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Biomedical subjects

A M Ross

Publications and source records attributed to A M Ross.

At least 91 records · Page 5Linked to original sources

A computer graphics program system for protein structure representation.

We have developed a computer graphics program system for the schematic representation of several protein secondary structure analysis algorithms. The programs calculate the probability of occurrence of alpha-helix, beta-sheet and beta-turns by the method of Chou and Fasman and assign unique predicted structure to each residue using a novel conflict resolution algorithm based on maximum likelihood. A detailed structure map containing secondary structure, hydrophobicity, sequence identity, sequence numbering and the location of putative N-linked glycosylation sites is then produced. In addition, helical wheel diagrams and hydrophobic moment calculations can be performed to further analyze the properties of selected regions of the sequence. As they require only structure specification as input, the graphics programs can easily be adapted for use with other secondary structure prediction schemes. The use of these programs to analyze protein structure-function relationships is described and evaluated.

Algorithms↗

Nuclear factors binding to the mini-exon repeat of Trypanosoma brucei.

In trypanosomes and related kinetoplastida a common short 5' leader sequence is encoded by the highly repetitive mini-exon gene and added to all protein coding mRNAs by trans-splicing. To initiate a search for transcription factors associated with transcription of the mini-exon we have used an electrophoretic mobility shift assay to detect trypanosome nuclear factors which interact specifically with mini-exon DNA. A factor present in the nuclei of both infectious bloodstream forms and non-infectious culture forms of Trypanosoma brucei was shown by DNAase I footprinting and oligonucleotide competition to bind 5' to the transcription start site of the mini-exon. A second factor which bound to the mini-exon itself at a sequence conserved in other kinetoplastida was evident only in the nuclei of infectious bloodstream forms.

Animals↗

Acute arrhythmogenicity of doxorubicin administration.

The magnitude of acute arrhythmogenicity of doxorubicin administration has not been characterized. In this study the type and frequency of cardiac arrhythmia is determined in the first hour and first 24 hours following doxorubicin given as a 10-minute infusion. Twenty-nine patients with diverse malignancies were studied with Holter monitors on 33 postdoxorubicin days. Control recordings were made on days remote from doxorubicin treatment. The frequency of arrhythmia that could be attributed to doxorubicin was low: 3% of studies in the first hour postinfusion and 24% of studies in 1 to 24 hours postinfusion. The most commonly seen arrhythmia was an increased frequency of ventricular premature beats. Arrhythmia following doxorubicin infusion is rare in the first hour and more common in the remainder of the first 24 hours postinfusion. There are no acute or long-term adverse consequences related to the appearance of arrhythmia due to doxorubicin.

Adult↗

Recurrent early ischemic events after thrombolysis for acute myocardial infarction.

Myocardium salvaged by early thrombolysis and then perfused through a residual stenosis may be at risk for ischemic events. To investigate this possibility, the short-term (2-week) clinical course of 81 consecutive patients managed within a randomized intracoronary thrombolysis trial was reviewed. All patients underwent coronary angiography within 5 hours of symptoms of acute myocardial infarction and were stratified into the following 3 outcome groups: patients with initially subtotal occlusion (subtotal group, n = 17), those with initial total occlusion and infarct artery reperfusion (reperfused group, n = 24) and those with continued infarct artery occlusion (occluded group, n = 40). Recurrent ischemic events were defined as spontaneous typical angina, provokable angina on predischarge exercise testing, and reinfarction. Eleven of 17 patients (65%) in the subtotal and 11 of 23 patients (48%) in the reperfused groups had an ischemic event (difference not significant). In contrast, 4 of 37 patients (11%) with occlusion had an ischemic event (p less than 0.01 compared with patients in the subtotal or reperfused groups). Four patients were excluded because of early (within 72 hours) elective coronary bypass surgery or death from pump failure. To eliminate the impact of multivessel coronary artery disease (CAD), 39 patients with 1-vessel CAD were analyzed separately. Five of 9 patients (56%) in the subtotal group, 3 of 10 (30%) in the reperfused group and only 2 of 20 (10%) in the occluded group had an ischemic event. These observations suggest the need for a more definitive revascularization strategy for acute myocardial infarction.

Angina Pectoris↗

Sequence similarities between human immunodeficiency virus gp41 and paramyxovirus fusion proteins.

Cell fusion is a characteristic cytopathic effect induced by the human immunodeficiency virus (HIV) that leads to the formation of syncytia between infected lymphocytes. Although this process has been shown to occur following the specific binding of the 110-120 kD externalized envelope molecule of the virus with the CD4 glycoprotein, the region of the HIV envelope that directly mediates cell fusion is unknown. In an attempt to identify this fusion domain, we compared the amino acid sequences from the envelope molecules of several HIV isolates to the fusion proteins of paramyxoviruses. We found that the amino terminal region of the HIV transmembrane protein gp41 had a striking degree of similarity with the fusion domain of the respiratory syncytial virus. Moreover, similar sequences were noted in the fusion proteins of other paramyxoviruses and the transmembrane envelope proteins of a variety of lentiviruses suggesting that a functional relationship exists between these glycoproteins. This finding indicates that the amino terminal region of the HIV gp41 molecule may mediate cell fusion for this virus, and could be an important target in the design of immunologic strategies for the prevention of HIV infection in vivo.

Amino Acid Sequence↗

Adrenal status during the first month of life in mature and premature human infants.

Measurements of 17-hydroxyprogesterone (17-OHP) in blood collected onto filter paper after heel puncture by lancet and steroid metabolites in random collections of urine, were made in human infants born from 25 weeks of gestation onwards. The concentration of 17-OHP in blood eluted from filter paper samples was inversely related to both gestational age and birth weight. In mature infants, 17-OHP concentrations fell rapidly soon after birth, whereas concentrations remained high over the first month of life in infants born earlier than 33 weeks of gestation. Sulphated urinary steroids were identified as having a 3 beta-hydroxy-5-ene structure and although the pattern of excretion was similar in mature and premature infants, significantly higher concentrations were found in the premature group. Steroid metabolites normally present when concentrations of circulating 17-OHP are increased due to 21-hydroxylase deficiency were not detectable in urine samples collected from infants born prematurely. Where direct comparison of 17-OHP in blood spots and urinary steroid metabolites was possible, the concentrations of 17-OHP in blood samples paralleled 3 beta-hydroxy-5-ene steroid metabolites in urine. The results suggest that a circulating cross-reacting 3 beta-hydroxy-5-ene steroid may be responsible for increased concentrations of 17-OHP in infants born prematurely. Increased concentrations of both 17-OHP in blood spots and steroid sulphates in urine were associated with stress in premature, but not in more mature, infants suggesting that in infants born prematurely postnatal stress may delay adrenal maturation.

17-alpha-Hydroxyprogesterone↗

The influence of residual coronary stenosis on size of infarction after reperfusion in a canine preparation.

The effect of a residual coronary artery stenosis on size of myocardial infarction was studied in an open-chest canine preparation of coronary occlusion and reperfusion. Eighteen male mongrel dogs (16 to 26 kg) underwent left thoracotomy under general anesthesia; the circumflex artery was instrumented with a hydraulic cuff occluder, a screw clamp, and an electromagnetic flow probe. Animals were randomized to one of three groups: group I (n = 6) had a 6 hr circumflex occlusion, group II (n = 6) had a 2 hr occlusion followed by 4 hr of partial reperfusion through a residual stenosis adjusted to approximately 30% of baseline flow, and group III (n = 6) had full reperfusion for 4 hr after a 2 hr occlusion. Zones of risk, infarction, and no reflow were defined by staining with Evans blue, triphenyl tetrazolium chloride, and fluorescein, respectively. At 6 hr the hearts were excised and areas of risk, infarction, no reflow, and hemorrhage were determined by planimetry of serial transverse heart slices (5 mm thick). Infarction as a percent of the risk area was 96 +/- 1% in group I, 90 +/- 2% in group II, and 79 +/- 4% in group III (p less than .001), and the differences between each of the groups were significant. Gross hemorrhage was seen in none of the six dogs in group I, two of the six in group II, and five of the six in group III, but did not affect infarct size. We conclude that residual stenoses may exert a deleterious effect on the outcome of coronary reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Neonatal screening for congenital adrenal hyperplasia: a programme based on a novel direct radioimmunoassay for 17-hydroxyprogesterone in blood spots.

We have assessed the feasibility of screening newborn babies for congenital adrenal hyperplasia (CAH) by the direct measurement of 17-hydroxyprogesterone (17-OHP) in blood spots collected on filter paper (Guthrie cards) for the phenylketonuria, hypothyroidism and galactosaemia screening programmes run in Scotland. The procedure described for CAH uses an iodinated 17-OHP tracer and a specific 17-OHP antiserum sheathed within semipermeable nylon microcapsules. The method does not require a solvent extraction step, is inexpensive, precise, efficient and, therefore, practical for large-scale use. With this system the value of a neonatal screening programme was assessed in a retrospective analysis and a prospective trial. The retrospective study of 15 paediatric cases of CAH illustrated that at least half were not diagnosed within 3 weeks of birth. Analysis of the original Guthrie card samples revealed increased levels of 17-OHP in all cases. The prevalence of CAH as calculated in the retrospective study was 1 in 20 907 with a range (within 95% confidence limits) of from 1 in 12 675 to 1 in 32 604 (n = 301 450). In the prospective trial a total of 92 051 consecutive samples was screened. Five cases of CAH were correctly identified with a current false positive rate of 0.042%. Analysis of urinary steroids confirmed defective adrenal 21-hydroxylase activity in all positive cases. In the prospective trial the prevalence was 1 in 18 401 with a range of from 1 in 7422 to 1 in 50 006. We conclude that mass screening for CAH is both feasible and desirable.

Adrenal Hyperplasia, Congenital↗

Lipoprotein and apolipoprotein levels in angiographically defined coronary atherosclerosis.

Recent studies suggest that apolipoproteins and subfractions of high-density lipoprotein (HDL) cholesterol may be better predictors of atherosclerotic coronary artery disease (CAD) than are plasma cholesterol and total HDL cholesterol. To examine this hypothesis, plasma cholesterol and triglyceride, cholesterol of low-density lipoprotein, HDL and its subfractions 2 and 3, apolipoprotein A-I, the apolipoprotein B of low-density lipoprotein, the ratio of apolipoprotein EII to EIII, and ratios of several of these variables were measured in a selected series of 126 patients (83 men and 43 women) who underwent coronary angiography for suspected CAD. Mean values of many of these variables differed significantly between the men with CAD and the men without significant CAD, when controlled for age, use of beta blockers and diuretic drugs. Using multivariate logistic regression analysis, the only variable that made a significant independent contribution in predicting CAD in men was the ratio of HDL cholesterol to total plasma cholesterol (p less than 0.0001). The mean of this ratio was 0.17 +/- 0.01 mg/dl in the men with CAD and 0.23 +/- 0.02 mg/dl in the male controls. All men with ratios of less than 0.15 mg/dl had significant CAD, defined as 50% or greater luminal diameter narrowing of 1 or more of the major coronary arteries. No measurement was a significant univariate or multivariate predictor of CAD in the women, but the power to detect such predictors was reduced because of small group sizes. In conclusion, the ratio of HDL cholesterol to plasma cholesterol may be superior to many of the more recently described lipoprotein and apolipoprotein-derived predictors of CAD.

Apolipoprotein A-I↗

Independent and interactive effects of digoxin and quinidine on the atrial fibrillation threshold in dogs.

To assess the effects of digoxin as single therapy and in combination with quinidine in the treatment of atrial fibrillation, the atrial fibrillation threshold was determined from the right atrial appendage and Bachmann's bundle in 11 open chest dogs. In group 1 (six dogs), the atrial fibrillation threshold was determined at baseline, post-quinidine (10 mg/kg intravenously) and then post-digoxin (50 micrograms/kg intravenously). In group 2 (five dogs), the order of drug administration was reversed. The results of this study were: 1) Digoxin had no significant effect on the atrial fibrillation threshold when given alone. 2) Quinidine significantly increased the atrial fibrillation threshold (p less than 0.002) and the addition of digoxin resulted in a further increase in threshold (p less than 0.002). 3) Quinidine produced greater suppression of atrial fibrillation induction at the right atrial site than at the Bachmann's bundle site, suggesting differential effects of quinidine on atrial fibers.

Animals↗

Arteriographic predictors of spontaneous improvement in left ventricular function after myocardial infarction.

To better characterize the changes in left ventricular ejection fraction after myocardial infarction, we compared radionuclide ventriculograms obtained acutely and 2 weeks after acute myocardial infarction in 40 patients. These patients underwent angiography within a mean of 4 hr and 20 min after the onset of symptoms of infarction and either received no therapy (32 patients who were control subjects in a thrombolysis trial) or did not experience reperfusion (eight patients) despite receiving streptokinase infusions. In all 40 patients, the change in left ventricular ejection fraction over 2 weeks was small (+2.6%). Patients were then grouped according to the presence or absence of residual flow on their angiograms. Residual flow was considered to be present in 21 patients, in 12 by virtue of subtotal occlusion of the artery supplying the area of infarct and in nine because of well-developed coronary collaterals to the distal infarct artery. Mean change in ejection fraction for patients with residual flow was +6.9 +/- 2.3% vs -2.2 +/- 1.7% for patients without residual flow (p less than .01). Fourteen of 21 (67%) patients with residual flow had a spontaneous rise in ejection fraction of greater than 5%, as compared with two of 19 (11%) patients without residual flow (p less than .01). Time to peak level of creatine kinase (CK) was significantly shorter in the residual flow group (15 vs 23 hr, p less than .01), while the peak level of CK was lower (1550 vs 2220 IU) in these patients. This latter difference did not reach statistical significance (p = .10).(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗

Exercise radionuclide ventriculographic responses in hypertensive patients with chest pain.

The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and - 1.4 +/- 1 per cent, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29 per cent) and in 4 of the 20 without it (20 per cent) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1 per cent, in contrast to the patients without coronary disease, who had an increase of 6 +/- 1 per cent (P less than 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48 per cent), as compared with 3 of the 38 without it, (8 per cent) (P less than 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain.

Adult↗

Detection of left ventricular wall motion abnormalities for the diagnosis of coronary artery disease: a comparison of exercise radionuclide and pacing intravenous digital ventriculography.

Intravenous digital ventriculography before and after pacing was compared with equilibrium gated nuclear ventriculography at rest and after exercise. Specifically, the relative abilities of the 2 techniques to detect resting and stress-related wall motion abnormalities were tested. Twelve normal patients and 28 patients with coronary artery disease (CAD) were tested. Neither technique produced a new wall motion abnormality in a patient with normal coronary arteries. Six patients with CAD had a history of a myocardial infarction (MI); an abnormality at rest was present in all 6 by both techniques. Of the 22 patients with CAD and a normal baseline ventriculogram, a wall motion abnormality developed in 18 during digital ventriculography with pacing; a wall motion abnormality developed in 15 with exercise nuclear ventriculography. Wall motion abnormalities by nuclear ventriculography (performed in the left anterior oblique projection) tended to be apical; digital ventriculography (performed in the right anterior oblique projection) more often produced an abnormality of the anterior or inferior wall, which could be predictive of coronary anatomy. Thus, the 2 techniques are substantially equivalent for the detection of wall motion abnormalities in CAD.

Adult↗

A randomized, angiographically controlled trial of intracoronary streptokinase in acute myocardial infarction.

Fifty-five patients with acute myocardial infarction evaluated within 4 hours of the onset of symptoms were entered into an angiographically controlled trial of intracoronary streptokinase (IC STK). Forty-three patients with total occlusion of their infarct artery were randomized to either IC STK or intracoronary nitroglycerin (IC NTG), and 12 patients with less-than-complete occlusion received only IC NTG. Reperfusion of a totally occluded vessel was achieved in 69% of STK patients and 17% of IC NTG patients. Time from onset of symptoms to peak CK activity was significantly shorter in reperfused patients and patients with subtotal occlusion on initial angiography than in patients with total occlusion who were not reperfused (p less than 0.0001). Comparison of radionuclide ejection fractions (EF) determined acutely and 10 to 14 days after infarction failed to show improvement in either the STK or IC NTG group (mean decrease of 2.8% and 0.4%, respectively). In contrast, patients with subtotal occlusion on baseline angiography demonstrated a significant (p = 0.05) spontaneous improvement in EF over 2 weeks (7.3% increase).

Aged↗

Intraoperative retrograde balloon-catheter dilatation to augment myocardial revascularization.

When bypass graft surgery is planned, it is appreciated that sequential coronary artery stenoses often entrap the origins of arterial branches that have a significant, but subgraftable, diameter. These branches are routinely not perfused by saphenous vein grafts implanted beyond the second lesion. Data are presented on improving perfusion of such branches in 26 patients by the technique of retrograde intraoperative balloon-catheter dilatation. During coronary artery surgery, specially designed angioplasty catheters, 2 to 3 mm in diameter, were introduced through the coronary arteriotomy and passed retrogradely across the distal lesion. Balloon inflation was performed two to four times at 4 to 7 atm. Lesion size was assessed before and after angioplasty with the use of graduated coronary probes. Probe-determined lesion diameter increased from 1.1 +/- 0.4 to 2.0 +/- 0.4 mm (percent increase, 109 +/- 8). In selected patients, intraoperative balloon-catheter dilatation is a promising technique adjunctive to coronary surgery. Clinical significance and long-term effectiveness of this procedure require further evaluation.

Aged↗