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Fragmental methods in the analysis of biological activities of diverse compound sets.

The current mini-review explains how fragmental methods (FMs) can be used in the analysis and prediction of physicochemical properties and biological activities. The considered properties include log P, solubility, pK(a), intestinal permeability, P-gp substrate specificity and toxicity. The focus will be a description of a "mechanistic" approach, which implies a gradual reduction of alternative explanations for any property or activity. This means a flexible construction of fragmental parameters using large amounts of experimental data. Since biological activities involve multiple (unknown) target macromolecules with multiple binding modes, a stepwise classification (C-SAR) analysis is most useful. It involves the following procedures: (i). construction of physicochemical profiles using parameters that can be reliably predicted, (ii). identification of reactive functional groups and the largest active skeletons, (iii). generalization of these groups and skeletons in terms of "site-specific physicochemical profiling". This entails a dynamic construction of 2D pharmacophores that can be converted into 3D models.

Algorithms↗

[Structural analysis of the new model of primary care in the community of Valencia].

OBJECTIVES: To analyse the structure of the new model of primary care (NMPC) in the Community of Valencia, and to identify the strategic importance of its characteristic variables and the possibilities of intervention to affect these variables. DESIGN: A qualitative study through a method of structural analysis (crossed impact method-multiplication applied to a classification) of the relationships between 37 variables characterising the NMPC which were identified by prior qualitative research, with interpretation of the results using the Téniere-Buchot Model. SETTING: Community of Valencia. RESULTS: The structural variables identified were those relating to the political-legal framework and to the allocation of primary care resources; and the resultant variables, those relating to efficiency and primary care quality. Between these two categories, the intervention variables covered management, NMPC professionals, health needs and the community's use of services. CONCLUSIONS: The structural analysis gives the legal-political and economical framework a determining role in NMPC, which can hardly be influenced from within the system. Management and organisation are identified as key variables from which an intervention can be made in the short or medium term to achieve the aims of the system.

Models, Organizational↗

In vivo detection of carotid plaque thrombus by ultrasonic tissue characterization.

The purpose of the study was to determine whether ultrasonic tissue characterization could detect carotid plaque thrombus in vivo. Patients undergoing carotid endarterectomy were examined preoperatively and the ultrasonic tissue characterization findings were compared to those of optical microscopy of the removed plaque specimens. Ten of 15 patients studied had plaque thrombus. Ultra-ultrasonic tissue characterization entailed an analysis of parameters obtained from the power spectrum of backscattered ultrasound signals. Data were obtained with a nominal 10 MHz sector scanning transducer with an effective bandwidth of 3 to 13 MHz. The parameters were the slope and intercept derived from the linear regression of the normalized spectrum and total power (log of the integrated power of the normalized spectrum over the effective bandwidth). The combined effect of the three parameters was determined by discriminant function analysis and showed a significant difference (P < 0.05) between nonthrombus and plaque thrombus in a small sample of patients with advance carotid atherosclerosis. These parameters applied singly could not provide such a distinction. Correct classification of carotid plaque thrombus using the multiple-parameter analysis revealed a sensitivity of 90%, specificity of 80%, and accuracy of 86.7%. This study demonstrates that analysis utilizing a combination of multiple spectral parameters was able to detect carotid plaque thrombus in vivo.

Aged↗

[Myelodysplastic syndrome with multiple chromosome aberrations in a patient with Werner's syndrome].

An unusual case of Werner's syndrome with myelodysplastic syndrome (MDS) in a 63-year-old male is reported. He was transferred to our hospital for evaluation of pancytopenia in August 1994. He had surgery for cataracts at age 47. On admission, his weight was 39 kg and his height was 148 cm. He looked pale, had thin limbs, a bird-like face, loss of hair, a hoarse voice, and atrophic skin with ulcers. A complete blood count showed: hemoglobin 8.7 g/dl; platelet count 1.5 x 10(4)/microliters; and white blood cell count 2,900/microliters with 3% blasts. A bone marrow aspiration revealed hypercellularity with 11.8% blasts and trilineage myelodysplasia. A diagnosis of RAEB was made according to the FAB classification. Cytogenetic analysis of the bone marrow cells revealed multiple aberrations such as 44, XY, -3, -5, add (4) (q?31), add(6) (p2?), del(7) (q22), add(10) (q24), del(12) (q?), add(14) (q32), -15, -16, -17, + mar1, +mar2, +mar3. He died of pneumonia on day 11. Although approximately 700 cases (about 300 cases in Japan) of Werner's syndrome have been reported, the occurrence of hematopoietic malignancies in Werner's syndrome is rare, and the literature includes 8 cases of leukemia and 4 cases of MDS.

Bone Marrow Cells↗

Systematic source estimation of spikes by a combination of independent component analysis and RAP-MUSIC. II: Preliminary clinical application.

OBJECTIVES: We tried to estimate epileptic sources by a combination of independent component analysis (ICA) and recursively applied and projected multiple signal classification (RAP-MUSIC) in real epileptiform EEG discharges. METHODS: EEG data including an array of spikes from 3 patients were decomposed by ICA, and source estimation was performed by applying RAP-MUSIC to the spatial information defined by the set of ICA components that showed epileptiform activity in their waveform. Sources were also estimated from the same data using RAP-MUSIC based on eigen-decomposition of the covariance matrix of averaged spikes, and common spatial pattern decomposition for comparison. RESULTS: RAP-MUSIC based on ICA could estimate generally correct epileptic sources in the 3 patients, and its results were better than those of the other methods, when compared to intracerebral data. The present analysis proceeded without introduction of subjective decision after data selection. The separation of epileptiform discharges from the background is essential for this analysis, and was successfully performed in the real EEG data. CONCLUSIONS: RAP-MUSIC based on ICA appears promising for estimation of epileptic sources with minimal dependence on subjective decisions in the process of analysis. In particular, it was not necessary to select the number of sources.

Brain↗

Method factors associated with assessment of child behavior: fact or artifact?

A sample of 64 phobic children between the ages of 6 and 16, with their general population matched controls, were rated by parents on the Louisville Behavior Check List and Louisville Fear survey and by School Behavior check list. The analysis of ratings by factor analysis revealed three instrument factors while a multiple discriminant analysis elicited a multidimensional phobic trait that crossed observers, situations, and instruments. The results are discussed in terms of the implications for multivariant analysis of behavior change as well as for classification of psychopathological disorders of childhood. The thesis is advanced that instrument factors elicited by factor analysis in psychotherapy change studies are statistical artifacts and that a multiple discriminant analysis is a more appropriate technique for the study of change as well as for classification.

Adolescent↗

Incidence of cleft palate fistula: an institutional experience with two-stage palatal repair.

The purpose of this study was to determine the incidence of cleft palatal fistula in a series of nonsyndromic children treated at the authors' institution. This retrospective analysis of 103 patients with cleft palate treated by five surgeons between 1982 and 1995 includes 60 boys and 33 girls, whose median age was 18.4 months at the time of surgery. The median length of follow-up was 4.9 years after primary palatoplasty. Cleft palatal fistula was defined as a failure of healing or a breakdown in the primary surgical repair of the palate. Intentionally unrepaired fistulas of the primary and secondary palate were excluded. Extent of clefting was described according to the Veau classification. Statistical examination of multiple variables was performed using contingency table analysis, multivariate logistic regression, and the Wilcoxon rank sum test. The incidence of cleft palatal fistula in this series was 8.7 percent. All of these fistulas were clinically significant. The rate of fistula recurrence was 33 percent. The incidence of cleft palatal fistula when compared by Veau classification was statistically significant, with nine fistulas occurring in patients with Veau 3 and 4 clefts and no fistulas occurring in patients with Veau 1 and 2 clefts (p = 0.0441). No significant differences between patients with and without fistulas were identified with respect to operating surgeon, patient sex, patient age at palatoplasty, type of palatoplasty, and use of presurgical orthopedics or palatal expansion. All three recurrent fistulas occurred in the anterior palate, two in patients with Veau class 3 clefts and one in a patient with a Veau class 4 cleft. The low rate of clinically significant fistula was attributed to early delayed primary closure, with smaller secondary clefts allowing repair with a minimum of dissection and disruption of vascularity.

Cleft Palate↗

cDNA sequence of four purine nucleoside phosphorylase (Np) alleles in the mouse.

The molecular basis of four electrophoretic and activity variants of purine nucleoside phosphorylase in the mouse was examined by amplification and sequence analysis of cDNA. Compared with the cDNA coding sequence for C3H/HeHa designated Npa, there were five nucleotide changes for C57BL/6J, Npb; three for MOLF/Ei, Npc; and five for SPRET-1, Npd. There was only a single codon change between Npa and Npb, the deduced substitution of threonine 176 by serine. Similarly, there was only a single codon change between Npa and Npc, resulting in substitution of methionine 258 by lysine. There were three codon changes between Npa and Npd, resulting in substitution of glutamate 22 by lysine, threonine 39 by alanine, and aspartate 152 by glutamate. These amino acid substitutions-neutral to neutral, neutral to basic, and acidic to basic--are in agreement with the electrophoretic properties of the gene products of Npa relative to Npb, Npc, and Npd previously described by isoelectric focusing. Codon differences were confirmed by PCR-RFLP or single nucleotide primer extension analysis and extended to include the assignment of other strains as Npa: C3H/HeHa, DBA/2J, CLA, Posch-2; or Npb: C57BL/6J, C57L/J, C58/J. Both RFLP analysis of amplified genomic DNA and Southern analysis are consistent with single but unique Np alleles present in the C3H/HeHa and C57BL/6J genomes. As these data do not support the previous two-loci, Np-1 and Np-2, classification, we propose and employ a new single locus multiple allele classification for Np on the basis of the sequence analysis.

Alleles↗

Thermal balloon ablation in patients with multiple morbidity: 3-year follow-up.

STUDY OBJECTIVE: To evaluate the effectiveness of a thermal uterine balloon therapy system in a specific group of patients with multiple morbidity. DESIGN: Retrospective cohort analysis (Canadian Task Force classification II-2). SETTING: Department of Obstetrics and Gynecology in two university teaching hospitals. PATIENTS: Seventy women with severe systemic disease (American Association of Anesthesiologists physical status score >/= III) and severe menorrhagia. INTERVENTION: Uterine balloon therapy under local anesthesia and 3 years of follow-up. MEASUREMENTS AND MAIN RESULTS: The women had a mean age of 44.3 years (range, 24-76). After treatment, 25.7% of the patients had no bleeding, 45.7% hypomenorrhea, and 21.4% normal menstrual flow. The procedure was repeated successfully for one patient, and five failures (7.1%) were observed. The blood count values differed significantly (p <.001) before and after balloon therapy. CONCLUSION: Uterine balloon therapy is a suitable and useful option for women with severe uterine bleeding and concomitant severe systemic nongynecologic disease.

Adult↗

Systematic source estimation of spikes by a combination of independent component analysis and RAP-MUSIC. I: Principles and simulation study.

OBJECTIVES: We propose a combination of independent component analysis (ICA) and recursively applied and projected multiple signal classification (RAP-MUSIC) as a new approach to dipole source estimation of epileptiform discharges. The method is minimally dependent on subjective decisions. METHODS: Ten electroencephalographic (EEG) data matrices were generated by computer, each matrix including real background activity from a normal subject and an array of added simulated spikes. Each spike was a summation of two transients originating from slightly different 'original dipole sources'. The unaveraged EEG matrices were decomposed by ICA, and source estimation was performed by applying RAP-MUSIC to the spatial information defined by the ICA components showing epileptiform activity in their waveform. For comparison, dipoles were also estimated from the same matrices using two existing methods: RAP-MUSIC based on eigen-decomposition of the covariance matrices of averaged spikes and common spatial pattern decomposition. RESULTS: In every simulated EEG data matrix, two dipoles close to the original sources were estimated by the present method. Their unaveraged activities were also similar to those of the original sources. The two existing methods gave less precise results than the proposed method. CONCLUSIONS: RAP-MUSIC based on ICA thus proved promising for source estimation of unaveraged epileptiform discharges.

Brain↗

Localization of calcium-binding proteins in physiologically and morphologically characterized interneurons of monkey dorsolateral prefrontal cortex.

In the primate neocortex, little is known about the possible associations between functional subclasses of GABA neurons, their morphological properties and calcium-binding protein (CaBP) content. We used whole-cell current clamp recordings, combined with intracellular labeling and fluorescence immunohistochemistry, to determine these relationships for interneurons in layers 2-3 of monkey prefrontal cortex (PFC). Eighty-one interneurons were included in the analysis. Thirty-eight of these cells showed immunoreactivity for one of the three CaBPs tested. Co-localization of more than one CaBP was not observed in any of the interneurons examined. Interneurons with different CaBPs formed distinct populations with specific physiological membrane properties and morphological features. Parvalbumin (PV)-positive cells had the physiological properties characteristic of fast-spiking interneurons (FS) and the morphology of basket or chandelier neurons. Most calretinin (CR)-containing cells had the physiological properties ascribed to non-fast-spiking cells (non-FS) and a vertically oriented axonal morphology, similar to that of double bouquet cells. Calbindin (CB)-positive interneurons also had non-FS properties and included cells with double bouquet morphology or with a characteristic dense web of axonal collaterals in layer 1. Classification of the interneurons based on cluster analysis of multiple electrophysiological properties suggested the existence of at least two distinct groups of interneurons. The first group contained mainly PV-positive FS cells and the second group consisted predominantly of CR- and CB-positive non-FS interneurons. These findings may help to illuminate the functional roles of different groups of interneurons in primate PFC circuitry.

Action Potentials↗

Abnormal expression of E-cadherin in early gastric carcinoma: its relationship with macroscopic growth patterns and catenin alpha and beta.

BACKGROUND: Abnormal expression of E-cadherin plays an important role in the differentiation and progression of gastric carcinoma. There are a few identifiable clinical, histopathologic, and molecular changes that are related with the macroscopic growth patterns of gastric carcinoma. The aim of this study is to elucidate the relation between the macroscopic growth patterns of gastric carcinoma and the abnormal expression of E-cadherin, alpha- and beta-catenins. STUDY: A total of 97 cases of early gastric carcinoma were examined by immunohistochemistry using monoclonal antibodies against E-cadherin, alpha- and beta-catenins. Macroscopically, 52 cases were elevated types and 45 cases were depressed types. RESULTS: Early gastric carcinomas with depressed growth showed diffuse histologic type, younger patients' age and smaller size more frequently than tumors with elevated growth. Abnormal expression rates of E-cadherin, alpha- and beta-catenins were 35.1, 36.1, and 46.4%, respectively. Abnormal expression of E-cadherin, alpha- and beta-catenins was significantly associated with depressed tumor growth and diffuse histologic type. By multiple logistic regression analysis. E-cadherin, age, Lauren classification, World Health Organization grade and size were identified as risk factors of macroscopic growth pattern of early gastric carcinomas. Positive associations between E-cadherin and beta-catenin and between alpha- and beta-catenins were found by log linear model analysis. CONCLUSION: We suggest that E-cadherin plays an important role in the macroscopic growth as well as microscopic differentiation of early gastric carcinomas.

Cadherins↗

An index of disease activity in patients with ulcerative colitis.

Quantification of disease severity was studied in 72 patients with ulcerative colitis, who had undergone total 85 clinical courses. We performed a multiple stepwise regression analysis, according to Truelove and Witts' classification, with disease severity as a dependent variable, and with 18 clinical, laboratory, and endoscopic parameters as independent variables. Results showed that disease severity in patients with ulcerative colitis is significantly influenced by five factors, namely, bloody stool, bowel movements, erythrocyte sedimentation rate (ESR), hemoglobin (Hb), and serum albumin. The activity index (AI) developed for ulcerative colitis is expressed as follows: AI = 60 x blood stool + 13 x bowel movements + 0.5 x ESR - 4 x HB - 15 x albumin + 200. Index values below 150, values between 150 and 220, and values above 220 nearly corresponded to mild, moderate, and severe disease, respectively, in Truelove and Witts' classification. We believe that the activity index is useful in evaluation of the effect of medical treatment in patients with ulcerative colitis. Its most important value will be in therapeutic trials.

Adolescent↗

Genomic organization of HLA-DMA and HLA-DMB. Comparison of the gene organization of all six class II families in the human major histocompatibility complex.

The genomic nucleotide sequences of HLA-DMA and HLA-DMB have been determined and their gene organizations have been compared with other human class II genes. The following features were found to be highly conserved throughout all human class II families. (i) All alpha genes are composed of 5 exons and all beta genes of 6 exons. (ii) The intron-exon boundary classes of exons 1-4 (alpha genes) and exons 1-5 (beta genes) are 100% conserved. Only the last boundary class which falls within the cytoplasmic domain appears to be variable. (ii) The size of exon 3 (membrane proximal domain) is also 100% conserved except for DMA (-1 codon) and DMB (+1 codon). The position and a possible functional implication of this deletion/insertion are discussed. Our findings confirm and extend the evidence based on sequence homology that DMA and DMB are different from typical class II genes suggesting that they may originate from a time prior to the divergence of the main class II genes. In addition we have identified various new repeat sequences within class II genes. Analysis of their classification and distribution reveal single and multiple repeat mediated recombination events. One of these events seems to have partially replaced exon 1 in DPA2. The possibility of this event causing DPA2 to become a pseudogene is discussed.

Amino Acid Sequence↗

Multivariate analysis of 9 disease-associated variables for outcome prediction in patients with sepsis.

OBJECTIVE: To assess the ability of 9 clinical or biological variables to predict outcome (survival or nonsurvival) using multiple regression and classification analyses. DESIGN: Prospective, descriptive cohort study with no interventions. SETTING: Surgical intensive care unit of a tertiary care hospital and a medical school research laboratory. PATIENTS: Eighteen patients with a documented source of infection who met currently accepted criteria for sepsis syndrome or septic shock. MAIN OUTCOME MEASURES: Prediction of survival or nonsurvival based on analysis of clinical (Multiple Organ Dysfunction score, Acute Physiology and Chronic Health Evaluation III scores) and biological (plasma levels of cortisol, interleukin 6, interleukin 10, phospholipase A2, soluble tumor necrosis factor receptor p75, and monocyte membrane tumor necrosis factor receptor levels) variables, with comparison of predicted and actual outcomes. RESULTS: Plasma interleukin 6, interleukin 10, and phospholipase A2 concentrations were not significantly (P>.05) different between survivors and nonsurvivors. By standard, forward stepwise, and backward stepwise multiple regression analyses, only monocyte membrane tumor necrosis factor receptor levels measured at the onset of sepsis significantly predicted outcome in all 3 analyses. However, by both standard and backward stepwise analyses, Multiple Organ Dysfunction scores based on evaluation at the onset of sepsis and 24 hours later were also significant predictors of outcome. Classification analysis showed that assignment to outcome group was statistically significant when based on monocyte membrane tumor necrosis factor receptor levels determined at the onset of sepsis or on Multiple Organ Dysfunction scores assessed 24 hours after sepsis was diagnosed. CONCLUSION: Although these findings were based on a relatively small cohort, both multiple regression and classification analyses indicated that only monocyte membrane tumor necrosis factor receptor levels are able to discriminate survivors from nonsurvivors at the onset of sepsis.

Biomarkers↗

Multiple feature sets based categorization of laryngeal images.

This paper is concerned with an automated analysis of laryngeal images aiming to categorize the images into three decision classes, namely healthy, nodular, and diffuse. The problem is treated as an image analysis and classification task. Aiming to obtain a comprehensive description of laryngeal images, multiple feature sets exploiting information on image colour, texture, geometry, image intensity gradient direction, and frequency content are extracted. A separate support vector machine (SVM) is used to categorize features of each type into the decision classes. The final image categorization is then obtained based on the decisions provided by a committee of support vector machines. Bearing in mind a high similarity of the decision classes, the correct classification rate of over 94% obtained when testing the system on 785 laryngeal images recorded at the Department of Otolaryngology, Kaunas University of Medicine is rather promising.

Algorithms↗

A case-based learning approach to grouping cases with multiple malformations.

A case-based classification system can provide assistance to specialists in dysmorphology. This article describes a case-based model designed to assist in identification and retrospective analysis of rare types of syndromes that have proved difficult to diagnose. The primary task of diagnosis is complemented by a learning, or grouping, task. Using data sets of diagnosed cases in related categories of syndromes, we demonstrate how a case-based learning algorithm can extend the retrieval and indexing mechanisms of standard databases to provide a focus for analysis of syndrome classifications.

Abnormalities, Multiple↗

The maturation of myeloma cells correlates with sensitivity to chemotherapeutic agents.

We analyzed both morphologic and phenotypic findings of myeloma cells before and after chemotherapy in 21 patients with multiple myeloma. The morphologic analysis was based on the Greipp classification, and phenotypic analysis was performed by 3-color flow cytometry using the CD38 plasma gating method (Marrow plasma 38). Results with flow cytometry using a combination of MPC1, CD49e, and CD45 supported the morphologic findings for the myeloma cells. Treatment with 3 or 4 cycles of VAD (vincristine, doxorubicin, and dexamethasone) therapy was effective in reducing the total numbers of myeloma cells, but the proportion of immature myeloma cells increased after this treatment. However, the immature myeloma cells were reduced by high-dose melphalan (HD-Mel) therapy followed by autologous stem cell transplantation (ASCT). High-dose cyclophosphamide treatment for stem cell harvesting did not show an effect on the residual immature myeloma cells after VAD treatment. In addition, thalidomide was not effective in reducing the numbers of immature myeloma cells. These results suggest that VAD (3 or 4 cycles) therapy plus HD-Mel followed by ASCT is a reasonable treatment for multiple myeloma and that Marrow plasma 38 analysis is a useful method for monitoring the response of multiple myeloma to chemotherapy.

ADP-ribosyl Cyclase↗