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Biomedical subjects

D Nelson

Publications and source records attributed to D Nelson.

At least 37 records · Page 2Linked to original sources

Neuronal metabolism of branched-chain amino acids: flux through the aminotransferase pathway in synaptosomes.

The metabolism of branched-chain amino acids (BCAAs) was studied in cortical synaptosomes. With [15N]leucine (1 mM) as precursor, the cumulative appearance of 15N in [15N]glutamate and [15N]aspartate was 0.2 nmol/min/mg of protein without supplemental alpha-ketoglutarate and 0.3 nmol/min/mg of protein in the presence of alpha-ketoglutarate (0.5 mM). The BCAA amino-transferase reaction also proceeded in the "reverse" direction [alpha-ketoisocaproate (KIC) + glutamate-->leucine + alpha-ketoglutarate]. This was documented by incubating synaptosomes with [15N]glutamate and measuring the formation of [15N]leucine. Without KIC in the medium, the rate of [15N]leucine production was 0.13 nmol/min/mg of protein. In the presence of 25 microM KIC the rate was 0.79 nmol/min/mg of protein and even greater (1.0 nmol/ min/mg of protein) in the presence of 500 microM KIC. The reamination of KIC was two- to threefold faster with [2-15N]glutamine as precursor compared with [15N]-glutamate. The ketoacid of valine, alpha-ketoisovalerate (KIV), was reaminated to [15N]valine at a rate comparable to that observed with respect to KIC. The BCAA transaminase mediated not only the bidrectional transfer of amino groups between leucine or valine and glutamate, but also the direct transfer of nitrogen between leucine and valine. This was ascertained in studies in which the incubation medium was supplemented with either [15N]leucine and KIV or [15N]valine and KIC (amino acids at 1 mM and ketoacids at 25 or 500 microM). The rate was faster in the direction of leucine formation at both the lower (6.1-fold) and higher (1.7-fold) KIC concentration. It is suggested that in synaptosomes the BCAA transaminase (a) functions predominantly in the direction of leucine formation and (b) maintains a constant ratio of BCAAs and ketoacids to one other.

Amino Acids, Branched-Chain

Regulation of GABA level in rat brain synaptosomes: fluxes through enzymes of the GABA shunt and effects of glutamate, calcium, and ketone bodies.

Stable isotopes were used to measure both the rate of GABA formation by glutamic acid decarboxylase (GAD) and the rate of utilization by GABA-transaminase (GABA-T). The initial rate of GABA accumulation, determined with either [2-15N]glutamine or [2H5]glutamine as precursor, was 0.3-0.4 nmol/min/mg of protein. Addition of the calcium ionophore A23187 enhanced GAD activity, whereas changes in levels of inorganic phosphate and H+ were without influence. Flux through GABA-T (GABA--> glutamate), measured with [15N]GABA as precursor, was 0.82 nmol/min/mg of protein, whereas the reamination of succinic acid semialdehyde (reverse flux through GABA-T) was almost sixfold faster, 4.8 nmol/min/mg of protein. The rate of GABA metabolism via the tricarboxylic acid cycle was very slow, with the upper limit on flux being 0.03 nmol/min/mg of protein. Addition of either acetoacetate or beta-hydroxybutyrate raised the internal content of glutamate and reduced that of aspartate; the GABA concentration and the rate of its formation increased. It is concluded that in synaptosomes (a) GABA-T is a primary factor in regulating the turnover of GABA, (b) a major regulator of GAD activity is the concentration of internal calcium, (c) GAD in nerve endings may not be saturated with its substrate, glutamate, and the concentration of the latter is a determinant of flux through this pathway, and (d) levels of ketone bodies increase, and maintain at a higher value, the synaptosomal content of GABA, a phenomenon that may contribute to the beneficial effect of a ketogenic diet in the treatment of epilepsy.

4-Aminobutyrate Transaminase

A seasonal staffing model.

The staffing of a nursing unit provides a unique challenge when that unit experiences significant seasonal fluctuations in census. Although overtime, perdiem, or agency personnel are staffing alternatives to meet seasonal fluctuations in census, they are costly alternatives that are not the most efficient use of human resources. The authors present a seasonal staffing model that reallocates employee work hours in a pattern that closely matches the seasonal work load trends of the department.

Cost Savings

Function and medical comorbidity in south Texas nursing home residents: variations by ethnic group.

OBJECTIVE: To evaluate differences in functional status and burdens of medical conditions in Mexican American and non-Hispanic white nursing home residents. DESIGN AND SETTING: Cross-sectional survey of 17 nursing homes in south Texas. PARTICIPANTS: A total of 617 older nursing home residents, of whom 366 were Mexican American and 251 were non-Hispanic white. MEASURES: Activities of Daily Living (ADL) status abstracted from standard nurses notes and Burden of Disease abstracted from medical records. RESULTS: Mexican American residents had greater numbers of ADL dependencies and poorer overall ADL scores than non-Hispanic white residents. This poor functioning was not explained by age, gender, or marital or educational status. The average number of medical conditions was greater, and specific conditions, such as cerebrovascular disease, recent acute infections, diabetes, hypertension, and anemia, were more common in Mexican American residents compared with non-Hispanic white residents. In models relating function with medical conditions and ethnic group, ADL scores and dependencies were significantly related to bowel and bladder incontinence, cerebrovascular disease, dementia, recent infections, and skin decubiti, but not to ethnic group. CONCLUSION: Mexican American nursing home residents are more functionally dependent than non-Hispanic white residents. The difference in function is explained by a greater burden of medical conditions in the Mexican American residents.

Activities of Daily Living

Does storage of sputum specimens adversely affect culture results?

It has been recommended that samples submitted for microbiological examination should be retained for 48 hours after issue of the final report. In order to ascertain whether reproducible results could be achieved following storage of sputum specimens, two laboratories each re-cultured 100 samples 48 hours after their report had been issued and a further laboratory re-cultured 100 samples 48 hours after receipt. Discordant results were obtained in only 5-25% of specimens, indicating that potential respiratory pathogens could survive storage.

Bacteriological Techniques

Synergy between lysosomotropic amines and cyclosporin A on human T cell responses to an exogenous protein antigen, tetanus toxoid.

Previously, it has been shown that the lysosomotropic amine, chloroquine, is effective in the prevention of graft-versus-host disease (GVHD) using murine models. Because chloroquine and hydroxychloroquine suppress MHC class II antigen presentation, their mechanism of action is different to other immune suppressant drugs (cyclosporin A) currently used to control GVHD. It is possible that the use of cyclosporin A and chloroquine in combination may have an additive or synergistic effect on T cell responses to antigens presented in the context of MHC class II. We investigated the effects of chloroquine or hydroxychloroquine in combination with cyclosporin A on human T cell responses in vitro to tetanus toxoid, an exogenous protein antigen dependent on MHC class II presentation for proliferative responses. We demonstrate that similar levels of chloroquine and hydroxychloroquine suppress human T cell responses to tetanus toxoid and that the use of either agent in combination with cyclosporin A results in synergistic suppression. Evaluation for a direct effect by the lysosomotropic amines on T cells, in the absence of antigen presenting cells, revealed that there was inhibition of T cell responses but only at high concentrations. No significant decrease or increase was seen in surface MHC II or invariant chain expression or in cytoplasmic invariant chain after exposure to chloroquine. Thus, lysosomotropic amines in combination with cyclosporin A are synergistic in suppression of T cell proliferation. Use of these agents in combination with cyclosporin A may improve control of graft-versus-host disease.

Adult

Single-word auditory stimulation and regional cerebral blood flow as studied by SPECT.

Single photon emission computed tomography (SPECT) examined changes in regional cerebral blood flow (rCBF) induced by passive auditory single-word stimulation. A split-dose SPECT technique was used between resting and activated states, in which a smaller amount of ligand (99m technetium hexamethyl propyleneamine oxide, HMPAO) was given with the first scan, accompanied by a prolonged scan time. A larger amount of ligand was given with the second scan, accompanied by a shorter scan time. This split-dose SPECT technique has met with previous success for other activation tasks. The brain regions of interest (ROIs) in this study were selected from ROIs previously found to be activated by passive auditory single-word stimulation and not by non-word stimuli in positron emission tomography (PET) rCBF studies. This study thus tested the sensitivity of SPECT with HMPAO to detect brain activation with a stimulus previously demonstrated to elicit changes in rCBF with PET. However, no significant difference was detected between resting and activated states in this study. Thus, SPECT was not as sensitive as PET in this activation task. Since SPECT is a less costly and more widely available modality to study brain activation than PET, it is important to delineate its potential capacities to maximize the efficiency of future research in this field.

Adult

Analysis of sevoflurane degradation products in vapor phase samples.

Sevoflurane degradation products were measured by GC-flame ionization detection in vapor phase samples using manual and automated injection methods. Sample handling techniques allowed the transfer and storage of samples for up to 72 h. Compound A, fluoromethyl 2,2-difluoro-1-(trifluoromethyl)vinyl ether, was the major vapor phase degradation product formed in simulated clinical conditions. Recoveries of 4-32 ppm (v/v) compound A concentrations using the manual method were in the range of 88-117% (n = 12, mean = 102%, R.S.D. = 9%).

Anesthetics

An n-allele model for progressive amplification in the FMR1 locus.

An n-allele model is developed for the FMR1 locus, which causes the fragile X syndrome, where n is the number of triplet repeats in the first exon. Frequencies in the general population and in index families are used to generate an n to n + delta transition matrix that predicts specific risks in satisfactory agreement with observation. However, until sequencing distinguishes between stable and unstable alleles with the same value of n, it is premature to infer whether allelic frequencies at the FMR1 locus are at equilibrium or, as some have suggested, are evolving toward higher frequencies of the pathogenic allele.

Alleles

Monoclonal anti-dipeptide antibodies cross-react with detyrosinated and glutamylated forms of tubulins.

Two monoclonal antibodies, GLU-1 and A1.6, raised against gamma-L-glutamyl-L-glutamic acid dipeptide (Glu-Glu) and Ca(2+)-dependent ATPase from Paramecium, respectively, recognized the dipeptide Glu-Glu sequence. Whereas the antibodies immunofluorescently stained very few, if any, cytoskeletal fibers in cultured mammalian cells, almost all interphase as well as mitotic spindle microtubules became visible after treatment of cells with carboxypeptidase A. Immunoblot analysis demonstrated intense cross-reaction of the antibodies to the alpha-tubulin subunit. alpha-Tubulin isotypes produced as fusion proteins in bacteria were labeled by both the antibodies only when the proteins did not contain a tyrosine residue at the C terminus, indicating that GLU-1 and A1.6 specifically recognize the detyrosinated form of alpha-tubulin. When microtubule protein purified from brain was probed, not only alpha-but also, to a lesser extent, beta-tubulin were revealed by the dipeptide antibodies. A synthetic tripeptide YED containing one glutamyl group linked to the second residue of the peptide via the gamma position was also recognized by the antibodies. Since this peptide sequence corresponds to the amino acid sequence of polyglutamyated class III beta isotype at amino acid position 437 to 439, it is suggested that GLU-1 and A1.6 are able to recognize the glutamylated form of beta-tubulin. These results indicate that the C-terminal Glu-Glu sequence displays strong antigenicity, and the antibodies recognize the sequence present in the C terminus of the detyrosinated form of alpha-tubulin and the glutamyl side chain of beta-tubulin. Particularly strong immunoreaction was detected with ciliary and flagellar microtubules; thus, stable axonemal microtubules appear to be rich in post-translationally modified tubulin subunits.

Animals

Research into research practice.

Since the Briggs report of 1972, the debate over whether nursing is a researched based profession continues. This paper attempts to establish whether research performed by practitioners in their own field is being directly utilised in practice. The paper describes a small scale study of registered nurses (n = 22) who have completed the Professional Studies 2 Accident & Emergency module, focusing on the utilisation of their action research and the factors influencing the outcome of its use. Data was collected by self-report questionnaire. The results of the study indicate that many action research projects are not being formally utilised within the clinical area. The main factor stated is the lack of research culture within units, underpinned by a lack of managerial and peer support for research studies. Despite this, research is being utilised, but only by the individuals who conducted it. The results suggest that greater integration between the college of nursing, management and the student is required to improve research utilisation in the clinical area.

Adult

Student nurses' perceptions of accident and emergency nursing: do they match the reality?

This study explores student nurses' perceptions of, and attitudes to, working in an Accident and Emergency (A & E) department prior to allocation there. An assessment of the students' actual experience within the department was then taken. This allowed the students' perceptions to be compared with the reality of the work. The sample consisted of all students training for part 10 of the register who were allocated to the unit over a 4-week period (n = 22). Data was collected by two self completion questionnaires, one given pre-allocation the second post-allocation, a 100% response rate was achieved for each. The results of the study indicate that students' perceptions of the A & E department do not match the reality of the work involved. These perceptions may cause increased anxiety and apprehension for students before they start in the department and this may hinder clinical learning. The results suggest that appropriate preparation prior to the period of clinical experience may help alleviate these difficulties.

Adult

Metabolic and energetic changes during apoptosis in neural cells.

Changes in cellular energetic and metabolic parameters were analyzed at several time points during apoptosis of differentiated PC12 cells following removal of nerve growth factor (NGF). As approximately 60% of the population died during the period of study (24 h), most of the measured metabolic indicators declined over time. However, this decline paralleled the overall decrease in cellular viability, suggesting that, in individual cells, a compromised metabolic state occurred suddenly and very late in the death process. For example, when expressed as a function of viable cells, protein and RNA synthesis did not decrease until 24 h. Glucose utilization in live cells was never significantly reduced relative to control levels; lactate production decreased slightly within 4-8 h after NGF removal, but eventually rebounded to 122% of control levels by 24 h. ATP levels dropped 27% in an early predeath period, but then returned to near control levels (on a per-live-cell basis) once the population actively began to die. The ATP/ADP ratio remained at least 84% of control throughout. UTP/UDP and GTP/GDP ratios did not change significantly at any time point.

Animals

Effects of NO-generating compounds on synaptosomal energy metabolism.

The effects of nitroprusside and S-nitrosocysteine, compounds that generate nitric oxide (NO), on synaptosomal energy-producing pathways and energy level were investigated. The decrease in respiration was much faster and more pronounced with S-nitrosocysteine than with nitroprusside. S-Nitrosocysteine, at 10 microM, inhibited by 80% respiration with glucose and succinate (plus rotenone) in intact synaptosomes and with ascorbate/cytochrome c in broken preparations. Oxygenated hemoglobin reversed and/or prevented the inhibition, whereas glutathione (GSH) prolonged it. Under aerobic conditions, the synaptosomal energy level (creatine phosphate/creatine and ATP/ADP ratios) was reduced by the presence of S-nitrosocysteine, whereas lactate generation was enhanced. The effects on energy parameters were greater at 5 min than at 15 min of incubation and were more pronounced in the presence of GSH. Under strictly anaerobic conditions, lactate production was reduced by the NO-generating compounds in a concentration-dependent manner. It is concluded that (a) inhibition of oxidative phosphorylation by NO leads to a fall in the synaptosomal energy level, which in turn stimulates glycolysis; (b) glycolysis can be inhibited by higher concentrations of the radical; and (c) inhibitory effects on the energy-generating pathway and ATP level could contribute to NO toxicity under some in vivo situations.

Animals

Overexpression of the human NFM subunit in transgenic mice modifies the level of endogenous NFL and the phosphorylation state of NFH subunits.

Neurofilaments (NFs), the major intermediate filaments of central nervous system (CNS) and peripheral nervous system (PNS) neurons, are heteropolymers formed from the high (NFH), middle (NFM), and low (NFL) molecular weight NF subunits. To gain insights into how the expression of NF subunit proteins is regulated in vivo, two transgenes harboring coding sequences for human NFM (hNFM) with or without the hNFM multiphosphorylation repeat domain were introduced into mice. Expression of both hNFM constructs was driven by the hNFM promoter and resulted in increased levels of hNFM subunits concomitant with an elevation in the levels of mouse NFL (mNFL) proteins in the CNS of both lines of transgenic mice. The increased levels of mNFL appear specific to NFM because previous studies of transgenic mice overexpressing either NFL or NFH did not result in increased expression of either of the other two NF subunits. Further, levels of the most heavily phosphorylated isoforms of mouse NFH (mNFH) were reduced in the brains of these transgenic mice, and electron microscopic studies showed a higher packing density of NFs in large-diameter CNS axons of transgenic versus wild-type mice. Thus, reduced phosphorylation of the mNFH carboxy terminal domain may be a compensatory response of CNS neurons to the increase in NFs, and reduced negative charges on mNFH sidearms may allow axons to accommodate more NFs by increasing their packing density. Taken together, these studies imply that NFM may play a dominant role in the in vivo regulation of the levels of NFL protein, the stoichiometry of NF subunits, and the phosphorylation state of NFH. NFM and NFH proteins may assume similar functions in regulation of NF packing density in vivo.

Aging

Recombinant endotoxin neutralizing protein improves survival from Escherichia coli sepsis in rats.

OBJECTIVE: A recombinant endotoxin neutralizing protein was evaluated for its ability to ameliorate the effects of Escherichia coli sepsis in rats. DESIGN: Prospective, controlled animal trial. SETTING: Hospital animal research laboratory. SUBJECTS: Wistar rats, treated with gentamicin 1 hr after challenge with intraperitoneal E. coli O18ac. INTERVENTIONS: The animals received a recombinant endotoxin neutralizing protein, in doses of 5, 25, or 50 mg/kg, either 30 or 60 mins after challenge; controls received saline. MEASUREMENTS AND MAIN RESULTS: Geometric mean serum endotoxin concentrations in endotoxin neutralizing protein-treated animals did not differ from control animals. Tumor necrosis factor concentrations in animals treated with endotoxin neutralizing protein 30 mins after challenge were significantly lower than controls. Animals treated with 25 or 50 mg/kg of endotoxin neutralizing protein 30 mins after E. coli challenge had significant improvements in survival compared with controls. Animals treated with 50 mg/kg of endotoxin neutralizing protein 60 mins after E. coli challenge had significant improvements in survival compared with controls. CONCLUSION: Endotoxin neutralizing protein significantly reduces mortality from Gram-negative sepsis in an antibiotic-treatment model of E. coli peritonitis and bacteremia in rats, mediated by a neutralization of the biological effects of endotoxin.

Animals