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Biomedical subjects

D Wilk

Publications and source records attributed to D Wilk.

15 recordsLinked to original sources
PubMed2001

The effect of protease inhibitor therapy on growth and body composition in human immunodeficiency virus type 1-infected children.

OBJECTIVE: To determine the effect of protease inhibitors (PIs) on growth and body composition in children with human immunodeficiency virus type 1 (HIV-1) infection. BACKGROUND: HIV-1-infected children have chronic problems with both linear growth and weight gain. Viral load may directly influence growth and nutritional status of HIV-1-infected children with reduction of viral load improving the nutritional condition. DESIGN/METHODS: Data from 67 patients who initiated PI therapy between 1996 and 1999 and who were enrolled in a prospective, longitudinal study of growth and nutrition in HIV-1-infected children were analyzed. Outcomes included pre-PI versus post-PI measures of height, weight, weight-for-height, triceps skinfold thickness, and arm muscle circumference. Predictor covariates included age, race, gender, Tanner stage, CD4 z score, Centers for Disease Control and Prevention stage, route of infection, plasma HIV-1 RNA, other antiretroviral therapy, recommended daily allowances for calories, treatment with megestrol acetate, and PI therapy. RESULTS: Sixty-seven children were followed for a median of 2.4 years with a total of 362 visits (median: 5 visits; range: 1-12). During follow-up, they received PIs for a median of 5 months. Fifty-one percent were girls, 54% black, 15% Hispanic, and 25% white. The mean age at first visit was 6.8 years. In a univariate analysis, weight z score (-0.67 to -0.35) and weight/height z score (0.25-0.76) improved on PI therapy. Using repeated-measures regression analysis, controlling for the above named covariates, PI treatment showed a significant effect on weight z score (increase in z score by 0.46), weight/height z score (increase in z score by 0.49), and arm muscle circumference (increase in percentile by 11.5). A borderline effect was found for height z score (increase in z score by 0.17) and no effect was found for triceps skinfold thickness. In a separate analysis, PI therapy increased CD4 counts twofold and reduced plasma HIV-1 RNA copies by 79%. CONCLUSION: In addition to a significant reduction in viral load, PI therapy in children has a positive effect on several growth parameters, including weight, weight/height, and muscle mass.

Anthropometry↗
PubMed1997

Distinct multisite synergistic interactions determine substrate specificities of human chymase and rat chymase-1 for angiotensin II formation and degradation.

Human chymase and rat chymase-1 are mast cell serine proteases involved in angiotensin II (Ang II) formation and degradation, respectively. Previous studies indicate that both these enzymes have similar P1 and P2 preferences, which are the major determinants of specificity. Surprisingly, despite the occurrence of optimal P2 and P1 residues at the Phe8 downward arrow and Tyr4 downward arrow bonds (where downward arrow, indicates the scissile bond in peptide substrates) in Ang I (DRVYIHPFHL), human chymase cleaves the Phe8 downward arrow bond with an approximately 750-fold higher catalytic efficiency (kcat/Km) than the Tyr4 downward arrow bond in Ang II (DRVYIHPF), whereas rat chymase-1 cleaves the Tyr4 downward arrow bond with an approximately 20-fold higher catalytic efficiency than the Phe8 downward arrow bond. Differences in the acyl groups IHPF and DRVY at the Phe8 downward arrow and Tyr4 downward arrow bonds, respectively, are chiefly responsible for the preference of human chymase for the Phe8 downward arrow bond. We show that the IHPF sequence forms an optimal acyl group, primarily through synergistic interactions between neighboring acyl group residues. In contrast to human chymase, rat chymase-1 shows a preference for the Tyr4 downward arrow bond, mainly because of a catalytically productive interaction between the enzyme and the P'1 Ile5. The overall effect of this P'1 Ile interaction on catalytic efficiency, however, is influenced by the structure of the acyl group and that of the other leaving group residues. For human chymase, the P'1 Ile interaction is not productive. Thus, specificity for Ang II formation versus Ang II degradation by these chymases is produced through synergistic interactions between acyl or leaving group residues as well as between the acyl and leaving groups. These observations indicate that nonadditive interactions between the extended substrate binding site of human chymase or rat chymase-1 and the substrate are best explained if the entire binding site is taken as an entity rather than as a collection of distinct subsites.

Amino Acid Sequence↗
PubMed1987

[Life satisfaction and the course of rehabilitation--a study of cardiovascular patients].

At the beginning and at the end of inpatient cardiac rehabilitation, 105 male cardiac patients were examined with a newly designed questionnaire for life satisfaction assessment (Fragebogen zur Lebenszufriedenheit-FLZ). Data collection moreover included the Freiburg Personality Inventory, the Freiburg Somatic Complaints Lists, an adjective list assessing current mood, questionnaires on anamnestic data, treatment expectancies and life habits, as well as medical data. Significant correlations found between the FLZ and subjective or objective criteria of rehabilitation outcome indicate the importance of life satisfaction, with more content patients showing better outcomes. No mean value differences were found in respect of medical data, less content patients, however, reported more previous hospital stays and rehabilitation treatments. Also, there is a tendency for physician to discharge these patients as "unfit for work". 83 of these 105 patients participated in the follow-up study twelve months later. Life satisfaction is now lower, somatic complaints and emotional lability have increased. 90 percent of the patients with high life satisfaction, but only 66 percent of those with low life satisfaction, are back at work on follow-up. Fitness for work at follow-up, though primarily related to the rating given at the end of inpatient cardiac rehabilitation, is influenced to a high degree by non-medical factors. The results obtained underline the significance of patient illness behaviour, and point to a need for further improving individual psychological counseling during cardiac rehabilitation.

Cardiac Rehabilitation↗
PubMed1984

Biochemical and immunological properties of dog brain isorenin.

A neutral protease with angiotensin I-forming activity which could readily be separated from acid proteases and plasma and renal renin was obtained from extracts of dog brain. This enzyme has an apparent mol wt of 40,000 by Sephadex chromatography. On chromatofocusing, it displays isoelectric points of 7.92, 7.73, and 7.42, and thus, it is a basic protein, in contrast to either renal or plasma renin which are acidic proteins. This brain enzyme does not react with antibodies specific for dog kidney renin. Since the brain enzyme forms angiotensin I from renin substrate at neutral pH, yet can be separated from and has isoelectric points different from renal renin, it is an isoenzyme of the kidney counterpart. The majority of the renin-like activity of dog brain is due to this isoenzyme.

Animals↗