Evaluation and management of plantar puncture wounds.
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Biomedical subjects
Publications and source records attributed to S A Arnold.
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Transglutaminases (EC 2.3.2.13) catalyze an acyl-transfer reaction between peptide-bound glutamine residues and primary amines, including the epsilon-amino group of lysine residues in protein. Purified human erythrocyte transglutaminase was found to have another activity, i.e., GTP hydrolysis. Treatment of the enzyme with iodoacetamide, a cysteine-directed reagent, caused a 94% loss of TGase activity within 8 min, but no significant loss of GTPase activity. Cys-277, a known residue which is selectively modified by iodoacetamide, was replaced with Ser by site-directed mutagenesis to assess the role of the Cys-277 in the transglutaminase/GTPase activities. Wild-type cDNA, coding for human endothelial cell transglutaminase, and its C277S-mutated cDNA were cloned into a plasmid vector that contained a promoter from phage T7, and then expressed in Escherichia coli. The wild-type recombinant enzyme was indistinguishable from human erythrocyte transglutaminase in mobility on a SDS-polyacrylamide gel, immunoreactivity and catalytic activities for transglutaminase and GTPase. However, the recombinant enzyme was not blocked at the N-terminal alanine residue, as is the case in the naturally occurring erythrocyte enzyme. The C277S mutant enzyme showed no transglutaminase activity, but had Km and kcat values for GTPase activity that were comparable to those of wild-type recombinant and natural erythrocyte enzymes. These results demonstrate that Cys-277 is essential for transglutaminase activity, but not for GTPase activity, and that N-terminal blocking of tissue-type transglutaminase is not critical for either transglutaminase or GTPase activities.
A computer-automated, threshold-tracking procedure was developed for measuring evoked response thresholds on-line. The procedure utilizes an objective detection criterion (correlation) to evaluate whether a response is absent or present. Sound intensity is adjusted according to a modified PEST (parameter estimation by sequential testing) procedure in order to estimate threshold. The computer-automated procedures were used to obtain objective estimates of evoked response thresholds in normal and hearing-impaired chinchillas. The evoked response waveforms stored in the computer were also used to obtain visual judgments of threshold. The objective thresholds determined by the computer were virtually identical to the visual detection thresholds. Thus, the computer-automated procedure provides a reliable, objective, and efficient method of estimating evoked response thresholds.
Life expectancy for children with serious congenital heart defects has dramatically increased in recent years due to advances in medical and surgical care. Anatomic studies of temporal bones in patients with non-syndromic congenital heart disease have demonstrated a high incidence of middle and inner ear anomalies. Systematic study of auditory function in these patients has not been reported. Fifty children with serious congenital heart disease have been evaluated with otologic examination and auditory brainstem-evoked response (ABR) testing. The patients ranged in age from 3 days to 17 years-8 months. Eight patients had hearing loss and normal otologic examinations, 14 patients had hearing loss and associated otitis media with effusion, and 28 patients had normal hearing by ABR testing. These results show a high incidence (16%) of hearing loss not associated with otitis media with effusion in the study population. We suggest that children with serious congenital heart disease are at high risk for hearing loss. This patient group will benefit from early identification, and appropriate medical and audiologic management.
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Most functional imaging studies of the auditory system have employed complex stimuli. We used positron emission tomography to map neural responses to 0.5 and 4.0 kHz sine-wave tones presented to the right ear at 30, 50, 70 and 90 dB HL and found activation in a complex neural network of elements traditionally associated with the auditory system as well as non-traditional sites such as the posterior cingulate cortex. Cingulate activity was maximal at low stimulus intensities, suggesting that it may function as a gain control center. In the right temporal lobe, the location of the maximal response varied with the intensity, but not with the frequency of the stimuli. In the left temporal lobe, there was evidence for tonotopic organization: a site lateral to the left primary auditory cortex was activated equally by both tones while a second site in primary auditory cortex was more responsive to the higher frequency. Infratentorial activations were contralateral to the stimulated ear and included the lateral cerebellum, the lateral pontine tegmentum, the midbrain and the medial geniculate. Contrary to predictions based on cochlear membrane mechanics, at each intensity, 4.0 kHz stimuli were more potent activators of the brain than the 0.5 kHz stimuli.
The use of objective (mathematical) procedures in auditory brain stem response (ABR) testing has been suggested in order to eliminate the subjectivity of visual judgments and to increase sensitivity of detection. This investigation compared with effectiveness of visual and objective detection of the ABR. Auditory brain stem responses were obtained in normal adults at several click levels. An equal number of waveforms obtained without stimulation were used to measure false-positive responses. Visual judgments of ABR presence were made by four experienced raters. Objective analysis was accomplished using three methods: correlation, variance ratio, and multiple pre-post z tests. The mean sensitivity score was highest for visual detection, followed in order by the correlation, variance ratio, and multiple z test methods. While visual scoring was statistically the most sensitive, the practical difference between measures was small. In addition, there was considerable disagreement between raters in their judgments. Therefore, the most sensitive of the objective measures--correlation, is considered to be a useful detection procedure to eliminate observer bias and to achieve consistency of scoring.