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Biomedical subjects

A E Carter

Publications and source records attributed to A E Carter.

At least 19 recordsLinked to original sources

Conformational preference for the binding of biaryl substrates and inhibitors to the active site of phenylethanolamine N-methyltransferase.

We have previously described regions of steric bulk tolerance in the aromatic-ring binding site of phenylethanolamine N-methyltransferase (PNMT, EC 2.1.1.28) for phenylethanolamine substrates and alpha-methylbenzylamine inhibitors. For bound substrates, this region is located in the vicinity of the para position of the aromatic ring, while for bound alpha-methylbenzylamine inhibitors, it is located in the region complementary to the meta position. In the present study, we sought to determine the preferred conformation of the biaryl portion of (m-phenylphenyl)- and (p-phenylphenyl)ethanolamine (4 and 5, respectively) as well as for m-phenyl- and p-phenyl-alpha-methylbenzylamine (7 and 8, respectively) for PNMT active site interactions. Planar derivatives of 4, 5, 7, and 8 were obtained through the synthesis of 2-(1-fluorenyl)-2-hydroxyethylamine (9), 2-(2-fluorenyl)-2-hydroxyethylamine (10), 1-(1-fluorenyl)ethylamine (11), and 1-(2-fluorenyl)ethylamine (12). The four fluorene derivatives were examined for in vitro activity as substrates and inhibitors of the PNMT-catalyzed reaction. As in the case of 4, 5, 7, and 8, we have observed a positional preference for the alkylamine side chain with respect to the biphenyl skeleton present in 9-12. Thus, fluorenylethanolamine 10 ("p-biphenyl") displays a Michaelis constant (Km = 26 microM) that is approximately 10 times lower than that for 9 ("m-biphenyl", Km = 297 microM); in the alpha-methylbenzylamine inhibitors, fluorenyl derivative 11 ("m-biphenyl", Ki = 4.14 microM) is approximately 40 times better than 12 ("p-biphenyl", Ki = 185 microM) for in vitro inhibition of PNMT. In each case, conformational restriction of the biaryl system present in 4, 5, 7, and 8, such that the aromatic rings are coplanar, resulted in enhanced affinity for the PNMT active site. Thus, conformational restriction of ethanolamine 5 (Km = 82 microM) as in 10 (Km = 26 microM) and alpha-methylbenzylamine 7 (Ki = 89 microM) as in 11 (Ki = 4.14 microM) leads, in each case, to a stronger enzyme-ligand dissociable complex. These results, in conjunction with others from these laboratories, indicate that the PNMT active site beyond the zone that interacts with the central aromatic ring portion of phenylethanolamine substrates and alpha-methylbenzylamine inhibitors is essentially a flat, hydrophobic pocket.

Adrenal Glands↗

Cryotherapy for advanced haemorrhoids: a prospective evaluation with 2-year follow-up.

The early and long-term results of treating 125 patients with advanced haemorrhoids by cryotherapy have been studied. Hospitalization requirements were brief; 54 per cent of patients were hospitalized for less than 24 h. The only significant early postoperative problem was a profuse serous discharge (67 per cent of patients). Bleeding, pain, or pruritus were rarely encountered. Ninety-three per cent of patients returned to work within 3 weeks. The principal long-term disadvantage was residual peri-anal skin tags and these were excised 6 months postoperatively in 18 patients. Four patients had first or second degree haemorrhoids at 2 years but only one patient (0.8 per cent) had prolapsing piles which required operation. Factors which might have influenced the results have been discussed. It is concluded that cryotherapy is an effective low cost method of dealing with advanced haemorrhoids.

Adult↗

The transduodenal per-ampullary approach to common bile duct calculi.

A method of management of 212 patients whose common bile duct calculi were removed through the Ampulla of Vater across the duodenum is described. One patient died from haemorrhagic pancreatitis directly related to the procedure and 11 others died from causes related to the need for a major procedure in people relatively late in life: an overall mortality of 5.7% and of 0.5% for directly related causes. Ten patients suffered non-fatal complications. Ninety three left hospital within 14 days after operation and 79 within 21 days. Although one patient, for a special reason, continued to form stones and discharged them without any difficulty, no others have formed stones that have been recognised symptomatically or clinically. No patient has had cholangitis or common duct stenosis.

Abscess↗

Bladder cancer.

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Aged↗

Effect of age and menopausal status on estimates of oestrogen binding by human malignant breast tumours.

The uptake of oestradiol by human breast-tumour tissue estimated by in-vivo and in-vitro techniques has been examined in relation to patients' ages and menopausal status. Results from in-vivo studies showed no convincing correlations, while in-vitro results were significantly correlated with menopausal status. There was a significant correlation between results obtained by the two techniques.

Adult↗

More on T-tubes.

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Drainage↗

Prevention of postoperative deep venous thrombosis and pulmonary embolism.

Two series of patients observed clinically and by phlebography suggest that one agent known to produce a reduction in platelet aggregation in vitro might be useful in reducing the incidence of deep venous thrombosis and pulmonary embolism postoperatively. The agent used in this study was hydroxychlorquine sulphate.

Aged↗