Potentiating effect of heparin in the activation of procollagenase by a low-Mr angiogenesis factor

A low-Mr freely dialysable endothelial cell-stimulating angiogenesis factor (ESAF) from conditioned medium of a mouse lymphoma cell line has previously been shown to activate latent skin fibroblast procollagenase. Activation comparable with the maximum that can be achieved with trypsin is obtained with chemically undetectable amounts of the factor. We now show that when even smaller amounts of ESAF are used heparin is able to potentiate its action in this system. The relationship between this activity and the mechanism of angiogenesis, which is itself potentiated by heparin, is discussed.

Localisation of collagen types and fibronectin in cartilage by immunofluorescence

Collagens type I, II, III, IV, and V and the minor cartilage collagens, 1 alpha 2 alpha 3 alpha, C-PS 1, and C-PS 2, were purified, antibodies raised, and then used in immunofluorescence studies on bovine nasal cartilage (BNC). Punctate localisation was seen with the type II antibody. However, pretreatment of sections with hyaluronidase to remove the proteoglycan resulted in diffuse staining over all the section with this antibody. Antibodies to 1 alpha 2 alpha 3 alpha, C-PS 1, and C-PS 2 collagens gave no staining on untreated BNC sections, but after treatment with hyaluronidase all 3 antibodies showed as a diffuse 'halo' round each chondrocyte lacuna. Anti-type I, anti-type III, and anti-type IV collagen antibodies did not stain untreated or enzyme treated BNC. Type V collagen antibodies gave a bright ring in the pericellular region of the lacunae of hyaluronidase-treated BNC. This was unexpected, as we could not detect type V collagen biochemically in the same cartilage. Anti-fibronectin antibodies stained areas distant from the chondrocytes, these areas being distinct from those stained by 1 alpha 2 alpha 3 alpha and C-PS antibodies, suggesting that fibronectin is not associated with these collagens in BNC. These results suggest that different collagen types may have different locations within the cartilage matrix, that proteoglycans may inhibit antibody association with collagen, and that fibronectin is normally not associated with all types of collagen.

Gluten-sensitive enteropathy. Immunoglobulin G heavy-chain (Gm) allotypes and the immune response to wheat gliadin

Anti-gliadin antibody was measured by radioimmunoassay in 30 Caucasians with gluten-sensitive enteropathy (GSE). 22 GSE patients maintained on a gluten-free diet for 1.5 to 20 yr (mean duration 76 mo) had elevated serum concentrations of IgG antigliadin antibody. Among GSE patients on a gluten-free diet, antigliadin antibody was seen only in those having the chromosome 14-encoded IgG immunoglobulin heavy chain allotype marker G2m(n). IgG antigliadin antibody was found in GSE patients with G2m(n) regardless of whether the HLA-B8 and/or -DR3 major histocompatibility complex antigens that occur frequently in GSE were present. No patient lacking G2m(n) had significant levels of antigliadin antibody. The association between antigliadin antibody and the immunoglobulin heavy chain allotype marker G2m(n) in GSE patients likely reflects the presence of Gmn-linked variable region genes or Gmn-linked genes that regulate variable region gene expression.

Angiogenic factor in vitreous from diabetic retinopathy

Vitreous from patients with proliferative diabetic retinopathy contains an angiogenic substance which stimulates the proliferation of blood vessels on the chick chorioallantoic membrane, whereas vitreous from non-diabetics who do not have a proliferative retinopathy does not.

Relationship of angiogenesis factor in synovial fluid to various joint diseases

A low-molecular-weight freely dialysable angiogenesis factor has been isolated from 49 synovial fluids obtained from patients with various joint diseases. An analysis of disease type and incidence of freely dialysable angiogenesis activity showed that the osteoarthrotic group had a significantly higher incidence than all the other groups (p = 0.0332). Angiogenesis factor has also been detected in a bound form in the retentates of fluids which gave positive results for dialysable factor. The possibility that an imbalance between carrier-bound and free factor may have a causative role in disease is discussed.

Comparison of the maternal and neonatal effects of halothane, enflurane, and isoflurane for cesarean delivery

The maternal and neonatal effects of 50% O2-50% N2O alone and 50% O2-50% N2O combined with 0.5% halothane, 1.0% enflurane, or 0.75% isoflurane were studied in 42 healthy parturients undergoing general anesthesia for elective primary or repeat cesarean delivery at term. All patients received thiopental and succinylcholine for induction and were intubated and ventilated with a tidal volume of 10 ml/kg at a rate of 10 breaths/min. Two of 12 (17%) patients given O2-N2O alone had recall; none who received a potent inhalation agent had any recall. Blood loss was similar in all four groups. There were no significant differences between groups in induction-to-delivery and uterine incision-to-delivery intervals, the frequency of Apgar scores less than 7 at 1 and 5 min, maternal and fetal blood-gas tensions, acid-base balance, lactate values, and early neonatal neurobehavioral scores at 2-4 h. It is concluded that analgesic concentrations of halothane, enflurane, and isoflurane can be safely added to 50% O2-50% N2O to prevent maternal awareness during general anesthesia for cesarean delivery while maintaining normal maternal and neonatal conditions.

Extraction, isolation and characterization of neutral salt soluble type V collagen from fetal calf skin

Collagen was extracted with neutral salt solution and examined for the presence of type V collagen. A fraction which was insoluble in both 0.02 M Na2HPO4, pH 9.2 and phosphate-buffered saline (PBS) pH 7.2 at 4 degrees C contained both alpha 1(V)- and alpha 2(V)-chains demonstrated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, diethylaminoethyl cellulose ion exchange chromatography, amino acid analysis and segment long spacing (SLS) crystallites. SLS crystallites showed a globular N-terminal extension peptide attached to the type V collagen monomer. Ion exchange chromatography also demonstrated the presence of a third, minor component, which was identified as the alpha 3(V)-chain. In certain extractions, components corresponding to the partially processed procollagen chains of type V collagen were also observed.

Immunoglobulin allotype markers in gluten-sensitive enteropathy

Immunoglobulin allotype markers and HLA-A, HLA-B, and HLA-DR locus antigens were determined in 30 White patients with gluten-sensitive enteropathy and 30 controls matched for age, ethnic background, and geographic origin. All patients lacking HLA-B8 and HLA-DR3 had the IgG (Gm) immunoglobulin heavy-chain phenotype Gm (f;n;b). Thus, in addition to major histocompatibility locus genes, it appears that genes linked to the immunoglobulin heavy-chain allotype locus on chromosome 14 may influence susceptibility in gluten-sensitive enteropathy.

Increased bone metabolism in rheumatoid arthritis as measured by the whole-body retention of 99Tcm methylene diphosphonate

Bone metabolism in 21 patients with rheumatoid disease was investigated by measurement of the 24-hour whole body retention (WBR) of 99Tcm methylene diphosphonate (MDP) in parallel with clinical, radiological, and biochemical measurements (urinary excretion of hydroxyproline) of disease activity. Corticosteroid-treated patients of those with other forms of metabolic bone disease were excluded from the study. WBR was increased in the rheumatoid patients as compared with 21 age- and sex-matched controls (p less than 0.05), and there was a significant correlation in the rheumatoid group between WBR and urinary excretion of hydroxyproline (p less than 0.01) and between urinary excretion of hydroxyproline and an articular index (p less than 0.05) and global index (p less than 0.01) of disease activity. The increased WBR of the rheumatoid patients was not explicable by factors such as immobilisation, and the results are interpreted as reflecting an overall increase in bone metabolism which may occur in rheumatoid arthritis as part of the disease process.

Activation of a procollagenase by low-molecular-weight angiogenesis factor

Avascular tumours have the ability to establish a blood supply for themselves by secreting a humoral factor which stimulates their host's endothelial cells to proliferate and to migrate towards the tumour source. The mechanism of action of such a humoral angiogenesis factor is more than that of an endothelial-cell growth factor since it requires an oriented migration of cells towards the tumour. We report here the activation of pure skin-fibroblast procollagenase by a low-molecular-weight angiogenesis factor capable of stimulating endothelial-cell growth in vitro. The activation was observed when either Type I or III collagen was used as substrate. It is suggested that at least one function of angiogenesis factor is to promote limited degradation of the connective tissue through which it passes causing channeling in the matrix along which stimulated endothelial cells may migrate.

Acid-base status of diabetic mothers and their infants following spinal anesthesia for cesarean section

Acid-base status and Apgar scores were evaluated in 10 rigidly controlled insulin-dependent diabetic mothers and 10 healthy nondiabetic control women having spinal anesthesia for cesarean section. Dextrose-free intravenous solutions were used for volume expansion before induction of anesthesia, and hypotension was prevented in all cases by prompt treatment with ephedrine. There were no significant differences in the acid-base values between the diabetic and nondiabetic mothers and the infants of the diabetic and control group. Apgar scores were also similar in the two groups. If maternal diabetes is well controlled, if dextrose-containing solutions are not used for maternal intravascular volume expansion before delivery, and if maternal hypotension is avoided, spinal anesthesia can be used safely for diabetic mothers having cesarean section.

Isolation and native characterization of cysteine-rich collagens from bovine placental tissues and uterus and their relationship to types IV and V collagens

A simplified procedure for the fractionation and purification of different collagen types from various tissues is described which is particularly efficient in separating type-V from type-IV collagen, and high-mol.-wt. (HMW) aggregates from 7 S collagen. Uterus and maternal villi contain 2 forms of type-V collagen - [alpha 1(V)]2 alpha 2(V) and [alpha 1(V) alpha 2(V) alpha 3(V) - which have been separated on DEAE-cellulose. Uterus however appears to be the richest source of both HMW aggregates and the [alpha 1(V) alpha 2(V) alpha 3(V)] collagen, and a probable relationship between these collagens is discussed.

Spinal anaesthesia for Caesarean section. The influence of hypotension on neonatal outcome

The effect upon the neonate of a short period of maternal hypotension sustained during the initiation of spinal analgesia for Caesarean section was studied. Babies born to mothers with hypotension were significantly more acidotic than controls although acid-base levels were still within normal limits. Neurobehavioural studies were found to be normal in both groups at 4 and 24 hours. It was concluded that a short period (less than 2 minutes) of hypotension was not harmful to the neonate.

A low-molecular-weight angiogenic factor in cat retina

A low-molecular-weight angiogenic factor has been isolated from healthy adult cat retinas. The factor, which has been purified by diethylaminoethyl (DEAE) cellulose chromatography and affinity chromatography, stimulates neovascularisation of the chick chorioallantoic membrane and has a number of properties similar to those previously described for a tumour factor. The finding of an angiogenic factor in healthy retina and its relationship to previously described inhibitors of angiogenesis is discussed.

[Hemodynamic effects of the association of nifedipine and acebutolol]

The aim of this study was to assess the effects of the association of sublingual nifedipine and intravenous acebutolol on left ventricular inotropism. A series of 30 randomised patients underwent hemodynamic investigation repeated after a 30 minute interval comprising measurement of left ventricular (LVP) and aortic (AoP) pressures and ventriculography (Vo). Between the two Vo, Group I (N = 10) were given 20 mg sublingual nifedipine (N), Group II (N = 0) were given I mg/Kg acebutolol (A) intravenously in 5 minutes, and Group III (N = 10) the association of 20 mg sublingual N and I mg/Kg intravenous A. All patients had normal resting left ventricular function (ejection fraction greater than 0,55). In Group I, a significant improvement in left ventricular function with reduction of end diastolic pressure, increase ejection fraction, VCF and cardiac index was observed. THese changes were secondary to the reduction in aortic impedence with no effects on the contractile element (assessed by end systolic pressure/end systolic volume - ESP/ESV - ratio). In Group II, a significant reduction in these indices of left ventricular function was recorded secondary to a reduction in contractility. Group III had a special hemodynamic profile comprising: a reduction in afterload identical to that observed in Group I; a significantly greater reduction in the ESP/ESV ratio than in Group II; a greater reduction in the indices of left ventricular function (especially EF, VCF and CI) than in Group II, but the difference was not significant. The data obtained under the conditions of this acute hemodynamic investigation in patients with normal basal left ventricular function may be summarised thus: 1) Nifedipine alone has no detectable negative inotropic effects. 2) The association with acebutolol, nifedipine seems to potentiate myocardial depression (ESP/ESV). 3) This therapeutic association, the value of which has already been demonstrated in coronary insufficiency should be used carefully without precise knowledge of the left ventricular function.

Treatment of hemorrhagic gastritis with 15(R)-15 methyl prostaglandin E2: report of a case

A 19-yr-old male developed severe hemorrhagic gastritis following three abdominal operations. Treatment with intravenous cimetidine and hourly antacids to maintain his gastric pH above 5 failed to affect gastrointestinal bleeding. Also, peripheral venous vasopressin, propantheline bromide, and glucagon were without effect. Total gastrectomy was considered to control his bleeding. However, since a number of prostaglandin analogs prevent gastric lesions produced by many noxious agents (e.g., aspirin, alcohol, strong acid or alkali, etc.) in animals and humans, the patient was treated with 50 micrograms of 15(R)-15 methyl prostaglandin E2 intragastrically every 6 h for 10 days. To epimerize the 15(R) form to the more active 15(S) form, 50-100 ml of 50-mN HCl was placed into the patient's stomach immediately before each dose. Bleeding ceased within 24 h of the onset of 15(R)-15 methyl prostaglandin E2 therapy and did not recur. The prompt response to 15(R)-15 methyl prostaglandin E2 in combination with hourly antacids in this patient with persistent and severe hemorrhagic gastritis suggests a therapeutic effect and the need for a prospective double-blind clinical trial.

Hypervitaminosis A unmasked by acute viral hepatitis

A case of acute hypervitaminosis A complicating viral hepatitis is reported. Twenty days after presenting with hepatitis B, a 42-yr-old vegetarian developed acute hypervitaminosis A in the absence of recent, massive exposure to the vitamin. Findings included headache, confusion, skin desquamation, and hypercalcemia. Prior to developing hepatitis, he had ingested supplemental vitamin A without recognized ill effect. Liver and serum vitamin A without recognized ill effect. Liver and serum vitamin A levels were both elevated; the liver biopsy showed abundant, lipid-filled Ito cells and perisinusoidal fibrosis. This case demonstrates that patients with excessive hepatic stores of vitamin A may develop hypervitaminosis A during acute, intercurrent liver disease. Levels of retinol binding protein are reduced in hepatitis. This phenomenon may account for the findings in this case, since vitamin A is more toxic when not specifically bound to retinol binding protein. The size of the population at risk for this complication of hepatitis in unknown, but presumably it is growing with the widespread use of supplemental vitamin A.