Fusion of dipalmitoylphosphatidylcholine vesicles at 4 degrees C

Small sonicated dipalmitoylphosphatidylcholine vesicles when incubated at 4 degrees C and high concentrations are shown to fuse completely to vesicles about 700-A diameter in 7 days, and these further fuse to about 950 A diameter vesicles after 3-4 weeks. The 950 A diameter vesicles are spherical, homogeneous, mostly unilamellar, have an internal aqueous space about 10 times that of small vesicles, and are stable for at least 6 months. The 950-A vesicles are characterized by agarose gel chromatography, freeze-fracturing electron microscopy, trapped volume measurements, differential scanning calorimetry, and diphenylhexatriene fluorescence polarization.

Aggregation of dipalmitoylphosphatidylcholine vesicles

Quasi-elastic and 90 degrees light scattering were used to study the aggregation of dipalmitoylphosphatidylcholine vesicles at temperatures below the gel-liquid-crystalline phase transition as a function of concentration, temperature, and size. Increased vesicle concentration did not appreciably change aggregate size but did change the total number of aggregates in a manner consistent with a bimolecular collisional mechanism for the conversion of aggregates to fused vesicles. Increased temperature decreased aggregation, indicating that the disaggregation rate constant increased faster than the aggregation rate constant. As a function of size, aggregation decreased slightly from small to 700 A diameter vesicles and increased considerably for 950 A diameter vesicles. A model of the interaction of small vesicles below the gel-liquid-crystalline phase transition is presented in which aggregation precedes fusion and collision between aggregates triggers fusion.

The correlates of an abnormal first heart sound in mitral-valve-prolapse syndromes

In 52 patients with mitral-valve prolapse we studied the intensity of the first heart sound (S1) in relation to the timing of the prolapse and to the presence of leaflet tip coaptation. Sixteen normal subjects served as controls. With two-dimensional echocardiography, three distinct groups were identified. Sixteen patients had early systolic mitral prolapse coincident with initial mitral-leaflet coaptation at the S wave on electrocardiography. Twenty-one had middle to late systolic mitral prolapse. Fifteen had flail mitral leaflet without normal leaflet coaptation at the free margins. The intensity of S1 was expressed as the ratio of the S1 amplitude to that of the aortic component of the second heart sound. This ratio was greater in the patients with early prolapse (6.2 +/- 3.1, mean +/- S.D.) than in the controls (1.4 +/- 0.7) (P less than 0.01). The ratio was reduced in patients with flail valves (0.3 +/- 0.5) (P less than 0.01) and did not differ between patients with middle to late prolapse (1.3 +/- 0.6) and controls. We conclude that the amplitude of S1 may provide a clue to the type and timing of mitral-valve prolapse.

Properties of oxaloacetate decarboxylase from Veillonella parvula

Oxaloacetate decarboxylase was purified to 136-fold from the oral anaerobe Veillonella parvula. The purified enzyme was substantially free of contaminating enzymes or proteins. Maximum activity of the enzyme was exhibited at pH 7.0 for both carboxylation and decarboxylation. At this pH, the Km values for oxaloacetate and Mg2+ were at 0.06 and 0.17 mM, respectively, whereas the Km values for pyruvate, CO2, and Mg2+ were 3.3, 1.74, and 1.85 mM, respectively. Hyperbolic kinetics were observed with all of the aforementioned compounds. The Keq' was 2.13 X 10(-3) mM-1 favoring the decarboxylation of oxaloacetate. In the carboxylation step, avidin, acetyl coenzyme A, biotin, and coenzyme A were not required. ADP and NADH had no effect on either the carboxylation or decarboxylation step, but ATP inhibited the carboxylation step competitively and the decarboxylation step noncompetitively. These types of inhibition fitted well with the overall lactate metabolism of the non-carbohydrate-fermenting anaerobe.

Functional heterogeneity of culture-grown bone marrow-derived macrophages. II. Lymphokine stimulation of antigen-presenting function

The activation of immunostimulatory activity and Ia expression was studied in pure populations of murine macrophages (M phi) grown in vitro from bone marrow precursor cells in the presence of L cell-conditioned medium as the source of colony-stimulating factor. During exponential growth, the M phi developed maximal Ia-dependent antigen-presenting activity as detected by the induction of antigen-specific T cell proliferation, but the proportion of Ia+ M phi was low (less than 10%). Fractionation of the M phi according to size by velocity sedimentation resulted in concentration of the antigen-presenting cells in the smallest fraction, but the enrichment of Ia+ M phi in this fraction was less than twofold. All fractions also showed comparable degrees of antigen uptake regardless of their T cell-stimulating activity. Thus Ia and antigen, although obviously essential, are insufficient for full manifestation of antigen-presenting function. Activation of M phi with lymphokines from Mycobacterium-activated lymph node cells resulted in enhanced Ia expression in all fractions, but only small M phi showed an enhancement in antigen presentation. Large activation M phi were found to exert an immunosuppressive effect that probably neutralized any augmentation of stimulatory activity. thus heterogeneity can be demonstrated in i) the function of unstimulated M phi, ii) the responsiveness of subsets to stimulation, and iii) the manifestation of activated functions.

Functional heterogeneity of culture-grown bone marrow-derived macrophages. II. Lymphokine stimulation of antigen-presenting function

The activation of immunostimulatory activity and Ia expression was studied in pure populations of murine macrophages (M phi) grown in vitro from bone marrow precursor cells in the presence of L cell-conditioned medium as the source of colony-stimulating factor. During exponential growth, the M phi developed maximal Ia-dependent antigen-presenting activity as detected by the induction of antigen-specific T cell proliferation, but the proportion of Ia+ M phi was low (less than 10%). Fractionation of the M phi according to size by velocity sedimentation resulted in concentration of the antigen-presenting cells in the smallest fraction, but the enrichment of Ia+ M phi in this fraction was less than twofold. All fractions also showed comparable degrees of antigen uptake regardless of their T cell-stimulating activity. Thus Ia and antigen, although obviously essential, are insufficient for full manifestation of antigen-presenting function. Activation of M phi with lymphokines from Mycobacterium-activated lymph node cells resulted in enhanced Ia expression in all fractions, but only small M phi showed an enhancement in antigen presentation. Large activation M phi were found to exert an immunosuppressive effect that probably neutralized any augmentation of stimulatory activity. thus heterogeneity can be demonstrated in i) the function of unstimulated M phi, ii) the responsiveness of subsets to stimulation, and iii) the manifestation of activated functions.

Saxitoxin binding sites in frog-myocardial cytosol

Cytosolic fractions of frog heart homogenates contain large amounts of a soluble, large molecular weight protein that binds the specific neurotoxin saxitoxin with the same high affinity as does the plasma membrane. Another neurotoxin, tetrodotoxin, which ordinarily is competitive with saxitoxin, does not displace saxitoxin from the cytosolic sites or from plasma membrane-enriched vesicular fractions even when its concentration exceeds that of saxitoxin by a factor of 1000. Thus, cytosolic sites are similar to membrane sites in this respect. The vesicular fraction accounts quantitatively for the amount of saxitoxin bound by whole ventricles, so that no appreciable losses seem to occur. Therefore, the cytosolic site probably is a membrane site precursor, although other possibilities cannot be ruled out. In any case, the occurrence of a soluble molecule closely related to the sodium channel provides opportunities for further study of the structure of the sodium channel.

Intravenous dipyridamole combined with isometric handgrip for near maximal acute increase in coronary flow in patients with coronary artery disease

Twenty-four patients with coronary artery disease were studied during cardiac catheterization to determine the effects of sustained isometric handgrip exercise and intravenous dipyridamole and their combination on coronary and systemic hemodynamics and measured coronary luminal caliber. During 4 to 5 minutes of 25 percent maximal handgrip, blood pressure and heart rate increased 24 and 19 percent, respectively, coronary sinus flow increased to 1.7 x baseline value, and epicardial coronary arteries constricted to increase predicted flow resistance by 40 percent in 36 diseased arterial segments. After a 4 minute intravenous infusion of dipyridamole (0.56 mg/kg body weight), systemic pressure decreased 8 percent, heart rate increased 23 percent, coronary sinus flow increased to 2.4 x baseline value and coronary luminal caliber was unchanged. During isometric handgrip initiated 6 minutes after the infusion of dipyridamole, systemic pressure and heart rate increased to 14 and 31 percent, respectively, above control values, coronary sinus flow increased to 3.3 x baseline value (3.8 x baseline value in patients with normal anterior perfusion) and stenotic flow resistance increased by 36 percent. The response of coronary flow to the combined stresses was 68 percent greater than the response to dipyridamole alone (p less than 0.02); these flow levels exceed values previously reported for the human coronary circulation. Aminophylline plus nitroglycerin appears to assure patient safety.

Abnormal mitral valve coaptation in hypertrophic obstructive cardiomyopathy: proposed role in systolic anterior motion of mitral valve

Two dimensional echocardiographic evaluation utilizing the apical four chamber and apical long axis views was made in 10 normal subjects and 35 patients with hypertrophic cardiomyopathy, including 16 without and 19 with systolic anterior motion of the mitral valve. Mitral valve leaflets were imaged throughout the cardiac cycle. The normal subjects and the patients with hypertrophic cardiomyopathy without systolic anterior motion demonstrated mitral valve coaptation that seemed to involve the distal tip of the anterior leaflet. In contrast, patients with hypertrophic cardiomyopathy with systolic anterior motion demonstrated abnormal coaptation, so that the posterior leaflet coapted with a mid portion of the anterior leaflet, leaving a distal "residual" anterior leaflet in the left ventricle during systole. A sharp angulation of this distal leaflet in mid systole toward the interventricular septum is thought to represent systolic anterior motion. It is speculated that abnormal mitral leaflet coaptation in necessary for development of leaflet systolic anterior motion, which is correlated with dynamic left ventricular outflow gradients in hypertrophic obstructive cardiomyopathy.

Ring chromosome 14: a distinct clinical entity

An infant girl with ring chromosome 14 is presented. The findings in this patient and in six previously reported cases of a ring 14 suggest that a characteristic clinical syndrome is associated with this chromosome aberration. The major features of the ring chromosome 14 syndrome include mental retardation, a disorder of skin pigmentation, seizures, and dysmorphic features, including flat occiput, epicanthal folds, downward slanting eyes, flat nasal bridge, upturned nostrils, short neck, and large low set ears.

Size and motion of the mitral valve annulus in man. I. A two-dimensional echocardiographic method and findings in normal subjects

Using wide-angle, phased-array, two-dimensional echocardiography, mitral leaflets and their annular attachments were recorded from a view close to the standard apical four-chamber view. The transducer was rotated and recordings were made at 30 degrees rotational intervals around the circumference of the mitral valve annulus. To reconstruct the annulus, the diameters (chords) from each rotational interval were arranged around a reference point. This was done for 12 times during the cardiac cycle. Annular areas were planimetered and circumferences measured. Correlation was good for areas reconstructed and measured by the same observer on separate occasions (r = 0.963) and by two different observers (r = 0.987). In 11 normal subjects the annular area index (area divided by body surface area) increased during diastole to a maximum of 3.8 +/- 0.7 cm2/m2 (mean +/- SD) in late diastole. There was presystolic followed by systolic narrowing to a minimum in midsystole. The mean reduction in area was 26 +/- 3%. The maximal annular circumference was 9.3 +/- 0.9 cm and the mean reduction in circumference was 13 +/- 3%. The overall motion pattern was similar to that reported in experimental studies in the dog. Mitral annular reconstruction may provide new information about normal and abnormal function of the mitral valve apparatus.

Reverse redistribution: worsening of thallium-201 myocardial images from exercise to redistribution

Reverse redistribution (RR) i.e., worsening of images from exercise to redistribution, was noted in 21 (7%) of 300 consecutive thallium-201 (201TI) exercise and redistribution myocardial imaging studies. In 13, there were reversible defects consistent with ischemia in addition to redistribution defects. Twenty RR defects were noted in 15 patients who underwent cardiac catheterization; 9 had triple, 4 had double and 2 had single vessel coronary artery disease. Seventeen (85%) of the RR defects were in the distribution of severely diseased vessels; 8 with 100% occlusion and 9 with 90-99% stenosis. The remainder were associated with 50-60% stenoses. Ten RR areas (50%) were supplied by collateral vessels and 3 (15%) by bypass grafts. Fourteen of the 18 (78%) areas studied with left ventriculography were associated with abnormally contracting segments. These results suggest that RR is a marker for significant coronary artery disease.

Characterization of macrophage subpopulations responsive to activation by endotoxin and lymphokines

The subpopulations of murine macrophages (M phi) that can be activated by endotoxin (LPS) and lymphokines to produce lymphocyte-activating factor, or interleukin 1 (IL-1), and to express cytostatic and cytolytic activities against tumor cells were characterized in 3 cell populations with immature and mature M phi in various proportions, namely, normal peritoneal cells, glycogen-induced peritoneal cells, and cultured bone marrow M phi. There is disagreement in the literature as to whether tumor cytotoxicity can be elicited from all M phi or from a subset of small, newly formed peroxidase-positive (p+) monocytes. Using the technique of cell size fractionation, which separates p+ and p- M phi to various extents, we have found that the magnitude of te response to LPS and lymphokines increases with cell size (and hence maturity or the degree of prior stimulation) and is not exclusive to p+ M phi. Our results are consistent with the concept that all M phi, irrespective of developmental stage, can exist in a continuum of activated states, depending on the nature of the activation signals.

Comparative evaluation of segmental asynergy in remote myocardial infarction by radionuclide angiography, two-dimensional echocardiography, and contrast ventriculography

Radionuclide angiography (RNA), two-dimensional echocardiography (2DE), and contrast ventriculography (CVG) were compared in the evaluation of regional wall motion (RWM) in 58 patients with remote myocardial infarction (MI). All 58 patients were studied by 2DE, 52 by RNA, and 24 by CVG. Severe degrees of segmental asynergy (akinesia/dyskinesia) were noted more often by 2DE (56% of all segments, p less than 0.005) and CVG (52%, p less than 0.05) than by RNA (39%). The apex more the most frequent site of akinesia/dyskinesia by all technique (43% by RNA, 36% by 2DE, and 45% by CVG). 2DE and RNA agreed in 64% of regions (p less than 0.005), 2DE and CVG agreed in 68% (p less than 0.005), and RNA and CVG agreed in 70% (p less than 0.005); the highest agreement was for the apical region. Dyskinesia was noted in 77% of patients by RNA, in 71% by 2DE, and 79% by CVG. RNA and CVG agreed in 89% of patients and in 57% of regions, 2DE and CVG agreed in 67% of patients and in 53% of regions, and RNA and 2DE agreed in 71% of patients and in 38% of regions. Combined RNA and 2DE detected dyskinesia in 94% of the 16 patients with dyskinesia by CVG who underwent all three techniques and in 90% of the 52 patients studied by RNA and 2DE. We conclude that (1) RNA, 2DE an CVG agree significantly in the evaluation of regional wall motion; (2) there is better agreement concerning the presence or absence of dyskinesia in a given patients than the exact region involved; and (3) the combination of RNA and 2DE is more useful than either alone as a screening procedure for the detection of ventricular dyskinesia.