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Biomedical subjects

E E Kim

Publications and source records attributed to E E Kim.

At least 19 recordsLinked to original sources

Refinement of the crystal structure of ribonuclease S. Comparison with and between the various ribonuclease A structures.

Ribonuclease S (RNase-S) is a complex that consists of two proteolytic fragments of bovine pancreatic ribonuclease A (RNase-A): the S-peptide (residues 1-20) and S-protein (residues 21-124). We have refined the crystal structures of three RNase-S complexes. The first two contain the full-length 20-residue S-peptide and were studied at pHs of 4.75 and 5.5. The third one consists of a truncated form of S-peptide (residues 1-15) and was studied at pH 4.75 as the reference structure for a series of mutant peptide complexes to be reported separately. Excluding residues 16-23 which are either missing (in the S15 complex) or disordered (in both S20 complexes), all three structures refined at 1.6-A resolution are identical within the estimated errors in the coordinates (0.048 A for the backbone atoms). The R-values, residual error, range from 17.4% to 18.6%. The final model of S20, pH 4.75, includes 1 sulfate and 84 water molecules. The side chains of 11 residues were modeled in two discrete conformations. The final structures were independent of the particular RNase-A or RNase-S used as a starting model. An extensive comparison with refined crystal structures of RNase-A reveals that the core of the molecule which is held together with extensive hydrogen bonds is in identical pattern in all cases. However, the loop regions vary from one structure to another and are often characterized by high B-factors. The pattern of thermal parameters appears to be dependent on crystal packing and correlates well with the accessibility calculated in the crystal. Gln60 is a conserved residue in all sequences known to date for this class of ribonucleases. However, it is the only residue that is clearly defined in an unfavorable position (phi = -100 degrees, psi = -130 degrees) on the Ramachandran plot. The origin of the substantial differences between RNase-A and RNase-S in stability to both acid and temperature denaturation and in susceptibility to proteolysis at neutral pH is not obvious in our visual comparison of these two structures.

Animals

Evaluation of sensitivity and specificity of upper extremity radionuclide venography in cancer patients with indwelling central venous catheters.

Two hundred twenty upper extremity radionuclide venograms were performed using upper extremity injection of 5 mCi of Tc-99m DTPA in each arm of patients with indwelling central lines. Evidence of obstruction was found in 123 patients, collateral flow without anatomic obstruction in six patients, and a slow-flow pattern in 12 patients. Twenty-six of these also underwent upper extremity contrast venography within 48 hours of the scan. Contrast venograms and radionuclide venograms agreed in 19 patients (16 correctly identified as obstructed, three correctly identified as unobstructed). Six patients showed the slow-flow pattern without collaterals or obstruction. Subsequently, six follow-up contrast studies showed no evidence of obstruction or collaterals. The authors conclude that obstruction with collateral flow on radionuclide venograms correctly predicts obstruction. However, the slow-flow pattern does not and should not be used as the sole criterion to diagnose partial obstruction.

Arm

Differentiation of residual or recurrent tumors from post-treatment changes with F-18 FDG PET.

Positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose (FDG) was used to differentiate recurrent or residual malignant disease from the effects of cancer treatment. Transaxial images were obtained after injection of 5-10 mCi (185-370 MBq) of F-18 FDG in 68 patients (including 33 with brain tumors) whose posttreatment computed tomographic (CT) or magnetic resonance (MR) imaging findings had been suggestive of malignant disease. PET findings were correlated with surgical results in 18 patients and with the outcomes of CT, MR imaging, clinical, and laboratory 9-month follow-up studies in 50 patients. There was good agreement between F-18 FDG uptake and presence or absence of malignant disease except in four cases of brain tumors in which histologic findings could not be correlated with biologic behavior. The putative sensitivity and specificity in the 33 cases of brain tumors were 80% and 94%, respectively. The authors conclude that PET with F-18 FDG is useful in detection of previously treated metabolically active tumors but is limited in diagnosis of recurrent microscopic or metabolically inactive tumors.

Abdominal Neoplasms

SPECT in the evaluation of cancer patients: not quo vadis; rather, ibi fere summus.

In the past 7 years, single photon emission computed tomography (SPECT) has evolved from an interesting nuclear medicine technique rarely performed because of technical difficulties into a valuable clinical tool in the management of cancer cases. The development of stable multidetector instruments with collimators and gantries specifically designed for SPECT and the introduction of new radiopharmaceuticals recently approved by the U.S. Food and Drug Administration have rapidly moved SPECT from the field of clinical investigation to clinical practice. SPECT is a valuable addition to other tomographic modalities capable of displaying the physiology of disease as well as anatomy. In this work the authors describe the role of SPECT in a cancer center and, in particular, how they use it to solve clinical problems. They also review the published literature, when appropriate. The authors have found SPECT of particular value in evaluation of myocardial ischemia, in differentiating tumor recurrence from posttherapy changes in the lymphomas, in tumor diagnosis and surveillance, and in separating hemangioma from malignant lesions in the liver.

Abdomen

Multiple myeloma: spinal MR imaging in patients with untreated newly diagnosed disease.

Spinal magnetic resonance (MR) imaging was performed in 29 patients with newly diagnosed, untreated multiple myeloma. Nineteen (66%) patients were asymptomatic. Sagittal pre- and postcontrast T1-weighted spin-echo images and gradient-recalled-echo images of the thoracic and lumbosacral spine were obtained. Marrow involvement was identified in 20 (69%) patients. There were three MR patterns: focal lesions in nine patients (31%), diffuse involvement in seven (24%), and an inhomogeneous pattern of tiny lesions on a background of normal marrow in four (14%). A statistically significant correlation between MR imaging patterns of marrow involvement and serum hemoglobin values (one-way, P = .0899; Kruskal-Wallis, P = .0620) and between MR imaging patterns and percentage of marrow plasmacytosis (Kruskal-Wallis, P = .0314) was noted, with patterns of diffuse and focal marrow involvement associated with more abnormal values. Spinal MR imaging in patients with early myeloma may reveal marrow involvement in both symptomatic and asymptomatic patients. Some correlation was found between MR imaging patterns and laboratory indexes of disease.

Adult

Mutation of a single amino acid converts germ cell alkaline phosphatase to placental alkaline phosphatase.

Human placental and germ cell alkaline phosphatases (PLAP and GCAP, respectively), are characterized by their differential sensitivities to inhibition by L-leucine, EDTA, and heat. Yet, they differ by only 7 amino acids at positions 15, 67, 68, 84, 241, 254, and 429 within their respective 484 residues. To determine the structural basis and the amino acid(s) involved in these physicochemical differences, we constructed three GCAP mutants by site-directed mutagenesis and six GCAP/PLAP chimeras and then expressed these alkaline phosphatase mutants in COS-1 cells. We report that the differential reactivity of PLAP and GCAP depends critically on a single amino acid at position 429. GCAP with Gly-429 is strongly inhibited by L-leucine, EDTA, and heat, whereas PLAP with Glu-429 is resistant. By substituting Gly-429 of GCAP with a series of amino acids, we demonstrate that the relative sensitivities of these mutants to L-leucine, EDTA, and heat inhibition are, in general, parallel. Mutants in the order of resistance to these treatments are: Glu (most resistant), Asp/Ile/Leu, Gln/Val/Lys, Ser/His, and Arg/Thr/Met/Cys/Phe/Trp/Tyr/Pro/Asn/Ala/Gly (least resistant). However, the Ser-429 and His-429 mutants were more resistant to EDTA and heat inhibition than the wild-type GCAP, but were equally sensitive to L-leucine inhibition. Structural analysis of mammalian alkaline phosphatase modeled on the refined crystal structure of Escherichia coli alkaline phosphatase indicates that the negative charge of Glu-429 of PLAP, which simultaneously stabilizes the protein as a whole and the metal binding specifically, probably acts through interactions with the metal ligand His-320 (His-331 in E. coli alkaline phosphatase). Replacement of codon 429 with Gly in GCAP leads to destabilization and loosening of the metal binding. The data suggest that the natural binding site for L-leucine may be near position 429, with the amino and carboxyl groups of L-leucine interacting with bound phosphate and His-432 (His-412 in E. coli alkaline phosphatase), respectively.

Alkaline Phosphatase

Reaction mechanism of alkaline phosphatase based on crystal structures. Two-metal ion catalysis.

Alkaline phosphatase (AP) is a widely distributed non-specific phosphomonoesterase that functions through formation of a covalent phosphoseryl intermediate (E-P). The enzyme also catalyzes phosphoryl transfer reaction to various alcohols. Escherichia coli AP is a homodimer with 449 residues per monomer. It is a metalloenzyme with two Zn2+ and one Mg2+ at each active site. The crystal structure of native E. coli AP complexed with inorganic phosphate (Pi), which is a strong competitive inhibitor as well as a substrate for the reverse reaction, has been refined at 2.0 A resolution. Some parts of the molecular have been retraced, starting from the previous 2.8 A study. The active site has been modified substantially and is described in this paper. The changes in the active site region suggest the need to reinterpret earlier spectral data, and suggestions are made. Also presented are the structures of the Cd-substituted enzyme complexed with inorganic phosphate at 2.5 A resolution, and the phosphate-free native enzyme at 2.8 A resolution. At pH 7.5, where the X-ray data were collected, the Cd-substituted enzyme is predominantly the covalent phosphoenzyme (E-P) while the native Zn/Mg enzyme exists in predominantly noncovalent (E.P) form. Implication of these results for the catalytic mechanism of the enzyme is discussed. APs from other sources are believed to function in a similar manner.

Alkaline Phosphatase

Bacillus subtilis alkaline phosphatases III and IV. Cloning, sequencing, and comparisons of deduced amino acid sequence with Escherichia coli alkaline phosphatase three-dimensional structure.

Bacillus subtilis has an alkaline phosphatase multigene family. Two members of this gene family, phoAIII and phoAIV, were cloned, taking advantage of in vitro constructed strains containing a plasmid insertion within one or the other of the structural genes. The DNA sequences of the two genes showed approximately 64% identity at the DNA level and 63% identity in the deduced primary amino acid sequences. The phoAIII and phoAIV genes code for predicted proteins of 47,149 and 45,935 Da, respectively. Comparison of the deduced primary amino acid sequence of the mature proteins with other sequenced alkaline phosphatases from Escherichia coli, yeast, and humans shows 25-30% identity. Based on the refined crystal structure of E. coli alkaline phosphatase, it appears that the active site and the core of the structure are retained in both Bacillus alkaline phosphatases. However, both proteins are truncated at the amino terminus compared with other mature alkaline phosphatases, three sizable surface loops of E. coli are deleted, and a minidomain is replaced with a larger domain in the model. Neither Bacillus alkaline phosphatase sequenced contains any cysteine residues, an amino acid implicated in intrachain disulfide bond formation in other alkaline phosphatases.

Alkaline Phosphatase

Case report 682. Neuroepithelioma of soft tissues of the knee.

Peripheral neuroepitheliomas should be included in the differential diagnosis of a soft-tissue tumor in the extremities or chest wall, especially in young adolescents. MRI provides useful information as to the extent of the tumor and relationship with adjacent structures, although it may not differentiate neuroepitheliomas from other, more common, soft-tissue sarcomas. Together with clinical and histological findings, MRI can assist in the diagnosis and treatment planning of this tumor.

Adolescent

Pitfalls of a 99mTc-RBC bleeding study due to gallbladder and ileal-loop visualization.

A series of 99mTc-labeled red blood cell (RBC) scintigrams in a patient with a past history of radiation proctitis demonstrated incidental findings of gallbladder activity, probably related to multiple blood transfusions and renal failure. Variable activity in an ileal-loop urinary diversion simulating bowel pooling was also noted. Thus, difficulties encountered in scan interpretation are presented.

Blood Transfusion

Reusable gels for germanium-68 sources.

Two water-soluble gels, gelatin and Carbowax, were mixed with radioactive 68Ge solutions and evaluated for their use as long-lived (half-life, 280 days) radioactive sources. These gels melt at 40-50 degrees C and solidify at room temperature. The amount of 68Ge mixed with them can be increased or decreased as needed, eliminating waste of 68Ge. These gel sources also may replace short-lived 68Ga (half-life 68 min) as attenuation correction sources in positron emission tomography (PET) and reduce frequency of source preparation, thus reducing exposure of PET operators to radiation.

Gelatin

Synthesis and in vitro receptor binding studies of fluorotamoxifen analogues.

We describe the synthesis of new fluorotamoxifen analogues with the fluorine atom positioned on the end of the aliphatic chain of tamoxifen. The binding of fluorotamoxifens to cytosol estrogen receptors of rat uteri was determined with [3H]estradiol (5 nM). The fluorotamoxifens had similar or superior binding affinities compared with tamoxifen. The IC50 value was as follows: tamoxifen, 5 x 10(-7) M; fluorotamoxifen (VII), 5 x 10(-7) M; N,N-diethylfluorotamoxifen (IV)-cis, 1 x 10(-6) M, and trans, 2 x 10(-7) M; and (cis) fluoromethyl-N,N-diethyltamoxifen (VI) 1 x 10(-7) M. Therefore, the fluorinated tamoxifens have potential use in imaging estrogen receptors by PET.

Animals

Acute spinal cord injury: magnetic resonance imaging correlated with myelopathy.

Thirty-one patients (29 males and two females, 13-87 years of age (mean, 46.7 years] with acute spinal cord injury were studied by MR (magnetic resonance) imaging and the results were correlated with neurological findings. Magnetic resonance images were obtained with a 0.5 T superconductive MR scanner (Phillips Gyroscan S5). Initial imaging was performed within 24 hours after trauma in 13 patients, 1-7 days in 13 patients and 7-14 days in five patients. Twenty-six patients underwent follow-up examinations with MR imaging. Cord abnormalities including cord compression (23 patients), cord swelling (seven patients), and abnormal signal intensities on either T1 or T2-weighted images (26 patients) were observed on initial examination. Multivariate analysis showed that cord compression and abnormal intensities on T1-weighted images were important prognostic indicators. Hyperintensity on T2-weighted images was non-specific but correlated well with clinical recovery. Magnetic resonance imaging is useful in predicting the prognosis and for planning treatment following spinal cord injuries.

Acute Disease

MR appearance of the distended iliopsoas bursa.

The purpose of this essay is to illustrate the MR appearance of the distended iliopsoas bursa. The bursa must be recognized on MR scans to avoid confusing it with malignant neoplasms and other lesions.

Aged

Soft-tissue sarcoma: MR imaging vs sonography for detection of local recurrence after surgery.

To determine the value of MR and sonography in detecting local recurrences of soft-tissue sarcomas after surgery, 26 MR and sonographic studies performed in 21 patients were reviewed retrospectively. Recurrences were confirmed histologically in 12 (46%) of 26 studies. The MR images and sonograms were obtained within 1 month of each other. The findings were classified as recurrence, no recurrence, or indeterminate. Sonography was instrumental in guiding fine-needle aspiration biopsy of impalpable lesions. In two cases, the findings on sonography were indeterminate. In both of these cases, the sonograms had been obtained soon after surgery (at 2 and 4 months). The sensitivity and specificity in the detection of local recurrences were 83% and 93%, respectively, for MR and 100% and 79%, respectively, for sonography. These differences were not statistically significant. We conclude that MR and sonography appear to be equally useful in the detection of local recurrences of soft-tissue sarcomas, sonography can be used for routine follow-up and in guiding needle biopsies, sonography may be more difficult to interpret than MR during the early postoperative period, and MR should be used if sonography is inconclusive.

Adolescent

Structure of alkaline phosphatases.

The crystal structure of alkaline phosphatase (AP) from Escherichia coli, which is a prototype for mammalian APs, has been refined to a crystallographic R-factor of 0.184 at 2.0 A resolution. During the course of the refinement residues 380 to 410 were retraced and 190 to 200 were shifted by one residue, and substantial changes in the active site of the enzyme were made. Based on the refined structure and the sequences of mammalian enzymes (25-30% strict homology) we have modelled the core of the three dimensional structures of the mammalian alkaline phosphatases. Considerable circumstantial evidence suggests that this is valid despite the fact that the mammalian enzymes are larger, contain carbohydrate and are membrane associated through a phosphatidylinositol moiety. The active site of the molecule is highly conserved but specific changes in the secondary ligands to bound phosphate and the Mg metal are observed.

Alkaline Phosphatase

Magnetic resonance imaging in aggressive fibromatosis.

The magnetic resonance imaging (MRI) features of aggressive fibromatosis in 11 patients (five with recurrent tumour) and its contribution to patient management are described. Tumour signal intensity ranged from being low to isointense with respect to muscle on T1-weighted images while being predominantly of heterogenous increased signal intensity on T2-weighted images. A post-contrast (Gd-DTPA) study demonstrating diffuse tumour enhancement was of value in assessing tumour extent in two patients. CT in six patients and angiography in two patients provided no additional information while tumour relationship to neurovascular structures and extent was better appreciated on MRI. MRI was accurate in predicting resectability in all six patients who had surgery.

Adolescent