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Biomedical subjects

D Robinson

Publications and source records attributed to D Robinson.

At least 235 records · Page 13Linked to original sources

A monomeric, tightly folded stromal intermediate on the delta pH-dependent thylakoidal protein transport pathway.

Two distinct mechanisms have been previously identified for the transport of proteins across the chloroplast thylakoid membrane, one of which is unusual in that neither soluble factors nor ATP are required; the system requires only the transthylakoidal delta pH. We have examined this mechanism by studying the properties of one of its substrates: the extrinsic 23-kDa protein (23K) of photosystem II. Previous work has shown that this protein can be transported into isolated thylakoids as the full-length precursor protein; we show that the stromal import intermediate form of this protein is similarly translocation-competent. Gel filtration tests indicate that the stromal intermediate is probably monomeric. Protease sensitivity tests on both the initial in vitro translation product and the stromal import intermediate show that the presequence is highly susceptible to digestion whereas the mature protein is resistant to high concentrations of trypsin. The mature protein becomes very sensitive to digestion if unfolded in urea, or after heating, and we therefore propose that the natural substrate for this translocation system consists of a relatively unfolded presequence together with a tightly folded passenger protein. The ability of thylakoids to import pre-23K is destroyed by prior treatment of the thylakoids with low concentrations of trypsin, demonstrating the involvement of surface-exposed proteins in the import process. However, we can find no evidence for the binding of pre-23K or i23K to the thylakoid surface, and we therefore propose that the initial interaction of these substrates with the thylakoidal translocase is weak, reversible, and probably delta pH-independent. In the second phase of the translocation mechanism, the delta pH drives either the translocation and unfolding of proteins, or the translocation of a fully folded protein.

Bacterial Proteins↗

Reduced caudate nucleus volume in obsessive-compulsive disorder.

BACKGROUND: Current hypotheses about the neuroanatomical structures involved in obsessive-compulsive disorder (OCD) suggest abnormalities in cortical-striatal-thalamic-cortical circuits. This study examined selected brain regions within or adjacent to these circuits. METHODS: Magnetic resonance imaging scans from 26 patients with OCD and 26 healthy controls were analyzed to determine the volumes of the following structures: prefrontal cortex (cortex anterior to the genu of the corpus callosum), caudate nucleus, lateral and third ventricles, and whole brain. RESULTS: Patients with OCD had significantly smaller caudate nucleus volumes than controls (F[1,48] = 9.4, P = .004) but did not differ in prefrontal cortex size or in volumes of the lateral or third ventricles. Structural volumes were not significantly correlated with the duration or severity of OCD symptoms. CONCLUSION: Our findings provide additional evidence for pathological involvement of the caudate in OCD.

Adolescent↗

Safety, tolerance, and preliminary pharmacokinetics of nefazodone after administration of single and multiple oral doses to healthy adult male volunteers: a double-blind, phase I study.

Safety, tolerance, and preliminary pharmacokinetics of nefazodone, a new antidepressant, were assessed in a randomized, double-blind, parallel group study carried out in two sequential segments: a single and a multiple daily dose segment. Nine subjects in the single daily dose segment were divided into three treatment groups and received nefazodone doses in a leapfrog fashion. Each day of treatment with nefazodone was followed by 2 days of placebo treatment and then administration of the next higher drug dose. Single doses ranged from 5-500 mg. 8 subjects enrolled in the multiple daily dose segment were divided into two treatment groups. In each group, 3 subjects received nefazodone and one received placebo 3 times a day. Each dosage level was administered for 2 days before proceeding to the next higher dose from 5 mg or 10 mg 3 times a day to a maximum of 500 mg 3 times a day. After the dose-escalation period, the subjects in the multiple daily dose segment underwent a 3-day washout, after which they received a single dose of nefazodone at the maximum tolerated level. Safety and tolerance assessment involved analyses of adverse events, laboratory tests, vital signs, ophthalmic examinations, and ECGs. Blood and urine samples were obtained only in the multiple daily dose segment and analyzed for nefazodone and its two pharmacologically active metabolites, hydroxynefazodone and mCPP. A single blood sample was collected on 8 different days for assessment of trough levels (Cmin) and serial samples were obtained on days 5, 9, and 22 of dosing for pharmacokinetic profiles. Additional serial samples were also obtained after the last single dose of 500 mg after a 3-day washout. Nefazodone was found to be safe and well-tolerated in total daily doses as high as 1350 mg (450 mg 3 times a day). Nefazodone was rapidly absorbed after oral administration and converted to hydroxynefazodone and mCPP. The pharmacokinetics of nefazodone, hydroxynefazodone, and mCPP were found to be dose-dependent, as evidenced by dose normalized values of Cmin, Cmax, and AUC0-8 that progressively increased with dose. Although exposure of normal subjects to nefazodone and its 2 pharmacologically active metabolites was disproportionately higher than the corresponding increase in dose, the safety and tolerance profiles did not show a parallel increase in adverse events. Nefazodone may be well-tolerated by patients receiving expected therapeutic doses from 200-600 mg per day when administered in divided doses every 8 to 12 hours.

Administration, Oral↗

Osteogenic growth peptide regulates proliferation and osteogenic maturation of human and rabbit bone marrow stromal cells.

The recently discovered osteogenic growth peptide (OGP) has been shown to regulate proliferation in fibroblastic and osteoblastic cell lines derived from rats and mice and also alkaline phosphatase activity in the latter was found to be affected. In vivo the OGP enhances bone formation and trabecular bone density. The results of the current study indicate that the OGP is also a potent regulator of marrow stromal cells from man and rabbit, as well as rabbit muscle fibroblasts. The main OGP activity in both marrow systems is a marked stimulation of alkaline phosphatase activity and matrix mineralization. In the rabbit-derived cell culture this enhancement is accompanied by a reciprocal inhibition of proliferation. On the other hand, the human cells show a concomitant increase of both parameters. The proliferative effect of the OGP is similar to that of growth hormone (GH) and basic fibroblast growth factor (bFGF). The combined activity of the OGP with GH is smaller than that of each of the polypeptides alone. The OGP and bFGF potentiate each other. Of the three polypeptides tested, OGP is the most potent enhancer of alkaline phosphatase activity and mineralization. bFGF has no influence on these characteristics of osteogenic maturation. The OGP maturational activity is unaffected by either GH or bFGF. These data suggest that the marrow stromal cells serve as targets for the OGP that mediate the OGP-induced increase in osteogenesis. The effect on the human cells implies a role for the OGP in clinical situations where the osteogenic potential of bone marrow is involved.

Alkaline Phosphatase↗

Scoliosis and lung function in spinal muscular atrophy.

The notes and radiographs of 43 patients with a confirmed diagnosis of spinal muscular atrophy were reviewed. A significant inverse linear relationship between the severity of scoliosis and the percentage of predicted vital capacity and peak flow was found. The patients who stood had a significantly better lung function than patients who were confined to a wheelchair, and their scoliosis deteriorated significantly more slowly. Sixteen patients underwent surgical spinal stabilisation, 4 with Harrington instrumentation and 12 with segmental spinal instrumentation, at an average age of 12 years and 11 months. The average curve correction achieved was 40%. The decline in lung function seen pre-operatively was not only reversed, but a significant improvement was found at final follow-up.

Adolescent↗

Typhoid fever in the park: epidemiology of an outbreak at a cultural interface.

The number of reported outbreaks of typhoid fever in the United States has recently increased. Only six were reported from 1980-1989, but seven outbreaks were reported in 1990. In August 1990, health officials in Montgomery County, Maryland, were notified of two cases of typhoid fever among persons who had attended both a family picnic attended by 60 persons and a Latin Food Festival attended by 100,000 people. We obtained interviews, blood and stool cultures, and Vi serologies from attendees at and food handlers for the picnic. We defined cases as culture-confirmed or probable. Of the 60 picnic attendees, 24 (40%) had cases, of which 16 were culture confirmed. Those who ate potato salad were at increased risk of disease (17/32 vs. 6/28, relative risk [RR] = 2.5, 95% confidence interval [CI] 1.1-5.4). Picnic attendees who also attended the Latin Food Festival were not at significantly greater risk of disease than those who did not, (11/22 vs. 13/38, RR = 1.5, CI = 0.8-2.7) and we found no evidence of disease among other festival attendees. The potato salad was prepared with intensive handling and without adequate temperature control by a recent immigrant from El Salvador who was asymptomatic, did not attend the picnic, had Salmonella typhi (S. typhi) in her stool, and had elevated Vi antibodies, strongly suggestive of the carrier state. Outbreaks of typhoid fever are a threat for cosmopolitan communities. While currently available control measures are unlikely to prevent all outbreaks, thorough investigation can identify previously unrecognized carriers.

Adolescent↗

Phase II trial of recombinant interferon-alpha with BCNU, cisplatin, DTIC and tamoxifen in advanced malignant melanoma.

Since cytotoxic chemotherapy (BCNU, DTIC and cisplatin, tamoxifen) and interferon-alpha (IFN-alpha) have each produced responses in advanced malignant melanoma, a phase II trial was conducted to evaluate the response and toxicity of simultaneous administration of both therapies. Of 33 assessable patients, two (6%) had complete response (CR) and 12 patients (36%) had partial response (PR), for a total response rate (CR+PR) of 42% (95% confidence interval 26-58). Four patients had minor response (12%). Mixed responses occurred in five patients (15%). The remaining patients had progressive disease. The duration of CR was 3, 7 and 17 (+) months and the duration of PR was 3+ to 19+ months (median 6 months). The median overall survival for all patients entered into the study was 5 months. Main toxicities included myelosuppression and fatigue. Combined simultaneous cytotoxic chemotherapy and IFN produced a high response rate (42%) which is comparable to that reported for chemotherapy alone. Further studies are needed to determine the optimal schedule for combining chemotherapy and immunotherapeutic agents as well as the impact of biological agents on survival in the treatment of melanoma.

Adult↗

Periurethral collagen injections for genuine stress incontinence: a 2-year follow-up.

OBJECTIVE: To assess the short- and medium-term efficacy of periurethral collagen injection in women with urethral sphincter incompetence and to determine if urodynamic variables can elucidate the mechanism of action. PATIENTS AND METHODS: Sixty women (mean age 64 years, range 20-90) with genuine stress incontinence received periurethral collagen injections under local anaesthesia; 55 had undergone previous continence surgery. A total of three injection sessions were allowed. Subjective and urodynamic assessments were obtained at 1, 3, 6, 12 and 24 months after injection to evaluate success and long-term effects of collagen. RESULTS: Subjective success rates were 86% at 3 months, 77% at 12 months and 68% at 24 months. Objective cure rates were 61% at 3 months, 54% at 12 months and 48% at 24 months. Low urethral pressures and decreased bladder neck mobility did not affect the outcome. Collagen injections significantly increased stress maximum urethral closure pressures and functional urethral length; increase in the latter and clinical assessment of bulking at the time of injection appeared to predict medium-term success. There were some minor early complications and none in the medium-term. CONCLUSIONS: Periurethral collagen injections continued to be effective at the 2-year follow-up, although there was a time-dependent decline. In comparison with more complicated procedures used in patients with previous failed continence surgery, periurethral collagen injection is a simple, acceptable, day case procedure which improves the quality of life in physically fit or frail patients, with few complications.

Adult↗

Correcting for rf inhomogeneities in multiecho pulse sequence MRI dosimetry.

The growing interest in using MRI to measure distributions of dose in specialized materials has prompted the need to improve existing methods for measuring NMR relaxation rates throughout large volume phantoms. The change in transverse relaxation rate (R2) has proven to be a more sensitive measure of dose than longitudinal relaxation rate (R1) in some materials; however, the accuracy of R2 measurements is limited by the presence of artifacts resulting from imperfect MRI tip angles throughout large phantoms. A novel echo quotient technique allowing accurate measurement of changes in R2 (delta R2) in regions of imperfect tip angle is presented. Application of this technique to the measurement of a dynamically wedged photon beam dose distribution demonstrates the improved accuracy of the echo quotient technique compared with other methods. Agreement of the MRI data with film and ion chamber data is within 2.5% throughout the volume of interest, indicating the potential for delta R2 MRI dosimetry to become a clinically useful tool.

Gelatin↗

Nucleus-targeting domain of the matrix protein (M1) of influenza virus.

The matrix protein M1 of influenza virus A/WSN/33 was shown by immunofluorescent staining to be transported into the nuclei of transfected cells without requiring other viral proteins. We postulated the existence of a potential signal sequence at amino acids 101 to 105 (RKLKR) that is required for nuclear localization of the M1 protein. When CV1 cells were transfected with recombinant vectors expressing the entire M1 protein (amino acids 1 to 252) or just the first 112 N-terminal amino acids, both the complete M1 protein and the truncated M1 protein were transported to the nucleus. In contrast, expression in CV1 cells of vectors coding for M1 proteins with deletions from amino acids 77 to 202 or amino acids 1 to 134 resulted only in cytoplasmic immunofluorescent staining of these truncated M1 proteins without protein being transported to the nucleus. Moreover, no nuclear membrane translocation occurred when CV1 cells were transfected with recombinant vectors expressing M1 proteins with deletions of amino acids 101 to 105 or with substitution at amino acids 101 to 105 of SNLNS for RKLKR. Furthermore, a synthetic oligopeptide corresponding to M1 protein amino acids 90 to 108 was also transported into isolated nuclei derived from CV1 cells, whereas oligopeptides corresponding to amino acid sequences 25 to 40, 67 to 81, and 135 to 164 were not transported into the isolated cell nuclei. These data suggest that the amino acid sequence 101RKLKR105 is the nuclear localization signal of the M1 protein.

Amino Acid Sequence↗

Optimal analysis of the signal averaged P wave in patients with paroxysmal atrial fibrillation.

OBJECTIVE: To define the ability of analysis of the signal averaged P wave to identify patients with paroxysmal atrial fibrillation (AF) and establish whether differences in quantitative variables between patients and controls are due to concurrent cardiopulmonary disease, greater atrial dimension, or to unrelated changes in atrial electrophysiology. DESIGN: An observational parallel group study. SETTING: Cardiac department of a busy district general hospital. PATIENTS: 58 participants without cardiopulmonary disease (24 with paroxysmal AF and 34 controls, group A) and 57 with cardiac or respiratory conditions (31 with paroxysmal AF and 26 controls, group B). Mean (range) age of patients was 54 (25-71) and controls 53 (34-78) for group A and 65 (45-81) and 62 (36-78) respectively for group B. Left atrial size was similar in patients and controls in each group (mean (SEM)) group A: 2.39 (0.1) v 2.19 (0.07) cm; group B: 2.51 (0.10) v 2.71 (0.12) cm). MAIN OUTCOME MEASURES: Analysis of the P wave after P-wave-specific signal averaging. Filtered P wave duration and spatial velocity were calculated. Energies contained in frequency bands from 20, 30, 40, 60, and 80 to 150 Hz after spectral analysis were expressed as absolute values (P20, P30 etc) and ratios of high to low frequency energy (PR20, PR30, etc). RESULTS: Duration and peak spatial velocity were increased in patients with paroxysmal AF (median (interquartile range) duration group A: 144 (137-155) v 136 (129-143) ms, P = 0.007; group B: 155 (144-159) v 142 (136-151) ms, P = 0.002; peak spatial velocity group A: 16.5 (14.1-21.2) v 14.5 (11.7-18.1) mV/s, P = 0.02; group B: 18.9 (14.8-21.8) v 14.3 (12.6-17.6) mV/s, P = 0.01). Energy contained in frequency bands from 20, 30, 40, 60 and 80 to 150 Hz was expressed as absolute values (P20, P30, P40, P60, and P80) and percentage energy ratios. P30, P60, and P80 were significantly greater in patients with AF in group A (for example P60: 3.9 (3.0-5.3) v 3.1 (2.0-4.3) microV2.s, P = 0.02) and P20, P30, and P40 were increased in those with AF in group B (for example P40: 16.7 (9.9-20.8) v 10.8 (8.1-14.8) microV2.s, P = 0.02). A score developed from logistic regression analysis of duration and P60 identified patients with paroxysmal AF with a sensitivity of 81% and specificity of 73%. CONCLUSIONS: Increased P wave duration and magnitude are associated with paroxysmal AF with and without additional cardiopulmonary disease. The discriminant ability of the signal averaged P wave is improved by analysis of duration and a magnitude variable. These results invite prospective assessment of the ability of the signal averaged P wave to predict paroxysmal AF in unselected patients.

Adult↗

Levels of cardiovascular risk factors in Japanese people living in the UK.

AIM: We set out to compare levels of cardiovascular risk factors (blood pressure, body mass and serum lipids) in Japanese people living in the UK with those of Japanese people living in Japan and also with residents of the UK. METHODS: Blood samples were taken from individuals attending routine health screening at three centres. The study group comprised 879 men and 723 women born in Japan but living in the UK; 21 248 Japanese men and 8282 Japanese women living in Japan; and 46 623 Caucasian men and 4914 Caucasian women living in the UK. RESULTS: In both men and women we found significantly higher mean blood pressures and cholesterol levels and lower mean triglyceride levels in the expatriate Japanese compared with those still living in Japan. These differences were independent of exercise, smoking and drinking habits and were not related to self-reported levels of stress. They were present even in those Japanese who had been living in the UK for less than 1 year. Higher cholesterol levels were associated with consumption of a Western diet in women but not in men, whereas mean triglyceride levels were lower in men, but not women, eating Western food. CONCLUSION: Our findings suggest that the levels of risk factors such as blood pressure and serum lipids are for the most part culturally, rather than genetically, determined.

Adult↗