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Biomedical subjects

David Martin

Publications and source records attributed to David Martin.

At least 19 recordsLinked to original sources

A high resolution A-to-I editing map in the mouse identifies editing events controlled by pre-mRNA splicing.

Pre-mRNA-splicing and adenosine to inosine (A-to-I) RNA-editing occur mostly cotranscriptionally. During A-to-I editing, a genomically encoded adenosine is deaminated to inosine by adenosine deaminases acting on RNA (ADARs). Editing-competent stems are frequently formed between exons and introns. Consistently, studies using reporter assays have shown that splicing efficiency can affect editing levels. Here, we use Nascent-seq and identify ∼90,000 novel A-to-I editing events in the mouse brain transcriptome. Most novel sites are located in intronic regions. Unlike previously assumed, we show that both ADAR (ADAR1) and ADARB1 (ADAR2) can edit repeat elements and regular transcripts to the same extent. We find that inhibition of splicing primarily increases editing levels at hundreds of sites, suggesting that reduced splicing efficiency extends the exposure of intronic and exonic sequences to ADAR enzymes. Lack of splicing factors NOVA1 or NOVA2 changes global editing levels, demonstrating that alternative splicing factors can modulate RNA editing. Finally, we show that intron retention rates correlate with editing levels across different brain tissues. We therefore demonstrate that splicing efficiency is a major factor controlling tissue-specific differences in editing levels.

Adenosine Deaminase↗

Interleukin-6 mediates low-threshold mechanical allodynia induced by intrathecal HIV-1 envelope glycoprotein gp120.

Spinal cord glia (microglia and astrocytes) contribute to enhanced pain states. One model that has been used to study this phenomenon is intrathecal (i.t.) administration of gp120, an envelope glycoprotein of HIV-1 known to activate spinal cord glia and thereby induce low-threshold mechanical allodynia, a pain symptom where normally innocuous (non-painful) stimuli are perceived as painful. Previous studies have shown that i.t. gp120-induced allodynia is mediated via the release of the glial pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF), and interleukin-1beta (IL-1). As we have recently reported that i.t. gp120 induces the release of interleukin-6 (IL-6), in addition to IL-1 and TNF, the present study tested whether this IL-6 release in spinal cord contributes to gp120-induced mechanical allodynia and/or to gp120-induced increases in TNF and IL-1. An i.t. anti-rat IL-6 neutralizing antibody was used to block IL-6 actions upon its release by i.t. gp120. This IL-6 blockade abolished gp120-induced mechanical allodynia. While the literature predominantly documents the cascade of pro-inflammatory cytokines as beginning with TNF, followed by the stimulation of IL-1, and finally TNF plus IL-1 stimulating the release of IL-6, the present findings indicate that a blockade of IL-6 inhibits the gp120-induced elevations of TNF, IL-1, and IL-6 mRNA in dorsal spinal cord, elevation of IL-1 protein in lumbar dorsal spinal cord, and TNF and IL-1 protein release into the surrounding lumbosacral cerebrospinal fluid. These results would suggest that IL-6 induces pain facilitation, and may do so in part by stimulating the production and release of other pro-inflammatory cytokines.

Analysis of Variance↗

Intrathecal interleukin-10 gene therapy attenuates paclitaxel-induced mechanical allodynia and proinflammatory cytokine expression in dorsal root ganglia in rats.

Paclitaxel is a commonly used cancer chemotherapy drug that frequently causes painful peripheral neuropathies. The mechanisms underlying this dose-limiting side effect are poorly understood. Growing evidence supports that proinflammatory cytokines, such as interleukin-1 (IL-1) and tumor necrosis factor (TNF), released by activated spinal glial cells and within the dorsal root ganglia (DRG) are critical in enhancing pain in various animal models of neuropathic pain. Whether these cytokines are involved in paclitaxel-induced neuropathy is unknown. Here, using a rat neuropathic pain model induced by repeated systemic paclitaxel injections, we examined whether paclitaxel upregulates proinflammatory cytokine gene expression, and whether these changes and paclitaxel-induced mechanical allodynia can be attenuated by intrathecal IL-1 receptor antagonist (IL-1ra) or intrathecal delivery of plasmid DNA encoding the anti-inflammatory cytokine, interleukin-10 (IL-10). The data show that paclitaxel treatment induces mRNA expression of IL-1, TNF, and immune cell markers in lumbar DRG. Intrathecal IL-1ra reversed paclitaxel-induced allodynia and intrathecal IL-10 gene therapy both prevented, and progressively reversed, this allodynic state. Moreover, IL-10 gene therapy resulted in increased IL-10 mRNA levels in lumbar DRG and meninges, measured 2 weeks after initiation of therapy, whereas paclitaxel-induced expression of IL-1, TNF, and CD11b mRNA in lumbar DRG was markedly decreased. Taken together, these data support that paclitaxel-induced neuropathic pain is mediated by proinflammatory cytokines, possibly released by activated immune cells in the DRG. We propose that targeting the production of proinflammatory cytokines by intrathecal IL-10 gene therapy may be a promising therapeutic strategy for the relief of paclitaxel-induced neuropathic pain.

Animals↗

Synthesis of extended polyphosphacumulenes.

Addition of two equivalents of (Me(3)Si)(2)CLiCl to the C-[(diphenyl) (diisopropylamino)phosphonio]-P-(diisopropylamino)phosphaalkene 2 affords the 1sigma(4),3sigma(3)-diphosphabuta-1,2,3-triene E1 in 55 % yield. Derivative E1 was fully characterized, including a single-crystal X-ray diffraction study. Alkylation of E1 with methyl trifluoromethanesulfonate gives rise to the first C-phosphonio-bis(methylene)phosphorane 5, which was isolated in 84 % yield. Because the second carbon center is also nucleophilic, cumulene E1 reacts as a "pincer" with BF(3)OEt(2), leading to the formation of a novel four-membered PCBC heterocycle 6 with a betaine-like structure. Addition of three equivalents of P-[diphenyl(diisopropylamino)]methylene phosphorane to (diisopropylamino)dichlorophosphane, followed by addition of one equivalent of CCl(4), and subsequent deprotonation with lithium hexamethyldisilazide gave rise to 1sigma(4),3sigma(3),5sigma(4)-triphosphapenta-1,2,3,4-tetraene F1, which was isolated in 62 % yield.

Journal Article↗

Penile length alterations following penile prosthesis surgery.

OBJECTIVE: Determine the impact of penile prosthetic surgery on penile length. METHODS: Stretched flaccid penile length was measured in men undergoing first-time penile implant surgery. Measurements were done before implantation and at 1 and 6 mo postoperatively. Patients were evaluated by the International Index of Erectile Function (IIEF) preoperatively and the IIEF and Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) at 6 mo postoperatively. Patients also provided subjective assessment of penile changes at 6 mo postoperatively. Preoperative and postoperative IIEF and EDITS scores were compared as were the patients who complained of penile length loss with those who did not. RESULTS: Of the 56 patients, 50% were diabetic and 28.5% had previous radical prostatectomy; 78% of the implants were three-piece (Alpha-1, Mentor) and 22% were two-piece (Ambicor, American Medical Service). There were no statistically significant differences in penile length after the surgery compared to preoperative measurements. Forty of 56 patients (72%) reported a decrease in penile length, 10 of 50 (19%) reported no change, and 6 of 56 (9%) had a slight increase. Subjective penile length loss was more common in patients who had undergone radical prostatectomy before prosthesis implantation (32%). No statistical difference in EF domain scores occurred between patients who complained of penile length loss and those who did not; however, men complaining of length loss had lower IIEF satisfaction domain and EDITS scores. CONCLUSION: Penile prostheses do not have a negative impact on measured stretched flaccid penile length. Treatment satisfaction scores do not depend on subjective penile length loss.

Humans↗

Effects of cocaine intoxication on the threshold for stun gun induction of ventricular fibrillation.

OBJECTIVES: This study sought to assess cocaine's effects on Taser-induced ventricular fibrillation (VF) threshold in a pig model. BACKGROUND: Stun guns are increasingly used by law enforcement officials to restrain violent subjects, who are frequently intoxicated with cocaine and other drugs of abuse. The interaction of cocaine and the stun gun on VF induction is unknown. METHODS: We tested five adult pigs using a custom device built to deliver multiples of standard neuromuscular incapacitating (NMI) discharge that matched the waveform of a commercially available electrical stun gun (Taser X-26, Taser International, Scottsdale, Arizona). The NMI discharges were applied in a step-up and step-down fashion at 5 body locations. End points included determination of maximum safe multiple, minimum VF-inducing multiple, and ventricular fibrillation threshold (VFT) before and after cocaine infusion. RESULTS: Standard NMI discharges (x1) did not cause VF at any of the 5 locations before or after cocaine infusion. The maximum safe multiple, minimum VF-inducing multiple, and VFT of NMI application increased with increasing electrode distance from the heart. There was a 1.5- to 2-fold increase in these values at each position after cocaine infusion, suggesting decreased cardiac vulnerability for VF. Cocaine increased the required strength of NMI discharge that caused 2:1 or 3:1 ventricular capture ratios at all of the positions. No significant changes in creatine kinase-MB and troponin-I were seen. CONCLUSIONS: Cocaine increased the VFT of NMI discharges at all dart locations tested and reduced cardiac vulnerability to VF. The application of cocaine increased the safety margin by 50% to 100% above the baseline safety margin.

Animals↗

Copper-catalyzed asymmetric conjugate addition of Grignard reagents to trisubstituted enones. Construction of all-carbon quaternary chiral centers.

The copper-catalyzed asymmetric conjugate addition of Grignard reagents to trisubstituted cyclic enones affords enantioenriched all-carbon quaternary centers with up to 96% ee. The chiral ligand is a diaminocarbene, directly generated in situ. The combination of Grignard reagent and diaminocarbene is unprecedented in conjugate addition, and the additon of the phenyl group, on such enones, cannot be done by other conjugate addition methods.

Catalysis↗

Calcium-sensing receptor abrogates secretagogue- induced increases in intestinal net fluid secretion by enhancing cyclic nucleotide destruction.

The calcium-sensing receptor (CaSR) provides a fundamental mechanism for diverse cells to detect and respond to modulations in the ionic and nutrient compositions of their extracellular milieu. The roles for this receptor are largely unknown in the intestinal tract, where epithelial cells are normally exposed to large variations in extracellular solutes. Here, we show that colonic CaSR signaling stimulates the degradation of cyclic nucleotides by phosphodiesterases and describe the ability of receptor activation to reverse the fluid and electrolyte secretory actions of cAMP- and cGMP-generating secretagogues, including cholera toxin and heat stable Escherichia coli enterotoxin STa. Our results suggest a paradigm for regulation of intestinal fluid transport where fine tuning is accomplished by the counterbalancing effects of solute activation of the CaSR on neuronal and hormonal secretagogue actions. The reversal of cholera toxin- and STa endotoxin-induced fluid secretion by a small-molecule CaSR agonist suggests that these compounds may provide a unique therapy for secretory diarrheas.

Aniline Compounds↗

Mechanisms for human cytomegalovirus-induced cytoplasmic p53 sequestration in endothelial cells.

Human cytomegalovirus (HCMV) infection results in endothelial dysfunction, typically known as dysregulated apoptosis, and aberrant expression and sub-cellular localization of p53, a tumor suppressor that accumulates at the late stage of infection. In this study, we examined three hypotheses that could be responsible for HCMV-induced cytoplasmic p53 accumulation at the later stage of infection: hyperactive nuclear export, cytoplasmic p53 tethering and delayed p53 degradation. Leptomycin B treatment, a nuclear export inhibitor, was unable to reduce cytoplasmic p53, thereby eliminating the hyperactive nuclear export mechanism. The findings that nascent p53 still entered nuclei after the nuclear export inhibition indicated that cytoplasmic tethering may play a minor role. Cytoplasmic p53 was still observed after the translation activities were blocked by cycloheximide. There was more than an eight-fold increase in the cytoplasmic p53 half-life with abnormal p53 ubiquitination. Taken together, these results suggest that delayed degradation could be responsible for the cytoplasmic p53 accumulation. The general slow-down of the proteasomal activity and the dysregulated p53 ubiquitination process at the later stage of infection could contribute to the reduced cytoplasmic p53 degradation and might be relevant to dysregulated endothelial apoptosis. The HCMV-induced changes in p53 dynamics could contribute to endothelial dysfunction.

Apoptosis↗

Leadership characteristics and business management in modern academic surgery.

BACKGROUND: Management skills are necessary to successfully lead a surgical department in future. OBJECTIVE: This article focuses on practical aspects of surgical management, leadership and training. It demonstrates how the implementation of business management concepts changes workflow management and surgical training. METHODS: A systematic Medline search was performed and business management publications were analysed. RESULTS: Neither management nor leadership skills are inborn but acquired. Management is about planning, controlling and putting appropriate structures in place. Leadership is anticipating and coping with change and people, and adopting a visionary stance. More change requires more leadership. Changes in surgery occur with unprecedented speed because of a growing demand for surgical procedures with limited financial resources. Modern leadership and management theories have to be tailored to surgery. It is clear that not all of them are applicable but some of them are essential for surgeons. In business management, common traits of successful leaders include team orientation and communication skills. As the most important character, however, appears to be the emotional intelligence. Novel training concepts for surgeons include on-the-job training and introduction of improved workflow management systems, e.g. the central case management. CONCLUSION: The need for surgeons with advanced skills in business, finance and organisational management is evident and will require systematic and tailored training.

Entrepreneurship↗

Calcimimetic R-568 decreases extraosseous calcifications in uremic rats treated with calcitriol.

Calcimimetics decrease parathyroid hormone (PTH) levels in uremic patients with secondary hyperparathyroidism without increasing serum calcium (Ca). The aim of this study was to evaluate the effect of calcimimetic R-568 alone or in combination with calcitriol on vascular and other soft tissue calcifications in uremic rats with secondary hyperparathyroidism. Sham-operated and 5/6 nephrectomized Wistar rats were studied. 5/6 Nephrectomized rats were treated with vehicle, calcitriol (80 ng/kg every other day), R-568 (1.5 and 3 mg/kg per d), and both calcitriol and R-568 1.5 mg/kg, as above. Rats were killed after 14 or 56 d of treatment. Blood was drawn for biochemical measurements. Aortic, heart, kidney, lung, and stomach tissue samples were processed for histopathology and measurement of tissue Ca and phosphorus content. PTH concentrations were significantly reduced by all treatments. Treatment with calcitriol induced significant vascular calcification (aortic Ca increased to 4.2+/-1.2 mg/g at day 14 and to 11.4+/-0.7 mg/g at day 56; P<0.05 versus vehicle). Treatment with R-568 did not induce vascular calcification. Concurrent administration of R-568 with calcitriol reduced the aortic Ca (1.9+/-0.2 mg/g at day 14 and 7.5+/-1.4 mg/g at day 56) in relation to calcitriol alone. Soft tissue calcifications mirrored aortic mineralizations. Survival was significantly (P<0.001) reduced in calcitriol-treated rats, and mortality was attenuated (P=0.01) by concurrent treatment with R-568. In uremic rats, R-568 reduces elevated PTH levels without inducing vascular calcification, prevents calcitriol-induced vascular calcification, and decreases mortality.

Aniline Compounds↗

Connexin43-dependent mechanism modulates renin secretion and hypertension.

To investigate the function of Cx43 during hypertension, we studied the mouse line Cx43KI32 (KI32), in which the coding region of Cx32 replaces that of Cx43. Within the kidneys of homozygous KI32 mice, Cx32 was expressed in cortical and medullary tubules, as well as in some extra- and intraglomerular vessels, i.e., at sites where Cx32 and Cx43 are found in WT mice. Under such conditions, renin expression was much reduced compared with that observed in the kidneys of WT and heterozygous KI32 littermates. After exposure to a high-salt diet, all mice retained a normal blood pressure. However, whereas the levels of renin were significantly reduced in the kidneys of WT and heterozygous KI32 mice, reaching levels comparable to those observed in homozygous littermates, they were not further affected in the latter animals. Four weeks after the clipping of a renal artery (the 2-kidney, 1-clip [2K1C] model), 2K1C WT and heterozygous mice showed an increase in blood pressure and in the circulating levels of renin, whereas 2K1C homozygous littermates remained normotensive and showed unchanged plasma renin activity. Hypertensive, but not normotensive, mice also developed cardiac hypertrophy. The data indicate that replacement of Cx43 by Cx32 is associated with decreased expression and secretion of renin, thus preventing the renin-dependent hypertension that is normally induced in the 2K1C model.

Animals↗

Association of blood lead and tibia lead with blood pressure and hypertension in a community sample of older adults.

Few studies have compared associations of blood lead and tibia lead with blood pressure and hypertension, and associations have differed in samples with occupational exposure compared with those with mainly environmental lead exposure. African Americans have been underrepresented in prior studies. The authors performed a cross-sectional analysis of 2001-2002 data from a community-based cohort in Baltimore, Maryland, of 964 men and women aged 50-70 years (40% African American, 55% White, 5% other race/ethnicity) to evaluate associations of blood lead and tibia lead with systolic and diastolic blood pressure and hypertension while adjusting for a large set of potential confounding variables. Blood lead was a strong and consistent predictor of both systolic and diastolic blood pressure in models adjusted and not adjusted for race/ethnicity and socioeconomic status. Tibia lead was associated with hypertension status before adjustment for race/ethnicity and socioeconomic status (p = 0.01); after such adjustment, the association was borderline significant (p = 0.09). Propensity score analysis suggested that standard regression analysis may have exaggerated the attenuation. These findings are discussed in the context of complex causal pathways. The data suggest that lead has an acute effect on blood pressure via recent dose and a chronic effect on hypertension risk via cumulative dose.

Black or African American↗

Spinal cord glia and interleukin-1 do not appear to mediate persistent allodynia induced by intramuscular acidic saline in rats.

UNLABELLED: Spinal glial activation and consequent interleukin-1 (IL-1) release are implicated in pain facilitation induced by inflammation/damage to skin and peripheral nerves. It is unclear whether pain facilitation induced at deep tissue sites also depends on these. We investigated whether spinal IL-1 and/or glial activation mediates bilateral allodynia induced by repeated unilateral intramuscular injections of acidic saline to rats. Given the prominent role of spinal IL-1 in various bilateral pain models, we predicted that intrathecal IL-1 receptor antagonist (IL-1ra) would suppress bilateral allodynia in this model as well. Surprisingly, neither single nor repeated intrathecal injections of IL-1ra affected allodynia, measured by the von Frey test, induced by prior intramuscular acidic saline compared with vehicle-injected controls. In addition, we tested the effect of 2 additional intrathecal manipulations that are broadly efficacious in suppressing glially mediated pain facilitation: (1) a glial metabolic inhibitor (fluorocitrate) and (2) the anti-inflammatory cytokine, interleukin-10 (IL-10). Like IL-1ra, fluorocitrate and IL-10 each failed to reverse allodynia. Finally, we observed no significant activation of glial cells, as assessed by immunohistochemistry of glial activation markers, in the lumbar spinal cord in response to intramuscular acidic saline. Taken together, the present data suggest that acidic saline-induced bilateral allodynia is created independently of glial activation. PERSPECTIVE: From converging lines of evidence, the current studies suggest that persistent bilateral allodynia induced by repeated intramuscular acidic saline is not mediated by spinal IL-1 and/or spinal glial activation. As such, this might represent the first evidence for pain facilitation occurring in the absence of glial involvement.

Animals↗

[Management qualifications for academic surgeons in the future: what can we learn from business administration?].

Health is a fundamental resource for social and economic development. Greater human development implies that people live longer and enjoy good health for a greater number of years. Healthcare systems should adapt to the new challenges posed by health: a sharp increase in population aging, the demand for more appropriate and transparent management, increased patient expectations, rising costs, and the emergence of ever more challenging economic contexts. At the vanguard of surgical development, surgical units in university hospitals play a fundamental role in the future of surgery and are therefore responsible for coping efficiently with these changes. To do this, effective surgical leaders are required. However, this poses the problem of how these future surgical leaders should be trained so that their training can be controlled and proactively influenced in advance. The present article reviews the arguments and need for management training among general surgeons, as well as knowledge of this process and its results. To maintain first-class healthcare and provide the most advanced medical education and biomedical research, modern surgical units in university hospitals will require effective surgical leaders. To train these modern leaders, business management programs are essential, both in undergraduate education and in specialized surgical training.

Delivery of Health Care↗

Overall quality of outcomes framework scores lower in practices in deprived areas.

BACKGROUND: There has been much debate as to whether quality points allocated through the new general medical services contract are more difficult to achieve for practices in deprived and rural areas. We used multiple regression to assess the relationships between deprivation, rurality and the number of overall quality points achieved by each practice. Multiple deprivation was significantly inversely related to quality points achieved. Practices in villages and towns gained 2% more quality points than urban areas and hamlets.

Family Practice↗

An Aboriginal-driven program to prevent, control and manage nutrition-related "lifestyle" diseases including diabetes.

Type 2 diabetes and other nutrition-related so-called "lifestyle" diseases, including obesity, and cardiovascular and chronic renal disease, are very prevalent in Australian Aboriginal people and contribute to their high rates of chronic illness and premature mortality. An Aboriginal-driven, community-based health protection, health promotion and improved disease detection, management and care program was introduced in four remote, discrete communities in the far north of Western Australia (WA) in order to attempt to prevent these disorders through community-based lifestyle modification. More energetic screening for early risk factors is involved as well as early dietary and exercise interventions and medical treatment, when indicated. Distinctive features of this program include its Aboriginal initiatives and perspectives, committed partnerships between the communities, the Unity of First People of Australia of Australia (UFPA) and its carers, the communities' health care providers, external clinical specialists, other external agencies and a locally-operated point-of-care (POC) pathology testing capability that is conducted by local and UFPA personnel. The POC component is quality managed by Flinders University. These features have ensured the viability of the program in three of the communities; the other one decided not to continue with the program despite risks of serious long-term health consequences. The pre-program prevalence of diabetes in screened adults was almost 40% and in adults aged (35 years was almost 60%. After several months of the program's operation, there have been positive changes in knowledge about food, nutrition, exercise and disease and altered attitudes and behaviours related to dietary and exercise patterns. There have also been improvements in weight control and in pathology test results relevant to the risk of subsequent development of diabetes and cardiovascular disease.

Adolescent↗