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Biomedical subjects

M Rosen

Publications and source records attributed to M Rosen.

At least 55 records · Page 3Linked to original sources

Molecular shape comparisons in searches for active sites and functional similarity.

Here we examine the reliability of surface comparisons in searches for active sites in proteins. Detection of a patch of surface on one protein which is similar to an active site in another, may suggest similarities in enzymatic mechanisms, in enzyme functions and implicate a potential target for ligand/inhibitor design. Specifically, we compare the efficacy of molecular surface comparisons with comparisons of surface atoms and of C(alpha) backbone atoms. We further investigate comparisons of specific atoms, belonging to a predefined pattern of catalytic residues versus comparisons of molecular surfaces and, separately, of surface atoms. This aspect is particularly relevant, as catalytic residues may be (partially) buried. We also explore active site comparisons versus comparisons in which the entire molecular surfaces are scanned. While here we focus on the geometrical aspect of the problem, we also investigate the effect of adding residue labels in these comparisons. Our extensive studies cover the serine proteases, containing the highly conserved triad motif, and the chorismate mutases. Since such active site comparisons entail comparisons between unconnected points in 3D space, an order-independent comparison technique is necessary. The geometric hashing algorithm is ideally suited to handling such a task. It can perform both global shape matching for the whole surfaces of large protein molecules and searching for local shape similarities for small surface motifs. Our results show that molecular surface comparisons work best when the similarity is high. As the similarity deteriorates, the number of potential solutions increases rapidly, making their ranking difficult, particularly when scanning entire molecular surfaces. Utilizing atomic coordinates directly appears more adequate under such circumstances.

Binding Sites↗

Reliability and acceptability of psychiatric diagnosis via telecommunication and audiovisual technology.

The reliability of psychiatric diagnoses made remotely by telecommunication was examined. Two trained interviewers each interviewed the same 30 psychiatric inpatients using the Structured Clinical Interview for DSM-III-R. Fifteen subjects had two in-person interviews, and 15 subjects had one in-person and one remote interview via telecommunication. Interrater reliability was calculated for the four most common diagnoses: major depression, bipolar disorder, panic disorder, and alcohol dependence. For each diagnosis, interrater reliability (kappa statistic) was identical or almost identical for the patients who had two in-person interviews and those who had an in-person and a remote interview, suggesting that reliable psychiatric diagnoses can be made via telecommunication.

Alcoholism↗

Cancer incidence among an HIV-infected cohort. Pulmonary Complications of HIV Infection Study Group.

Malignancies, particularly Kaposi's sarcoma and non-Hodgkin's lymphoma (NHL), are associated with human immunodeficiency virus (HIV) infection. Cancer incidence among 1,073 asymptomatic HIV-infected individuals from the Pulmonary Complications of HIV Infection Study cohort, persons from six states followed from 1988 to 1994, was examined. Total cancer incidence was 3.99/100 person-years; for Kaposi's sarcoma, incidence was 2.64 cases/100 person-years, and for NHL, it was 1.18 cases/100 person-years. Total cancer (n = 156 cases) was higher among nonblacks than among blacks (rate ratio = 2.8, 95% confidence interval 1.3-6.1), with similar results for Kaposi's sarcoma and NHL. The rate of lung cancer (n = 5) among white, homosexual/bisexual males was 0.18 per 100 person-years, suggesting a high risk of lung cancer.

Adult↗

Investigation of the enzymatic mechanism of the yeast chorismate mutase by docking a transition state analog.

The structure of the complex of the chorismate mutase from the yeast Saccharomyces cerevisiae with a transition state analog is constructed using a suite of docking tools. The construction finds the best location for the active site in the enzyme, and the best orientation of the analog compound in the active site. The resulting complex shows extensive salt links and hydrogen bonds between the enzyme and the compound, including those mediated by water molecules. A network of polar interactions between amino acid residues is found to solidify the active site of the enzyme. The enzymatic mechanism suggested for a bacterial chorismate mutase, that the active site is by design capable of selecting an active conformer of the substrate, and of stabilizing the transition state, is apparently intact in the yeast enzyme. No direct evidence is found to support an alternative mechanism which involves specific catalytic groups, although the possibility is not eliminated. This finding reinforces the notion of a function being evolutionarily conserved via a common mechanism, rather than via sequential or structural homology.

Binding Sites↗

Mechanism of action and spectrum of cell types susceptible to doxorubicin photochemotherapy.

We have shown that, whereas argon ion laser irradiation alone is not cytocidal for L929 cells, it greatly increases the cytotoxicity of intracellular doxorubicin. The present study showed that light enhancement of doxorubicin cytotoxicity was not restricted to stock L929 cells, but could also be demonstrated using L929 cells selected for doxorubicin resistance and several standard cell lines that are relatively resistant to doxorubicin prior to selection. Light-enhanced cytotoxicity resulted in extensive nuclear DNA loss and was strongly inhibited by anoxia. These findings suggest that the mechanism by which light exposure enhances doxorubicin cytotoxicity involves DNA damage by intranuclear generation of reactive oxygen species.

Antibiotics, Antineoplastic↗

A double-blind, parallel-group, placebo-controlled, dose-ranging, multicenter study of intravenous granisetron in the treatment of postoperative nausea and vomiting in patients undergoing surgery with general anesthesia.

STUDY OBJECTIVE: To compare the effectiveness of granisetron with placebo in the treatment of established postoperative nausea and vomiting (PONV). DESIGN: Randomized, placebo-controlled study. SETTING: 34 hospitals in Europe, Scandinavia, and South Africa. PATIENTS: 519 ASA physical status I, II, and III patients who developed PONV within 4 hours of the end of surgery performed with general anesthesia. INTERVENTIONS: Patients received a single intravenous dose of granisetron 0.1 mg, 1 mg, or 3 mg, or placebo when symptoms of nausea or vomiting were experienced. Additional rescue medication could be given at the investigator's discretion if nausea and vomiting were not controlled. MEASUREMENTS AND MAIN RESULTS: At all doses investigated, granisetron was significantly more effective (p < or = 0.001) than placebo in controlling vomiting: 38%, 46%, and 49% of patients receiving granisetron, 0.1 mg, 1.0 mg, and 3.0 mg, respectively, experienced no vomiting in the first 24 hours following drug administration, compared with 20% receiving placebo. There was a statistically significant linear relationship between vomiting control and granisetron dose (p < 0.001). Survival distributions of time to resolution of vomiting confirmed the statistically significant difference between patients receiving granisetron and those receiving placebo. Granisetron was well tolerated: the most common adverse experiences were pain, constipation, anemia, and headache, and the incidence of adverse experiences was not statistically significantly higher in any of the granisetron groups than in the placebo group. CONCLUSION: Granisetron was significantly more effective than placebo in all groups. Further studies in specific subgroups may be warranted.

Adolescent↗

Recurrent personal memories during intoxication reported by patients with alcoholism.

BACKGROUND: Experimental studies have demonstrated that alcohol has state-dependent effects on learning and memory. We, therefore, sought to determine if alcohol intoxication triggers selective retrieval of memories which could alter patterns of alcohol use. METHODS: Eighteen alcoholic patients were studied as well as a comparison group of 12 patients who abused cocaine, a drug not associated with memory state-dependence. Patients underwent a semi-structured interview to elicit information about recurrent personal memories experienced when intoxicated. Recurrent memories experienced during craving were also studied as a comparison condition. RESULTS: The prevalence of recurrent personal memories during intoxication was reported to be much higher for alcoholic patients compared with the cocaine-abusing patients. These experiences occurred more frequently than during craving, generally reflected prior disturbing events and were often reported to promote continued drinking. CONCLUSIONS: The association of recurrently experienced personal memories with intoxication in alcoholic patients suggests, but does not establish, pharmacological state-dependence. Further studies of this memory phenomenon are indicated.

Adult↗

Ventricular fibrillation following blunt chest trauma from a baseball.

OBJECTIVE: Baseball injuries account for a significant number of sports-related fatalities in children. We present a case of a 12-year-old male who died after being struck in the chest by a high velocity baseball propelled from a pitching machine. We examine the pathophysiology of blunt chest trauma, discuss possible explanations for the development of arrhythmias, review baseball-related fatalities, and suggest injury prevention strategies. DESIGN: A case report and review of the literature. SETTING: A pediatric emergency department (ED) in an urban, tertiary care, general hospital. PATIENTS: One case report. INTERVENTIONS: Advanced pediatric life support interventions, including emergency thoracotomy, direct cardiac massage, and direct cardiac defibrillation. RESULTS: The patient remained unresponsive to extraordinary therapy and died. CONCLUSIONS: Blunt trauma to either the chest or head accounts for the majority of baseball-related deaths. This case was similar to other reports of cardiac arrest following blunt chest trauma from a baseball. The patient had no prior medical problems, collapsed immediately, had no pathological findings on direct visualization, remained unresponsive despite rapid and maximal treatment, and died. Direct blows to the chest can stimulate inherently excitable cardiac tissue producing arrhythmias, particularly ventricular fibrillation, that are difficult to treat. A child's unique anatomy provides minimal protection to the underlying thoracic organs. The key to reducing the risk of injury lies in always complying with accepted safety rules, and in developing appropriate chest protection and safer baseballs.

Adolescent↗

Multiple mechanisms in the long-QT syndrome. Current knowledge, gaps, and future directions. The SADS Foundation Task Force on LQTS.

The congenital long-QT syndrome (LQTS) is characterized by prolonged QT intervals, QT interval lability, and polymorphic ventricular tachycardia. The manifestations of the disease vary, with a high incidence of sudden death in some affected families but not in others. Mutations causing LQTS have been identified in three genes, each encoding a cardiac ion channel. In families linked to chromosome 3, mutations in SCN5A, the gene encoding the human cardiac sodium channel, cause the disease, Mutations in the human ether-à-go-go-related gene (HERG), which encodes a delayed-rectifier potassium channel, cause the disease in families linked to chromosome 7. Among affected individuals in families linked to chromosome 11, mutations have been identified in KVLQT1, a newly cloned gene that appears to encode a potassium channel. The SCN5A mutations result in defective sodium channel inactivation, whereas HERG mutations result in decreased outward potassium current. Either mutation would decrease net outward current during repolarization and would thereby account for prolonged QT intervals on the surface ECG. Preliminary data suggest that the clinical presentation in LQTS may be determined in part by the gene affected and possibly even by the specific mutation. The identification of disease genes in LQTS not only represents a major milestone in understanding the mechanisms underlying this disease but also presents new opportunities for combined research at the molecular, cellular, and clinical levels to understand issues such as adrenergic regulation of cardiac electrophysiology and mechanisms of susceptibility to arrhythmias in LQTS and other settings.

Cardiology↗