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Biomedical subjects

J P Lee

Publications and source records attributed to J P Lee.

At least 19 recordsLinked to original sources

1H NMR of A beta amyloid peptide congeners in water solution. Conformational changes correlate with plaque competence.

To begin to examine the structural basis for the deposition of soluble A beta amyloid peptide onto senile plaques in Alzheimer's disease, we have prepared A beta congeners and measured their activity in an in vitro plaque growth assay. The N-terminal fragment, A beta (1-28)-OH, was inactive at all pH values tested. While the central fragment, A beta (10-35)-NH2, and the full length peptide, A beta (1-40)-OH, were inactive below pH 4, both were active (plaque competent) between pH 5 and 9. The active and inactive fragments were studied by nuclear magnetic resonance spectroscopy in water at submillimolar concentrations at pH 2.1 and 5.6. Changes in chemical shifts, coupling constants, and nuclear Overhauser enhancements indicate a pH dependent folding transition in A beta (10-35)-NH2 as it becomes active. The conformation of the active fragment is not helical, and preliminary data indicate the presence of several turns and at least two short strands. In contrast, the inactive fragment A beta (1-28)-OH did not undergo a similar folding transition. Earlier nuclear magnetic resonance studies of amyloid peptides in fluorinated alcohols or detergent micelles at low pH described a helical conformation and proposed a helix to sheet transition in plaque formation; the present study demonstrates that no such conformations are present in water under conditions where the peptides can adhere to authentic amyloid plaques.

Alzheimer Disease

Aromatic-aromatic interactions in the zinc finger motif. Analysis of the two-dimensional nuclear magnetic resonance structure of a mutant domain.

The folding and stability of globular proteins are determined by a variety of chemical mechanisms, including hydrogen bonds, salt bridges and the hydrophobic effect. Of particular interest are weakly polar interactions involving aromatic rings, which are proposed to regulate the geometry of closely packed protein interiors. Such interactions reflect the electrostatic contribution of pi-electrons and, unlike van der Waals' interactions and the hydrophobic effect, may, in principle, introduce a directional force in a protein's hydrophobic core. Although the weakly polar hypothesis is supported by a statistical analysis of protein structures, the general importance of such contributions to protein folding and stability is unclear. Here, we show the presence of alternative aromatic-aromatic interactions in the two-dimensional nuclear magnetic resonance structure of a mutant Zn finger. Changes in aromatic packing lead in turn to local and non-local differences between the structures of a wild-type and mutant domain. The results provide insight into the evolution of Zn finger sequences and have implications for understanding how geometric relationships may be chemically encoded in a simple sequence template.

Amino Acid Sequence

NMR analysis of regioselectivity in dephosphorylation of a triphosphotyrosyl dodecapeptide autophosphorylation site of the insulin receptor by a catalytic fragment of LAR phosphotyrosine phosphatase.

An autophosphorylation site in the activated insulin receptor tyrosine kinase domain has three tyrosines phosphorylated when fully activated. To begin to examine recognition of triphosphotyrosyl sites by protein tyrosine phosphatases in possible control of signal transduction a triphosphotyrosyl dodecapeptide TRDIpYETDpYpYRK corresponding to residues 1,142-1,153 of the insulin receptor was prepared and incubated with the 40-kDa catalytic domain of the human PTPase LAR. To assess regioselectivity of recognition, the three diphosphotyrosyl regioisomers, and the three monophosphotyrosyl regioisomers were prepared and assayed. All seven peptides were PTPase substrates. To identify any preferences in dephosphorylation at pY5, pY9, or pY10, 1H-NMR analyses were conducted during enzyme incubations and distinguishing fingerprint regions determined for each of the seven phosphotyrosyl peptides. LAR PTPase shows strong preference for dephosphorylation first at pY5 (at tri-, di-, and monophosphotyrosyl levels). Initially this regioselectivity gives the Y5(pY9)(pY10) diphospho regioisomer, followed by equal dephosphorylation at pY9 or pY10 to give the corresponding monophosphoryl species on the way to fully dephosphorylated product. The NMR methodology is applicable to other peptides with multiple sites of phosphorylation that undergo attack by any phosphatase.

Amino Acid Sequence

Segmental colonic dilatation in a neonate.

Segmental dilatation of the colon is rare, usually affecting older children, and may mimic Hirschsprung's disease. A neonate with Down's syndrome and malrotation presented with this condition and was cured by segmental resection.

Colon

Recovery of anterior segment circulation after strabismus surgery in adult patients.

The effects of vertical rectus muscle surgery on the anterior segment and iris fluorescein angiogram were documented in 43 eyes of 41 adult patients. Characteristic iris sector perfusion defects were seen in 33 of 37 eyes (89%) after primary vertical rectus muscle surgery (no previous surgery on these muscles). Although iris perfusion defects were commonly present, associated clinical signs were mild. Two patients developed permanent pupillary changes after simultaneous surgery on two rectus muscles (superior/inferior rectus muscles and contiguous inferior/medial rectus muscles). In most patients, clinical findings resolved and the iris circulation recovered during the first 2 weeks after surgery. In 3 of 8 patients with grade 3 anterior segment ischemia (pupil dysfunction and cells) or early "postoperative uveitis," recovery of iris circulation took up to 12 weeks. These findings indicate that the time course of recovery of the anterior segment circulation after vertical rectus muscle surgery may be shorter than previously assumed.

Adolescent

A scoring method for Hess charts.

A new scoring system for Hess charts is described. Scores for both horizontal and vertical deviations are calculated from the displacement of individual points on the Hess chart, using weighting factors for the centre, inner and outer zones. The scoring system was validated in a group of 24 patients undergoing surgery for paralytic or restrictive strabismus. Subjective scores were obtained from patients both before and after corrective surgery, and corresponding Hess charts were scored using the new system. There was a good correlation between the changes in subjective and objective score. Our scoring system has applications in both research and clinical practice, allowing objective analysis of changes in muscle balance in a variety of motility disorders.

Diplopia

Management of VIth nerve palsy--avoiding unnecessary surgery.

Unresolved VIth nerve palsy that is not adequately controlled by an abnormal head posture or prisms can be very suitably treated by surgery. It is however essential to differentiate partially recovered palsies, which are amenable to horizontal rectus surgery, from unrecovered palsies, which must be treated initially by a vertical muscle transposition procedure. Botulinum toxin is a valuable tool in making this distinction. It also facilitates full tendon transposition in unrecovered palsies, which appears to produce the best functional outcome of all the transposition procedures, with a reduction in the need for further surgery. A study of the surgical management of 12 patients with partially recovered VIth nerve palsy and 59 patients with unrecovered palsy provides clear guidelines on how to attain a successful functional outcome with the minimum amount of surgery.

Abducens Nerve

Aetiology and management of the 'detached' rectus muscle.

The clinical features and management of 17 cases of detached extraocular muscles are described. They are classified into four groups: (1) the muscle which is cut and lost during squint surgery, (2) the muscle which breaks during squint surgery, (3) the muscle which slips following squint surgery, and (4) the muscle which is damaged during facial or orbital trauma. The prognosis for group 1 is poor whereas groups 2-4 have a good chance of successful muscle relocation.

Humans

Hepatoma presenting as craniospinal metastasis: analysis of sixteen cases.

Sixteen cases of hepatoma presenting as craniospinal metastasis without obvious hepatic involvement were reviewed. Metastatic spread of hepatoma to the cerebrum was found in one case, to the cranium in six cases, and to the vertebrae in nine cases. All of these cases had midly abnormal liver function when first evaluated. Of those patients with hepatoma, 56% had evidence of hepatomegaly. Alpha fetoprotein was present, at levels greater than 320 ng/ml, in 69%. Ninety four per cent died of the primary liver disease within one year. For any patient who develops craniospinal metastasis of unknown origin in a geographical area where hepatoma is a common disease, hepatoma should be considered in the differential diagnosis.

Adult

The Saccharomyces cerevisiae SPT14 gene is essential for normal expression of the yeast transposon, Ty, as well as for expression of the HIS4 gene and several genes in the mating pathway.

To investigate the role of the trans-acting transcription factor encoded by the essential SPT14 (SPT = Suppressor of Ty insertion mutations) gene, we have cloned, mapped and sequenced the gene. From the analysis of the effect of spt14 mutations on expression of various genes, we conclude that the SPT14 product has an important role in activation of Ty transcription as well as in the regulation of other genes including HIS4 and several of the a- and alpha-specific mating type genes. Similarities in the phenotypes of spt14 and spt13 mutants (suppression of Ty insertion mutations but not delta insertion mutations), lead to the suggestion that the SPT14 gene and the previously characterized SPT13/GAL11 gene might encode transcriptional regulators with related functions. Our current findings show that in contrast to SPT13/GAL11, which appears negatively to regulate Ty transcription, SPT14 plays a role in the activation of Ty transcription. Thus, despite the similarities in the suppression phenotype exhibited by spt13 and spt14 mutants, SPT13/GAL11 and SPT14 probably differ in their transcriptional roles.

Amino Acid Sequence

Intraparenchymal and intraventricular hemorrhage without mass effect in traumatic coma.

A group of 57-head injured patients showing computerized tomographic (CT) findings compatible with "diffuse brain injury" or of the so called "diffuse axonal injury" is analyzed. Thirty-four patients showed intraparenchymal hemorrhage in the CT scan study, 8 intraventricular hemorrhage and 15 patients had both intraparenchymal and intraventricular hemorrhage. Forty percent (23/57) of those with these findings had associated intracranial focal lesions. The deep nuclei are the most common location of intraparenchymal hemorrhage. Signs of brain stem hemorrhage were seen in 9 patients. Forty-nine percent of patients in this series had a good outcome. Old age (greater than 60), abnormal motor response, abnormal eye signs, associated with focal lesions, and evidence of brain stem hemorrhage are reliable prognostic parameters for a grave outcome.

Adolescent

Binocular diplopia in unilateral aphakia: the role of botulinum toxin.

We have treated 12 unilaterally aphakic patients, with a manifest squint and binocular diplopia, with botulinum toxin injection to the appropriate horizontal rectus muscle, in an attempt to reduce the angle of squint and thereby resolve the diplopia. In all cases a short-term reduction in the angle of squint was achieved. In nine patients, whose aphakia was corrected with a contact lens, and eight of whom had had their lenses removed because of trauma, this reduction was only temporary. In three patients, however, who had had a non-traumatic cataract removed, replaced with a posterior chamber implant, control of the deviation was maintained long after the acute effect of the toxin had disappeared, with the development of coarse binocular single vision, a fusion range, and abolition of all diplopia. The possible reasons for these different responses are discussed and it is suggested that in cases of binocular diplopia following lens extraction, botulinum toxin treatment should be considered prior to any extraocular muscle surgery, as temporary reduction of the deviation may be sufficient to allow recovery of binocular single vision.

Adolescent

Acute post-traumatic intraventricular hemorrhage analysis of 25 patients with emphasis on final outcome.

A series of 25 patients suffering acute post-traumatic intraventricular hemorrhage (IVH) after closed head injury is reviewed. Post-traumatic IVH was associated with other brain lesion in most cases; intracerebral lesions with contusion, subdural hematoma, and epidural hematoma coexisted with post-traumatic IVH in ten, three, and one instance, respectively. In six cases, no CT abnormality other than IVH was noted. The final outcome in this series is poor, only 10 (40%) patients made a functional survival. Four different groups of IVH were proposed according to the CT scan findings: deep nuclei hemorrhage, brain stem injury, white matter hemorrhage and isolated IVH. The group of isolated IVH usually got a good outcome. The abnormal motor response, abnormal pupil reaction and impaired oculocephalic response were reliable parameters for poor prognosis.

Adolescent

Extraocular muscle surgery in myasthenia gravis.

Myasthenia gravis is typically a disease of young people in active employment who need a field of binocular single vision. Although it is systemically controllable with a good chance of spontaneous remission, persistent loss of binocularity may cause chronic disability. We report our experience of extraocular muscle surgery in five patients with stable myasthenia gravis and persistent double vision. Extraocular muscle involvement was selective, giving rise to incomitant and concomitant squints, with individual muscle overactions as well as underactions. Treatment was by conventional recession and resection procedures with the additional use of Faden and adjustable sutures where appropriate. In all five cases a larger, stable field of binocular single vision was established. It is concluded that extraocular muscle surgery may be beneficial in selected cases of myasthenia gravis.

Adolescent

Intramedullary spinal cord metastasis: report of a case and review of the literature.

Intramedullary spinal cord metastasis (ISM) is an unusual cause of myelopathy, in comparison to the common problem of extramedullary metastasis. Most patients with ISM are found at autopsy. When patients with ISM are diagnosed premorbidly, they usually have a previously known or concurrently diagnosable primary neoplasm. Radiation therapy is the definitive therapy. We recently encountered a patient who was seen initially because of progressive myelopathy, without evidence of underlying malignancy, in whom a papillary carcinoma was found at myelotomy. The condition improved after surgery and the patient returned to his previous work for five months. Subsequently, a lesion histologically identical with that obtained from the previous myelotomy was found in the lung. This case illustrates the value of surgical intervention in selected situation. When there is no identifiable organ metastasis or multiple intramedullary lesions, radical microsurgical resection of a focal intramedullary lesion should be considered.

Carcinoma, Papillary