Physicians contracting with managed care

It has been observed that enrollees in managed care systems such as HMOs and PPOs have lower expenditures and utilization rates than those in conventional insurance plans. Few studies have investigated this issue by examining providers. This paper studies whether physicians with low costs are more likely to sign contracts with HMOs and PPOs in order to help explain the observation of lower expenditures and utilization rates by HMO and PPO enrollees. A logistic regression is applied to the data from the 1984-1985 Physician Practice Costs and Income Survey. The results do not show strong evidence that a physician's likelihood of contracting with HMOs and PPOs is related to the physician's practice costs and utilization pattern. Instead, major factors that significantly affect a physician's decision of contracting with managed care systems are the physician's socio-demographics, the physician's practice region, and the market conditions.

Hospitals contracting with managed care

It has been observed that enrollees in managed care systems such as health maintenance organizations (HMOs) and preferred provider organizations (PPOs) have lower utilization rates and lower expenditures than those in conventional fee-for-service health insurance programs. To date, no study has investigated this issue by examining providers. This paper studies whether lower cost hospitals are more likely to sign contracts with HMOs and PPOs and thus explain the observed lower utilization rates and lower expenditures by HMO and PPO enrollees. A logistic regression is applied to the data from the 1988 AHA Annual Survey of Hospitals. The results show that private hospitals, teaching hospitals, hospitals accredited by JCAHO, hospitals with high case mix index, and hospitals located in MSAs are more likely to contract with HMOs and PPOs than their counterparts. If hospitals with these characteristics have higher costs, then the results do not suggest that hospital costs can explain the lower utilizations and lower expenditures by HMO and PPO enrollees.

Genomic structure and chromosomal localization of processed pseudogenes for human RBP-Jk

The functional gene for human recombination signal sequence-binding protein (RBP-Jk) and corresponding processed psudogenes have been isolated from various species, such as Drosophila, Xenopus, mouse, and human. Here we report the isolation of another two genomic pseudogenes of human RBP-Jk, named K2 and K7, from a cosmid library of Hela cells. The nucleotide sequences of both genes exhibited more than 95% homology to the functional human gene for RBP-Jk. Moreover, they did not contain any intron sequences and were interrupted by several stop codons in all frames. In situ hybridization demonstrated that the pseudogenes, K2 and K7, were localized at chromosomes 9p13 and 9q13, respectively. Their physical maps differed from those of the true functional gene and of the pseudogenes reported previously by Amakawa et al. (1993).

Autoradiographic localization of beta-endorphin binding in the pancreas

Autoradiographic localization of 125I-labeled beta-endorphin binding in the rabbit pancreas demonstrated specific binding in the pancreatic islet cells. Binding was inhibited by (1) nonradioactive beta-endorphin, (2) the opioid antagonist naloxone, (3) the mu receptor agonists morphine and [D-Ala2, (Me)Phe4, Gly(ol)5]enkephalin, (4) the delta receptor agonist [D-penicillamine2, D-penicillamine5]-enkephalin, (5) the mu and delta agonist met-enkephalin and (6) the delta and kappa agonist dynorphin. Specific binding was not clearly demonstrable in the acinar portion of the rabbit pancreas. The binding characteristics of 125I-beta-endorphin in the pancreatic islets were comparable with those of mu and delta opioid receptors in the rabbit brain. In the pancreas, beta-endorphin binding appeared to be concentrated in discrete areas in the islets. Combined immunohistochemistry and autoradiography demonstrated that beta-endorphin binding was primarily concentrated in the glucagon-containing alpha and somatostatin-containing delta cells, but was also found in the insulin-containing beta cells to a lesser extent. Given the intraislet location of the opioid binding sites, and our previous finding of immunoreactive beta-endorphin in the pancreatic beta cells and the inhibitory effect of beta-endorphin on insulin secretion, it appears that beta-endorphin may serve a paracrine or autocrine function in the regulation of pancreatic hormone secretion.

T cell cytokine responses in persons with tuberculosis and human immunodeficiency virus infection

Tuberculosis causes more extensive and life-threatening disease in patients with HIV infection than in immunocompetent persons. To investigate the hypothesis that these severe manifestations of tuberculosis may be due to alterations in cytokine production, we evaluated cytokine patterns in HIV-infected tuberculosis patients. Upon stimulation with Mycobacterium tuberculosis in vitro, PBMC from HIV-infected tuberculosis patients had reduced proliferative and type 1 responses, compared with HIV-seronegative tuberculosis patients. The reduction in proliferative responses was independent of the CD4 cell count, but the reduced type 1 response was a direct result of CD4 cell depletion. There was no enhancement of type 2 cytokine production in HIV-infected patients, although production of IL-10 was prominent in all tuberculosis patients. In HIV-infected tuberculosis patients, M. tuberculosis-induced proliferative responses were significantly enhanced by neutralizing antibodies to IL-10 but not by antibodies to IL-4 or by recombinant IL-12. The M. tuberculosis-induced type 1 response was augmented both by antibodies to IL-10 and by recombinant IL-12. Tuberculosis in the context of HIV infection is characterized by diminished type 1 responses, probably induced by immunosuppressive cytokines produced by macrophages/monocytes, rather than by type 2 cells.

[The distribution and pharmacokinetics in lung of bovine serum albumin microspheres for pulmonary targeting in mice]

125I-labeled bovine serum albumin microspheres loaded cisplatinum (CDDP-125I-BSA-MS) with the size range of 7-25 microns were prepared and injected into the tail vein of mice. The results showed that the microspheres were accumulated almost entirely in the lung after i.v. injection (about 97.52% injected dose at the highest concentration). While in blood and other organs almost no accumulation was found. Photomicrographs showed that microspheres reached the lung and lodged in precapillary arteriols and capillaries of lung. The microspheres in lung were eliminated gradually. The pharmacokinetics of microspheres in lung of mice was also studied with "practical pharmacokinetic program-version 87", and was fitted by two-compartment model with i.v. injection or one-compartment model with 1st order absorption, but the meaning of some parameters changed. Based on the analysis of the models and parameters, it was concluded that the pharmacokinetics of microspheres in lungs can be described by the model of "one-compartment of first-order intake and first-order elimination".

[Transcript expression of the CPL 5x, BMD-3A, BMD-10 Interrogans leptospira]

Total RNA of Leptospira interrogans SV Lai strain 017 was prepared by the method of Licl-Urea, and was used in dot hybridization with biotin-labelled DNA probes. The probes included BMD-3A, BMD-10, which were the leptospirial protective antigen genes, and CPL 5x, which was the genus specific gene of interrogans Leptospira. All of the three probes have shown various degrees of hybridization signs, proving that they all have transcript expression in leptospira. The transcript expression is the main way of regulating the gene expression in procaryotae, and it is significant in molecular genetics of Leptospira. The results indicate that the antigens encoded by the BMD-3A, BMD-10 may play an important role in immune reaction against leptospiral infection and provide a clue to the development of gene-engineering vaccine. The results also suggest that the antibody against the antigen encoded by CPL 5x is a useful tool in the classification of Leptospira interrogans.

The malignancy of dementia. Predictors of mortality in clinically diagnosed dementia in a population survey of Shanghai, China

OBJECTIVE

To evaluate the effect of dementing illnesses on the risk of dying, taking into account other conditions that would shorten survival.

DESIGN

Five-year follow-up of community survey of dementia.

SETTING

Five-year data were obtained for the 3531 subjects, aged 65 years and older, who participated in the 1987 population survey of dementia in Shanghai, China.

MAIN OUTCOME MEASURE

Time to death. Relative risks of dying were calculated for demographic variables, dementia diagnoses based on findings of clinical evaluations, and 15 reported prevalent medical conditions using the proportional hazards model.

RESULTS

In those subjects aged 65 to 74 years, the mortality risk ratio was 5.4 (95% confidence interval, 2.0 to 14.6) for Alzheimer's disease and 7.2 (95% confidence interval, 3.6 to 14.4) for vascular dementia. The risk ratio for Alzheimer's disease was similar to the mortality risk ratio for cancer (5.6 [range, 2.9 to 10.9]). In this age group, dementing illnesses were uncommon, and few deaths were therefore attributable to the dementing illnesses. In those subjects aged 75 years and older, the mortality risk ratios were 2.8 (95% confidence interval, 2.1 to 3.6) for Alzheimer's disease, 3.5 (95% confidence interval, 2.4 to 5.1) for vascular dementia, and 3.6 (95% confidence interval, 2.0 to 6.7) for "other dementias." Because these dementing disorders were common in those subjects aged 75 years and older, 23.7% of the risk of death could be attributed to these disorders.

CONCLUSIONS

Both Alzheimer's disease and vascular dementias are truly malignant and constitute major risk factors for death in persons older than 75 years.

The Central Role of Broken Bond-Bending Constraints in Promoting Glass Formation in the Oxides

A glass network of N atoms with n(1) of the atoms with a coordination number of 1, and m(2) of the atoms with a coordination number of 2 about which the bond-angle constraint is broken, will in general display a stiffness threshold (rigidity percolation threshold) when the average coordination increases to a critical value (r)(c) = 2.4 - 0.4 (n(1) - m(2))/N. Silica and sodium tellurate glasses provide model examples for which this general relation predicts the observed rigidity percolation threshold; this relation predicts the percolation threshold only if one includes broken bond-bending constraints due to bridging oxygen in the former network and nonbridging oxygen in the latter network. The rigidity percolation threshold in (Na(2)O)x,(TeO(2))1-x glasses observed to occur near x approximately 0.18 in tellurium-125 Lamb-Mössbauer factor measurments.

Gene frequencies of alcohol dehydrogenase2 (ADH2) and aldehyde dehydrogenase2 (ALDH2) in five Chinese minorities

The gene frequencies of ADH2(2) and ALDH2(2) were lower in Tibetan and Mongolian populations than in Vietnamese, Han Chinese, and three Chinese minority populations.

Measurement of allergen-specific IgD and correlation with allergen-specific IgE

A new method for the measurement of allergen-specific IgD (as-IgD) was developed by modifying the ImmunoCAP assay (Pharmacia), and amplification of the signal with a goat anti-human/rabbit anti-goat detection system. The assay was sensitive enough to measure as-IgD in serum samples. The specificity of the assay was examined using inhibition tests with excess corresponding and non-corresponding allergens. For the different allergens inhibition rates between 56% (house dust mite) and 88% (cat) could be achieved. Non-corresponding allergens did not inhibit the as-IgD binding. Total IgE and allergen-specific IgE (as-IgE) was measured using the ImmunoCAP system. Total IgD was measured using a sandwich ELISA. As-IgD was measured in serum samples from 51 atopic and 23 non-atopic subjects, and the correlation with as-IgE was examined. As-IgD was detected in both atopics and non-atopics but at higher levels in atopics. As-IgD against birch pollen and timothy pollen allergen was found to be increased in atopics with IgE directed against these allergens compared to atopics without IgE against these allergens (P < 0.02 and P < 0.03). As-IgD against birch pollen allergen was higher in atopics with IgE specific to this allergen than in non-atopics (P < 0.02). In contrast to total IgE and total IgD, significant correlations were observed between as-IgD and as-IgE against timothy pollen (r = 0.34, P < 0.04), birch pollen (r = 0.38, P < 0.05) and cat dander allergen (r = 0.52, P < 0.01). The observed correlations between as-IgD and IgE suggest that IgD and IgE may be similarly regulated, and thus the measurement of as-IgD may give further insight into the regulation of IgE.

[An approach for PCR amplification of long DNA fragments]

The polymerase chain reaction (PCR) technique, evolved as a standard laboratory technique, has a major limitation: its inability to efficiently amplify fragments higher than 1.5 kb. In this paper, PCR conditions allowing the efficient amplification of long DNA fragments, especially a new proper buffer system, have been developed. The difference between the new PCR reaction buffer system and standard reaction system is that no KCl is included in the former. The results indicated that specificity and reproducibility for amplifying long DNA fragments by using new buffer system are satisfactory.

Thermal activation of a group II intron ribozyme reveals multiple conformational states

Conformational changes often accompany biological catalysis. Group II introns promote a variety of reactions in vitro that show an unusually sharp temperature dependence. This suggests that the chemical steps are accompanied by the conversion of a folded-but-inactive form to a differently folded active state. We report here the kinetic analysis of 5'-splice-junction hydrolysis (SJH) by E1:12345, a transcript containing the 5'-exon plus the first five of six intron secondary structure domains. The pseudo-first-order SJH reaction shows (1) activation by added KCl to 1.5 M; (2) cooperative activation by added MgCl2, nHill = 4.1-4.3, and [MgCl2]vmax/2 approximately 0.040 M; and (3) a rather high apparent activation energy, Ea approximately 50 kcal mol-l. In contrast, the 5'-terminal phosphodiester bond of a domain 5 transcript (GGD5) was hydrolyzed with Ea approximately 30 kcal mol-1 under SJH conditions; the 5'-GG leader dinucleotide presumably lacks secondary structure constraints. The effect of adding the chaotropic salt tetraethylammonium chloride (TEA) was also investigated. TEA reduced the melting temperatures of GGD5 and E1:12345. TEA also shifted the profile of rate versus temperature for SJH by E1:12345 toward lower temperatures without affecting the maximum rate. TEA had little effect on the rate of hydrolysis of the 5'-phosphodiester bond of GGD5. The high apparent activation enthalpy and entropy for SJH along with the effect of TEA on these parameters imply that conversion of an inactive form of E1:12345 to an active conformation accompanies enhanced occupation of the transition state as the temperature is raised to that for maximum SJH. Analytical modeling indicates that either a two-state model (open and disordered, with open being active) or a three-state model (compact, open, and disordered) could account for the temperature dependence of kSJH. However, the three-state model is clearly preferable, since it does not require that the activation parameters for phosphodiester bond hydrolysis exhibit exceptional values or that the rates for the chemical steps of SJH respond directly to TEA addition.

Crystal structure of bovine heart phosphotyrosyl phosphatase at 2.2-A resolution

The first X-ray crystallographic structure of a member of the class of low molecular weight (M(r) 18,000) phosphotyrosyl phosphatases is presented. Bovine heart phosphotyrosyl phosphatase (BHPTP) exemplifies this class and is highly homologous (94% sequence identity) to an isoenzyme known as red cell acid phosphatase that is present throughout human tissues. The high-resolution (2.2-A) crystal structure of BHPTP shows that the enzyme consists of a four-strand central parallel beta sheet with alpha helices packed on both sides in a manner characteristic of a Rossmann fold. A bound phosphate ion defines the active site location in a loop of the first beta alpha beta motif at the C-terminus of the beta sheet. The location and enzymatic significance of the residues in the characteristic low molecular weight PTPase active site motif, including the essential arginine (Arg 18) and nucleophilic cysteine (Cys 12), are described. The functional role of a histidine (His 72) suggested previously to be near the active site is defined in the structure, as well as a potential proton donor for the leaving group in the tyrosyl phosphate cleavage. Surface maps of BHPTP define a hydrophobic crevice suitable for phosphotyrosyl peptide binding. Comparison of the BHPTP structure to the related, but structurally distinct enzyme PTP1B is made, illustrating the unique way this smallest of these phosphatases has formed the phosphotyrosine active site.

Isotope-edited Fourier transform infrared spectroscopy studies of calmodulin's interaction with its target peptides

The ubiquitous calcium-binding protein calmodulin (CaM) regulates a wide variety of cellular events by binding to and activating many distinct target enzymes. The CaM-binding domains of most of these enzymes are contained in a contiguous stretch of amino acids with a length of approximately 20 residues. In this work, we have used "isotope-edited" Fourier transform infrared spectroscopy to study the interaction of CaM with synthetic peptides resembling the CaM-binding domains of myosin light chain kinase (MLCK), constitutive nitric oxide synthase (cNOS), and caldesmon (CaD). Uniform labeling of CaM with carbon-13 causes the amide I band of the protein to shift approximately 55 cm-1 to lower frequency in D2O, leaving a clear window in the infrared spectrum for observing the amide I band of the unlabeled target peptides. Upon complex formation, the amide I bands of the CaM-binding domains of MLCK and cNOS shift 4 cm-1 toward higher frequency (to approximately 1648 cm-1), and have a narrower bandwidth compared to the peptide in aqueous solution. These spectral changes and the fact that the infrared spectra of these two peptides in their complex with CaM closely resemble those recorded in a mixture of D2O and the helix inducing solvent trifluoroethanol indicate that they bind to CaM in an alpha-helical conformation. The CaM-binding domain of CaD also showed similar, but less dramatic, spectral changes; this is in agreement with the fact that it binds to CaM with lower affinity and a shorter alpha-helix.(ABSTRACT TRUNCATED AT 250 WORDS)

Crystal structure of domain A of Thermus flavus 5S rRNA and the contribution of water molecules to its structure

This is the first high resolution crystal structure of an RNA molecule made by solid phase chemical synthesis and representing a natural RNA. The structure of the domain A of Thermus flavus ribosomal 5S RNA is refined to R = 18% at 2.4 A including 159 solvent molecules. Most of the 2'-hydroxyl groups as well as the phosphate oxygens are involved either in specific hydrogen bonds in intermolecular contacts or to solvent molecules. The two U-G and G-U base-pairs are stabilized by H-bonds supplied via three water molecules to compensate for the lack of base-pair hydrogen bonds. The structure shows for the first time in detail the importance of highly ordered internal water in stabilizing an RNA structure.

[Anastomosis of small artery using ZT medical adhesive and soluble stent]

The conventional technique of interrupted suture in microvascular anastomosis is difficult to perform and timeconsuming. A new method with ZT medical adhesive and soluble intravascular stent is introduced. Using this method, end-to-end anastomosis of small arteries could be performed easily and quickly. Both the patency rate and histopathologic changes at the anastomosis sites were examined. In comparison with suture technique, similar patency rate was obtained. Inflammatory reaction in mid and outer layers of the vessel was observable and reendothelialization of the intima was identical.

[Relationship between effect of tetrandrine on pleurisy and phospholipase A2]

A model of pleurisy was established with an intrapleural injection of carrageenan (Car, 10 mg.kg-1) in rats to explore the anti-inflammatory action of tetrandrine (Tet) and its mechanism. After the injection of Car, the exudate, protein and neutrophils appeared in the pleural cavity of rats at 2 h, then increased progressively, and reached a peak level at 12 h and remained high up to 48 h. The phospholipase A2(PLA2) activity of neutrophils (Neu-PLA2) and of the acellular component (ACC-PLA2) in the pleural exudate intensified at 2 h, rose to maximal intensity at 8 h, and started to decline at 48 h. The changes of the amount of exudate, protein content and neutrophil count, and parameters indicating the inflammatory response, were closely related to that of the PLA2 activity (r = 0.749-0.928, P < 0.05 or 0.01). By ig gavage of Tet (10-80 mg.kg-1) to rats at 30 min before and 4 h after the injection of Car, the inflammatory parameters were reduced and the PLA2 activity was inhibited, dose-dependently. The reductions of the inflammatory parameters were significantly associated with the inhibition of the PLA2 activity (r = 0.928-0.993, P < 0.05 or 0.01). These results indicate that Tet has a fine anti-inflammatory action and its mechanism may involve the inhibition on the activation and release of PLA2 of inflammatory cells.

Epidemiology of back injury in university hospital nurses from review of workers' compensation records and a case-control survey

Reviewing Workers' Compensation records for back injury from a large university hospital for a 2-year period, we found a yearly incidence of lost work time back injury among nurses of 2.0% per year, exceeded only by physical plant staff, who had a rate of 3.5%. Nurses' aides had an injury rate 3.3-fold higher than registered nurses and licensed practical nurses and higher than any other occupational group. We compared 100 cases of nurses with back injury in the previous 2 years with 197 noninjured control subjects using a mailed 40-item questionnaire. Multivariate logistic modelling showed that prior nonback injury and performing combined lifting activities were statistically significant risk factors for back injury, and being overweight approached significance, after adjusting for the effects of age, gender, and each of the evaluated risk factors.

Ectopic Hoxa-1 induces rhombomere transformation in mouse hindbrain

Homeobox genes are expressed with a specific spatial and temporal order, which is essential for pattern formation during the early development of both invertebrates and vertebrates. Here we show that widespread ectopic expression of the Hoxa-1 (Hox 1.6) gene directed by a human beta-actin promoter in transgenic mice is embryolethal and produces abnormal phenotypes in a subset of domains primarily located in anterior regions. Interestingly, this abnormal development in the Hoxa-1 transgenic mice is associated with ectopic expression of the Hoxb-1 (Hox 2.9) gene in select hindbrain regions. At gestation day 9.5, two domains of strong Hoxb-1 expression are found in the anterior region of the hindbrains of Hoxa-1 transgenic embryos. One region represents the normal pattern of Hoxb-1 expression in rhombomere 4 and its associated migrating neural crest cells, while another major domain of Hoxb-1 expression consistently appears in rhombomere 2. Similar ectopic domains of beta-galactosidase activity are detected in dual transgenic embryos containing both beta-actin/Hoxa-1 transgene and a Hoxb-1/lacZ reporter construct. Expression of another lacZ reporter gene that directs beta-galactosidase activity predominantly in rhombomere 2 is suppressed in the Hoxa-1 transgenic embryos. We have also detected weaker and variable ectopic Hoxb-1 expression in rhombomeres 1, 3 and 6. No ectopic Hoxb-1 expression is detected in rhombomere 5 and the expression of Hoxa-3 and Krox-20 in this region is unchanged in the Hoxa-1 transgenic embryos. While no obvious change in the morphology of the trigeminal or facial-acoustic ganglia is evident, phenotypic changes do occur in neurons that emanate from rhombomeres 2 and 3 in the Hoxa-1 transgenic embryos. Additionally, alterations in the pattern of Hoxa-2 and Hoxb-1 expression in a subpopulation of neural crest cells migrating from the rhombomere 2 region are detected in these transgenics. Taken together, these data suggest that ectopic Hoxa-1 expression can reorganize select regions of the developing hindbrain by inducing partial transformations of several rhombomeres into a rhombomere-4-like identity.

Suppression of the allogeneic response by human IL-10: a critical role for suppression of a synergy between IL-2 and TNF-alpha

The effect of IL-10 on T-cell activation by alloantigens in primary mixed lymphocyte reaction (MLR) was examined. IL-10 strongly suppressed proliferation and cytokine synthesis observed in this reaction. To determine the cytokine synthesis inhibition that was critical for the IL-10 induced suppression of proliferation in MLR, the effect of exogenous cytokines (IL-1 alpha, IL-1 beta, IL-2, IL-4, IL-6, IFN-gamma, or TNF-alpha) on this suppression was examined. None of these cytokines, when used at high concentration, was able to completely restore proliferation in the MLR to the levels observed in the absence of IL-10. However, IL-2 and TNF-alpha, when added alone at high concentration, could partially overcome the IL-10 induced suppression of proliferation in MLR. Moreover, when a combination of IL-2 and TNF-alpha was added at suboptimal doses to IL-10-suppressed MLR, complete restoration of the proliferative response was obtained. The ability of IL-10 to suppress proliferation in MLR was dependent on the type of cells used as stimulators. Thus, IL-10 suppressed proliferation in MLR when allogeneic normal peripheral blood mononuclear cells (PBMC), highly purified monocytes or B cells, were used, but not when B-cell lines were used as stimulators. Investigation of the effect of IL-10 on cytokine synthesis revealed that when B-cell lines were used as stimulators of MLR, IL-10 suppressed IFN-gamma and IL-2 synthesis but was unable to suppress TNF-alpha production. In contrast, CSA, which inhibited proliferation in MLR induced by B-cell lines, also inhibited TNF-alpha. IL-2 and IFN-gamma synthesis. Together these data suggest that the suppression of MLR by IL-10 requires the effective inhibition of both IL-2 and TNF-alpha production to suppress a synergy between these two cytokines.

Solution conformation of a cyclic neurokinin antagonist: a NMR and molecular dynamics study

The solution structure of a hexapeptide, cyclo (Gln-Trp-Phe-Gly-Leu-Met), which is a selective NK-2 antagonist, has been studied by a combination of two-dimensional nmr and molecular dynamics (MD) techniques. The simulation based on nmr and MD data resulted in the convergence to a family of structures. Free molecular dynamics for 50 ps in the presence of DMSO solvent molecules shows that the structure is energetically stable. One intramolecular hydrogen bond between the amide proton of Gln and the carbonyl oxygen of Gly was revealed. This result is consistent with the results from the measurement of the temperature coefficient of the amide protons. The extent of intermolecular hydrogen bonding between the amide protons of the peptide and DMSO was also revealed by the free MD simulation. The resulting structure of the cyclic peptide contains a variation type I' beta-turn in the Gly-Leu-Met-Gln segment. Comparison of the structure of this peptide with that of other NK-2 antagonist cyclic hexapeptides was made, and the activity of cyclic antagonists appears to be inversely related to the conformational rigidity of the cyclic peptides.

[Influence of refined amorphophallus konjac on osteoporosis in the aged female rats: a preliminary bone histomorphometric analysis]

The hypolipidaemic and antisteatotic effects of refined amorphophallus konjac (RAK) have been reported. In order to further evaluate the effect of RAK on osteoporosis in the aged female SD rats, forty one month aged female SD rats were divided into three groups: a normal diet group (S), another normal diet group (A) and a test group (B) in which the animals were fed on a diet similar to that of the normal diet group with the addition of RAK at a dosage of 1%. At the end of the sixth month of the diet treatment, all the animals in S group were killed. Animals of the other two groups were sacrificed at the end of experiments for 18 months. Blood and right femora samples were collected for serum Ca, P, and for bone mineral contents (BMC), respectively. Inorganic matter (ash content), and calcium and phosphorus contents of the left femur were measured. Meanwhile, undecalcified sections of left tibia were processed for bone histomorphometry. The results showed that trabecular bone volume (Vv), trabecular perimeters (TRP), bone mineral contents (BMC) as well as the Ca, P contents of bone were lower in A and B than in S, but no significance was found between A and B in all of the above indices. These data exhibited: (1) Similar to the postmenopausal osteoporosis in aged women, the bone mass of the aged female rats was markedly lost in A and B. (2) A diet treatment with 1% RAK would not aggravate osteoporosis.

Use of antibodies to identify satellite cells with a light microscope

Satellite cells are essential for the growth and regeneration of skeletal muscles but the study of them has been difficult due to the need to use an electron microscope. This article describes a method which enables satellite cells to be identified with a light microscope. Satellite cells were distinguished from: (1) myonuclei on the basis of whether the nuclei were inside or outside the plasmalemma of a fiber (stained with antidystrophin); and (2) interstitial cells depending on whether they were inside or outside of a fiber's basal lamina (stained with anticollagen IV). Some satellite cells were stained by the antidystrophin which further aided their identification. The question of whether all satellite cells are myogenic has been investigated and discussed. This method will facilitate the study of satellite cells in biopsies of human muscles and the estimation of satellite cell number in laboratory animals.

Community-based psychiatric rehabilitation in Shanghai. Facilities, services, outcome, and culture-specific characteristics

This paper describes the community mental health services in Shanghai, analyses the effectiveness of these services, and discusses their culture-specific characteristics. It reports on a prospective, matched-control study of the three most important types of service: a community follow-up programme in psychiatric out-patient clinics at primary-level general hospitals, 'guardianship networks' operated by non-professional volunteers, and work therapy stations. In total 308 pairs of subjects completed the study. Using Chinese versions of the Disability Assessment Schedule to assess impairment in psychosocial functioning and the Present State Examination to assess the levels of positive and negative symptoms, ten blind evaluators who had excellent inter-rater reliability assessed the functioning of subjects at enrollment and every six months for the next two years. Over the two years, symptoms and social functioning improved in the treatment groups and deteriorated in the control groups. Thus these community psychiatric services have the dual benefit of promoting rehabilitation and preventing psychosocial deterioration.

Deletion within the Src homology domain 3 of Bruton's tyrosine kinase resulting in X-linked agammaglobulinemia (XLA)

The gene responsible for X-linked agammaglobulinemia (XLA) has been recently identified to code for a cytoplasmic tyrosine kinase (Bruton's agammaglobulinemia tyrosine kinase, BTK), required for normal B cell development. BTK, like many other cytoplasmic tyrosine kinases, contains Src homology domains (SH2 and SH3), and catalytic kinase domain. SH3 domains are important for the targeting of signaling molecules to specific subcellular locations. We have identified a family with XLA whose affected members have a point mutation (g-->a) at the 5' splice site of intron 8, resulting in the skipping of coding exon 8 and loss of 21 amino acids forming the COOH-terminal portion of the BTK SH3 domain. The study of three generations within this kinship, using restriction fragment length polymorphism and DNA analysis, allowed identification of the mutant X chromosome responsible for XLA and the carrier status in this family. BTK mRNA was present in normal amounts in Epstein-Barr virus-induced B lymphoblastoid cell lines established from affected family members. Although the SH3 deletion did not alter BTK protein stability and kinase activity of the truncated BTK protein was normal, the affected patients nevertheless have a severe B cell defect characteristic for XLA. The mutant protein was modeled using the normal BTK SH3 domain. The deletion results in loss of two COOH-terminal beta strands containing several residues critical for the formation of the putative SH3 ligand-binding pocket. We predict that, as a result, one or more crucial SH3 binding proteins fail to interact with BTK, interrupting the cytoplasmic signal transduction process required for B cell differentiation.

Randomised-control trial of family intervention for 78 first-episode male schizophrenic patients. An 18-month study in Suzhou, Jiangsu

At the time of discharge from their first stay in psychiatric hospital, 78 male schizophrenic patients were randomly assigned to a family intervention (experimental) group or a 'standard care' control group and were followed for the next 18 months. The family intervention consisted of both group and individual counselling sessions every 1-3 months that focused on education about the illness and on methods of dealing with the patient. There was a significantly lower rate of hospital readmission in the family intervention group than in the control group (15.4% versus 53.8%, chi 2 = 12.75, P < 0.01), and the mean hospital-free period for those who were readmitted was significantly longer in the experimental group than in the control group (245 days versus 130 days, t = 2.91, P < 0.01). Moreover, the clinical status and overall level of functioning in patients who were not readmitted were significantly better in experimental subjects than in control subjects. Stratified analysis showed that family intervention and regular use of medication had independent and additive effects on the outcome. During the 18 months after the index discharge patients who did not take medication regularly and who did not receive family intervention were 7.9 times as likely to be readmitted to hospital as patients who took medication regularly and received family intervention.

Reductive methylation and pKa determination of the lysine side chains in calbindin D9k

The Lys residues in the 75-residue Ca(2+)-binding protein calbindin D9k were reductively methylated with 13C-enriched formaldehyde. The possible structural effects resulting from the chemical modification were critically investigated by comparing two-dimensional NMR spectra and the exchange rates of some of the amide protons of the native and the modified protein. Our results show that the protein retains its structure even though 10 Lys out of a total of 75 amino acid residues were modified. In the Ca(2+)- and apo-forms of the protein, the 13C-methylated Lys residues can be detected with high sensitivity and resolution using two-dimensional (1H, 13C)-heteronuclear multiple quantum coherence (HMQC) NMR spectroscopy. The pKa values of the individual Lys residues in Ca(2+)-calbindin D9k and apo-calbindin D9k were obtained by combining pH titration experiments and (1H, 13C)-HMQC NMR spectroscopy. Each Lys residue in the Ca(2+)- and apo-forms of calbindin D9k has a unique pKa value. The Lys pKa values in the calcium protein range from 9.3 to 10.9, while those in the apo-protein vary between 9.7 and 10.7. Although apo-calbindin D9k has a very similar structure compared to Ca(2+)-calbindin D9k, the removal of two Ca2+ ions from the protein leads to an increase of the pKa values of the Lys residues.

The optimization of preparations of competent cells for transformation of E. coli

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Modulation of connexins during differentiation of oval cells into hepatocytes

The connexins are a family of related gap-junction proteins, implicated in embryonic development, cell growth control, and cellular differentiation. To identify connexins involved in liver cell differentiation, both in vivo and in vitro systems were employed to study expression of connexins 26, 32, and 43. Northern blot analysis and in situ hybridization were used to measure the levels of connexin expression and cellular localization of the transcripts, respectively. Normal liver expressed high connexin 32, low connexin 26, and barely detectable connexin 43. In vivo proliferation and differentiation of oval cells was at first accompanied by increased connexin 43 and decreased connexin 32 expression; later as the oval cells differentiated into hepatocytes, connexin 43 disappeared and connexin 32 increased to control levels. In situ hybridization showed that both oval cells and bile duct epithelial cells, but not hepatocytes, expressed connexin 43. A switch from connexin 43 to connexin 32 expression was observed following in vitro transformation and differentiation of rat liver epithelial cells toward the hepatocytic lineage. These results suggest that early progenitor cells in the liver express connexin 43 and a switch from connexin 43 to connexin 32 may signal commitment to hepatocytic differentiation.

Study on polyamide microcapsules containing oily liquids

Oily liquids were microencapsulated within polyphthalamide membranes with dodecyl sulphonate sodium (DSS) as an emulsifier. The mean diameter and the distribution, as well as the zeta-potential, of the microcapsules were analysed. It was found that the mean diameter decreases with an increase in stirring speed and emulsifier concentration during the emulsification step. The addition of DSS to aqueous phase resulted in a decrease in zeta-potential of the microcapsules.

Two-dimensional NMR studies of selenomethionyl calmodulin

Calmodulin (CaM) is a ubiquitous calcium regulatory protein that can interact with almost 30 different target proteins. The majority of the CaM-binding domains of the target proteins are believed to interact with two hydrophobic surfaces on Ca(2+)-CaM; these two regions are very rich in Met residues. To obtain more information about the role of these residues, we have biosynthetically incorporated selenomethionine (SeMet) in place of the nine Met residues of CaM. Amino acid analysis shows that the SeMet-CaM contains 15% Met and 85% SeMet. SeMet-CaM retains many of the properties of the wild-type protein; it activates the enzyme cyclic nucleotide phosphodiesterase, it binds to phenyl-Sepharose and myosin light chain kinase (MLCK) in a calcium-dependent manner, and it experiences a calcium-dependent band shift during SDS-gel electrophoresis. Moreover, by comparing the natural abundance (1H,13C)-heteronuclear multiple quantum coherence (HMQC) spectra of the calcium, apo and target peptide-bound forms of wild-type CaM and SeMet-CaM, we have found that the two proteins have very similar, if not identical, structures. Thus, the substitution of SeMet for Met does not cause a change in the conformation and function of CaM, in agreement with the results obtained for other proteins. The apo, calcium and target peptide-bound forms of SeMet-CaM were subsequently studied by natural abundance (1H,77Se)-heteronuclear multiple bond correlation (HMBC) and (1H,13C)-HMQC NMR. Nine well-resolved 77Se resonances could be observed. Substitution of SeMet for Met gave rise to the same 1H and 13C chemical shift changes for each individual Met residue, this facilitated making the assignments from known 1H,13C assignments of the Met residues. Some of these assignments were confirmed by studying Met-->Leu mutants of CaM. With the exception of Met76, which always remains solvent exposed, all resonances experienced large 77Se chemical shift changes upon the addition of Ca2+ and the MLCK peptide. The large shift changes indicate that the electron distribution in the SeMet side-chain can be adjusted for the different states of CaM, suggesting that the polarizability of sulfur or selenium may be important for the proper functioning of CaM. This study also shows that the natural abundance (1H,77Se)-HMBC experiment provides a sensitive approach for the study of SeMet proteins.

The effect of Met-->Leu mutations on calmodulin's ability to activate cyclic nucleotide phosphodiesterase

Calmodulin (CaM) has two hydrophobic surface patches that are particularly rich in Met residues, and these are the major contact areas where CaM interacts with its target enzymes. The amino acid Leu has been introduced by site-directed mutagenesis to replace all the Met residues in CaM. All nine individual Met-->Leu mutants of CaM as well as some double and quadruple mutants were expressed in Escherichia coli. All mutants could be purified by calcium-dependent hydrophobic affinity chromatography, indicating that they still expose their hydrophobic surfaces upon binding calcium. Each single Met-->Leu mutation in the C-terminal domain of the protein had little effect on its ability to activate phosphodiesterase (PDE), while a quadruple mutant with four C-terminal Leu residues instead of Met has a significantly lower affinity for PDE. The M36L mutant is a poor activator compared with the other three N-terminal single Met-->Leu mutants, which have a slightly lower affinity for PDE than wild-type CaM. The introduction of a positively charged Arg for Met-145 resulted in an almost complete loss of CaM's ability to activate PDE. Nuclear magnetic resonance spectroscopy was used to show that most CaM mutants retain their overall three-dimensional structure. Thus, the altered activation properties appear to arise from differences in the flexibility and polarizability of the Met and Leu sidechains, rather than from structural perturbations.

Overexpression and characterization of recombinant human fusion protein IL-6/IL-2 (CH925)

An expression vector encoding the human recombinant fusion protein interleukin 6/interleukin 2 (IL-6/IL-2) was constructed. When a flexible linker had been synthesized and ligated with the IL-2 gene fragment by polymerase chain reaction (PCR) amplification, the IL-6 gene fragment was unidirectionally inserted into the upstream of the linker-IL-2 sequence. The molecule of the IL-6-linker-IL-2 fusion gene named E. coli DH5 alpha/pfIL-6/2 was cloned and identified by DNA sequencing. The expressed protein named as CH925 showed a strong band on SDS-PAGE and amounted to 32% of total cell protein, and its estimated molecular weight was about 37 kDa. The fusion protein purified by gel filtration and reversed-phase HPLC showed as almost homogeneous. CH925 possesses both IL-2 and IL-6 activities when assayed by CTLL2- and 7TD1-dependent cell lines, respectively. The specific activity of IL-2 was 2.1 x 10(6) U/mg while that of IL-6 was 2.3 x 10(8) U/mg. Our studies exhibited that CH925 exerted a significant augmentative effect on the growth of erythroid colony forming units (CFU-E), and synergized with erythropoietin (EPO) and/or IL-3 in a dose-dependent way. Our experimental results also showed CH925 at a low dose causing active lymphokine-activated killer (LAK) cell proliferation more vigorous than IL-2 and/or IL-6 (p < 0.001). CH925 is a novel fusion protein, being neither IL-6 nor IL-2, more potent than IL-2 and/or IL-6 and causing non-IL-2 and non-IL-6 functions of strong EPO-like and mild IL-3-like effects on erythroid progenitor cell growth. There is a potential for efficacious clinical application of CH925.

Crystallization and preliminary X-ray analysis of the low molecular weight phosphotyrosyl protein phosphatase from bovine heart

Two crystal forms of bovine heart phosphotyrosyl protein phosphatase (BHPTP) have been examined by X-ray analysis. One crystal form grows as long rods with triclinic crystal symmetry and diffracts to 3 A resolution. The diffraction pattern of this form of the crystal shows twinning about a major axis. A second crystal form of BHPTP grows as flat trapezoidal prisms with monoclinic symmetry C2, and unit cell parameters a = 95.3 A, b = 43.3 A, c = 41.2 A and beta = 113.5 degrees. The unit cell dimensions indicate that there is one 18 kDa molecule per asymmetric unit. These crystals diffract to at least 2.2 A resolution and are resistant to decay in the X-ray beam.

Interleukin 12 at the site of disease in tuberculosis

Interleukin 12 (IL-12), a heterodimeric cytokine composed of p40 and p35 chains, has potent immunologic effects in vitro. We used tuberculous pleuritis as a model to study the immunoregulatory potential of IL-12 in vivo at the site of human infectious disease. Messenger RNAs for p40 and p35 were detected in pleural fluid from six of six patients by reverse-transcription polymerase chain reaction. By using an ELISA that detected both free p40 and heterodimeric IL-12, we found that mean concentrations were 585 +/- 89 pg/ml in pleural fluid of patients with tuberculous pleuritis, which were significantly higher than those in serum of the same patients (54 +/- 36 pg/ml), or in malignant pleural effusions (123 +/- 35 pg/ml). By using an ELISA specific for heterodimeric IL-12, we found that mean concentrations in pleural fluid of patients with tuberculous pleuritis were 165 +/- 28 pg/ml and undetectable in serum of the same patients, or in malignant pleural effusions. Bioactive IL-12 was detectable in five of five supernatants of pleural fluid cells stimulated with Mycobacterium tuberculosis. Addition of anti-IL-12 antibodies suppressed proliferative responses of pleural fluid cells to M. tuberculosis by 36 +/- 7%. These data indicate that IL-12 may play a role in the human immune response to infectious agents in vivo. We hypothesize that IL-12 contributes to the antimycobacterial immune response by enhancing production of interferon-gamma, facilitating development of Th1 cells and augmenting cytotoxicity of antigen-specific T cells and natural killer cells.

[The relationship between thymus involution and diseases in childhood]

70 thymuses obtained at autopsy from children who died of various diseases were studied with histological, immunohistochemical and ultrastructural methods. In the immunohistochemical study, antibodies against 8 lymphocyte differentiation antigens, including CD4, CD8, CD3, CD1, CD2, CD25, CD22 and T9 as well as those against keration and S-100 protein were used. The findings suggest that thymus involution can occur in different diseases. The differentiation process of thymocytes and the distribution of different sub-populations of T cells in the thymus are not changed by thymus involution. Among the major changes of thymus involution, the decrease in number of dendritic cells and the degeneration of epithelial cells are more important than the decrease in the number of thymocytes. Phagocytosis of macrophages seems to be the secondary way to dispose of the degenerated and dead thymocytes.

Distribution of NADPH-diaphorase-positive neurons in the enteric nervous system of the human colon

Recent investigations have demonstrated the colonization of NOS-immunoreactivity and NADPH-diaphorase staining in central and peripheral neurons. The current study investigates the presence and distribution of NADPH-diaphorase-stained nerve cells and fibres in whole-mount preparations of the enteric nervous system of the human colon. Numerous NADPH-diaphorase-stained nerve cell bodies were found in the plexus myentericus and in the plexus submucosus externus. In contrast, we found but very few NADPH-diaphorase-stained nerve cells in the plexus submucosus internus. The majority of the NADPH-diaphorase-stained nerve cells had morphological characteristics similar to those of the Dogiel type I neuron, i.e. possessing broad flat dendrites and one major axonal projection. NADPH-diaphorase-stained nerve fibres can be observed in all three ganglionic networks and in the aganglionic plexus of the circular muscle layer.

Beneficial effect of an ACTH-(4-9) analog (Org2766) in the treatment of experimental cortex lesion in rats

This paper reports that lesions of the medial frontal cortex (MFC) caused behavioral deficit in rats and that this deficit could be attenuated by a well formulated treatment with Org2766, an analog of ACTH-(4-9). Wistar rats were distributed in 3 groups: MFC lesion treated with saline (M-N); MFC lesion treated with Org2766 (M-O); and sham-operation treated with saline (S). Repeated Org2766 or saline injection commenced from the day of surgery and lasted for 13 days. After surgery, the rats were trained in a passive avoidance task and then in an active avoidance task. MFC lesions were found to be strongly associated with behavioral deficits. The M-N group rats displayed poor retention of the passive avoidance response and showed much slower learning of the active avoidance task as compared to S group rats. The result showed that chronic Org2766 administration improved the behavioral performance of both tasks in MFC lesioned rats. The also revealed that the superoxide dismutase (SOD) activity was significantly increased in the M-O group as compared to the M-N group 15 days after surgery. The possible mechanisms related to the beneficial effect of Org2766 on cortex damage are discussed.

Nuclear magnetic resonance studies of the structure of B50/neuromodulin and its interaction with calmodulin

B50/neuromodulin is a neuronal phosphoprotein that is found in association with the inner membrane of nerve cells. In this work, we have studied the structure of bovine B50 in aqueous solution (pH 7.5) by 1H nuclear magnetic resonance (NMR) spectroscopy and our results indicate that B50 is an unstructured protein under these conditions. One-dimensional 1H-NMR titration studies of the interaction between B50 and calmodulin (CaM) have shown that B50 does not interact with (or) interacts very weakly with apo-CaM in solution; neither does B50 interact with Ca(2+)-CaM. These NMR data are consistent with an earlier observation that B50 is not capable of binding apo-CaM in vitro unless some nonionic detergent is present. We have also detected aromatic NMR peaks for a new posttranslational modification that might involve the His residues of the protein. The interaction of a 14-residue peptide (I38-L51) encompassing the CaM-binding domain of B50 with CaM was also studied by NMR. We have found from two-dimensional transferred nuclear Overhauser enhancement experiments that the B50 peptide binds weakly to apo-CaM in an alpha-helical conformation; the alpha-helix appears to be induced by the binding of the peptide to apo-CaM.

Radioimmunoguided surgery in gastric cancer using 131-I labeled monoclonal antibody 3H11

A clinical trial of radioimmunoguided surgery (RIGS) using 131-I labeled monoclonal antibody (MAb) 3H11 was performed on 25 cases with gastric cancer in this study. The results showed that the route of the administration of radiolabeled MAb is the key point of successful RIGS for gastric cancer. The RIGS in 19 cases in the group of submucosal injection via endoscope was very satisfying. For the detection of metastatic lymph nodes, the sensitivity rate of RIGS was 99.2% (118/119), the specificity, 97.7% (43/44), and the accuracy 98.8% (161/163). The accuracy rate in detecting tumor infiltration of the gastric wall was 95.9% (94/98), the sensitivity 94.6% (35/37), and the specificity 96.7% (59/61). Thus, the use of RIGS may improve the radical resectability rate and possibly the overall survival rate in patients with gastric cancer.

Characterization of trimethyllysine 115 in calmodulin by 14N and 13C NMR spectroscopy

In this paper, we describe three approaches to study the single trimethyllysine 115 in calmodulin. First, 14N NMR spectroscopy has been used as a novel spectroscopic tool. Because of the unique symmetrical tetrahedral substitution of its side chain, the trimethyllysine residue gives rise to a sharp 14N NMR resonance; hence, this has allowed the detection and quantitation of the level of trimethylation. Trimethyllysine side chains of bovine testis calmodulin and yeast cytochrome c were shown to have a high mobility in aqueous solution as determined by 14N NMR relaxation measurements. Second, we have purified mammalian calmodulin from an overproducing Escherichia coli strain. By comparison of the 1H-13C heteronuclear multiple quantum coherence spectra of 13C-dimethylated calmodulin samples from bovine testis and E. coli, the resonance for Lys-115 in bacterially expressed calmodulin could be identified. pH titration experiments showed that epsilon-NH2 group of Lys-115 has a normal pKa value both in the apo and Ca2+ forms of the protein and in a complex of calmodulin with a 22-residue calmodulin-binding peptide derived from myosin light chain kinase. Third, we have shown that mutation of Lys-115 to the uncharged Gln residue does not alter the ability of the protein to stimulate the enzymes cyclic nucleotide phosphodiesterase and myosin light chain kinase. These results show that the trimethylation of Lys-115 is not caused by an unusual pKa and reactivity of its epsilon-NH2 group and that its side chain remains flexible. Moreover, our data suggest that the introduction of a permanent positive charge on Lys-115 by trimethylation is also not the major reason for this specific post-translational modification.

The calmodulin-binding domain of caldesmon binds to calmodulin in an alpha-helical conformation

The binding of calcium-calmodulin (CaM) to caldesmon (CaD) contributes to the regulation of smooth muscle contraction. It has been reported that a 17-residue synthetic peptide encompassing the residues Gly651-Ser667 of smooth muscle CaD constitutes its CaM-binding domain [Zhan, Q., Wong, S. S., & Wang, C.L.A. (1991) J. Biol. Chem. 266, 21810-21814]. This peptide does not share sequence homology with the CaM-binding domains of other proteins, and in addition, the binding of CaM to CaD is known to be relatively weak. Here we have investigated the properties of this atypical CaM-binding domain by NMR and circular dichroism (CD) spectroscopy. Two dimensional NMR studies performed in aqueous TFE mixture (75%/25%) showed that the peptide has the capacity to adopt an amphiphilic alpha-helical conformation. TRNOESY experiments and CD spectroscopy were used to determine that the CaD peptide binds in an alpha-helical conformation to CaM. The addition of TFE or the binding of the CaD peptide to CaM induces an alpha-helical structure only for the central 10 amino acid residues of the peptide. Titrations of CaM with the CaD peptide were followed by proton NMR and show the formation of a 1:1 complex and that the binding is calcium-dependent. The chemical shifts of 13C-methyl groups of specifically labeled Met residues and of the 15N backbone amide groups of CaM undergo changes upon addition of the CaD peptide; these data suggest that both domains and the central helix of CaM are involved in the binding of the peptide.(ABSTRACT TRUNCATED AT 250 WORDS)