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Biomedical subjects

F C Stevens

Publications and source records attributed to F C Stevens.

At least 19 recordsLinked to original sources

Small molecule peptidomimetics containing a novel phosphotyrosine bioisostere inhibit protein tyrosine phosphatase 1B and augment insulin action.

Protein tyrosine phosphatase 1B (PTP1B) attenuates insulin signaling by catalyzing dephosphorylation of insulin receptors (IR) and is an attractive target of potential new drugs for treating the insulin resistance that is central to type II diabetes. Several analogues of cholecystokinin(26)(-)(33) (CCK-8) were found to be surprisingly potent inhibitors of PTP1B, and a common N-terminal tripeptide, N-acetyl-Asp-Tyr(SO(3)H)-Nle-, was shown to be necessary and sufficient for inhibition. This tripeptide was modified to reduce size and peptide character, and to replace the metabolically unstable sulfotyrosyl group. This led to the discovery of a novel phosphotyrosine bioisostere, 2-carboxymethoxybenzoic acid, and to analogues that were >100-fold more potent than the CCK-8 analogues and >10-fold selective for PTP1B over two other PTP enzymes (LAR and SHP-2), a dual specificity phosphatase (cdc25b), and a serine/threonine phosphatase (calcineurin). These inhibitors disrupted the binding of PTP1B to activated IR in vitro and prevented the loss of tyrosine kinase (IRTK) activity that accompanied PTP1B-catalyzed dephosphorylation of IR. Introduction of these poorly cell permeant inhibitors into insulin-treated cells by microinjection (oocytes) or by esterification to more lipophilic proinhibitors (3T3-L1 adipocytes and L6 myocytes) resulted in increased potency, but not efficacy, of insulin. In some instances, PTP1B inhibitors were insulin-mimetic, suggesting that in unstimulated cells PTP1B may suppress basal IRTK activity. X-ray crystallography of PTP1B-inhibitor complexes revealed that binding of an inhibitor incorporating phenyl-O-malonic acid as a phosphotyrosine bioisostere occurred with the mobile WPD loop in the open conformation, while a closely related inhibitor with a 2-carboxymethoxybenzoic acid bioisostere bound with the WPD loop closed, perhaps accounting for its superior potency. These CCK-derived peptidomimetic inhibitors of PTP1B represent a novel template for further development of potent, selective inhibitors, and their cell activity further justifies the selection of PTP1B as a therapeutic target.

3T3 Cells↗

Synthesis and biological activity of aminoguanidine and diaminoguanidine analogues of the antidiabetic/antiobesity agent 3-guanidinopropionic acid.

3-Guanidinopropionic acid (1) has been demonstrated both to improve insulin sensitivity and to promote weight loss selectively from adipose tissue in animal models of non-insulin-dependent diabetes mellitus (NIDDM). However, 1 has also been shown to be a substrate for both the creatine transporter and creatine kinase, leading to marked accumulation in muscle tissue as the corresponding N-phosphate. The corresponding aminoguanidine analogue 2 was recently discovered to retain the antidiabetic activity of 1 while being markedly less susceptible to creatine-like metabolism, suggesting that it should have less potential to accumulate in muscle. Further structural modification of 2 was undertaken to investigate whether the antidiabetic potency could be augmented while maintaining resistance to creatine-like metabolism. Modifications such as alpha-alkylation, homologation, and bioisosteric replacement of the aminoguanidine all were detrimental to antidiabetic activity. However, the simple regioisomeric aminoguanidinoacetic acid 9 and diaminoguanidinoacetic acid analogue 7 were found to be equipotent to 2, leading eventually to the discovery of the significantly more potent diaminoguanidinoacetic acid regioisomers 52 and 53. Further attempts to modify the more active template represented by 52 led only to reductions in antidiabetic activity. Each of the new active analogues displayed the same resistance to creatine-like metabolism as 2. Further testing of 7, 9, and 53 in obese diabetic ob/ob mice confirmed that weight loss is induced selectively from adipose tissue, similar to the lead 1. Administration of 53 to insulin-resistant rhesus monkeys led to reductions in both fasting and post-prandial plasma glucose levels with concomitant reductions in plasma insulin levels, suggesting that the compound improved the action of endogenous insulin. Compounds 7 and 53 were selected for further preclinical development.

Acetates↗

Synthesis and biological activity of analogues of the antidiabetic/antiobesity agent 3-guanidinopropionic acid: discovery of a novel aminoguanidinoacetic acid antidiabetic agent.

3-Guanidinopropionic acid (1, PNU-10483) has been demonstrated to both improve insulin sensitivity and to promote weight loss selectively from adipose tissue in animal models of non-insulin-dependent diabetes mellitus (NIDDM). However, 1 has also been shown to be a substrate for both the creatine transporter and creatine kinase, leading to marked accumulation in muscle tissue as the corresponding N-phosphate 4. In an effort to identify novel entities that maintain antidiabetic potency without susceptibility to creatine-like metabolism, an analogue program was undertaken to explore the effects of various structural modifications, including homologation, simple substitution, single atom mutations, and bioisosteric replacements for the guanidine and carboxylic acid. Overall, the scope of activity encompassed by the set of new analogues proved to be exceedingly narrow. Notable exceptions demonstrating equivalent or improved antidiabetic activity included the alpha-amino derivative 29, aminopyridine 47, isothiourea 67, and aminoguanidine 69. On the basis of its superior therapeutic ratio, aminoguanidine 69 was selected for preclinical development and became the foundation for a second phase of analogue work. Furthermore, in vitro studies demonstrated that 69 is markedly less susceptible to phosphorylation by creatine kinase than the lead 1, suggesting that it should have less potential for accumulation in muscle tissue than 1.

Acetates↗

How ageing and social factors affect memory.

OBJECTIVES: To explore the relationships between lifestyle and memory, and determine whether social factors influence memory. METHODS: the relationship between memory and lifestyle was examined in 497 adults aged 25-80 years, using the Mectamemory in Adulthood questionnaire. We asked about sports activity and perceived activity, participation in voluntary organizations and social contacts. RESULTS: Activity and frequent contact with friends and family were related to higher memory capacity scores. Those with higher capacity scores were also younger, had better health and a stronger internal locus of control. In contrast, people with higher anxiety scores had more symptoms and less education, and were more externally oriented. CONCLUSIONS: people who consider themselves socially and physically active also consider their memory capacity to be good and are less anxious about their memory than less socially and physically active people. Perceived memory change appears to be predominantly influenced by ageing, whereas memory capacity and memory anxiety are more influenced by social factors.

Adult↗

Women of a middle generation and parent care.

This article addresses women who are caring for both parents and children, the so called sandwich generation or women-in-the-middle. Gerontological studies on this topic reflect controversies on the concept as well as on the size of the phenomenon. Our study attempts to demonstrate empirically to what extent middle-aged women respond to the care demands of both the generation ahead as well as the generation behind them. A population-based sample among women aged forty to fifty-four in the Netherlands (N = 933) is utilized. The study indicates the prevalence of women-in-the-middle and presents analyses of their socio-demographic characteristics as well as of patterns of parent care. Further, the potential for a cross-cultural comparison between the Netherlands and other countries is discussed regarding parent care as a normative experience and the chances of middle-aged women getting "caught" between care demands from two generations.

Adult↗

Assessing the responsiveness of a functional status measure: the Sickness Impact Profile versus the SIP68.

In this study, the Sickness Impact Profile (SIP) and the SIP68 are studied for their ability to detect changes in health-related behavioral status. Methodological approaches toward responsiveness are invented and discussed. Next, literature findings on the responsiveness of the SIP are presented and judged for their validity. The SIP appeared to be able to demonstrate changes in the expected direction and in accordance with changes detected by other instruments. Using data from seven different longitudinal projects in populations with different diagnoses, the responsiveness of both the SIP136 and the SIP68 are subsequently studied and compared. In all populations, changes in functional status were indicated by both instruments. In terms of effect sizes, the SIP136 and the SIP68 do not differ significantly in their responsiveness. Moreover, changes detected by both SIPs appear to be valid representations of changes in health-related functional status.

Activities of Daily Living↗

Predictors of professional and non-professional community care for care-dependent adults.

The increasing number of elderly people in most industrialized countries makes reforms in health care necessary. However, knowledge of factors that determine the use of care is scarce. The study described in this article focuses on predictors of the diversity of professional and non-professional care used by care-dependent adults who live in the community. A group of 177 care-dependent adults was identified by means of a large scale telephone survey in the Dutch community of Tegelen. Potential predictors of the diversity of professional and non-professional care were derived from Andersen's Behavioral Model of Health Services [4,5] and Litwak's Task Specifity Model [12]. Both models proved to be valuable for the explanation of variance in the diversity of care. Potential predictors derived from the two models could account for 21% of the variance for total care, 25% of the variance for professional care, and 34% of the variance for non-professional care.

Caregivers↗

Longitudinal study on quality of life and social support in cancer patients.

The aim of the present study is to acquire insight into the changes of quality of life, social networks, and social support of cancer patients during the first year after diagnosis, as well as into the relation between social support and the changes in quality of life. Newly diagnosed cancer patients (n = 51) were followed for 1 year. Semistructured personal interviews and questionnaires were used to gather data. On the average, patients' functioning improved and the amount of physical complaints decreased over the year. Psychological complaints and the global evaluation of life, however, did not change significantly over time. The patients were supported by small, dense networks, consisting mostly of family members. Size of the networks as well as the amount of emotional support showed some decrease over time. It appeared that emotional support was positively related to quality of life. Moreover, a tendency was found to indicate that patients with a deterioration in quality of life perceived a larger decrease in emotional support than patients with a positive course. The amount of perceived instrumental support did not change significantly. There is a tendency that patients who were functioning worse had a greater need for instrumental support. Although these findings indicate relations between types of support and quality of life, we cannot make statements on the causality of these relations.

Adult↗

[Women of the middle generation and informal care for the elderly].

In this study women are described as caregivers of both younger and older generations, the so called "sandwich generation', "women in the middle' or "middle generation'. The aim of this article was to collect data indicating the size of this phenomenon and to explore whether women in the middle provide less family care for the elderly than other caregivers. Women in the middle were defined as those women who have dependent children and give help to their parents (-in-law). In 1994 a random sample was drawn among a cohort of women aged 40-54. A telephone survey was carried out (N = 933). It appeared that almost half of the respondents (45%) gave parent care, usually 1-2 mornings/afternoons per week. A considerable proportion of the cohort (29%) were women-in-the-middle. These respondents differed in few respects from other respondents. They were relatively young and worked fewer hours per week outdoors. From this study it could not be concluded that women-in-the-middle provide less parent care than other caregivers. They appeared to spend about the same amount of time on parent care, were as often the primary caregiver of their parents(-in-law) and experienced a similar caregiver burden as often as other caregivers. However, they provided less often very intensive care.

Adolescent↗

Implementing coordination of care--task performance and problems encountered.

In recent years the effects of interventions in the field of coordination of care have been well reported. However, the implementation of coordination of care is hardly addressed. This article focuses on the implementation of coordination of care for the elderly in three community settings in The Netherlands. A group of 38 professional and non-professional care-givers functioned as coordinators during a period of one year. Open interviews with coordinators, minutes from group meetings and forms and logbooks were used as sources of data. Major problems during implementation involved conflicting roles, preserving the client's privacy, lack of recognition and the perception that coordination was not always necessary. Coordinators had no difficulty in making a care inventory and in organizing care. On the other hand, introducing oneself as a coordinator, and planning and evaluating are tasks that need more attention in future interventions.

Aged↗

The development of a short generic version of the Sickness Impact Profile.

This study concerns the development of a short version of a well-known and much used clinimetric instrument called the Sickness Impact Profile (SIP). The SIP is a generic measure of functional status. Based on findings of a principal components analysis of over 800 SIPs from a multi-diagnostic population, a selection of 68 items divided over 6 dimensions was made and initially tested. As no support was found for the statistical validity of the categorical structure of the original SIP, a new structure, discovered through principal components analysis, was used as the basis for selecting items. Comparison of the scores on the selection with information provided by the original SIP showed very promising results: the 68 item selection may serve as a valid short SIP-version.

Female↗

Community nursing in Belgium, Germany and The Netherlands.

This paper contains a comparative study on community nursing in the Netherlands, Belgium and Germany, carried out in the region around Maastricht, where the borders of the three countries meet. The well-known problem of comparative studies (the incomparability of concepts and data) has been solved by using the same measuring instruments in the three countries. The comparison between the countries was on three aspects: the level of care dependency of the patients, the type and number of services provided and the nurses' job interpretation and job satisfaction. During 1 week in June or September 1991, 89 community nurses made records of all their home visits and nursing activities. In total the community nurses paid 5165 home visits to provide care to 1796 patients. The results indicate that both the level of care dependency of the patients as well as the type of care provided differs between the three countries. Belgian community nurses have the highest number of patients with a high level of care dependency. Curative services like technical nursing care and domestic care are most frequently provided by the German and Belgian community nurses. Informing, educating and supporting care is most frequently provided by the Dutch community nurses. The German community nurses spend less time on administration activities. With respect to job interpretation and job satisfaction the following results were found. The Dutch community nurses mentioned in their job interpretation many more preventive tasks, whereas the German community nurses more often mentioned domestic tasks. Concerning the hygienic and technical tasks, no significant differences were found between the three countries. Finally, job satisfaction is lowest in the Netherlands. Dutch community nurses are less satisfied with the work organization and the possibilities of autonomy and professionalization than the German and Belgian community nurses.

Belgium↗

[Family care for Moluccan ans Dutch elderly persons: a comparative study of readiness and expectations].

Care expectations of Moluccan and Dutch elderly (n = 48), and the willingness of their children (n = 25) to provide care are explored. It appeared, that Moluccan elderly received more family care than the Dutch comparison group. Moluccan children were considered to be responsible for the care of the elderly as well as for arranging additional care. Dutch elder persons stressed that they didn't want to become a 'burden' to their children, and were more willing to call in professional help. However, all elderly persons were reluctant concerning the involvement of professional care. Dutch elder persons stressed their loss of independency. For Moluccan elderly, professional care did not fit in with their traditional (care) beliefs. In general, Moluccan children were more willing to provide care than Dutch children. However, many of them expected problems in combining family life, a job and the care of their parents. In this respect opinions of Moluccan and Dutch children were more alike than those of their parents.

Adult↗

[Activity level, boredom, health and participative climate in nursing homes].

In this paper an analysis is presented of factors accounting for differences in levels of boredom and activities of residents of homes for the aged. Eighty respondents in two homes for the aged were interviewed. Results indicate that residents with a positive perception of the participatory climate report lower levels of boredom but do not participate in activities more often than other residents. Moreover, persons who report psychological distress report higher levels of boredom. Other factors such as age, gender and level of activity do not seem to be related to boredom. It also appears that actual participation in activities is only predicted by age and two health indicators: health perception and ADL/HDL score. Persons who are younger and persons who report a better health situation participate more often in activities.

Activities of Daily Living↗

[Job satisfaction of physicians in academic and general hospitals].

Based on a study of 20 medical departments (general surgery, internal medicine, radiology) an analysis is presented of variables which may account for differences in work satisfaction. The results show: (a) (experienced) work load correlates negatively with work satisfaction; (b) satisfied physicians define their medical domain more broadly than dissatisfied physicians. Besides, they do not regard their salary as an important aspect of their work. In general, radiologists are most satisfied with their work, internists least; medical specialists are more satisfied than residents. In the discussion it is argued that hospital physicians prefer regularity in their work, combined with a professional work climate. In terms of the growing bureaucratization of the physician's work it is concluded that satisfaction is positively influenced by standardization of work processes and negatively by external pressures which limit professional autonomy.

Academic Medical Centers↗

Calmodulin: an introduction.

Calmodulin is the most widely distributed and most versatile member of a family of calcium-binding proteins which probably serve as receptors for the Ca2+ signal. Through the regulation of a wide variety of intracellular enzymes, calmodulin plays a key role in many physiological processes. An understanding of the different mechanisms by which calmodulin exerts its influence is beginning to emerge and an interesting hypothesis regarding the interrelationship between the cAMP and Ca2+ second messenger systems has recently been put forward.

Amino Acid Sequence↗

Circular dichroism studies of native and chemically modified Ca2+-dependent protein modulator.

The structural features of the native Ca2+-dependent protein modulator and two chemically modified derivatives, namely, nitrotyrosyl modulator and alkylated modulator, were examined by circular dichroism. The binding of Ca2+ to the native molecule was accompanied by an increase in helical content from 40 to 49%, with little effect on the local environments of aromatic residues in the modulator. The Mg2+ and Mn2+ do not elicit the conformational change induced by the binding of Ca2+, which also stabilizes the modulator against urea denaturation. The overall secondary structure of nitrotyrosyl modulator is indistinguishable from that of the native protein and undergoes a similar conformational change upon binding Ca2+. These observations are in agreement with the fact that nitration has no effect on modulator functions. Furthermore, nitrotyrosyl modulator interacts with troponin I only in the presence of Ca2+, as detected by circular dichroism (cd). On the other hand, alkylation of five methionine residues on the modulator with benzyl bromide affects protein conformation, as evidenced by a reduced helical content of only 35%. Alkylated modulator retains the ability of the native protein to bind Ca2+ although the affinity of this derivative for Ca2+ is reduced some three orders of magnitude relative to the native protein, with Kd = 3.2 X 10(-4) M. The results with the alkylated modulator, in conjunction with previous cd studies on N-chlorosuccinimide oxidized modulator are utilized to advance a model for the Ca2+ activation of modulator protein, based on three conformational states of the molecule.

Alkylation↗

Chemical modification studies on the Ca2+-dependent protein modulator: the role of methionine residues in the activation of cyclic nucleotide phosphodiesterase.

Methionine residues have been implicated in the activation of cyclic nucleotide phosphodiesterase by the Ca2+-dependent protein modulator [Walsh, M., & Stevens, F.C. (1977) Biochemistry 16,2742-2749]. Treatment of the modulator with N-chlorosuccinimide in the presence of Ca2+ resulted in selective oxidation of methionine residues at positions 71,72, 76, and, possibly, 109 in the modulator sequence. These residues lie on the surface of the molecule exposed to solvent. This modification has several effects on the modulator protein: (1) the Ca2+-binding properties of the oxidized modulator are changed with apparent loss of high-affinity binding sites, (2) the oxidized protein no longer interacts with phosphodiesterase, and (3) troponin C like activities, viz., Ca2+-dependent change in mobility on urea-polyacrylamide gel electrophoresis and formation of a urea-stable complex with troponin I, are lost upon oxidation of the modulator. The phosphodiesterase binding domain of the modulator protein appears to be located between the second and third Ca2+-binding loops, a region of the molecule known from previous partial proteolysis studies [Walsh, M., Stevens, F.C., Kuznicki, J., & Drabikowski, W.(1977), J. Biol. Chem. 252, 7440-7443] to be exposed in the presence of Ca2+.

3',5'-Cyclic-AMP Phosphodiesterases↗