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Cao J, Inadomi MJ, Daignault-Newton S, Dauw CA, George A, Hiller S, Ghani KR, Krumm AE, Singh K. Development and Validation of a Model to Predict Ureteral Stent Placement Following Ureteroscopy: Results From a Statewide Collaborative. Urology 2023; 177:34-40. [PMID: 37044310 DOI: 10.1016/j.urology.2023.01.059] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 12/22/2022] [Accepted: 01/03/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE To develop and validate a model to predict whether patients undergoing ureteroscopy (URS) will receive a stent. METHODS Using registry data obtained from the Michigan Urological Surgery Improvement Collaborative Reducing Operative Complications from Kidney Stones initiative, we identified patients undergoing URS from 2016 to 2020. We used patients' age, sex, body mass index, size and location of the largest stone, current stent in place, history of any kidney stone procedure, procedure type, and acuity to fit a multivariable logistic regression model to a derivation cohort consisting of a random two-thirds of episodes. Model discrimination and calibration were evaluated in the validation cohort. A sensitivity analysis examined urologist variation using generalized mixed-effect models. RESULTS We identified 15,048 URS procedures, of which 11,471 (76%) had ureteral stents placed. Older age, male sex, larger stone size, the largest stone being in the ureteropelvic junction, no prior stone surgery, no stent in place, a planned procedure type of laser lithotripsy, and urgent procedure were associated with a higher risk of stent placement. The model achieved an area under the receiver operating characteristic curve of 0.69 (95% CI 0.67, 0.71). Incorporating urologist-level variation improved the area under the receiver operating characteristic curve to 0.83 (95% CI 0.82, 0.84). CONCLUSION Using a large clinical registry, we developed a multivariable regression model to predict ureteral stent placement following URS. Though well-calibrated, the model had modest discrimination due to heterogeneity in practice patterns in stent placement across urologists.
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Affiliation(s)
- Jie Cao
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, MI
| | | | | | - Casey A Dauw
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Arvin George
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Spencer Hiller
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Khurshid R Ghani
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI
| | - Andrew E Krumm
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI; University of Michigan School of Information, Ann Arbor, MI
| | - Karandeep Singh
- Department of Urology, University of Michigan Medical School, Ann Arbor, MI; Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI; University of Michigan School of Information, Ann Arbor, MI; Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.
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2
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Jakob R, Kaur H, Marzinek J, Green R, Imai Y, Bolla J, Agustoni E, Robinson C, Bond P, Lewis K, Maier T, Hiller S. The antibiotic darobactin mimics a β-strand to inhibit outer membrane insertase. Acta Cryst Sect A 2022. [DOI: 10.1107/s205327332209619x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
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Meier K, Hiller S, Dauw C, Hollingsworth J, Kim T, Qi J, Telang J, Ghani KR, Jafri SMA. Understanding Ureteral Access Sheath Use Within a Statewide Collaborative and Its Effect on Surgical and Clinical Outcomes. J Endourol 2021; 35:1340-1347. [PMID: 33827269 DOI: 10.1089/end.2020.1077] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction: Ureteral access sheaths (UASs) are frequently used during ureteroscopy (URS), but their use is not without potential risk. We investigated patterns of UAS use and associated outcomes across practices in Michigan within a quality improvement collaborative. Methods: The Michigan Urological Surgery Improvement Collaborative (MUSIC) Reducing Operative Complications from Kidney Stones (ROCKS) initiative maintains a web-based, prospective clinical registry of patients undergoing URS for urinary stone disease (USD). We analyzed all patients undergoing primary URS for renal and ureteral stones from June 2016 to July 2018 in the ROCKS registry. We determined rates of UAS usage across practices and associated outcomes, including 30-day emergency department (ED) visits and hospitalization, as well as stone-free rates. Using multivariate logistical regression, we determined the predictors of UAS use as well as outcomes, including stone-free rates, ED visits, and hospitalizations, associated with UAS use. Results: Of the 5316 URS procedures identified, UASs were used in 1969 (37.7%) cases. Stones were significantly larger and more likely to be located in the kidney in cases with UAS use. UAS use during URS varied greatly across practices (1.9%-96%, p < 0.05). After adjusting for clinical and surgical risk factors, UAS use significantly increased the odds of postoperative ED visits (odds ratio [OR] = 1.50, 95% confidence interval [CI] 1.17-1.93, p < 0.05) and hospitalization (OR = 1.77, 95% CI 1.22-2.56, p < 0.05) as well as decreased the odds of being stone free (OR = 0.75, 95% CI 0.57-0.99, p < 0.05). Conclusions: In the current study, UAS use during URS for USD was not associated with an increased likelihood of being stone free; moreover, it increased the odds of a postoperative ED visit and or hospitalization. Our findings demonstrate that UAS use is not without risk and should be employed judiciously.
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Affiliation(s)
- Kristen Meier
- Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
| | - Spencer Hiller
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Casey Dauw
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Tae Kim
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Ji Qi
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jaya Telang
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - Khurshid R Ghani
- Department of Urology, University of Michigan, Ann Arbor, Michigan, USA
| | - S Mohammad A Jafri
- Department of Urology, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, USA
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Hiller S, Kowalewska-Łuczak I, Czerniawska-Piątkowska E. Associations between CATHL2 Gene Polymorphism and Milk Production Traits and Somatic Cells Count in Dairy Cattle. RUSS J GENET+ 2020. [DOI: 10.1134/s1022795420030072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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5
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Hewitt T, Killinger KA, Hiller S, Boura JA, Lutz M. Exploring Racial Differences Surrounding Prostate Cancer Screening: Beliefs and Attitudes in Community Dwelling Men Attending an Urban Men's Health Event. Am J Mens Health 2018; 12:1929-1936. [PMID: 29952245 PMCID: PMC6199456 DOI: 10.1177/1557988318784838] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The purpose of the study was to explore attitudes/beliefs in men attending an urban health fair to explore barriers to prostate cancer (PCa) screening. Five hundred and forty-four men attending the PCa booth at the fair in 2014 or 2015 completed questionnaires about PCa. Data were examined using Pearson’s χ2, Fisher’s Exact, and Wilcoxon rank tests after grouping men by African American (AA) and non-African American ethnicity. Three hundred and twenty-six (60%) men were AA and two hundred and eighteen (40%) were non-AA (89% white). Median age (54 vs. 56 years) and prior PCa screening were similar between AA and non-AA; income (p = .044) and education (p = .0002) differed. AA men were less likely to have researched prostate-specific antigen (PSA) on the internet (p = .003), but more used TV (p = .003) and media (p = .0014) as information sources. Family members had a stronger influence over screening decisions for AA men (p = .005). After reading PSA information, AA men were more likely to still be confused (p = .008). A higher proportion of AA men were less worried about dying from PCa (p = .0006), but would want treatment immediately instead of watchful waiting (p < .0001). Interestingly, a higher proportion of AA men indicated that they would prefer not to know if they had PCa (p = .001). Ultimately, more AA men had a PSA done (98.4% vs. 95.1%; p = .031). When considering screening eligible men, a higher proportion of AA men had an abnormal PSA (13.1% vs. 5.3%; p = .037). AA men’s beliefs surrounding PCa differ from non-AA men, and should be considered when developing culturally appropriate education, screening, and treatment strategies for this group.
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Affiliation(s)
- Timothy Hewitt
- 1 Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kim A Killinger
- 1 Oakland University William Beaumont School of Medicine, Rochester, MI, USA.,2 Beaumont Hospital, Royal Oak, MI, USA
| | | | - Judith A Boura
- 1 Oakland University William Beaumont School of Medicine, Rochester, MI, USA.,2 Beaumont Hospital, Royal Oak, MI, USA
| | - Michael Lutz
- 1 Oakland University William Beaumont School of Medicine, Rochester, MI, USA.,2 Beaumont Hospital, Royal Oak, MI, USA
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Hiller S, Zakrzewicz A, Wilker S, Jurastow I, Hecker A, Kummer W, Padberg W, Grau V. β-NAD inhibits ATP-mediated interleukin-1β release. Pneumologie 2015. [DOI: 10.1055/s-0035-1556629] [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: 10/23/2022]
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Jamil H, Elsouhag D, Hiller S, Arnetz JE, Arnetz BB. Sociodemographic risk indicators of hookah smoking among White Americans: a pilot study. Nicotine Tob Res 2010; 12:525-9. [PMID: 20308223 DOI: 10.1093/ntr/ntq026] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Despite the sustained public health efforts to decrease cigarette smoking, there is an increasing trend in the use of alternative tobacco products that are perceived by some as less harmful. One example is hookah smoking. This study aimed to assess hookah trends among White Americans. METHODS Two hundred and forty-five White American adults residing in southeast Michigan answered a self-administered standardized questionnaire that included basic demographics, socioeconomic status, and questions related to hookah smoking behavior. Logistic regression was used to determine risk indicators for hookah smoking. RESULTS The combined prevalence of hookah smoking in the White American study population was 19%, with 10% of the sample smoking hookah only and 9% smoking both hookah and cigarettes. Approximately 19% of respondents believed that smoking hookah was less harmful than smoking cigarettes. Significant risk indicators for smoking hookah were being younger than 22 years and living with a family member who used tobacco. DISCUSSION In addition to reporting the prevalence of use in this important group of potential users, we outline important sociodemographic risk factors for hookah use in a non-Arab American population. More research is needed with a larger population to better understand this new tobacco trend in order to curb a new potential health threat.
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Affiliation(s)
- Hikmet Jamil
- Division of Occupational and Environmental Health, Department of Family Medicine and Public Health Sciences, Wayne State University, 3800 Woodward Ave., Suite 808, Detroit, MI 48201, USA.
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Gossert AD, Hiller S, Fiorito F, Wüthrich K. NMR assignment of the E. coli type 1 pilus protein FimF. J Biomol NMR 2007; 38:195. [PMID: 17417715 DOI: 10.1007/s10858-006-9123-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2006] [Accepted: 11/30/2006] [Indexed: 05/14/2023]
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Affiliation(s)
- S. A. Pikin
- a Institute of Crystallography, Russian Academy of Sciences , 59, Leninskii prosp., 117333, Moscow , Russia
| | - S. Hiller
- b Institut für Physikalische Chemie, Technische Hochschule Darmstadt , Petersenstr. 20, 64287, Darmstadt , FRG
| | - W. Haase
- b Institut für Physikalische Chemie, Technische Hochschule Darmstadt , Petersenstr. 20, 64287, Darmstadt , FRG
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Waage-Baudet H, Dunty WC, Dehart DB, Hiller S, Sulik KK. Immunohistochemical and microarray analyses of a mouse model for the smith-lemli-opitz syndrome. Dev Neurosci 2006; 27:378-96. [PMID: 16280635 DOI: 10.1159/000088453] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2005] [Accepted: 06/05/2005] [Indexed: 12/30/2022] Open
Abstract
The Smith-Lemli-Opitz syndrome is a mental retardation/malformation syndrome with behavioral components of autism. It is caused by a deficiency in 3beta-hydroxysteroid-Delta7-reductase (DHCR7), the enzyme required for the terminal enzymatic step of cholesterol biosynthesis. The availability of Smith-Lemli-Opitz syndrome mouse models has made it possible to investigate the genesis of the malformations associated with this syndrome. Dhcr7 gene modification (Dhcr7-/-) results in neonatal lethality and multiple organ system malformations. Pathology includes cleft palate, pulmonary hypoplasia, cyanosis, impaired cortical response to glutamate, and hypermorphic development of hindbrain serotonergic neurons. For the current study, hindbrain regions microdissected from gestational day 14 Dhcr7-/-, Dhcr7+/- and Dhcr7+/+ fetuses were processed for expression profiling analyses using Affymetrix oligonucleotide arrays and filtered using statistical significance (S-score) of change in gene expression. Of the 12,000 genes analyzed, 91 were upregulated and 98 were downregulated in the Dhcr7-/- hindbrains when compared to wild-type animals. Fewer affected genes, representing a reduced affect on these pathways, were identified in heterozygous animals. Hierarchical clustering identified altered expression of genes associated with cholesterol homeostasis, cell cycle control and apoptosis, neurodifferentiation and embryogenesis, transcription and translation, cellular transport, neurodegeneration, and neuronal cytoskeleton. Of particular interest, Dhcr7 gene modification elicited dynamic changes in genes involved in axonal guidance. In support of the microarray findings, immunohistochemical analyses of the netrin/deleted in colorectal cancer axon guidance pathway illustrated midline commissural deficiencies and hippocampal pathfinding errors in Dhcr7-/- mice. The results of these studies aid in providing insight into the genesis of human cholesterol-related birth defects and neurodevelopmental disorders and highlight specific areas for future investigation.
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Affiliation(s)
- H Waage-Baudet
- Department of Cell and Developmental Biology, The University of North Carolina, Chapel Hill, N.C. 27599-7178, USA
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11
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Hiller S, Mergenthaler HG. Paclitaxel and carboplatin in patients with metastatic or recurrent squamous cell carcinoma of the head and neck. A phase II study. J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.5579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- S. Hiller
- Klinikum Stuttgart, Klinik fur Onkologie, Stuttgart, Germany
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12
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Waage-Baudet H, Lauder JM, Dehart DB, Kluckman K, Hiller S, Tint GS, Sulik KK. Abnormal serotonergic development in a mouse model for the Smith-Lemli-Opitz syndrome: implications for autism. Int J Dev Neurosci 2004; 21:451-9. [PMID: 14659996 DOI: 10.1016/j.ijdevneu.2003.09.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.4] [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: 11/24/2022] Open
Abstract
The Smith-Lemli-Opitz syndrome (SLOS) is a malformation/mental retardation syndrome resulting from an inborn error in 3beta-hydroxysteroid Delta7-reductase (DHCR7), the terminal enzyme required for cholesterol biosynthesis. Using a targeting strategy designed to virtually eliminate Dhcr7 activity, we have created a SLOS mouse model that exhibits commissural deficiencies, hippocampal abnormalities, and hypermorphic development of serotonin (5-HT) neurons. The latter is of particular interest with respect to current evidence that serotonin plays a significant role in autism spectrum disorders and the recent clinical observation that 50% of SLOS patients present with autistic behavior. Immunohistochemical analyses have revealed a 306% increase in the area of 5-HT immunoreactivity (5-HT IR) in the hindbrains of mutant (Dhcr7-/-) mice as compared to age-matched wild type animals. Amount of 5-HT IR was measured as total area of IR per histological section. Additionally, a regional increase as high as 15-fold was observed for the most lateral sagittal hindbrain sections. In Dhcr7-/- mice, an expansion of 5-HT IR into the ventricular zone and floor plate region was observed. In addition, the rostral and caudal raphe groups exhibited a radial expansion in Dhcr7-/- mice, with 5-HT IR cells present in locations not seen in wild type mice. This increase in 5-HT IR appears to represent an increase in total number of 5-HT neurons and fibers. These observations may help explain the behavioral phenotype seen in SLOS, and provide clues for future therapeutic interventions that utilize pharmacological modulation of the serotonergic system.
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Affiliation(s)
- H Waage-Baudet
- Department of Cell and Developmental Biology, The University of North Carolina, Chapel Hill, NC 27599-7178, USA
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13
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Fitzky BU, Moebius FF, Asaoka H, Waage-Baudet H, Xu L, Xu G, Maeda N, Kluckman K, Hiller S, Yu H, Batta AK, Shefer S, Chen T, Salen G, Sulik K, Simoni RD, Ness GC, Glossmann H, Patel SB, Tint GS. 7-Dehydrocholesterol-dependent proteolysis of HMG-CoA reductase suppresses sterol biosynthesis in a mouse model of Smith-Lemli-Opitz/RSH syndrome. J Clin Invest 2001; 108:905-15. [PMID: 11560960 PMCID: PMC200927 DOI: 10.1172/jci12103] [Citation(s) in RCA: 66] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Smith-Lemli-Opitz/RSH syndrome (SLOS), a relatively common birth-defect mental-retardation syndrome, is caused by mutations in DHCR7, whose product catalyzes an obligate step in cholesterol biosynthesis, the conversion of 7-dehydrocholesterol to cholesterol. A null mutation in the murine Dhcr7 causes an identical biochemical defect to that seen in SLOS, including markedly reduced tissue cholesterol and total sterol levels, and 30- to 40-fold elevated concentrations of 7-dehydrocholesterol. Prenatal lethality was not noted, but newborn homozygotes breathed with difficulty, did not suckle, and died soon after birth with immature lungs, enlarged bladders, and, frequently, cleft palates. Despite reduced sterol concentrations in Dhcr7(-/-) mice, mRNA levels for 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, the rate-controlling enzyme for sterol biosynthesis, the LDL receptor, and SREBP-2 appeared neither elevated nor repressed. In contrast to mRNA, protein levels and activities of HMG-CoA reductase were markedly reduced. Consistent with this finding, 7-dehydrocholesterol accelerates proteolysis of HMG-CoA reductase while sparing other key proteins. These results demonstrate that in mice without Dhcr7 activity, accumulated 7-dehydrocholesterol suppresses sterol biosynthesis posttranslationally. This effect might exacerbate abnormal development in SLOS by increasing the fetal cholesterol deficiency.
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Affiliation(s)
- B U Fitzky
- Institute of Biochemical Pharmacology, Innsbruck, Austria
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Abstract
By inactivating the gene for L-gulono-gamma-lactone oxidase, a key enzyme in ascorbic acid synthesis, we have generated mice that, like humans, depend on dietary vitamin C. Regular chow, containing about 110 mg/kg of vitamin C, is unable to support the growth of the mutant mice, which require L-ascorbic acid supplemented in their drinking water (330 mg/liter). Upon withdrawal of supplementation, plasma and tissue ascorbic acid levels decreased to 10-15% of normal within 2 weeks, and after 5 weeks the mutants became anemic, began to lose weight, and die. Plasma total antioxidative capacities were approximately 37% normal in homozygotes after feeding the unsupplemented diet for 3-5 weeks. As plasma ascorbic acid decreased, small, but significant, increases in total cholesterol and decreases in high density lipoprotein cholesterol were observed. The most striking effects of the marginal dietary vitamin C were alterations in the wall of aorta, evidenced by the disruption of elastic laminae, smooth muscle cell proliferation, and focal endothelial desquamation of the luminal surface. Thus, marginal vitamin C deficiency affects the vascular integrity of mice unable to synthesize ascorbic acid, with potentially profound effects on the pathogenesis of vascular diseases. Breeding the vitamin C-dependent mice with mice carrying defined genetic mutations will provide numerous opportunities for systematic studies of the role of antioxidants in health and disease.
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MESH Headings
- Animals
- Antioxidants/metabolism
- Aorta, Thoracic/enzymology
- Aorta, Thoracic/pathology
- Aorta, Thoracic/ultrastructure
- Ascorbic Acid/administration & dosage
- Ascorbic Acid/biosynthesis
- Ascorbic Acid/blood
- Ascorbic Acid Deficiency/enzymology
- Ascorbic Acid Deficiency/genetics
- Cell Division
- Cholesterol/blood
- Cholesterol, HDL/blood
- Diet
- Elastic Tissue/pathology
- Elastic Tissue/ultrastructure
- Female
- Genotype
- Homozygote
- L-Gulonolactone Oxidase
- Male
- Mice
- Mice, Inbred C57BL
- Mice, Mutant Strains
- Microscopy, Electron
- Muscle, Smooth, Vascular/cytology
- Mutagenesis, Site-Directed
- Rats
- Sugar Alcohol Dehydrogenases/genetics
- Sugar Alcohol Dehydrogenases/metabolism
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Affiliation(s)
- N Maeda
- Department of Pathology and Laboratory Medicine, University of North Carolina, Chapel Hill, NC 27599-7525, USA.
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Oliverio MI, Kim HS, Ito M, Le T, Audoly L, Best CF, Hiller S, Kluckman K, Maeda N, Smithies O, Coffman TM. Reduced growth, abnormal kidney structure, and type 2 (AT2) angiotensin receptor-mediated blood pressure regulation in mice lacking both AT1A and AT1B receptors for angiotensin II. Proc Natl Acad Sci U S A 1998; 95:15496-501. [PMID: 9860997 PMCID: PMC28071 DOI: 10.1073/pnas.95.26.15496] [Citation(s) in RCA: 241] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/1998] [Indexed: 11/18/2022] Open
Abstract
The classically recognized functions of the renin-angiotensin system are mediated by type 1 (AT1) angiotensin receptors. Whereas man possesses a single AT1 receptor, there are two AT1 receptor isoforms in rodents (AT1A and AT1B) that are products of separate genes (Agtr1a and Agtr1b). We have generated mice lacking AT1B (Agtr1b -/-) and both AT1A and AT1B receptors (Agtr1a -/-Agtr1b -/-). Agtr1b -/- mice are healthy, without an abnormal phenotype. In contrast, Agtr1a -/-Agtr1b -/- mice have diminished growth, vascular thickening within the kidney, and atrophy of the inner renal medulla. This phenotype is virtually identical to that seen in angiotensinogen-deficient (Agt-/-) and angiotensin-converting enzyme-deficient (Ace -/-) mice that are unable to synthesize angiotensin II. Agtr1a -/-Agtr1b -/- mice have no systemic pressor response to infusions of angiotensin II, but they respond normally to another vasoconstrictor, epinephrine. Blood pressure is reduced substantially in the Agtr1a -/- Agtr1b -/- mice and following administration of an angiotensin converting enzyme inhibitor, their blood pressure increases paradoxically. We suggest that this is a result of interruption of AT2-receptor signaling. In summary, our studies suggest that both AT1 receptors promote somatic growth and maintenance of normal kidney structure. The absence of either of the AT1 receptor isoforms alone can be compensated in varying degrees by the other isoform. These studies reaffirm and extend the importance of AT1 receptors to mediate physiological functions of the renin-angiotensin system.
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MESH Headings
- Adrenal Glands/metabolism
- Angiotensin II/pharmacology
- Angiotensin II/physiology
- Angiotensinogen/deficiency
- Angiotensinogen/genetics
- Angiotensinogen/physiology
- Animals
- Atrophy
- Blood Pressure/drug effects
- Blood Pressure/genetics
- Crosses, Genetic
- Epinephrine/pharmacology
- Female
- Growth/genetics
- Homozygote
- Humans
- Kidney/abnormalities
- Kidney/pathology
- Kidney/physiology
- Kidney Medulla/pathology
- Male
- Mice
- Mice, Knockout
- Phenotype
- Protein Isoforms/deficiency
- Protein Isoforms/genetics
- Protein Isoforms/physiology
- RNA, Messenger/genetics
- Receptor, Angiotensin, Type 1
- Receptor, Angiotensin, Type 2
- Receptors, Angiotensin/deficiency
- Receptors, Angiotensin/genetics
- Receptors, Angiotensin/physiology
- Renal Circulation/genetics
- Restriction Mapping
- Reverse Transcriptase Polymerase Chain Reaction
- Transcription, Genetic
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Affiliation(s)
- M I Oliverio
- Duke University and Durham Veterans Affairs Medical Centers, Durham, NC 27705, USA
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Creutzig A, Hiller S, Appiah R, Thum J, Caspary L. Nailfold capillaroscopy and laser Doppler fluxmetry for evaluation of Raynaud's phenomenon: how valid is the local cooling test? VASA 1997; 26:205-9. [PMID: 9286153] [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: 02/05/2023]
Abstract
BACKGROUND Since there is a need for an objective parameter of microcirculation in follow-up of patients with Raynaud's syndrome we evaluated the reproducibility of the reaction to a cold exposure test with nailfold capillaroscopy and laser Doppler fluxmetry during a winter period. PATIENTS AND METHODS 10 healthy subjects and 16 patients with primary Raynaud's syndrome were evaluated with nailfold capillaroscopy and laser Doppler fluxmetry of the finger tips during and after a standardized cold exposure stress test. The measurements were repeated in the controls within 2 weeks, in the patient population twice within 24 weeks. RESULTS In the healthy controls the percentage of capillaries with flow stop was stable (r = 0.785) and the duration of flow stop was reproducible (r = 0.993). Both parameters were significantly lower in controls than in the patients. The flow stop durations in patients varied intra-individually to a great extent between the different weeks without any significant correlation. For all calculated laser Doppler perfusion and time parameters we did not find any significant differences between controls and patients nor any consistent correlations in the intra-individual comparison within the different weeks for both, controls and patients. CONCLUSION Nailfold capillaroscopy during cold exposure is able to discriminate between healthy persons and patients with primary Raynaud's syndrome, but seems to be of minor value for follow-up evaluation of patients because of intraindividual variations. Laser Doppler fluxmetry is invalid for both purposes when using the applied cold exposure test.
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Affiliation(s)
- A Creutzig
- Department of Angiology, Hannover Medical School
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Abstract
OBJECTIVE Evaluation of the effects of a standardized acupuncture treatment in primary Raynaud's syndrome. DESIGN A controlled randomized prospective study. SETTING A winter period of 23 weeks, angiological clinic of Hannover Medical School. SUBJECTS Thirty-three patients with primary Raynaud's syndrome (16 control, 17 treatment). INTERVENTIONS The patients of the treatment group were given seven acupuncture treatments during the weeks 10 and 11 of the observation period. MAIN OUTCOME MEASURES All patients kept a diary throughout the entire observation period noting daily frequency, duration and severity of their vasospastic attacks. A local cooling test combined with nailfold capillaroscopy was performed for all patients at baseline (week 1) and in weeks 12 and 23, recording flowstop reactions of the nailfold capillaries. RESULTS The treated patients showed a significant decrease in the frequency of attacks from 1.4 day-1 to 0.6 day-1, P < 0.01 (control 1.6 to 1.2, P = 0.08). The overall reduction of attacks was 63% (control 27%, P = 0.03). The mean duration of the capillary flowstop reaction decreased from 71 to 24 s (week 1 vs. week 12, P = 0.001) and 38 s (week 1 vs. week 23, P = 0.02) respectively. In the control group the changes were not significant. CONCLUSIONS These findings suggest that traditional Chinese acupuncture is a reasonable alternative in treating patients with primary Raynaud's syndrome.
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Affiliation(s)
- R Appiah
- Medizinische Hochschule Hannover, Department of Angiology, Germany
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Hiller S, Biradar AM, Wrobel S, Haase W. Dielectric behavior at the smectic-C*-chiral-nematic phase transition of a ferroelectric liquid crystal. Phys Rev E Stat Phys Plasmas Fluids Relat Interdiscip Topics 1996; 53:641-649. [PMID: 9964295 DOI: 10.1103/physreve.53.641] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
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Schmidt J, Kain HU, Hiller S. [Fulminating pulmonary embolisms: thrombolysis versus thrombectomy]. Dtsch Med Wochenschr 1992; 117:1340. [PMID: 1505358] [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: 12/27/2022]
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20
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Hiller S. A better way to make the medicine go down. Science 1991; 253:1095-6. [PMID: 1679567 DOI: 10.1126/science.1679567] [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: 12/28/2022]
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Hiller S, Breit S, Wang ZQ, Wagner EF, Schwab M. Localization of regulatory elements controlling human MYCN expression. Oncogene 1991; 6:969-77. [PMID: 2067849] [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: 12/30/2022]
Abstract
Expression of the cellular oncogene MYCN is restricted to few cell lineages and is highest during development both in mouse and in humans. In pursuit of elucidating the mechanisms underlying MYCN regulation we introduced a human MYCN clone (pNb-9) with approximately 2.5 kbp 5'- and 6 kbp 3'-flanking genomic sequences into different murine and human cell lines as well as into mice. In all cases we found a correlation between the expression of the exogenous and the endogenous MYCN. Among cell lines, only those expressing the endogenous gene also expressed the transfected gene. In the transgenic mice transcripts of the transgene were present in proportion to the transcripts of the endogenous MYCN gene with the highest level in the brain. Therefore, the genetic information necessary for regulated expression of MYCN appears to be contained in pNb-9. To localize the DNA-regions responsible for regulated expression, we generated MYCN/CAT hybrid genes with different portions of the putative MYCN promoter region linked to the reporter gene. Transient transfections into various murine and human cell lines identified three DNA regions apparently involved in the regulation of expression. One region about 200 bp upstream of the transcriptional start site is responsible for a basal level of MYCN expression. A second region located about 800 bp further upstream appears to be involved in cell type-specific gene activation. The third regulatory element is located at the 3' end of the first exon and/or in the first intron and may mediate tissue-specific down regulation of gene expression.
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Affiliation(s)
- S Hiller
- Institut für Experimentelle Pathologie, Deutsches Krebsforschungszentrum, Heidelberg, Germany
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22
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Abstract
Twenty-nine consecutive patients with symptomatic hypertrophic cardiomyopathy and a mean age of 44.8 +/- 12.2 years (range 21 to 63) underwent complex invasive and noninvasive testing to identify a risk profile for syncope. Clinical, morphologic, electrophysiologic and hemodynamic variables at rest and at a symptom-limited pacing rate were analyzed for a significant association with syncope. Exact stepwise logistic regression analysis identified three variables as significant independent predictors of syncope in hypertrophic cardiomyopathy: 1) age less than 30 years (beta = 4.803; p = 0.0007); 2) left ventricular end-diastolic volume index less than 60 ml/m2 (beta = 3.302; p = 0.006); and 3) nonsustained ventricular tachycardia on 72 h ambulatory electrocardiographic monitoring (beta = 2.5909; p = 0.03). The combined occurrence of all three variables had a sensitivity and specificity of 100% in identifying eight patients with syncopal events. Thus, the risk for syncope in hypertrophic cardiomyopathy is high in young patients with the combination of low left ventricular filling volume and episodes of nonsustained ventricular tachycardia. This finding might also explain the mechanism of syncope in hypertrophic cardiomyopathy as low input-low output failure induced by a sudden increase in heart rate in the presence of a low filling volume.
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Affiliation(s)
- C A Nienaber
- Department of Cardiology, University Hospital Eppendorf, Hamburg, Federal Republic of Germany
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Nienaber CA, Hiller S, Spielmann RP, Geiger M, Kuck KH. [Risk of syncope in hypertrophic cardiomyopathy: a multivariate analysis of prognostic variables]. Z Kardiol 1990; 79:286-96. [PMID: 2356642] [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] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Twenty-nine consecutive patients with symptomatic hypertrophic cardiomyopathy and a mean age of 44.8 +/- 12.2 years (range 21 to 63 years) underwent complex invasive and noninvasive testing in an attempt to identify a risk profile for syncope. Clinical, morphologic and electrophysiologic as well as functional parameters at rest and at symptom-limited pacing rate were analyzed for significant association with syncope. Exact stepwise logistic regression analysis identified three variables as significant independent predictors of syncope in hypertrophic cardiomyopathy: 1) age less than 30 years (beta = 4.803; p = 0.0007); 2) left ventricular end-diastolic volume index less than 60 ml/m2 (beta = 3.302; p = 0.006) and 3) non-sustained ventricular tachycardia on 72 h ambulatory ECG monitoring (beta = 2.5909; p = 0.03). The combined occurrence of all three variables had a 100% sensitivity and specificity to identify eight patients with syncopal events. Thus, the risk for syncope in hypertrophic cardiomyopathy is high in young patients with the combination of low left ventricular filling volume and episodes of non-sustained ventricular tachycardia. This finding might also explain the mechanism of syncope in hypertrophic cardiomyopathy as low-input-low-output failure induced by a sudden increase in heart rate in presence of a low filling volume.
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Affiliation(s)
- C A Nienaber
- Medizinische Klinik, Abteilung Kardiologie, Universitätskrankenhaus Eppendorf, Hamburg
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Abstract
A plasmid carrying a promoterless herpes simplex virus thymidine kinase gene was transfected via calcium phosphate precipitation into LM (tk-) mouse fibroblast cells. The transfected gene was efficiently expressed, as the transfected cells grew perfectly well in selective hypoxanthine-aminopterin-thymidine medium, suggesting that the thymidine kinase-coding region became linked to a promoterlike element on integration into the recipient genome. To investigate the structure of the surrogate promoter, we first isolated the integrated gene from a genomic library. The nucleotide sequence of the DNA adjacent to the thymidine kinase-coding sequence was then determined. We found, first, that the integration of the transfected DNA apparently occurred by a blunt end ligation mechanism involving no obvious sequence similarities between integrated and recipient DNA and, second, that the 5'-flanking region included a TATA box, two CCAAT boxes, and a GC box element. However, the TATA box motif and the most proximal CCAAT box appeared to be sufficient for full promoter activity, as determined by the transfection efficiencies of appropriate plasmid constructs. Except for these canonical promoter elements, the surrogate promoter had no obvious similarities to known thymidine kinase gene promoters.
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Affiliation(s)
- S Hiller
- Division of Biology, University of Konstanz, Federal Republic of Germany
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Auer IO, Habscheid W, Hiller S, Gerhards W, Eilles C. [Non-steroidal anti-inflammatory agents increase intestinal permeability]. Dtsch Med Wochenschr 1987; 112:1032-7. [PMID: 3109868 DOI: 10.1055/s-2008-1068189] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
51Cr-EDTA activity was measured in urine and blood of patients receiving non-steroidal anti-inflammatory (NSA) drug treatment and of healthy subjects and other patients (controls), after oral intake of 51Cr-EDTA, for the purpose of deciding whether NSA treatment increases urinary excretion of oral 51Cr-EDTA as an expression of increased intestinal permeability. 51Cr-EDTA activity in urine and blood of patients with rheumatoid arthritis (13) being treated with NSA was significantly higher (similar to results in 13 patients with Crohn's disease) than that of a control group (14) of patients with rheumatoid arthritis without such treatment (9) and patients without rheumatic disease (5). Both in patients with rheumatoid arthritis receiving NSA drugs and patients with Crohn's disease there was a highly significant correlation between urinary and blood activity. There was no effect of NSA drugs on renal function. The results indicate that NSA drugs increase interenterocytic permeability to an extent comparable to permeability abnormalities in Crohn's disease.
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Taub M, Saier MH, Chuman L, Hiller S. Loss of the PGE1 requirement for MDCK cell growth associated with a defect in cyclic AMP phosphodiesterase. J Cell Physiol 1983; 114:153-61. [PMID: 6185509 DOI: 10.1002/jcp.1041140203] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Chung SD, Alavi N, Livingston D, Hiller S, Taub M. Characterization of primary rabbit kidney cultures that express proximal tubule functions in a hormonally defined medium. J Biophys Biochem Cytol 1982; 95:118-26. [PMID: 6292232 PMCID: PMC2112352 DOI: 10.1083/jcb.95.1.118] [Citation(s) in RCA: 258] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Primary cultures of rabbit-kidney epithelial cells derived from purified proximal tubules were maintained without fibroblast overgrowth in a hormone-supplemented serum-free medium (Medium RK-1). A hormone-deletion study indicated that the primary cultures derived from purified rabbit proximal tubules required all of the three supplements in Medium RK-1 (insulin, transferrin, and hydrocortisone) for optimal growth but did not grow in response to EGF and T3. In contrast, the epithelial cells in primary cultures derived from an unpurified preparation of rabbit kidney tubules and glomeruli grew in response to EGF and T3, as well as insulin, transferrin, and hydrocortisone. These observations suggest that kidney epithelial cells derived from different segments of the nephron grow differently in response to hormones and growth factors. Differentiated functions of the primary cultures derived from proximal tubules were examined. Multicellular domes were observed, indicative of transepithelial solute transport by the monolayers. The proximal tubule cultures also accumulated alpha-methylglucoside (alpha-MG) against a concentration gradient. However, little or no alpha-MG accumulation was observed in the absence of Na+. Metabolic inhibitor studies also indicated that alpha-MG uptake by the primaries is an energy-dependent process, and depends upon the activity of the Na+/K+ ATPase. Phlorizin at 0.1 mM significantly inhibited 1 mM alpha-MG uptake whereas 0.1 mM phloretin did not have a significant inhibitory effect. Similar observations have been made concerning the Na+-dependent sugar-transport system located on the lumenal side of the proximal tubule, whereas the Na+-independent sugar transporter on the peritubular side is more sensitive to inhibition by phloretin than phlorizin. The cultures also exhibited PTH-sensitive cyclic AMP synthesis and brush-border enzymes typical of proximal cells. However, the activities of the enzymes leucine aminopeptidase, alkaline phosphatase, and gamma-glutamyl-transpeptidase were lower in the cultures than in purified proximal-tubule preparations from which they are derived.
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