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D M Epstein

Publications and source records attributed to D M Epstein.

At least 19 recordsLinked to original sources

Dynamics of the dihydrofolate reductase-folate complex: catalytic sites and regions known to undergo conformational change exhibit diverse dynamical features.

Backbone and tryptophan side-chain dynamics of uniformly 15N-labeled Escherichia coli dihydrofolate reductase were determined for the binary folate complex. The 15N T1 and T2 relaxation times and [1H]-15N heteronuclear NOEs were measured for 118 protonated backbone nitrogen atoms. The generalized order parameter (S2), the effective correlation time for internal motions (tau e), and the contribution to spin-spin relaxation through 15N exchange broadening (Rex) were determined for each residue by model-free analysis. Back-calculation of the relaxation rates for each resonance showed that the calculated dynamical parameters accurately predict the experimental data. Diverse dynamical features were evident in the DHFR backbone. Six sites exhibited order parameters significantly below the weighted mean S2 value (for the complex) of 0.81 +/- 0.002: residues G67 and D69 of the adenosine binding domain, and "hinge" residues K38 and V88, exhibited low S2 (0.29 < or = S2 < or = 0.6) and high tau e values (700 ps < or = tau e < or = 2 ns), as did sites within the beta A-alpha B loop and the beta F-beta G loop. Thus, large amplitude backbone motions, on the picosecond and nanosecond time scales, occurred at regions implicated in transition-state stabilization and in ligand-dependent conformational change. Significant Rex values (> or = 1 s-1) were determined for 45% of assigned resonances, many of which arise from residues surrounding the folate binding site. The mean S2 values of the occupied folate binding site and the unoccupied NADPH binding site were similar, indicating the backbone of the latter is at least as conformationally restricted as that of the occupied folate site. We conclude that the observed time-dependent structural fluctuations of the binary complex are in fact associated with catalytic properties of the molecule.

Amino Acid Sequence

Role of serine 214 and tyrosine 171, components of the S2 subsite of alpha-lytic protease, in catalysis.

The function of a hydrogen bond network, comprised of the hydroxyl groups of Tyr 171 and Ser 214, in the hydrophobic S2 subsite of alpha-lytic protease, was investigated by mutagenesis and the kinetics of a substrate analog series. To study the catalytic role of the Tyr 171 and Ser 214 hydroxyl groups, Tyr 171 was converted to phenylalanine (Y171F) and Ser 214 to alanine (S214A). The double mutant (Y171F: S214A) also was generated. The single S214A and double Y171F:S214A mutations cause differential effects on catalysis and proenzyme processing. For S214A, kcat/Km is (4.9 x 10(3))-fold lower than that of wild type and proenzyme processing is blocked. For the double mutant (Y171F:S214A), kcat/Km is 82-fold lower than that of wild type and proenzyme processing occurs. In Y171F, kcat/Km is 34-fold lower than that of wild type, and the proenzyme is processed. The data indicate that Ser 214, although conserved among serine proteases and hydrogen bonded to the catalytic triad [Brayer, G. D., Delbaere, L. T. J., & James, M. N. G. (1979) J. Mol. Biol. 131, 743], is not essential for catalytic function in alpha-lytic protease. A substrate series (in which peptide length is varied) established that the mutations (Y171F and Y171F:S214A) do not alter enzyme-substrate interactions in subsites other than S2. The pH dependence of kcat/Km for Y171F and Y171F:S214A has changed less than 0.5 unit from that of wild type; this suggests the catalytic triad is unperturbed. In wild type, hydrophobic interactions at S2 increase kcat/Km by up to (1.2 x 10(3))-fold with no effect on Km.(ABSTRACT TRUNCATED AT 250 WORDS)

Base Sequence

Is drinking water related to spontaneous abortion? Reviewing the evidence from the California Department of Health Services Studies.

Because preliminary data suggested a relation between risk of spontaneous abortion and tapwater consumption during pregnancy, the California Department of Health Services included questions on prenatal water consumption in all reproductive studies conducted between 1982 and 1988. Results from four of these five retrospective data bases suggest that women abstaining from tapwater or drinking bottled water during the first trimester of pregnancy may be at reduced risk of spontaneous abortion. Fetal resorption frequencies seen in an accompanying toxicology study were consistent with these epidemiologic findings, although not conclusive. Tap and bottled water samples from these study areas were analyzed for agents that might account for these findings. Differences in trace element composition and biological activity were observed, but the reproductive significance of these differences is unknown. This paper presents an overview of these studies, which are presented in detail separately. Three alternative explanations for these findings--bias, chance, and causality--are reviewed.

Abortion, Spontaneous

Adverse pregnancy outcomes in relation to water consumption: a re-analysis of data from the original Santa Clara County Study, California, 1980-1981.

Residents of a census tract that received drinking water from a well contaminated with solvents were previously shown to experience a spontaneous abortion rate over twice that occurring in an unexposed census tract. In addition, the rate of birth defects in the exposed tract was three times that in the unexposed tract. Surprisingly, increased tapwater consumption was associated with higher rates of spontaneous abortions in both the exposed and the unexposed tracts. Subsequent studies in this area have investigated the relation between spontaneous abortions and consumption of tapwater in more detail. In this report, data from the original study have been re-analyzed using methods comparable with those used in more recent studies. These results confirm the association between spontaneous abortions and reported cold tapwater consumption that was seen in the original study. The observed effect was not due to maternal risk factors, nor was it a function of consumption of bottled water. After controlling for bottled water, the odds ratio for consumption of tapwater was 3.4 (95% confidence interval = 0.6-19.4).

Abortion, Spontaneous

Spontaneous abortions and birth defects related to tap and bottled water use, San Jose, California, 1980-1985.

We recently studied pregnancies occurring during 1980-1985 in four study areas in Santa Clara County, California. Two of the areas were exposed to solvent-contaminated drinking water during 1980 and 1981, and two were unexposed. There was an overall excess of spontaneous abortions among women who reported any tapwater consumption during the first trimester of pregnancy compared with those who reported no tapwater consumption [odds ratio (OR) = 4.0; 95% confidence interval (CI) = 1.8-9.1)], regardless of exposure to the contaminated water. The odds ratio for spontaneous abortion for women reporting any vs no tapwater was 6.9 (95% CI = 2.7-17.7) after adjustment for numerous potential confounders using multiple logistic regression analyses. The elevated odds ratio of spontaneous abortion was seen among tapwater drinkers who used no filters or softener-type filters but not among women who reported use of active filters. Spontaneous abortion rates were reduced in women who reported any vs no bottled water consumption (OR = 0.26; 95% CI = 0.16-0.43). Among women who reported no tapwater consumption, no birth defects occurred among 263 live births; in comparison, among women who reported tapwater consumption, 4% of 908 live births had defects (P = 0.0001). We observed no relation between birth defects and bottled water use.

Abortion, Spontaneous

Tap or bottled water consumption and spontaneous abortion in a case-control study of reporting consistency.

A recent case-control study of 1,926 women found a slightly increased risk of spontaneous abortion associated with reported consumption of tapwater and a decreased risk with reported consumption of bottled water. In a case-control study of spontaneous abortion designed to examine the consistency of prenatal exposure reporting, the association of spontaneous abortion with tap or bottled water consumption was also examined. Cases of spontaneous abortion (N = 100) were ascertained from hospital pathology reports, and pregnant controls (N = 200) were obtained from obstetrical appointment logs. Subjects were first interviewed approximately 24 weeks after their last menstrual period and again approximately 48 weeks after their last menstrual period. Neither an increased risk for spontaneous abortion associated with consumption of tapwater nor a protective effect for consumption of bottled water was observed. Changes in reporting of tapwater consumption from the first to the second interview suggest the possibility of differential reporting in cases and controls. There was no evidence suggesting biased reporting of bottled water consumption.

Abortion, Spontaneous

Thymoma--report of 71 cases and a review.

Of the 71 cases of thymoma reviewed, 31 were benign and 40 were malignant. Associated syndromes were common--myasthenia gravis 51% (36/71), red cell aplasia 3%, hypogammaglobulinemia 4%, mucocutaneous candidiasis 1%, and a number of other autoimmune diseases and neoplasms. These were almost equally distributed among benign and malignant tumors. A plain radiograph showing diffuse involvement of the mediastinum always indicates invasive (malignant) thymoma, while a localized pattern usually suggests a benign lesion (25 of 39 cases). Computerized tomography or MRI often gives additional information. An optimistic approach and aggressive radiotherapy are indicated in patients whose only metastatic disease is to one pleural space; prolonged survival is frequent in this group.

Adolescent

Bronchioloalveolar carcinoma.

It is helpful to consider BAC as two distinct clinical entities. The solitary or focal form presents as a well circumscribed pulmonary nodule, tends to remain localized with slow growth, and has an excellent prognosis following resection. While it may progress to diffuse disease, this is distinctly unusual and is only supported by Hill's study in the literature. It may metastasize to regional lymph nodes or to distant sites not unlike other carcinomas of the lung, although the incidence of metastatic disease is quite low. The diffuse form of BAC, recognizable as multiple nodules or consolidation, represents an aggressive malignancy with limited survival regardless of intervention.

Adenocarcinoma, Bronchiolo-Alveolar

The role of radiologic screening in lung cancer.

The present available data do not support the routine utilization of chest radiography or sputum cytology for the early detection of lung cancer. While on an individual basis, as part of a general health maintenance consideration, some high risk individuals may benefit from radiologic or cytologic screening, there has been no overall decrease in cancer mortality associated with these screening procedures. The early cases picked up by screening while asymptomatic and often detected by sputum cytology have lead-time bias to account for prolonged survival. Furthermore, many of these asymptomatic lesions are so indolent that they may never come to the patient's attention during his or her lifetime and the patient may die of other causes. There are other cancers, which may be of the same histology, that develop in the interval between even closely applied screening examinations. Patients with these cancers are often symptomatic and the biologic behavior of these lung cancers is so aggressive that, regardless of intervention, the prognosis is miserable. The cooperative studies also show a fairly high miss rate for the diagnosis of lung cancer even in patients who are being heavily screened. The miss rate for the early detection of lung cancer with chest radiography is probably on the order of 30% or more. That is, in at least 30% of cases, the tumor can be identified retrospectively on earlier examination. Nevertheless, in spite of the significant miss rate, those tumors with an indolent biologic behavior can be present for 2, 3, or more years and still remain localized, have a high resectability rate, and carry a prolonged survival prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Cytodiagnosis

Lung cancer in childhood.

A 16-year-old boy had unresolving right lower lobe consolidation due to primary adenocarcinoma of the lung. Lung cancer is rare in children, is usually adenocarcinoma or undifferentiated histology, and frequently presents with advanced disease. It may be confused with atelectasis attributable to a foreign body or bronchial adenoma, plasma cell granuloma, pulmonary sequestration, or chronic infection. We review the clinical features of pediatric lung cancer and differences in lung cancer between children and adults.

Adenocarcinoma

Adverse pregnancy outcomes in relation to water contamination, Santa Clara County, California, 1980-1981.

An epidemiologic study was conducted to investigate a suspected cluster of adverse outcomes of pregnancies conceived in 1980-1981 among women who resided in a census tract in Santa Clara County, California that was thought to be exposed to drinking water from a well contaminated by an organic solvent, trichloroethane. A comparison census tract that received water from a different source was selected on the basis of demographic comparability. The cluster was confirmed; the odds ratio for spontaneous abortion was 2.3 (95% confidence interval (Cl) 1.3-4.2) after adjustment by multiple logistic regression for maternal risk factors, including maternal age, alcohol consumption, smoking, and prior fetal loss. The relative risk for congenital malformations was 3.1 (95% Cl 1.1-10.4). Because of the lack of precise information on the timing and extent of contamination, the pattern of spontaneous abortion rates throughout the study period cannot be used to either support or refute a causal inference.

Abnormalities, Drug-Induced

The diagnosis of pulmonary nodules: comparison between standard and inverse digitized images and conventional chest radiographs.

We compared plain chest radiographs, standard (bones white) digitized images, and inverse-intensity (bones black) images to determine their ability to identify pathologically confirmed malignant pulmonary nodules. The images were digitized by using a photo-optical laser scanner and were displayed on a 1024 x 1024 x 8 bit system capable of operator-controlled magnification (2x or 4x) and nonlinear (logarithmic/exponential) contrast transformation in both standard and inverse-intensity modes. Receiver-operator curve analysis was used to study the detection performance of six observers who viewed 40 images obtained in 15 normal subjects and 25 abnormal subjects. There was no statistically significant difference in the area under the ROC curve between the standard digital images and the plain chest radiographs. However, ROC areas were significantly greater (p less than or equal to .05) for inverse-intensity digital images when compared with either standard-intensity digital images or plain chest radiographs. These results suggest that inverse-intensity images may have some advantages in the detection of pulmonary nodules.

Humans

Pulmonary lymphoproliferative disorders.

Nonlymphomatous pulmonary lymphoproliferative disorders include plasma cell granuloma, Castleman's disease, pseudolymphoma, lymphocytic interstitial pneumonitis, angioimmunoblastic lymphadenopathy, and lymphomatoid granulomatosis. They are thought to represent a hyperplasia of the pulmonary immune system in response to chronic antigenic stimulation. A description of the variable clinical, radiographic, and pathologic features of each entity is presented.

Humans

The alpha-lytic protease gene of Lysobacter enzymogenes. The nucleotide sequence predicts a large prepro-peptide with homology to pro-peptides of other chymotrypsin-like enzymes.

alpha-Lytic protease is a 19.8-kDa protein secreted from the Gram-negative bacterium Lysobacter enzymogenes. We have cloned and sequenced the gene for this serine protease. The nucleotide sequence contains an open reading frame which codes for the 198-residue mature enzyme and a potential prepro-peptide, also of 198 residues. The COOH-terminal 49 residues of the pro-peptide are significantly homologous to the propeptides of Streptomyces griseus proteases A and B. We suggest that this pro-peptide region facilitates formation of the active enzyme. A region bridging the NH2-terminal pre- and pro-peptides is homologous to a maize inhibitor of serine proteases. We speculate that this region inhibits enzymatic activity of the prepro-enzyme.

Amino Acid Sequence

Selenium and human health implications in California's San Joaquin Valley.

An evaluation was conducted on the human health impacts of elevated levels of selenium in the Kesterson National Wildlife Refuge and its surroundings in Merced County, California. Investigative activities of various agencies were summarized and assessed. Agricultural waste water not intended for human use showed elevated selenium concentrations of up to 1400 ppb. Levels of selenium in fish (up to 96 ppm, wet weight), aquatic birds (up to 130 ppm in liver, dry weight), and waterfowl (up to 5.3 ppm flesh, wet weight) were unsafe for unrestricted human consumption. Data on selenium in drinking water (less than 10 ppb), animals (mean values: beef liver 0.3-0.35 ppm, wet weight; milk, 0.01-0.02 ppm), and air (particulate, 14.8 ng/m3; gaseous, less than 1080 ng/m3) did not suggest a high level of exposure. Selenium concentrations in soil were highly variable and suggested a potential source of high exposure. Selenium values in blood and urine of workers were within normal range. A community health survey did not show any trend of adverse health effects in the local population.

Animals

Chronic traumatic diaphragmatic hernia: the significance of pleural effusion.

Five patients with chronic traumatic diaphragmatic hernia presented with symptoms of acute intestinal obstruction and unilateral pleural effusion. In each case, infarcted herniated abdominal structures were found at surgery. The presence of an ipsilateral pleural effusion is an important radiographic sign, which may indicate strangulation in patients with chronic traumatic diaphragmatic hernia.

Adult

Clinical evaluation of a medical image management system for chest images.

The clinical efficacy and physicians' assessment of a medical image management system (MIMS) for chest images that involved the medical intensive care unit (MICU) and the radiology department were evaluated. A token-passing fiber-optic network was implemented to connect display stations in the MICU and in the chest reading area in the radiology department with a laser film digitizer and an archiving system. To study the clinical efficacy of this system, blocks of 8 weeks during which portable chest images were digitized and immediately made available in the MICU were alternated with blocks of 8 weeks during which film images only were available. Approximately 3000 portable chest examinations were tracked; patients were entered into the study at a rate of 65 per month. Data on time intervals associated with the examination process were collected from MICU physicians, radiologists, radiographers, and film librarians. The time from the completion of an examination to the time an action was taken that was based on radiographic findings showed significant reductions during the digital periods for certain actions. For example, the time to begin drug therapy decreased from a mean of 4.7 hr when films were viewed to a mean of 3.3 hr when digital images were viewed. In conclusion, if prompt action by the MICU physician improves a patient's outcome, a positive effect on patient care will result from the immediate availability of radiographic images.

Computer Systems