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Biomedical subjects

R Jacob

Publications and source records attributed to R Jacob.

At least 145 records · Page 8Linked to original sources

(Na + K + 2Cl) cotransport in cultured embryonic chick heart cells.

The coupled movements of Na, K, and Cl were studied in cultured chick embryonic heart cells using ion-selective microelectrodes. Movements of K and Cl in response to changes in extracellular [K] ([K]o) showed a furosemide-sensitive coupled process. The movement of Na was then studied. Lowering extracellular [Na] ([Na]o) to 27 mM caused a decrease in intracellular Cl activity (aicl). Upon restoring [Na]o to 143 mM, Cl was taken up against its electrochemical gradient (delta mu Cl). In Cl-free solution, cells lost Na against delta mu Na and simultaneously lost Cl. Upon restoring extracellular [Cl] ([Cl]o), Cl was taken up against delta mu Cl; this was accompanied by an uptake of Na. The Cl uptake was 4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonic acid (SITS)-insensitive (0.1 mM) but inhibited by removing Nao. Both Cl and Na uptakes were potentiated by raising [K]o from 5.4 to 15 mM, and Na uptake was diminished by lowering [K]o to 1 mM. In all experiments, Cl and Na movements were furosemide (0.3 mM) or bumetanide-sensitive (0.1 mM). Removal of Nao, with resultant depletion of intracellular [Na] ([Na]i), blocked the furosemide or bumetanide-sensitive Cl loss or uptake upon exposure to zero or 133 mM [K]o + SITS (0.1 mM), respectively. These results suggest that cultured heart cells possess an electroneutral (Na + K + 2Cl) cotransport.

4-Acetamido-4'-isothiocyanatostilbene-2,2'-disulfo↗

Functional significance of contractile proteins in cardiac hypertrophy and failure.

The functional significance of alterations in contractile proteins was investigated in the chronically overloaded left ventricle of Goldblatt rats and spontaneously hypertensive rats (SHRs). Congestive cardiac insufficiency occurring in late stages of pressure overload is associated with impaired contractility, as well as significant structural dilatation. Only in the event of extreme dilatation, however, would pumping failure occur in the presence of intact myocardial contractile capability. The transformation toward a slower myocardium is associated with a reduced rate of Ca2+ uptake by the sarcoplasmic reticulum. Transformation influences ventricular and myocardial working capacity to a much lesser extent than do the velocity parameters of contraction. Although a fairly homogeneous VM-3 pattern is typical for ventricles when cardiac failure is experimentally induced, extreme myocardial transformation, as such, does not cause congestive failure. With cardiac insufficiency, left ventricular volume, systolic wall stress, and hydroxyproline concentration are overproportionately increased, as related to VM-3 content, whereas noradrenaline content is decreased. This is consistent with the assumption that myocardial transformation is not necessary for the development of these alterations. Myocardial transformation may be promoted by structural dilatation. Extreme transformation, however, should, in turn, decrease contractility, contributing to cardiac failure. A considerable decrease in contractility indirectly causes depletion of the catecholamine stores. The energy-saving effect of myocardial transformation toward a slower muscle cannot compensate for the unfavorable effects of a substantial degree of ventricular dilatation.

Animals↗

[Closed femoral intramedullary nailing without drilling--a 14-year evaluation].

A sufficiently stable osteosynthesis is demanded on the basis of the conditions formulated for the healing of bone fractures. This demand applies to fractures in general. For intramedullary nailing in particular, it is a major postulate that sufficient stability can only be attained if the medullar cavity is drilled open. Such drilling aims at establishing an extended contact between the cortical substance of the bone and the nail while exercising at the same time a clamping force that is elastic in transverse direction. In our accident emergency hospital (Ludwigshafen) the medullar cavity is not drilled open. This entails the use of frequently very thin intramedullary nails so that the nail can pass through the hourglass-like narrow pathway in the centre. Although this kind of osteosyntheses is insufficient in respect of stability and ensuring rotation, the healing of bone fractures does not present any problems. As a matter of fact, 450 femurs have been treated at our hospital during the pase 14 years with intramedullary Küntscher nailing without drilling. It is demonstrated that this kind of stabilising the fracture is associated with an extremely low incidence of pseudarthroses and infections. Further complications are stated.

Adult↗

[Aneurysm of the infrarenal abdominal aorta].

Preoperative and postoperative treatment as well as standardisation of surgical techniques over the past 20 years have helped to bring about considerable reduction of operative mortality in cases of asymptomatic aortic aneurysm. Yet, with all improvement, rupture of aneurysm has continued to be associated with high rates of mortality. At the Department of Surgery of Cologne University, between 1963 and 1985, operations were performed on 681 patients for abdominal aortic aneurysm. Asymptomatic aneurysm were surgically removed from 41.7 per cent of them, while 27.5 per cent underwent surgery in symptomatic stages. Aneurysm had ruptured in 210 patients. Operative mortality accounted for 5.3 per cent of all asymptomatic patients. High mortality rates among patients with ruptured aortic aneurysms were attributable to preoperative shock. Only 16.3 per cent of patients survived in this group. The mortality rate among patients without shock amounted to 39.5 per cent.

Adult↗

Intrabiliary glutathione hydrolysis. A source of glutamate in bile.

High concentrations of glutathione (GSH) and two of its constituent amino acids, glutamate and glycine, are normally found in rat bile. To examine the role of intrabiliary GSH hydrolysis as a source of these amino acids, as well as of cystine in bile, the biliary excretion of GSH and free amino acids was measured in normal male Sprague-Dawley rats; in animals given either phenol 3,6-dibromphthalein disulfonate or diethyl maleate, inhibitors of GSH secretion into bile; and after a retrograde intrabiliary infusion of (alpha S, 5S)-alpha-amino-3-chloro-4,5-dihydro-5-isoxazoleacetic acid (AT-125), an irreversible inhibitor of gamma-glutamyl transferase activity. Total concentration of amino acids in normal rat bile ranged from 4 to 7 mM and was more than double the concentration in plasma (2-3 mM). Although most amino acids were detected in bile, glutamate and glycine were the most prevalent (1.2 and 1.0 mM, respectively), followed by the branched chain amino acids valine and leucine. The administration of phenol 3,6-dibromphthalein disulfonate (180 mumol/kg, intravenous), or of diethyl maleate (1 mmol/kg, intraperitoneal), resulted in a marked decrease in the biliary excretion of GSH, as well as a decrease in the excretion of glutamate, cystine, and glycine; however, the effects of these agents were not specific for the amino acid constituents of GSH. Following retrograde intrabiliary infusion of AT-125 (10 mumol/kg), there was an immediate and sustained doubling in the rate of biliary excretion of both GSH and glutathione disulfide and a marked decrease in the rate of excretion of glutamate. Varying the dose of AT-125 (0-20 mumol/kg) resulted in an inverse linear relation between hepatic gamma-glutamyl transferase activity and the biliary excretion of intact GSH. These findings suggest that most, if not all, of the free glutamate in excreted bile is formed from the intrabiliary hydrolysis of GSH. Prior to hydrolysis within the biliary tree, substantial concentrations of GSH must be transported from liver cells into bile; minimal canalicular concentrations of this tripeptide are estimated at 5 mM.

Amino Acids↗

Correlation between total catecholamine content and redistribution of myosin isoenzymes in pressure loaded ventricular myocardium of the spontaneously hypertensive rat.

In the spontaneously hypertensive rat (SHR) with established hypertension left ventricular mass closely correlated with the proportion of ventricular myosin (VM)-3. A 60% VM-3 content was reached corresponding, under the present housing conditions, to an average age of 40 weeks without any significant change in total noradrenaline content. However, all 72-week-old SHR showed marked reduction in total noradrenaline content which corresponded to noradrenaline depletion. At this stage, the proportion of VM-3 varied greatly; some of the SHR exhibited a higher proportion of VM-3 than would be expected from their ventricular weight. The excessive redistribution in the direction of VM-3 might, therefore, be considered as a reaction secondary to noradrenaline depletion. Total dopamine content was also reduced in 72-week-old SHR. In younger SHR, a positive correlation was found for dopamine content and left ventricular weight. It is concluded that a redistribution of the myosin isoenzymes up to 60% VM-3 in SHR is not associated with deterioration of ventricular performance to the extent that an excessive neurohumoral drive ensues. However, in the late stage of haemodynamic overload, a functional state is reached which is prone to noradrenaline depletion. A causative factor involved in this process could be the extreme redistribution of the myosin isoenzyme population, besides other factors such as fibrosis and dilatation. Which functional determinants or structural elements are finally decisive for the transition into a myocardium with depleted noradrenaline stores requires further investigation.

Animals↗

Significance of physical exercise in hypertension. Influence of water temperature and beta-blockade on blood pressure, degree of cardiac hypertrophy and cardiac function in swimming training of spontaneously hypertensive rats.

In previous studies swimming training (ST) of spontaneously hypertensive rats (SHR) at 36 degrees water temperature (WT) led to a decrease in blood pressure (BP). A similar effect of ST has not been described in human hypertension. Our purpose was to investigate the influence of WT on this training effect, the influence of ST on LV hypertrophy and the involvement of adrenergic stimuli in the latter. Male SHR (20 weeks old) were divided randomly into 4 groups. 1) SHR sedentary 2) SHR ST 36 degrees 3) SHR ST 26 degrees 4) SHR ST 36 degrees + atenolol (50 mg/kg/die). ST was performed 2 X 90 min/day for 31 days and then reduced to 2 X 60 min/day. After 7 weeks of ST BP was lower in all ST groups compared with SHR sedentary (p less than 0.001). BP was higher in ST 26 degrees than in ST 36 degrees (p less than 0.05). No additional effect of atenolol on BP was observed. The increase in the degree of LV hypertrophy during ST (ST 36 degrees: +15%; ST 26 degrees: +26%) could be prevented by atenolol (ST 36 degrees + atenolol: -1.5%). ST 36 degrees led to improved ventricular and myocardial performance with decreased LV wall stress ("luxury hypertrophy"), while in ST 26 degrees ventricular dilatation occurred with increased systolic wall stress and elevated LVEDP. It was uncertain whether this should be interpreted as a state of LV pre-insufficiency in ST 26 degrees in spite of no indications of impaired myocardial contractile capability. Peripheral vascular resistance (PVR) was significantly reduced by ST. The reduction was more evident in ST 26 degrees, but was partially compensated for by an increased cardiac output. The weights of adrenal glands increased (p less than 0.001), most markedly for ST 26 degrees. The level of thyroid hormones (T3 and fT3) was increased in ST 26 degrees. In summary, ST proved to be effective in lowering BP of SHR. WT had great influence with respect to cardiovascular adaptation and mechanisms involved in ST of SHR. Cardioadrenergic drive was of great significance for the process of hypertrophy during ST in SHR.

Animals↗

Pathophysiological mechanisms in cardiac insufficiency induced by chronic pressure overload--an attempt to analyze specific factors in animal experiment.

Experimental results obtained from studies on Goldblatt rats and spontaneously hypertensive rats as well as theoretical considerations render possible an approximate analysis and evaluation of the relative significance of specific factors at different levels of the heart for the manifestation of cardiac failure under chronic pressure overload. In our experimental models congestive failure was never observed independently of structural dilatation. Thus, as a rule dilatation had already set in before symptoms of heart failure became manifest. However, at moderate dilatation of the ventricle, e.g., at double the end-diastolic volume, the geometrical state per se cannot be the cause of hydropic decompensation whereas extreme dilatation would, in principle, cause cardiac pumping failure even in the absence of any impairment of myocardial "contractility". Generally, a more or less marked impairment of myocardial contractile capability was found, which exceeded the effects due to the altered isoenzyme pattern of myosin. As a rule, a reduction in myocardial "contractility" could be ascertained before a marked degree of dilatation was reached. Diffuse fibrosis impairs the contractile capability of the myocardium and certainly contributes to the manifestation of heart insufficiency; although, as a rule, it should not be the main cause. The adaptive transformation of myocardium towards a slower muscle (isoenzyme pattern of myosin; sarcoplasmatic reticulum) as such does not lead to resting insufficiency, not even under persisting pressure load. Further investigations on processes of excitation-mechanical coupling in the advanced stage of cardiac overload are indicated. The absence of sympathetic support to the heart, e.g., following blockade of beta-adrenergic receptors can, in the advanced stage, elicit a transition from the stage of pre-insufficiency to manifest failure. However, this was only observed when dilatation had already occurred. A network of factors are responsible for cardiac insufficiency due to pressure overloading, whereby the respective significance of each component varies, depending on the experimental model used.

Animals↗

Amino acid and glucose metabolism in the postabsorptive state and following amino acid ingestion in the dog.

Amino acid and glucose metabolism was studied in nine awake 18-hour fasted dogs with chronic portal, arterial, and hepatic venous catheters before and for three hours after oral ingestion of amino acids. The meal was composed of a crystalline mixture of free amino acid, containing neither carbohydrate nor lipid. Following the amino acid meal, plasma glucose concentration declined slowly and this occurred despite a rise in hepatic glucose release. Portal plasma insulin rose transiently (30 +/- 7 to 50 +/- 11 microU/mL, P less than 0.05) while the increase in portal glucagon was more striking and persisted throughout the study (162 +/- 40 to 412 +/- 166 pg/mL). Over the three hours following amino acid ingestion, the entire ingested load of glycine, serine, phenylalanine, proline, and threonine was recovered in portal blood as was 80% of the ingested branched chain amino acids (BCAA). The subsequent uptake of these glucogenic amino acids by the liver was equivalent to the amount ingested, while hepatic removal of BCAA could account for disposal of 44% of the BCAA absorbed; the remainder was released by the splanchnic bed. During this time, ongoing gut production of alanine was observed and the liver removed 1,740 +/- 170 mumol/kg of alanine, which was twofold greater than combined gut output of absorbed and synthesized alanine. In the postcibal state, the total net flux of alanine and five other glucogenic amino acids from peripheral to splanchnic tissues (1,480 mumol/kg 3 h) exceeded the net movement of branched chain amino acids from splanchnic to peripheral tissues (590 mumol/kg/3 h).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorption↗

Na/H exchange in cultured chick heart cells: secondary stimulation of electrogenic transport during recovery from intracellular acidosis.

Intracellular acidosis is capable of stimulating a rapid amiloride-sensitive Na/H exchange mechanism in the cell membrane of cultured chick heart cells. The sequence of changes of intracellular sodium and potassium contents during recovery from an acid load in heart cells was determined by atomic absorption spectrophotometry and correlated with electrophysiological measurements. Induction of an intracellular acid load by removal of NH4Cl from the bathing solution caused a rapid rise in sodium content that was amiloride-sensitive. Following a peak, sodium content declined concomitant with a rise in potassium content; these changes were ouabain-sensitive and corresponded with a ouabain-sensitive membrane hyperpolarization beyond the calculated potassium equilibrium potential. These observations indicate that pHi regulation in cardiac muscle, following an intracellular acid load involves extrusion of H+ by electroneutral Na/H exchange with the consequent rise in Nai stimulating the electrogenic Na/K pump to return Nai to control level. In the presence of amiloride (10(-4) M), the hyperpolarization was slower although still present: this suggests the existence of another sodium uptake mechanism which contributes to stimulation of electrogenic transport.

Action Potentials↗

Vitamin K deficiency in chronic alcoholic males.

Twenty male alcoholic subjects were studied initially within 1 day after stopping alcohol and again after about 1 week. Vitamin and mineral measurements were made on blood and abnormal prothrombin molecules quantitated for vitamin K status. Nine of the 20 patients received menadiol after the initial blood sample. Twelve of the alcoholics had significant elevations of abnormal prothrombin. Of these 12, all five who received vitamin K reduced the abnormal prothrombin levels toward normal but no change was observed in the seven who did not receive vitamin K. All nine patients receiving vitamin K lowered the abnormal prothrombin level significantly whereas there was no change in those 11 who did not receive vitamin K. The prothrombin time by the one-stage technique was normal in all patients. These data suggest that the production of abnormal prothrombin is frequently present in alcoholics and this may represent a subclinical vitamin K deficiency.

Adult↗

Coupled sodium-calcium transport in cultured chick heart cells.

In cultured embryonic chick heart cells, alterations of extracellular Na (Nao) and Ca (Cao), intracellular Na (Nai) and Ca, extracellular pH, and membrane potential resulted in changes in Na and Ca contents that were consistent with sarcolemmal Na-Ca exchange. 24Na efflux measurements revealed a large ouabain-insensitive component, one-third of which was inhibited by removal of Cao. Incubating the cells in Na-free solution resulted in a rapid, 1.5- to 2-fold increase in total cell Ca that remained elevated for at least 15 min. Cells exposed for 15 min to Nao less than or equal to 20 mM became maximally loaded with Ca, whereas Ca loading fell off sharply at values of Nao greater than 20 mM. The movement of Na against its electrochemical gradient was shown to be associated with Ca accumulation. During Na-K pump inhibition (in 10(-4) M ouabain), Na initially rose 2- to 3-fold to a level below its equilibrium value; then, lowering Cao for 30 min from 1.25 to 0.75 mM caused a 26% elevation in Nai, whereas raising Cao from 1.25 to 2.7 mM resulted in a 25% fall in Nai against its electrochemical gradient. These data are consistent with Nai being maintained by a Na-Ca exchange during Na-K pump inhibition. In the presence of ouabain (10(-4) M), Ca uptake into intracellular organelles, e.g., mitochondria, was suggested by an increase in total cell Ca as well as the occurrence of mitochondrial matrix granules, which were shown qualitatively by X-ray analysis to contain Ca. Although matrix granules also occurred in mitochondria during Na-free incubation, they did not contain detectable amounts of Ca when examined under identical conditions of fixation and analysis.

Animals↗

Removal of infused amino acids by splanchnic and leg tissues in humans.

To compare the contributions of splanchnic and skeletal muscle tissues to the disposal of intravenously administered amino acids, regional amino acid exchange was measured across the splanchnic bed and leg in 11 normal volunteers. Postabsorptively, net release of amino acids by leg (largely alanine and glutamine) was complemented by the net splanchnic uptake of amino acids. Amino acid infusion via peripheral vein (0.2 g X kg-1 X h-1) caused a doubling of plasma insulin and glucagon levels and a threefold rise in blood amino acid concentrations. Both splanchnic and leg tissues showed significant uptake of infused amino acids. Splanchnic tissues accounted for approximately 70% of the total body amino acid nitrogen disposal; splanchnic uptake was greatest for the glucogenic amino acids but also included significant quantities of branched-chain amino acids. In contrast, leg amino acid uptake was dominated by the branched-chain amino acids. Based on the measured leg balance, body skeletal muscle was estimated to remove approximately 25-30% of the total infused amino acid load and approximately 65-70% of the infused branched-chain amino acids. Amino acid infusion significantly stimulated both the leg efflux and the splanchnic uptake of glutamine (not contained in the infusate). We conclude that when amino acids are infused peripherally in normal humans, splanchnic viscera (liver and gut) are the major sites of amino acid disposal.

Adolescent↗

Effect of free fatty acids on blood amino acid levels in human.

Raised plasma free fatty acid (FFA) levels effectively impede glucose uptake in vivo, thereby conserving plasma glucose and sparing glycogen. To test whether FFA have any effect on blood amino acid levels, we infused Intralipid plus heparin or saline into healthy volunteers under four different experimental conditions: A) overnight fast; B) euglycemic hyperinsulinemia (approximately 100 microU/ml); C) hyperglycemic (approximately 200 mg/100 ml) hyperinsulinemia (approximately 50 microU/ml); and D) hyperglycemic (approximately 300 mg/100 ml) normoinsulinemia (approximately 20 microU/ml). In the fasting state (A), lipid infusion was associated with lower blood levels of most amino acids, both branched chain and glucogenic. This effect, however, could not be ascribed to lipid infusion alone, because plasma insulin levels were also stimulated. The clamp studies (B, C, and D) allowed to assess the influence of lipid on blood amino acid levels at similar plasma insulin and glucose levels. It was thus observed that lipid infusion has a significant hypoaminoacidemic effect of its own under both euglycemic (B) and hyperglycemic (C) conditions; this effect involved many glucogenic amino acids (alanine, glycine, phenylalanine, serine, threonine, and cystine) but none of the branched-chain amino acids (leucine, isoleucine, and valine). In marked contrast, normoinsulinemic hyperglycemia (D), with or without lipid infusion, caused no change in the blood level of any measured amino acid. We conclude that lipid infusion has a hypoaminoacidemic action. We also suggest that this action is permitted by insulin and may involve specific metabolic interactions (e.g., reduced availability of glucose-derived pyruvate or glycerophosphate) as well as enhanced uptake by the liver.

Adolescent↗

Characterization of glutamine transport by liver plasma membrane vesicles.

Plasma membrane vesicles were prepared from livers of fed normal and diabetic rats and used to characterize the membrane transport process responsible for glutamine uptake by the liver cell. In vesicles from normal rats the initial velocity of glutamine uptake was fourfold more rapid (0.20 +/- 0.02 vs. 0.05 +/- 0.02 nmol X mg protein-1 X 10 s-1) when Na+ replaced K+ in the extravesicular buffer. In the presence of a Na+-gradient glutamine uptake by vesicles was saturable, with a Km of 1.3 +/- 0.5 mM and a Vmax of 10 +/- 2.3 nmol X mg-1 X min-1. Lithium could fully substitute for Na+ in stimulating glutamine entry. In the presence of an imposed K+-gradient glutamine uptake was a linear function of its extravesicular concentration. In accord with the sodium-stimulated uptake of glutamine occurring via a sodium symport process, we observed that glutamine stimulated the initial rate of 22Na+ entry into vesicles by four- to fivefold. We further observed that glutamine entry was more rapid when lipophilic anions accompanied sodium in the incubation buffer, suggesting that Na+-glutamine flux is electrogenic. Preloading of vesicles with glutamine did not effect subsequent entry of labeled glutamine (no transstimulation), whereas intravesicular alanine did enhance alanine but not glutamine entry. Alloxan diabetes, which is known to stimulate the Na+-alanine cotransporter in these vesicles did not increase glutamine entry at any concentration tested.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine↗

Continuous subcutaneous insulin infusion (CSII) reduces counter-regulatory hormone concentrations in a patient receiving enteral hyperalimentation.

A 61-year-old male, while recovering from a Whipple's procedure for pancreatic carcinoma, was treated for 13 days with an insulin infusion pump for diabetes exacerbated by enteral hyperalimentation. Treatment with continuous subcutaneous insulin infusion resulted in improved blood glucose control. Associated with this improvement was a reduction in plasma cholesterol, triglyceride and free fatty acid levels. Plasma epinephrine, norepinephrine, glucagon and cortisol concentrations were also lowered although growth hormone levels remained unchanged. It is concluded that enhanced metabolic control during hyperalimentation results in a decrease in counter-regulatory hormone levels and an improvement in the catabolic state in this patient. These preliminary observations provide evidence for maintaining euglycemia in diabetic patients while receiving nutritional support.

Blood Glucose↗