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Biomedical subjects

R P Rand

Publications and source records attributed to R P Rand.

At least 55 records · Page 3Linked to original sources
PubMed1994

Enhancement of intestinal absorptive capacity with omental flaps.

The ability of pedicled omental flaps to revascularize isolated jejunal segments was determined in the initial phase of this project. These bowel segments were capable of surviving independent of their mesenteric perfusion, and absorptive function was equal to that of controls as measured by D-xylose assays. In the second phase of this research, we studied in 10 dogs the absorptive capacity of isolated jejunal segments with both an intact mesentery and an omental flap sutured to the antimesenteric border compared with controls that were perfused only by the mesentery. Absorption was measured at 1, 2, 5, and 10 weeks after application of the omental flap. Absorptive function was augmented an average of 25.8% at 2 weeks, reaching 67.6% (p < 0.001) at 5 weeks. This result remained consistent at 10 weeks. Laser Doppler and colored microsphere studies were performed during a secondary laparotomy at 10 weeks and revealed 42.3% and 53.5% increases, respectively, in blood flow to bowel segments receiving both mesenteric and omental perfusion. This finding suggested that the augmentation of absorptive function was a result of increased blood flow.

Animals↗
PubMed1994

Color-flow duplex scanning in the preoperative assessment of TRAM flap perforators: a report of 32 consecutive patients.

This is a report of the results of preoperative color-flow duplex Doppler scanning in the assessment of TRAM flap perforators in 32 consecutive patients. A total of 190 perforators were detected with peak systolic flow velocities ranging from 8 to 81 cm/s. Perforator locations were tabulated according to their vertical position relative to the umbilicus and their lateral location relative to the abdominal midline. The periumbilical region (zones I to III) contained 80.5 percent of the perforators. Asymmetry between the two sides was detected in the majority of patients when perforator positions were evaluated laterally from the midline. The total flap survival rate within the series was 97.9 percent (46 to 47). The present study proposes that the preoperative color-flow Doppler localization of TRAM flap perforators improves the surgeon's ability to design and elevate the flap in order to capture the dominant vessels and maximize survival. In addition, preoperative knowledge of the number and flow velocity characteristics of the perforators allows for the selection of single- and double-pedicle and free TRAM flaps based on each patient's individual perfusion characteristics.

Abdominal Muscles↗
PubMed1993

Measured change in protein solvation with substrate binding and turnover.

Osmotic stress is used to measure solvation changes that accompany the conformational changes of an active enzyme. For hexokinase both the equilibrium dissociation constant and the kinetic Michaelis-Menten constant for glucose vary linearly, and to the same extent, with the activity of water in the protein medium, as adjusted with large molecular weight (> 2000) osmolytes. The variation over the whole osmotic pressure range studied indicates that glucose binding is accompanied by the release of at least 65 +/- 10 water molecules, and this is reversed on enzyme turnover. The results indicate that near the physiological range of pressures the number may be higher. Most of this water, which behaves like an inhibitor, likely comes from the cleft which is induced to close around the substrate. Such large dehydration/rehydration reactions during turnover imply a significant contribution of solvation to the energetics of the conformational changes. Osmotic stress is a method of general applicability to probe water's contribution to functioning molecules.

Catalysis↗
PubMed1993

Pyoderma gangrenosum after coronary artery bypass grafting.

Pyoderma gangrenosum is a rare cutaneous disorder that may complicate recovery after a cardiac operation. The lesions appear to represent a necrotizing infection; however, they do not respond to surgical debridement and antibiotic therapy. The treatment is based on high-dose corticosteroids and concomitant treatment of any underlying systemic disease.

Aged↗
PubMed1993

Hydration forces.

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Aluminum Silicates↗
PubMed1992

Energetics of a hexagonal-lamellar-hexagonal-phase transition sequence in dioleoylphosphatidylethanolamine membranes.

The phase diagram of DOPE/water dispersions was investigated by NMR and X-ray diffraction in the water concentration range from 2 to 20 water molecules per lipid and in the temperature range from -5 to +50 degrees C. At temperatures above 22 degrees C, the dispersions form an inverse (HII) phase at all water concentrations. Below 25 degrees C, an HII phase occurs at high water concentrations, an L alpha phase is formed at intermediate water concentrations, and finally the system switches back to an HII phase at low water concentrations. The enthalpy of the L alpha-HII-phase transition is +0.3 kcal/mol as measured by differential scanning calorimetry. Using 31P and 2H NMR and X-ray diffraction, we measured the trapped water volumes in HII and L alpha phases as a function of osmotic pressure. The change of the HII-phase free energy as a function of hydration was calculated by integrating the osmotic pressure vs trapped water volume curve. The phase diagram calculated on the basis of the known enthalpy of transition and the osmotic pressure vs water volume curves is in good agreement with the measured one. The HII-L alpha-HII double-phase transition at temperatures below 22 degrees C can be shown to be a consequence of (i) the greater degree of hydration of the HII phase in excess water and (ii) the relative sensitivities with which the lamellar and hexagonal phases dehydrate with increasing osmotic pressure. These results demonstrate the usefulness of osmotic stress measurements to understand lipid-phase diagrams.

Calorimetry, Differential Scanning↗
PubMed1992

Membrane dipole potentials, hydration forces, and the ordering of water at membrane surfaces.

We have compared hydration forces, electrical dipole potentials, and structural parameters of dispersions of dipalmitoylphosphatidylcholine (DPPC) and dihexadecylphosphatidylcholine (DHPC) to evaluate the influence of fatty acid carbonyl groups on phospholipid bilayers. NMR and x-ray investigations performed over a wide range of water concentrations in the samples show, that in the liquid crystalline lamellar phase, the presence of carbonyl groups is not essential for lipid structure and hydration. Within experimental error, the two lipids have identical repulsive hydration forces between their bilayers. The higher transport rate of the negatively charged tetraphenylboron over the positively charged tetraphenylarsonium indicates that the dipole potential is positive inside the membranes of both lipids. However, the lack of fatty acid carbonyl groups in the ether lipid DHPC decreased the potential by (118 +/- 15) mV. By considering the sign of the potential and the orientation of carbonyl groups and headgroups, we conclude that the first layer of water molecules at the lipid water interface makes a major contribution to the dipole potential.

1,2-Dipalmitoylphosphatidylcholine↗
PubMed1991

Molecular organization and stability of hydrated dispersions of headgroup-modified phosphatidylethanolamine analogues.

Measurements of the thermotropic behavior of various headgroup-modified analogues of 1-palmitoyl-2-oleoylphosphatidylethanolamine (POPE) and of the ion-triggered destabilization of unilamellar vesicles containing these species have been correlated with X-ray diffraction measurements of the organization of hydrated dispersions of these analogues in the absence and presence of dodecane. The hexagonal II lattice repeat dimension -dhex for dodecane-supplemented dispersions, which reflects the optimal or "spontaneous" radius of surface curvature of the phospholipid component, is increased relative to POPE for most analogues with N-alkyl substitutents or increased amino-to-phosphate group separations. Interestingly, however, POPE analogues that are alkylated on C-1 or C-2 of the ethaolamine group show smaller -dhex values (and hence smaller spontaneous radii of surface curvature) than does POPE itself, despite the greater steric bulk of their headgroups. The lamellar-to-hexagonal II transition temperatures of the various POPE analogues and their abilities to promote contact-dependent vesicle destabilization both show strong correlations with the analogues' measured -dhex values (and hence with their spontaneous radii of curvature). The uniformity of these correlations over a wide range of headgroup structures strongly supports, and may help to refine, recent theories which postulate that the spontaneous surface curvature of a lipid or lipid mixture is a central, quantitative determinant of its tendency to adopt nonlamellar phases and to undergo contact-dependent bilayer destabilization.

Calorimetry↗
PubMed1990

Membrane curvature, lipid segregation, and structural transitions for phospholipids under dual-solvent stress.

Amphiphiles respond both to polar and to nonpolar solvents. In this paper X-ray diffraction and osmotic stress have been used to examine the phase behavior, the structural dimensions, and the work of deforming the monolayer-lined aqueous cavities formed by mixtures of dioleoylphosphatidylethanolamine (DOPE) and dioleoylphosphatidylcholine (DOPC) as a function of the concentration of two solvents, water and tetradecane (td). In the absence of td, most PE/PC mixtures show only lamellar phases in excess water; all of these become single reverse hexagonal (HII) phases with addition of excess td. The spontaneous radius of curvature R0 of lipid monolayers, as expressed in these HII phases, is allowed by the relief of hydrocarbon chain stress by td; R0 increases with the ratio DOPC/DOPE. Mixtures with very large R0's can have water contents higher than the L alpha phases that form in the absence of td. The drive for hydration is understood in terms of the curvature energy to create large water cavities in addition to direct hydration of the polar groups. Much of the work of removing water to create hexagonal phases of radius R less than R0 goes into changing monolayer curvature rather than dehydrating polar groups. Single HII phases stressed by limited water or td show several responses. (a) The molecular area is compressed at the polar end of the molecule and expanded at the hydrocarbon ends. (b) For circularly symmetrical water cylinders, the degrees of hydrocarbon chain splaying and polar group compression are different for molecules aligned in different directions around the water cylinder. (c) A pivotal position exists along the length of the phospholipid molecule where little area change occurs as the monolayer is bent to increasing curvatures. (d) By defining R0 at the pivotal position, we find that measured energies are well fit by a quadratic bending energy, K0/2 (1/R-1/R0); the fit yields bilayer bending moduli of Kc = (1.2-1.7) X 10(-12) ergs, in good agreement with measurements from bilayer mechanics. (e) For lipid mixtures, enforced deviation of the HII monolayer from R0 is sufficiently powerful to cause demixing of the phospholipids in a way suggesting that the DOPE/DOPC ratio self-adjusts so that its R0 matches the amount of td or water available, i.e., that curvature energy is minimized.

Chemical Phenomena↗
PubMed1990

Effects of cholesterol on the structural transitions induced by diacylglycerol in phosphatidylcholine and phosphatidylethanolamine bilayer systems.

The transient membrane lipid diacylglycerol (DG) is known to modify and destabilize phospholipid bilayers and can lead to the formation of nonbilayer structures. Since cholesterol forms a major fraction of many plasma membranes, we have investigated how it modifies the structural effects of DG on bilayers of egg phosphatidylcholine (PC) and egg phosphatidylethanolamine (PE). We view these systems as modelling the behaviour of local, DG-containing sites in membranes. Using X-ray diffraction, we have characterized the lamellar (L alpha) and inverse hexagonal (HII) structures that these ternary lipid mixtures form in excess aqueous solution. As the DG level increases, the lipid progresses from a single L alpha structure to a mixture of L alpha and HII, and then to a pure HII structure. This allows determination of the DG levels at which the HII transition begins, which we interpret as those levels that destabilize bilayers. In both PC and PE bilayers, the presence of 30 mol% cholesterol reduces the amounts of DG required to destabilize the bilayer structure. The destabilization can be translated into the number of neighbouring lipid molecules that a DG molecule perturbs, and of bilayer areas that it affects. The data show that the presence of cholesterol greatly enhances the perturbing effects of DG. We examine the possible role of DG in enzyme activation and membrane fusion.

Cholesterol↗
PubMed1989

Bilayer-stabilizing properties of myelin basic protein in dioleoylphosphatidylethanolamine systems.

31P-NMR and X-ray diffraction techniques are used to study the comparative ability of myelin basic protein (MBP) vs. other basic proteins to convert hexagonal (HII) phases to stable lamellar (L alpha) structures. Pure dioleoylphosphatidylethanolamine (DOPE) at pH 9 and 7, and mixtures of DOPE/phosphatidylserine (PS) (95:5 and 80:20% w/w) at pH 7 were employed for this investigation. The polymorphic behavior of the lipid suspensions was evaluated in the presence and absence of several basic proteins (MBP, calf thymus histone, lysozyme, melittin) and the cationic polypeptide, polylysine (PL). Each of the proteins and PL was capable of binding the pure DOPE HII phase at pH 9 but with varying morphological consequences, i.e., lamellar stabilization (MBP, histone, PL), formation of new protein-DOPE HII phases (lysozyme) or lipid disordering/vesiculation (melittin). Reduction to pH 7 resulted in the dissociation of protein from DOPE - with the exception of melittin - and the reformation of a pure lipid HII phase. Additions of PS to DOPE at pH 7 facilitated protein binding, but among the proteins examined, only MBP was capable of converting the lipid suspension into a stable multilamellar form. Differences in the lipid morphology produced by each protein are discussed in terms of protein physicochemical characteristics. In addition, a possible relationship between MBP-lipid interactions and the stability of myelin sheath lipid multilayers is inferred from the significant bilayer-stabilizing capacity of MBP.

Calorimetry, Differential Scanning↗
PubMed1989

Primary treatment of the infected sternotomy wound with muscle flaps: a review of 211 consecutive cases.

Between 1978 and 1987, 15,595 median sternotomies were performed at Emory University Hospitals. Sternal wound infections developed in 246 patients (1.6 percent). Mediastinitis was present in 211 patients, while superficial infections were detected in the remaining 35 patients. Debridement and muscle or omental flap closure were performed in all instances of mediastinitis, with an overall mortality rate of 5.3 percent. The results of this treatment are reviewed, and the evolution of current therapeutic guidelines is described. When compared with closed-catheter irrigation and open granulation techniques, flap closure is shown to result in a fourfold decrease in mortality, an increased success of primary therapy, and a diminished length of hospitalization following treatment. This evidence supports the conclusion that debridement and flap closure should be considered the primary therapy for patients with poststernotomy mediastinitis.

Humans↗
PubMed1988

Variation in hydration forces between neutral phospholipid bilayers: evidence for hydration attraction.

It is now generally recognized that hydration forces dominate close interactions of lipid hydrophilic surfaces. The commonality of their characteristics has been reasonably established. However, differences in measured net repulsion, particularly evident when phosphatidylethanolamine (PE) and phosphatidylcholine (PC) bilayers are compared, suggest there exists a variety of behavior wider than expected from earlier models of hydration and fluctuation repulsion balanced by van der Waals attraction. To find a basis for this diverse behavior, we have looked more closely at measured structural parameters, degrees of hydration, and interbilayer repulsive forces for the lamellar phases of the following lipids: 1-palmitoyl-2-oleoyl-PE (POPE), egg PE, transphosphatidylated egg PE (egg PE-T), mono- and dimethylated egg PE-T (MMPE and DMPE), 1-stearoyl-2-oleoyl-PC (SOPC), and mixtures of POPE and SOPC. POPE and SOPC bilayers differ not only in their maximum degrees of hydration but also in the empirical hydration force coefficients and decay lengths that characterize their interaction. When mixed with POPE, SOPC effects sudden and disproportionate increases in hydration. POPE, egg PE, and egg PE-T differ in their degree of hydration, molecular area, and hydration repulsion. A single methylation of egg PE-T almost completely converts its hydration and bilayer repulsive properties to those of egg PC; little progression of hydration is seen with successive methylations. In order to reconcile these observations with the conventional scheme of balancing interbilayer hydration and fluctuation-enhanced repulsion with van der Waals attraction, it is necessary to relinquish the fundamental idea that the decay of hydration forces is a constant determined by the properties of the aqueous medium. Alternatively, one can retain that fundamental idea if one recognizes the possibility that polar group hydration has an attractive component to it. In the latter view, that attractive component originates from interbilayer hydrogen-bonded water bridges between apposing bilayer surfaces, arising from correlation of zwitterionic or other complementary polar groups or from factors that affect polar group solubility. The same Marcelja and Radic formalism that accounts so well for the repulsive component also leads to an estimate of the attractive one. We suggest that the full range of degrees of hydration and of interbilayer spacings observed for different neutral bilayers results in part from variable contributions of the attractive and repulsive hydration components.(ABSTRACT TRUNCATED AT 400 WORDS)

Hydrogen Bonding↗
PubMed1988

Pyoderma gangrenosum and progressive cutaneous ulceration.

Pyoderma gangrenosum is a cutaneous disorder characterized by slowly progressive ulceration which is refractory to local wound care and antibiotic therapy. The diagnosis is made after the exclusion of other causes of cutaneous ulceration. The cause of pyoderma is thought to be a deficiency in host immune reactivity, and a systemic illness is present in 80% of patients. High-dose corticosteroids and appropriate treatment of the underlying disease represent the mainstays of therapy, although hyperbaric oxygen has recently shown promise in the healing of skin grafts over these lesions.

Adult↗