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Molecular cloning of mouse ERK5/BMK1 splice variants and characterization of ERK5 functional domains.

The mitogen-activated protein kinases (MAPKs) play important roles in regulation of cell growth and survival. Human MAPK 5 (ERK5) or Big MAP kinase 1 (BMK1) is a recently cloned member of the MAPK family. To identify ERK5-related kinases, we searched the GenBanktrade mark expressed sequence tag (EST) data base for mouse cDNAs with homology to human ERK5. A full-length mouse cDNA that was highly homologous to the human ERK5 was identified. Further analysis of ERK5 polymerase chain reaction products generated from mouse embryo cDNA yielded three mouse ERK5 cDNAs (mERK5a, mERK5b, and mERK5c). Sequence analysis showed that these cDNAs are alternative splice products of the mouse ERK5 gene. Interestingly, expressed mERK5b and mERK5c act as dominant negative inhibitors based on inhibition of mERK5a kinase activity and mERK5a-mediated MEF2C transactivation. However, the physiological significance of mERK5b and mERK5c is not fully understood. Further investigation using these mouse ERK5 splice variants and other constructed mutants identified functional roles of several regions of mERK5, which appear to be important for protein-protein interaction and intracellular localization. Specifically, we found that the long C-terminal tail, which contains a putative nuclear localization signal, is not required for activation and kinase activity but is responsible for the activation of nuclear transcription factor MEF2C due to nuclear targeting. In addition, the N-terminal domain spanning amino acids (aa) 1-77 is important for cytoplasmic targeting; the domain from aa 78 to 139 is required for association with the upstream kinase MEK5; and the domain from aa 140-406 is necessary for oligomerization. Taken together, these observations indicate that ERK5 is regulated by distinct mechanisms determined by its unique structure and presumably the presence of multiple splice variants.

Alternative Splicing↗

Relationship between loss of pedal sensibility, balance, and falls in patients with peripheral neuropathy.

: The purpose of this study was to describe the relationship between balance and foot sensibility in a population of patients with impaired lower extremity sensation. The hypothesis was that increasing impairment of sensation correlates with impaired balance. To date, no report has investigated the relationship between loss of balance with the degree of sensibility in the foot in a population with neuropathy. Ten control subjects and 35 patients with sensory abnormalities and balance problems related to a neuropathy were evaluated. The MatScan Measurement System was used to measure their ability to stand still, maintaining their balance with their eyes open and then with their eyes shut. The degree to which the person moves while attempting to stand still is defined as "sway," which was recorded for normal and neuropathy patients. Sensibility of the foot was measured with the Pressure-Specified Sensory Device, which is noninvasive and nonpainful. The 1- and 2-point static touch thresholds are measured for the pulp of the big toe, medial heel, and the dorsum of the foot. Loss of 2- or 1-point sensation was recorded as sensibility score and compared with controls. Statistical analysis of data and their comparisons for the 2 groups was completed. There were 55% females in control and 64% in neuropathy patients, whereas average age was 50 and 62 years, respectively. Neuropathy was the result of diabetes in 64.5%, hypothyroidism in 19.3%, their combination in 13%, and of unknown etiology in the remaining 19% of patients. Controls had significantly lower mean sway than neuropathy patients (22.9 +/- 9% vs. 189.5 +/- 180%, P = 0.006). Likewise, sensibility score for normal and neuropathy patients was also significantly different (31.4 +/- 9% vs. 232.8 +/- 59%, P <0.0001). When compared with the controls, 99% upper limit of confidence, sensibility in the neuropathy group at the hallux pulp was abnormal at a level consistent with axonal loss in 52% and was completely absent in the remaining 48%. Similarly, at the heel, sensibility was normal in 6.5%, abnormal at a level consistent with axonal loss in 71%, and absent in the remaining 22.5%. The correlation coefficient between sway and sensibility score was 0.36. The results of this investigation for the first time document the intuitive relationship between increasing loss of foot sensibility and increasing loss of balance. These measurements can now be used prospectively to evaluate whether restoration of sensation to patients with neuropathy, through peripheral nerve decompression, can improve balance and reduce falls/fractures in this patient population.

Accidental Falls↗

Interoperability as a quality label for portable & wearable health monitoring systems.

Advances in ICT promising universal access to high quality care, reduction of medical errors, and containment of health care costs, have renewed interest in electronic health records (EHR) standards and resulted in comprehensive EHR adoption programs in many European states. Health cards, and in particular the European health insurance card, present an opportunity for instant cross-border access to emergency health data including allergies, medication, even a reference ECG. At the same time, research and development in miniaturized medical devices and wearable medical sensors promise continuous health monitoring in a comfortable, flexible, and fashionable way. These trends call for the seamless integration of medical devices and intelligent wearables into an active EHR exploiting the vast information available to increase medical knowledge and establish personal wellness profiles. In a mobile connected world with empowered health consumers and fading barriers between health and healthcare, interoperability has a strong impact on consumer trust. As a result, current interoperability initiatives are extending the traditional standardization process to embrace implementation, validation, and conformance testing. In this paper, starting from the OpenECG initiative, which promotes the consistent implementation of interoperability standards in electrocardiography and supports a worldwide community with data sets, open source tools, specifications, and online conformance testing, we discuss EHR interoperability as a quality label for personalized health monitoring systems. Such a quality label would support big players and small enterprises in creating interoperable eHealth products, while opening the way for pervasive healthcare and the take-up of the eHealth market.

Biomedical Technology↗

[Neurological symptoms in parasagittal meningiomas in relation to the disturbance of the venous circulation].

Classification of symptom complexes typic for different localization of parasagittal meningiomas at upper sagittal sinus and big falciform process area was presented in this article on the basis of neurological symptoms. The main symptoms typical for parasagittal meningiomas of any localization were picked out. The data concerning clinical pattern of parasagittal meningiomas in 323 patients were generalized in this article. Besides the analysis of interaction between neurological symptoms intensification and compensated venous outflow disturbance level was also performed.

Cerebral Veins↗

Endothelin-1 production and endothelin converting enzyme expression by guinea pig airway epithelial cells.

Significant amount of endothelin-1 (ET-1) production and endothelin converting enzyme (ECE) activity have been detected in cultured guinea pig airway epithelial cells. Subsequent screening of the cDNA library constructed from epithelial cells, a complete cDNA of guinea pig ECE and a partial cDNA encoding preproET-1 were newly isolated. The production of ET-1 from epithelial cells was influenced by some vasoactive or inflammatory mediators, especially LPS enhances ET-1 production. Northern blot analysis revealed that mRNA level of ET-1 was increased in the LPS stimulated epithelial cells, but the effect on the ECE mRNA expression was obscure. These data suggest that the ET-1 production in the airway epithelial cells is regulated by the level of ET-1 mRNA expression with a constitutive manner, and the level of ECE, which act at a key biosynthetic step of the conversion of big ET-1 to ET-2, seems not to make a major contribution to the regulation of ET-1 release.

Amino Acid Sequence↗

Being big or growing fast: systematic review of size and growth in infancy and later obesity.

OBJECTIVES: To assess the association between infant size or growth and subsequent obesity and to determine if any association has been stable over time. DESIGN: Systematic review. DATA SOURCES: Medline, Embase, bibliographies of included studies, contact with first authors of included studies and other experts. INCLUSION CRITERIA: Studies that assessed the relation between infant size or growth during the first two years of life and subsequent obesity. MAIN OUTCOME MEASURE: Obesity at any age after infancy. RESULTS: 24 studies met the inclusion criteria (22 cohort and two case-control studies). Of these, 18 assessed the relation between infant size and subsequent obesity, most showing that infants who were defined as "obese" or who were at the highest end of the distribution for weight or body mass index were at increased risk of obesity. Compared with non-obese infants, in those who had been obese odds ratios or relative risks for subsequent obesity ranged from 1.35 to 9.38. Ten studies assessed the relation of infant growth with subsequent obesity and most showed that infants who grew more rapidly were at increased risk of obesity. Compared with other infants, in infants with rapid growth odds ratios and relative risks of later obesity ranged from 1.17 to 5.70. Associations were consistent for obesity at different ages and for people born over a period from 1927 to 1994. CONCLUSIONS: Infants who are at the highest end of the distribution for weight or body mass index or who grow rapidly during infancy are at increased risk of subsequent obesity.

Adolescent↗

Yours, mine, and ours: the importance of scientific collaboration in advancing the field of behavior change research.

The Behavior Change Consortium (BCC) has provided a unique opportunity to combine and explore resources, data, processes, and knowledge as a means of strengthening the validity, reliability, and outcomes that compose the field of behavioral science. The workgroups of the BCC were able to transcend disciplinary boundaries by developing a collaborative framework that fused scholarship and creativity to explore research problems in the area of health behavior change theory and intervention. We have identified seven common elements that emerged from each workgroup and fostered inclusion, progress, and ultimately results. These elements were (a) establishing communication channels, (b) identifying objectives, (c) utilizing common measures, (d) obtaining financial support, (e) seeking outside feedback, (f) engaging "big picture" thinking, and (g) bridging theory to practice. In this article we describe the various processes involved in the creation and sustainability of the BCC, including internal and external communications, leadership, workgroup roles, private and public partnerships, and issues associated with data sharing. We also discuss why, in the case of the BCC, the whole is far greater than the sum of its parts. We present this example of unparalleled multibehavioral research collaboration as a model to other collaborative efforts that will be spawned by the new National Institutes of Health Roadmap initiative.

Behavior Therapy↗

Influenza Virus Database (IVDB): an integrated information resource and analysis platform for influenza virus research.

Frequent outbreaks of highly pathogenic avian influenza and the increasing data available for comparative analysis require a central database specialized in influenza viruses (IVs). We have established the Influenza Virus Database (IVDB) to integrate information and create an analysis platform for genetic, genomic, and phylogenetic studies of the virus. IVDB hosts complete genome sequences of influenza A virus generated by Beijing Institute of Genomics (BIG) and curates all other published IV sequences after expert annotation. Our Q-Filter system classifies and ranks all nucleotide sequences into seven categories according to sequence content and integrity. IVDB provides a series of tools and viewers for comparative analysis of the viral genomes, genes, genetic polymorphisms and phylogenetic relationships. A search system has been developed for users to retrieve a combination of different data types by setting search options. To facilitate analysis of global viral transmission and evolution, the IV Sequence Distribution Tool (IVDT) has been developed to display the worldwide geographic distribution of chosen viral genotypes and to couple genomic data with epidemiological data. The BLAST, multiple sequence alignment and phylogenetic analysis tools were integrated for online data analysis. Furthermore, IVDB offers instant access to pre-computed alignments and polymorphisms of IV genes and proteins, and presents the results as SNP distribution plots and minor allele distributions. IVDB is publicly available at http://influenza.genomics.org.cn.

Databases, Genetic↗

[Inequalities in mortality in the Italian longitudinal studies].

The article presents some of the most relevant results on inequalities in mortality, obtained by the two Italian longitudinal studies carried out in Turin, and Tuscany (in Leghorn and Florence). The two studies share the same methodology. Each database contains census data, information from population register and from death certificates. The authors approach this issue not in an analytical way (as they did in the works cited in the reference list), but answering some questions, relevant both from a scientific and a political point of view. How big are the health inequalities in Italy? Are the health inequalities in Italy increasing or decreasing? Are the health inequalities due to absolute or to relative deprivation? Does the mortality profile of the Italian population express the presence of old or new health inequalities? Can the health inequalities be reduced? The study's results prove that the health inequalities in Italy are deep and strictly related to individuals' position in the social fabric. Facing the other questions the authors focus only in the Turin data. From the 1970's to the 1990's the health inequalities in Turin have increased, despite of general improvement of population's health condition and the progressive reduction of the size of deprived groups. Turin data support both the hypotheses on the source of health inequalities, using long term unemployment as absolute deprivation's indicator, and status' inconsistency as (a row) indicator of relative deprivation. The growth of drug-related causes of death (AIDS and overdose) shows that in the Turin and--quite reasonably--Italian population old and new health inequalities live together. The essay closes offering evidence on the possibility to reduce health inequalities. For this purpose the authors analyses the Turin trend of avoidable deaths and infant and adolescent mortality.

Adult↗

Students' perceptions of effective learning experiences in dental school: a qualitative study using a critical incident technique.

Students' views of their educational experience can be an important source of information for curriculum assessment. Although quantitative methods, particularly surveys, are frequently used to gather such data, fewer studies have employed qualitative methods to examine students' dental education experiences. The purpose of this study is to explore characteristics of effective learning experiences in dental school using a qualitative method. All third-year (seventy) and fourth-year (seventy) dental students enrolled in one midwestern dental school were invited to participate. Fifty-three dental students (thirty-five male and eighteen female; thirty-two third-year and twenty-one fourth-year) were interviewed using a critical incident interview technique. Each student was asked to describe a specific, particularly effective learning incident that he or she had experienced in dental school and a specific, particularly ineffective learning incident, for comparison. Each interview was audiotaped. Students were assured that only the interviewer and one additional researcher would have access to the tapes. Data analysis resulted in identification of key themes in the data describing characteristics of effective learning experiences. The following characteristics of effective learning experiences were identified: 1) instructor characteristics (personal qualities, "checking-in" with students, and an interactive style); 2) characteristics of the learning process (focus on the "big picture," modeling and demonstrations, opportunities to apply new knowledge, high-quality feedback, focus, specificity and relevance, and peer interactions); and 3) learning environment (culture of the learning environment, technology). Common themes emerged across a wide variety of learning incidents. Although additional research is needed, the characteristics of effective learning experiences identified in this study may have implications for individual course design and for the dental school curriculum as a whole.

Attitude of Health Personnel↗

Novel selective quinazoline inhibitors of endothelin converting enzyme-1.

PD 069185 is a highly selective and structurally novel inhibitor of endothelin converting enzyme-1 (ECE-1). PD 069185 is a trisubstituted quinazoline with an IC50 value of 0.9 +/- 0.1 microns for inhibition of human ECE-1 from the solubilized membrane fraction of CHO cells stably transfected with human ECE-1 cDNA. Kinetic analysis revealed that PD 069185 is best fit with a competitive inhibition model with a Ki value of 1.1 +/- 0.1 microns and binds in a reversible manner. The closely related enzyme, ECE-2, is not inhibited at up to 100 microns PD 069185. In addition, PD 069185 at 200-300 microns has little effect on other metalloproteases, such as neutral endopeptidase 24.11, stromelysin, gelatinase A, and collagenase, showing a high ECE-1 specificity. Data are also presented to show that this series of inhibitors are effective in inhibiting ECE-1 in intact cells and in attenuating the increase in perfusion pressure induced by big ET-1 in isolated rat mesentery. These non-peptidic ECE-1 inhibitors should serve as a valuable tool to study the pathophysiological role of endothelin and the therapeutic potential of ECE-1 inhibitors.

Animals↗

"Things that went well--no serious injuries or deaths": ethical reasoning in a normal engineering design process.

We argue that considering only a few 'big' ethical decisions in any engineering design process--both in education and practice--only reinforces the mistaken idea of engineering design as a series of independent sub-problems. Using data collected in engineering design organisations over a seven year period, we show how an ethical component to engineering decisions is much more pervasive. We distinguish three types of ethical justification for engineering decisions: (1) consequential, (2) deontological or non-consequential, and (3) virtue-based. We find that although there is some evidence for engineering designers as 'classic' consequentialists, a more egocentric consequentialism would appear more fitting. We also explain how the idea of a 'folk ethics'--a justification in the second category that consciously weighs one thing with another--fits with the idea of the engineering design process as social negotiation rather than as technological progress.

Architecture↗

Detection of weak ligand interactions of leukocyte Ig-like receptor B1 by fluorescence correlation spectroscopy.

Fluorescence correlation spectroscopy (FCS) can directly and quickly detect the translational diffusion of individual fluorescence-labeled molecules in solutions. Although FCS analyses for protein-protein interactions have been performed, the very weak interactions generally observed in cell-cell recognition of the immune system have not been examined in detail. Here, we report the FCS analysis for low-affinity and fast-kinetic binding (K(d) greater than muM range) of the human inhibitory immune cell surface receptor, leukocyte immunoglobulin-like receptor B1 (LILRB1), to its ligands, MHC (major histocompatibility complex) class I molecules (MHCIs) by using the single-molecule FCS detection system which requires only a small amount of sample. Since the random labeling technique for LILRB1 disturbed the MHCI binding, we performed site-specific labeling of LILRB1 by introducing a cysteine residue at the C-terminus, which could be covalently attached with the fluorescence reagent, Alexa647. This technique can be applied to other type I membrane receptors. The low-affinity binding of LILRB1-Alexa647 to MHCIs (HLA-Cw4, and -G1) was detected by FCS, even though non-labeled MHCIs were only twice as big as the labeled LILRB1. Their dissociation constants (7.5 muM (HLA-Cw4) and 5.7 muM (HLA-G1)) could be determined and were consistent with surface plasmon resonance (SPR) data. These results indicate that the single-molecule FCS detection system is capable of analyzing the binding characteristics of immune cell surface receptors even in difficult cases such as (1) small amount of protein samples, (2) small difference in molecular weight and (3) weak affinity. Therefore, it is a powerful tool for characterization and high throughput inhibitor screening of a wide variety of cell-cell recognition receptors involved in immunologically relevant events.

Antigens, CD↗

Spatiotemporal relationship between particle air pollution and respiratory emergency hospital admissions in Brisbane, Australia.

The nature of spatial variation in the relationship between air pollution and health outcomes within a city remains an open and important question. This study investigated the spatial variability of particle matter air pollution and its association with respiratory emergency hospital admissions across six geographic areas in Brisbane, Australia. Data on particles of 10 microm or less in aerodynamic diameter per cubic metre (PM10), meteorological conditions, and daily respiratory emergency hospital admissions were obtained for the period of 1 January 1998 to 31 December 2001. A Poisson generalised linear model was used to estimate the specific effects of PM10 on respiratory emergency hospital admissions for each geographic area. A pooled effect of PM10 was then estimated using a meta-analysis approach for the whole city. The results of this study indicate that the magnitude of the association between particulate matter and respiratory emergency hospital admissions varied across different geographic areas in Brisbane. This relationship appeared to be stronger in areas with heavy traffic. We found an overall increase of 4.0% (95% confidence interval [CI]: 1.1-6.9%) in respiratory emergency hospital admissions associated with an increase of 10 microg /m3 in PM10 in the single pollutant model. The association was weaker but still statistically significant (an increase of 2.6%; 95% CI: 1.0-5.5%) after adjusting for O3, but did not appear to be affected by NO2. The effect estimates of PM10 were generally consistent for three spatial methods used in this study, but appeared to be underestimated if the spatial nature of the data was ignored. Therefore, the spatial variation in the relationship between PM10 and health outcomes needs to be considered when the health impact of air pollution is assessed, particularly for big cities.

Adolescent↗

Transduction of hepatocellular carcinoma (HCC) using recombinant adeno-associated virus (rAAV): in vitro and in vivo effects of genotoxic agents.

BACKGROUND/AIMS: Adeno-associated virus (AAV) is an attractive tool for gene therapy. Here we investigated the in vitro and in vivo transduction of hepatocellular carcinoma (HCC) cells by an AAV vector and the efficacy of different strategies to enhance the transduction of the tumor. METHODS: Transduction efficiency was determined by analyzing AAV-mediated beta-galactosidase gene (rAAV/lacZ) expression. RESULTS: Adenovirus help or pretreatment of HCC cells with y-irradiation or with the topoisomerase inhibitor etoposide resulted in marked enhancement of cell transduction in vitro. In vivo studies in nude mice with subcutaneous HCC tumors showed that HCC cells were not transduced by AAV vector alone. However, co-infection of the tumor with adenovirus allowed an efficient expression of the reporter gene but only at the sites of vector injection. Previous gamma-irradiation of subcutaneous tumors with 1800 rad was able to improve transduction of HCC cells (up to 30%) using recombinant AAV. Continuous i.p. infusion of etoposide in buffalo rats harboring HCC tumors in the liver resulted in transduction of normal liver tissue and also of very small neoplastic lesions (<2 mm) but no transduction was observed in tumors bigger than 2 mm. To analyze this phenomenon we determined etoposide concentration in hepatic tissue. Our results revealed high concentrations of the drug in non-tumoral tissue but almost undetectable levels in big tumor nodules. CONCLUSIONS: Our results indicate that while both radiotherapy and etoposide enhance transduction of tumor cells by rAAV in vitro, only radiotherapy increases tumor transduction in vivo. Our data suggest the existence of a barrier which limits in vivo the diffusion of chemotherapeutic agents to well-established HCC nodules.

Animals↗

Learning tumor diagnostics and medical image processing via the WWW--the case-based radiological textbook ODITEB.

New Internet technologies offer excellent chances to build high-quality on-line learning media for the education in medicine. Especially, the teaching of diagnostics with medical imaging as well as medical image processing can be supported by the excellent visualization and interaction capabilities. In cooperation with three radiological departments at German universities in Munich, Erlangen and Würzburg, the case-based open distributed Internet text book (ODITEB) for tumor diagnosis of the GI-tract, liver, pancreas and thorax has been developed at the Institut für Medizinische Statistik und Epidemiologie (IMSE) of the Technische Universität München. It offers a big collection of clinical tumor cases located on servers at the provider sites Munich, Erlangen and Würzburg, visualization and interaction similar to a real CT or MRI console, original DICOM data, X-rays and endoscopic and endosonographic videos, and expert-guided tours through the cases. In a first evaluation in summer 1998, 32 medical students graded the application with 1.9 ('good') on a scale from 1 ('very good') to 5 ('very bad'). The textbook supports German language, an English version is in preparation. In a second part, it contains lessons in medical image processing for students of medical informatics. An ODITEB release 2 with several improvements will be finished until February 2000. The use of the textbook is free of cost.

Computer-Assisted Instruction↗

Endothelin-1 mRNA and protein in vascular wall cells is increased by reactive oxygen species.

A dysregulated metabolism of oxygen-derived free radicals, nitric oxide and endothelin-1(ET-1) in conditions such as hypercholesterolaemia or hypertension may promote the development of atherosclerosis. We therefore subjected cultured human umbilical vein endothelial cells and coronary artery smooth muscle cells to oxidative stress induced by xanthine oxidase or hydrogen peroxide and observed alterations in ET-1 metabolism. Incubation with oxygen-derived free radicals increased preproET-1 promoter activity, ET-1 mRNA synthesis and big ET-1 concentrations in both cell types. This interaction of oxidative stress and ET-1 expression may be relevant in atherogenic conditions such as hypercholesterolaemia and hypertension since our data indicate that oxidative stress further aggravates the injurious effects attributed to ET-1.

Cells, Cultured↗