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Geometry, reduction potential, and reorganization energy of the binuclear Cu(A) site, studied by density functional theory.

The dimeric Cu(A) site found in cytochrome c oxidase and nitrous oxide reductase has been studied with the density functional B3LYP method. We have optimized the structure of the realistic (Im)(S(CH(3))(2))Cu(SCH(3))(2)Cu(Im)(CH(3)CONHCH(3)) model in the fully reduced, mixed-valence, and fully oxidized states. The optimized structures are very similar to crystal structures of the protein, which shows that the protein does not strain the site significantly. Instead, inorganic model complexes of the protein site are strained by the macrocyclic connections between the ligand models. For the mixed-valence (Cu(I)+Cu(II)) state, two distinct equilibrium structures were found, one with a short Cu-Cu distance, 248 pm, similar to the protein structure, and one with a longer distance, 310 pm, similar to what is found in inorganic models. In the first state, the unpaired electron is delocalized over both copper ions, whereas in the latter, it is more localized to one of the ions. The two states are nearly degenerate. The potential energy surfaces for the Cu-Cu, Cu-S(Met), and Cu-O interactions are extremely flat. In fact, all three distances can be varied between 230 and 310 pm at an expense in energy of less than 8 kJ/mol, which explains the large variation observed in crystal structures for these interactions. Inclusion of solvation effects does not change this significantly. Therefore, we can conclude that a variation in these distances can change the reduction potential of the Cu(A) site by at most 100 mV. The model complex has a reorganization energy of 43 kJ/mol, 20 kJ/mol lower than for a monomeric blue-copper site. This lowering is caused by the delocalization of the unpaired electron in the mixed-valence state.

Journal Article↗

Small area variation in orthopedics.

It is clear that small area variation exists in orthopedics, but there is still much to learn. Given the many unanswered questions regarding area variation, regulatory policy at this time would be premature. The biggest piece of the puzzle that needs to be solved is the influence of disease prevalence and severity. While it seems unlikely this will explain all of the variation, it is equally unlikely that musculoskeletal diseases are distributed evenly across geopolitical boundaries, hence, it likely accounts for some of the observed variation. More patient-level studies need to be conducted in non-Medicare populations. For example, the extent to which area variation exists in sports medicine and knee surgery for younger patients is unknown. Profiling is likely here to stay. In accord, it should be exploited by the orthopedic community for its strengths while keeping in mind its limitations. Orthopedic surgeons should be at the forefront of this research and consequently influential in its evolution rather than have the managed care industry or government dictate policy.

Health Services Needs and Demand↗

Genetic variability of flight metabolism in Drosophila melanogaster. III. Effects of Gpdh allozymes and environmental temperature on power output.

The effect of allozyme variation at the sn-glycerol-3-phosphate dehydrogenase (Gpdh) locus on variation in the mechanical power output of the flight muscles of Drosophila melanogaster was investigated. The influence of different rearing and flight temperatures and of their interactions with the Gpdh allozymic genotypes (allotypes) on flight ability also were analyzed. Populations from three continents were used, and Gpdh allotypes were generated from crosses between randomly paired isofemale lines made autozygous for each of the two alleles by inbreeding. Measurements made during tethered flight, together with wing morphology, were used to estimate power output using both Weis-Fogh's and Ellington's formulas. Analyses of variance (ANOVA) indicated significant main effects for both environmental components (rearing and flight temperatures) but for only one of the three genetic components (genetic backgrounds within continent); Gpdh allotypes and populations (continent of origin) were not significant. The interaction between rearing and flight temperature was highly significant, indicating some physiological adaptation. The effect of Gpdh allozymes depended on both rearing and flight temperature and was either significant or marginally so, depending on which set of formulas was used. In either case, the S/S allotype showed a 2-4% greater power output than the F/F allotype at low temperature for both interactions. In addition, the S/S allotype showed significantly greater power output than the F/F allotype among flies raised at 15 degrees and flown at 15 degrees, whereas the reverse was true for flies raised at 30 degrees and flown at 30 degrees. Significant differences among the three allotypes for GPDH activity level were found in general, with S/S having the highest, F/S intermediate and F/F the lowest activity, and an inverse relationship existed between rearing temperature and activity. The temperature effects on power output are consistent with the geographical and seasonal variation observed at the Gpdh locus in nature. In general, the results show that Gpdh can be considered a minor polygene affecting quantitative variation in the power output during flight and that genotype-by-environment interaction is an important component of that effect.

Alleles↗

Sugar absorption by foetal and neonatal rat intestine in vitro.

1. Sugar absorption by foetal and neonatal rat intestine has been examined using an in vitro accumulation technique. 2. The capacity for active sugar absorption is present in the rat intestine by the 17th day of gestation. Considerable variation in uptake occurs during the first month post partum; the greatest uptake place during the first week. 3. The absorption of sugars by the developing gut resembles in several respects that by the mature intestine. However, the adult pattern of functional localization along the intestine is not fully established until after the 3rd week post partum. 4. Kinetic studies indicate that variations with age in the distribution of sugar "carriers' along the intestine, rather than changes in the "carriers' themselves, account for the observed variations in absorption.

Age Factors↗

Inpatient management: variations in some aspects of practice in Scotland.

Data for four aspects of inpatient management-namely, variations in length of stay, the time patients spend in hospital before or after operation, and the proportion of patients operated on in surgical units-show considerable variations in certain aspects of practice by Scottish consultants. It is suggested that there may be simple explanations for some of the observed variations. The differences could be due to great variation in the constraints encountered by the consultants in their work, or to wide differences of opinion about the optimum treatment for specific diagnoses.

Journal Article↗

What is too much variation? The null hypothesis in small-area analysis.

A small-area analysis (SAA) in health services research often calculates surgery rates for several small areas, compares the largest rate to the smallest, notes that the difference is large, and attempts to explain this discrepancy as a function of service availability, physician practice styles, or other factors. SAAs are often difficult to interpret because there is little theoretical basis for determining how much variation would be expected under the null hypothesis that all of the small areas have similar underlying surgery rates and that the observed variation is due to chance. We developed a computer program to simulate the distribution of several commonly used descriptive statistics under the null hypothesis, and used it to examine the variability in rates among the counties of the state of Washington. The expected variability when the null hypothesis is true is surprisingly large, and becomes worse for procedures with low incidence, for smaller populations, when there is variability among the populations of the counties, and when readmissions are possible. The characteristics of four descriptive statistics were studied and compared. None was uniformly good, but the chi-square statistic had better performance than the others. When we reanalyzed five journal articles that presented sufficient data, the results were usually statistically significant. Since SAA research today is tending to deal with low-incidence events, smaller populations, and measures where readmissions are possible, more research is needed on the distribution of small-area statistics under the null hypothesis. New standards are proposed for the presentation of SAA results.

Age Factors↗

Anterior inferior tibiofibular ligament. Variations and relationship to the talus.

The anterior inferior tibiofibular ligament was evaluated in 46 preserved specimens with a mean age of 73.8 years. A classification system was devised to encompass the observed variations in ligamentous structure. Particular emphasis was placed on evaluating the extent of impingement between the inferior border of the ligament and the talus. It was determined that the presence of a separate inferior fascicle is not a prerequisite for impingement. However, a triangular, beveled region located anteriorly on the border between the trochlear and lateral surfaces of the talus was identified in association with anterior inferior tibiofibular ligament impingement.

Aged↗

Histones in Xenopus laevis' early development: the race against time.

Using cloned histone gene variants, the expression of three types of histone gene clusters was studied at the RNA level during early development in Xenopus laevis. For each histone class the number of mRNA molecules per embryo strongly decreased upon ovulation and steadily increased during early development, with a slight decrease at the neurula stage. Variation of the stringency of hybridization revealed that none of the histone genes probed is specifically and uniquely expressed at any time point in embryogenesis. The observed variation of histone mRNA content with time after fertilization is consistent with what is known about rate constants for RNA synthesis and degradation and about histone mRNA storage in the oocyte, provided that approximately 11 h after fertilization a regulatory transition is proposed (KOSTER, DESTREE and WESTERHOFF (1988) J. Theor. Biol. 135, 139-167). Similarly, the observed amounts of histone mRNA could well be sufficient to direct the synthesis of the required amount of histone protein. Control Analysis reveals that late in development, the histone to DNA ratio is controlled virtually equally strongly by the rate constants of DNA replication, transcription and translation. The control coefficient for RNA degradation is only a little smaller, whereas that for proteolysis is negligible. Indeed, the deceleration of DNA synthesis around the Mid Blastula Transition (some 8 h after fertilization in our studies) is a regulatory step that is essential in order to allow Xenopus to synthesize sufficient histones to structure its DNA; otherwise the embryo would run out of histone protein and histone mRNA soon thereafter. A model that assumes that the lengthening of the cell cycle around the Mid Blastula Transition it itself a response to the decrease in the concentration of histone protein not complexed to DNA, is shown to account for the dynamics of histone and DNA synthesis during the first 50 h after fertilization.

Animals↗

Seasonal variation in the incidence of aneurysmal subarachnoid hemorrhage in hospital- and community-based studies.

OBJECT: The aim of this study was to examine seasonal variations in the onset of aneurysmal subarachnoid hemorrhage (SAH) in one hospital-based and one community-based patient series. METHODS: The study population consisted of 941 patients with aneurysmal SAH who were admitted to Shimane Prefectural Central Hospital and 358 patients who were treated in Izumo City, Japan. When investigated as a whole, no significant seasonal variations were found in either population; however, in both series, statistically significant seasonal trends, with a peak in winter and a nadir in summer, were found among patients aged 59 years or younger (p < 0.05 for the hospital-based series and p < 0.005 for the community-based series), but not among those aged 60 years or older, regardless of sex. In the hospital-based series, seasonal variations were most apparent at certain times of day, with significant variations observed between 8:00 a.m. and 10:00 a.m. or 8:00 a.m. and noon (p < 0.001 and p < 0.005, respectively), regardless of patient age, and between 4:00 p.m. and 6:00 p.m. for patients aged 59 years or younger (p < 0.05). Consequently, seasonal variations were significant during daytime hours (between 8:00 a.m. and 8:00 p.m., p < 0.005) but not during the night (between 8:00 p.m. and 8:00 a.m.). Similar tendencies were found in the community-based series. Among patients aged 59 years or younger who had no risk factors for SAH, these seasonal variations were significant in both series. In patients with untreated hypertension, who were current smokers and daily alcohol drinkers, however, no significant patterns were observed in either series, even among younger patients. CONCLUSIONS: In both hospital- and community-based studies, aneurysmal SAH appears to undergo seasonal variation, with a peak in winter and a nadir in summer. This seasonal pattern may be derived mainly from the occurrence of SAH in the morning, but may also be modified by patient age and SAH risk factors, resulting in the masking of significant seasonal patterns when all patients are considered together.

Adult↗

Alterations in expression of the multidrug resistance-associated protein (MRP) gene in high-grade transitional cell carcinoma of the bladder.

Expression of the MRP gene has been demonstrated in vitro to be a casual factor in non-P-glycoprotein-mediated multidrug resistance, and is implicated in resistance to a number of the chemotherapeutic agents currently used in the treatment of high-grade transitional cell carcinoma (TCC) of the bladder (doxorubicin, epirubicin and vinblastine). Using a sensitive RT-PCR-based technique, we have quantified MRP mRNA levels in a series of untreated TCC (n=24), normal bladder (n=5) and control tissue and cell line samples. MRP mRNA was widely expressed and detectable in all samples analysed, with considerable (up to 190-fold) variation observed between individual tumour samples. MRP mRNA levels found in TCC samples were lower than those determined for normal peripheral mononucleocyte (2.3-fold) and testis (4.1-fold) samples, previously reported to be high-expressing tissues, and varied over a similar range to that observed in normal bladder samples. Results indicate that MRP mRNA levels in a greater proportion of high-grade (G3) bladder tumours (55%, 6/11) are significantly reduced (P=0.018) compared with low- and moderate-grade (G1/2) bladder tumours (8%, 1/13), and suggest that MRP mRNA levels frequently become reduced as a consequence of tumour progression to advanced, poorly differentiated disease. No correlation was apparent between MRP and MDR1 mRNA levels, thus providing no evidence to suggest common regulation of the two genes. In a limited number of patients, no evidence was found to support a role for MRP mRNA levels as a determinant of response to chemotherapy in patients being uniformly treated with either cisplatin-methotrexate-vinblastine (n=6) or epirubicin-cisplatin-methotrexate (n=4) regimens. Similarly, no overall pattern of altered MRP mRNA expression was observed following chemotherapy in four patients from whom post chemotherapy biopsies were taken. This study provides a useful pilot investigation regarding the level, variation and pattern of MRP mRNA expression in TCC of the bladder, and suggests that further studies to establish the clinical significance of these variations are required.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Secondary and tertiary structure changes of reconstituted P-glycoprotein. A Fourier transform attenuated total reflection infrared spectroscopy analysis.

The structure of purified P-glycoprotein functionally reconstituted into liposomes was investigated by attenuated total reflection Fourier transform infrared spectroscopy. A quantitative evaluation of the secondary structure and a kinetic of 2H/H exchange of the P-glycoprotein were performed both in the presence and in the absence of MgATP, MgATP-verapamil, and MgADP. This approach was previously shown to be a useful tool to detect tertiary structure changes resulting from the interaction between a protein and its specific ligands, as established for the Neurospora crassa H+-ATPase. 2H/H exchange measurements provided evidence that a large fraction of the P-glycoprotein is poorly accessible to the aqueous medium. Addition of MgATP induced an increased accessibility to the solvent of a population of amino acids, while addition of MgATP-verapamil resulted in a subtraction of a part of the protein from access to the aqueous solvent. No significant changes were observed upon addition of MgADP or verapamil alone. The secondary structure of P-glycoprotein was not affected by addition of ligands. The variations observed in the 2H/H exchange rate when P-glycoprotein interacted with the above ligands therefore represented tertiary structure changes. Fluorescence quenching experiments confirmed that MgATP-induced changes are to be found in the tertiary structure of the enzyme.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

Natural selection on extrafloral nectar production in Chamaecrista fasciculata: the costs and benefits of a mutualism trait.

Cost-benefit models of the evolution of mutualism predict that the current state of mutualism results from trade-offs between fitness costs of mutualist traits and the fitness benefits of association. We test the assumptions of such models by measuring patterns of natural selection on a mutualist trait, extrafloral nectar production in Chamaecrista fasciculata. Selection was measured on plants from which ants had been excluded (removing the mutualist benefit of the trait), from which all insects had been excluded (removing costs of herbivory in addition to mutualist benefits), and unmanipulated plants (where both costs and benefits were present). Selection analysis based on half-sibling-mean regressions of fitness on the trait revealed no evidence of costs of extrafloral nectar production in the absence of all insects or in the absence of ants. However, examination of the selective surfaces for these treatments suggest that costs of nectar production may exist and are exacerbated by the presence of herbivory. In the presence of ants, natural selection favors high extrafloral nectar production, consistent with a fitness benefit to this mutualist trait in the presence of the mutualist partner. In this study, the interaction of costs and benefits did not produce an evolutionary optimum for the trait within the range of variation observed, suggesting that application of a cost-benefit framework to this trait will benefit from considering the influence of temporal and spatial variation on the quality of costs and benefits.

Adaptation, Physiological↗

Variations of H, A and B antigen strengths among Melanesians.

Melanesians of groups O, A1 and B all show greater variation of H antigen strength than do Caucasians. This is least marked in O bloods. Although the average H content of Melanesian and Caucasian samples did not differ significantly, 10% of O and over 20% of A1 and B bloods from coastal Austronesian speakers had higher H than was found among Caucasians, There is evidence that some non-Austronesian populations in New Guinea have twice this incidence of A1 high H. Melanesian and Bantu H, A1 and B genes appear to function similarly, in that their B genes act more effectively than Caucasian, their A1 genes less so, while H produces greater variation. It is suggested that this gene interaction, rather than the significantly greater availability of H or substrate in the Bantu, causes the observed variations from the Caucasian pattern found in the other races. Subjects with selective antigenic depression were excluded from the comparative studies, but the relevance of this phenomenon to apparent H content in Melanesians is discussed.

ABO Blood-Group System↗

Contraction-related variation in frequency dependence of acoustic properties of canine myocardium.

Results of experiments performed in several laboratories indicate that contracting myocardium exhibits a cyclic variation of the magnitude of ultrasonic backscatter, with maxima occurring at end-diastole and minima at end-systole. The mechanisms responsible for this variation are not well understood. The purpose of the present study was to determine whether the frequency dependence of backscatter exhibits systematic variation throughout the cardiac cycle, analysis of which may facilitate improved understanding of biologic factors responsible for the cyclic variation of the magnitude of backscatter. In this study, the myocardial backscatter coefficient, as a function of frequency, was measured throughout the cardiac cycle in nine open-chest dogs. The frequency dependence of the backscatter coefficient was computed from a least-squares linear fit to log backscatter coefficient versus log frequency data. A cyclic variation of frequency dependence of backscatter was found with maximum near end-diastole (f2.6 +/- 0.1) and minimum near end-systole (f2.2 +/- 0.1), a significant variation (p less than 0.01). These results suggest that mechanisms responsible for the cyclic variation of backscatter may include changes in the effective size of the dominant scatterers throughout the cardiac cycle. An alternative explanation for the observed variation is an increase in the myocardial attenuation coefficient during systole followed by a decrease in diastole.

Animals↗

Relationship between the percentage of subgingival spirochetes and the severity of periodontal disease.

The purpose of this study was to determine the correlations between various clinical assessments of inflammatory periodontal disease and the percentage of motile bacteria in the subgingival flora of sites representing widely varying states of periodontal disease. Darkfield microscopy was used to determine the percentage of spirochetes and other motile bacteria at two sites from each of 60 volunteers. For each site the following clinical assessments were recorded: Plaque Index (PII), gingival exudate (GE), Gingival Index (GI), bleeding tendency (BT), pocket depth (PD), connective tissue attachment loss (AL) and Periodontal Disease Index (PDI). Statistically significant (P less than 0.001) positive correlations (r) were found between the percentage of subgingival spirochetes and PII (r=0.54), GE (r=0.61), GI (r=0.57), BT (r=0.59), PD (r=0.56), AL (r=0.56) and PDI (r=0.61). Clinically healthy sites harbored much lower percentages of motile bacteria than did clinically disease sites. Most of the observed variation in the percentage of motile bacteria could be accounted for by variations in the percentage of spirochetes. The most significant increases in the relative percentages of subgingival spirochetes occurred when bleeding upon probing was observed as a sign of inflammation and/or when pocket depth and attachment loss exceeded 3 mm.

Adult↗

A new digital image analysis system useful for surface assessment of vitiligo lesions in transplantation studies.

So far there is no uniformity in the evaluation methods used in the assessment of treatment outcome in vitiligo studies. The ability to objectively measure surfaces of vitiligo lesions is important for both clinical practice and research. Our objective was to assess the reproducibility, accuracy, user-friendliness and time effectiveness of a new digital image analysis system for surface measurement of vitiligo lesions. Three different observers performed both a visual estimation and a digital image analysis on 30 images of 10 vitiligo lesions. Inter- and intra-observer variation were evaluated and results were compared with the 2D gold standard measurements and a 3D measurement. A high inter- and intra-observer variability was observed for the visual estimation of surfaces. With the digital image analysis system a significant improvement of the reproducibility was achieved (p = 0.01). Moreover, results were accurate and the measurement procedure was user-friendly. Importantly, a systematic underestimation was demonstrated when comparing the 2D with the 3D measurements. We introduced an objective measurement method that might be useful in the future for consistently measuring surfaces of selected vitiligo lesions both before and after different therapeutic modalities.

Adolescent↗

[Evaluation of the biocompatibility of a new cellulose membrane by studying the complement system and histamine liberation].

This biocompatibility of the new cellulosic membrane hemophane (HE) is compared to that of cuprophane (CU) in ten maintenance hemodialysis (HD) patients dialyzed on the two types of membranes in randomized order, under otherwise similar technical conditions. Total white blood cell (WBC) and differential counts, blood concentrations of C3a, and C3d and histamine are determined at start of dialysis (TO) and 10, 20 and 180 minutes thereafter. HE is distinct from CU in exerting a minor effect on the generation of C3a, a minor drop of leucocytes during the course of dialysis (P less than 0.01) and also by a lesser increase in blood histamine concentration (P less than 0.05). Histamine liberation is observed on CU together with the generation of anaphylotoxin C3 and with a diminution of circulating basopolymorpho-nuclear cells. According to the variations observed for these three parameters (C3a, leucocytosis and blood histamine concentration), HE appears as being more biocompatible than CU.

Aged↗

Treatment of hyperlipoproteinemia, types II and IV, with pirifibrate: one hundred observations.

A new drug, pirifibrate, was investigated in a multicenter study of 100 patients with type IIa, IIb, or IV hyperlipoproteinemia (HLP). After one month of dieting, patients completed six months of treatment with a dose of 1,500 mg/day of pirifibrate. An average fall of about 20% in plasma cholesterol was observed in type IIa and IIb HLP, and more than 50% in the triglycerides in type IIb and IV HLP. Both reductions were statistically significant (P less than 0.00005). Increases in the alpha-lipoproteins were observed in the three types of HLP. The pre-beta-lipoproteins showed a statistically significant fall in type IIb and IV HLP. Variations observed in beta-lipoproteins were significant only in some controls with type IV, HLP, who had low basal levels.

Adolescent↗