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Schreeg ME, Evans BJ, Allen J, Lewis MC, Luckring E, Evola M, Richard DK, Piner K, Thompson EM, Adin DB, Tokarz DA. Cardiac Leiomyosarcoma in a Cat Presenting for Bilateral Renal Neoplasia. J Comp Pathol 2019; 168:19-24. [PMID: 31103054 DOI: 10.1016/j.jcpa.2019.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/21/2019] [Accepted: 02/25/2019] [Indexed: 11/27/2022]
Abstract
A 10-year-old neutered female domestic longhair cat was presented to a tertiary care veterinary hospital for evaluation of a right renal mass that was identified incidentally on abdominal radiographs and classified further as a sarcoma based on fine needle aspiration cytology. Further diagnostic workup, including ultrasound and cytology, identified a sarcoma in the left kidney. After approximately 1 month of conservative medical management, the clinical condition deteriorated and the cat was humanely destroyed. Post-mortem examination confirmed bilateral renal masses with multifocal infarction and extensive necrosis, and further identified a large mass at the apex of the heart as well as multiple pulmonary nodules. Microscopical examination of the masses identified a population of poorly-differentiated neoplastic spindle cells, consistent with sarcoma. Immunohistochemically, the neoplastic cells expressed smooth muscle actin and muscle-specific actin, but were negative for myoglobin and factor VIII. Phosphotungstic acid-haematoxylin staining was unable to identify cross-striations in the neoplastic cells. Based on these results and the pattern of lesion distribution, the cat was diagnosed with cardiac leiomyosarcoma with pulmonary and bilateral renal metastasis.
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Affiliation(s)
- M E Schreeg
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - B J Evans
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - J Allen
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - M C Lewis
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - E Luckring
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - M Evola
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D K Richard
- Cleveland School Animal Hospital, 79 Oxholm Circle, Garner, USA
| | - K Piner
- Veterinary Specialty Hospital of the Carolinas, 6405 Tryon Rd, Cary, North Carolina, USA
| | - E M Thompson
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D B Adin
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA
| | - D A Tokarz
- North Carolina State University, College of Veterinary Medicine, 1060 William Moore Drive, Raleigh, USA.
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2
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Bryant RV, Prowse S, Nguyen-Hoang A, Lewis MC. Gastrointestinal: Adenocarcinoma in ileal Crohn's disease: A devil in disguise. J Gastroenterol Hepatol 2017; 32:1535. [PMID: 28845588 DOI: 10.1111/jgh.13673] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 12/09/2016] [Indexed: 01/30/2023]
Affiliation(s)
- R V Bryant
- Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.,School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Sjb Prowse
- Department of Radiology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - A Nguyen-Hoang
- Department of Pathology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - M C Lewis
- Department of Colorectal Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Wagner FF, Zhang YL, Fass DM, Joseph N, Gale JP, Weïwer M, McCarren P, Fisher SL, Kaya T, Zhao WN, Reis SA, Hennig KM, Thomas M, Lemercier BC, Lewis MC, Guan JS, Moyer MP, Scolnick E, Haggarty SJ, Tsai LH, Holson EB. Kinetically Selective Inhibitors of Histone Deacetylase 2 (HDAC2) as Cognition Enhancers. Chem Sci 2015; 6:804-815. [PMID: 25642316 PMCID: PMC4310013 DOI: 10.1039/c4sc02130d] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Kinetically selective inhibitors of HDAC2 enhanced learning and memory in a CK-p25 mouse model of neurodegeneration.
Aiming towards the development of novel nootropic therapeutics to address the cognitive impairment common to a range of brain disorders, we set out to develop highly selective small molecule inhibitors of HDAC2, a chromatin modifying histone deacetylase implicated in memory formation and synaptic plasticity. Novel ortho-aminoanilide inhibitors were designed and evaluated for their ability to selectively inhibit HDAC2 versus the other Class I HDACs. Kinetic and thermodynamic binding properties were essential elements of our design strategy and two novel classes of ortho-aminoanilides, that exhibit kinetic selectivity (biased residence time) for HDAC2 versus the highly homologous isoform HDAC1, were identified. These kinetically selective HDAC2 inhibitors (BRD6688 and BRD4884) increased H4K12 and H3K9 histone acetylation in primary mouse neuronal cell culture assays, in the hippocampus of CK-p25 mice, a model of neurodegenerative disease, and rescued the associated memory deficits of these mice in a cognition behavioural model. These studies demonstrate for the first time that selective pharmacological inhibition of HDAC2 is feasible and that inhibition of the catalytic activity of this enzyme may serve as a therapeutic approach towards enhancing the learning and memory processes that are affected in many neurological and psychiatric disorders.
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Affiliation(s)
- F F Wagner
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - Y-L Zhang
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - D M Fass
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; SL Fisher Consulting, LLC, PO Box 3052, Framingham, Massachusetts, USA
| | - N Joseph
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Howard Hughes Medical Institute, Cambridge, Massachusetts, USA
| | - J P Gale
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - M Weïwer
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - P McCarren
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - S L Fisher
- SL Fisher Consulting, LLC, PO Box 3052, Framingham, Massachusetts, USA
| | - T Kaya
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - W-N Zhao
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Chemical Neurobiology Laboratory, Center for Human Genetic Research, Massachusetts General Hospital, Department of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - S A Reis
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Chemical Neurobiology Laboratory, Center for Human Genetic Research, Massachusetts General Hospital, Department of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - K M Hennig
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Chemical Neurobiology Laboratory, Center for Human Genetic Research, Massachusetts General Hospital, Department of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - M Thomas
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - B C Lemercier
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - M C Lewis
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - J S Guan
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Howard Hughes Medical Institute, Cambridge, Massachusetts, USA
| | - M P Moyer
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - E Scolnick
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
| | - S J Haggarty
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Chemical Neurobiology Laboratory, Center for Human Genetic Research, Massachusetts General Hospital, Department of Neurology and Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - L-H Tsai
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA ; Picower Institute for Learning and Memory, Massachusetts Institute of Technology, Howard Hughes Medical Institute, Cambridge, Massachusetts, USA
| | - E B Holson
- Stanley Center for Psychiatric Research; Broad Institute of Harvard and MIT; 7 Cambridge Center, Cambridge, Massachusetts, USA
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Panagiotopoulou IG, Carter N, Lewis MC, Rao S. Early laparoscopic cholecystectomy in a district general hospital: is it safe and feasible? INT J EVID-BASED HEA 2012; 10:112-6. [PMID: 22672600 DOI: 10.1111/j.1744-1609.2012.00260.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early laparoscopic cholecystectomy (ELC) is becoming the accepted treatment for the management of acute gallstone disease in specialist centres. It has also been achieved safely in the district general hospital (DGH) setting. We audited the management of acute gallstone disease in our DGH and set about to see if we could implement ELC safely and effectively. PATIENTS AND METHODS A retrospective audit of 2 years of practice was performed using our hospital-computerised systems. Following this, departmental education regarding the benefits of early cholecystectomy was widely disseminated. Management guidelines were altered to promote and consider ELC for all suitable patients. A prospective audit of practice was then performed for 6 months. RESULTS The first cycle revealed that only 10.42% of emergency patients admitted with gallstone-related disease had ELC. In the second cycle, 63 patients were admitted with acute gallstone disease. Three died from acute pancreatitis. Twenty-one (58%) of the 36, who were deemed suitable, had ELC. Fifteen (42%) had planned delayed laparoscopic cholecystectomy (DLC), with six (40%) being readmitted whilst waiting for their elective surgery (all undergoing ELC during their readmission). Conversion rates were similar between all groups. One of the patients having DLC had a bile leak, which settled following Endoscopic Retrograde Cholangiopancreatography and stent. CONCLUSION We were able to increase ELC rates following the implementation of necessary changes. There did not appear to be any difference in conversion or morbidity rates between ELC and DLC. We conclude ELC is safe and feasible in the DGH setting.
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Abstract
AIM To describe a new technique for the Soave trans-anal pull-through. METHOD After the mucosectomy during a Soave's procedure, a laparoscopic wound retractor was used to line the distal rectal segment to facilitate delivery of the proximal bowel through a narrow scarred pelvis. RESULTS The technique greatly assisted delivery of the proximal bowel and helped prevent mesenteric injury. CONCLUSION Soave trans-anal pull-through is a difficult operation that is largely confined to specialist centres. We describe an improvement to the technique that greatly facilitates the procedure.
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Affiliation(s)
- J F Broadhurst
- Department of General Surgery, Dorset County Hospital NHS Foundation Trust, Dorchester, UK.
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Lewis MC, Nevo I, Paniagua MA, Ben-Ari A, Pretto E, Eisdorfer S, Davidson E, Matot I, Eisdorfer C. Uncomplicated general anesthesia in the elderly results in cognitive decline: does cognitive decline predict morbidity and mortality? Med Hypotheses 2006; 68:484-92. [PMID: 17141964 DOI: 10.1016/j.mehy.2006.08.030] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2006] [Accepted: 08/16/2006] [Indexed: 11/22/2022]
Abstract
Elderly surgical patients constitute a unique surgical group. They require special consideration in order to preempt the long term adverse effects of anesthesia. This paper examines the proposition that general anesthesia causes harm to elderly patients with its impact being felt long after the anesthetic agents are cleared from the body. One complication, Postoperative Cognitive Decline (POCD), is associated with the administration of anesthesia and deep sedation. Its' occurrence may herald an increase in morbidity and mortality. Based on both human and animal data, this paper outlines a unitary theoretical framework to explain these phenomena. If this hypothesis proves to be correct, anesthesiologist should consider regional rather than general anesthesia for equivalent surgical procedures to reduce POCD and consequently achieving superior patient outcome.
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Affiliation(s)
- M C Lewis
- Miller School of Medicine, University of Miami, Miami, FL 33101, USA.
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7
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Lewis MC, Phillips ML, Slavotinek JP, Kow L, Thompson CH, Toouli J. Change in liver size and fat content after treatment with Optifast very low calorie diet. Obes Surg 2006; 16:697-701. [PMID: 16756727 DOI: 10.1381/096089206777346682] [Citation(s) in RCA: 154] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB) requires surgical access to the gastroesophageal junction, which may be compromised by the enlarged, fatty liver that is frequently encountered in the obese. Liver size appears reduced and surgical access improved following preoperative weight loss with Optifast Very Low Calorie Diet (VLCD). The aim of this study was to assess the effects of 6 weeks Optifast VLCD on liver volume and fat content. METHODS 18 morbidly obese subjects underwent magnetic resonance imaging and spectroscopy to measure liver size and fat content before and after intensive treatment with Optifast VLCD for 6 weeks. RESULTS All subjects completing 6 weeks Optifast VLCD lost weight. Body weight and BMI (median [interquartile range]) reduced from 119.7 [111.9-131.3] kg and 44 [40-51] kg/m(2) respectively, to 110.6 [98.0124.5] kg and 40 [36-47] kg/m(2), P<0.001. Median excess weight loss (EWL) was 15.1 [9.6-21.1]%. Baseline liver volume and fat content were related (r=0.633, P=0.005). After 6 weeks Optifast VLCD, there was a 14.7% reduction in mean liver volume (P<0.001) and a 43% reduction in mean liver fat (P=0.016). The change in liver volume was predicted by the change in the liver fat (r = 0.610, P=0.012). CONCLUSION This study has demonstrated that a 6 week diet with Optifast VLCD results in significant related reductions in liver size and liver fat content. This suggests that the reduction in liver volume is due to loss of fat. The reduction in liver fat and volume likely accounts for the perceived improved operability in patients undergoing LAGB.
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Affiliation(s)
- Mark C Lewis
- Department of General and Digestive Surgery, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia, Australia
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8
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Phillips ML, Lewis MC, Chew V, Kow L, Slavotinek JP, Daniels L, Valentine R, Toouli J, Thompson CH. The Early Effects of Weight Loss Surgery on Regional Adiposity. Obes Surg 2005; 15:1449-55. [PMID: 16354526 DOI: 10.1381/096089205774859353] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Weight loss beyond 6 months following laparoscopic adjustable gastric banding (LAGB) is associated with a preferential mobilization of visceral adipose tissue and an improvement in insulin sensitivity in insulin resistant subjects. Because the rate of weight loss is greatest in the first 3 months after LAGB, we investigated the impact of LAGB on changes in regional lipid deposition and insulin sensitivity over this period. METHODS 10 female obese non-diabetic subjects underwent magnetic resonance (MR) imaging and spectroscopy before and 12 weeks after LAGB (using the Swedish band), for the quantification of abdominal subcutaneous and visceral adipose tissue areas and intrahepatic lipid. Fasting blood free fatty acids were analyzed. Insulin sensitivity was monitored by fasting insulin and homeostasis model assessment (HOMA). RESULTS Median weight loss 12 weeks after gastric banding was 9.5 kg [interquartile range (IQR): -16.5 to -6]. There were significant reductions in median abdominal subcutaneous (-20% [IQR: -24 to -13]) and visceral (-15% [IQR: -49 to -8]) adipose tissue depots as well as plasma free fatty acids (-34% [IQR: -79 to -8]). The amount of weight lost was directly proportional to the initial BMI (r=0.778; P=0.008). Visceral fat loss was proportional to initial visceral adiposity (r=0.80, P=0.01). There was no significant improvement in insulin sensitivity. CONCLUSION Significant fat loss occurs 3 months after LAGB. The absence of a concurrent improvement in insulin sensitivity may reflect the relatively small reduction in visceral adipose tissue at this stage. Improvement in insulin sensitivity beyond 3 months after LAGB may be due to the continued loss of visceral adipose tissue.
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Affiliation(s)
- Madeleine L Phillips
- Department of Medicine, Flinders Medical Centre, Flinders University of South Australia, Bedford Park, South Australia.
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Winegar DA, Brown PJ, Wilkison WO, Lewis MC, Ott RJ, Tong WQ, Brown HR, Lehmann JM, Kliewer SA, Plunket KD, Way JM, Bodkin NL, Hansen BC. Effects of fenofibrate on lipid parameters in obese rhesus monkeys. J Lipid Res 2001; 42:1543-51. [PMID: 11590209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Fenofibrate is a member of the fibrate class of hypolipidemic agents used clinically to treat hypertriglyceridemia and mixed hyperlipidemia. The fibrates were developed primarily on the basis of their cholesterol and triglyceride lowering in rodents. Fibrates have historically been ineffective at lowering triglycerides in experimentally-induced dyslipidemia in nonhuman primate models. The spontaneously obese rhesus monkey is a well-recognized animal model for the study of human obesity and type 2 diabetes, and many of these monkeys exhibit naturally occurring lipid abnormalities, including elevated triglycerides and low HDL cholesterol (HDL-C), similar to patients with type 2 diabetes. To explore whether the obese rhesus model was predictive of the lipid lowering effects of fibrates, we evaluated fenofibrate in six hypertriglyceridemic, hyperinsulinemic, nondiabetic animals in a 20-week, dose-escalating study. The study consisted of a 4-week baseline period, two treatment periods of 10 mg/kg twice daily (b.i.d) for 4 weeks and 30 mg/kg b.i.d. for 8 weeks, and a 4-week washout period. Fenofibrate (30 mg/kg b.i.d) decreased serum triglycerides 55% and LDL-C 27%, whereas HDL-C increased 35%. Apolipoproteins B-100 and C-III levels were also reduced 70% and 29%, respectively. Food intake, body weight, and plasma glucose were not affected throughout the study. Interestingly, plasma insulin levels decreased 40% during the 30 mg/kg treatment period, suggesting improvement in insulin sensitivity. These results support the use of obese rhesus monkey as an excellent animal model for studying the effects of novel hypolipidemic agents, particularly agents that impact serum triglycerides and HDL-C.
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Affiliation(s)
- D A Winegar
- GlaxoSmithKline, Five Moore Drive, Research Triangle Park, NC 27709, USA.
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Brown PJ, Stuart LW, Hurley KP, Lewis MC, Winegar DA, Wilson JG, Wilkison WO, Ittoop OR, Willson TM. Identification of a subtype selective human PPARα agonist through parallel-array synthesis. Bioorg Med Chem Lett 2001; 11:1225-7. [PMID: 11354382 DOI: 10.1016/s0960-894x(01)00188-3] [Citation(s) in RCA: 144] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Using solid-phase, parallel-array synthesis, a series of urea-substituted thioisobutyric acids was synthesized and assayed for activity on the human PPAR subtypes. GW7647 (3) was identified as a potent human PPARalpha agonist with approximately 200-fold selectivity over PPARgamma and PPARdelta, and potent lipid-lowering activity in animal models of dyslipidemia. GW7647 (3) will be a valuable chemical tool for studying the biology of PPARalpha in human cells and animal models of disease.
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Affiliation(s)
- P J Brown
- GlaxoSmithKline, Research Triangle Park, NC 27709-3398, USA.
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11
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Oliver WR, Shenk JL, Snaith MR, Russell CS, Plunket KD, Bodkin NL, Lewis MC, Winegar DA, Sznaidman ML, Lambert MH, Xu HE, Sternbach DD, Kliewer SA, Hansen BC, Willson TM. A selective peroxisome proliferator-activated receptor delta agonist promotes reverse cholesterol transport. Proc Natl Acad Sci U S A 2001; 98:5306-11. [PMID: 11309497 PMCID: PMC33205 DOI: 10.1073/pnas.091021198] [Citation(s) in RCA: 856] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The peroxisome proliferator-activated receptors (PPARs) are dietary lipid sensors that regulate fatty acid and carbohydrate metabolism. The hypolipidemic effects of the fibrate drugs and the antidiabetic effects of the glitazone drugs in humans are due to activation of the alpha (NR1C1) and gamma (NR1C3) subtypes, respectively. By contrast, the therapeutic potential of the delta (NR1C2) subtype is unknown, due in part to the lack of selective ligands. We have used combinatorial chemistry and structure-based drug design to develop a potent and subtype-selective PPARdelta agonist, GW501516. In macrophages, fibroblasts, and intestinal cells, GW501516 increases expression of the reverse cholesterol transporter ATP-binding cassette A1 and induces apolipoprotein A1-specific cholesterol efflux. When dosed to insulin-resistant middle-aged obese rhesus monkeys, GW501516 causes a dramatic dose-dependent rise in serum high density lipoprotein cholesterol while lowering the levels of small-dense low density lipoprotein, fasting triglycerides, and fasting insulin. Our results suggest that PPARdelta agonists may be effective drugs to increase reverse cholesterol transport and decrease cardiovascular disease associated with the metabolic syndrome X.
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Affiliation(s)
- W R Oliver
- Metabolic Diseases Drug Discovery and Nuclear Receptor Discovery Research, GlaxoSmithKline, Research Triangle Park, NC 27709, USA
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12
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Goodwin B, Jones SA, Price RR, Watson MA, McKee DD, Moore LB, Galardi C, Wilson JG, Lewis MC, Roth ME, Maloney PR, Willson TM, Kliewer SA. A regulatory cascade of the nuclear receptors FXR, SHP-1, and LRH-1 represses bile acid biosynthesis. Mol Cell 2000; 6:517-26. [PMID: 11030332 DOI: 10.1016/s1097-2765(00)00051-4] [Citation(s) in RCA: 1425] [Impact Index Per Article: 59.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Bile acids repress the transcription of cytochrome P450 7A1 (CYP7A1), which catalyzes the rate-limiting step in bile acid biosynthesis. Although bile acids activate the farnesoid X receptor (FXR), the mechanism underlying bile acid-mediated repression of CYP7A1 remained unclear. We have used a potent, nonsteroidal FXR ligand to show that FXR induces expression of small heterodimer partner 1 (SHP-1), an atypical member of the nuclear receptor family that lacks a DNA-binding domain. SHP-1 represses expression of CYP7A1 by inhibiting the activity of liver receptor homolog 1 (LRH-1), an orphan nuclear receptor that is known to regulate CYP7A1 expression positively. This bile acid-activated regulatory cascade provides a molecular basis for the coordinate suppression of CYP7A1 and other genes involved in bile acid biosynthesis.
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MESH Headings
- Animals
- Bile Acids and Salts/biosynthesis
- Blotting, Northern
- Cells, Cultured
- Cholesterol 7-alpha-Hydroxylase/genetics
- Cholesterol 7-alpha-Hydroxylase/metabolism
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Gene Expression Regulation, Enzymologic/physiology
- Hepatocytes/cytology
- Hepatocytes/enzymology
- Humans
- Intracellular Signaling Peptides and Proteins
- Male
- Promoter Regions, Genetic/physiology
- Protein Tyrosine Phosphatase, Non-Receptor Type 11
- Protein Tyrosine Phosphatase, Non-Receptor Type 6
- Protein Tyrosine Phosphatases/genetics
- Protein Tyrosine Phosphatases/metabolism
- RNA, Messenger/analysis
- Rats
- Rats, Inbred F344
- Receptors, Cytoplasmic and Nuclear/genetics
- Receptors, Cytoplasmic and Nuclear/metabolism
- Repressor Proteins/genetics
- Repressor Proteins/metabolism
- Transcription Factors/genetics
- Transcription Factors/metabolism
- Transfection
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Affiliation(s)
- B Goodwin
- Department of Molecular Endocrinology, Glaxo Wellcome Research and Development, Research Triangle Park, North Carolina 27709, USA
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Maloney PR, Parks DJ, Haffner CD, Fivush AM, Chandra G, Plunket KD, Creech KL, Moore LB, Wilson JG, Lewis MC, Jones SA, Willson TM. Identification of a chemical tool for the orphan nuclear receptor FXR. J Med Chem 2000; 43:2971-4. [PMID: 10956205 DOI: 10.1021/jm0002127] [Citation(s) in RCA: 423] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- P R Maloney
- Department of Medicinal Chemistry, Glaxo Wellcome Research & Development, Research Triangle Park, North Carolina 27709, USA.
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Abstract
The effects of needle bevel orientation and cerebrospinal fluid (CSF) pressure on dural displacement and force required to penetrate cadaveric dura were studied using 40 samples. A constant hydrostatic pressure was applied to the subdural surface, either high or low, simulating the sitting and lateral positions. A 17-gauge Tuohy needle was advanced through the dura with the bevel oriented parallel or perpendicular to dural fibres. Travel distance and peak force at which dural penetration occurred were measured under both pressure conditions. The work required to produce dural penetration was calculated. Greater force and work were required to penetrate dura in the perpendicular orientation (P < 0.05), regardless of the subdural pressure exerted. Dural displacement was similar under both pressure conditions.
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Affiliation(s)
- M C Lewis
- Department of Anesthesiology, Veterans Affairs Medical Center, Miami, FL 33125, USA
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15
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Abstract
We compared the pungency and tolerability of three inhaled anaesthetics in a randomized, double-blind study. Eighty-one unpremedicated patients (n = 27, each group) inhaled 2 MAC of isoflurane (2.3%), desflurane (12%) or sevoflurane (4%) for 60 s from an anaesthetic breathing circuit via a mask. Two blinded observers recorded coughing, complaints of burning and irritation, and how long the inhalation was tolerated. One sevoflurane patient coughed, but completed the study period, whereas 11 isoflurane patients and 20 desflurane patients coughed, objected verbally or removed the mask forcefully. All sevoflurane, 20 isoflurane and seven desflurane patients completed the study period (average 60, 49 and 33 s, respectively, P < 0.05). The irritability grading was: desflurane > isoflurane > sevoflurane (P < 0.05). Sevoflurane is the least irritating agent for inhalation at 2 MAC concentration.
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Affiliation(s)
- M F TerRiet
- Anesthesiology Service, VA Medical Center, Miami, FL 33125, USA
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Brown PJ, Winegar DA, Plunket KD, Moore LB, Lewis MC, Wilson JG, Sundseth SS, Koble CS, Wu Z, Chapman JM, Lehmann JM, Kliewer SA, Willson TM. A ureido-thioisobutyric acid (GW9578) is a subtype-selective PPARalpha agonist with potent lipid-lowering activity. J Med Chem 1999; 42:3785-8. [PMID: 10508427 DOI: 10.1021/jm9903601] [Citation(s) in RCA: 100] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- P J Brown
- Department of Medicinal Chemistry, Glaxo Wellcome Research & Development, Research Triangle Park, North Carolina 27709, USA.
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Lewis MC, Schauer JC, Gold MI. Single breath induction technique: comparison of sevoflurane and isoflurane. Anesth Analg 1996; 83:890-1. [PMID: 8831354 DOI: 10.1097/00000539-199610000-00058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Abstract
Laparoscopic surgery is growing in popularity. As a result, laparoscopic procedures are being done on a broader and older patient population. These patients may have underlying cardiopulmonary disease that predisposes them to complications not seen in younger patients. Anesthesiologists should be aware of this possibility and of the problems inherent to the pneumoperitoneum necessary for laparoscopy. We present two cases involving elderly patients to illustrate cardiopulmonary complications that can occur during establishment or maintenance of the increased intra-abdominal pressures required for laparoscopic surgery. The first case describes a patient who developed bradycardia and asystole during insufflation for a laparoscopic hernia repair. The second case involves severe hypercarbia and a pneumothorax due to massive subcutaneous emphysema that developed during a laparoscopic colon resection.
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Affiliation(s)
- L J Lehmann
- Department of Anesthesiology, University of Miami/Jackson Memorial Hospital, Fla, USA
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Root C, Smith CD, Winegar DA, Brieaddy LE, Lewis MC. Inhibition of ileal sodium-dependent bile acid transport by 2164U90. J Lipid Res 1995; 36:1106-15. [PMID: 7658159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Inhibition of the ileal bile acid active transport system, previously shown to be mechanism underlying the hypocholesterolemic activity of 2164U90 in rodents, was further characterized in isolated intestinal preparations from three species. 2164U90 inhibited sodium-dependent transport of taurocholic acid by Caco-2 cells and by monkey and human ileal brush border membrane vesicles in a concentration-dependent manner with IC50s of 7 microM, 5 microM, and 2 microM, respectively. In rat ileal brush border membrane vesicles, 2164U90 was a competitive inhibitor of sodium-dependent taurocholic acid uptake with an estimated Ki of 1.8 +/- 0.2 microM. In anesthetized rats, 5 microM 2164U90 placed in the isolated distal ileum with 3 mM [3H]taurocholic acid decreased ileal uptake, transport into the bile, and transport rate of taurocholic acid by 31-35%. Stereospecificity of inhibition by 2164U90 was demonstrated by the relative inactivity of three other possible stereoisomers in rat ileal sacs and brush border membrane vesicles. 2164U90 did not inhibit sodium-dependent glucose transport by monkey jejunal brush border membrane vesicles, indicating that 2164U90 may be specific for the bile acid transporter. These results suggest that 2164U90 is a potent, selective, stereospecific, competitive inhibitor of the sodium-dependent bile acid transporter in the ileal mucosal cell brush border membrane.
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Affiliation(s)
- C Root
- Division of Pharmacology, Burroughs Wellcome Co., Research Triangle Park, NC 27709, USA
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Lewis MC, Brieaddy LE, Root C. Effects of 2164U90 on ileal bile acid absorption and serum cholesterol in rats and mice. J Lipid Res 1995; 36:1098-105. [PMID: 7658158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
2164U90, [(3R,5R)-trans-3-butyl-3-ethyl-2,3,4,5-tetrahydro-5-phenyl-1,4- benzothiazepine 1,1-dioxide], was found to be a potent inhibitor of the ileal bile acid active transport system. In vitro, 2164U90 decreased uptake and active transport of taurocholic acid by rat everted ileal sacs with IC50s of 4.0 microM and 1.5 microM, respectively. In vivo, 2164U90 produced dose-dependent increases in 23,25-75Se-labeled homocholic acid taurine (SeHCAT) fecal excretion in rats and mice at doses of 3-30 mg/kg and 1-10 mg/kg, respectively. In rats, 30 mg/kg 2164U90 was equivalent to 500 mg/kg cholestyramine. Two days oral administration of 10 mg/kg 2164U90 to rats decreased the bile concentrations of total bile acids 42%, orally administered [3H]taurocholic acid ([3H]TC) 82%, and cholesterol 35%. Cholestyramine (500 mg/kg) had effects similar to 2164U90 on total bile acid and orally administered [3H]TC concentrations but had no effect on biliary cholesterol. The hypocholesterolemic activity of 2164U90 was determined in cholesterol-cholic acid-fed rats and cholesterol-cholic acid-coconut oil-fed mice. 2164U90 inhibited the dietary-induced increase in dextran sulfate-precipitable lipoprotein cholesterol (VLDL+LDL) at doses comparable to doses needed to increase the fecal excretion of bile acids. These data indicate that 2164U90 decreases bile acid absorption by inhibiting the ileal bile acid active transport system, resulting in hypocholesterolemic activity.
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Affiliation(s)
- M C Lewis
- Division of Pharmacology, Burroughs Wellcome Co., Research Triangle Park, NC 27709, USA
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Distefano RJ, Neves RJ, Helfrich LA, Lewis MC. Response of the crayfish Cambarus bartonii bartonii to acid exposure in southern Appalachian streams. CAN J ZOOL 1991. [DOI: 10.1139/z91-222] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Intermolt adult and juvenile Cambarus bartonii bartonii (Fabricius) from southern Appalachian Mountains streams tolerated considerable acidity when acutely exposed to greatly reduced pH levels in laboratory bioassays. Tolerance increased with increasing size or age of crayfish. Ninety-six-hour exposures yielded LC50 values of pH 2.43, 2.56, and 2.85 for adults, advanced juveniles, and early juveniles, respectively. Lowering the water temperature increased the acid tolerance and survival time of intermolt adults during severe acidification (temperatures ranged from 20.2 to 13.3 °C). Acid exposure of intermolt adults in soft water up to 96 h caused a linear decrease in hemolymph [Na]. Hemolymph [Ca] increased through 48 h and then returned to near pre-exposure levels. An initial increase in [K] was followed by a decrease to slightly below pre-exposure levels. Hemolymph [Mg] remained unchanged. No Ca was lost from carapaces. These observations indicate that occasional episodes of higher than normal acidity in southern Appalachian streams are not necessarily a threat to intermolt adult and juvenile C. b. bartonii. Nevertheless, gradually increasing acidity and loss of watershed buffering capacity could produce sublethal effects such as altered reproductive activity, or changes in early life history stages and more sensitive molt cycle stages, that could damage these populations.
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Abstract
Muscle cells from adult male Schistosoma mansoni have been isolated using a combination of papain digestions and mechanical dissociation procedures. The muscle fibres isolated in this way lacked nuclei but they did contract and relax in response to high [K+], a response which was blocked in the presence of Co2+. From this we conclude that the isolation procedure yields viable muscle fibres useful for physiological studies. Patch-clamp recordings taken from the isolated fibres show a variety of discrete ionic conductances. In inside-out patches one prominent channel was a Ca(2+)-activated K+ channel with a conductance of 195 pS and a selectivity greater than 10:1 for K+ over Na+, Cs+ or NH4+. Percentage open time was dependent on [Ca2+] at the intracellular face. With [Ca2+] at 1 microM or greater percentage open time was greater than 95%; at 0.1 microM it was less than 2%. No voltage sensitivity could be detected in the voltage range from -50 to -10 mV membrane potential. Ba2+ (10 mM), but neither tetraethylammonium nor 3,4-diaminopyridine blocked the channel from the intracellular face. This Ca(2+)-activated K+ channel in the muscle membrane of this acoelomate animal is similar in most respects to the maxi-K+ channels which have been described in a variety of cells from more highly evolved animals.
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Affiliation(s)
- K L Blair
- Department of Zoology, Michigan State University, East Lansing 48824
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Abstract
The transport kinetics and distribution of taurocholate (TC) from the ileum and jejunum were evaluated in anesthetized Sprague-Dawley rats. Uptake and transport kinetics were determined after simultaneous administration of equimolar solutions of [3H]taurocholic acid ([3H]TC) in the ileum and [24-14C]taurocholic acid ([14C]TC) in the jejunum of anesthetized rats. At TC concentrations between 0.3 and 15 mM, total ileal absorption exceeded jejunal absorption 15- to 25-fold. The apparent Km and Vmax for ileal absorption of TC were 5.6 mM and 65.5 nmol.min-1.cm-1, respectively. Tissue distribution studies following uptake from the ileum and jejunum were done with 75Se-labeled homocholic acid taurine (75Se-HCAT). In the ileum, 82% of the 75Se-HCAT removed from the lumen was found in the bile, 10.6% was found in the ileal wall, and 7.3% was found in the liver. In the jejunum, 24.1% was found in bile, 0.6% was found in the liver, and 75.3% remained in the jejunal wall. These data show that the ileum is much more efficient and better equipped than the jejunum to take up and transport TC at concentrations up to 15 mM.
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Affiliation(s)
- M C Lewis
- Division of Pharmacology, Burroughs Wellcome Company, Research Triangle Park, North Carolina 27709
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Abstract
Upon request by the local American Red Cross, the Savannah Regional Center for Cancer Care irradiates whole blood or blood components to prevent post-transfusion graft-versus-host reaction in patients who have severely depressed immune systems. The rationale for blood irradiation, the total absorbed dose, the type of patients who require irradiated blood, and the regulations that apply to irradiated blood are presented. A method of irradiating blood using a linear accelerator is described.
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Affiliation(s)
- M C Lewis
- Savannah Regional Center for Cancer Care, Memorial Medical Center, GA 31403
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Stein H, Fairey AE, Mulholland JM, Lewis MC. General practitioners and child health preventive services. BMJ 1989; 299:1033. [PMID: 2511955 PMCID: PMC1837887 DOI: 10.1136/bmj.299.6706.1033-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Lewis MC, Uglem GL. Evolution of Cutaneous Sugar Transport Functions in Proterometra dickermani (Digenea: Azygiidae). J Parasitol 1989. [DOI: 10.2307/3282608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Lewis MC. Attributions and inflammatory bowel disease: patients' perceptions of illness causes and the effects of these perceptions on relationships. AARN News Lett 1988; 44:16-7. [PMID: 3389064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Affiliation(s)
- M C Lewis
- University of California, San Francisco
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Geller E, Halpern P, Barzelai E, Sorkine P, Lewis MC, Silbiger A, Nevo Y. Midazolam infusion and the benzodiazepine antagonist flumazenil for sedation of intensive care patients. Resuscitation 1988; 16 Suppl:S31-9. [PMID: 2849176 DOI: 10.1016/0300-9572(88)90003-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
ICU patients often require sedation. Midazolam (M), a new imidazobenzodiazepine, features rapid onset and rapid elimination time. Flumazenil (Ro 15-1788) is a new benzodiazepine antagonist. We studied the efficacy and safety of M by continuous infusion in 28 ICU patients: 16 post major surgery, and 12 medical patients, aged 20-77 years. M was administered as a loading dose of 0.05-0.15 mg/kg per min followed by continuous infusion of 0.05-0.1 mg/kg per h titrated to maintain patients asleep but arousable. M was administered for up to 14 days in doses of 1-15 mg/h and cumulative doses of up to 1915 mg. No untoward effects were noted except for slight decreases in blood pressure following the loading dose. ACTH challenge tests performed before and 24 h or more following the start of M showed no depression of adrenal responsivity. All patients meeting weaning criteria were weaned off mechanical ventilation while still on M. In 13 patients extubation was performed immediately after M was stopped, and flumazenil (0.38 +/- 0.27 mg, i.v.) given until full awakening. Patients remained awake yet calm. Vital signs remained stable after flumazenil. Midazolam by continuous infusion appears to be a safe and effective mode of sedation in ICU patients. Flumazenil may increase the flexibility and safety of this mode of sedation.
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Affiliation(s)
- E Geller
- Department of Anesthesia and Intensive Care, Tel Aviv Medical Center, Ichilov Hospital, Israel
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Abstract
Xenalipin (4'-trifluoromethyl-2-biphenylcarboxylic acid) is a chemically novel compound which has been found to be an effective hypolipidemic agent in two animal species. Significant reductions in serum cholesterol and triglycerides were observed in cholesterol-cholic acid-fed rats following oral doses of 10-30 mg/kg/day. Xenalipin was considerably more potent than clofibrate, nicotinic acid, and cholestyramine in the same model. Lipoprotein analysis showed that xenalipin reduced cholesterol and protein content in very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), and low density lipoprotein (LDL). Triglycerides were reduced in VLDL and IDL. Xenalipin was also effective in reducing serum cholesterol and triglyceride concentrations in normocholesterolemic rats. In diet-induced hypercholesterolemic African green monkeys, xenalipin at oral doses of 15-60 mg/kg b.i.d. reduced serum LDL-cholesterol concentrations. These results suggest that xenalipin has a profile of activity which would be beneficial in therapy for hyperlipidemia.
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Khoury GA, Lewis MC, Meleagros L, Lewis AA. Colostomy or ileostomy after colorectal anastomosis?: a randomised trial. Ann R Coll Surg Engl 1987; 69:5-7. [PMID: 3566123 PMCID: PMC2498441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Sixty one patients were entered in a randomised trial to compare transverse loop colostomy with loop ileostomy after a colorectal anastomosis thought to be at risk of dehiscence. Radiologically proven breakdown of the colorectal anastomosis occurred in 13% of these selected patients and most frequently in the colostomy group. Ileostomies functioned earlier than colostomies (P less than 0.001) but there was no other significant difference in outcome between the groups. In 52 patients intestinal continuity was restored by excision of the stoma within a month of construction with no difference in morbidity between the two groups. A loop ileostomy, closed as soon as the colorectal anastomosis has healed, is recommended as an alternative to transverse colostomy.
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Uglem GL, Lewis MC. Specificity of the surface aminopeptidase in Moniliformis moniliformis (Acanthocephala). J Helminthol 1986; 60:288-92. [PMID: 3794291 DOI: 10.1017/s0022149x00008506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The hydrolysis of various oligopeptides in solution by intact Moniliformis moniliformis was examined using paper chromatographic analysis of the incubation medium. In the presence of transport inhibitors, the respective peptide sub-units and/or amino acid residues accumulated in the bathing medium. Only peptides with serine, methionine, leucine or alanine at the NH2-terminal end of the peptide were hydrolysed. There was no hydrolysis when these amino acids were located internally or at the COOH-terminus indicating genuine aminopeptidase activity of the class, alpha-aminoacylpeptide hydrolase. Hydrolysis was negligible when the NH2-terminus was arginine, aspartic acid, glutamic acid, glycine, histidine, lysine, phenylalanine, proline, tryptophan, tyrosine, or valine. In separate experiments, mediated uptake of 0.1 mM 3H-leucine by the worms in 2 min was inhibited 100% by 5 mM unlabelled leucine or tri-serine, but only partially inhibited by 5 mM Ser-Gly (66%), 10 mM Ser-Gly (74%), 5 mM Leu-Leu (69%), 10 mM Leu-Leu (70%), 5 mM Leu-Gly (58%) or 5 mM Met-Met (69%). Because the inhibitions produced by 5 mM Leu-Leu plus 5 mM Met-Met (79%) or 5 mM Leu-Leu plus 5 mM Ser-Gly (76%) were not additive, a single enzyme is indicated. The name serine aminopeptidase is proposed because of its preference for serine.
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Abstract
One hundred and twenty consecutive patients were entered into a randomized trial of single versus multiple phenol injection for the treatment of haemorrhoids. Follow-up at 3 and 12 months was available in 105 patients (56 in the single group and 49 in the multiple group). The results have shown that injection therapy, whether this be single or multiple, is an extremely effective form of therapy for patients with first or second degree haemorrhoids.
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Lewis MC. A two week hemodialysis training program for nurses. J Nephrol Nurs 1985; 2:62-6. [PMID: 3845980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Lewis MC. A black perspective: Afro-American men in nursing. Nurs Leadersh (Tor Ont) 1981; 4:31-3. [PMID: 6912411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
The present study examined the saliency of size, movement, and human content variables in visual selective attention. Ss named stimuli present in motion pictures of real world scenes or in animated cartoon controls during a 15-sec. exposure period. Regardless of the type of presentation that they saw, Ss tended to name large and/or moving stimuli more often than small and/or nonmoving stimuli. Also, small human stimuli were named more frequently than small nonhuman stimuli, while there were no differences between the frequencies with which large human and nonhuman stimuli were named. The order in which Ss named stimuli was not related to either the size, movement, or human content variables. Results are discussed in terms of the generalizability of the results of previous studies to conditions simulating the real world.
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Lewis MC. The Cancer Clinic Problem. J Natl Med Assoc 1942; 34:141-143. [PMID: 20893104 PMCID: PMC2625028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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