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Biomedical subjects

R L Simmons

Publications and source records attributed to R L Simmons.

At least 163 records · Page 9Linked to original sources
PubMed1991

Herpes simplex virus hepatitis after solid organ transplantation in adults.

Twelve patients developed herpes simplex (HSV) hepatitis a median of 18 days after solid organ transplantation. This is earlier than cytomegalovirus hepatitis, which usually occurs 30-40 days after transplantation. Eight recipients (67%) died, and in seven, the diagnosis was made at autopsy or less than 48 h before death. Clinical manifestations associated with mortality were hypotension, disseminated intravascular coagulation (DIC), metabolic acidosis, gastrointestinal bleeding, and bacteremia. Laboratory abnormalities at diagnosis associated with mortality were high creatinine, low platelet counts, prolonged partial thromboplastin time, and a high percentage of band forms on the blood smear. Disseminated HSV disease was noted in four of six patients who had an autopsy and included involvement of lungs in three and the gastrointestinal tract in three. Five recipients developed DIC and all died. Pathologically, HSV hepatitis has two forms, focal and diffuse. All three patients with diffuse liver pathology died. However, three of seven with focal liver pathology survived with antiviral therapy, which suggests that early diagnosis and treatment may be lifesaving. None of these patients had received prophylactic acyclovir. It is possible that acyclovir prophylaxis may be able to prevent this disease.

Adult↗
PubMed1991

Nitric oxide and nitric oxide-generating compounds inhibit hepatocyte protein synthesis.

Hepatocytes are stimulated to produce nitric oxide (NO.) from L-arginine in response to conditioned Kupffer cell medium or a combination of cytokines. Associated with the production of NO.in hepatocytes, there is a profound decrease in total protein synthesis ([3H]leucine incorporation). This report demonstrates that authentic NO.and the NO.-generating compound S-nitroso-N-acetylpenicillamine inhibit hepatocyte total protein synthesis in a reversible and concentration-dependent fashion. In parallel with the suppression of hepatocyte total protein synthesis, authentic NO.inhibits the production of two specific hepatocyte proteins, albumin and fibrinogen, without influencing the quantity of albumin mRNA. Although authentic NO.induces a rapid increase in cGMP levels in hepatocytes, the addition of the cGMP analog 8-bromoguanosine 3':5' cyclic monophosphate to unstimulated HC cultures does not reproduce the inhibition of total protein synthesis. These data show that NO.is the hepatocyte L-arginine metabolite that inhibits protein synthesis. Furthermore, these findings indicate that NO.does not inhibit hepatocyte protein synthesis solely through the activation of soluble guanylate cyclase but appears to affect a translational or posttranslational process.

Albumins↗
PubMed1991

Nitrogen oxide levels in patients after trauma and during sepsis.

The mediators responsible for maintenance of the hyperdynamic state and the low systemic vascular resistance (SVR) observed in sepsis have not been elucidated. Nitric oxide (.N = O) is a mediator with numerous functions, including regulation of vascular tone and a role in macrophage-mediated cytostasis and microbiostasis. Thirty-nine critically ill trauma and septic patients were studied to determine the relationship between .N = O production and the hyperdynamic state. high plasma levels of NO2-/NO3- (the stable end products of .N = O) were observed in septic patients (p less than 0.02). Low SVR and high endotoxin levels were associated with high NO2-/NO3- values (p = 0.029, p = 0.002). Changes in .N = O levels may mediate the vasodilation seen in sepsis. Low NO2-/NO3- levels were observed in trauma patients (p less than 0.001) and remained low even in the presence of sepsis (p = 0.001).

Adult↗
PubMed1991

Evidence that production of interleukin 6 within the rejecting allograft coincides with cytotoxic T lymphocyte development.

Current evidence suggests that the development of allosensitized cytotoxic T lymphocytes within sponge matrix allografts takes place primarily in situ and may be regulated by the secretory products of the cells infiltrating the graft. In vitro studies have implicated IL-2, IL-4, and IL-6 in CTL development. We have reported that TNF-alpha, macrophage colony-stimulating factor, IL-1, IFN-alpha, and IFN-beta are present in the allograft, but that IL-2 and IL-4 cannot be detected at any time using specific bioassays. In this study, we found significantly higher levels of IL-6 within the allografts compared with the syngeneic grafts. Peak IL-6 activity coincided with the appearance of allosensitized CTL in the allografts. IL-6 concentration in the serum of sponge allografted mice was less than 1% of that found in the graft. The sponge fluid exhibited both hybridoma growth factor and hepatocyte-stimulating factor activities in vitro, and both these activities were neutralized by antibody to murine IL-6 but not by antibody to murine IL-1-beta or TNF-alpha. Messenger RNA for murine IL-6 was detected in the graft-infiltrating cells. The high level of IL-6 found in the allograft coincident with the appearance of cellular immunity suggests that this cytokine might play some role in the development of allospecific CTL in vivo.

Animals↗
PubMed1991

The relative role of neutrophils and platelets in the local accumulation of circulating lymphocytes at sites of ionophore A23187 inoculation.

The early cellular infiltrate at inflammatory sites consists predominantly of neutrophils and cells of the monocyte/macrophage lineage. The mechanism by which circulating, unsensitized lymphocytes accumulate at sites of inflammation is unknown. The pattern of accumulation of 111indium-labeled circulating thymocytes in response to local injections of the ionophore A23187 was studied and compared with the pattern of (125)iodinated albumin accumulation as a measure of vascular permeability. The kinetics of thymocyte accumulation differed from those of vascular permeability. Sublethal total-body irradiation (750 rads) markedly decreased thymocyte accumulation but had little effect on vascular permeability. Irradiation of the local site alone had no effect. T lymphocyte, T lymphoblast, and platelet accumulation generally followed the same pattern as thymocytes. Intravenous injection of neutrophils, but not platelets, partially restored lymphocyte accumulation in vivo in irradiated mice via a pathway involving the circulating neutrophil, and seemed to be independent of changes in vascular permeability.

Animals↗
PubMed1991

Effect of exogenous and endogenous nitric oxide on mitochondrial respiration of rat hepatocytes.

Although nitric oxide (.N = O) biosynthesis is inducible in rat hepatocytes (HC), the physiological significance of .N = O production by these cells is unknown. Short exposure of HC to authentic .N = O led to a concentration-dependent inhibition of mitochondrial aconitase, NADH-ubiquinone oxidoreductase, and succinate-ubiquinone oxidoreductase (complexes I and II of the mitochondrial electron transport chain). Most susceptible to .N = O inhibition was mitochondrial aconitase, in which a reduction in enzyme activity to 20.2 +/- 1.6% of control was observed. In contrast to mitochondrial aconitase, cytosolic aconitase activity was not inhibited by .N = O. After exposure to a maximal inhibitory concentration of .N = O, mitochondrial aconitase activity recovered completely within 6 h. Complex I did not fully recover within this incubation period. Endogenous .N = O biosynthesis was induced in HC by a specific combination of cytokines and lipopolysaccharide. After 18 h of incubation with these stimuli, a significant inhibition of mitochondrial aconitase activity to 70.8 +/- 2.4% of controls was detected. However, this was due only in part to the action of .N = O. A non- .N = O-dependent inhibition of mitochondrial function appeared to be mediated by tumor necrosis factor.

Animals↗
PubMed1991

Nitric oxide synthesis in the in vivo allograft response: a possible regulatory mechanism.

Activated macrophages are known to oxidatively metabolize L-arginine to nitric oxide and citrulline. We have recently shown that nitric oxide is a potent inhibitory molecule in the in vitro rat mixed-splenocyte culture, resulting in inhibition of proliferation and cytolytic T-cell induction. We undertook this study using the sponge matrix allograft model in the rat to determine whether nitric oxide plays a role in an in vivo allograft response. Our experiments showed that on day 6 after grafting, when cytolytic activity of allograft-infiltrating cells is first detected, allogeneic graft fluid contains higher levels of NO2-/NO3- (the stable endproducts of nitric oxide metabolism) than syngeneic graft fluid. Furthermore, evaluation of the supernatants of cultured graft-infiltrating cells revealed that allogeneic graft-infiltrating cells spontaneously produce higher amounts of nitric oxide than syngeneic graft-infiltrating cells. The nitric oxide production was inhibited in the presence of NG-monomethyl-L-arginine (NMA), the competitive inhibitor of nitric oxide production. Most of the nitric oxide production was observed in the adherent macrophage fraction of the allograft-infiltrating cells. When allograft-infiltrating cells were cultured in the presence of NMA, donor-specific cytolytic activity was observed, whereas allograft-infiltrating cells cultured in the absence of NMA showed no cytolytic activity. These data show that nitric oxide production may play an important regulatory role in the allograft response.

Animals↗
PubMed1991

Misconduct and fraud in research: social and legislative issues symposium of the Society of University Surgeons.

The symposium was concluded with a question and answer period, which served to clarify and further emphasize the aforementioned issues. Many concerns of coauthorship responsibilities, due process, and potential sanctions were discussed. Moral and ethical issues reflecting the extent of punishment, reporting of misconduct to hospitals and specialty boards, and the almost assured litigation and counter-litigation were approached with considerable apprehension and concern. Misconduct in science will clearly be monitored more closely than in the past. Increasing coauthorship responsibility, conscientious senior investigator supervision, and institutional cooperation will provide the framework to discourage dishonesty in science and encourage proper educational development of both young and established investigators in a milieu of scientific integrity.

Biomedical Research↗
PubMed1990

Alloantigen-induced activation of rat splenocytes is regulated by the oxidative metabolism of L-arginine.

Activated macrophages have been demonstrated to metabolize the amino acid L-arginine by the oxidative pathway to produce nitric oxide, citrulline, and NO2-/NO3-. Nitric oxide has been shown to be cytostatic for tumor targets and to inhibit the mitochondrial respiration and other functions of the macrophages that produce it. Addition of NG monomethyl-L-arginine (NMA), a competitive inhibitor of oxidative L-arginine metabolism, to rat splenocyte (SPL) MLC results in allospecific lymphocyte proliferation and CTL induction. In the absence of NMA, neither proliferation nor CTL induction is observed. Citrulline and NO2-/NO3- levels in the supernatants of rat SPL MLC are decreased in the presence of NMA compared with cultures without NMA. NMA also augments the proliferation and CTL induction in mouse SPL MLC. Detectable levels of cytokines able to induce T cell proliferation were present in supernatants of rat SPL MLC without NMA on days 1 to 5 of culture. Supernatants of cultures with NMA contained detectable levels of cytokines on days 1 to 3 and undetectable levels by days 4 and 5 of culture, concomitant with the observed lymphocyte proliferation and presumed depletion of cytokines. Thus, inhibition of rat SPL proliferation to alloantigen seems not to be caused by the lack of production of cytokines able to induce T cell proliferation. The inhibition of proliferation and CTL induction in rat SPL cultures may be caused by a direct effect of the cytostatic products of oxidative L-arginine metabolism on lymphocyte proliferation, or by an indirect deleterious effect on the mitochondrial respiration and viability of macrophages that oxidatively metabolize L-arginine. Alternatively, diversion of L-arginine to the oxidative pathway may affect production of polyamines that are necessary for cell growth and proliferation.

Animals↗
PubMed1990

Inducible cytosolic enzyme activity for the production of nitrogen oxides from L-arginine in hepatocytes.

The in vivo conditions needed for the induction of nitrogen oxide synthesis by hepatocytes were determined. Hepatocytes obtained from rats injected with killed Corynebacterium parvum spontaneously produced NO2(-)+NO3- in culture and were found to contain cytosolic enzyme activity for nitrogen oxide synthesis. The enzyme activity required both L-arginine and NADPH, and was not found in hepatocytes obtained from normal rats or rats injected with lipopolysaccharide (LPS) alone. In contrast, nonparenchymal cells were stimulated to synthesize NO2(-)+NO3- by LPS. These results show the presence of inducible cytosolic enzyme activity for nitrogen oxide synthesis in hepatocytes, which is distinct from nonparenchymal cell NO. synthesis.

Animals↗