Studies of platelet hyperactivity in patients with ischemic cerebrovascular diseases: IV. Determination of the optimal dosage of aspirin by measuring plasma salicylate level.
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Biomedical subjects
Publications and source records attributed to T K Lee.
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In 12 of 76 stroke patients complicated by the syndrome of inappropriate secretion of antidiuretic hormone (SIADH), a significant increase in urinary prostaglandin E (PGE) (p less than 0.005), and a significant positive relationship between the plasma arginine vasopressin (AVR) level and urinary PGE excretion were observed (r = 0.72, p less than 0.05). The experimental results are consistent with the view that renal PGE acts as a modulator of ADH. Nowadays acetylsalicylic acid (ASA), an inhibitor of prostaglandin biosynthesis, is widely used in ischemic stroke, it was felt necessary to study the effect of this drug on urinary PGE excretion. Therefore various daily doses of ASA were given orally for 3 days to patients with ischemic stroke. PGE values in 24-hour urine samples were measured every day for 3 days before administration of the drug and for 3 days during ASA administration. In 10 patients who took 75 mg of ASA, the decrease in urinary PGE excretion was not statistically significant. On the other hand when ASA was administered 300 mg once in 19 patients or 300 mg 4 times in 11 cases, urinary PGE excretion decreased significantly (p less than 0.05 and p less than 0.05 respectively). In another group of 8 patients who were observed before, during and after the ASA administration, a daily oral dose of 300 mg for 3 days caused a significant decrease in urinary PGE excretion during these 3 days (p less than 0.05). The urinary PGE excretion returned to the control level within 3 days after cessation of the ASA administration.
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Lactose synthase was found to show anomeric preference for beta-D-glucose. This information was utilized in the design of methyl, ethyl, propyl, butyl, and pentyl N-acetyl-beta-D-glucosaminides, which were subsequently demonstrated to be substrates for galactosyltransferase with apparent Km values in the low millimolar range. alpha-Lactalbumin competitively inhibits the transferase activity against these N-acetylglucosamine derivatives. This pattern of inhibition has also been observed when the dimer, trimer, and tetramer of N-acetylglucosamine and ovomucoid served as the galactose acceptor. The data suggest that the binding of alpha-lactalbumin and the N-acetylglucosamine derivatives is mutually exclusive. This assertion is further supported by the inability of methyl and butyl N-acetyl-beta-D-glucosaminides to facilitate retention of galactosyltransferase on a column of alpha-lactalbumin immobilized onto Sepharose. Free N-acetylglucosamine, on the other hand, does cause retention of the transferase under the same conditions. Thus, alpha-lactalbumin must bind to a region on galactosyltransferase in close proximity to the monosaccharide binding site and exert its substrate-specifying action through competitive and mutually exclusive binding with the N-acetylglucosamine analogues accompanied by an increased affinity for glucose. In short, our substrate analogue studies have revealed that the association-dissociation modulation of galactosyltransferase activity is effected through a topographical blockade of glycoprotein binding by alpha-lactalbumin.
The association between mitotic rate and biologic behavior was studied in 127 cases of thyroid cancer. Based on the observation of 12,700 high-power fields (HPF), the mitotic rate varied from 0 to 316 (33.3 +/- 4.9) mitoses/100 HPF. Mitotic rate differed among the four types of thyroid cancers and correlated inversely with the differentiation of the tumors, being highest (156.8 +/- 32.9) in the undifferentiated tumors and lowest (17.3 +/- 2.4) in the papillary tumors. By analysis of variance (AOVA), the relations between mitotic rate and the sex or age of the patient, maximal diameter of the tumor, and vascular or capsular invasion were assessed, but significant relations were not found (r2 = 44.2 per cent). Follow-up observation, possible in 74 patients, showed mitotic rate to be significantly related to the survival period (Student's t-test; P values ranging from 0.02 to 0.05). The patients who were alive five and ten years after surgery had had lower mitotic rates than those who had died during the same follow-up period. The correlation of low mitotic rate with a high degree of differentiation and low potential for invasion might, in part, explain the better surgical cure rates for papillary thyroid carcinoma than for other types of thyroid cancers.
In studies on 779 fresh, unselected ANA+ sera, 50 (6.4%) were found to have anti-dsDNA antibodies, by using CIP (C. luciliae immunoperoxidase), and 84% of the 50 patients met the criteria for definite SLE. After freezing 36 of these sera for 13 +/- 1 months, only 52.8% were again positive by CIP. Using CIF (C. luciliae immunofluorescence), 16.7% and 52.8% of the same stored sera were anti-dsDNA+, with transmitted and epi-illumination, respectively. We favour CIP to CIF because: slide files are permanent, overcoming any lability of antibodies in frozen sera; kinetoplast, flagellum and nucleus are easily distinguished; perikinetoplast staining is avoided; specialized microscopic equipment is not needed.
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Rabbit mononuclear leukocytes isolated from a variety of anatomic sites were examined for ability to generate procoagulant activity in vitro. Marrow, blood and spleen mononuclear cell populations were found to differ functionally from lymph node, thymus and alveolar populations by having much greater ability to increase in tissue factor activity in response to an endotoxin stimulus. Thus, after incubation in the presence of endotoxin, leukocytes obtained from marrow, blood, and spleen were found to increase in procoagulant activity characterized as tissue factor by 832, 1942 and 12.6 fold, respectively. In contrast, pulmonary alveolar macrophages increased in tissue factor activity only by 2.8 fold, and lymph node and thymus mononuclear cells showed little or no increases. These functional differences, demonstrated by exposing the six cell populations to endotoxin under controlled conditions in vitro, likely explain the similar pattern of anatomic selectivity of leukocyte tissue factor increases reported to occur in vivo during endotoxemia and Shwartzman reactions (1).
Experiments were carried out to examine relationships between alveolar macrophage maturity and amounts of tissue factor (Clotting Factor III) in these cells under physiologic conditions and during immunologically induced pneumonitis. Using discontinuous density gradient centrifugation, alveolar macrophages from healthy rabbits were rapidly isolated into five subpopulations at different stages of maturation, as demonstrated by morphologic and morphometric evaluation. Very large amounts of tissue factor activity were found in fully mature cells that were purified in the lowest density subpopulation and assayed without preliminary in vitro stimulation or culture. In the remaining four subpopulations of increasing density, amounts of tissue factor were found to progressively diminish in direct correlation with declines of cell maturity. These differences at mean levels were as great as 35-fold. In addition, blood monocytes had less than 1/219 and less than 1/6 of the activity of the fully mature and the least mature subpopulations, respectively. After 16 h culture of the five isolated subpopulations in the absence of lymphokines or of significant numbers of lymphocytes, tissue factor activity increased in inverse correlation with the preincubation stage of cell maturity (2,387 and 109% in the least mature and most mature subpopulations, respectively). These increases required protein synthesis and were accompanied by morphologic and morphometric changes which indicated cellular maturation during the period of tissue factor activity generation in vitro, thus further demonstrating relationships between macrophage maturity and tissue factor content. In additional experiments, direct correlations between cell maturity and tissue factor activity content were also found in activated alveolar macrophage populations from rabbits with Bacillus Calmette Guering (BCG)-induced granulomatous pneumonitis. However, as compared with controls, the BCG populations had increased total amounts of tissue factor activity due to the presence of large numbers of mature alveolar macrophage forms that had high levels of the procoagulant. Thus, tissue factor activity in alveolar macrophages is a marker of cellular maturation in vivo and in vitro. Increased amounts of this initiator of the extrinsic clotting pathway, as found in alveolar macrophage populations from animals with granulomatous pneumonitis induced by BCG hypersensitivity, suggest that alveolar macrophage tissue factor may contribute to the pathology of immune lung diseases.
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A photoaffinity analogue of UDP-galactose, 4-azido-2-nitrophenyluridylyl pyrophosphate (ANUP), has been synthesized for the investigation of the binding topography of alpha-lactalbumin on galactosyltransferase. Results obtained from steady state kinetics show that ANUP is an effective competitive inhibitor against UDP-galactose in the reactions of lactose and N-acetyllactosamine syntheses. The specific binding of ANUP to the UDP-galactose-binding site is further demonstrated by its ability to facilitate the formation of the lactose synthase complex on solid supports, either alone or in the presence of glucose or N-acetyl-glucosamine. ANUP inactivates galactosyltransferase on irradiation. One mole of ANUP was incorporated per mol of enzyme inactivated. This process is Mn2+-dependent and can be prevented by UDP-galactose. Glucose and N-acetylglucosamine render only partial protection. Photoaffinity labeling of lactose synthase either free in solution or immobilized on Sepharose does not result in any reduction of the alpha-lactalbumin modifier activity. In addition, no incorporation of radioactivity into alpha-lactalbumin was observed when radioactive ANUP was used, whereas galactosyltransferase was labeled. These data indicate that alpha-lactalbumin does not bind to galactosyltransferase in the region of the ANUP site, suggesting that the location of protein-protein interaction between the two subunits of lactose synthase may be removed from the UDP-galactose-binding domain.
Galactosyltransferase (EC 2.4.1.38) has been shown to bind to Con A-Sepharose. Concentrations of methyl-alpha-mannoside greater than 0.7 M were required to release the enzyme from the immobilized lectin. Molecular weight determination by gel filtration revealed that galactosyltransferase formed a 1:1 complex with concanavalin A. Preincubation of the enzyme with excess concanavalin A did not affect its catalytic activity either in the presence or absence of alpha-lactalbumin. The galactosyltransferase-concanavalin A complex was retained on an alpha-lactalbumin-Sepharose column in the presence of N-acetylglucosamine and manganese chloride and was eluted from the column in their absence. Galactosyltransferase immobilized onto a Con A-Sepharose was still active either in the presence or absence of alpha-lactalbumin. Lactose synthase activity was also observed when the galactosyltransferase-concanavalin A complex was assayed with alpha-lactalbumin immobilized on Sepharose. These data indicate that the carbohydrate moiety of galactosyltransferase is involved in neither the catalytic process nor the binding of alpha-lactalbumin and must be linked to the enzyme at a location where it does not present any steric hindrance on the binding of concanavalin A, either free or immobilized on Sepharose.
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