PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Mechanism”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 55 records · Page 3Linked to original sources

Pulmonary mechanics in patients with prolonged mechanical ventilation requiring tracheostomy.

This study was performed to assess the changes in pulmonary mechanics before and after tracheostomy in patients with prolonged mechanical ventilation and to detect pre-tracheostomy physiologic factors that predict the outcome of weaning from mechanical ventilation. Pulmonary mechanics were recorded before and after tracheostomy in 20 patients. Work of breathing, mean airway resistance and pressure/time product showed no significant differences after tracheostomy. Peak inspiratory pressure was significantly reduced (pre 33.4 +/- 11.8 vs post 28.6 +/- 9.2 mmHg). There was no difference in age or duration of mechanical ventilation between two different groups according to the outcome (weaned and not-weaned). Pre-tracheostomy intrinsic positive end expiratory pressure (PEEPi) was significantly lower in the weaned group (1.1 +/- 1.6 vs 2.7 +/- 1.4 mmHg). A significant difference was also found in pre-tracheostomy compliance (Cstatic) (47.3 +/- 36.9 vs 28.8 +/- 16.5 ml/cmH2O). We concluded that tracheostomy changed pulmonary mechanics very little except for a fall in peak inspiratory pressure. Patients who had better underlying lung mechanics (higher Cstatic and lower PEEPi) had better chances of weaning from mechanical ventilation after tracheostomy.

Adult↗

Prone position improves lung mechanical behavior and enhances gas exchange efficiency in mechanically ventilated chronic obstructive pulmonary disease patients.

UNLABELLED: Pronation might favorably affect respiratory system (rs) mechanics and function in volume-controlled, mode-ventilated chronic obstructive pulmonary disease (COPD) patients. We studied 10 COPD patients, initially positioned supine (baseline supine [supine(BAS)]) and then randomly and consecutively changed to protocol supine (supine(PROT)), semirecumbent, and prone positions. Rs mechanics and inspiratory work (W(I)) were assessed at baseline (0.6 L) (all postures) and sigh (1.2 L) (supine(BAS) excluded) tidal volume (V(T)) with rapid airway occlusion during constant-flow inflation. Hemodynamics and gas exchange were assessed in all postures. There were no complications. Prone positioning resulted in (a) increased dynamic-static chest wall (cw) elastance (at both V(Ts)) and improved oxygenation versus supine(BAS), supine(PROT), and semirecumbent, (b) decreased additional lung (L) resistance-elastance versus supine(PROT) and semirecumbent at sigh V(T), (c) decreased L-static elastance (at both V(Ts)) and improved CO(2) elimination versus supine(BAS) and supine(PROT), and (d) improved oxygenation versus all other postures. Semirecumbent positioning increased mainly additional cw-resistance versus supine(BAS) and supine(PROT) at baseline. V(T) W(I)-sub-component changes were consistent with changes in rs, cw, and L mechanical properties. Total rs-W(I) and hemodynamics were unaffected by posture change. After pronation, five patients were repositioned supine (supine(POSTPRO)). In supine(POSTPRO), static rs-L elastance were lower, and oxygenation was still improved versus supine(BAS). Pronation of mechanically ventilated COPD patients exhibits applicability and effectiveness and improves oxygenation and sigh-L mechanics versus semirecumbent ("gold standard") positioning. IMPLICATIONS: By assessing respiratory mechanics, inspiratory work, hemodynamics, and gas exchange, we showed that prone positioning of mechanically ventilated chronic obstructed pulmonary disease patients improves oxygenation and lung mechanics during sigh versus semirecumbent positioning. Furthermore, certain pronation-related benefits versus preprone-supine positioning (reduced lung elastance and improved oxygenation) are maintained in the postprone supine position.

APACHE↗

Signal transduction of mechanical stimuli is dependent on microfilament integrity: identification of osteopontin as a mechanically induced gene in osteoblasts.

Mechanical perturbation has been shown to modulate a wide variety of changes in second message signals and patterns of gene expression in osteoblasts. Embryonic chick osteoblasts were subjected to a dynamic spatially uniform biaxial strain (1.3% applied strain) at 0.25 Hz for a single 2-h period, and osteopontin (OPN), an Arg-Gly-Asp (RGD)-containing protein, was shown to be a mechanoresponsive gene. Expression of opn mRNA reached a maximal 4-fold increase 9 h after the end of the mechanical perturbation that was not inhibited by cycloheximide, thus demonstrating that mechanoinduction of opn expression is a primary response through the activation of pre-existing transcriptional factors. The signal transduction pathways, which mediated the increased expression of opn in response to mechanical stimuli, were shown to be dependent on the activation of a tyrosine kinase(s) and protein kinase A (PKA) or a PKA-like kinase. Selective inhibition of protein kinase C (PKC) had no effect on the mechanoinduction of osteopontin even though opn has been demonstrated to be an early response gene to phorbol 12-myristate 13-acetate (PMA) stimulation. Mechanotransduction was dependent on microfilament integrity since cytochalasin-D blocked the up-regulation of the opn expression; however, microfilament disruption had no effect on the PMA induction of the gene. The microtubule component of the cytoskeleton was not related to the mechanism of signal transduction involved in controlling opn expression in response to mechanical stimulation since colchicine did not block opn expression. Mechanical stimulus was shown to activate focal adhesion kinase (FAK), which specifically became associated with the cytoskeleton after mechanical perturbation, and its association with the cytoskeleton was dependent on tyrosine kinase activity. In conclusion, these results demonstrate that the signal transduction pathway for mechanical activation of opn is uniquely dependent on the structural integrity of the microfilament component of the cytoskeleton. In contrast, the PKC pathway, which also activates this gene in osteoblasts, acts independently of the cytoskeleton in the transduction of its activity.

Actin Cytoskeleton↗

Mechanisms of red blood cell trauma in assisted circulation. Rheologic similarities of red blood cell transformations due to natural aging and mechanical stress.

Clinical experience with circulatory support devices has typically shown alteration of patient blood rheology exhibited through increasing blood viscosity and decreasing erythrocyte deformability. Our hemorheologic studies have additionally shown a remarkable increase in red blood cell (RBC) aggregation in the blood of artificial heart patients as compared to healthy donors. These hemorheologic changes may be caused by mechanical trauma to RBCs. The authors hypothesize that the mechanical trauma process, from a rheologic point of view, could be analogous to an "accelerated" RBC aging process. The hypothesis was examined through in vivo and in vitro experiments on RBCs, age-separated on the basis of density, specifically to identify the rheologic similarities between aged and mechanically traumatized RBCs. Older RBCs demonstrated an increased mechanical fragility, a decreased deformability, and a increased ability to aggregate as compared to younger RBCs. RBCs exposed to mechanical stress demonstrated similar alterations in the same rheologic parameters. Our experiments have also shown that mechanical stress decreases the negative surface charge of RBCs as is known to occur in aged RBCs. Similarities found between the processes of RBC mechanical trauma and senescence enhance our understanding of mechanisms of subhemolytic trauma incurred in assisted circulation. This may improve the design and evaluation of future heart assist devices through minimizing shear induced blood trauma.

Animals↗

Synchronized mechanical ventilation for respiratory support in newborn infants.

BACKGROUND: During synchronous ventilation, positive pressure ventilation and spontaneous inspiration coincide. Thus, if synchronous ventilation is provoked, it is likely that adequate gas exchange should be achieved at lower peak pressures, reducing barotrauma and hence airleak and chronic lung disease. Synchronous ventilation can be achieved by manipulation of rate and inspiratory time during conventional ventilation and employment of patient assisted ventilation. OBJECTIVES: To compare (i) the efficacy of synchronized mechanical ventilation, delivered as high frequency positive pressure ventilation or triggered ventilation (patient triggered ventilation (PTV) or synchronous intermittent mandatory ventilation (SIMV)) with conventional ventilation (ii) different types of triggered ventilation SEARCH STRATEGY: Searches were made of the Oxford Database of Perinatal Trials, Medline (MESH terms: mechanical ventilation; triggered ventilation; newborn infant); previous reviews, abstracts, symposia proceedings, hand searching of journals in the English language and contacting expert informants. SELECTION CRITERIA: Randomized or quasi randomized clinical trials comparing synchronized ventilation delivered as high frequency positive pressure ventilation (HFPPV) or triggered ventilation (PTV/SIMV) to conventional ventilation (CMV) in neonates. Randomized trials comparing different triggered ventilation modes (PTV and SIMV) in neonates. DATA COLLECTION AND ANALYSIS: Data regarding clinical outcomes including mortality, airleaks (pneumothorax or pulmonary interstitial emphysema (PIE)), severe intracerebral haemorrhage (grades 3 and 4), chronic lung disease (oxygen dependency beyond 28 days) and duration of weaning/ventilation. Data subdivided into three groups: (i) HFPPV vs CMV; (ii) PTV/SIMV vs CMV; (iii) PTV vs SIMV. Data analysis was conducted according to the standards of the Neonatal Cochrane Review Group. MAIN RESULTS: The meta-analysis demonstrates that HFPPV compared to CMV was associated with a reduction in the risk of airleak (typical relative risk 0.68, 95% CI 0.55, 0.68). PTV/SIMV compared to CMV was associated with a shorter duration of ventilation (Weighted mean difference -45.2 hours, 95% CI -78.3, -12.1). PTV compared to SIMV was associated with a trend to a shorter duration of weaning (Weighted mean difference 42.4 hours, 95% CI -9.6,94.4). No disadvantage to HFPPV or triggered ventilation was noted regarding other outcomes. REVIEWER'S CONCLUSIONS: Compared to conventional ventilation, benefit is demonstrated for both HFPPV and triggered ventilation with regard to a reduction in airleak and a shorter duration of ventilation respectively. In none of the trials was complex respiratory monitoring undertaken and thus it is not possible to conclude that the mechanism of producing those benefits is by provocation of synchronized ventilation. Further trials are needed to determine whether synchronized ventilation is associated with a reduction in chronic oxygen dependency.

Humans↗

The nature of the monomer insertion step in the allylnickel(II)-catalyzed 1,4-polymerization of 1,3-butadiene: sigma-allyl-insertion mechanism versus pi-allyl-insertion mechanism.

We present a theoretical investigation on the nature of the monomer insertion step in the allylnickel(II)-catalyzed 1,4-polymerization of 1,3-butadiene that employed a gradient-corrected DFT method. We have explored critical elementary steps of the whole polymerization cycle for the trans-1,4 regulating cationic allylnickel(II) [RC3H4NiII(C4H6)L]+ catalyst. These steps are i) cis-butadiene insertion into either the eta 1-sigma-butenyl-NiII bond (sigma-allyl insertion mechanism) or the eta 3-pi-butenyl-NiII bond (pi-allyl insertion mechanism) along with competing pathways for generation of trans-1,4 and cis-1,4 polymer units, and ii) anti-syn isomerization. Based on the analysis of geometric and electronic structures of key species involved and the energetics, we present a detailed insight into the different nature of the monomer insertion step according to the two mechanistic alternatives. An understanding of why the pi-allyl insertion mechanism is favored over the sigma-allyl insertion mechanism is provided. eta 1-sigma-butenyl-NiII Species are predicted to be sparsely populated and also distinctly less reactive than eta 3-pi-butenyl-NiII species. Although they are commonly believed to be reactive intermediates, eta 1-sigma-butenyl-NiII species are, therefore, not likely to be involved along viable pathways for cis-butadiene insertion into the butenyl-NiII bond. The present investigation corroborates our previous conclusion that the pi-allyl insertion mechanism represents the preferred mechanism for the monomer insertion step in the allylnickel(II)-catalyzed 1,4-polymerization of 1,3-butadiene. On the other hand, the suggested alternative sigma-allyl insertion mechanism has to be considered to be not operative, for both thermodynamic and kinetic reasons. Furthermore, the sigma-allyl insertion mechanism would neither provide a rationalization of cis-trans selectivity nor of chemoselectivity in the allylnickel(II)-catalyzed 1,4-polymerization of 1,3-butadiene.

Journal Article↗

Electrical and mechanical effects of vasoactive intestinal peptide and pituitary adenylate cyclase-activating peptide in the rat colon involve different mechanisms.

This work aimed to study the effects of pituitary adenylate cyclase-activating peptide (PACAP) and vasoactive intestinal peptide (VIP) on the mechanical and electrical activity of the circular muscle of the rat colon and the mechanisms involved in such effects. Spontaneous mechanical activity was studied in vitro in an organ bath and the membrane potential was recorded using the microelectrode technique. Both VIP and PACAP (0.1 microM) caused an immediate, sustained and tetrodotoxin (1 microM)-resistant inhibition of the cyclic spontaneous mechanical activity and hyperpolarization. The small-conductance Ca(2+)-activated K(+) channel blocker, apamin (1 microM), did not change the VIP- and PACAP-induced relaxation but reduced the hyperpolarization induced by PACAP whereas it did not change that induced by VIP. In contrast, the purinoceptor antagonist, suramin (100 microM), blocked the hyperpolarization caused by PACAP and VIP but failed to change their mechanical inhibitory effects. Moreover, the putative PACAP and VIP receptor antagonists, PACAP-(6-38) and VIP-(10-28), respectively, both 3 microM, failed to change the effects of either peptide and modified neither the inhibitory junction potential nor the relaxation induced by electrical-field stimulation. Thus, these results suggest that the mechanisms mediating relaxation are not strictly coupled to the mechanisms mediating hyperpolarization. This could be due to activation of two distinct mechanisms of action after agonist receptor interaction.

Animals↗

Mechanism independence for texture-modulation detection is consistent with a filter-rectify-filter mechanism.

The ability of the visual system to detect stimuli that vary along dimensions other than luminance or color--"second-order" stimuli--has been of considerable interest in recent years. An important unresolved issue is whether different types of second-order stimuli are detected by a single, all purpose, mechanism, or by mechanisms that are specific to stimulus type. Using a conventional psychophysical paradigm, we show that for a class of second-order stimuli--textures sinusoidally modulated in orientation (OM), spatial frequency (FM), and contrast (CM)--the human visual system employs mechanisms that are selective to stimulus type. Whereas the addition of a subthreshold mask to a test pattern of the same stimulus type was found to facilitate the detection of the test, no facilitation was observed when mask and test were of different types, suggesting mechanism independence for the different types of stimulus. This finding raises the important question of whether mechanism independence is compatible with the well-known filter-rectify-filter (FRF) model of second-order stimulus detection, since FRF mechanisms, in principle, do not discriminate between stimulus types. We show that for all mask/test combinations except those with CM masks, the FRF mechanism giving the largest response to the test modulation is largely unaffected by subthreshold levels of a different stimulus-type mask. For this reason, we cannot rule out the possibility that FRF mechanisms mediate the detection of our stimuli. For combinations involving CM masks, however, we propose that a process of contrast normalization renders the test stimulus insensitive to the mask stimulus.

Contrast Sensitivity↗

Mechanical stimuli regulate rapamycin-sensitive signalling by a phosphoinositide 3-kinase-, protein kinase B- and growth factor-independent mechanism.

In response to growth factors, mTOR (mammalian target of rapamycin) has been identified as a central component of the signalling pathways that control the translational machinery and cell growth. Signalling through mTOR has also been shown to be necessary for the mechanical load-induced growth of cardiac and skeletal muscles. Although the mechanisms involved for mechanically induced activation of mTOR are not known, it has been suggested that activation of PI3K (phosphoinositide 3-kinase) and protein kinase B (Akt), via the release of locally acting growth factors, underlies this process. In the present study, we show that mechanically stimulating (passive stretch) the skeletal muscle ex vivo results in the activation of mTOR-dependent signalling events. The activation of mTOR-dependent signalling events was necessary for an increase in translational efficiency, demonstrating the physiological significance of this pathway. Using pharmacological inhibitors, we show that activation of mTOR-dependent signalling occurs through a PI3K-independent pathway. Consistent with these results, mechanically induced signalling through mTOR was not disrupted in muscles from Akt1-/- mice. In addition, ex vivo co-incubation experiments, along with in vitro conditioned-media experiments, demonstrate that a mechanically induced release of locally acting autocrine/paracrine growth factors was not sufficient for the activation of the mTOR pathway. Taken together, our results demonstrate that mechanical stimuli can activate the mTOR pathway independent of PI3K/Akt1 and locally acting growth factors. Thus mechanical stimuli and growth factors provide distinct inputs through which mTOR co-ordinates an increase in the translational efficiency.

Animals↗

Respiratory mechanics during mechanical ventilation: a model study on the effects of leak around a tracheal tube.

Air leak around a tracheal tube (TT) during mechanical ventilation is likely to occur during the inspiratory phase because airway pressure is high for a prolonged period. The presence of a leak may introduce errors in measurements of respiratory mechanics made at the airway opening. If so, respiratory mechanics can be measured more accurately when data are collected during the expiratory phase of ventilation. We examined this phenomenon in a lung model. When a leak was introduced into the model, simulating a leak around the TT, the leak occurred predominantly during the inspiratory phase of respiration. As the magnitude of the leak increased, the overestimation of resistance progressively increased, when calculated from pressure and flow measured at the airway opening. A large leak (38%) resulted in an overestimation of respiratory system resistance by 51% and an underestimation of elastance (Ers) by 23% when calculated from the entire ventilatory cycle. However, there was no under- or overestimation in Rrs when calculated from the expiratory phase only, and ERS was overestimated by only 6.1%. Varying peak inspiratory pressure, end-expiratory pressure, and expiratory time did influence the effect of leak, however, respiratory mechanics could still be calculated accurately from the expiratory phase under these conditions. We conclude that measurements of lung mechanics from the expiratory phase is a promising approach to dealing with the problem of measuring respiratory mechanics in mechanically ventilated infants with leaks around the tracheal tube.

Airway Resistance↗

Sensitization of unmyelinated sensory fibers of the joint nerve to mechanical stimuli by interleukin-6 in the rat: an inflammatory mechanism of joint pain.

OBJECTIVE: Pain during mechanical stimulation of the joint and spontaneous pain are major symptoms of arthritis. An important neuronal process of mechanical hypersensitivity of the joint is the sensitization of thin myelinated Adelta fibers and unmyelinated C fibers innervating the joint. Because interleukin-6 (IL-6) is a major inflammatory mediator, we investigated whether this cytokine has the potential to sensitize joint afferents to mechanical stimuli. METHODS: In electrophysiologic experiments conducted on anesthetized rats, action potentials were recorded from afferent fibers supplying the knee joint. Responses to innocuous and noxious rotation of the tibia against the femur in the knee joint were monitored before and 1-2 hours after injection of test compounds into the joint cavity. RESULTS: Injection of IL-6 and coinjection of IL-6 plus soluble IL-6 receptor (sIL-6R) caused a gradual increase in the responses of C fibers to innocuous and noxious rotation within 1 hour. The increase in responses to IL-6 and IL-6 plus sIL-6R was prevented by coadministration of soluble glycoprotein 130 (sgp130), but sgp130 did not reverse established mechanical hyperexcitability. Responses of Adelta fibers were not altered by the compounds. While injection of sIL-6R alone into the normal knee joint did not influence responses to mechanical stimulation, injection of sIL-6R into the acutely inflamed knee joint caused an increase in responses. CONCLUSION: IL-6 has the potential to sensitize C fibers in the joint to mechanical stimulation. Thus, IL-6 contributes to mechanical hypersensitivity, most likely due to an action of IL-6 on nerve fibers themselves.

Action Potentials↗

Molecular mechanism of cardiac cellular hypertrophy by mechanical stress.

Mechanical stress is a major cause of cardiac hypertrophy. Although the mechanisms by which mechanical load induces cardiac cellular hypertrophy have long been a subject of great interest for cardiologists, the lack of a good in vitro system has hampered the understanding of the biochemical mechanisms. For these past several years, however, an in vitro cardiocyte culture system has made it possible to examine the biochemical basis for the signal transduction of mechanical stress. Passive stretch of cardiomyocytes cultured on silicone membranes activates protein kinase cascades of phosphorylation and induces an increase in protein synthesis and the expression of both immediate early genes such as c-fos, c-myc, c-jun, Egr-1, and late response genes such as beta-myosin heavy chain and skeletal alpha-actin. Although an important question regarding how mechanical stimulus is converted into biochemical signals remains unknown, the cultured cardiomyocyte is a good model to examine the signal transduction pathways of mechanical stress.

Actins↗

Mechanical thresholds for initiation and persistence of pain following nerve root injury: mechanical and chemical contributions at injury.

There is much evidence supporting the hypothesis that magnitude of nerve root mechanical injury affects the nature of the physiological responses which can contribute to pain in lumbar radiculopathy. Specifically, injury magnitude has been shown to modulate behavioral hypersensitivity responses in animal models of radiculopathy. However, no study has determined the mechanical deformation thresholds for initiation and maintenance of the behavioral sensitivity in these models. Therefore, it was the purpose of this study to quantify the effects of mechanical and chemical contributions at injury on behavioral outcomes and to determine mechanical thresholds for pain onset and persistence. Male Holtzman rats received either a silk or chromic gut ligation of the L5 nerve roots, a sham exposure of the nerve roots, or a chromic exposure in which no mechanical deformation was applied but chromic gut material was placed on the roots. Using image analysis, nerve root radial strains were estimated at the time of injury. Behavioral hypersensitivity was assessed by measuring mechanical allodynia continuously throughout the study. Chromic gut ligations produced allodynia responses for nerve root strains at two-thirds of the magnitudes of those strains which produced the corresponding behaviors for silk ligation. Thresholds for nerve root compression producing the onset (8.4%) and persistence of pain (17.4%-22.2%) were determined for silk ligation in this lumbar radiculopathy model. Such mechanical thresholds for behavioral sensitivity in a painful radiculopathy model begin to provide biomechanical data which may have utility in broader experimental and computational models for relating injury biomechanics and physiologic responses of pain.

Animals↗

Mechanisms leading to reversible mechanical dysfunction in severe CAD: alternatives to myocardial stunning.

Patients with severe chronic coronary artery disease (CAD) exhibit a highly altered myocardial pattern of perfusion, metabolism, and mechanical performance. In this context, the diagnosis of stunning remains elusive not only because of methodological and logistic considerations, but also because of the pathophysiological characteristics of the myocardium of these patients. In addition, a number of alternative pathophysiological mechanisms may act by mimicking the functional manifestations usually attributed to stunning. The present review describes three mechanisms that could theoretically lead to reversible mechanical dysfunction in these patients: myocardial wall stress, the tethering effect, and myocardial expression and release of auto- and paracrine agents. Attention is focused on the role of these mechanisms in scintigraphically "normal" regions (i.e., regions usually showing normal perfusion, glucose metabolism, and cellular integrity as assessed by nuclear imaging techniques), in which stunning is usually considered, but these mechanisms could also operate throughout the viable myocardium. We hypothesize that reversion of these three mechanisms could partially explain the unexpected functional benefit after reperfusion recently highlighted by high-spatial-resolution imaging techniques.

Animals↗

Partitioning of respiratory mechanics in mechanically ventilated patients.

In ten mechanically ventilated patients, six with chronic obstructive pulmonary disease (COPD) and four with pulmonary edema, we have partitioned the total respiratory system mechanics into the lung (l) and chest wall (w) mechanics using the esophageal balloon technique together with the airway occlusion technique during constant-flow inflation (J. Appl. Physiol. 58: 1840-1848, 1985). Intrinsic positive end-expiratory pressure (PEEPi) was present in eight patients (range 1.1-9.8 cmH2O) and was due mainly to PEEPi,L (80%), with a minor contribution from PEEPi,w (20%), on the average. The increase in respiratory elastance and resistance was determined mainly by abnormalities in lung elastance and resistance. Chest wall elastance was slightly abnormal (7.3 +/- 2.2 cmH2O/l), and chest wall resistance contributed only 10%, on the average, to the total. The work performed by the ventilator to inflate the lung (WL) averaged 2.04 +/- 0.59 and 1.25 +/- 0.21 J/l in COPD and pulmonary edema patients, respectively, whereas Ww was approximately 0.4 J/l in both groups, i.e., close to normal values. We conclude that, in mechanically ventilated patients, abnormalities in total respiratory system mechanics essentially reflect alterations in lung mechanics. However, abnormalities in chest wall mechanics can be relevant in some COPD patients with a high degree of pulmonary hyperinflation.

Aged↗

Respiratory mechanics before and after hemodialysis in mechanically ventilated patients.

Hemodialysis, which leads to negative fluid balance, is often required in mechanically ventilated patients with renal failure. We conducted a prospective study on the influence of hemodialysis on the respiratory mechanics in 14 mechanically ventilated patients (10 men, 4 women, mean age 70.1 +/- 8.1 yr) with various causes of renal failure requiring hemodialysis in an intensive care unit. Respiratory mechanics were measured before and after hemodialysis using the interrupter technique under constant flow and constant volume. The values of several parameters of respiratory mechanics were significantly lower after hemodialysis: peak airway pressure (26.97 +/- 4.62 vs 23.45 +/- 4.13 cmH2O), airway pressure at zero flow (23.81 +/- 4.18 vs 21.50 +/- 3.79 cmH2O), airway plateau pressure (18.56 +/- 3.70 vs 16.48 +/- 3.07 cmH2O), and intrinsic positive end-expiratory pressure (4.03 +/- 2.90 vs 2.65 +/- 1.84 cmH2O). Minimal respiratory resistance and maximal respiratory resistance were significantly decreased after hemodialysis (4.38 +/- 1.26 vs 2.99 +/- 1.00 cmH2O/L/s and 9.93 +/- 2.50 vs 8.39 +/- 2.43 cmH2O/L/s, respectively), but effective additional respiratory resistance and static respiratory compliance were not. Significant correlations were found between body weight reduction by hemodialysis and changes in minimal respiratory resistance (r = 0.758, p < 0.01), maximal respiratory resistance (r = 0.544, p < 0.05), and static respiratory compliance (r = 0.703, p < 0.01). We conclude that hemodialysis significantly alters the respiratory mechanics in mechanically ventilated renal failure patients and that the alteration may be related to the negative fluid balance caused by hemodialysis.

Aged↗

Substrate binding and catalytic mechanism in phospholipase C from Bacillus cereus: a molecular mechanics and molecular dynamics study.

For the first time a consistent catalytic mechanism of phospholipase C from Bacillus cereus is reported based on molecular mechanics calculations. We have identified the position of the nucleophilic water molecule, which is directly involved in the hydrolysis of the natural substrate phosphatidylcholine, in phospholipase C. This catalytically essential water molecule, after being activated by an acidic residue (Asp55), performs the nucleophilic attack on the phosphorus atom in the substrate, leading to a trigonal bipyramidal pentacoordinated intermediate (and structurally similar transition state). The subsequent collapse of the intermediate, regeneration of the enzyme, and release of the products has to involve a not yet identified second water molecule. The catalytic mechanism reported here is based on a series of molecular mechanics calculations. First, the x-ray structure of phospholipase C from B cereus including a docked substrate molecule was subjected to a stepwise molecular mechanics energy minimization. Second, the location of the nucleophilic water molecule in the active site of the fully relaxed enzyme-substrate complex was determined by evaluation of nonbonded interaction energies between the complex and a water molecule. The nucleophilic water molecule is positioned at a distance (3.8 A) from the phosphorus atom in the substrate, which is in good agreement with experimentally observed distances. Finally, the stability of the complex between phospholipase C, the substrate, and the nucleophilic water molecule was verified during a 100 ps molecular dynamics simulation. During the simulation the substrate undergoes a conformational change, but retains its localization in the active site. The contacts between the enzyme, the substrate, and the nucleophilic water molecule display some fluctuations, but remain within reasonable limits, thereby confirming the stability of the enzyme-substrate-water complex. The protocol developed for energy minimization of phospholipase C containing three zinc ions located closely together at the bottom of the active site cleft is reported in detail. In order to handle the strong electrostatic interactions in the active site realistically during energy minimization, delocalization of the charges from the three zinc ions was considered. Therefore, quantum mechanics calculations on the zinc ions and the zinc-coordinating residues were carried out prior to the molecular mechanics calculations, and two different sets of partial atomic charges (MNDO-Mulliken and AMI-ESP) were applied. After careful assignment of partial atomic charges, a complete energy minimization of the protein was carried out by a stepwise procedure without explicit solvent molecules. Energy minimization with either set of charges yielded structures, which were very similar both to the x-ray structure and to each other, although using AMI-ESP partial atomic charges and a dielectric constant of 4, yielded the best protein structure.

Bacillus cereus↗

The effect of irradiation, annealing temperature, and artificial aging on the oxidation, mechanical properties, and fracture mechanisms of UHMWPE.

UHMWPE crosslinked using Gamma radiation is believed to have improved wear properties, and this has been extensively studied during the past 10 years. Mechanical properties, oxidation, and wear properties of UHMWPE materials subjected to various thermal treatments have been investigated immediately after irradiation as well as after several years of aging. Nevertheless, the relationship between all these parameters is not yet fully understood. The aim of this study was to investigate the relationship between the thermal treatments that could be applied to irradiated UHMWPE [lower (gamma 60) or higher (gamma 150) than 140 degrees C, the melting temperature of the polymer] and the mechanical properties, the oxidation and the fracture behavior of the material. The effect of artificial aging on these properties was also investigated. This study concludes that immediately after the annealing, the mechanical properties (UTS and epsilon) of the irradiated and annealed material are improved compared with those of nonirradiated material. Although nonirradiated material has higher fracture toughness than irradiated and annealed materials, the materials break according to the same mechanism of fracture. After aging, no changes could be observed in any of the measured properties for nonirradiated material. On the other hand, important changes could be seen in both irradiated and annealed material after aging. Both UTS and epsilon decreased, much more so in the case of gamma 60. Furthermore, the aging induced a subsurface peak of oxidation in both irradiated and annealed materials, twice as intense for gamma 60 than for gamma 150. The mechanism of fracture of these materials changed drastically after aging, probably due to the presence of the oxidation peak, which seems to occur at a location where cracks initiate easily compared with the nonoxidized bulk of the material. In the case of gamma 60, it seems clear that a correlation between mechanical property, oxidation, and fracture mechanism exists. Such a relationship could not be found for gamma 150.

Biomechanical Phenomena↗