Search PubMedSearch

Biomedical subjects

C J Wallace

Publications and source records attributed to C J Wallace.

At least 19 recordsLinked to original sources

Functional role of heme ligation in cytochrome c. Effects of replacement of methionine 80 with natural and non-natural residues by semisynthesis.

The nature of the axial ligation to heme iron has been suggested to be the major determinant of the oxidation-reduction potential of a particular cytochrome, but natural cytochromes that vary significantly in E'm invariably differ from one another in many ways. We proposed to clarify this issue by engineering many different ligation patterns within the same basic molecule, mitochondrial cytochrome c. Since many of the potentially informative substitutions require non-coded amino acids, semisynthesis was the approach we chose, and solid-phase peptide synthesis was used to make a set of nin 39-residue peptides that have been incorporated by autocatalytic fragment religation into the structure of horse cytochrome c. An additional two analogues modified at this position were made by chemical modification of the whole protein. As well as looking at the effect on reduction potential, we examined the effect of varying the ligand sphere on the efficiency of the autocatalytic fragment religation reaction, on the conformation of cytochrome c, on its spectroscopic properties, and in promoting electron transfer between heme c and other redox centers. Substitute residues were chosen to put sulfur, selenium, oxygen, and nitrogen, or even no ligating atom at all in the place of methionine sulfur. We found both subtle and dramatic alterations in spectral properties, which were informative about changes in internal structure and stability brought about by the modifications and which may be useful in identifying novel natural ligation patterns. An unexpected finding was that alanine 80 cytochrome c acquires a hemoglobin-like spectrum, and binds O2 most effectively. Reduction potential changes of greater than 300 mV with nitrogen, greater than 400 mV with oxygen, and greater than 300 mV with thiol sulfur ligation were observed, confirming that variation of the ligand sphere is indeed the most effective way in which the protein coat may modulate the potential of the redox center it encloses. Finally, we obtained more evidence that this axial ligand plays an active role in electron transfer and discovered that histidine could be even more effective in this role.

Amino Acids

Deficits in social schemata in schizophrenia.

Several recent studies have examined the manner in which social information is processed in an attempt to better understand the interpersonal functioning deficits of schizophrenia. In this study, the manner in which schizophrenic subjects represent social information, and the relationships between these social representations and measures of information processing, are examined. Specifically, 30 DSM-IIIR patients with schizophrenia and 15 normal controls were assessed on measures of social schema processing, information processing, and symptomatology. Results showed that schizophrenic patients earned significantly lower schema processing scores than the normal comparison group. Schema deficits of the schizophrenic group were significantly associated with recall memory and vigilance. These findings suggest that deficits in the representation of social information provides a unique perspective for understanding the interpersonal dysfunctions of schizophrenia.

Adult

Effectiveness and replicability of modules for teaching social and instrumental skills to the severely mentally ill.

OBJECTIVE: This study evaluated the effectiveness and replicability of psychoeducational modules designed to improve the social and instrumental competencies of severely mentally ill patients. METHOD: Staff in seven facilities used the modules to teach 108 severely mentally ill patients. Staff received 2 days of formal training followed by periodic consultation. Each module's effectiveness was measured by a test of the patients' knowledge and performance of the skills taught in that module. Staff's adherence to the instructional techniques specified in the modules was measured by directly observing them and assessing the fidelity of their behaviors to those specified in the modules. RESULTS: The patients' skills significantly improved and were maintained during a 1-year follow-up, and staff accurately followed the modules with minimal consultation. CONCLUSIONS: These training modules are effective and replicable techniques for teaching social and instrumental skills to severely mentally ill patients. The modules can be easily disseminated to a variety of facilities and used as components in a comprehensive rehabilitation program.

Activities of Daily Living

A successful computerized protocol for clinical management of pressure control inverse ratio ventilation in ARDS patients.

We have developed a computerized protocol that provides a systematic approach for management of pressure control-inverse ratio ventilation (PCIRV). The protocols were used for 1,466 h in ten around-the-clock PCIRV evaluations on seven patients with severe adult respiratory distress syndrome (ARDS). Patient therapy was controlled by protocol 95 percent of the time (1,396 of 1,466 h) and 90 percent of the protocol instructions (1,937 of 2,158) were followed by the clinical staff. Of the 221 protocol instructions, 88 (39 percent) not followed were due to invalid PEEPi measurements. Compared with preceding values during CPPV, the expired minute ventilation was reduced by 27 percent during PCIRV while maintaining a pH that was not clinically different (mean difference in pH = 0.02). There was no difference in the PaO2, PEEPi, or the FIO2 between PCIRV and CPPV. The PEEP setting was reduced by 33 percent from 9 +/- 0.05 to 6 +/- 0.6 and the I:E ratio increased from 0.64 +/- 0.04 to 2.3 +/- 0.10. Peak airway pressure was reduced by 24 percent (from 59 +/- 1.5 to 45 +/- 0.6) and mean airway pressure increased by 27 percent (from 22 +/- 0.8 to 28 +/- 0.6) in PCIRV. Right atrial and pulmonary artery pressures were higher and cardiac output lower in PCIRV but blood pressure was unchanged. The success of this protocol has demonstrated the feasibility of using PEEPi as a primary control variable for oxygenation. This computerized PCIRV protocol should make the future use of PCIRV less mystifying, simpler, and more systematic.

Adult

Multiple sclerosis: the impact of MR imaging.

MR imaging has had a significant impact on the understanding of multiple sclerosis. The procedure now plays an important role in initial diagnostic workup, replacing some other radiologic and paraclinical tests and often confirming clinically suggested locations of lesions. It also has contributed greatly to the understanding of the natural history of this disease, allowing objective assessment of disease load, detection of asymptomatic lesions, and differentiation between acute and chronic lesions. MR imaging is highly sensitive to inflammation and demyelination caused by multiple sclerosis, and although there is a long differential diagnosis for some of the MR findings, increasing experience has defined a number of relatively specific criteria for multiple sclerosis. Recent advances may allow faster imaging and highly objective lesion quantification, which will aid in therapeutic trials.

Brain

Calcified herniations of the thoracic disk: role of magnetic resonance imaging and computed tomography in surgical planning.

Herniations of thoracic disks are uncommon, and their surgical management can be challenging. Magnetic resonance imaging (MRI) is rapidly becoming the method of choice for assessing degenerative disease in thoracic disks. However, calcification may be difficult to detect with MRI and plain films alone. The authors report a case in which MRI and myelography underestimated the true extent of disk calcification, the detection of which would have altered the initial surgical approach.

Adult

Enhancing protein engineering capabilities by combining mutagenesis and semisynthesis.

If site-directed mutagenesis could be used to facilitate protein semisynthesis, then structural engineering goals should be achieved that are unattainable by either technique alone. We tested this possibility by mutating Ser65 of yeast cytochrome c to methionine, creating a new site for CNBr cleavage. Fragments obtained by cleaving there were found to refold cooperatively, bringing together the breakpoint termini and leading to efficient autocatalytic peptide bond synthesis. Structurally modified fragments may be substituted for natural ones. Generally, naturally occurring sites are unsuitable for autocatalytic religation, for reasons briefly discussed, and thus the power of this new approach lies in the freedom to choose sites, including enzymatic ones, that are appropriate to the semisynthetic goals.

Amino Acid Sequence

The specificity and Kd at physiological ionic strength of an ATP-binding site on cytochrome c suit it to a regulatory role.

Cytochrome c binds ATP with marked specificity at a site that contains the evolutionarily invariant residue Arg-91. The binding of ATP to this site was studied using equilibrium gel filtration, equilibrium dialysis and affinity chromatography. At physiological ionic strength the affinity is such that the major change in occupancy coincides with the normal cellular ATP concentration range, and the degree of saturation is proportional to the ratio of [ATP]/[ADP]. The specificity of binding at this site is more a function of the degree of phosphorylation of the nucleotide, than of the nature of the nucleoside moiety. Thus under physiological conditions the degree of occupancy of this site is proportional to the energy state of the cell, providing a means for the regulation of the respiratory chain which is sensitive to cytoplasmic ATP levels.

Adenosine Triphosphate

Quantitative imaging of osteoarthritis.

Plain-film radiography currently remains the mainstay of imaging for diagnosis and follow-up in osteoarthritis (OA). However, recent studies have questioned some aspects of its use, particularly the correlation between radiographically evident joint-space narrowing and articular cartilage loss. The results with imaging modalities such as magnetic resonance imaging and ultrasound suggest that these methods will allow accurate noninvasive definition of the structure of articular cartilage and other soft tissues of joints. Other modalities, including microfocal radiography and high-resolution computed tomography, can produce detailed images of trabecular structure and bony alterations in osteoarthritis. Improvements in image analysis and data manipulation, including three-dimensional reconstruction and digitized storage and measurement of images, will likely enable improved quantitative assessment of the abnormalities demonstrated by these techniques. One can hope that such developments will facilitate not only improved detection and definition of OA, but also better evaluation of the effectiveness of pharmacological and physical therapy in practice and in clinical trials.

Cartilage, Articular

Magnetic resonance imaging of the brain.

Magnetic resonance imaging (MRI) of the brain has become essential to a neurologic work-up. In Canadian centres where access to MRI is limited, use of this technique is usually restricted to assessment of disorders for which it is likely to provide unique information after computed tomography (CT); examples include abnormalities of the temporal lobes and posterior fossa, some diseases that show subtle or no abnormalities on CT (many inflammatory and demyelinating disorders) and cases in which detailed anatomic assessment is necessary (vascular malformation, congenital anomalies and many tumours). Although MRI of the brain has become quite standardized, recent developments such as improved gradient-echo imaging, new coil designs, magnetic resonance angiography and the use of contrast agents in MRI have resulted in improved speed and utility.

Brain

Clinical evaluation of computer-based respiratory care algorithms.

A collection of computer-based respiratory care algorithms were implemented as a prototype computer-based patient advice system (COMPAS) within the existing HELP hospital information system. Detailed medical logic recommended ventilator adjustments for 5 different modes of ventilation: assist/control (A/C), intermittent mandatory ventilation (IMV), continuous positive airway pressure (CPAP), pressure controlled inverted ratio ventilation (PC-IRV), and extracorporeal carbon dioxide removal (ECCO2R). Suggestions for adjusting the mode of ventilation, fraction of inspired oxygen (FiO2), positive end-expiratory pressure (PEEP), peak inspiratory pressure, and several other therapeutic measures related to the treatment of severe arterial hypoxemia in adult respiratory distress syndrome (ARDS) patients were automatically presented to the clinical staff via bedside computer terminals. COMPAS was clinically evaluated for 624 hours of patient care on the first 5 ARDS patients in a randomized clinical trial. The clinical staff carried out 84% (320/379) of the computerized therapy suggestions. In response to a questionnaire distributed to clinical users of the system, 86% judged the system to be potentially valuable. Through implementation of COMPAS, a computer-based ventilatory therapy advice system, we have laid the groundwork for standardization of ventilator management of arterial hypoxemia in critically ill ARDS patients.

Algorithms

Assessment of interpersonal problem-solving skills.

A new instrument for assessing social skills of schizophrenic patients, Assessment of Interpersonal Problem-Solving Skills (AIPSS), is a videotaped-based test with an examiner's administration and scoring manual. The test measures an examinee's ability to describe an interpersonal social problem, to derive a solution to the problem, and to enact a solution in a role-played simulation test. In a study using a sample of schizophrenic outpatients and a comparison group of nonpatients, we found that the test had adequate psychometric properties, and the patients demonstrated deficits on all scales relative to the nonpatients. The results of the study also provided partial support for the validity of an information-processing model of social skills, which was used as a basis for constructing the AIPSS. Thus, the AIPSS represents a departure from previous methods of assessing social skills.

Adult

Effectiveness of the kinetic treatment table for preventing and treating pulmonary complications in severely head-injured patients.

The efficacy of using the Kinetic Treatment Table (KTT) to prevent or reduce pulmonary complications in severely head-injured patients is unclear. This study is a prospective, randomized trial using the KTT vs. conventional bed care in severely head-injured patients. Outcome measures were hospital length of stay (LOS), mortality, CNS morbidity at hospital discharge, and rate of improvement of pulmonary status as gauged by chest radiograph, arterial/alveolar PO2 ratio, patient temperature, WBC count, suctioning frequency, sputum volume, and days on ventilator. The KTT group (n = 23) and conventional bed care group (n = 26) were well matched for age, sex, severity of injury, and pulmonary status. There was no significant difference in mortality, CNS morbidity, LOS in ICU or hospital, or rate of pulmonary improvement between the groups. The efficacy of the KTT in reducing pulmonary complications in head-injured patients remains unclear.

Acute Disease

The semisynthesis of fragments corresponding to residues 66-104 of horse heart cytochrome c.

We describe the N epsilon-acetimidylation of horse heart cytochrome c with retention of biological activity, the cleavage of the modified protein by CNBr, the separation of the fragments, and their further side-chain protection. We describe the manipulation of the amino acid sequences of the fragments by stepwise semisynthetic methods. We have prepared fragments corresponding to residues 66-78 and 66-79 of the protein, as well as the [Asp66] analogue of fragment 66-79. We have prepared the natural sequence and the [o-fluoro-Phe82] analogue of the fragment corresponding to residues 81-104 of the protein, and the [N epsilon-trifluoroacetyl-Lys79], the [N epsilon-dinitrophenyl-Lys79] and the [S-acetamidomethyl-Cys79] analogues of fragment 79-104, and the [N epsilon-Cbz-Lys81] analogue of fragment 80-104. We have coupled back the fragments of natural sequence to form a semisynthetic fragment corresponding to residues 66-104 of the protein. Modified fragments were also coupled to give analogues of the 66-104-residue sequence. In every case the homoserine residue representing methionine-80 was removed from the C-terminus of the 66-80-residue fragment and replaced by methionine on the N-terminus of the 81-104 residue fragment during the preparation of the fragments for coupling. The semisynthetic fragments are ready for specific deprotection and further coupling. We have coupled one such fragment to the (1-65)-peptide to produce semisynthetic [Hse65]cytochrome c. The product has satisfactory characteristics on chemical analysis, and on assay of its biological activity.

Amino Acid Sequence