How to evaluate measuring methods in the case of non-defined external validity.

In the clinical routine of chronic diseases, a new measurement has to be compared to an established criterion to see whether there is agreement on assessing disease progress. Because of the nonexistence of established criteria for rheumatoid arthritis the evaluation of grading systems for radiological assessment needs an alternative approach. Using the measurement error as a measure for repeatability and rater agreement in comparison to the progress of the grading score might be a solution to this dilemma.

Relations between beta-adrenoceptor occupancy and increases of contractile force and adenylate cyclase activity induced by catecholamines in human ventricular myocardium. Acute desensitization and comparison with feline ventricle.

The function of beta-adrenoceptors was investigated in ventricular myocardium obtained from patients undergoing open heart surgery. 1. Dopamine increased contractile force up to 1/2 and 1/4 of the maximum increase caused by (-)-noradrenaline or (-)-adrenaline in right and left ventricular preparations, respectively. 2. beta-Adrenoceptors were labelled with 3H-(-)-bupranolol. For 3/4 of the receptors (beta 1) the affinity of (-)-noradrenaline was 20 times higher than for the remaining 1/4 (beta 2). (-)-Adrenaline and dopamine appeared to be non-selective for beta 1 and beta 2. 3. Dopamine was able to stimulate the adenylate cyclase only up to 1/3 of the maximum stimulation caused by (-)-noradrenaline and (-)-adrenaline. 4. Increases in contractile force by (-)-noradrenaline were closely associated with small increases of cyclase activity through beta 1-adrenoceptors, consistent with a common link. 5. The experiments on human myocardium were compared with similar experiments on feline myocardium. Feline ventricle exhibited a 20- to 30-fold higher sensitivity to catecholamines as activators of contractile force than did human ventricle. However, the binding affinities for catecholamines were similar in cat and man. 6. A 3 h exposure of human and feline ventricular myocardium to (-)-isoprenaline caused desensitization by uncoupling beta-adrenoceptors from the adenylate cyclase. Desensitization reduced the maximum contractile response to (-)-isoprenaline in human but not in feline ventricle. 7. The more efficient activation of contractile force by (-)-noradrenaline in cat, compared to man, appears to be related to a 2-fold higher density of beta 1-adrenoceptors, a 6-fold higher production of cyclic AMP per beta 1-adrenoceptor and possibly to a more effective use of cyclic AMP for contraction.

Variability and reproducibility of morphologic findings in endomyocardial biopsies of patients with hypertrophic obstructive cardiomyopathy.

Morphometric investigations of endomyocardial catheter biopsies (EMCB) promise to give more insight in the morphologic-functional relationship in patients with hypertrophic obstructive cardiomyopathy (HOCM), and may disclose the morphologic course of the disease. Variability and reproducibility of morphologic findings in EMCB of patients with HOCM are still undefined. We investigated 112 right ventricular biopsies of 25 patients with HOCM of a mean age of 38.3 +/- 15.2 years (six women, 19 men). Mean EMCB size was 0.755 +/- 0.567 mm2. 28.6% of EMCB were not suitable for morphometric investigation. Variability of morphologic findings was investigated by analysis of variance and described by the coefficient of variation (CV). Sampling variabilities of muscle fiber diameter (CV = 5%), volume density of interstitium (CV = 9%) and fibrous tissue (CV = 17%) differed. Reproducibility in terms of intra- and interobserver variations for these variables reached a comparable level, diminishing observed differences between biopsies from the same heart, which became non-significant. Sampling variability of endocardial thickness (CV = 79%) and muscle fiber disarray (CV = 100%) were higher than intra- and interobserver variations. For an estimate of muscle fiber size, one EMCB specimen is sufficient, three for volume density of interstitium and nine for fibrous tissue. High sampling variability of endocardial thickness and muscle fiber disarray demand numerous biopsies; here the greatest measured value from a few biopsies may be of more clinical relevance. From our data, five EMBC are desirable, and give the most information at an acceptable strain.

Shape and position of the haploid peak in flow cytometric sperm histograms for the assessment of andrological diseases.

Ejaculates from 45 patients with various andrological diseases and from healthy men were analyzed by flow cytometric DNA measurements. The sperm histograms obtained by this method were subjected to mathematical analysis. The height, width and position of the haploid (1 C) peak proved to be a useful criterion for the discrimination of spermatozoa from patients with heterogeneous testicular disorders (SHTD, "mixed atrophy") and homogeneous testicular disorders (SETD) with delivery of immature spermiogenetic cells as compared to healthy persons.

Direct labelling of beta 2-adrenoceptors. Comparison of binding potency of 3H-ICI 118,551 and blocking potency of ICI 118,551.

A radioligand that selectively labels beta 2-adrenoceptors, 3H-ICI 118,551 (3H-ICI), is introduced. Experiments were performed on guinea-pig tissues. The binding characteristics of 3H-ICI on lung membrane particles are compared with the blocking characteristics of ICI 118,551 against the tracheo-relaxant effects of (-)-noradrenaline, (-)-adrenaline and (+/-)-fenoterol. Binding to both beta 1- and beta 2-adrenoceptors were also performed with 3H-(-)-bupranolol on lung and ventricular myocardium. The binding inhibition characteristics of unlabelled ICI 118,551 on ventricle were compared with its characteristics as antagonist of the positive chronotropic effects of (-)-noradrenaline, (-)-adrenaline and (+/-)-fenoterol in spontaneously beating right atria. 1. ICI 118,551 blocked more the relaxant effects of (+/-)-fenoterol and (-)-adrenaline than those of (-)-noradrenaline on trachea. The positive chronotropic effects of (+/-)-fenoterol on sinoatrial node were blocked more than those of both (-)-adrenaline and (-)-noradrenaline. A non-linear regression analysis of blocking data with ICI 118,551 according to the model of Lemoine and Kaumann (1983) revelas that both beta 1- and beta 2-adrenoceptors contribute to the tracheo-relaxant and positive chronotropic effects of agonists. The estimated equilibrium dissociation constants pKB (-log KB = pKB; mol/l) were 7.1 and 9.6 for beta 1- and beta 2-adrenoceptors, respectively. Tracheal beta 2-adrenoceptors contribute 99%, 97% and 7%, sinoatrial beta 2-adrenoceptors contribute 76%, 3% and 0% to the fractional stimuli induced by (+/-)-fenoterol, (-)-adrenaline and (-)-noradrenaline, respectively. 2. 3H-ICI associated to beta 2-adrenoceptors of lung membranes with a kon of 0.521 X nmol-1 X min-1 and dissociated with a koff of 0.19 min-1. 3H-ICI bound to lung beta 2-adrenoceptors with an equilibrium dissociation constant pKL* of 9.2. Unlabelled ICI 118,551, (-)-bupranolol, (+)-bupranolol, (-)-adrenaline, (-)-noradrenaline and (+/-)-fenoterol competed with 3H-ICI for lung beta 2-adrenoceptors with pKL-values of 9.0, 9.4, 8.1, 5.9, 4.9 and 6.4, respectively. 3. 3H-(-)-bupranolol associated to beta-adrenoceptors of lung membranes with a kon 1.21 X nmol-1 X min-1 and dissociated with a koff of 0.26 min-1. 3H-(-)-bupranolol bound to lung beta 2-adrenoceptors and to heart beta 1-adrenoceptors with a pKL of 9.6 and a pKL of 8.8, respectively.(ABSTRACT TRUNCATED AT 400 WORDS)

Improved evaluation of binding of ligands to membranes containing several receptor-subtypes.

In order to evaluate accurately affinity characteristics and relative size of populations of receptor-subtypes in one system we analysed three relevant problems encountered in binding assays. Binding to receptors caused a decrease in the free ligand concentration (i.e. "depletion"). The neglect of depletion may lead to significant distortions of the estimates of affinity and size of receptor-subtype population when the concentrations of both receptor and ligand are of similar magnitude. The distortion is particularly marked when the affinity of a competing ligand is higher than the affinity of the radioligand. We present a formula that describes binding inhibition in a system with receptor-subtypes under conditions of depletion. Binding data usually exhibit heteroscedasticity (i.e. heterogeneous variance), which can not be neglected especially in a system with receptor heterogeneity. Assuming a log normal distribution of experimental errors and a Poisson distribution for errors due to radioactivity counting we derived a function for the transformation of binding data. Transformed data show homoscedasticity, as illustrated with experiments on membranes of guinea-pig lung using ICI 118,551 as inhibitor of 3H-(-)-bupranolol binding to beta 1- and beta 2-adrenoceptors. The hypothesis that affinity characteristics of receptor subtypes are independent of the tissue class can not be tested accurately by the use of standard methods because of interferences of errors between experiments. We propose a method to account for differences between experiments. Assuming invariance of affinity characteristics one is able to perform common fits of data from different tissue classes.(ABSTRACT TRUNCATED AT 250 WORDS)

The affinity of (-)-propranolol for beta 1- and beta 2-adrenoceptors of human heart. Differential antagonism of the positive inotropic effects and adenylate cyclase stimulation by (-)-noradrenaline and (-)-adrenaline.

An appraisal of the affinity of (-)-propranolol was made for beta-adrenoceptors of isolated heart preparations and myocardial membrane particles from patients undergoing open heart surgery. In order to eliminate possible distorting influences of neuronal and extraneuronal uptakes of catecholamines on the affinity estimates for (-)-propranolol, isolated tissues were pretreated once with 5 or 10 mumol/l phenoxybenzamine for 2 h. Phenoxybenzamine caused potentiation of the positive inotropic effects of (-)-noradrenaline and (-)-adrenaline but not of (-)-isoprenaline; potentiation was more pronounced in atrial than in ventricular preparations. Potentiation was greater for (-)-noradrenaline than for (-)-adrenaline. It is concluded that the concentration of physiological catecholamines at the human heart beta-adrenoceptors is limited by neuronal capture but not by extraneuronal uptake. The antagonism of the positive inotropic effects of (-)-adrenaline and (-)-noradrenaline by (-)-propranolol was simple competitive in left ventricular myocardium of patients with mitral lesion. The effects of (-)-adrenaline and (-)-noradrenaline were antagonized to similar extent by (-)-propranolol. An equilibrium dissociation constant KB (-log mol/l) of 8.6 was estimated for (-)-propranolol. In atrial preparations the inotropic effects of (-)-adrenaline were antagonized significantly more by (-)-propranolol than those of (-)-noradrenaline. KB-Values (-log mol/l) of 8.9 [against (-)-adrenaline] and 8.5 [against (-)-noradrenaline] were estimated for (-)-propranolol. Concentration-effect curves for the stimulation of adenylate cyclase of both atrium and ventricle were biphasic for (-)-noradrenaline and monophasic for (-)-adrenaline. The high-sensitivity and low-sensitivity components of (-)-noradrenaline comprised 1/3 and 2/3, respectively, of maximum cyclase stimulation. As expected from beta 1-adrenoceptors, the high-sensitivity component of the curve for (-)-noradrenaline was selectively antagonized by (-)-bisoprolol; as expected from beta 2-adrenoceptors, the low-sensitivity component was selectively antagonized by ICI 118,551. (-)-Propranolol antagonized the effects of (-)-noradrenaline mediated by beta 2-adrenoceptors 2 to 3 times more potently than the effects mediated by beta 1-adrenoceptors. (-)-Propranolol competed with 3H-(-)-bupranolol for binding to left ventricular beta-adrenoceptors. An equilibrium dissociation constant (-log mol/l) of 8.6 was estimated for (-)-propranolol.(ABSTRACT TRUNCATED AT 400 WORDS)