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Inhibition and activation of enzymes. The effect of a modifier on the reaction rate and on kinetic parameters.

A combined analysis of enzyme inhibition and activation is presented, based on a rapid equilibrium model assumption in which one molecule of enzyme binds one molecule of substrate (S) and/or one molecule of a modifier X. The modifier acts as activator (essential or non-essential), as inhibitor (total or partial), or has no effect on the reaction rate (v), depending on the values of the equilibrium constants, the rate constants of the limiting velocity steps, and the concentration of substrate ([S]). Different possibilities have been analyzed from an equation written to emphasize that v = f([X]) is, in general and at a fixed [S], a hyperbolic function. Formulas for Su (the value of [S], different from zero, at which v is unaffected by the modifier) and v(su) (v at that particular [S]) were deduced. In Lineweaver-Burk plots, the straight lines related to different [X] generally cross in a point (P) with coordinates (Su, v(su)). In certain cases, point P is located in the first quadrant which implies that X acts as activator, as inhibitor, or has no effect, depending on [S]. Furthermore, we discuss: (1) the apparent Vmax and Km displayed by the enzyme in different situations; (2) the degree of effect (inhibition or activation) observed at different concentrations of substrate and modifier; (3) the concept of Ke, a parameter that depends on the concentration of substrate and helps to evaluate the effect of the modifier: it equals the value of [X] at which the increase or decrease in the reaction rate is half of that achieved at saturating [X]. Equations were deduced for the general case and for particular situations, and used to obtain computer-drawn graphs that are presented and discussed. Formulas for apparent Vmax, Km and Ke have been written in a way making it evident that these parameters can be expressed as pondered means.

Enzyme Activation↗

A comparative study of the cost and effectiveness of a modified system of MDT drug delivery system in a high endemic district (Nalagonda) of South India.

Fall in the case load (from 17,000 to 4,500), has changed the disease profile and introduction of fixed duration Therapy (FDT) has made management of leprosy cases rather easy in Nalgonda, a backward district in Andhra Pradesh. The system of drug delivery which was conceived for managing large case load, however, remains unchanged, thereby resulting not only in considerable wastage of resources but also in hampering other activities like case detection and patient care. This study was undertaken to develop and assess a modified system of drug delivery in terms of the cost and effectiveness, its overall effect on other activities in the programme and its acceptability by the field staff. Four Leprosy Control Units (LCUs) were selected and were randomly assigned either to study (Gudibanda, Suryapet) or control (Nalgonda, Bhuvanagiri) group. In the study group the modified drug delivery system replaced the existing system. The modified system consisted of the para medical worker being made responsible for patients at all the DDPs in his subcentre. The clinics were managed alternately by medical officers and non medical supervisors every month. In the control group each clinic was managed by medical officers every month and it covered two sub centers with each drug delivery point being assisted by a para medical worker. The study revealed that the modified system resulted in a saving of 130 man-days a month, a 30% saving in use of vehicle, a 30% saving in POL and improvement in case detection. There was no change in the clinic attendance and drug consumption compliance in the units where modified system was introduced.

Cost-Benefit Analysis↗

Validation of an immunoassay for detection and quantitation of a genetically modified soybean in food and food fractions using reference materials: interlaboratory study.

An immunoassay for detection of a specific genetically modified soybean (Roundup-Ready) was validated on dried soybean powder in an interlaboratory study. Different percentages of genetically modified soybeans in nonmodified soybean matrix were evaluated in a blind study. Thirty-eight laboratories from 13 countries participated. The immunoassay was evaluated for 2 endpoints: (1) To give a semiquantitative result, i.e., determination of a given sample above or below a given threshold, or (2) to compute a quantitative result, i.e., percentage of genetically modified soybeans in the sample. Semiquantitative results showed that a given sample which contained <2% genetically modified soybeans was identified as below 2% with a 99% confidence level. Quantitative use of the assay resulted in a repeatability (r) and reproducibility (R) that were computed to be RSDr = 7% and RSDR = 10%, respectively, for a sample containing 2% genetically modified soybeans. Application of this method depends on availability of appropriate reference materials for a specific food matrix. Only matrix-matched reference materials can be used for analysis of food or food fractions.

Antibodies, Monoclonal↗

Characterization of the interaction of recombinant apolipoprotein(a) with modified fibrinogen surfaces and fibrin clots.

Elevated levels of lipoprotein(a) [Lp(a)] in plasma are a significant risk factor for the development of atherosclerotic disease, a property which may arise from the ability of this lipoprotein to inhibit fibrinolysis. In the present study we have quantitated the binding of recombinant forms of apolipoprotein(a) [17K and 12K r-apo(a); containing 8 and 3 copies, respectively, of the major repeat kringle sequence (kringle IV type 2)] to modified fibrinogen surfaces. Iodinated 17K and 12K r-apo(a) bound to immobilized thrombin-modified fibrinogen (i.e., fibrin) surfaces with similar affinities (Kd approximately 1.2-1.6 microM). The total concentration of binding sites (Bmax) present on the fibrin surface was approximately 4-fold greater for the 12K than for the 17K (Bmax values of 0.81 +/- 0.09 nM, and 0.20 +/- 0.01 nM respectively), suggesting that the total binding capacity on fibrin surfaces is reduced for larger apolipoprotein(a) (apo(a)) species. Interestingly, binding of apo(a) to intact fibrin was not detected as assessed by measurement of intrinsic fluorescence of free apo(a) present in the supernatants of sedimented fibrin clots. In other experiments, the total concentration apo(a) binding sites available on plasmin-modified fibrinogen surfaces was shown to be 13.5-fold higher than the number of sites available on unmodified fibrin surfaces (Bmax values of 2.7 +/- 0.3 nM and 0.20 +/- 0.01 nM respectively) while the affinity of apo(a) for these surfaces was similar. The increase in Bmax was correlated with plasmin-mediated exposure of C-terminal lysines since treatment of plasmin-modified fibrinogen surfaces with carboxypeptidase B produced a significant decrease in total binding signal as detected by ELISA (enzyme linked immunosorbent assay). Taken together, these data suggest that apo(a) binds to fibrin with poor affinity (low microM) and that the total concentration of apo(a) binding sites available on modified-fibrinogen surfaces is affected by both apo(a) isoform size and by the increased availability of C-terminal lysines on plasmin-degraded fibrinogen surfaces. However, the low affinity of apo(a) for fibrin indicates that Lp(a) may inhibit fibrinolysis through a mechanism distinct from binding to fibrin, such as binding to plasminogen.

Apolipoproteins A↗

[Modified lipoproteins in atherosclerotic lesions of human aorta].

OBJECTIVE: To study the distribution patterns, amount, as well as the physical and chemical properties of malondialdehyde (MDA) and 4-hydroxynonenal (HNE) modified apolipoprotein B (apo B) in atherosclerotic lesions of human aorta. The distribution patterns of MDA and HNE modified apo B were also compared with those of lipoprotein(a) [LP(a)] and apo B. METHODS: Immunohistochemistry, electronic microscopy, immunoelectronic microscopic and biochemistry methods were used for qualitative and quantitative analysis. RESULTS: It was found that the distribution of MDA and HNE modified apo B coincided with Lp(a) and apo B in the extracellular matrix. While the distribution of MDA-apo B and HNE-apo B in foam cells appeared annular or particulate, similar to ceroids but different from that of Lp(a) or apo B. The physical and chemical properties of LDL from lesions on the intima were similar to those of in vitro modified LDL. In addition, a higher level of aldehyde modified LDL was extracted from the lesion areas than from normal intima. CONCLUSION: Oxidative modification of apo B containing lipoproteins is necessary for atherogenesis.

Aorta, Thoracic↗

Prospectively performed modified D1 lymphadenectomy for clinically diagnosed mucosal, node negative gastric cancer: findings over the past decade.

Based on retrospective analyses demonstrating the low probabilities of both lymph node metastasis and recurrence of curatively resected mucosal gastric cancer, we have established criteria for modified D1 lymphadenectomy (lymphadenectomy in the perigastric region as well as along the left gastric artery) and performed this in a prospective manner. In this study, we evaluate our treatment strategy by reviewing the patients prospectively undergoing modified D1 lymphadenectomy. The clinicopathological characteristics and survival data of 138 patients who underwent modified D1 lymphadenectomy between 1987--when we first introduced endoscopic ultrasonography--and 1996 were analyzed. The criteria for modified D1 lymphadenectomy were mucosal, node negative gastric cancer by pre-operative and intra-operative examinations. Depth of invasion was correctly diagnosed in 80% of the patients. Among the resultant submucosal gastric cancer patients, the incidence of slight submucosal invasion was increased in the second half-period (78%) as compared with that in the first half-period (44%). Nodal involvement was observed in 4 patients (2.9%); all of them exhibited the depressed type with ulceration and a histologically high grade of gastric cancer. Because their metastasized lymph nodes were all confined to the perigastric region, surgical treatment resulted in no residual cancer macroscopically. No patients succumbed to gastric cancer within the median and mean follow-up periods of over 6 years. These results suggest that our modified D1 lymphadenectomy is an effective option for the pre-operatively and intra-operatively diagnosed mucosal, node negative gastric cancer which meets our criteria.

Female↗

Facilitated electrochemical oxidation of NADH and its model compound at gold electrode modified with terminally substituted electroinactive self-assembled monolayers.

The electrochemical oxidation of NADH and its model compound, N-benzyl-1,4-dihydronicotinamide (DHN), has been studied at gold electrode modified with self-assembled monolayer of terminally substituted thiols/disulfide, i.e., cystamine (CYST), mercaptopropionic acid (MPA) and mercaptoethanol (ME). A substantial decrease in the overpotential (approximately 250 mV) when compared to the bare electrode has been observed for the oxidation of NADH at the monolayer-modified electrodes, containing no so-called redox mediator. The bare electrode shows an ill-defined voltammetric peak for the oxidation of DHN, whereas the monolayer-modified electrodes showed a well-defined voltammetric peak. The monolayer assembly on the gold electrode prevents the fouling of electrode surface by the oxidation products, which favors the oxidation at the less positive potential. The square-wave voltammograms showed a sharp voltammetric signal for the oxidation of NADH at all the monolayer-modified electrodes. All the monolayer-modified electrodes showed a linear current response to change in the NADH concentration in its range of 25-300 microM and their sensitivities were found to be 0.005+/-0.0003, 0.0063+/-0.0002 and 0.0052+/-0.0003 microA/microM for CYST-Au, ME-Au and MPA-Au electrodes, respectively. The hydrodynamic voltammograms obtained at the rotating CYST-Au electrode for the oxidation of NADH and DHN were used to estimate the diffusion coefficient of DHN, and the number of electrons involved in the oxidation process of NADH.

Electrochemistry↗

Modified Devine exclusion for unresectable pancreatic head carcinoma.

BACKGROUND/AIMS: Gastrojejunostomy is generally performed for unresectable pancreatic head carcinoma. However, in the case of conventional gastrojejunostomy, the bypass does not always function effectively. METHODOLOGY: For unresectable pancreatic head carcinoma accompanied by severe duodenal stenosis, conventional gastrojejunostomy was performed in 5 cases, and modified Devine exclusion was performed in 7 cases. There were no significant differences between the groups regarding their backgrounds. RESULTS: There were no significant differences between the two groups for the average operation time, the days before peroral ingestion and the hospital stay. The state of peroral ingestion showed better results for modified Devine exclusion. The discharge rates were better for modified Devine exclusion, showing a significant difference (P = 0.028). The 50%-survival periods were 65 days and 159 days, respectively. The bleeding from the tumor occurred in 2 patients from the conventional gastrojejunostomy group, but none in modified Devine exclusion group. CONCLUSIONS: Modified Devine exclusion is a simple and effective technique for unresectable pancreatic head carcinoma.

Aged↗

Color stability of glass-ionomers and polyacid-modified resin-based composites in various environmental solutions.

PURPOSE: To evaluate the degree of color stability of glass-ionomers (GIs) and polyacid modified resin-based composites (PMRBCs) in various environmental solutions. MATERIALS AND METHODS: Seven polyacid-based esthetic restorative materials were used: three chemical-cured GIs, one resin-modified GI and three polyacid-modified RBCs. A light-cured resin-based composite (RBC) (Z 100) was used as a control. Disk type specimens were prepared and were aged in four different solutions (deionized water, 0.1 mole acetic acid solution, 75% ethanol, and 10% hydrogen peroxide solution) for 1, 7, 14, 21, 28, and 56 days. The specimens were kept at 37 degrees C throughout the study. Color coefficients (CIE L*a*b*) were measured by a reflection spectrophotometer with SCE mode, and the surface of specimens was examined by a stereo zoom microscope. RESULTS: In deionized water, all specimens showed an acceptable color stability. All of the GIs and PMRBCs showed significant color change in 0.1 mole acetic acid solution. The light-cured resin-modified GI showed a significant color change in 75% ethanol solutions. 10% hydrogen peroxide solution resulted in degradation and a high degree of color change for chemical-cured GIs. The light-cured resin-modified GI and PMRBCs showed high color change in 10% hydrogen peroxide solution. The light-cured RBC (Control), showed excellent color stability in all experimental solutions.

Acetic Acid↗

Cost-effectiveness of a modified care protocol substituting bladder tumor markers for cystoscopy for the followup of patients with transitional cell carcinoma of the bladder: a decision analytical approach.

PURPOSE: Decision analysis models were established to determine the cost-effectiveness of a plan alternating a bladder tumor marker with cystoscopy and cytology at 3-months intervals or modified care versus followup cystoscopy and cytology every 3 months or standard care. MATERIALS AND METHODS: We performed a comprehensive literature review for bladder tumor markers using 1966 to current MEDLINE data and other search engines. Statistical performance data on tumor markers were calculated by hierarchical Bayes meta-analysis with 95% confidence intervals used for the model. Other basic assumptions included cost data on tumor markers, cytology, cystoscopy, transurethral bladder resection and cystectomy as well as recurrence and progression rates from the literature. Decision trees were built with computer software using a 12 and a 24-month model with linear recurrence and progression rate assumptions. RESULTS: Overall specificity for common tumor markers was 73% to 90% and sensitivity was 49% to 77%. As expected, sensitivity increased for higher disease grades and stages. The modified care protocol was more cost-effective than standard care for the 1 and 2-year followups. On 1-year 1-way sensitivity analysis for cost only tumor marker cost, recurrence and progression rates achieved a threshold at which the modified care protocol was as or more expensive as standard care. Modified care was more cost-effective at a tumor marker cost of less than $264. On 2-way sensitivity analysis there was no significant impact of parameters at a wide range of tumor marker costs, recurrence and progression rates. CONCLUSIONS: Using a modified followup protocol in transitional cell carcinoma cases with an initial tumor occurrence using a urine based tumor marker alternating with cystoscopy and/or cytology is cost-effective for a wide range of marker sensitivities, specificities and costs, cystoscopy and/or cytology cost, a 20% to 80% yearly recurrence and a 2% to 40% yearly progression rate. This protocol should be evaluated in a prospective randomized trial to determine whether the financial and emotional benefits outweigh any potential drawbacks.

Biomarkers, Tumor↗

Modified rapid-sequence induction of anesthesia: a survey of current clinical practice.

The purpose of this study was to identify the use of rapid-sequence induction (RSI) and its hybrids. For the study, 67 Certified Registered Nurse Anesthetists at 1 hospital completed a survey describing their experience using a modified technique for patients with a moderately increased risk of regurgitation and aspiration. Patient selection criteria and the use of aspiration prophylaxis, preoxygenation, cricoid pressure, and positive-pressure ventilation were evaluated. In contrast with routine induction and standard RSI techniques, the modified RSI technique consisted of aspiration prophylaxis, preoxygenation, application of cricoid pressure, and positive-pressure ventilation. The survey revealed that a modification of standard RSI is used commonly in clinical practice. These modified RSI techniques are not standardized, as variation was noted in the delivery of positive pressure ventilation. Further study is necessary to identify widespread use of modified RSI techniques and to clarify the risks and benefits of modified RSI.

Anesthesia↗

Fluoride release and caries inhibition associated with a resin-modified glass-ionomer cement at varying fluoride loading doses.

PURPOSE: To measure, over time, the release of fluoride from a resin-modified glass-ionomer cement, loaded with different levels of fluoride, then to evaluate the adjacent dentin demineralization inhibition relative to these fluoride levels. MATERIALS AND METHODS: (Phase I) 25 standardized discs were fabricated from a non-fluoridated resin-based composite (control), resin-modified glass-ionomer cement and resin-modified glass-ionomer cement loaded with sodium fluoride at 1%, 2% and 3% by weight fluoride. Fluoride release was evaluated over 30 days. (Phase II) 50 restorations, from the materials listed in Phase I, were placed as Class V restorations in teeth, the teeth were acid-challenged, then dentin margins adjacent to restoration margins were evaluated for demineralization. RESULTS: As sodium fluoride additions increased, fluoride release increased. Evaluation of demineralization indicated the resin-modified glass-ionomer cement inhibited adjacent demineralization in a direct relationship with sodium fluoride concentration where 3% fluoride exhibited significantly less adjacent demineralization than all other groups; 2% and 1% fluoride exhibited significantly less adjacent demineralization than the non-loaded resin-modified glass-ionomer cement and non-fluoridated resin-based composite control (P< 0.05).

Acid Etching, Dental↗

[Clinical study on surgical repair of acute acromioclavicular dislocation by modified Weaver-Dunn technique].

OBJECTIVE: To investigate the clinical value of modified Weaver-Dunn technique in repair of acute acromioclavicular dislocation. METHODS: From January 1993 to December 1998, 18 cases of acromioclavicular dislocation were treated by modified Weaver-Dunn technique, and other 17 cases of the same suffering were treated by tension band fixation of the acromioclavicular joints. All of the patients were followed up for 12-36 months before clinical evaluation of the function of shoulder joints, according to University of Pennsylvanian Shoulder Score System. RESULTS: In short term, the shoulder joints recovered much more rapidly in the cases repaired by modified Weaver-Dunn technique; 12, 24 and 36 months after operation, the scores of the cases repaired by modified Weaver-Dunn technique were (189.7 +/- 6.7), (193.7 +/- 3.6) and (194.7 +/- 3.4) respectively according to the Shoulder Score System, while those of the cases treated by tension band fixation were (167.3 +/- 7.8), (170.2 +/- 6.3) and (165.6 +/- 5.9) respectively. The above data indicated that there was significant difference between two groups (P < 0.05). CONCLUSION: The modified Weaver-Dunn technique was a better surgical approach than tension band fixation for repair of acute acromioclavicular dislocation.

Adolescent↗

Modified percutaneous endoscopic gastrostomy tubes: experience in Thai children.

BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is a well-established alternative to open gastrostomy for providing long-term enteral nutrition. Although the commercial PEG tube is available and suitable for the procedure, its cost is relatively high for low socioeconomic people. Therefore, modified PEG tubes have been used in our hospital. OBJECTIVES: To evaluate the outcome and complications of PEG performed in children at Ramathibodi Hospital and compare the results between the commercial PEG and modified PEG tubes. METHOD: All children who had PEG performed at Ramathibodi Hospital, from January 1999 to May 2002, were included in the study. The demographic data, indications for PEG, types of PEG tube, outcomes and complications were retrospectively reviewed. The modified PEG tube was made by connecting a Malecot four-wing catheter to the previously used, re-sterilized distal part of a commercial PEG tube. RESULTS: PEG was performed on 34 children, aged 4 months to 13 years, and successfully placed in 30 children (88.2%). The commercial and modified PEG tubes were used in 20 cases and 10 cases, respectively. Early complications occurring in the first 7 days post-procedure were found in 9 cases (30%) as follow: peritonitis (1 case), peristomal wound infection (7 cases), and subcutaneous emphysema (1 case). Late complications occurring at more than 7 days post-procedure were found in 15 cases (50%) and all were minor problems. There was no difference in complication rates between the 2 types of PEG tubes. CONCLUSION: PEG is safe even in small infants. Minor complications are common but can be simply managed. The modified PEG tube is an alternative for a commercial PEG tube in an unaffordable situation.

Adolescent↗

[Single-pump on-line addition of modifier for supercritical fluid chromatography].

Modified CO2 as mobile phase is usually necessary for packed-column supercritical fluid chromatography. Single syringe pump was applied in this work to add modifier through a parallel connection device, which can maintain constant and stable volume fraction of modifier without any contamination of the pump. Viscosity of the modifiers (here are methanol and acetone) and the length of the CO2 pipe line/modifier pipe line can affect the volume fraction. Volume fractions of methanol and acetone were determined by gas chromatography and ultraviolet spectrometry respectively and their rules of variation were also examined. It shows that the volume fraction of methanol is lower than that of acetone under similar condition. With fixed modifierr line, the longer the CO2 line is, the higher the volume fraction will be. The new device can conveniently alter the nature and ratio of the modifier with quite stable volume fraction. The online addition device can tentatively replace the dual-pump system.

Chromatography, Supercritical Fluid↗

[Electrochemical behavior of dopamine at the poly (isonicotinic acid) modified glassy carbon electrode].

AIM: To study the determination of dopamine (DA) in the presence of ascorbic acid (AA) using poly (isonicotinic acid) film modified electrode. METHODS: The cyclic voltammetry and differential pulse voltammetry were used to study the electrochemical behavior of DA at the poly (isonicotinic acid) film modified electrode. RESULTS: The poly (isonicotinic acid) film modified electrode showed an electrocatalytic effect on DA, and shifted the oxidation of AA to negative potential. The difference between the oxidation potentials of DA and AA was 204 mV, thus, AA did not interfere with the determination of DA. The linear range between the anodic currents and DA concentration was: 1.0 x 10(-7)-2.0 x 10(-5) and 2.0 x 10(-5)-1.0 x 10(-4) mol.L-1. The detection limit was 8.0 x 10(-9) mol.L-1. CONCLUSION: The useful life period of the modified electrode is three weeks at least. The modified electrode can be used to the determination of DA in the sample.

Ascorbic Acid↗

Modifier genes and heart failure.

Recent progress in genomic applications have led to a better understanding of the relationship between genetic background and cardiovascular diseases such as heart failure. A considerable component of the variability in heart failure outcome is due to modifier genes, i.e. genes that are not involve in the genesis of a disease but modify the severity of the phenotypic expression once the disease has developed. The strategy most commonly used to identify modifier genes is based on association studies between the severity of the phenotype of the disease (morbidity and/or mortality) and the sequence variation(s) of selected candidate gene(s). This strategy has showed that several polymorphisms of the beta1 and beta2 adrenergic receptors genes and the angiotensin converting enzyme gene are correlated to the prognosis of patients with heart failure. Recently, we have applied an experimental strategy, known as genome mapping, for the identification of heart failure modifier genes. Genome mapping has previously been used with success to identify the genes involved in the development of both monogenic and multifactorial diseases. We have showed that the prognosis of heart failure mice, induced through overexpressing calsequestrin, is linked to 2 Quantitative Trait Loci (QTL) localized on chromosome 2 and 3. Using both strategies (candidate gene and genome mapping) should allow us to identify a number of modifier genes that may provide a more rational approach to identify patients at risk for disease and response to therapy.

Calsequestrin↗

[Experimental study of modified bio-derived material by pluronic F-127 in vitro].

OBJECTIVE: To investigate the effects of three-dimentional culture in bioderived material modified by Pluronic F-127 on the growth and function of rabbit periosteal osteoblast in vitro. METHODS: Bio-derived materials were from fresh pig ribs and were modified by Pluronic F-127. Then rabbit periosteal osteoblasts were cultured in bio-derived materials(group A), in the modified bio-derived materials(group B) and on the plastic surfaces as a control (group C), respectively. During a 7-day period, the status of growth, cell viability and alkaline phosphatase(ALP) activity were measured. RESULTS: Osteoblasts attached, elongated and grew well on the modified bio-derived materials. There were no significant difference in osteogenesis and ALP activity between group A and group B(P > 0.05). The osteogenesis and ALP activity in groups A, B were less than those in group C (P < 0.01). CONCLUSION: Pluronic F-127 can be used for a carrier for bioactive factors to modify bio-derived material.

Animals↗