 red blood cells. The CwCw sample was detected by only one of the 4 anti-C IgM MAbs using enzyme-treated red blood cells. All anti-c MAbs were able to detect treated Cx samples. Because of the small number of weakly expressed E and e samples, definitive conclusions cannot be drawn on the ability of these antibodies to detect these antigens.

Antibodies, Monoclonal↗

Cardiovascular responses to exercise in sprinters and distance runners.

The purpose of this study was to examine the cardiovascular responses of sprinters and distance runners to isometric (IE) and dynamic exercise (DE). Normotensive males were selected and grouped according to prior running performance: sprinter (N = 6) or distance runner (N = 6). Each subject completed an incremental DE (cycle ergometry) test (6-min stages) at 20%, 40%, and 60% of VO2peak, and 3 min of isometric handgrip at 30% of MVC. Blood pressure (BP), heart rate (HR), cardiac output (Q), oxygen uptake, and blood lactate were measured, while mean arterial blood pressure (MABP), cardiac index (CI), and systemic vascular resistance (SVR) were calculated during each stage of DE. BP and HR were measured during each minute of IE. Muscle biopsies of the vastus lateralis revealed a significant difference in capillary density (capillaries per mm2 and capillaries per fiber) between the sprinters and distance runners (323 +/- 23 vs 409 +/- 27 and 2.2 +/- 0.2 vs 3.2 +/- 0.3, P < 0.05) and for the percentage of Type I fibers (46.4 +/- 4% vs 64.8 +/- 7%, P < 0.05). The IE challenge elicited a greater BP response at minute 3 in the sprinters, which was associated with a greater HR response. During DE, there were no significant differences in BP or HR between the groups. However, at 60% of VO2peak, the distance runners had a significantly higher cardiac index and a lower systemic vascular resistance than the sprinters (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Idiopathic middle cerebral artery occlusion in children: report on three cases.

Three cases of middle cerebral artery occlusion in children are reported. The origin of M1 was the site of occlusion in two cases, while occlusion 1 cm after the origin of M1 was found in the third. The possible etiological diagnosis was infectious arteritis in the first two cases, cranial trauma in the third. In no case were serious contralateral motor deficits detected in follow-up examinations. Follow-up digital subtraction angiography showed complete regression of arterial lesions in the second case. The authors conclude that middle cerebral artery occlusion may have a benign clinical course in children; surgical revascularization is indicated only in highly selected cases.

Arteritis↗

Comparison of techniques for measurement of gelatinases/type IV collagenases: enzyme-linked immunoassays versus substrate degradation assays.

Radiolabeled substrate degradation assays and gelatin zymography are routinely employed to assay 72 kDa gelatinase A (MMP-2) and 92 kDa gelatinase B (MMP-9) in biological fluids. Enzyme-linked immunosorbent assays (ELISA) have recently been developed for the quantitation of these matrix metalloproteinases (MMP). In this study, we have compared ELISA to standard substrate degradation assays for measurement of MMP-2 and MMP-9 in human plasma and tumor-conditioned media. Gelatin Sepharose chromatography and gel filtration chromatography were employed as partial purification procedures for MMP-2 and MMP-9. The ELISA data for MMP-2 and MMP-9 are linear on a log:log regression curve over a wide range of MMP concentrations and are specific for the designated gelatinase, with no overlap detected with related metalloproteinases. The minimum detectable concentrations of MMP-2 and MMP-9 were approximately 0.5 ng/ml and 0.2 ng/ml, respectively, in the ELISA as compared to 4 ng/ml and 3 ng/ml, respectively, in gelatin zymography. The [3H]gelatin degradation assay required a combination of > 50 ng/ml of MMP-2 and MMP-9 for detection. Although gelatin zymography was less sensitive than ELISA (primarily due to the smaller sample volume employed) and was more difficult to quantitate, this procedure offers the important advantage of being able to distinguish between latent and activated gelatinases.

Collagenases↗

Mechanism of endothelin activation of phospholipase A2 in rat renal medullary interstitial cells.

Previous studies from this laboratory have demonstrated that endothelin-1 (ET) stimulates phosphatidylinositol (PI) hydrolysis, activates dihydropyridine-insensitive Ca2+ channels, and promotes prostaglandin E2 (PGE2) accumulation in cultured rat renal medullary interstitial cells (RMIC). The mechanism whereby ET augments PGE2 production was explored in the current study. ET-evoked PGE2 accumulation proceeded independent of large increments in cytosolic free Ca2+ concentration ([Ca2+]i), derived from either extracellular or intracellular sources. Chelation of intracellular Ca2+ with 1,2-bis(2-aminophenoxy)ethane-N,N,N',N'-tetraacetic acid eliminated ET-evoked PGE2 production, indicating that eicosanoid production was nonetheless a Ca(2+)-requiring process. Nanomolar concentrations of phorbol 12-myristate 13-acetate (PMA) alone did not stimulate PGE2 production, nor did PMA alter ET-stimulated PGE2 accumulation. Furthermore, downregulation of protein kinase C (PKC) by prolonged exposure of cells to PMA did not mitigate ET-mediated PGE2 production, demonstrating that PKC stimulation was not required for PGE2 production. ET stimulated PGE2 accumulation despite PI-specific phospholipase C (PI-PLC) inhibition by nanomolar concentrations of PMA, indicating that eicosanoid production was not a downstream event of PI hydrolysis. ET stimulated arachidonic acid metabolite release in parallel with a loss of label from membrane phospholipids. Phosphatidylethanolamine was the preferred substrate for ET-mediated activation of phospholipase A2 (PLA2). Immunocytochemical studies including immunostaining, immunoblotting, and immunoprecipitation confirmed the presence of cytosolic PLA2 (cPLA2) in RMIC. In summary, ET stimulation of PGE2 production in RMIC is mediated via agonist activation of cPLA2 independent of activation of PI-PLC, suggesting direct coupling to the ET receptor. Constitutive levels of [Ca2+]i rather than abrupt increments in [Ca2+]i are sufficient for activation of this receptor-effector system, with no obligatory requirement for PKC.

Animals↗

Foramen magnum stenosis and bilateral benign subdural collections in achondroplasia: case report.

A case of achondroplasia is presented in which cervico-medullary junction compression by foramen magnum stenosis and generalized seizures by bilateral subdural effusions were relieved by suboccipital craniectomy with C1 laminectomy and drainage of the collections. The important role played by NMR in the diagnosis of foramen magnum stenosis is stressed; the possible causes of hydrocephalus and subdural collections in achondroplasic patients are discussed. According to the authors surgical drainage of benign subdural collections in these patients is indicated in case of intractable seizures.

Achondroplasia↗

Linear contrast enhancement at the operative site on early post-operative CT after removal of brain tumors.

It is unclear whether a linear contrast enhancement at the edges of the operative site on early CT scan indicates a residual tumor or rather reflects postoperative changes. We have studied 15 patients treated with surgical removal of malignant brain tumor, submitted to periodic CT scan. The enhancement of linear contrast was due to a residual tumor, when seen on very early CT scan (within 24 hours after surgery). If occurring later, this enhancement was either generated by a residual tumor or by post-operative changes.

Adolescent↗

The effect of moderate resistance weight training on peak arm aerobic power.

The purpose of this study was to examine the effect of moderate resistance weight training (MRWT) on peak arm aerobic power as measured by arm cranking ergometry. Fourteen sedentary college age males, divided equally into two groups, served as subjects. The seven subjects in the MRWT group completed 12, 1-hr bouts of weight lifting over a 4 week period, exercising on Monday, Wednesday and Friday of each week. Exercise sessions included 3 sets of 10 repetitions of the following lifts: bench press, overhead dumbbell press, dumbbell arm curl, and behind the neck pull down. The remaining seven subjects served as a non-training control group, whose purpose was to account for possible learning effects on the arm ergometer test that could distort the statistical relevance of the aerobic power data. These subjects did not serve as a control for the weight training exercises, as the procedures used to determine muscular strength may produce a modest training effect. Peak arm aerobic power and muscular strength, as measured by the one-repetition maximum for each lift, were determined before and after the training program. The average increase in strength for all lifts combined for the trained group was 20.0%. They also experienced a 13.4% (p < .005) increase in peak arm aerobic power, whereas there was no significant change in this variable for the control group. It is concluded that peak arm aerobic power is enhanced by the changes in muscular strength produced by 4 wks of MRWT.

Adolescent↗