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D Needham

Publications and source records attributed to D Needham.

At least 37 records · Page 2Linked to original sources
PubMed1998

Focus groups reveal perils and promises of managed care for nurse practitioners.

Decades of practice and research suggest that nurse practitioners (NPs) provide cost-effective and high-quality care. Managed care's emphasis on prevention and cost savings led some policy makers to view NPs as a way to meet the need for primary care providers. However, access to and utilization of NPs has increasingly been controlled by managed care organizations (MCOs) through their selection of providers for primary care panels. This study employed qualitative methodology to examine NPs' experiences with MCOs. Three focus groups, comprising 27 NPs in New York and Connecticut, revealed NPs' mixed reactions to managed care and a range of sentiments regarding NPs' efforts to be listed as primary care providers. The results reflected NPs' concerns about their perceived "invisibility," as well as their sense of "invincibility" in the ways in which NPs are responding to the barriers posed by MCOs. They identified barriers to, as well as ways to facilitate, being listed by MCOs, and described the importance of NPs working individually and collectively in negotiating with MCOs.

Connecticut↗
PubMed1997

Africa's emerging AIDS-orphans crisis.

Although AIDS has had a huge impact around the world, nowhere has its effect been greater than in Africa. In Zambia alone the disease is expected to create 500,000 orphans by the turn of the century. In this article Dr. Rachel Baggaley and Dale Needham examine the huge social problems AIDS is creating in some of the world's poorest countries.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Exchange of monooleoylphosphatidylcholine as monomer and micelle with membranes containing poly(ethylene glycol)-lipid.

Surface-grafted polymers, such as poly(ethylene glycol) (PEG), provide an effective steric barrier against surface-surface and surface-macromolecule interactions. In the present work, we have studied the exchange of monooleoylphosphatidylcholine (MOPC) with vesicle membranes containing 750 mol wt surface-grafted PEG (incorporated as PEG-lipid) from 0 to 20 mol % and have analyzed the experimental results in terms of thermodynamic and stationary equilibrium models. Micropipette manipulation was used to expose a single lipid vesicle to a flow of MOPC solution (0.025 microM to 500 microM). MOPC uptake was measured by a direct measure of the vesicle area change. The presence of PEG(750) lipid in the vesicle membrane inhibited the partitioning of MOPC micelles (and to some extent microaggregates) into the membrane, while even up to 20 mol % PEG-lipid, it did not affect the exchange of MOPC monomers both into and out of the membrane. The experimental data and theoretical models show that grafted PEG acts as a very effective molecular scale "filter" and prevents micelle-membrane contact, substantially decreasing the apparent rate and amount of MOPC taken up by the membrane, thereby stabilizing the membrane in a solution of MOPC that would otherwise dissolve it.

Kinetics↗
PubMed1996

Visit to Zambia offers humbling reminder of privileges Canadians enjoy.

McMaster University medical student Dale Needham is spending 6 months in Zambia, where he is focusing on HIV/AIDS research. He describes the home environment of two of his Zambian colleagues, who recently travelled to Vancouver to attend the XI International AIDS Conference.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Biomembrane templates for nanoscale conduits and networks.

Long nanotubes of fluid-lipid bilayers can be used to create templates for photochemical polymerization into solid-phase conduits and networks. Each nanotube is pulled from a micropipette-held feeder vesicle by mechanical retraction of the vesicle after molecular bonding to a rigid substrate. The caliber of the tube is controlled precisely in a range from 20 to 200 nanometers merely by setting the suction pressure in the micropipette. Branched conduits can be formed by coalescing separate nanotubes drawn serially from the feeder vesicle surface. Single nanotubes and nanotube junctions can be linked together between bonding sites on a surface to create a functionalized network. After assembly, the templates can be stabilized by photoinitiated radical cross-linking of macromonomers contained in the aqueous solution confined by the lipid bilayer boundary.

Biophysical Phenomena↗
PubMed1996

The reality of despair: AIDS in Malawi.

While completing a recent medical elective in the Central African country of Malawi, medical student Dale Needham learned firsthand that HIV/AIDS represents a true pandemic in Africa. By the end of 1993, Malawi had the continent's highest per capita number of cumulative reported AIDS cases. Although Canadian physicians have had their own struggles helping patients with HIV/AIDS, many more battles are being fought in countries like Malawi, where financial resources are limited. In Africa, HIV-positive people of all ages suffer incredibly from diseases such as protein energy malnutrition, tuberculosis and cryptococcal meningitis. Primary health care programs, education in the primary schools and community awareness and support are partial answers to the pandemic.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Avidin-biotin interactions at vesicle surfaces: adsorption and binding, cross-bridge formation, and lateral interactions.

Densely packed domains of membrane proteins are important structures in cellular processes that involve ligand-receptor binding, receptor-mediated adhesion, and macromolecule aggregation. We have used the biotin-avidin interaction at lipid vesicle surfaces to mimic these processes, including the influence of a surface grafted polymer, polyethyleneglycol (PEG). Single vesicles were manipulated by micropipette in solutions of fluorescently labeled avidin to measure the rate and give an estimate of the amount of avidin binding to a biotinylated vesicle as a function of surface biotin concentration and surface-grafted PEG as PEG-lipid. The rate of avidin adsorption was found to be four times less with 2 mol% PEG750 than for the unmodified surface, and 10 mol% PEG completely inhibited binding of avidin to biotin for a 2-min incubation. Using two micropipettes, an avidin-coated vesicle was presented to a biotinylated vesicle. In this vesicle-vesicle adhesion test, the accumulation of avidin in the contact zone was observed, again by using fluorescent avidin. More importantly, by controlling the vesicle membrane tension, this adhesion test provided a direct measure of the spreading pressure of the biotin-avidin-biotin cross-bridges confined in the contact zone. Assuming ideality, this spreading pressure gives the concentration of avidin cross-bridges in the contact zone. The rate of cross-bridge accumulation was consistent with the diffusion of the lipid-linked "receptors" into the contact zone. Once adherent, the membranes failed in tension before they could be peeled apart. PEG750 did not influence the mechanical equilibrium because it was not compressed in the contact zone, but it did perform an important function by eliminating all nonspecific adhesion. This vesicle-vesicle adhesion experiment, with a lower tension limit of 0.01 dyn/cm, now provides a new and useful method with which to measure the spreading pressures and therefore colligative properties of a range of membrane-bound macromolecules.

Adsorption↗
PubMed1995

Experimental tests for protrusion and undulation pressures in phospholipid bilayers.

Theoretical treatments predict that strong entropic pressures between adjacent bilayer membranes can arise from out of plane motions caused by either thermally induced bending undulations of the entire bilayer [Harbich, W., & Helfrich, W. (1984) Chem. Phys. Lipids 36, 39-63; Evans, E. A., & Parsegian, V. A. (1986) Proc. Natl. Acad. Sci. U.S.A. 83, 7132-7136] or protrusions of individual lipid molecules from the bilayer surface [Israelachvili, J. N., & Wennerström, H. (1992) J. Phys. Chem. 96, 520-531]. To determine the relative contributions of these motions to the repulsive pressure between phospholipid bilayers, the osmotic stress/X-ray diffraction method was used to measure the range and magnitude of the total repulsive pressure, and micropipet methods were used to measure the bending moduli of phosphatidylcholine bilayers containing lysophosphatidylcholine and polyunsaturated diarachidonoylphosphatidylcholine (DAPC) bilayers. In the gel phase, incorporation of equimolar lysophosphatidylcholine into phosphatidylcholine bilayers caused the hydrocarbon chains from apposing monolayers to interdigitate, but did not appreciably change the equilibrium fluid spacing in excess buffer from its control value of 12 A. In contrast, the incorporation of equimolar lysophosphatidylcholine into liquid-crystalline phase phosphatidylcholine bilayers markedly increased the range of the repulsive pressure so that equilibrium fluid separation increased from 15 to 28 A, and also decreased the bilayer bending modulus from 5.1 x 10(-13) to 1.3 x 10(-13) erg. Liquid-crystalline DAPC bilayers had intermediate values of both equilibrium fluid separation (20 A) and bending modulus (2.8 x 10(-13) erg). Analysis of these data indicates that (1) the relative importance of entropic pressures compared to the hydration pressure depends strongly on the composition and structure of the bilayer, (2) the protrusion pressure may contribute to the total repulsive pressure at large pressures or small fluid spacings, and (3) the repulsive undulation pressure, together with the attractive van der Waals pressure, is a primary factor in determining the fluid spacing at low and/or zero applied pressures in liquid-crystalline bilayers.

Electrons↗
PubMed1995

Range and magnitude of the steric pressure between bilayers containing phospholipids with covalently attached poly(ethylene glycol).

The interactive properties of liposomes containing phospholipids with covalently attached poly(ethylene glycol) (PEG-lipids) are of interest because such liposomes are being developed as drug delivery vehicles and also are ideal model systems for measuring the properties of surface-grafted polymers. For bilayers containing PEG-lipids with PEG molecular weights of 350, 750, 2000, and 5000, pressure-distance relations have been measured by X-ray diffraction analysis of liposomes subjected to known applied osmotic pressures. The distance between apposing bilayers decreased monotonically with increasing applied pressure for each concentration of a given PEG-lipid. Although for bilayers containing PEG-350 and PEG-750 the contribution of electrostatic repulsion to interbilayer interactions was significant, for bilayers containing PEG-2000 and PEG-5000 the major repulsive pressure between bilayers was a steric pressure due to the attached PEG. The range and magnitude of this steric pressure increased both with increasing PEG-lipid concentration and PEG size, and the extension length of the PEG from the bilayer surface at maximum PEG-lipid concentration depended strongly on the size of the PEG, being less than 35 A for PEG-750, and about 65 A for PEG-2000 and 115 A for PEG-5000. The measured pressure-distance relations have been modeled in terms of current theories (deGennes, 1987; Milner et al., 1988b) for the steric pressure produced by surface-grafted polymers, as modified by us to take into account the effects of polymer polydispersity and the possibility that, at low grafting densities, polymers from apposing bilayers surfaces can interpenetrate or interdigitate. No one theoretical scheme is sufficient to account for all the experimental results. However, for a given pressure regime, PEG-lipid size, and PEG-lipid surface density, the appropriately modified theoretical treatment gives a reasonable fit to the pressure-distance data.

Kinetics↗
PubMed1994

Role of the membrane cortex in neutrophil deformation in small pipets.

The simplest model for a neutrophil in its "passive" state views the cell as consisting of a liquid-like cytoplasmic region surrounded by a membrane. The cell surface is in a state of isotropic contraction, which causes the cell to assume a spherical shape. This contraction is characterized by the cortical tension. The cortical tension shows a weak area dilation dependence, and it determines the elastic properties of the cell for small curvature deformations. At high curvature deformations in small pipets (with internal radii less than 1 micron), the measured critical suction pressure for cell flow into the pipet is larger than its estimate from the law of Laplace. A model is proposed where the region consisting of the cytoplasm membrane and the underlying cortex (having a finite thickness) is introduced at the cell surface. The mechanical properties of this region are characterized by the apparent cortical tension (defined as a free contraction energy per unit area) and the apparent bending modulus (introduced as a bending free energy per unit area) of its middle plane. The model predicts that for small curvature deformations (in pipets having radii larger than 1.2 microns) the role of the cortical thickness and the resistance for bending of the membrane-cortex complex is negligible. For high curvature deformations, they lead to elevated suction pressures above the values predicted from the law of Laplace. The existence of elevated suction pressures for pipets with radii from 1 micron down to 0.24 micron is found experimentally. The measured excess suction pressures cannot be explained only by the modified law of Laplace (for a cortex with finite thickness and negligible bending resistance), because it predicts unacceptable high cortical thicknesses (from 0.3 to 0.7 micron). It is concluded that the membrane-cortex complex has an apparent bending modulus from 1 x 10(-18) to 2 x 10(-18) J for a cortex with a thickness from 0.1 micron down to values much smaller than the radius of the smallest pipet (0.24 micron) used in this study.

Adult↗
PubMed1994

A novel micropipet method for measuring the bending modulus of vesicle membranes.

A theoretical model and an experiment are presented for determining the bending modulus of a bilayer vesicle membrane. The vesicle is held with a pipet having a radius between 1 and 2 microns, and the tension in the membrane is changed by changing the suction pressure. Then the vesicle membrane is deformed by aspirating it into a smaller pipet having a radius on the order of 0.5 microns. The relationship between the suction pressures in the two pipets is found to be linear, as predicted by the theoretical model. The curvature of the vesicle membrane at the pipet orifice and the bending modulus are found with the help of the model from the slope and the intercept of the linear experimental relationship between the suction pressures in the two pipets. The bending modulus for the two SOPC membranes studied in these experiments was found to be either 0.6 or 1.15 x 10(-19) J, which is similar to the values measured previously.

Elasticity↗
PubMed1994

Increased adhesion between neutral lipid bilayers: interbilayer bridges formed by tannic acid.

Tannic acid (TA) is a naturally occurring polyphenolic compound that aggregates membranes and neutral phosolipid vesicles and precipitates many proteins. This study analyzes TA binding to lipid membranes and the ensuing aggregation. The optical density of dispersions of phosphatidylcholine (PC) vesicles increased upon the addition of TA and electron micrographs showed that TA caused the vesicles to aggregate and form stacks of tightly packed disks. Solution calorimetry showed that TA bound to PC bilayers with a molar binding enthalpy of -8.3 kcal/mol and zeta potential measurements revealed that TA imparted a small negative charge to PC vesicles. Monolayer studies showed that TA bound to PC with a dissociation constant of 1.5 microM and reduced the dipole potential by up to 250 mV. Both the increase in optical density and decrease in dipole potential produced by TA could be reversed by the addition of polyvinylpyrrolidone, a compound that chelates TA by providing H-bond acceptor groups. NMR, micropipette aspiration, and x-ray diffraction experiments showed that TA incorporated into liquid crystalline PC membranes, increasing the area per lipid molecule and decreasing the bilayer thickness by 2 to 4%. 2H-NMR quadrupole splitting measurements also showed that TA associated with a PC molecule for times much less than 10(-4) s. In gel phase bilayers, TA caused the hydrocarbon chains from apposing monolayers to fully interdigitate. X-ray diffraction measurements of both gel and liquid crystalline dispersions showed that TA, at a critical concentration of about 1 mM, reduced the fluid spacing between adjacent bilayers by 8-10 A. These data place severe constraints on how TA can pack between adjacent bilayers and cause vesicles to adhere. We conclude that TA promotes vesicle aggregation by reducing the fluid spacing between bilayers by the formation of transient interbilayer bridges by inserting its digallic acid residues into the interfacial regions of adjacent bilayers and spanning the interbilayer space.

Adsorption↗
PubMed1993

Increased microvascular permeability contributes to preferential accumulation of Stealth liposomes in tumor tissue.

Stealth liposomes have recently emerged as a promising antitumor drug delivery system, yet no studies have been reported to examine their dynamic behavior at the microcirculatory level. In this investigation, we have used in vivo fluorescence videomicroscopy to study the decay in plasma concentration and the interstitial accumulation of Stealth and conventional liposomes in tumor and granulating tissue microcirculatory preparations. Fluorescently labeled Stealth or conventional liposomes were injected i.v. into rats bearing dorsal skinflap window chambers, some of which contained a vascularized mammary adenocarcinoma. After injection, fluorescent light intensities arising from liposomes within blood vessels and the interstitium were measured over time. These measurements were used to derive plasma pharmacokinetics and vascular permeability coefficients for each liposome species in both tumor and granulating normal tissues. Within the first 90 min after injection, Stealth liposome accumulation in the tumor interstitium was 3-4-fold that for conventional liposomes. The percentage of administered liposomes remaining in the circulation at the end of 90 min was 60.2% for Stealth and 20.4% for conventional liposomes. Tumor vascular permeability was 3.42 +/- 0.78 x 10(-7)cm/s for Stealth and 1.75 x 0.38 x 10(-7)cm/s for conventional liposomes. In normal granulating tissues permeability for the 2 constructs was equivalent at 0.8-0.9 x 10(-7)cm/s. In conclusion, preferential accumulation of Stealth liposomes in tumors was attributable to a combination of slower plasma clearance and higher vascular permeability relative to conventional liposomes. Our method of combining in vivo microscopy with a tumor microcirculatory model provides a unique approach to study quantitatively the delivery of liposomes to tumor tissues, since it can be used to study the process in real time at the microcirculatory level.

Animals↗
PubMed1993

Volume and osmotic properties of human neutrophils.

Quantitative models describing the dynamics of human neutrophils in the microcirculation require accurate morphometric parameters such as volume and surface membrane area. Using both a micropipette technique and video light microscopy (LM) to measure the diameters of the spherical cells, we have accurately determined the volume of the human neutrophil. Our value, 299 +/- 32 microns 3, is in good agreement with our earlier results, but 55% larger than that reported by Schmid-Schönbein et al (Blood 56:866, 1980). However, the measurements of Schmid-Schönbein et al were based on the actual mass of the cells derived from transmission electron microscopic (TEM) images. The membrane surface area, at lysis, was calculated to be 2.6 times its initial projected area. After lysis, the cells do not reduce their size, indicative of the possibility of a F-actin network formation that would stiffen the structure. Further, we show that neutrophils behave as ideal osmometers when exposed to anisotonic solutions at 21 degrees C, as predicted by the Boyle-Van't Hoff relationship. The calculated Ponder's value, R, is 0.77, which corresponds to 77% of the cell volume being osmotically active under isotonic conditions. However, at 37 degrees C, the cells are able to regulate their volumes toward the original volumes after an osmotic stress.

Humans↗
PubMed1993

Tension-stabilized pores in giant vesicles: determination of pore size and pore line tension.

We present the first observations of giant, long-existing, stabilized pores in vesicle membranes. Using a new experimental technique for studying the electro-permeabilization of lipid membranes, giant liposomes (from 25 to 56 microns in diameter) were subjected to single, square, electric pulses (duration 150 microseconds and electric field strength from 63 to 126 kV/m). The liposomes were held by a micropipet and small membrane tensions were created by controlling the pipet suction pressure. The liposomes were loaded with media having different refractive index from the outside solution, and, under these conditions, the formation of pores in the pressurized liposome could be visualized by the jet of inside solution that flowed out from the membrane pore. By adjusting the membrane tension, pores were kept open, and pore lifetimes could be varied from tenths of a second to several seconds. The pore size was determined from the volumetric flow in the pore region and the measured pressure differences across the bilayer. It was clear from the experiments that only one pore remained opened after the pulse. The estimated pore radii were on the order of one micrometer. The pores were in a quasi-stationary state and when they closed they did so spontaneously in a quick process (in milliseconds). The isotropic membrane tension was determined for the same measurements and from determinations of both pore size and dynamic membrane tension the pore line tension was found. The line tension of the pore region was determined for two lipid compositions, stearoyl-oleoylphosphatidylcholine and stearoyl-oleoylphosphatidylcholine with 50 mol% cholesterol, and the obtained values for single bilayers were (0.92 +/- 0.07) x 10(-11) N and (3.05 +/- 0.12) x 10(-11) N, respectively.

Cell Membrane Permeability↗
PubMed1993

Measurement of material extravasation in microvascular networks using fluorescence video-microscopy.

We have developed a new method using fluorescence videomicroscopy to quantitate the extravasation of intravenously injected materials. This method can measure the relative plasma concentration of, and the vascular permeability to, these materials in microcirculatory preparations which contain multiple blood vessels in a field of view. The image of a tissue area containing multiple blood vessels is recorded via a SIT camera immediately before, and for an extended period after, the intravenous injection of a bolus of fluorescent test tracers. The videotape is analyzed off-line. At various time points, the light intensities of the entire tissue area and of several spots over selected vessels are measured. These measurements are then used to calculate the fluorescent light intensities arising from the tracers inside vessels (Iv) and in the interstitial region (Ii). Iv represents the relative amount of the tracers in the plasma, and Ii represents that in the interstitium. Iv and Ii are used to calculate an average permeability (P) for the vessels in the observed region. The benefit of this method is that it can be used to compare permeability of various tissues of interest or to serially evaluate changes in P in the same tissue over time. In this study, it was applied to measuring P to albumin as well as to liposomes in granulating and implanted tumor tissues in a rat skin flap window chamber. Changes in permeability to a small molecule (sulforhodamine B) before and during bradykinin application were also measured. The results of these experiments indicate that the relative plasma concentrations predicted by this method conformed well to those measured directly from blood samples, and the measured permeability values were consistent with previously published data. Therefore, this method provides a valid approach for quantitatively measuring the extravasation of intravenously injected molecular and colloidal materials in microcirculatory preparations. The method has a set of defined experimental conditions and assumptions that cannot be violated, however, or erroneous results can be obtained.

Animals↗