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Biomedical subjects

R A Hoffman

Publications and source records attributed to R A Hoffman.

At least 37 records · Page 2Linked to original sources
PubMed1997

Induction of heat shock protein 70 protects thymocytes against radiation-induced apoptosis.

OBJECTIVES: To determine if induction of heat shock protein 70 (HSP 70), a stress protein that plays a cytoprotective role and inhibits cell death in response to various stimuli, will protect thymocytes and T-cell clones from radiation-induced apoptosis, and to define the mechanism of such protection. DESIGN: Thymocytes from BALB/c mice or T-lymphocyte clones were incubated at 43 degrees C for 1 hour to induce HSP 70, then irradiated. Control cells were irradiated but not heated. Fragmentation of DNA was quantitated, and p53, bax, and bcl-2 expression was analyzed at various times by the Western blot method. RESULTS: Only heated cells expressed HSP 70. The induction of HSP 70 increased basal apoptosis but significantly decreased radiation-induced apoptosis. Furthermore, introduction of an HSP 70 antisense oligomer prior to heating reversed the protective effect of HSP 70. Induction of HSP 70 in T-cell clones with sodium arsenite had a similar protective effect against radiation-induced apoptosis. Irradiation induced p53 and markedly up-regulated bax. The expression of p53 peaked at 4 hours and preceded maximal bax induction. Induction of HSP 70 prior to irradiation suppressed p53 and significantly decreased bax levels. Levels of bcl-2 were unaffected. CONCLUSIONS: Our data show that HSP 70 induction protects thymocytes from radiation-induced apoptosis by down-regulating p53 and bax expression. The induction of HSP 70 may represent a novel mechanism by which the immunosuppressive effects and the associated infectious complications of radiation therapy can be minimized.

Animals↗
PubMed1997

Cochlear implant in the child under two years of age: skull growth, otitis media, and selection.

Early cochlear implantation is desirable to effect maximal development of receptive and expressive language. Factors to consider in implanting before the age of 2 years include anatomic considerations, temporal bone growth and device extrusion or migration, the sequela of otitis media, and the accuracy of early diagnosis. Clinical experience and laboratory data indicate that cochlear implantation before the age of 2 years is possible.

Age Factors↗
PubMed1997

Constitutive expression of inducible nitric oxide synthase in the mouse ileal mucosa.

It has been demonstrated previously that the inducible isoform of nitric oxide synthase (iNOS) is present throughout the intestinal tract in various inflammatory disease processes. Here we demonstrate that iNOS mRNA is present in the ileum but not in the jejunum or colon of normal mice. By Western blot analysis, iNOS protein is also detected in normal ileum, but not in the normal jejunum. However, by 3 h postinjection of 0.5 mg/kg lipopolysaccharide (LPS), iNOS mRNA is also detectable in the jejunum and colon. The enzyme message and protein, localized immunohistochemically by in situ hybridization and iNOS expression, is normally restricted to the villus epithelial cells. The iNOS mRNA was also present in the ilea of mice with defined intestinal flora (anaerobes only), germ-free mice, nude mice, and to a lesser extent in mice with severe combined immunodeficiency. These results suggest that the constitutive presence of iNOS in ileal epithelium indicates a role for this enzyme in maintaining intestinal homeostasis.

Animals↗
PubMed1997

Cochlear implantation in children with cochlear malformations.

OBJECTIVE: To address the surgical and habilitative issues raised by cochlear implantation in children with cochlear dysplasia. STUDY DESIGN: The English-language literature is reviewed and the New York University Medical Center experience with three patients is detailed. Two hundred institutions performing cochlear implants were queried by questionnaire. SETTING: Hospitals performing cochlear implantation. PATIENTS: Pediatric patients with a cochlear implant in an ear with a dysplastic cochlea. MAIN OUTCOME MEASURES: Preoperative computed tomography analysis of cochlear anatomy was compared with operative findings, complications, and postoperative device use. RESULTS: Facial nerve anatomy was anomalous in 16% of patients, and there were two surgical injuries. There were no cases of meningitis. All patients who received multichannel implants derive benefit and wear their devices. CONCLUSIONS: All degrees of cochlear dysplasia, ranging from incomplete partition to common cavity, can be safely implanted and auditory responses expected.

Adult↗
PubMed1997

Open-set speech perception in congenitally deaf children using cochlear implants.

OBJECTIVE: To assess and document the development of open-set speech recognition in congenitally deaf children implanted with the Nucleus multichannel cochlear prosthesis at < 5 years of age. STUDY DESIGN: The study group consisted of 38 consecutively chosen children in whom the decision to proceed with implantation had already been made. PATIENTS AND SETTING: Congenitally profoundly deaf children were implanted with the Nucleus multichannel cochlear implant at < 5 years of age and followed at NYU Medical Center for a period of 1-5 years. MAIN OUTCOME MEASURES: Open-set speech perception was evaluated preoperatively and postoperatively using the following: the Glendonald Auditory Screening Procedure (GASP) word subset, the GASP sentence subtest, Phonetically Balanced Kindergarten monosyllabic word lists, Common Phrases test, Multisyllabic Lexical Neighborhood test, and Lexical Neighborhood test. RESULTS: Correlation coefficients were calculated between scores at each interval and age at implantation; one-way analyses of variance were performed independently. Results showed that all subjects had significant open-set speech recognition at the time of the last postoperative evaluation. Thirty-seven of the children use oral language as their sole means of communication. CONCLUSIONS: Multichannel cochlear implants provide significant and usable open-set speech perception in congenitally deaf children given implants at < 5 years of age.

Auditory Threshold↗
PubMed1996

Nitric oxide production by mouse bone marrow-derived dendritic cells: implications for the regulation of allogeneic T cell responses.

Dendritic cells (DC) are the most potent known antigen presenting cells, and play important roles both in immunity and tolerance induction. Nitric oxide (NO) is an important effector molecule that is involved in numerous aspects of the immune response. There have been no accounts to date of efforts to determine NO generation by well-characterized DC. In this report we describe the production of NO by highly purified DEC 205+ DC propagated from mouse bone marrow in response to granulocyte/macrophage-colony stimulating factor (GM-CSF) + interleukin-4 (IL-4). NO synthesis was induced in DC by interferon-gamma (IFN-gamma) and lipopolysaccharide (LPS), and was blocked by the inhibitor of nitric oxide synthase (NOS), NG-monomethyl-L-arginine (NMMA). Both "mature" B7-2+ (CD86+) DC and B7-2- (CD86-) DC progenitors could be induced to release NO. NO was also recovered from the supernatants of primary mixed leukocyte cultures containing comparatively high concentrations of B7-2+ DC in relation to purified allogeneic T cells. Furthermore, inhibition of NO release in these cultures by NMMA resulted in an increase in T cell proliferation. These observations suggest that NO may be an important soluble mediator of the interaction between DC and activated T cells. In addition to its ability to inhibit T cell proliferation, NO was also shown to induce programmed cell death in DC. This was visualized by the detection of DNA strand breaks with in situ nick translation. The percentage of DC apoptosis correlated with the level of NO in the cultures. Apoptosis was inhibited by the addition of NMMA. These results indicate that DC have the capacity both to stimulate and potentially limit the same allogeneic T cell response, in accordance with their production of NO.

Animals↗
PubMed1996

Graft hyporeactivity induced by donor-specific bone marrow.

Much interest has recently focused on administration of donor cells with organ transplantation to improve graft outcome. However, whether donor cell administration actually confers donor-specific (DS) hyporeactivity is unknown. The intra-graft events after DS bone marrow (BM) infusion were therefore examined in an in vivo sponge matrix allograft model. Recipient C57BL/6J (B6,H2b) mice (five per group) received either media alone, 10(7) syngeneic (B6), or allogeneic (DBA/2J,H2d) BM cells intravenously. Seven days later, a sponge matrix allograft containing 10(7) allogeneic (DBA) splenocytes was implanted. On various days after grafting, graft-infiltrating cells were tested for in vitro cytotoxicity by 51Cr release assay. Previous DSBM infusion significantly reduced intragraft allospecific cytolytic T-cell (CTL) activity compared with mice receiving syngeneic BM or media alone (3.5 +/- 5.1% vs. 46.2 +/- 13.3% and 47.9 +/- 13.5% at 100:1 E:T, respectively, P < 0.001). Time course studies showed that DSBM impaired allospecific CTL activity whether given on day -10 (3.3% at 100:1 E:T), day -7 (2.2%), day -2(7.7%), or day 0 (6.5%), but was not as effective when given on day +7 (27.1%). Flow cytometry of graft-infiltrating cells on day +12 showed a decreased percentage of CD8+ cells after DSBM, compared with syngeneic BM or media alone (13.1% vs. 38.0% and 36% respectively, P = 0.01), but the percentage of CD4+ cells was similar in all groups (5.5%, 6.9%, and 4%, respectively). Thus, (1) DSBM inhibits allospecific CTL development in the allograft, (2) decreased intra-graft CTL activity after DSBM correlates with a decreased percentage of intragraft CD8+ cells, and (3) DSBM induces hyporeactivity up until the day of the allograft placement, but not thereafter. DSBM may, thus, induce graft hyporeactivity by impairing intragraft immune activation.

Animals↗
PubMed1996

Induction of nitric oxide synthase in mouse dendritic cells by IFN-gamma, endotoxin, and interaction with allogeneic T cells: nitric oxide production is associated with dendritic cell apoptosis.

Nitric oxide (NO) is an important effector molecule that is involved in immune regulation and host defense. In this study, highly purified NLDC 145+ (DEC-205+) MHC class II(bright) B7-2+ dendritic cells (DC) propagated from normal mouse bone marrow in response to granulocyte-macrophage CSF + IL-4 were induced to produce NO by IFN-gamma and LPS. NO production was inhibited by the nitric oxide synthase (NOS) inhibitor N(G)-monomethyl-L-arginine (NMMA). Nitrite also accumulated in mixed leukocyte culture supernatants as the result of coculture of DC with purified naive allogeneic T cells. Furthermore, NO production was induced by CD40 ligation. Suboptimal T cell proliferation observed at high relative concentrations of DC correlated with increased NO production and was mitigated by NMMA. Induction of mRNA for an inducible NOS (iNOS) in DC was confirmed by Northern blotting, whereas intracellular iNOS was visualized by two-color flow cytometry and by both immunofluorescent and immunogold labeling in a subpopulation of IFN-gamma + LPS-stimulated cells. Both endogenous NO production and exposure of unstimulated DC to the NO donor S-nitroso-N-acetyl-penicillamine (SNAP) resulted in DC apoptosis. Thus, although DC function initially as the most potent APCs for T cell activation, DC induced to synthesize NOS by IFN-gamma may inhibit (allogeneic) T cell proliferation: NO may suppress lymphocyte proliferation and also induce apoptosis of the most potent source of alloantigenic stimulation.

Animals↗
PubMed1996

Bystander injury of host lymphoid tissue during murine graft-verus-host disease is mediated by nitric oxide.

The suppressed lymphocyte proliferative responses characteristic of graft-versus-host disease (GVHD) are due, in part, to production of nitric oxide (NO). In order to more fully elucidate the role of NO during GVHD, an NO synthesis inhibitor, aminoguanidine (AG), was administered to unirradiated (C57BL/6J X DBA/2J)F1 mice injected with 5 X 10(7) C57BL/6J splenocytes. Administration of AG resulTed in abrogation of the elevation in serum NO2- + NO3- levels characteristic of GVHD. A significantly increased percentage of splenocytes of host phenotype (H2b/d, B220+, and THY1.2+) and a significantly higher hematocrit value were detected in GVHD animals receiving AG therapy. Additionally, the Con A-induced proliferative response of splenocytes obtained from GVHD mice receiving AG therapy was increased compared with the responses of splenocytes from animals that did not receive AG therapy. Parameters not affected by AG therapy included NO synthesis by recovered peritoneal macrophages, donor antihost cytolytic activity in splenocyte populations, serum GM-CSF levels and long-term engraftment of donor cells. These data indicate that NO may play a role in the destruction of both lymphoid and erythroid host tissue as well as the reduced lymphoproliferative responses associated with the acute phase of GVHD.

Animals↗
PubMed1996

Spontaneous cerebrospinal fluid leaks originating from multiple skull base defects.

Spontaneous cerebrospinal fluid (CSF) leaks of temporal bone origin are more prevalent than once believed. Twenty-eight of the 61 cases documented in the world literature have been reported since 1992. All but four of these cases involved unilateral defects. The authors have previously reported experiences with 12 cases, with the vast majority of defects localized to the tegmen tympani. These patients also had demonstrated a single area of bone and dural dehiscence. We report two additional cases of spontaneous CSF leak originating from multiple/distant skull base defects. As in previously reported multisite cases, one of our patients demonstrated an elevated opening pressure on lumbar puncture. Significant time intervals existed between leak site presentations, which emphasizes the importance of careful follow-up for treated patients. Potential etiologies and associated factors are also discussed. This patient subset contributes another dimension to the evolving natural history of spontaneous CSF leakage.

Journal Article↗
PubMed1996

Functional changes of intestinal intraepithelial lymphocytes during acute graft versus host disease: correlation with phenotype.

While the pathological characteristics of acute graft versus host disease (GvHD) have been defined for many target organs, little attention has been paid to the functional changes to lymphocytes in target organs such as the liver and small intestine. We have shown previously, utilizing a nonlethal parent (C57BL/6J) into the F1 (C57BL/6J x DBA2J F1) GvHD model, that the intestinal mucosa is infiltrated exclusively by donor T cells with a CD8+ phenotype during the first 3 weeks post-GvHD induction. The present study investigated the functional changes associated with the phenotypic changes of intestinal intraepithelial lymphocytes (IEL) during the acute phase of GvHD. IEL displayed specific anti-host cytolytic activity during the second and third week after GvHD induction. In addition, enhanced cytolytic activity, detected in the presence of anti-CD3 antibody, was apparent during the second through fourth week, with a peak in the third week after GvHD induction. The IEL also showed enhanced proliferative responses to immobilized anti-CD3 during the first 2 weeks of acute GvHD, while profound inhibition of proliferation was observed in the splenocyte population of the same animals. During weeks 2 and 3 post-GvHd induction, the V beta distribution of host IEL remained unchanged while the V beta distribution of infiltrating donor CD8+ cells resembled that of the donor IEL population. In the small intestine, the increased cytolytic and proliferative activity of IEL during the course of the disease may provide a rationale for the involvement of this organ in the pathology associated with GvHD.

Acute Disease↗
PubMed1996

Cerebrospinal fluid drainage in the management of CSF leak following acoustic neuroma surgery.

A retrospective analysis was performed on 174 patients operated on from 1992 to 1995 to evaluate the safety and efficacy of continuous lumbar cerebrospinal fluid drainage (CLCFD) in the management of cerebrospinal fluid (CSF) leaks following acoustic neuroma surgery. There was a 17% incidence of CSF leak. CLCFD stopped the leak in 87% of cases. There were no cases of meningitis associated with CLCFD. One deep vein thrombosis was treated without sequelae. It is concluded that CLCFD is safe and efficacious. The authors recommend that CLCFD be implemented immediately when indicated, foregoing a trial of conservative therapy. Indications and precautions are discussed.

Cerebrospinal Fluid↗
PubMed1995

Aequorea green fluorescent protein analysis by flow cytometry.

The isolation and expression of the cDNA for the green fluorescent protein (GFP) from the bioluminescent jellyfish Aequorea victoria has highlighted its potential use as a marker for gene expression in a variety of cell types (Chalfie et al.: Science 263: 802-805, 1994). The longer wavelength peak (470 nm) of GFP's bimodal absorption spectrum better matches standard fluorescein filter sets; however, it has a considerably lower amplitude than the major absorption peak at 395. In an effort to increase the sensitivity of GFP with routinely available instrumentation, Heim et al. (Nature 373:663-664, 1995) have generated a GFP mutant (serine-65 to threonine; S65T-GFP) which possesses a single absorption peak centered at 490 nm. We have constructed this mutant in order to determine whether it or wild-type GFP (wt-GFP) afforded greater sensitivity when excited near their respective absorption maxima. Using the conventionally available 488 nm and ultraviolet (UV) laser lines from the argon ion laser as well as the 407 nm line from a krypton ion laser with enhanced violet emission, we were able to closely match the absorption maxima of both the S65T and wild-type forms of Aequorea GFP and analyze differences in fluorescence intensity of transiently transfected 293 cells with flow cytometry. The highest fluorescence signal was observed with 488 nm excitation of S65T-GFP relative to all other laser line/GFP pairs. The wt-GFP fluorescence intensity, in contrast, was significantly higher at 407 nm relative to either 488 nm or UV. These results were consistent with parallel spectrofluorometric analysis of the emission spectrum for wt-GFP and S65T-GFP. The relative contribution of cellular autofluorescence at each wavelength was also investigated and shown to be significantly reduced at 407 nm relative to either UV or 488 nm.

Base Sequence↗
PubMed1995

Phenotypic analysis of donor cells infiltrating the small intestinal epithelium and spleen during graft-versus-host disease.

One of the principal target organs during graft-versus-host disease (GvHD) is the intestinal epithelium, although the reasons for the preferential involvement of particular organs in this disease are not known. This study analyzed the subset distribution of donor and host lymphocytes in the small intestinal epithelium and the spleen during GvHD in a parent (C57BL/6J) into F1 (C57BL/6JxDBA2/J F1) model. While the donor cell population in the spleen consisted of B and T cells, the donor cell population in the intestine contained only T cells during the course of GvHD. These infiltrating donor cells resembled the host intraepithelial lymphocytes (IELs), which are predominantly CD8+ T cells. This subset distribution of donor cells in the intestinal epithelium was remarkable since they originated from a donor splenocyte population containing few CD8+ lymphocytes. In addition, although the injected donor splenic T cells were virtually all alpha/beta TCR+, several months after GvHD induction more than 30% of the donor cells in the intestine were gamma/delta TCR+, thereby resembling the host IELs not only in their expression of CD4 and CD8, but also in their TCR expression. In contrast, no gamma/delta TCR+ donor cells were detectable in the spleen of GvHD mice. The subset distribution of donor and host IELs remained constant throughout the disease, while in the spleen a decrease of both donor and host B cells and a temporary increase of both donor and host CD8+ cells was observed. These findings demonstrate that in a given target organ during GvHD the disease process affects both donor and host lymphoid populations. In addition the different tissue microenvironments eventually lead to donor cell repopulation with a subset distribution similar to the host natural lymphoid population of the particular target organ.

Animals↗
PubMed1995

Model study detecting breast cancer cells in peripheral blood mononuclear cells at frequencies as low as 10(-7).

A flow cytometric assay was developed to detect rare cancer cells in blood and bone marrow. Multiple markers; each identified by a separate color of immunofluorescence (yellow and two shades of red), are used to reliably identify the cancer cells. Blood or bone marrow cells, which are not of interest but interfere in detecting the cancer cells, are identified by a panel of immunofluorescence markers, each of which has the same color (green). Thus, the rare cancer cells of interest are yellow and two different shades of red but not green. The requirement that the rare cancer cell be simultaneously positive for three separate colors (the specific markers) and negative for a fourth color (the exclusion color) allowed detection of as few as one cancer cell in 10(7) nucleated blood cells (a frequency of 10(-7). To test this rare-event assay prior to clinical studies, a model study was performed in which the clinical sample was simulated by mixing small numbers of cells from the breast carcinoma line BT-20 with peripheral blood mononuclear cells. We detected statistically significant numbers of BT-20 cells at mixing frequencies of 10(-5), 10(-6), and 10(-7). In control samples, no target events (BT-20) were observed when more than 10(8) cells were analyzed. For additional confirmation that the BT-20 cells in the model study were correctly identified and counted, the BT-20 cells (and only BT-20 cells) were covalently stained with a fifth fluorescence dye, 7-amino-4-chloromethylcoumarin (CMAC). CMAC fluorescence data were not used in the assay for detecting BT-20 cells. Only after the analysis using data from the specific and exclusion colors had been completed were the events identified as BT-20 cells checked for CMAC fluorescence. The putative BT-20 events were always found to be positive for CMAC fluorescence, which further increases confidence in the assay. Manual data analysis and an automated computer program were compared. Results were comparable with the manual and automated methods, but the automated "genetic algorithm" always found more BT-20 events. Cell sorting of BT-20 cells from samples that contained BT-20 at frequencies of 10(-5), 10(-6), and 10(-7) provided further evidence that these rare cells could be reliably detected. The good performance of the assay with the model system will encourage further studies on clinical samples.

Algorithms↗
PubMed1995

Retrofacial approach to the hypotympanum.

Otologic disease often extends into the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments. Surgical access to these areas can be difficult because of the proximity of the facial nerve. In patients with a normal bone anatomy, these regions can be accessed by a retrofacial approach, which spares the posterior canal wall and avoids transposition of the facial nerve. The anatomy of the hypotympanum, posterior mesotympanum, and infralabyrinthine compartments will be reviewed emphasizing gross anatomic documentation. We will detail the surgical approach to these areas along the retrofacial air cell tract, and will present an appropriate case history.

Ear Neoplasms↗