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Biomedical subjects

J Morais

Publications and source records attributed to J Morais.

At least 19 recordsLinked to original sources

Structure of the tetraheme cytochrome from Desulfovibrio desulfuricans ATCC 27774: X-ray diffraction and electron paramagnetic resonance studies.

The three-dimensional X-ray structure of cytochrome c3 from a sulfate reducing bacterium, Desulfovibrio desulfuricans ATCC 27774 (107 residues, 4 heme groups), has been determined by the method of molecular replacement [Frazão et al. (1994) Acta Crystallogr. D50, 233-236] and refined at 1.75 A to an R-factor of 17.8%. When compared with the homologous proteins isolated from Desulfovibrio gigas, Desulfovibrio vulgaris Hildenborough, Desulfovibrio vulgaris Miyazaki F, and Desulfomicrobium baculatus, the general outlines of the structure are essentialy kept [heme-heme distances, heme-heme angles, His-His (axial heme ligands) dihedral angles, and the geometry of the conserved aromatic residues]. The three-dimensional structure of D. desulfuricans ATCC 27774 cytochrome c3Dd was modeled on the basis of the crystal structures available and amino acid sequence comparisons within this homologous family of multiheme cytochromes [Palma et al. (1994) Biochemistry 33, 6394-6407]. This model is compared with the refined crystal structure now reported, in order to discuss the validity of structure prediction methods and critically evaluate the steps used to predict protein structures by homology modeling. The four heme midpoint redox potentials were determined by using deconvoluted electron paramagnetic resonance (EPR) redox titrations. Structural criteria (electrostatic potentials, heme ligand orientation, EPR g values, heme exposure, data from protein-protein interaction studies) are invoked to assign the redox potentials corresponding to each specific heme in the three-dimensional structure.

Crystallography, X-Ray

Release of 5-ASA from Pentasa in patients with Crohn's disease of the small intestine.

BACKGROUND: Pentasa is a controlled-release tablet made from semipermeable microspheres and designed to continuously deliver therapeutic quantities of 5-ASA (5-aminosalicylic acid) throughout the gastrointestinal tract. Scintigraphic studies in healthy subjects have documented that 5-ASA release could occur in the small intestine. We tested here the disintegration of Pentasa in the digestive tract of nine patients with Crohn's disease of the small intestine. MATERIALS: Each patient was given, after breakfast, a 250 mg tablet of Pentasa containing samarium-153 oxide. For 8 h the progression of the isotope in the gastrointestinal tract was followed using gamma camera scintigraphy. Plasma measurement of 5-ASA and acetylated 5-ASA was used to verify the liberation and absorption of 5-ASA. RESULTS: The Pentasa tablet appeared completely dissolved in the stomach by 117 +/- 18 min. Samarium oxide was first detected in the small intestine 60 +/- 5 min after its ingestion; it reached the colon after 280 +/- 13 min and it was completely absent from the small intestine at 360 +/- 26 min. Plasma concentrations of 5-ASA started to rise after 67 +/- 7 min and were maximal at 222 +/- 25 min. CONCLUSION: In patients with Crohn's disease of the small intestine, Pentasa microgranules start releasing 5-ASA in the proximal small intestine, acting locally to exert its beneficial effect.

Adult

Myocardial viability. Open artery theory.

Left ventricular ejection fraction at rest is the most powerful predictor of death in survived patients after acute myocardial infarction (AMI). Areas of poor contractility after AMI are not always related to necrosis. Stunned and hibernating myocardium are areas of potentially reversible damage which can improve spontaneously or after intervention to re-establish coronary blood flow. Several techniques has been investigated to study myocardial viability. Positron emission tomography (PET) is the gold standard for that purpose. However PET scan is a very expensive technique not available in a lot of countries. Myocardial perfusion scintigraphy and stress echocardiography are the most attractive alternative strategies. With these techniques is possible to predict the outcome and to properly select such patients which can improve with revascularization. A close relationship between open coronary artery and left ventricular (LV) function after AMI is a very well addressed topic in some published trials. However, the most significant benefits are obtained when artery patency is achieved in few hours, with a strong flow and the patency is sustained. We can summarize the benefits of an open artery: time dependent benefits (the traditional sequence of events after early reperfusion with infarct size reduction and left ventricular function improvement) and time independent benefits (thrombolysis may improve healing of infarction; may prevent the infarct expansion; may perfuse areas of hibernating segments; may increase electrical stability; may improve collateral blood flow). The role of collateral blood flow after AMI and its influence on LV function preservation is an important topic poorly elucidated.(ABSTRACT TRUNCATED AT 250 WORDS)

Collateral Circulation

MIBG scintigraphy of a patient with pheochromocytoma on labetalol therapy.

A patient with pheochromocytoma was studied by MIBG scintigraphy while on labetalol therapy, which has been reported to interfere with imaging. Serial imaging was performed at 2, 18, 25, and 90 hours to obtain time/activity curves. Blood samples were taken at each imaging study to determine activity counts. Tumor activity per gram of tissue (surgery 116 hours after injection) was compared with blood activity. Tumor and blood activity decreased concurrently, whereas the decrease in peritumoral activity was faster, thus providing transiently improved contrast on 18- and 25-hour images. The diagnostic implications of these results are discussed.

3-Iodobenzylguanidine

Anti-beta HCG abdominopelvic immunoscintigraphy in patients with resistant gestational trophoblastic disease.

The clinical utility of abdominopelvic immunoscintigraphy (IS) using anti-beta HCG-labelled monoclonal antibodies was evaluated in six patients with resistant gestational trophoblastic disease and no common pathological site. Five patients with abnormal retrovesical uptake had persistence of uterine trophoblastic disease confirmed on hysterectomy. Four of these patients are now in remission. It is concluded that IS provides a useful indication for surgery when a single abnormal uptake site is found.

Abdomen

[Psychiatric morbidity in general hospital inpatients].

Psychiatric morbidity was studied in 73 patients of three Units (Medicine, Surgery and Obstetrics) of a general hospital (S. Francisco Xavier Hospital, Lisbon). In the first stage, the patients were clinically evaluated by their doctors. In the second stage, psychiatrists using the General Health Questionnaire (G.H.Q. 30) interviewed all the patients according to the clinical evaluation, 41% of the patients had a significant psychological disorder. However, very significant differences were found between the prevalence rates in the three units. As defined by the G.H.Q. 30, 50 patients (68.5%) had psychiatric disorders, which is statistically different from the results obtained through clinical evaluation. The depression and anxiety syndromes were the most frequent disorders. Organic mental disorders were less frequent and almost limited to medical patients. The results of this study confirm a high rate of psychiatric morbidity in the general hospital, although considerable differences exist between the three units included in the study. We can also conclude that many psychiatric disorders are not correctly identified. This fact, more frequent in units where there is a more brief doctor-patient relationship, supports the necessity of implementing liaison psychiatry programs.

Cross-Sectional Studies

[Relations between the levels of lipoprotein (a) and results of coronarography in patients with ischemic heart disease. Preliminary results].

The authors make a short revision about Lipoprotein(a) [Lp(a)], which has been referred as an independent risk factor for coronary disease. To confirm this results in a portuguese population, we studied serum Apo(a) [method IRMA.Kit Pharmacia.1 U/L Apo(a) = 1 mg/L Lp(a)], Apo A, Apo B, total cholesterol, HDL-cholesterol, triglycerides, calcium, uric acid, glucose, fibrinogen and ESR in 37 patients who were submitted to postmyocardial infarction coronarography (Judkins technic--Seldinger. Classic incidences. Significative lesions: greater than or equal to 75% in coronary vessels or greater than or equal to 50% in common main nk). The purpose was to search for changes on the plasmatic levels according to the results of the coronarography. The only change observed was in the Lp(a) levels, with important variations (p less than 0.05) between the defined groups: patients without significant coronary disease or disease on just one vessel [media (mean) = 30.1 mg/dl. Standard error (SE) = 7.9 mg/dl.n = 11] and another group of patients with coronary disease of two or three vessels [mean = 50.5 mg/dl.SE = 7.0 mg/dl.n = 26]; among the patients with two vessels disease were found significant changes (p less than 0.02) on Lp(a) levels according to the descending anterior coronary being [mean = 79.5 mg/dl.SE = 4.3 mg/dl.n = 8] or not [mean = 38.5 mg/dl.SE = 14.3 mg/dl.n = 7] implicated. These observations make the suggestion of Lp(a) as a risk factor for coronary disease, and a predictor for the gravity of the coronary disease in myocardial infarction.

Adult

Scintigraphic aspect of Rotor's disease with technetium-99m-mebrofenin.

A 28-yr-old male with Rotor's disease was studied with 99mTc-mebrofenin. The scintigraphic pattern was that of a slow liver uptake with unimpaired excretion and persistent visualization of the cardiac blood pool, kidneys and urinary tract up to 6 hr. The gallbladder was visualized at 55 min postinjection.

Adult

Dichotic perception and laterality in neonates.

Groups of 4-day-old neonates were tested for dichotic discrimination and ear differences with the High-Amplitude-Sucking procedure. In the first experiment, dichotic speech discrimination was attested by comparison with a control group. Furthermore, among those subjects who showed a substantial recovery of sucking response at least after one of the two syllable changes, it was observed that significantly more subjects manifested a stronger reaction to a right-ear change than to a left-ear change. In the second experiment, 4-day-old neonates were tested on syllable and music timbre discrimination. The significant Stimulus Type x Ear interaction observed suggests perceptual asymmetries indicative of very precocious brain specialization.

Arousal

Pharmacological study of certain extracts of Laurobasidium lauri.

On the basis of observational screening in conscious rats, the essential oil of Laurobasidium lauri seems to be the main agent responsible for the sedating and analgesic effects of this fungus. The inhibitory activity observed in isolated rat uterus with the butanol and alkaloid-rich fractions of this species appears to be related to a decrease in the calcium available for contraction.

Acetylcholine

Phonological priming in spoken word recognition: task effects.

In two experiments, we examined the role of phonological relatedness between spoken items using both the lexical decision task and the shadowing task. In Experiment 1, words were used as primes and overlaps of zero (control), one, two, or all four or five (repetition) phonemes were compared. Except for the repetition conditions, in which facilitation was found, phonological overlap resulted in interference on word responses. These effects occurred in both tasks but were larger in lexical decision than in shadowing. The effects that were evident in shadowing can be attributed to an attentional mechanism linked to the subjects' expectancies of repetitions. The extra effects obtained in lexical decision can be interpreted by taking into account both activation of the response corresponding to the prime's lexical status and postlexical processes that check for phonological congruency between prime and target. In Experiment 2, some modifications were introduced to prevent the involvement of strategic factors, and pseudowords were used as primes. No effect at all was observed in shadowing, whereas in lexical decision interference effects occurred, which is consistent with the hypothesis that lexical decision may be negatively affected by finding a phonological discrepancy at the same time as the primed response is reactivated. Neither experiment provided evidence for the occurrence of phonological priming in the perceptual processing of words.

Adult

[Non-invasive evaluation of left ventricular function (systolic time interval) in patients using double-chamber pacemakers programmed on DDD and VVI].

OBJECTIVE: To evaluate changes on left ventricular function as assessed by systolic time intervals (STI), by programming "physiological" pacemakers either on VVI or DDD mode. STUDY DESIGN: Comparison of STI values--electromechanical systole (QS2); left ventricular ejection time (LVET); pre-ejection period (PEP); PEP/LVET--in patients submitted to double chamber pacing programmed in DDD or VVI mode. SETTING: Cardiac Pacing Center in a Department of Cardiology at a University Hospital. PATIENTS: We have studied 12 patients (3 men, 9 women), mean age 56.16 years (range 25-76 years) treated with double chamber pacing. INTERVENTIONS: Initial measurements of STI in DDD or one week in VVI mode, and again after one week in DDD mode. RESULTS: Significant changes were found after the first week in VVI pacing, versus baseline determination in DDD pacing, for LVET, PEP, and PEP/LVET (p less than 0.05). At the end of the second week (DDD pacing), there were also statistically significant differences for QS2 (P less than 0.05), LVET (P less than 0.01) and PEP/LVET (P less than 0.05) values when compared with the ones obtained in VVI pacing, at the end of the preceding week. No significant changes were found between the initial and the final STI determinations (both in DDD pacing). CONCLUSION: We concluded for a better performance of the left ventricle at rest when "physiological" pacing is compared with VVI pacing.

Adult

[Diabetes mellitus and coronopathy].

Diabetes Mellitus represents an important public health problem in the most developed industrialized countries. Clinical presentations of diabetes are strongly related to the cardiovascular system, namely, coronary disease and angiopathic renal failure. Diabetes modifies the clinical course of arteriosclerosis by carrying the angiopathic process to a microvascular level, where typical microangiopathic lesions can be observed. The risk of developing atherosclerotic disease is 2-3 fold higher in diabetics than in nondiabetics and arterial hypertension reaches a prevalence of 40 to 80%. Authors analyse Arterial Hypertension in the context of Diabetes putting focus on the underlying pathophysiological mechanisms. Where considering the coronary disease (CD), its high prevalence among the diabetics is also emphasized, which is expressed by an increase of morbidity and mortality when compared to normal subjects. In diabetics not only the incidence of Acute Myocardial Infarction is higher, but also the long term prognosis is more complicated, a reality that the authors try to explain by anatomic and metabolic factors. The association of Diabetes plus hyperlipidemia represents undoubtedly one of the major factors that justify the worsening and progression of CD. Briefly, some interesting points that allow the understanding of this topic are described, pointing the pathogenic differences of types I and II and the clinical implications of their knowledge. Finally, the approach of Diabetes as a cardiovascular risk factor is discussed in a prophylactic perspective.

Aged

Gallium-67 pulmonary uptake in eosinophilic pneumonia.

Eosinophilic pneumonia is usually diagnosed based on the findings on chest x-ray, white blood count, and transbronchial biopsy. After reporting a case of Ga-67 lung uptake in eosinophilic pneumonia, its histopathology is discussed and the mechanisms of Ga-67 uptake by inflammatory lesions are reviewed.

Gallium Radioisotopes