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Providing information and detecting concerns about health in general practice populations using a computer system in the waiting area.

Theoretical and practical problems for general practice exist following the increased emphasis placed upon preventive care in the 1990 contract for general practitioners. In particular, the risk that questionable systematic activity is encouraged while opportunistic prevention is discouraged, suggests the need for better targeted and more efficient methods of health promotion. This paper describes computer software which provides a broad range of information about health on a patient-dedicated terminal in general practice waiting areas. The software is interactive and monitors both the level of use of the component parts of the database and specific information sought but not found. In this way the system generates an indicator of 'health concerns' in the practice population. Experience of the system at four contrasting sites in Merseyside is reported. Data from the first year suggest that site-specific differences in use and perceived need are emerging, and could lead to an information source which evolves in response to local demand. In addition, the system should provide a resource for opportunistic prevention in primary care and a way of monitoring the emergence of new concerns about health.

Computer Terminals↗

Calcium binding induces interaction between the N- and C-terminal domains of yeast calmodulin and modulates its overall conformation.

Calmodulin from the yeast Saccharomyces cerevisiae binds 3 mol of Ca2+ cooperatively. We report here lines of evidence supporting the intramolecular interaction between the N- and C-terminal domains which modulates the Ca2+ binding properties of yeast calmodulin. First, the sum of the Ca2+ binding curves of the N-terminal and the C-terminal half-molecule did not yield the Ca2+ binding curve of yeast calmodulin. Second, the mean residue CD of yeast calmodulin at 222 nm (-Delta epsilon222) decreased with increases in the concentration of Ca2+, whereas those of each half-molecule increased. Finally, the C2 proton of His107 in the C-terminal domain of yeast calmodulin showed three resonance peaks with increases in the concentration of Ca2+, each corresponding to the apo, the intermediate, and the Ca2+-saturated state. The intermediate peak could not be observed in the C-terminal half-molecule of yeast calmodulin. Computer simulation considering the macroscopic Ca2+ binding constants assigned this intermediate to a species consisting of the apo C-terminal domain and the N-terminal domain with at least one of the two sites occupied by Ca2+. Peptide segments spanning the defective fourth Ca2+ binding site may be involved in the interdomain interaction and the yeast-specific function of calmodulin.

Binding Sites↗

The propagation of transient potentials in some linear cable structures.

1. Analytical solutions have been given for the time course of voltage transients occurring in one-dimensional cable structures, with linear uniform membrane properties.2. These solutions show how the time course of the voltage transients generated at different distances are affected by variations in the time course of current injection (at one point on the cable) and by alterations in the length of the cable, with either sealed or open end terminations. These effects are illustrated with computed results.3. Simple measurements from the time course of a membrane potential displacement, occurring in a one-dimensional cable structure following a brief current injection across the membrane, are used to evaluate the parameters which describe the cable model. These parameters are the membrane time constant, the electrotonic length of the cable, the cable end termination, and in the case of a post-synaptic potential, the distance between the electrode and the active synapse.

Action Potentials↗

Patch-clamp investigations and compartmental modeling of rod bipolar axon terminals in an in vitro thin-slice preparation of the mammalian retina.

To extend the usefulness of rod bipolar cells for studies of chemical synaptic transmission, we have performed electrophysiological recordings from rod bipolar axon terminals in an in vitro slice preparation of the rat retina. Whole cell recordings from axon terminals and cell bodies were used to investigate the passive membrane properties of rod bipolar cells and analyzed with a two-compartment equivalent electrical circuit model developed by Mennerick et al. For both terminal- and soma-end recordings, capacitive current decays were well fitted by biexponential functions. Computer simulations of simplified models of rod bipolar cells demonstrated that estimates of the capacitance of the axon terminal compartment can depend critically on the recording location, with terminal-end recordings giving the best estimates. Computer simulations and whole cell recordings demonstrated that terminal-end recordings can yield more accurate estimates of the peak amplitude and kinetic properties of postsynaptic currents generated at the axon terminals due to increased electrotonic filtering of these currents when recorded at the soma. Finally, we present whole cell and outside-out patch recordings from axon terminals with responses evoked by GABA and glycine, spontaneous inhibitory postsynaptic currents, voltage-gated Ca(2+) currents, and depolarization-evoked reciprocal synaptic responses, verifying that the recorded axon terminals are involved in normal pre- and postsynaptic relationships. These results demonstrate that axon terminals of rod bipolar cells are directly accessible to whole cell and outside-out patch recordings, extending the usefulness of this preparation for detailed studies of pre- and postsynaptic mechanisms of synaptic transmission in the CNS.

Animals↗

An on-line method for the acquisition of medical information for computer processing as applied to radiotherapy.

Based on a structured medical record, specially designed for patients with malignant disease, an on-line data capture system has been developed. This enables the collection of virtually any type of information contained in the patient's case notes. The structure of the record is described, with actual examples. The record is typed on a typewriter terminal linked to a mini-computer. Data is recorded as code + heading + value string. The headings are identified automatically, and an internal code generated, describing the type of information. Record keeping according to the principles described was introduced in clinical routine at the department in 1971. Data collection was implemented later that year, using an off-line magnetic tape encoder (IBM MT72). The system has been developed further and converted to a versatile on-line system. The data base, collected with these systems, now contains data on about 20,000 patients.

Computers↗

Computer assisted medical diagnosis using the Web.

The ADM (Aide au diagnostic Medical) project was started 15 years ago and was the first telematic project for physicians in France using the MINITEL terminal. The knowledge base contains information on more than 10000 diseases from all pathological fields, using more than 100000 signs or symptoms. The ADM system has two main functionalities for physicians: consultation of diseases descriptions and list of diseases containing one or more symptoms. The ADM knowledge base is supported by a relational database management system (DBMS ORACLE) and we developed a Web interface using the Perl language to produce HTML pages for the web server. We will describe our experience on redesigning a large existing medical knowledge base for diffusion on the web Internet.

Artificial Intelligence↗

[Quantitative changes in the ultrastructural elements of presynapses exposed to low-intensity laser radiation within the framework of a factorial model].

The ultrastructure elements of presynaptic terminals (PT) in a dorsal horn of cat spinal cord were studied morphometrically in norm and after helium-neon laser irradiation. The disperse computer analysis showed changes in a median terminal radius, the number and localization of synaptic vesicles, and no changes in the shape and length of the plasmalemma profile of the irradiated PT.

Animals↗

A novel RNA-binding motif in omnipotent suppressors of translation termination, ribosomal proteins and a ribosome modification enzyme?

Using computer methods for database search, multiple alignment, protein sequence motif analysis and secondary structure prediction, a putative new RNA-binding motif was identified. The novel motif is conserved in yeast omnipotent translation termination suppressor SUP1, the related DOM34 protein and its pseudogene homologue; three groups of eukaryotic and archaeal ribosomal proteins, namely L30e, L7Ae/S6e and S12e; an uncharacterized Bacillus subtilis protein related to the L7A/S6e group; and Escherichia coli ribosomal protein modification enzyme RimK. We hypothesize that a new type of RNA-binding domain may be utilized to deliver additional activities to the ribosome.

Amino Acid Sequence↗

An experimental study on home health care support information system construction.

The need for home health care has been increasing in Japan and the expectation is to apply advanced technology to home health care in order to promote it. We already studied the development of a home care support information system using a personal computer and a telephone set with multifunction. In the present study a new system using a new telephone terminal was developed in order to increase flexibility. To work out the concrete social system in the near future, a model of a PHD (Personal Health Data) management system was constructed and tested. Experimental studies were conducted by physicians and public health nurses. The model system would be useful for daily monitoring of home patients in the chronic stage of a disease and for dealing with their emergency states.

Aged↗

Effects of neutral posture on muscle tension during computer use.

This study focused on developing a new approach to seated work positions was conducted on 67 office workers who use a Visual Display Terminal (VDT) as a major function of their working day. Muscle tension was measured by surface electromyography (sEMG) while participants were asked to adopt 4 selected working postures. Pain was measured before and after ergonomic intervention on the Nordic scale, which was modified for this study. Adjustable workstations were used to place participants in desired positions during the clinical testing sessions and the extended intervention period. Results indicate the effects of this ergonomic intervention may have positive effects on muscle tension and pain, significant enough to encourage employers to implement training and workstation modifications following these guidelines.

Alaska↗

Cloning and expression of the beta-N-acetylglucosaminidase gene from Streptococcus pneumoniae. Generation of truncated enzymes with modified aglycon specificity.

The gene encoding a beta-N-acetylglucosaminidase from Streptococcus pneumoniae has been obtained by screening an expression library for beta-N-acetylglucosaminidase activity. Clones of different nucleotide sizes each having arylglycoside activity were obtained, and DNA sequencing revealed a gene of 3933 base pairs possessing typical bacterial transcription initiation and termination sequences and terminating in an ochre stop codon. Computer analysis of the translated protein of 1311 amino acids (144,210 Da) identified a tandem repeat within which lies a sequence homologous with six other hexosaminidase gene products from a wide variety of species ranging from bacteria to humans. Also found were an amino-terminal putative secretion signal peptide and a carboxyl-terminal cell sorting/anchorage motif typically found in over 20 other Gram-positive surface proteins. The expression of an almost complete DNA clone in Escherichia coli produced a functional and authentic beta-N-acetylglucosaminidase with aglycon specificity identical to the wild-type enzyme. However, enzymes produced from truncated DNA clones show more restricted aglycon specificity and are unable to hydrolyze terminal beta 1-2GlcNAc residues from N-glycans containing a bisecting N-acetylglucosamine. The availability of these clones allows structural analyses to be made of catalytic and oligosaccharide recognition protein domains that enhance functional activity.

Acetylglucosaminidase↗

[Idea and practice with the systematization of clinical laboratory in the Central Laboratory, Osaka University Hospital].

On 1 September 1993, we left our old hospital and moved to our brand new establishment, and at that time we adopted the order-entry and reporting system. In this paper we report on our new laboratory computer system that has been developed to manage a lot of information and to analyze rapidly many test tubes (4000 samples per day) and to elevate the service for our patients. We developed the automated clinical laboratory system and this new system was named as the Clinical Laboratory Supervised System (CLASSY). We used the NEC system 3500 Model 10, NEC N5200 Model 03 sx and NEC PC9821 Ae as a laboratory host computer, an interface unit and a terminal for routine work, respectively. CLASSY covers the automated analysis not only for clinical chemistry, but also for hematology, urinalysis and microbiology. As the ordering and reporting system is applied to the hospital information system, order information for clinical test is transferred to our laboratory host computer when the bar-code label is printed out from the automatic bar-code labeller. Then it is transferred from the laboratory host computer to some subsystems or automatically to an analyzer through the interface units or modems.

Clinical Laboratory Information Systems↗

C-terminal retroviral-type zinc finger domain from the HIV-1 nucleocapsid protein is structurally similar to the N-terminal zinc finger domain.

Two-dimensional NMR spectroscopic and computational methods were employed for the structure determination of an 18-residue peptide with the amino acid sequence of the C-terminal retroviral-type (r.t.) zinc finger domain from the nucleocapsid protein (NCP) of HIV-1 [Zn(HIV1-F2)]. Unlike results obtained for the first retroviral-type zinc finger peptide, Zn(HIV1-F1), [Summers et al. (1990) Biochemistry 29, 329], broad signals indicative of conformational lability were observed in the 1H NMR spectrum of Zn-(HIV1-F2) at 25 degrees C. The NMR signals narrowed upon cooling to -2 degrees C, enabling complete 1H NMR signal assignment via standard two-dimensional (2D) NMR methods. Distance restraints obtained from qualitative analysis of 2D nuclear Overhauser effect (NOESY) data were used to generate 30 distance geometry (DG) structures with penalties (penalty = sum of the squared differences between interatomic distances defined in the restraints file and in the DG structures) in the range 0.02-0.03 A2. All structures were qualitatively consistent with the experimental NOESY spectrum based on comparisons with 2D NOESY back-calculated spectra. Superposition of the backbone atoms (C, C alpha, N) for residues C(1)-C(14) gave pairwise RMSD values in the range 0.16-0.75 A. The folding of Zn(HIV1-F2) is very similar to that observed for Zn(HIV1-F1). Small differences observed between the two finger domains are localized to residues between His(9) and Cys(14), with residues M(11)-C(14) forming a 3(10) helical corner.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗

Computer-specific spectacle lens design preference of presbyopic operators.

Twenty-nine presbyopic subjects who spent at least 20 hours a week at a video display terminal compared a progressive addition lens designed for this function, with another commonly prescribed task-specific lens. Each of the paired lens types was worn for 4 weeks and then compared directly for 1 week. A statistically significant (P < .05) portion of the subjects (76%) preferred the task-specific lenses overall. It also was preferred more frequently for each feature compared, although the difference was statistically significant (P < .05) only for utility of distance vision. Both of the task-specific designs contributed to symptomatic relief. The presence of a distance-clear zone and the absence of lens discontinuities most likely account for user preference for the task-specific lenses. That preference suggests improved performance for presbyopic computer users wearing task-specific progressive addition lenses.

Adult↗

Structure-function analysis of the Escherichia coli GrpE heat shock protein.

We have isolated various missense mutations in the essential grpE gene of Escherichia coli based on the inability to propagate bacteriophage lambda. To better understand the biochemical mechanisms of GrpE action in various biological processes, six mutant proteins were overexpressed and purified. All of them, GrpE103, GrpE66, GrpE2/280, GrpE17, GrpE13a and GrpE25, have single amino acid substitutions located in highly conserved regions throughout the GrpE sequence. The biochemical defects of each mutant GrpE protein were identified by examining their abilities to: (i) support in vitro lambda DNA replication; (ii) stimulate the weak ATPase activity of DnaK; (iii) dimerize and oligomerize, as judged by glutaraldehyde crosslinking and HPLC size chromatography; (iv) interact with wild-type DnaK protein using either an ELISA assay, glutaraldehyde crosslinking or HPLC size chromatography. Our results suggest that GrpE can exist in a dimeric or oligomeric form, depending on its relative concentration, and that it dimerizes/oligomerizes through its N-terminal region, most likely through a computer predicted coiled-coil region. Analysis of several mutant GrpE proteins indicates that an oligomer of GrpE is the most active form that interacts stably with DnaK and that the interaction is vital for GrpE biological function. Our results also demonstrate that both the N-terminal and C-terminal regions are important for GrpE function in lambda DNA replication and its co-chaperone activity with DnaK.

Adenosine Triphosphatases↗

Quantitative studies of fly visual sustained neurons.

We present a quantitative study of a neural network model [1] proposed for the sustained neurons in the fly visual system. Electrophysiological recordings of sustained neurons [2] are digitized and transferred to a computer. A numerical ordinary differential equation solver is used to simulate the model. In order to obtain an initial set of parameters, we introduce approximations to the model and obtain fits to parts of the response characteristics. These initial parameter values are then refined by optimization routines. The model is compared to data in 4 different experimental paradigms and in general is in good agreement with data. We conclude that the simplified versions of temporal and spatial adaptation mechanisms of the model capture the essential features of the dynamics of sustained neurons and that the refinement of the model requires further experimental studies to elucidate the number of stages involved in temporal adaptation as well as the precise shape of the relationship between the membrane potentials and the spike frequency for the sustained neurons.

Action Potentials↗

Purification and characterization of folate binding proteins from rat placenta.

Rat placenta contains virtually no unsaturated (i.e., apo-form) folate binding protein. However, by lowering the pH of a solubilized membrane preparation of this tissue to 3.5, the endogenous bound folate was dissociated from the protein and adsorbed to charcoal. The apo-form of the folate binding protein thus obtained was purified by affinity chromatography using pteroylglutamic acid covalently coupled to Sepharose 4B. A single protein band with an apparent M(r) of 36,000 was observed by SDS-polyacrylamide gel electrophoresis of the eluate from the affinity matrix. Western blot of this preparation using a rabbit antiserum raised with the affinity eluate also identified a single 36 kDa protein band. However, peptide sequencing of the N-terminal region of the proteins in the affinity eluate established that it contained two homologous proteins. Computer alignment of the first 22 N-terminal amino acids of each rat placental protein with human, bovine milk and mouse folate binding proteins showed 50-64% identical homology and 27% homology when the eight proteins were aligned together. The affinity of both rat proteins is highest for pteroylglutamic acid (Ka = 1.6.10(9) l/mol) lower for N5-methyltetrahydrofolate and substantially lower for N5-formyltetrahydrofolate. In the dose-response range studied there was no apparent affinity for methotrexate. The folate binding proteins could be released from a preparation of placental membranes using phospholipase C indicating that these proteins belong to the class of proteins anchored to the plasma membrane by a glycosyl phosphatidylinositol adduct.

Amino Acid Sequence↗

N-terminal halves of gramicidin S synthetase 1, and tyrocidine synthetase 1 as novel members of firefly luciferase family.

It was found, by computer-assisted homology search, that the N-terminal halves of gramicidin S synthetase 1 and tyrocidine synthetase 1 are homologous with beetle luciferases and plant 4-coumarate:CoA ligases. The comparison of the reactions catalyzed by these enzymes showed that they are involved in similar reactions; the adenylation of their substrates and the formation of thiolester. Structural and functional implication of the sequence homology and molecular evolution of these proteins are discussed.

Amino Acid Isomerases↗