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Atomic resolution (0.83 A) crystal structure of the hydrophobic protein crambin at 130 K.

To enhance the already high quality of diffraction data for crystals of the hydrophobic protein crambin, X-ray data were collected at 130 K by the method of H. Hope to 0.83 A resolution. Refinement with PROLSQ yields a model with an R value of 10.5%. The final model had three parameter anisotropic vibration factors for all atoms, which included 367 protein heavy atoms, 372 hydrogen atoms and 144 solvent atoms with one ethanol molecule. Dihedral angles and hydrogen-bonding distances generally agree with earlier studies of high-resolution protein structures, but some new patterns are noted. Solvent-related helix distortions are reminiscent of those described by others. Helix and beta-sheet regions show distinct patterns in their side-chain conformations. Despite crambin's hydrophobic nature, its accessible surface area in the crystal is surprisingly close to that of water-soluble proteins like myoglobin and carboxypeptidase A. More of crambin's hydrophobic surface is buried in the crystal, perhaps accounting for its high order of diffraction. A total of 24% of the 46 residues show discrete disorder at 130 K. This includes five side-chains at both 300 and 130 K, and six more side-chains and an ethanol molecule at 130 K. Disorder is associated with the sequence microheterogeneity at Pro/Ser22 and Leu/Ile25, with space filling or with solvent disorder. Correlated conformations extend over three to five residues. The patterns of disorder in this structure reveal important principles of protein structure and its dynamics. Finding disordered groups correlated over 5 to 8 A suggests that co-ordinated motion extends in groups rather than simply as uncorrelated movement around an atom center. Thermal diffuse scattering experiments on insulin and lysozyme are consistent with this interpretation. Nearly all of the protein-bound solvent has been located. Less than 1% of protein accessible surface area remains uncovered by solvent or crystal contacts. Preliminary analysis of the solvent network reveals two main networks in each of four solvent regions.

Crystallography↗

Effect of hypocapnea on CBF and extracellular intermediates of secondary brain injury.

We examined the metabolic response of the brain underlying subdural hematomas or surrounding contusions to hyperventilation and looked for evidence of ischemia. Twelve consecutive patients with severe traumatic brain injury (TBI) (GCS < 8) who required surgery for evacuation of subdural hematoma or hemorrhagic contusion were studied. At surgery, a microdialysis catheter was placed into the cortex in a gyrus adjacent to the contusion or underlying the subdural hematoma. A thermal diffusion flow probe was placed on the cortex directly above the dialysis catheter. On days 1 and 3 post injury, two trials of hyperventilation were performed which dropped the patients' pCO2 10 mm Hg for 30 minutes. Monitoring of CBF and collection of dialysis fluid continued throughout each hyperventilation trial. Data was analyzed for a three hour window surrounding each hyperventilation. Brief periods of hyperventilation did not cause a significant elevation of the extracellular lactate/pyruvate ratio or glutamate level in areas of the brain likely to be the most vulnerable to secondary injury. In spite of hyperventilation leading to a significant decline in local CBF in 20% of the trials, there was no evidence of ischemia or excitatory amino acid release associated with hyperventilation.

Brain↗

ICP-CBF trauma bolt, laboratory evaluation.

Thermal diffusion flowmetry is a continuous quantitative technique of measuring regional cerebral blood flow utilizing a silastic strip probe placed through a craniotomy or craniectomy in the operating room. A new bolt like application of this technology is now available for commercial use and is especially designed for bedside placement in trauma patients. This new trauma bolt is tested in juvenile pigs who are subjected to episodes of hypercapnea to increase cerebral blood flow, and records significant changes in blood flow. Another feature of the trauma bolt is a second port for the placement of an intracranial pressure (ICP) monitor. Placement of the probe and ICP monitor were easier than with the silastic probe and had relatively little complication.

Animals↗

Significance of temperature difference between cerebral cortex and axilla in patients under hypothermia management.

It is believed that the brain temperature is about 1 degree C higher than the other peripheral temperature. But the result has been mostly obtained in normothermia patients. The objective of this study was to evaluate whether the brain temperature is still higher than the axillary one in the hypothermia patients. Sixty-three patients who underwent craniotomy with implantation of the thermal diffusion thermometer were included in this study. Fifty-four patients were in normothermia and nine patients were managed with mild to moderate hypothermia (about 32 degrees C). The temperature of the cerebral cortex and axilla was measured simultaneously every 2 hours. 1900 paired sample data were collected and analyzed. The temperature difference between the cerebral cortex and the axilla was 1.04 +/- 0.67 degrees C in normothermia patients and 0.91 +/- 0.84 degree C in hypothermic patients. The temperature difference has no statistical significance between the two groups (unpaired t-test, P > 0.05). Our results demonstrate that the brain temperature in the patients under hypothermia management appears to be still about 1 degree C higher than the axilla throughout the study period almost in the same fashion as in normothermia patients.

Adolescent↗

FT-IR photoacoustic depth profiling spectroscopy of enamel.

Photoacoustic Fourier transform infrared (PA-FT-IR) depth profiling spectra of the enamel of an intact human tooth are obtained in a completely nondestructive fashion. The compositional and structural changes in the tissue are probed from the enamel surface to a depth of about 200 microns. These changes reflect the state of tissue development. The subsurface carbonate gradient in the enamel could be observed over the range of about 10-100 microns. The carbonate-to-phosphate ratio increases in the depth profile. The depth profile also reveals changes in the substitutional distribution of carbonate ions. Type A carbonates (hydroxyl substituted) increase relative to type B carbonates (phosphate substituted) with increasing thermal diffusion length. In addition to the changes in the carbonate ion distribution and content, the PA-FT-IR depth profile clearly indicates a dramatic increase in the protein content relative to the phosphate content with increased depth. The changes in the carbonate content and distribution, along with the changes in the protein content, may be responsible for the changes observed in the apatitic structure in the depth profile of the enamel.

Carbonates↗

Pre- and intraoperative methods of controlling cerebral circulation in giant aneurysm surgery.

The surgical treatment of giant aneurysms usually requires temporary clipping of the aneurysmatic vessel. In planning the surgical approach and in applying temporary clips, the surgeon must consider collateral circulations. The functional integrity of the collateral vessels frequently decides the patient's outcome. In 8 patients with internal carotid artery giant aneurysm, measurements of blood flow velocities in the ipsilateral middle cerebral artery were performed preoperatively with transcranial Doppler ultrasound (TCD) during manual occlusion of the carotid artery at the neck. Three different perfusion patterns were established, and each collateral capacity was rated as insufficient, temporarily sufficient, or long-term unproblematic. Surgical strategies were conceived. In one patient with giant aneurysm of the middle cerebral artery the temporary occlusion test was not carried out preoperatively. Intraoperatively, collateral circulation was controlled using microvascular Doppler sonography (MVD). In 8 cases cortical blood flow (CoBF) was monitored by thermal diffusion flow probe and/or laser Doppler. In some cases, the complex pathological anatomy required a change in surgical strategy and a new MVD determination of collateral capacity. Despite these precautions 2 patients suffered ischemia of the basal ganglia and the white matter.

Adult↗

Cerebral blood flow and intracranial pressure during experimental subarachnoid haemorrhage.

The relationships of intracranial pressure (ICP), systemic blood pressure (SBP) and cerebral blood flow (CBF) during experimental subarachnoid haemorrhage were investigated in cats. Continuous monitoring of regional cerebral blood flow (rCBF) was done by a thermal diffusion method using a Peltier stack. During haemorrhage ICP rose within 5.4 +/- 0.97 minutes from 10.5 +/- 4.9 to 176.1 +/- 27.8 mmHg. This strong increase of ICP resulted in a temporary arrest of cerebral circulation. The Cushing response during the haemorrhage could not improve the cerebral circulation, but in contrast caused a further increase of ICP. After the haemorrhage the cerebral blood flow normalised within minutes. It is concluded, that the Cushing response during a subarachnoid haemorrhage should be regarded as a deleterious rather than a beneficial mechanism.

Animals↗

Cortical blood flow recorded during early or delayed surgery for ruptured intracranial aneurysms.

Forty-three patients were operated on for ruptured intracranial aneurysms during a 12-month-period. Intraoperative evaluation of cortical blood flow by means of a thermal diffusion probe was performed in 23 out of the 41 patients who were operated on for aneurysms of the anterior circulation. The autoregulation index was determined at the time of raising the systemic blood pressure after clipping of the aneurysm(s). No statistically significant difference was found between the averages of the autoregulation indexes calculated in the subgroups of patients submitted respectively to early or delayed surgery. There was no correlation of both cortical blood flow and autoregulation with either age of the patients, or preoperative neurological grade. On the contrary, the autoregulation index showed a statistically significant correlation with outcome.

Adult↗

Validation of real-time continuous perfusion measurement.

Perfusion, the rate at which blood in tissue is replenished at the capillary level, is a primary factor in the transport of heat, drugs, oxygen and nutrients. While there have been many measurement techniques proposed, most do not lend themselves to routine, continuous and real-time use. A minimally invasive probe, called the thermal diffusion probe (TDP), which uses a self-heated thermistor to measure absolute perfusion continuously and in real time, was validated at low flows with the microsphere technique. In 27 rabbits, simultaneous TDP measurements were made in liver from 0 to 60 ml min-1 100 g-1. The TDP perfusion correlated well with the microspheres (R2 = 0.898) and the agreement between techniques is very good with a slope close to unity (0.921) and an intercept close to zero (0.566 ml min-1 100 g-1). Variability between the two techniques was primarily due to the sampling error from the microsphere 'snap shot' of periodic blood flow when compared with the continuous TDP perfusion measurement. The ability to quantify local perfusion continuously and in real time may have a profound impact on patient management in a number of clinical areas such as organ transplantation, neurosurgery, oncology and others, in which quantitative knowledge of perfusion is of value.

Animals↗

Effect of vibration magnitude and repetitive exposure on finger blood flow in healthy subjects.

In order to study the effect of the magnitude of vibrations and repetitive exposure on finger blood flow, we exposed ten healthy subjects to three experimental conditions: (1) vibration of 3.16 m/s2 at 60 Hz, (2) vibration of 31.6 m/s2 at 60 Hz, and (3) no vibration, as a control. Under the experimental conditions, the right hand was exposed to 5-min vibration three times, with intervening 5-min rests. Meanwhile, the blood flows of both middle fingers were continuously measured with a blood flow meter based on the thermal diffusion method. Finger blood flow was significantly decreased in both hands with exposure to vibrations of 3.16 m/s2 and 31.6 m/s2. Increased magnitude of vibration tended to enhance the decrease in finger blood flow in both hands, and repeated exposure to vibration had cumulative effects on the decrease in finger blood flow in the unexposed left hand.

Adult↗

Correlation of continuously monitored regional cerebral blood flow and brain tissue oxygen.

BACKGROUND: The purpose of this study was to investigate the relationship between continuously monitored regional cerebral blood flow (CBF) and brain tissue oxygen (PtiO2). METHODS: Continuous advanced multimodal neuromonitoring including monitoring of PtiO2 (Licox, GMS) and CBF (QFlow, Hemedex) was performed in eight patients after severe subarachnoid haemorrhage (n=5) and traumatic brain injury (n=3) for an average of 9.6 days. Parameters were measured using a flexible polarographic PtiO2-probe and a thermal diffusion CBF-microprobe. FINDINGS: Regarding the whole monitoring period in all patients, the data indicated a significant correlation between CBF and PtiO2 (r=0.36). In 72% of 400 analysed intervals of 30 minutes duration with PtiO2 changes larger than 5 mmHg, a strong correlation between CBF and PtiO2 existed (r>0.6). In 19% of intervals a still statistically significant correlation was observed (0.3<r<0.6). During the remaining 9% no correlation was found (r<0.3). Regarding the clinical stability of the monitoring devices, the CBF monitoring system allowed monitoring of CBF in 64% of the time when PtiO2 monitoring was possible only. Phases of non-monitoring were mostly due to fever of the patient, when the system does not allow monitoring to avoid overheating of the cerebral tissue. CONCLUSIONS: This study suggests a correlation between CBF and PtiO2. The level of PtiO2 seems to be predominately determined by regional CBF, since changes in PtiO2 were correlated in 90% of episodes to simultaneous changes of CBF.

Brain↗

Characterization of renal parenchymal perfusion during experimental infrarenal aortic clamping and declamping with enhanced thermodiffusion electrodes.

Despite multiple previous experimental and clinical investigations, it has not been fully clarified until now whether infrarenal aortic cross-clamping (IRAC) induces a significant disturbance of renal parenchymal perfusion. Most renal cortical flow data collected thus far have been heterogenous because of inherent limitations of available measurement technology. The enhanced thermal diffusion (TD) electrode is a newly developed and previously validated prototype device that allows continuous quantification of parenchymal kidney perfusion after local probe implantation. We monitored renal perfusion during experimental IRAC with TD for the first time, thereby also evaluating the potential applicability of the method in clinical aortic surgery. IRAC (20 min) followed by sudden declamping was performed in pigs under general anesthesia (n = 14). Renal cortical blood flow (RCBF) was continuously quantified by TD, total aortic flow (TABF) and renal artery flow (RABF) were measured by ultrasonic flow probes, and parameters of systemic circulation were determined by Swan-Ganz catheter. Our results showed that kidney perfusion can be continuously quantified using TD electrodes during experimental aortic surgery in a porcine model. IRAC does not lead to a significant impairment of RCBF in young pigs as measured by TD. Renal perfusion appears to be predominantly pressure driven. Consequently, abrubt aortic declamping can bring about prolonged renal ischemia. Transfer of the TD method to RCBF monitoring during clinical aortic surgery appears to be feasible and should be investigated in selected cases.

Animals↗

Computer-assisted analysis of photoacoustic spectra of solid and solution state cyanide methemoglobin.

A computer-assisted method for analyzing photoacoustic spectra has been developed. Using this analysis, the relative absorption spectrum and either the chromophore concentration or thermal diffusivity characteristic of a sample can be derived from its photoacoustic spectrum. We have demonstrated the accuracy of the method by analyzing photoacoustic spectra of solution and crystalline-phase bovine cyanide methemoglobin. BASIC and FORTRAN routines used to collect and to analyze photoacoustic spectra are described. Photoacoustic spectroscopy can be used in conjunction with the analytical method presented here to obtain accurate absorption spectra from a variety of solid, opaque, and/or turbid samples.

Animals↗

Quantitative measurements of porphyrin pigments in tissues via photoacoustic spectroscopy.

We investigated the possibility of using photoacoustic spectroscopy as an analytical technique for the quantitative measurement of injected porphyrins in tissues. Samples of liver excised from treated (i.e., injected 24 h in advance with 100 mg/kg Photofrin II) mice and control mice were lyophilized and reduced to powder; then, about 16-mg powder samples were compacted to equal volumes inside the photoacoustic cell. Amplitude and phase spectra were measured in the range 280-760 nm. From these data we computed the photoacoustic absorbance spectra; they were suitably normalized in order to account for differences in hemoglobin concentration among the livers of different mice. The absorbance difference spectra (treated minus control) were computed in the region of wavelengths above 450 nm, where porphyrins and hemoglobin exhibit major differences. Finally, by estimating the value of the thermal diffusion length of the powdered sample and those of the extinction coefficients of the most relevant Photofrin II components in the spectral region considered, we were able to evaluate the local drug concentration and determined a value (260 micrograms/g of wet tissue) that is in the range expected for the dose of Photofrin II injected.

Acoustics↗

Lesion development in focused ultrasound surgery: a general model.

An analytical model has been constructed for the process of formation of thermal lesions in tissue, resulting from exposure to intense, highly focused ultrasound beams such as may be used in minimally invasive surgery. The model assumes a Gaussian approximation to beam shape in the focal region and predicts, for any such focal beam, the time delay to initiation of a lesion and the subsequent time course of growth of that lesion in lateral and axial dimensions, taking into account the effects of thermal diffusion and blood perfusion. The necessary approximations and assumptions of the model are considered. Comparison of predictions with experimentally measured data on excised pig liver indicate generally good agreement. Comparisons are also made of this theory with previously published data on exposure-time dependence of lesioning threshold intensity. Deficiencies are identified in existing practice for measuring and reporting acoustic exposures for focused ultrasound surgery, and the proposal is therefore made that a quantity that would be more satisfactory, from the viewpoints both of metrology and biophysical relevance, is the intensity spatially averaged over the area enclosed by the half-pressure-maximum contour in the focal plane, as determined under linear conditions, provisionally denoted as ISAL.

Acoustics↗

EGF signalling amplification induced by dynamic clustering of EGFR.

Lateral interaction is an important feature of various types of cell surface receptors including the receptor tyrosine kinases (RTKs). Here we report that dynamic lateral interaction produces amplification and variation in signalling of the EGF receptor, a member of RTKs. Binding of EGF is known to induce transphosphorylation inside EGFR dimers. Using single-molecule techniques, the relationship between EGF binding and EGFR phosphorylation has been determined. The number of phosphorylated EGFR molecules became larger than that of EGF binding as unliganded EGFR was phosphorylated, meaning an amplification of EGF signalling. EGFR formed clusters continuously exchanging their elements through thermal diffusion, and direct and/or indirect lateral interactions. As a result, various types of activation sites differing in number of activated receptors were generated. Amplification required no cytoplasmic factors and was observed on semi-intact cells for a wide range of number of EGFR molecules (10(4)-10(6) per cell) suggesting generality of this process.

Adenosine Triphosphate↗

Influence of moderate and profound hyperventilation on cerebral blood flow, oxygenation and metabolism.

OBJECTIVE: The aim of the present study was to examine the impact of moderate and profound hyperventilation on regional cerebral blood flow (rCBF), oxygenation and metabolism. MATERIALS AND METHODS: Twelve anesthetized pigs were subjected to moderate (mHV) and profound (pHV) hyperventilation (target arterial pO(2): 30 and 20 mmHg, respectively) for 30 min each, after baseline normoventilation (BL) for 1 h. Local cerebral extracellular fluid (ECF) concentrations of glucose, lactate, pyruvate and glutamate as well as brain tissue oxygenation (p(ti)O(2)) were monitored using microdialysis and a Licox oxygen sensor, respectively. In nine pigs, regional cerebral blood flow (rCBF) was also continuously measured via a thermal diffusion system. RESULTS: Both moderate and profound hyperventilation resulted in a significant decrease in rCBF (BL: 37.9+/-4.3 ml/100 g/min; mHV: 29.4+/-3.6 ml/100 g/min; pHV: 23.6+/-4.7 ml/100 g/min; p<0.05) and p(ti)O(2) (BL: 22.7+/-4.1 mmHg; mHV: 18.9+/-4.9 mmHg; pHV: 13.0+/-2.2 mmHg; p<0.05). A p(ti)O(2) decrease below the critical threshold of 10 mmHg was induced in three animals by moderate hyperventilation and in five animals by profound hyperventilation. Furthermore, significant increases in lactate (BL: 1.06+/-0.18 mmol/l; mHV: 1.36+/-0.20 mmol/l; pHV: 1.67+/-0.17 mmol/l; p<0.005), pyruvate (BL: 46.4+/-7.8 micromol/l; mHV: 58.0+/-10.3 micromol/l; pHV: 66.1+/-12.7 micromol/l; p<0.05), and lactate/glucose ratio were observed during hyperventilation. (Data are presented as mean+/-S.E.M.) CONCLUSIONS: Both moderate and profound hyperventilation may result in insufficient regional oxygen supply and anaerobic metabolism, even in the uninjured brain. Therefore, the use of hyperventilation cannot be considered as a safe procedure and should either be avoided or used with extreme caution.

Animals↗