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Biomedical subjects

M Vieth

Publications and source records attributed to M Vieth.

At least 19 recordsLinked to original sources

DoMCoSAR: a novel approach for establishing the docking mode that is consistent with the structure-activity relationship. Application to HIV-1 protease inhibitors and VEGF receptor tyrosine kinase inhibitors.

DoMCoSAR is a novel approach for statistically determining the docking mode that is consistent with a structure-activity relationship. The approach establishes the binding mode for the compounds in a chemical series with the assumption that all molecules exhibit the same binding mode. It involves three stages. In the first stage all molecules that belong to a given chemical series are docked to the active site of the protein target. The only bias used in the docking at this stage involves the location of the protein binding site. Coordinates of the common substructure (CS) that results from the unbiased docking are then clustered to establish the major substructure docking modes. In the second stage all molecules are docked to the major docking modes (MDMs) with constraints based on the common substructure. The third stage generates, for the major docking modes, interaction-based descriptors that include electrostatic, VDW, strain, and solvation contributions. The problem of docking mode evaluation is now reduced to the question of which descriptor set is more predictive. To establish a quantitative comparison of the descriptor sets associated with the major docking modes, we use 50 instances of random 4-fold cross-validation. For each 4-fold cross-validation the predictive squared correlation coefficient (R(2)) is computed. t-Tests are applied to establish significance of the differences in mean R(2) for one docking mode versus another. We test the methodology on two test cases: HIV-1 protease inhibitors (Holloway et al. J. Med. Chem. 1995, 38, 305-317) and vascular endothelial growth factor (VEGF) receptor tyrosine kinase oxoindoles (Sun et al. J. Med. Chem. 1998, 41, 2588-2603). For both test cases there is statistically significant preference for the binding mode consistent with the X-ray structure. The appeal of this methodology is that researchers gain the objectivity of statistical justification for the selected docking mode. The methodology is relatively insensitive to subtle variations of the protein structure that include, but are not limited to, side chain and small backbone rearrangement during binding. In addition, predictive models that result from the approach can be used to further optimize chemical series.

Crystallography, X-Ray↗

Endoscopic mucosal resection of early cancer and high-grade dysplasia in Barrett's esophagus.

BACKGROUND & AIMS: In view of the mortality and morbidity rates of esophagectomy and the relatively large group of inoperable patients, local therapeutic techniques are required for high-grade dysplasia and early Barrett's cancer. METHODS: A prospective investigation of endoscopic mucosal resection was conducted in 64 patients (mean age, 65 +/- 10 years) who had early carcinoma (61 patients) or high-grade dysplasia (3 patients) in Barrett's esophagus. Thirty-five patients met the criteria for low risk: macroscopic types I, IIa, IIb, and IIc; lesion diameter up to 20 mm; mucosal lesion; and histological grades G1 and G2 and/or high-grade dysplasia (group A). The remaining 29 patients were included in group B (high risk). RESULTS: A total of 120 resections were performed, with no technical problems encountered. The mean number of treatment sessions per patient was 1. 3 +/- 0.6 in group A and 2.8 +/- 2.0 in group B (P < 0.0005). Only one major complication occurred, a case of spurting bleeding, which was managed endoscopically. Complete local remission was achieved significantly earlier (P = 0.008) in group A than in group B. In May 1999, complete remission had been achieved in 97% of the patients in group A and in 59% of those in group B; however, 1 patient in group A and 9 in group B are still undergoing treatment or awaiting the first check-up. During a mean follow-up of 12 +/- 8 months, recurrent or metachronous carcinomas were found in 14%. CONCLUSIONS: Endoscopic mucosal resection of early carcinoma in Barrett's esophagus is associated with promisingly low morbidity and mortality rates. The procedure may offer a new minimally invasive therapeutic alternative to esophagectomy, especially in low-risk situations. Comparisons with surgical results will need to be done when the long-term results of this procedure become available.

Adult↗

Ablation of Barrett's epithelium by endoscopic argon plasma coagulation in combination with high-dose omeprazole.

BACKGROUND: Barrett's esophagus is a premalignant condition induced by gastroesophageal reflux. The aim of this prospective study was to assess the efficacy of argon plasma coagulation in combination with high-dose omeprazole therapy to ablate nondysplastic Barrett's epithelium. METHODS: In 73 patients with histologically confirmed Barrett's epithelium, argon plasma coagulation was used in combination with maximal acid suppression (omeprazole 40 mg three times a day). Histologic and endoscopic changes were evaluated at 6- and 12-month intervals. RESULTS: In 69 of 70 patients (98.6%) complete squamous regeneration was achieved after a median of 2 argon plasma coagulation sessions (range 1 to 5). During a median follow-up of 12 months (range 2 to 51 months) there has been no relapse or evidence of the development of dysplasia under continuous acid suppression. Three patients (4.3%) developed a mild stricture of the distal esophagus that resolved after a single session of bougie dilation. CONCLUSIONS: In our experience, argon plasma coagulation in combination with high-dose omeprazole treatment is an effective and safe technique for complete ablation of nondysplastic Barrett's epithelium. Restoration of squamous mucosa after argon plasma coagulation appears to be long-lasting.

Adult↗

Differential expression of mucins and trefoil peptides in native epithelium, Barrett's metaplasia and squamous cell carcinoma of the oesophagus.

BACKGROUND AND AIMS: In humans, trefoil peptides (TFF peptides) and some mucins have been reported to be expressed in a cell-specific manner at mucosal surfaces of normal gastrointestinal tissues. Neoplastic conditions cause characteristic changes of these expression patterns. To study such patterns in Barrett's metaplasia and squamous cell carcinoma of the oesophagus (SCC), the distribution of MUC1, MUC2, MUC5AC and the three TFF peptides (TFF1, TFF2 and TFF3) was investigated. METHODS: In 40 archival samples of SCC and in 21 samples of Barret's metaplasia, expression of the three mucins and two TFF peptides (TFF1 and TFF2) was assessed by specific antibodies. Reverse transcriptase/polymerase chain reaction amplification (RT-PCR) was performed on frozen tissue samples from the 11 biopsies of SCC for the three TFF peptides. RESULTS: Immunohistochemical tests for MUC2 and TFF2 were negative both in samples of Barret's metaplasia and in SCC. MUC1 expression was detected in 57.5% of the tumour samples, while TFF1 and MUC5AC were found in 10% and 7.5% of the cases respectively. In Barrett's metaplasia MUC1 was detected in 90.5% of the cases and TFF1 and MUC5AC in all of them. RT-PCR analysis revealed a more complex pattern: TFF1 and TFF3 expressed the corresponding mRNA in all samples investigated; the third member, TFF2, was active in 45.5% of the carcinoma biopsies and not in the corresponding native tissue. CONCLUSIONS: This finding in oesophageal carcinoma contrasts with the situation found in normal and neoplastic stomach epithelium where TFF1 and TFF2 are found co-expressed and TFF3 remains silent. Interestingly, MUC1 is expressed in a significant proportion of SCC. Both in Barett's metaplasia and in SCC the expression of MUC5AC mirrors the TFF1 synthesis in intensity and spatial distribution.

Adult↗

The differentiation of true adenomas from colitis-associated dysplasia in ulcerative colitis: a comparative immunohistochemical study.

Adenomas in areas involved by ulcerative colitis (UCA) are difficult to identify because of their morphological similarity to ulcerative colitis-associated dysplasia (UCD) and have an uncertain biology. Recently, a set of morphopathologic criteria were published for the diagnosis of UCA versus UCD. As a first step to analyze these criteria, we studied p53 and bcl-2 expression in groups of UCA and UCD along with a sporadic adenoma control group. Ninety lesions from UC areas (62 patients) were examined, including 24 UCA without high-grade dysplasia (HGD) and 66 UCD consisting of 43 polypoid and 23 flat dysplastic lesions (29 with HGD). Immunohistochemical p53 and bcl-2 expression were evaluated semiquantitatively. P53-positive cases were significantly less frequent in the UCA (4%) versus the UCD group (30%, P = .01) and the polypoid UCD subgroup (35%, P = .005). Moderate or strong bcl-2 expression was significantly more frequent in the UCA than in the UCD group (96% v 70%, P = .01) and in the UCA versus both polypoid and flat UCD subgroups. Comparison of UCA with low-grade dysplastic polypoid UCD cases alone showed a difference just below significance for p53 (P = .07). p53 and bcl-2 expression rates were very similar in the UCA group and the sporadic adenoma (n = 25) control group. These results show that UCA has phenotypic features more similar to sporadic adenomas than UCD and supports the concept that adenomas in UC have a biology different from UC-associated dysplasia.

Adenoma↗

Short Barrett: prevalence and risk factors.

BACKGROUND: The incidence of adenocarcinoma at the gastro-oesophageal junction is on the increase. These carcinomas are usually diagnosed too late and thus have a poor prognosis. Only early diagnosis can improve the situation. Classical Barrett oesophagus (length, >3 cm) is a known precancerous condition. There is also specialized columnar epithelium (SCE) in the grossly unremarkable gastro-oesophageal transitional zone (short Barrett). METHODS: To determine the frequency of SCE, 370 patients were investigated by gastroscopy (OGD) consecutively between September 1995 and February 1996. RESULTS: Classical Barrett oesophagus was found to have an incidence of 4.6%. In contrast, microscopic evidence of SCE was observed in 13.6% of the cases. Patients with short Barrett presented with reflux symptoms (odds ratio (OR), 4.7), irregular zona serrata ('tongues') in the cardia (OR, 2.8), and reflux oesophagitis significantly more frequently. Patients with reflux symptoms and concomitant 'tongues', however, had an OR of 13.16. Careful history-taking, together with a subtle histologic work-up of the gastro-oesophageal transitional zone can improve the rate of detecting patients with short Barrett. CONCLUSION: Patients with reflux symptoms and irregular zona serrata should be selectively biopsied at the gastro-oesophageal junction, even when the latter presents a grossly normal appearance, with the aim of detecting patients at risk of developing a Barrett carcinoma.

Adenocarcinoma↗

[Short-term triple therapy with pantoprazole, amoxicillin and metronidazole in Helicobacter pylori infection].

BACKGROUND: The present study was conducted to investigate the efficacy and tolerability of a 7-day treatment with pantoprazole, amoxicillin and metronidazole for the eradication of Helicobacter pylori (H. pylori) infection. PATIENTS AND METHODS: Fifty patients (26 male, 24 female, age 18 to 86, mean 54 years) with an active duodenal (n = 25) or gastric ulcer (n = 25) were recruited into the study, 48 patients being H. pylori positive at the study start. Patients were treated with pantoprazole (40 mg bid), amoxicillin (1 g bid) and metronidazole (500 mg bid) for 7 days and for another 21 days with pantoprazole (40 mg/od). Four weeks after the end of study medications the patients were re-examined endoscopically and their H. pylori status was re-assessed using urease test, histology and 13C-urea-breath test. RESULTS: In 39 of 48 intention to treat patients, H. pylori infection was cured, according to 81% (95%-CI = 67 to 91%). In the per protocol population in 35 of 41 patients H. pylori was eradicated, which results in an eradication rate of 85% (95%-CI = 71 to 94%). Ulcer healing was endoscopically confirmed in 45 of 48 patients (94%; 95%-CI = 83 to 99%) after 8 weeks. Six of 50 patients (12%) reported mild to moderate probable side-effects of the study medication. Cure of the infection was associated with a distinct reduction of the gastritis grade and activity. CONCLUSION: A 7-day triple therapy using pantoprazole, amoxicillin and metronidazole is an effective and cost-effective alternative to regimens including clarithromycin for the treatment of H. pylori infection.

2-Pyridinylmethylsulfinylbenzimidazoles↗

Adenocarcinoma in an ileal pouch after prior proctocolectomy for carcinoma in a patient with ulcerative pancolitis.

We report the first known case of pouch carcinoma in a 35-year-old female patient following proctocolectomy for adenocarcinoma in ulcerative pancolitis with backwash ileitis. Pouch cancer was diagnosed 2 years after the pelvic pouch procedure, illustrating that there might be a risk of pouch cancer in such patients. Adenocarcinoma arising in an ileoanal reservoir is rare. Two other cases have been reported: both patients concerned were believed to have developed cancer in small areas of residual remaining rectal mucosa.

Adenocarcinoma↗

Do active site conformations of small ligands correspond to low free-energy solution structures?

We compare the low free energy structures of ten small, polar ligands in solution to their conformations in their respective receptor active sites. The solution conformations are generated by a systematic search and the free energies of representative structures are computed with a continuum solvation model. Based on the values of torsion angles, we find little similarity between low energy solution structures of small ligands and their active site conformations. However, in nine out of ten cases, the positions of 'anchor points' (key atoms responsible for tight binding) in the lowest energy solution structures are very similar to the positions of these atoms in the active site conformations. A metric that more closely captures the essentials of binding supports the basic premise underlying pharmacophore mapping, namely that active site conformations of small flexible ligands correspond to their low energy structures in solution. This work supports the efforts of building pharmacophore models based on the information present in solution structures of small isolated ligands.

Binding Sites↗

Dramatic increase of alpha-hydroxyaldehydes derived from plasmalogens in the aged human brain.

Plasmalogens-substantial compounds of brain tissue--suffer degradation either by hydrolysis under production of aldehydes or by oxidation with lipid peroxylradicals by generation of plasmalogen epoxides. The latter react by addition of pentafluorobenzylhydroxylamine HCl (PFBHA HCL) under hydrolysis to alpha-hydroxyaldehydes which are immediately transformed to pentafluorobenzyloximes (PFBO). Likewise, free aldehydes are transformed to PFBO-derivatives. PFBO-derivatives of free aldehydes and PFBO-derivatives of alpha-hydroxyaldehydes were extracted and after trimethylsilylation quantified by GC/FID and by GC/MSD. The remaining aqueous phase, containing plasmalogens besides other lipids, was hydrolyzed by treatment with acid. The hydrolysis products of plasmalogens, long chain aldehydes, react with PFBHA HCl to produce PFBO-derivatives. These were also quantified by GC/FID. This method allows the quantification of plasmalogens, free aldehydes and plasmalogenepoxides in human brain samples to study changes in the relation of these compounds with increasing age. While the ratio of plasmalogens in respect to derived aldehydes seems to remain constant during life time, the quotient of plasmalogenepoxides to plasmalogens increases with age, indicating that lipid peroxidation processes are involved in the damage of plasmalogens in the brain of aged individuals, starting at an age of about 70 years.

Adolescent↗

[The status of diagnosis of Barrett esophagus. An analysis of 1000 histologically diagnosed cases].

OBJECTIVE: To evaluate the quality of diagnosis in cases of Barrett's oesophagus (BOe). It was examined whether: (1) there had been regular pre-treatment investigations;(2) characteristic mucosal changes had been recognized by endoscopy; (3) a diagnosis of intraepithelial neoplasia had been made more often than of advanced Barrett carcinoma. PATIENTS AND METHODS: Endoscopic and associated bioptic reports on 1000 consecutive patients with histologically confirmed BOe, seen between 1990 and 1995, were analysed. (Average age was 63 +/- 14.3 years; male to female ratio: 2.2:1). RESULTS: In 85.1% of patients the histological diagnosis was BOe without dysplasia. The neoplasias consisted of carcinoma in 8.8%, suspected carcinoma in 0.5%, actual or suspected low-grade dysplasia in 4.6%, actual or high-grade dysplasia in 1.0%. Endoscopic diagnosis in cases without neoplasia was in 60.8% correct for actual BOe or suspected BOe. At endoscopy dysplasia was suspected in 5.4%. The diagnosis or suspected diagnosis of Barrett's carcinoma was correct in 69%. Repeat endoscopy a year after the initial diagnosis was performed in 9.4% with BOe and no neoplasia. Repeat endoscopy was performed in 37.5% of patients with an initial diagnosis of suspected low-grade dysplasia, in 43.3% with low-grade dysplasia, in 42.9% of suspected high-grade and in 100% of actual high-grade dysplasia. CONCLUSION: Neoplasia in Barrett's oesophagus is found too late. Only half of the histologically confirmed cases are found by endoscopy and follow-up is not sufficient.

Aged↗

Method for predicting the state of association of discretized protein models. Application to leucine zippers.

A method that employs a transfer matrix treatment combined with Monte Carlo sampling has been used to calculate the configurational free energies of folded and unfolded states of lattice models of proteins. The method is successfully applied to study the monomer-dimer equilibria in various coiled coils. For the short coiled coils, GCN4 leucine zipper, and its fragments, Fos and Jun, very good agreement is found with experiment. Experimentally, some subdomains of the GCN4 leucine zipper form stable dimeric structures, suggesting the regions of differential stability in the parent structure. Our calculations suggest that the stabilities of the subdomains are in general different from the values expected simply from the stability of the corresponding fragment in the wild type molecule. Furthermore, parts of the fragments structurally rearrange in some regions with respect to their corresponding wild type positions. Our results suggest for an Asn in the dimerization interface at least a pair of hydrophobic interacting helical turns at each side is required to stabilize the stable coiled coil. Finally, the specificity of heterodimer formation in the Fos-Jun system comes from the relative instability of Fos homodimers, resulting from unfavorable intra- and interhelical interactions in the interfacial coiled coil region.

Amino Acid Sequence↗

Predicting leucine zipper structures from sequence.

The leucine zipper structure is adopted by one family of the coiled coil proteins. Leucine zippers have a characteristic leucine repeat: Leu-X6-Leu-X6-Leu-X6-Liu (where X may be any residue). However, many sequences have the leucine repeat, but do not adopt the leucine zipper structure (we shall refer to these as non-zippers). We have found and analyzed residue pair patterns that allow one to identify correctly 90% of leucine zippers and 97% of non-zippers. Simpler analyses, based on the frequency of occurrence of residues at certain positions, specify, at most, 65% of zippers and 80-90% of non-zippers. Both short and long patterns contribute to the successful discrimination of leucine zippers from non-zippers. A number of these patterns involve hydrophobic residues that would be placed on the solvent-exposed surface of the helix, were the sequence to adopt a leucine zipper structure. Thus, an analysis of protein sequences has allowed us to improve discrimination between leucine zippers and non-zippers, and has provided some further insight into the physical factors influencing the leucine zipper structure.

Amino Acid Sequence↗

Prediction of the quaternary structure of coiled coils: GCN4 leucine zipper and its mutants.

A methodology for predicting coiled coil quaternary structure and for the dissection of the interactions responsible for the global fold is described. Application is made to the equilibrium between different oligomeric species of the wild type GCN4 leucine zipper and seven of its mutants that were studied by Harbury et al. Over the entire experimental concentration range, agreement with experiment is found in five cases, while in two other cases, agreement is found over a portion of the concentration range. These simulations suggest that the degree of chain association is determined by the balance between specific side chain packing preferences and the entropy reduction associated with side chain burial in higher order multimers.

Amino Acid Substitution↗

Prediction of quaternary structure of coiled coils. Application to mutants of the GCN4 leucine zipper.

Using a simplified protein model, the equilibrium between different oligomeric species of the wild-type GCN4 leucine zipper and seven of its mutants have been predicted. Over the entire experimental concentration range, agreement with experiment is found in five cases, while in two cases agreement is found over a portion of the concentration range. These studies demonstrate a methodology for predicting coiled coil quaternary structure and allow for the dissection of the interactions responsible for the global fold. In agreement with the conclusion of Harbury et al., the results of the simulations indicate that the pattern of hydrophobic and hydrophilic residues alone is insufficient to define a protein's three-dimensional structure. In addition, these simulations indicate that the degree of chain association is determined by the balance between specific side-chain packing preferences and the entropy reduction associated with side-chain burial in higher-order multimers.

Computer Simulation↗