Oxidative damage to DNA in diabetes mellitus

BACKGROUND

Increased production of reactive oxygen species (ROS) and lipid peroxidation may contribute to vascular complications in diabetes. to test whether DNA is also oxidatively damaged in diabetes, we measured 8-hydroxydeoxyguanosine (8-OHdG), an indicator of oxidative damage of DNA, in mononuclear cells.

METHODS

For this laboratory-based study, 12 patients with insulin-dependent diabetes mellitus (IDDM) and 15 patients with non-insulin-dependent diabetes mellitus (NIDDM) were matched by age with ten healthy volunteers each. DNA was extracted from mononuclear cells from whole blood. 8-OHdG was assayed by high-pressure liquid chromatography, and ROS were assayed by chemiluminescence.

FINDINGS

IDDM and NIDDM patients had significantly higher median concentrations (p , 0.001, U test) of 8-OHdG in their mononuclear cells than their corresponding controls (in fmol/micrograms DNA): 128.2 (interquartile range 96.0-223.2) and 95.2 (64.0-133.5) vs 28.2 (21.7-43.4) and 21.9 (18.0-24.4), respectively. ROS generation by mononuclear cells was also significantly greater (p < 0.01) in diabetic patients than in their controls (in mV): 238.0 (107.0-243.0) and 101.3 (66.0-134.0) vs 69.5 (49.8-91.9) and 56.0 (38.8-62.5), respectively.

INTERPRETATION

IDDM and NIDDM patients showed greater oxidative damage to DNA, with increased generation of ROS, than controls. Such changes might contribute to accelerated aging and atherogenesis in diabetes and to the microangiopathic complications of the disease.

Nursing perceptions of using physical restraints on hospitalized children

PURPOSE

To describe the perceptions of pediatric nurses about restraint use in children.

METHOD

A descriptive survey using a questionnaire collected data from nurses working in four types of pediatric facilities. Nurses were asked to rate reasons for using restraints and alternatives to restraints on a Likert Scale. Analysis of variance analyzed the nurses' responses according to type of institution and age of the child. An open-ended question asked nurses to list reasons for using restraints.

RESULTS

Responses were collected from 60 nurses. There were significant differences in responses according to age of the child and according to the type of hospital. There were no interaction effects. The perceived need for restraints was highest between 1 and 6 years of age. Reasons for using restraints differed among types of facility.

CONCLUSIONS

Restraint policies may need to vary according to the type of institution. Intervention and outcome studies are needed regarding the use of physical restraints in children.

Vascular reactivity in patients with peripheral vascular disease

Noninvasive techniques have been used to demonstrate a specific pattern of impaired vasoactive response in the normal brachial artery of patients with clinical atherosclerosis. This is a physiologic reflection of the systemic nature of atherosclerosis and may be useful as a marker for identifying patients with preclinical atherosclerotic disease.

Ceruloplasmin levels in the human superior temporal gyrus in aging and Alzheimer's disease

In the present study we observed a loss in excess of 1/3 of the copper transport and anti-oxidant protein ceruloplasmin in both the gray and white matter from superior temporal gyrus in Alzheimer's diseased brains compared to age-matched controls. A decrease in ceruloplasmin could be reflected in decreased cellular metabolic processes such as the electron transport system and a decrease in the ability of the brain to protect itself from oxidative damage. Both decreased metabolic activity and an increase in oxidative insults are known to be associated with the neurological events in Alzheimer's disease, but the mechanism by which these phenomena occur are unknown. These results coupled with previous reports from this laboratory on iron regulatory proteins in the brain suggests one way in which cellular dysfunction and oxidative stress occurs in AD may be through a loss of ability to maintain a balance of essential metals.

Examination of the patient with a knee dislocation. The case for selective arteriography

One hundred fifteen patients with a unilateral knee dislocation underwent arteriography to examine the popliteal artery. The incidence of popliteal artery injury was 23% (27 patients). Clinically, 29 (25%) of the 115 patients had an abnormal ipsilateral pedal pulse and 23 (79%) of these 29 patients had an arteriographically identified popliteal artery injury. Twenty-two arteries were surgically repaired and one was treated without surgery. Eight-six patients had normal pulses; the arteriogram showed no abnormalities in 77, demonstrated spasm in five, and revealed an intimal flap in four. All 86 patients were treated without surgery and had no delayed vascular complications. This demonstrates that the vascular examination is an accurate predictor of major popliteal artery injury following knee dislocation. Patients with an abnormal pedal pulse warrant arteriography due to a high incidence (79%) of popliteal artery injury. Patients with normal pulses may be monitored by clinical examination only. Popliteal artery injuries in this group are minor and rarely require intervention.

A pictographic essay on blood and tissue oxygen transport

This review describes the transport of oxygen from ambient air to mitochondria in the cells. Using simple equations and diagrams, the presentation illustrates the variables which determine the magnitude of each of the three major steps in the partial pressure of O2 along the passage, from: (i) ambient air to alveolar gas; (ii) arterial blood to venous blood; and (iii) capillary blood to tissue. The emphasis is on steps (ii) and (iii), and how they are modified from the normoxic case by ischemia, anemia, hypoxia, and increased VO2. The basic context of step (iii) is the Krogh model. This model, despite its limitations, is proposed as conceptually useful in analyzing whole-body or tissue O2 transport.

Reversible and irreversible components of central-airway flow resistance

The flow energy loss (head loss) through a cast of canine central airways is found to be nearly independent of flow direction. By contrast, head loss in geometrically-simpler branching sections at comparable flow conditions is highly irreversible, with inspiratory loss being greater by nearly two units of dynamic pressure (2 X 1/2 rho V2). In these branching sections head loss appears to be independent of important geometric parameters such as the branch length/diameter ratio and the exit/inlet flow-area ratio. An analysis of these observations suggests that kinetic energy factors, not shear stresses, account for most of the energy dissipated in central airways and in simple bifurcating sections. Inspiratory loss in bifurcations is greatly increased by the onset of flow separation: irreversibility is minimal in central airways, where separation either is absent or else is much less pronounced.

Binding stoichiometry and structural mapping of the epsilon polypeptide of chloroplast coupling factor 1

Fluorescent probes were attached to the single sulfhydryl residue on the isolated epsilon polypeptide of chloroplast coupling factor 1 (CF1), and the modified polypeptide was reconstituted with the epsilon-deficient enzyme. A binding stoichiometry of one epsilon polypeptide per CF1 was obtained. This stoichiometry corresponded to a maximum inhibition of the Ca2+-dependent ATPase activity of the enzyme induced by epsilon removal. Resonance energy transfer between the modified epsilon polypeptide and fluorescent probes attached to various other sites on the enzyme allowed distance measurements between these sites and the epsilon polypeptide. The epsilon-sulfhydryl is nearly equidistant from both the disulfide (23 A) and the dark-accessible sulfhydryl (26 A) of the gamma subunit. Measurement of the distance between epsilon and the light-accessible gamma-sulfhydryl was not possible due to an apparent exclusion of modified epsilon from epsilon-deficient enzyme after modification of the light-accessible site. The distances measured between epsilon and the nucleotide binding sites on the enzyme were 62, 66, and 49 A for sites 1, 2, and 3, respectively. These measurements place the epsilon subunit in close physical proximity to the sulfhydryl-containing domains of the gamma subunit and approximately 40 A from the membrane surface. Enzyme activity measurements also indicated a close association between the epsilon and gamma subunits: epsilon removal caused a marked increase in accessibility of the gamma-disulfide bond to thiol reagents and exposed a trypsin-sensitive site on the gamma subunit. Either disulfide bond reduction or trypsin cleavage of gamma significantly enhanced the Ca2+-ATPase activity of the epsilon-deficient enzyme. Thus, the epsilon and gamma polypeptides of coupling factor 1 are closely linked, both physically and functionally.

Selective modification of an alpha subunit of chloroplast coupling factor 1

Lucifer yellow (4-amino-N-[3-(vinylsulfonyl)phenyl]naphthalimide-3,6-disulf onate), a fluorescent probe that can react covalently with sulfhydryl or amino groups, has been used to modify chloroplast coupling factor 1 (CF1). Conditions are described under which Lucifer yellow selectively labels the alpha subunit of CF1 to the extent of about 1 mol of probe per mole of CF1. An especially reactive amino group is apparently labeled, and modification has little effect on the ATPase activity of the enzyme. Lucifer yellow is a useful probe for fluorescence energy transfer measurements. The distances between this probe and fluorescent and absorbing molecules attached to seven specific sites on the beta, gamma, and epsilon subunits were determined. These distances converge to a single location. In addition to providing further information about the structure of CF1, these results suggest that the alpha subunits of CF1 are not structurally equivalent.

Structural organization of chloroplast coupling factor

Fluorescence resonance energy transfer measurements have been used to construct spatial maps for the accessible sulfhydryl of the gamma subunit (dark site) and the essential tyrosine residue of the beta subunits relative to previously mapped sites on the H+-ATPase from chloroplasts. The extent of energy transfer was measured between a coumarinylmaleimide derivative reacted covalently at the dark site and acceptor species selectively bound at the gamma-disulfide and the three nucleotide binding sites of the solubilized coupling factor complex. The nucleotide energy acceptor was 2'(3')-(trinitrophenyl)adenosine triphosphate, and the gamma-disulfide site was labeled with fluoresceinylmaleimide. The dark-site sulfhydryl also was labeled with pyrenylmaleimide which served as an energy donor for 7-chloro-4-nitro-2,1,3-benzoxadiazole reacted at the beta-tyrosine sites. Similar measurements were also made with pyrenylmaleimide covalently attached to the gamma-sulfhydryl accessible only under energized conditions on the thylakoid membrane surface (light site). The observed transfer efficiencies indicate that the dark-site sulfhydryl is approximately 45 A from all three nucleotide sites and 41-46 A from the gamma-disulfide site. The average distances separating the essential beta-tyrosines and the light- and dark-site sulfhydryls are 38 and 42 A, respectively. (In calculating these distances, random orientation of the donor-acceptor dipoles was assumed.) The results are consistent with a previously described structural model of the intact enzyme and can be used to gain insight into the overall structural organization or alpha-, beta-, and gamma-polypeptides within the coupling factor.

Structural mapping of chloroplast coupling factor

Fluorescence resonance energy transfer measurements have been used to investigate the spatial relationships between the nucleotide binding sites and the gamma-subunit of the H+-ATPase from chloroplasts and the orientation of these sites with respect to the membrane surface. Fluorescent maleimides reacted covalently at specific sulfhydryl sites on the gamma-subunit served as energy donors. One sulfhydryl site can be labeled only under energized conditions on the thylakoid membrane surface (light site). The two gamma-sulfhydryls exposed after catalytic activation served as a second donor site (disulfide site). In one set of experiments, the nucleotide analogue 2'(3')-(trinitrophenyl)adenosine triphosphate, selectively bound at each of the three nucleotide binding sites of the solubilized coupling factor, was used as an energy acceptor; in another, octadecylrhodamine with its acyl chain inserted in the vesicle bilayer and the rhodamine fluorophore exposed along the membrane surface was the energy acceptor. The distance between the sulfhydryl and disulfide sites was also obtained by sequentially labeling the sites with coumarin (donor) and fluorescein (acceptor) maleimide derivatives, respectively. The results indicate that all three nucleotide sites are approximately equal to 50 A from the light-labeled gamma-sulfhydryl. Two of the nucleotide sites are very far from the gamma-disulfide (greater than 74 A), while the third site, which binds nucleotides reversibly under all conditions, is 62 A from this sulfhydryl. The light-labeled sulfhydryl and disulfide sites are about 42-47 A apart. Finally, the distance of closest approach between the membrane surface of the reconstituted system and the gamma-disulfide is 31 A.(ABSTRACT TRUNCATED AT 250 WORDS)

A pulsed wire probe for the measurement of velocity and flow direction in slowly moving air

This report describes the theory and operation of a pulsed-probe anemometer designed to measure steady three-dimensional velocity fields typical of pulmonary tracheo-bronchial airflows. Local velocities are determined by measuring the transport time and orientation of a thermal pulse initiated at an upstream wire and sensed at a downstream wire. The transport time is a reproducible function of velocity and the probe wire spacing, as verified by a theoretical model of convective heat transfer. When calibrated the anemometer yields measurements of velocity accurate to +/- 5 percent and resolves flow direction to within 1 deg at airspeeds greater than or equal to 10 cm/s. Spatial resolution is +/- 0.5 mm. Measured flow patterns typical of curved circular pipes are included as examples of its application.

Lobar flow patterns in a hollow cast of canine central airways

To demonstrate that the regional partitioning of flow in central airways is direction dependent, we compared inspiratory and expiratory lobar flows in a hollow rigid cast of canine lungs. Lobar flows were measured by a hot-wire anemometer, simultaneous tracheal flows by a pneumotachograph, and data displayed as (lobar) flow-(tracheal) flow curves. For tracheal airflows between 50 and 370 ml/s, we found that inspiratory apical flows were smaller, and basal flows larger, than corresponding expiratory distributions. This effect was largely extinguished by substituting a gas mixture of 85% He-15% N2; resulting regional flows were comparable to expiratory distributions obtained on room air. Thus canine central airways structure induces a kinematically irreversible flow pattern, consistent with a model of "cascade flow" in which branching structure modifies the distribution only of inspiratory flow. These results support Fowler's concept that lung regions fill and empty sequentially and may be pertinent to analyses of regional washout.

Fluorescence energy transfer in two dimensions. A numeric solution for random and nonrandom distributions

A method of Monte Carlo calculations has been applied to the problem of fluorescence energy transfer in two dimensions in order to provide a quantitative measure of the effects of nonideal mixing of lipid and protein molecules on the quenching profiles of membrane systems. These numerical techniques permit the formulation of a detailed set of equations that describes in a precise manner the quenching and depolarization properties of planar donor-acceptor distributions as a function of specific spectroscopic and organizational parameters. Because of the exact nature of the present numeric method, these results are used to evaluate critically the validity of previous approximate treatments existing in the literature. This method is also used to examine the effects of excluded volume interactions and distinct lattice structures on the expected transfer efficiencies. As a specific application, representative quenching profiles for protein-lipid mixtures, in which donor groups are covalently linked to the protein molecules and acceptor species are randomly distributed within lipid domains, have been obtained. It is found that the existence of phase-separated protein domains gives rise to a shielding effect that significantly decreases the transfer efficiencies with respect to those expected for an ideal distribution of protein molecules. The results from the present numerical study indicate that the experimental application of fluorescence energy transfer measurements in multicomponent membrane systems can be used to obtain organizational parameters that accurately reflect the lateral distribution of protein and lipid molecules within the bilayer membrane.

Quantitative characterization of the lateral distribution of membrane proteins within the lipid bilayer

The dependence of the lateral distribution of membrane proteins on the size, protein/lipoid molar ratio, and the magnitude of the interaction potentials has been investigated by computer modeling protein-lipid distributions with Monte Carlo calculations. These results have allowed us to develop a quantitative characterization of the distribution of membrane proteins and to correlate these distributions with experimental observables. The topological arrangement of protein domains, protein plus annular lipid domains, and free lipid domains is described in terms of radial distribution, pair connectedness, and cluster distribution functions. The radial distribution functions are used to measure the distribution of intermolecular distances between protein molecules, whereas the pair connectedness functions are used to estimate the physical extension of compositional domains. It is shown that, at characteristic protein/lipid molar ratios, previously isolated domains become connected, forming domain networks that extend over the entire membrane surface. These changes in the lateral connectivity of compositional domains are paralleled by changes in the calculated lateral diffusion coefficients and might have important implications for the regulation of diffusion controlled processes within the membrane.

Flow partitioning in symmetric cascades of branches

We have found markedly nonuniform partitioning of flow in idealized models of physiological cascades of branches. Liquids having viscosities of 0.8-7.0 cP were used to investigate this effect systematically in a regime characterizing a limited range of pulmonary flows, comprising inlet flow rates of 500-3,000 ml/min and branch diameters of 1.0 cm ID. Factors that affect the nonuniformity of inspiratory flow include inlet velocity profile and flow rate, cascade aspect (L/D) ratio, exit pressure distribution, and, to a lesser extent, kinematic viscosity (mu/rho). More qualitative observations using sinusoidally oscillating airflow revealed inspiratory and expiratory flow patterns to be quite dissimilar, emphasizing the inadequacy of a resistance model of flow partitioning based on Kirchhoff's law. These results might suggest, in part, why regional ventilation in man is flow or frequency dependent and how bronchial smooth muscle could fine tune regional ventilation.

Monte Carlo studies of the lateral organization of molecules in two-component lipid bilayers

The lateral organization of two-component phosphatidylcholine bilayers has been investigated using Monte Carlo calculations based upon non-ideality parameters deduced from the phase diagrams of these mixtures. The results are used to develop a quantitative description of the distribution and spatial localization of compositional regions along the bilayer plane in both the gel and liquid crystalline phases. In particular, a detailed analysis of the physical extension (lateral connectivity) and compactness of the compositional clusters is made. It is concluded that the chemical composition of the membrane, the physical state of the bilayer and the interaction energies between molecules greatly influence the lateral connectivity and compactness of compositional regions and that these parameters might play an important role in the formation of diffusional pathways along the membrane plane.

Compositional domain structure in phosphatidylcholine--cholesterol and sphingomyelin--cholesterol bilayers

the lateral distribution of cholesterol in phospholipid bilayers has been investigated through a method of Monte Carlo calculations, using interaction energies deduced from calorimetric results for cholesterol-phospholipid mixtures. Analysis of computer-generated bilayer configurations allows calculation of the spatial localization and relative abundance of distinct regions of varying cholesterol content along the plane of the bilayer. An interfacial phospholipid region between cholesterol-bound and cholesterol-free domains is found to extend one lipid beyond the cholesterol-bound domain for mixtures of cholesterol with palmitoyl sphingomyelin, lignoceroyl sphingomyelin, and dipalmitoyl phosphatidylcholine. The results indicate that the degree of nonideality in the mixing of cholesterol is dependent on fatty acid chain length and that cholesterol mixes more ideally in sphingomyelins than in phosphatidylcholines of equal chain length. It is found that at approximately 20 mol % cholesterol the cholesterol-rich areas suddenly become connected, forming a network that extends over the entire bilayer. This change in the lateral connectivity of the cholesterol-rich domains occurs over a narrow concentration interval and is presumably responsible for the abrupt change in the lateral diffusion coefficient observed at this concentration.

Estimation of the lateral distribution of molecules in two-component lipid bilayers

A new formalism to investigate the lateral distribution of molecules in lipid bilayers has been developed, and the results have been applied to the case of phosphatidylcholine mixtures. It is demonstrated that the experimental phase diagrams for these mixtures can provide the necessary information to generate computer-simulated bilayers with the desired molecular interactions and lattice constraints. Analysis of these computer-generated bilayers allows calculation of the number of contacts between like and unlike molecules, the average size and number of compositional clusters, and the pair correlation functions. The results of this analysis provide a full quantitative description of the molecular organization of phosphatidylcholine within the plane of the bilayer.