Biomedical subjects
Publications and source records attributed to R A Stone.
The effect of a single, high dose of aspirin has been assessed against low chloride cough challenge. The drug does not affect the cough response, suggesting that airway prostaglandin generation is not responsible for the tussive activity of low chloride solution.
BACKGROUND: Abnormalities in baroreflex control of heart rate may be important in the pathogenesis of essential hypertension. METHODS AND RESULTS: To investigate the influence of heredity on baroreflex function, we measured baroreflex sensitivity in 40 untreated patients with essential hypertension grouped by the presence (FH+) or absence (FH-) of a family history of hypertension and in 24 normotensive counterparts. Baroreflex sensitivity was assessed by both high-pressure (phenylephrine bolus) and low-pressure (amyl nitrite inhalation) stimuli. Subject groups were matched for age, blood pressure, body weight, and race. Baroreflex sensitivity (in milliseconds per millimeter of mercury) assessed by amyl nitrite inhalation was 24.3 +/- 2.8 in FH- normotensives, 12.3 +/- 1.7 in FH+ normotensives, 15.4 +/- 3.3 in FH- hypertensives, and 8.1 +/- 1.2 in FH+ hypertensives. Baroreflex sensitivity assessed by phenylephrine bolus was 28.8 +/- 5.6 in FH- normotensives, 19.3 +/- 2.8 in FH+ normotensives, 19.1 +/- 2.0 in FH- hypertensives, and 13.6 +/- 1.3 in FH+ hypertensives. Two-factor analysis of variance showed significant effects on baroreflex sensitivity for blood pressure status (normotensive versus hypertensive) and for family history of hypertension. After control line (controlling) for the effects of several variables, including age, mean arterial pressure, body weight, and race through multiple linear regression analysis, the effect of family history of hypertension on baroreflex sensitivity was still highly significant. Indeed, of all variables investigated, family history of hypertension was the strongest unique baroreflex sensitivity predictor. CONCLUSIONS: These data suggest that the impairment in baroreflex sensitivity in hypertension is in part genetically determined and may be an important hereditary component in the pathogenesis of essential hypertension.
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Using immunohistochemistry, brain natriuretic peptide (BNP)-like immunoreactive (-LI) nerves localize to the anterior segment of the porcine eye. BNP-LI nerve fibers are visualized mainly in the aqueous outflow pathway, ciliary processes and anterior ciliary muscle. A small number of immunoreactive nerve fibers occur in the anterior iris stroma and in relation to the iris muscles and in the cornea. Given the known ocular effects of atrial natriuretic peptide (ANP) and that BNP and ANP seem to share common receptors, these results suggest an ocular role for peptides of this class independent of delivery by the systemic circulation.
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The authors examined the effect of local administration of a dopamine receptor agonist on visual deprivation-induced excessive ocular growth and myopia. Eight rhesus monkeys were monocularly deprived of vision from birth with opaque contact lenses. Four of the monkeys received drops of 1% apomorphine HCl 2-3 times/day in the occluded eye; the four control monkeys received vehicle only. Axial lengths were determined by A-scan ultrasonography at birth and at 5-7 months of age. The authors assessed the axial elongation by comparing the postnatal growth in the axial dimension of the occluded eyes with the postnatal growth in nonoccluded eyes. In three of the four control monkeys, occlusion increased axial growth by an average of 1.3 mm. In contrast, they found that growth of the occluded and nonoccluded eyes of the apomorphine-treated monkeys was equivalent, except in one monkey whose nonoccluded eye did not develop normally and was anomalously small. At 6.5-9.5 months of age, three of four controls had myopic refractive errors (-3 to -7 diopters) in the occluded eyes; three of four of the apomorphine-treated monkeys had hyperopic refractive errors (+1-(+)3 diopters) in their occluded eyes. The occluded eye of the fourth monkey was only -0.5 diopters myopic. The findings suggest that apomorphine administration retards excessive axial elongation and the concomitant development of myopia associated with visual deprivation in primates.
In the cat ciliary ganglion, 16% and 23% respectively of the neurons are surrounded by nerve fibers immunoreactive to calcitonin gene-related peptide (CGRP) and somatostatin (SOM). One-third of the ganglion cell perikarya are immunoreactive to neuropeptide Y (NPY). Analysis of the coincidence of immunoreactivities shows a striking correlation. Practically all of the ganglion cells surrounded by CGRP-like immunoreactive (LI) nerve fibers also are surrounded by SOM-LI nerve processes and demonstrate NPY-LI perikarya. These observations define a subset of NPY-LI ciliary ganglion cells with a particular peptidergic input and perhaps a specific physiologic function.
A vision-dependent feedback mechanism contributes to the regulation of postnatal eye growth and refraction; this mechanism is located at least in part in the retina. In chicks and rhesus monkeys, visual deprivation leads to ocular enlargement and a myopic refractive error, and it also reduces the retinal concentration of dopamine. In neonatal chicks, local application of the dopamine agonist apomorphine limits the excessive axial elongation that is associated with visual deprivation. Both D1 and D2 dopamine receptor mechanisms may participate. Remarkably, apomorphine is geometrically selective, not limiting the exaggerated equatorial growth that occurs during visual deprivation. Preliminary results in neonatal rhesus monkeys indicate that apomorphine eye drops also suppress exaggerated axial growth and myopic refractive error during visual deprivation; equatorial diameters were not measured. Our observations are consistent with a retinal hypothesis for emmetropization and suggest that retinal dopamine participates in a mechanism linking ocular growth control to vision. In addition, we conclude that axial and equatorial dimensions are independently regulated in the chick.
The presence of an amino acid other than aspartic acid at position 57 of the HLA-DQ beta chain (non-Asp-57) is highly associated with susceptibility to insulin-dependent diabetes mellitus (IDDM), whereas an aspartic acid at this position (Asp-57) appears to confer resistance to the disease. We hypothesize that the 30-fold difference in IDDM incidence across racial groups and countries is related to variability in the frequency of these alleles. Diabetic and nondiabetic individuals were evaluated in five populations, including those at low, moderate, and high risk. HLA-DQ beta genotype distributions among the IDDM case groups were markedly different (P less than 0.001), as were those among nondiabetic controls (P less than 0.001). Non-Asp-57 alleles were significantly associated with IDDM in all areas; population-specific odds ratios for non-Asp-57 homozygotes relative to Asp-57 homozygotes ranged from 14 to 111. Relative risk information from the case-control study and population incidence data were combined to estimate genotype-specific incidence rates for the Allegheny County, PA, Caucasians. These rates were used to predict the overall incidence rates in the remaining populations, which were within the 95% confidence intervals of the actual rates established from incidence registries. These results are consistent with the hypothesis that population variation in the distribution of non-Asp-57 alleles may explain much of the geographic variation in IDDM incidence.
Consumption of n-3 polyunsaturated fatty acids (n-3 PUFAs) is associated with a reduced incidence of coronary arterial diseases. Dietary n-3 PUFAs act via several mechanisms. They depress plasma lipids, especially triglycerides (TGs), by inhibiting hepatic TGs and possibly apoprotein synthesis. They replace arachidonic acid (AA) in phospholipid pools with eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA). EPA and DHA, when released, inhibit cyclooxygenase and lipoxygenase and reduce eicosanoid synthesis, particularly thromboxane (TXA2) and leukotriene B4 (LTB4), by platelets and macrophages. Reduction of the proaggregatory, vasoconstrictive TXA2 decreases the thrombotic tendency of platelets. This is augmented by the limited depression of the vasoactive antiaggregatory prostacyclin (PGI2) and the generation of antiaggregatory prostaglandin I3 (PGI3) from EPA. The n-3 PUFAs also depress eicosanoid metabolism in platelets, monocytes, and macrophages, and thereby may retard the initiation and progress of atherogenesis. n-3 PUFAs reduce blood pressure and blood viscosity and modulate membrane fluidity and associated enzyme and receptor functions. The collective effects of n-3 PUFAs may account for the reduction in coronary arterial disease in populations consuming foods containing n-3 PUFAs.
This 1983 to 1985 update of an earlier study examined the mortality experience of 16,661 man-made mineral fiber workers employed 1 year or more (6 months for two plants) during 1945 to 1963 (1940 to 1963 for one plant) at one or more of 17 US manufacturing plants. Using local death rates to estimate expected deaths there was a small statistically significant (P less than .05) excess in all malignant neoplasms (standardized mortality ratio [SMR] = 108.3) and in respiratory cancer (SMR = 112.1) for the total period 1946 to 1985. For respiratory cancer the excess was greatest for mineral wool workers. For glass wool workers and glass filament workers respiratory cancer SMR values were much lower. For workers exposed in the production of small-diameter fibers, the overall respiratory cancer SMR was slightly elevated but lower than in earlier reports. A total of four malignant mesotheliomas have now been noted on death certificates. Two of these were coded to the International Classification of Disease rubrics used to estimate 1.45 expected mesothelioma deaths for the total study. Overall, the evidence of a relationship between exposure to man-made mineral fibers and respiratory cancer appears to be somewhat weaker than in the previous update.
Previous biochemical assessment of sympathetic nervous system activity including plasma catecholamines, plasma renin activity, and plasma dopamine-beta-hydroxylase levels has suggested racial differences in the contribution of the sympathetic nervous system to the pathogenesis or maintenance of hypertension. We, therefore, performed physiological and pharmacological studies in white and black subjects with essential hypertension and their age-matched normotensive counterparts to assess autonomic and sympathetic nervous system function. One hundred one male subjects (47 white hypertensive, 17 black hypertensive, 22 white normotensive, and 15 black normotensive subjects) were evaluated for baroreceptor reflex sensitivity to low-pressure (amyl nitrite inhalation) and high-pressure (phenylephrine infusion) stimuli; cold pressor test heart rate and blood pressure responses; and blood pressure response to phentolamine alpha-adrenergic blockade. Hypertensive subjects exhibited an increase in resting heart rate, a decrease in baroreceptor reflex sensitivity, and an exaggerated decline in mean arterial pressure in response to phentolamine. These abnormalities were present to a comparable degree in black and white hypertensive subjects. Cold pressor testing revealed greater increases in heart rate in blacks as compared with whites; however, this racial difference was present regardless of blood pressure status, occurring in black normotensive and black hypertensive subjects to a comparable degree. Cold pressor test blood pressure increments were similar in the four groups. We conclude that both white hypertensive and black hypertensive subjects demonstrate similar abnormalities in autonomic and sympathetic nervous system function including blunting of baroreceptor reflex sensitivity and an increased alpha-adrenergic receptor participation in blood pressure maintenance. The results do not suggest major racial differences in autonomic pathogenetic mechanisms in hypertension.
Acid extracts of guinea pig and rhesus monkey anterior uvea, choroid and retina contain immunoreactive VIP. By reversed phase high performance liquid chromatography, the immunoreactive material from these ocular tissues elutes at a position similar to synthetic porcine VIP. Only in the guinea pig anterior uvea is a second smaller peak detected. By size exclusion high performance liquid chromatography, the peptide in the monkey anterior uvea, choroid and retina elutes in the identical position as the synthetic porcine VIP standard with an apparent molecular weight of 3450 daltons. We conclude that a single form of VIP, chromatographically similar to the porcine standard, is the predominant form of the peptide in the eye of guinea pig and rhesus monkey.
Using immunocytochemistry, the authors studied the peptidergic innervation to the vasculature of the optic nerve and retina in the rhesus monkey and rat. In the monkey, beaded nerve fibers immunoreactive to the vasoactive peptides, calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), substance P (SP), and vasoactive intestinal peptide (VIP), are present in the adventitia and perivascular space along the course of the central retinal artery within the optic nerve. The CGRP and SP immunoreactivities fully co-localize. Perivascular peptidergic nerve fibers terminate as the blood vessel enters the globe and do not follow the branches of the central retinal artery inside the eye. Within the substance of the optic nerve behind the lamina cribrosa, small blood vessels occasionally are supplied with CGRP-, SP-, and sometimes NPY- or VIP-immunoreactive nerve fibers. Of special note, fine nerve fibers not clearly related to blood vessels are seen within the lamina cribrosa; their simultaneous immunoreactivity to CGRP and SP suggests a sensory function. In the rat as in the monkey, the retinal arterioles beyond the surface of the optic disc lack evident peptidergic innervation. Perhaps an explanation for the known physiologic reactivity of the retinal circulation to neurohumors in the absence of recognizable peripheral innervation can be based on comparison to the brain where intraparenchymal blood vessels may be regulated by local neurons. Since the inner plexiform layer has abundant amacrine-derived nerve processes containing classical neurotransmitters and/or neuropeptides, a local mechanism coupled to intrinsic retinal activity might contribute to the regulation of the circulation.
Angiotensin binding sites in membrane homogenates of rabbit iris/ciliary body and human nonpigmented ciliary epithelial (NPE) cells grown in culture were characterized using radioligand binding assays with (125I)-sarcosine1-isoleucine8-angiotensin II [(125I)-SARILE]. Scatchard analysis of the binding of (125I)-SARILE yielded linear plots with a Kd value of 0.55 +/- 0.1 nM and a Bmax of 98 +/- 23 fmol/mg protein in rabbit iris/ciliary body, and a Kd value of 0.63 +/- 0.1 nM, and a Bmax of 36.2 +/- 24 fmol/mg protein in NPE cells. Studies of the inhibition of the binding of (125I)-SARILE in rabbit iris/ciliary body were performed with a series of competing ligands, including the angiotensin receptor antagonist SARILE and the agonists angiotensin I, angiotensin II and angiotensin III. Inhibition curves for the antagonist resulted in Hill coefficients of approximately 1, consistent with the presence of a single class of binding sites with high affinity for (125I)-SARILE. Competition for the binding of (125I)-SARILE to binding sites with each of the agonists resulted in inhibition curves with Hill coefficients significantly less than 1 in the absence of GTP. However, in the presence of 100 microM GTP the Hill coefficients increased to approximately 1. The order of potencies of these agents was consistent with the pharmacologic profile of angiotensin II receptors. Thus rabbit iris/ciliary body homogenates, which include vascular tissue, contain a homogeneous population of angiotensin binding sites coupled to a guanine nucleotide binding protein. The presence of binding sites in cultured NPE cells indicates that at least some are located on the cells thought to be responsible for aqueous humor secretion.
Investigation of retinal neurochemistry in a well-defined chick model of form-deprivation myopia indicated that dopamine and its metabolite 3,4-dihydroxyphenylacetic acid are reduced in myopic as compared to control eyes. The reduction in retinal dopamine is evident only during light adaptation and is accompanied by a decreased rate of dopamine biosynthesis. To test whether the alteration in dopamine metabolism is related to eye growth, agents known to interact with dopamine receptors were administered locally to deprived eyes. Remarkably, the expected growth in the axial dimension was reduced, while that in the equatorial dimension was not. Therefore retinal dopamine may participate in the pathway linking visual experience and the postnatal regulation of the eye's growth in the axial dimension. The mechanism for control of chick eye growth in the equatorial dimension remains unknown.
Proteinuria is a laboratory finding that can have a wide range of clinical meanings, so a knowledgeable diagnostic approach is extremely important. The condition is transient in some patients, and they should be spared the negative psychological and financial impact that aggressive evaluation can cause. Alternatively, proteinuria can be the first sign of meaningful renal disease, and early assessment can help prevent renal failure. The ability to decide who needs further testing is an important skill.
Contradictory observations have accumulated regarding a secular trend and/or an epidemic pattern in the incidence of insulin-dependent diabetes mellitus. In this study, insulin-dependent diabetes mellitus incidence below age 15 years was examined in Allegheny County, Pennsylvania, and in Wielkopolska, Poland, two areas diverse in terms of their geography and average risk for this disease. Numerator data were extracted from individual patient records, and annual denominator data were available for the years 1970-1985. Poisson regression models were used to disentangle the contributions of country, race, sex, age, period, and cohort effects to the observed variation in incidence. Poles and Allegheny County nonwhites were at greatly and moderately reduced risk, respectively, relative to Allegheny County whites. An increase in risk with age was significant and proportional in all three groups. There was significant time variability in Wielkopolska, where an epidemic began in 1982 and continued through 1985. This was a period rather than a cohort phenomenon and was a result of a recent outbreak of the disease rather than a long-term trend. In Allegheny County, changes in risk over the 16-year period were insignificant, although incidence doubled among whites aged 0-9 years during 1982-1983. The Poisson regression modeling provided a quantification and formal comparison of determinants of the incidence of insulin-dependent diabetes mellitus.