HEPATIC CIRCULATION IN HEMORRHAGIC AND ANAPHYLACTIC SHOCK. ITS BEARING ON SYSTEMIC CIRCULATION.
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Anaphylaxis↗
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The determination of mean pulmonary circulation time and pulmonary circulating blood volume in man with iodinated (I131) human serum albumin.
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Albumins↗
[Some hemodynamic problems of extracorporeal circulation perfusion in relation to the hemodynamics of physiological circulation].
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Blood Circulation↗
Detection of increased levels of circulating intercellular adhesion molecule 1 in some patients with rheumatoid arthritis but not in patients with systemic lupus erythematosus. Lack of correlation with levels of circulating vascular cell adhesion molecule 1.
OBJECTIVE: To compare the levels of circulating intercellular adhesion molecule 1 (cICAM-1) and vascular cell adhesion molecule 1 (cVCAM-1) in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). METHODS: Levels of cICAM-1 and cVCAM-1 were measured in both plasma and synovial fluid using monoclonal antibody sandwich enzyme-linked immunoassays. RESULTS: Levels of both cICAM-1 and cVCAM-1 were significantly increased (P < 0.001) in RA patients compared with normal controls. In contrast, only cVCAM-1, and not cICAM-1, was increased in patients with SLE. Levels of cICAM-1 and cVCAM-1 were significantly elevated in synovial fluid compared with plasma in paired samples from patients with RA. There was no correlation between levels of cICAM-1 and levels of cVCAM-1, in either plasma or synovial fluid. Whereas levels of cVCAM-1 correlated significantly with the erythrocyte sedimentation rate (ESR) and C-reactive protein level in RA patients and with the ESR in SLE patients, no significant correlations were found between cICAM-1 and either of these indices of disease activity. CONCLUSION: These observations indicate that levels of cICAM-1 and cVCAM-1 reflect separate pathophysiologic processes. Both may be useful markers for the diagnosis and management of patients with rheumatic diseases.
Adult↗
Influence of brain death and cardiac preservation on systolic and diastolic function and coronary circulation in the cross-circulated canine heart.
Previous studies have demonstrated hemodynamic instability and cardiac dysfunction in the brain-dead organ donor. It remains unclear if primary cardiac dysfunction is responsible for hemodynamic deterioration or decreased cardiac function is secondary to brain death-associated altered loading conditions. Therefore in the present study the effects of brain death on hemodynamics and cardiac function were analyzed in vivo in an open chest model and ex vivo in a cross-circulated heart preparation. In a second protocol, the impact of brain death-associated hemodynamic changes on postischemic graft function was investigated. Brain death was induced injecting saline in a subdural Foley catheter. Induction of brain death led to a hyperdynamic reaction followed by hemodynamic deterioration with a decrease of systemic vascular resistance and myocardial contractility. If the hearts were explanted and assessed ex vivo, no differences were found between control and brain-dead hearts. Furthermore, both control and brain-dead hearts showed full functional recovery after 4 hours of hypothermic ischemic storage. Despite hemodynamic deterioration in situ after brain death, there were no differences between the postischemic function of control and brain-dead hearts. These results indicate that myocardial dysfunction is not irreversible and may be secondary to altered loading conditions, and that the recovery of cardiac function after long-term hypothermic storage is not impaired by the hemodynamic changes observed in situ after brain death induction. These data may also indicate that potential donor hearts might not be excluded from transplantation on the basis of impaired hemodynamic characteristics, especially if they are evaluated by load-dependent parameters.
Analysis of Variance↗
Surface receptors and immune activity of purified human circulating mononuclear cells. IV. The demonstration of seven subclasses of T cells in the circulation of the normal individual: the cytotoxic activities of these cells.
T lymphocytes were isolated from monocyte-depleted mononuclear cells of normal individuals by rosetting them with sheep erythrocytes. These purified T cells were preferentially depleted of cells with receptors for FcG (TG cells), FcM (TM cells), or C'3 (TC cells) by rosette formation with EA(G), EA(M), and EAC, respectively, before or after incubation for 24 hr in medium 199 fortified with fetal calf serum (20%). The unfractionated lymphocytes and the purified and the depleted T cells were analyzed for receptors to FcG, FcM, and C'3 and for cytotoxic activity in the natural killer (NK), antibody dependent cell-mediated cytotoxicity (ADCC), and mitogen-induced cell-mediated cytotoxicity (MICC) assays. The TG and TC cells were detected among the freshly isolated T cells, whereas the TM cells were detected only following 24 hr of incubation. Removal of TC cells from the 24-hr-cultured T cells resulted in removal of all the TC cells and in the concomitant removal of the majority of TM cells. Similarly, removal of TM cells from the 24-hr-cultured T cells resulted in the elimination of all TM cells as well as the majority of TC cells. These results demonstrate the in vitro generation of T cells with receptors for both FcM and C'3 (TM+C cells). Ten percent of the freshly isolated TG cells possessed detectable receptors for C'3 and/or FcM. These cells constitute the TG+C and TG+M lymphocytes. Support for consideration of these receptor-bearing cells as unique and stable cells is provided by the finding that TM and TC cells maintained in culture for up to 72 hr do not generate other receptors but retain the single receptor which characterizes each of these cells. Only a small percentage of cultured TG cells generate receptors for C'3 and FcM. It may therefore be concluded that the TG, TM, and TC cells are stable unireceptor-bearing cells. The TG, TM, TC, TG+C, TG+M, and TM+C lymphocytes account for approximately 50% of the circulating lymphocytes. Whether the remaining cells, the T null or TN cells, constitute the precursors for any or all of the receptor-bearing T cells remains to be determined. Unfractionated freshly isolated T cells were highly cytotoxic in the NK and PWM-mediated MICC assays but were relatively inactive in the ADCC, naturally occurring cell-mediated cytotoxicity (NOCC), and PHA- and Con-A-mediated MICC assays.(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
ICMR task force study on hormonal contraception. Transfer of levonorgestrel (LNG) administered through different drug delivery systems from the maternal circulation into the newborn infant's circulation via breast milk.
The transfer of levonorgestrel (LNG) from the maternal plasma via breast milk to the infant was studied in 38 fully lactating and breast-feeding women at 4-6 weeks postpartum, for a duration of 28 days. These volunteers were provided with LNG contraceptive treatment delivered through three, different routes of drug delivery system: (i) intrauterine devices impregnated with LNG (LNG-IUD); (ii) subdermal implant (Norplant (R)-2); and (iii) minipills (LNG 30 micrograms daily). On the first day after either the LNG-IUD (n = 14 women) or Norplant (R)-2 (n = 14 women) insertion, the maternal blood and breast milk samples were collected at 2, 4 and 8 hourly intervals. This was followed by daily collection of these samples as well as infant's blood from days 2 to 4 and thereafter on days 7, 14 and 28. For infant's blood samples from LNG minipill users (n = 10 women), only a single 4-hour sample was collected on the first day and no samples were collected on days 3 and 4. The rest of the schedule for collection of maternal blood and breast milk as well as infant's blood samples were the same in minipill users as for the other two treatment groups. The study revealed a lower LNG percentage transfer from maternal sera to breast milk--11.8 +/- 2, 7 +/- 2 and 8 +/- 1 and relatively higher percentage LNG transfer from breast milk to infant's sera--75 +/- 17, 68 +/- 20 and 32 +/- 3, in LNG-IUD, Norplant (R)-2 and minipill users, respectively. Therefore, LNG contraceptive steroid is transferred into the infant's circulation, the biological significance of which remains to be established.
Administration, Oral↗
Caribbean international circulation: are Puerto Rican women tied-circulators?
Aspects of migration between Puerto Rico and the United States are explored. "This examination of the multiple-movement behaviour of a sample of Puerto Rican women seeks to unravel the relations between their circulation patterns, their family and contextual situations and their declared motives for undertaking international mobility. The leading question asked in this study is whether this international mobility behaviour of Puerto Rican women is autonomous or dependent upon the movement or decision-making of others. Structural theory suggests the latter is most likely, but behavioural divergence occurs in return movement."
Americas↗
Circulating levels of isoflavones and markers of 5alpha-reductase activity are higher in Japanese compared with New Zealand males: what is the role of circulating steroids in prostate disease?
Epidemiological evidence implicates dietary isoflavone intake as protective against prostate disease. A putative mechanism is attenuated circulating androgen levels in male populations consuming an isoflavone rich diet. We investigated this hypothesis by collecting plasma from 60 Japanese and 60 New Zealand males aged between 21 and 31 years each consuming their traditional diets. We measured plasma testosterone, dihydrotestosterone (DHT), androstenedione, dehydroepiandrosterone sulfate (DHEAS), the combined levels of androsterone sulfate and epiandrosterone sulfate (AoS/epiAoS), sex hormone-binding globulin, and cortisol and corticosteroid-binding globulin as well as the isoflavones genistein and equol. Plasma genistein and equol levels were several times higher in Japanese males as would be expected from an isoflavone rich diet. However, androstenedione, DHEAS, calculated free testosterone and paradoxically markers of 5alpha-reductase, DHT and AoS/epiAoS were all also significantly higher in Japanese rather than the New Zealand male counterparts. All other comparisons were not significant. Plasma DHT and DHEAS correlated positively with plasma equol and plasma AoS/epiAoS correlated positively with genistein levels. Taken together the results suggest that, rather than reduced levels of steroidogenesis, Japanese males may have increased 5alpha-reductase activity and possibly altered 17beta OH steroid dehydrogenase activity. Significantly the positive association between isoflavones levels and 5alpha-steroids is counter-intuitive to isoflavone intake offering prostate protection, unless this is postulated to occur through other mechanisms.
Adult↗
Circulating immune complexes in human tuberculosis sera: demonstration of specific antibodies against Mycobacterium tuberculosis glycolipid (DAT, PGLTb1, LOS) antigens in isolated circulating immune complexes.
An enzyme-linked immunosorbent assay (ELISA) for IgG using three glycolipid antigens from Mycobacterium tuberculosis in 65 tuberculosis (TB) patients and 50 healthy control subjects was performed. The circulating immune complexes (CICs) were isolated by precipitation with polyethylene glycol 6000 (PEG). This method associated to ELISA measured the specific antibodies present in these CICs. PEG [optical density (OD) 280] was shown to be significantly elevated (P < 0.001) in tuberculous samples. The concentrations of IgG antibodies complexed to the three glycolipid antigens were shown to be higher in patient with tuberculosis than in normal control subjects (P < 0.001). No correlation was observed between levels of free and CIC-bound antibodies. These antibodies isolated from CICs were responsible for almost all of the false-negative serological results. However, great heterogeneity was noticed depending on the antigen used, showing a more positive ELISAs against DAT (77%) than against LOS (71%) or PGLTb1 (18.5%). No correlation was established between the presence of specific CIC-complexed IgG and the bacteriological load or the tuberculosis localization (pulmonary vs. extrapulmonary). The sensitivity of ELISA for CIC-complexed IgG to DAT and LOS was lower in HIV-infected TB patients. From these results, we conclude that detection of complexed IgG DAT and LOS glycolipid antigen will be useful as a complementary technique for the serodiagnosis of tuberculosis.
Adult↗
Irregular circulating insulin concentrations in type 2 diabetes mellitus: an inverse relationship between circulating free fatty acid and the disorderliness of an insulin time series in diabetic and healthy individuals.
Insulin is released in a high-frequency pulsatile secretory pattern, which is reflected as quantifiable oscillations in peripheral circulating insulin concentrations. Type 2 diabetes mellitus is characterized by a broad spectrum of abnormalities in beta-cell function, including disturbed pulsatile insulin secretion as assessed by autocorrelation analysis. To achieve further insight into beta-cell pathophysiology in type 2 diabetes, we examined the orderliness of the baseline serum insulin time series (blood collection every minute for 75 minutes) in 16 type 2 diabetics (fasting plasma glucose, 170 +/- 10 mg/dL [mean +/- SE]; serum free fatty acid [FFA], 0.794 +/- 0.083 mmol/L; and known diabetes duration, 6 +/- 2 years) and 15 healthy controls (serum FFA, 0.523 +/- 0.055 mmol/L). We used approximate entropy (ApEn), a recently introduced scale- and model-independent measure of serial irregularity. ApEn was significantly increased in the type 2 diabetics compared with the controls (0.671 +/- 0.016 v 0.653 +/- 0.008, P = .04), indicating more irregular serum insulin time series in diabetics. Autocorrelation also discriminated between groups, although only when the data were pooled. Interestingly, an inverse relationship between ApEn and serum FFA was observed in the controls (r = -.63, P = .01) and diabetics (r = -.65, P < .01), whereas no relationships were found between ApEn and the age, body mass index (BMI), or plasma glucose. In conclusion, type 2 diabetes is characterized by an increased disorderliness of the fasting serum insulin time series, strongly suggesting perturbed rapid oscillatory insulin release. An inverse relationship between ApEn and fasting serum FFA among both groups might suggest a hitherto unknown stabilizing action of FFA on the high-frequency pulsatile insulin release process. This hypothesis needs to be tested in experimental designs that more specifically focus on this issue, eg, during changes in serum FFA.
Diabetes Mellitus, Type 2↗
Elimination of circulating antibodies. Attempts to eliminate antibodies circulating in rabbits using a fraction of normal human epidermis.
Rabbits were immunised with a fraction of normal human epidermis to produce circulating antibodies. In each experiment, half of the immunised rabbits were given a dose of the same antigen intravenously and the changes in the titres of antibodies were recorded. Doses of the antigen used in different experiments varied from 0.09 to 3.5 mg protein per rabor the first 24 h, followed by a secondary rise. Administration of corticosteroids together with the antigen intravenously could check this secondary rise in antibody titre. Repeated intravenous injections of the antigen led to severe anaphylactic reactions, while subcutaneously administered antigen produced no significant effects.
Animals↗
[Cholesterol-containing circulating immune complexes in patients with cerebral arteriosclerosis and disorders of cerebral circulation].
A study was made of the level of circulating immune complexes (CIC) in patients with circulatory encephalopathy and brain infarction to find out the CIC level to be increased. The content of cholesterol in CIC was discovered to be also augmented, with that phenomenon being in agreement with the degree of atherosclerotic lesions to carotids. It has been shown that in patients with the increased content of cholesterol-containing CIC, the rise of platelet aggregation and blood coagulation is most remarkable.
Adult↗
Alterations in circulating lymphocyte number and function after circulation through colorectal carcinomas.
Thirty-six patients undergoing curative resection for colorectal cancer were studied to determine the effect of the tumor on lymphocytes circulating through it. In the venous blood draining the tumor, there was an increased percentage of natural killer (NK) cells (p = 0.001), no difference in overall NK cell function, and decreased T-lymphocyte activation (p = 0.035) and proliferation (p = 0.002) compared with the lymphocytes in the arterial blood supplying the tumor. There were no significant differences in the control group of 16 patients. Local effects of colorectal cancer may include the ability to down-regulate T and NK cell function while increasing the number of NK cells. Means of enhancing antitumor activity therapeutically in an adjuvant setting, possibly through the portal vein during surgery, need to be considered, especially in the light of the immunosuppressive effects of surgery.
Aged↗
[Experimental study of the effect on the liver of cortisol after diverting the adrenal venous circulation into the portal circulation].
In order to evaluate the operation of the adrenal autotransplantation into omentum with arterio-venous anastomosis, the right adrenal of fifteen dogs was preliminarily removed and then the left adrenal vein was diverted into the portal circulation by micro surgical technique. Before and after the diversion, the serum cortisol taken from portal vein, hepatic vein, inferior vena cava and peripheral vein was analysed by radioimmunoassay. The dog's adrenal cortex, pituitary were removed for light and electron-microscopic examination. The experimental results demonstrate that the cortisol inactivation effect of the liver was not statistically different before and after the procedure (P greater than 0.05). Thus, we believe that the omentum which has obvious absorbability and revascularity is a reasonable site for adrenal transplantation. And we also found the adrenal cortex left appear slight hypotrophy and pituitary hypertrophy after the diversion. The cause however, requires further research.
Adrenal Glands↗
Studies on circulating immune complexes. I: Circulating immune complexes in various types of glomerulonephritis and collagen disease: a comparative study employing conglutinin solid phase radioimmunoassay and raji cell radioimmunoassay.
A study was undertaken to examine the differences in serum levels of circulating immune complexes (CIC) detected by different methods in various types of collagen disease and primary glomerulonephritis. The subjects used were 16 patients with SLE, 22 with IgA nephropathy, 8 with membranoproliferative glomerulonephritis, 8 with membranous nephropathy, 6 with minimal change nephrotic syndrome, and 2 each with RA, PSS, DM, Sjögren syndrome, PN, MCTD and overlap syndrome, respectively. CIC were measured by two assays, namely, bovine conglutinin solid phase radioimmunoassay (C-assay) and Raji cell radioimmunoassay (R-assay). In SLE, the incidence and amounts of CIC detected were higher in R-assay than in C-assay. Similar results were obtained for the other types of collagen diseases. Furthermore, a discrepancy in the incidence of CIC detected by the two assays was found in 30% of patients with collagen diseases. Concerning the detection of CIC in primary glomerulonephritis, the sensitivity of C-assay was higher than that of R-assay. This discrepancy appears to reflect the different sensitivities of the two assays. No significant correlation was found between the CIC level and the intensity of IgG deposits in various types of glomerulonephritis. These results suggest that the R-assay was better for the detection of CIC in collagen diseases, and that the C-assay was suitable for that in primary glomerulonephritis.
Adolescent↗
Studies on circulating immune complexes. II: Circulating immune complexes in primary IgA nephropathy and membranoproliferative glomerulonephritis.
A study of circulating immune complexes (CIC) was undertaken in 25 patients with primary IgA nephropathy and 13 patients with membranoproliferative glomerulonephritis (MPGN). Clinically, the 25 patients with IgA nephropathy were divided into two groups: the latent type, characterized by chance proteinuria and/or hematuria; and the acute onset type, revealing acute nephritic syndrome. Both the IgG class of CIC (IgG-IC) and the IgA class of CIC (IgA-IC) were measured by conglutinin binding enzyme immunoassay (C-assay). IgG-IC were found to be positive in 32% of the patients with IgA nephropathy, and in 77% of those with MPGN. IgA-IC were positive in 72% of the patients with IgA nephropathy, and in 54% of those with MPGN. Concerning the acute onset type of IgA nephropathy, IgG-IC and IgA-IC were found in 71% and 86% of the patients, respectively, which was more frequent than in the latent type group. Simultaneous presence of IgA-IC and glomerular IgA deposits detected by an immunofluorescence study was noted in 75% of the patients with IgA nephropathy. On the other hand, 78% of the patients with MPGN revealed IgG-IC and glomerular IgG deposits simultaneously. Thus, IgG-IC and IgA-IC appear to play important roles in the pathogenesis of MPGN and IgA nephropathy, respectively.
Adolescent↗
Studies on circulating immune complexes. III: Kinetics of the immunoglobulin class of circulating immune complexes in systemic lupus erythematosus.
The IgG, IgA and IgM classes of circulating immune complexes (CIC) were examined in 49 patients with systemic lupus erythematosus (SLE). The presence of the IgG class of CIC (IgG-IC), IgA class of CIC (IgA-IC) and IgM class of CIC (IgM-IC) was observed in 39.4%, 24.2% and 35.3%, respectively. During the course of the disease, the levels of IgG-IC and IgM-IC remained generally higher than that of IgA-IC. The patients were divided into three groups, according to the changes in IgG-IC. Group 1: these had IgG-IC persistently, associated with clinically active features (active stage). The presence of IgA-IC was occasionally transient, although IgM-IC did coexist. Group 2: these showed an increased level of IgG-IC, associated with a tendency to relapse (flaring up stage). IgM-IC disappeared occasionally, although IgA-IC appeared to be persistently present. Group 3: these showed levels of IgG-IC which decreased or disappeared and the clinical activity tended to subside (remissible and inactive stages). All classes of CIC tended to disappear. That is to say, IgG-IC, then IgA-IC, and finally IgM-IC decreased in that order. Either IgA-IC or IgM-IC was present alone persistently in a few cases. The correlations between each class of CIC and the immunological parameters were investigated. IgG-IC and IgM-IC were closely related to anti-nuclear antibody, but not to anti-DNA antibody.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗