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SitePrint: three-dimensional pharmacophore descriptors derived from protein binding sites for family based active site analysis, classification, and drug design.

Integrating biological and chemical information is one key task in drug discovery, and one approach to attaining this goal is via three-dimensional pharmacophore descriptors derived from protein binding sites. The SitePrint program generates, aligns, scores, and classifies three-dimensional pharmacophore descriptors, active site grids, and ligand surfaces. The descriptors are formed from molecular fragments that have been docked, minimized, filtered, and clustered in protein active sites. The descriptors have geometric coordinates derived from the fragment positions, and they capture the shape, electrostatics, locations, and angles of entry into pockets of the recognition sites: they also provide a direct link to databases of organic molecules. The descriptors have been shown to be robust with respect to small changes in protein structure observed when multiple compounds are cocrystallized in a protein. Five aligned thrombin cocrystals with an average core alpha-carbon RMSD of 0.7 A gave three-dimensional pharmacophore descriptors with an average RMSD of 1.1 A. On a larger test set, alignment and scoring of the descriptors using clique-based alignment, and a best first search strategy with an adapted forward-looking Ullmann heuristic was able to select the global minimum three-dimensional alignment in twenty-nine out of thirty cases in less than one CPU second on a workstation. A protein family based analysis was then performed to demonstrate the usefulness of the method in producing a correlation of active site pharmacophore descriptors to protein function. Each protein in a test set of thirty was assigned membership to a family based on computed active site similarity to the following families: kinases, nuclear receptors, the aspartyl, cysteine, serine, and metallo proteases. This method of classifying proteins is complementary to approaches based on sequence or fold homology. The values within protein families for correctly assigning membership of a protein to a family ranged from 25% to 80%.

Algorithms↗

[Prognostic evaluation in multiple myeloma. Relationship between immunological types, single prognostic factors, clinical staging systems, morphological classification systems and survival].

The prognostic value of the multiple myeloma (MM) immunological type, of 20 different single prognostic variables, of 11 clinical staging systems, and of 6 morphological classification systems was evaluated in 121 patients (71 males and 50 females, 75 MM IgG, 26 MM IgA, and 20 MM micromolecular), who were followed from diagnosis to demise. The values of the prognostic variables related to diagnosis were correlated with survival by means of univariate analysis; multivariate analysis according to Cox's model was employed to select highly-significant parameters correlated with survival among these variables. Every patient was retrospectively staged according to each clinical and morphological system. Mean survivals were computed for each group on the basis of immunological type, mean value of each prognostic factor, clinical and morphological stage. Survival curves were computed and compared. All prognostic parameters showed a significant relationship with survival, even though p-value differed. Multivariate analysis according to Cox's model has indicated the following variables as significantly correlated with survival: bone marrow plasma cell percentage, degree of lytic bone lesions, hemoglobinemia value, and serum levels of beta 2-microglobulin. Each clinical and morphological staging system, as well as immunological types and mean value of single prognostic parameters, have divided patients into separate groups with significant differences in mean survival and in survival curves. All of these factors could be taken into account for correct prognostic evaluation, and, if they were applied in different steps of diagnosis and therapy, it would be possible to study the MM patient under different perspectives, in order to have a more complete picture of the disease and of the patient.

Adult↗

A simulation study of cross-validation for selecting an optimal cutpoint in univariate survival analysis.

Continuous measurements are often dichotomized for classification of subjects. This paper evaluates two procedures for determining a best cutpoint for a continuous prognostic factor with right censored outcome data. One procedure selects the cutpoint that minimizes the significance level of a logrank test with comparison of the two groups defined by the cutpoint. This procedure adjusts the significance level for maximal selection. The other procedure uses a cross-validation approach. The latter easily extends to accommodate multiple other prognostic factors. We compare the methods in terms of statistical power and bias in estimation of the true relative risk associated with the prognostic factor. Both procedures produce approximately the correct type I error rate. Use of a maximally selected cutpoint without adjustment of the significance level, however, results in a substantially elevated type I error rate. The cross-validation procedure unbiasedly estimated the relative risk under the null hypothesis while the procedure based on the maximally selected test resulted in an upward bias. When the relative risk for the two groups defined by the covariate and true changepoint was small, the cross-validation procedure provided greater power than the maximally selected test. The cross-validation based estimate of relative risk was unbiased while the procedure based on the maximally selected test produced a biased estimate. As the true relative risk increased, the power of the maximally selected test was about 10 per cent greater than the power obtained using cross-validation. The maximally selected test overestimated the relative risk by about 10 per cent. The cross-validation procedure produced at most 5 per cent underestimation of the true relative risk. Finally, we report the effect of dichotomizing a continuous non-linear relationship between covariate and risk. We compare using a linear proportional hazard model to using models based on optimally selected cutpoints. Our simulation study indicates that we can have a substantial loss of statistical power when we use cutpoint models in cases where there is a continuous relationship between covariate and risk.

Humans↗

Analysis of the complete nucleotide sequence of the picornavirus Theiler's murine encephalomyelitis virus indicates that it is closely related to cardioviruses.

Theiler's murine encephalomyelitis viruses (TMEV) are naturally occurring enteric pathogens of mice which constitute a separate serological group within the picornavirus family. Persistent TMEV infection in mice provides a relevant experimental animal model for the human demyelinating disease multiple sclerosis. To provide information about the TMEV classification, genome organization, and protein processing map, we determined the complete nucleotide sequence of the TMEV genome and deduced the amino acid sequence of the polyprotein coding region. The RNA genome, which is typical of the picornavirus family, is 8,098 nucleotides long. The 5' untranslated region is 1,064 nucleotides long (making it the longest in the picornavirus family after the aphthoviruses) and lacks a poly(C) tract. Computer-generated comparison of the 5' and 3' noncoding regions and polyprotein revealed the highest level of nucleotide and predicted amino acid identity between the TMEV and the cardioviruses encephalomyocarditis virus (EMCV) and Mengo virus. The TMEV polyprotein, which appears to be processed like EMCV since the amino acids flanking the putative proteolytic cleavage sites have been conserved, begins with a short leader peptide followed by 11 other gene products in the standard L-4-3-4 picornavirus arrangement. Because of these similarities, we propose that the TMEV be grouped with the cardioviruses. However, since TMEV and EMCV have different biophysical properties and show no cross-neutralization, they most likely belong in a separate cardiovirus subgroup.

Amino Acid Sequence↗

Multiplicity of 2,3-dihydroxybiphenyl dioxygenase genes in the Gram-positive polychlorinated biphenyl degrading bacterium Rhodococcus rhodochrous K37.

Rhodococcus rhodochrous K37, a Gram-positive bacterium grown under alkaline conditions, was isolated for its ability to metabolize PCBs. Analysis revealed that it has eight genes encoding extradiol dioxygenase, which has 2,3-dihydroxybiphenyl 1,2-dioxygenase activity, and these genes were designated bphC1 to bphC8. According to the classification of extradiol dioxygenases [Eltis, L. D., and Bolin, J. T., J. Bacteriol., 178, 5930-5937 (1996)], BphC3 and BphC6 belong to the type II enzyme group. The other six BphCs were classified as members of the type I extradiol dioxygenase group. BphC4 and BphC8 were classified into a new subfamily of type I, family 3. Two linear plasmids, 200 kb and 270 kb in size, were found in K37, and the bphC6 and bphC8 genes were located in the 200 kb linear plasmid. Northern hybridization analysis revealed that the bphC1, bphC2, and bphC7 genes were induced in the presence of testosterone, the bphC6 gene was induced by fluorene, and the bphC8 gene was induced by biphenyl. All eight BphC products exhibited much higher substrate activity for 2,3-dihydroxybiphenyl than for catechol, 3-methylcatechol, or 4-methylcatechol.

Blotting, Northern↗

Automated image analysis methods for 3-D quantification of the neurovascular unit from multichannel confocal microscope images.

BACKGROUND: There is a need for integrative and quantitative methods to investigate the structural and functional relations among elements of complex systems, such as the neurovascular unit (NVU), that involve multiple cell types, microvasculatures, and various genomic/proteomic/ionic functional entities. METHODS: Vascular casting and selective labeling enabled simultaneous three-dimensional imaging of the microvasculature, cell nuclei, and cytoplasmic stains. Multidimensional segmentation was achieved by (i) bleed-through removal and attenuation correction; (ii) independent segmentation and morphometry for each corrected channel; and (iii) spatially associative feature computation across channels. The combined measurements enabled cell classification based on nuclear morphometry, cytoplasmic signals, and distance from vascular elements. Specific spatial relations among the NVU elements could be quantified. RESULTS: A software system combining nuclear and vessel segmentation codes and associative features was constructed and validated. Biological variability contributed to misidentified nuclei (9.3%), undersegmentation of nuclei (3.7%), hypersegmentation of nuclei (14%), and missed nuclei (4.7%). Microvessel segmentation errors occurred rarely, mainly due to nonuniform lumen staining. CONCLUSIONS: Associative features across fluorescence channels, in combination with standard features, enable integrative structural and functional analysis of the NVU. By labeling additional structural and functional entities, this method can be scaled up to larger-scale systems biology studies that integrate spatial and molecular information.

Animals↗

[Analysis of 128 cases of multiple myeloma and 31 cases of monoclonal gammapathies of undetermined significance].

Monoclonal immunoglobulin from 138 patients with multiple myeloma (MM) showed that 68 patients were of IgG type, 23 of IgA type,33 of BJ type, 6 of IgD type, one of IgM type, 5 of nonsecreting type and the remaining 2 of IgA and IgG double monoclonal type. Urinary Bence Jones protein was tested with concentrated urine specimen with a positive rate of 75%. Classification of light chain revealed the ratio of oK/L being 1.09:1. The difference of distribution of K or L among IgG, IgA BJ types was no significant. 31 cases with monoclonal gammapathies of undetermined significance (MGUS) were also analyzed in this study. There were some difficulties in the differential diagnosis of MGUS and MM,but a significant difference was present in the plasma cell percentage of bone marrow smear of the two groups. Dynamic investigation in this series showed that patients with percentage of plasma cell less than 10% persisting for a long duration are likely to have MGUS only.

Adult↗

Clinical subtypes of unipolar depression: Part II. Quantitative and qualitative clinical differences between the vital and nonvital depression groups.

This study examines whether the differences in the cluster-analytically generated classes--nonvital versus vital depression--are dimensional (quantitative) rather than categorical (qualitative). To this end, we used various pattern-recognition methods based on principal component analysis (PCA), e.g., display methods (PC plotting), eigenanalysis, and SIMCA (statistical isolinear multiple components analyses). We found several arguments supporting the dimensional hypothesis that the nonvital and vital classes constitute relevant stages (continuous categories) in the continuum of illness-severity. Nevertheless, we found some arguments supporting the categorical hypothesis that the cluster-analytically generated classes are qualitatively different with reference to the similarity of the vital symptoms. Our findings suggest that a nosological or categorical classification is possible from the moment that one component (i.e., the vital component) is quantitatively prominent to the extent that it has become qualitative. As the overall severity of illness increases, vital symptoms emerge which, grouped together, shape a new symptom profile (i.e., vital depression). Thus, our results favor the hypothesis that there are simultaneous quantitative (dimensional: overall severity of illness) and qualitative (categorical: vital symptoms) differences between the nonvital and vital depression groups.

Adult↗

[Prognostic factors in perforating diverticulitis of the large intestine].

Morbidity and mortality after emergency procedures in 105 patients with perforated colonic diverticulitis were evaluated in a retrospective study. In different stages of diverticulitis (Hinchey classification: I, 8.6%; II, 14.3%; III, 57.1%; IV, 20.0%) mortality was 12.4%. Preoperative sepsis syndrome with leucopenia and disturbed liver function, cardiac risk factors and obesity were independent prognostic factors in multiple logistic regression. Accompanied by immunosuppression the mortality rate remarkably increased to 33%. The stage of peritonitis showed no influence on the prognosis. In multivariate analysis, surgical procedure (primary resection 12.4%. Hartmann's procedure 61.9%, non-resection procedures 25.7%) showed influence only on increased general complications.

Adult↗

Sentinel lymph node biopsy for melanoma: experience with 234 consecutive procedures.

Sentinel lymph node biopsy is increasingly used to identify occult metastases in regional lymph nodes of patients with melanoma. Selection of patients for sentinel lymph node biopsy and subsequent lymphadenectomy is an area of debate. The purpose of this study was to describe a large clinical series of these biopsies for cutaneous melanoma and to identify patients most likely to gain useful clinical information from sentinel lymph node biopsy. The Indiana University Melanoma Program computerized database was queried to identify all patients who underwent this procedure for clinically localized cutaneous melanoma. It was performed using preoperative technetium Tc 99m lymphoscintigraphy and isosulfan blue dye. Pertinent demographic, surgical, and histopathologic data were recorded. Univariate and multivariate logistic regression and classification table analyses were performed to identify clinical variables associated with sentinel node and nonsentinel node positivity. In total, 234 biopsy procedures were performed to stage 291 nonpalpable regional lymph node basins. Mean Breslow's thickness was 2.30 mm (2.08 mm for negative sentinel lymph node biopsy, 3.18 mm for positive). The mean number of sentinel nodes removed was 2.17 nodes per basin (range, 1 to 8). Forty-seven of 234 melanomas (20.1 percent) and 50 of 291 basins (17.2 percent) had a positive biopsy. Positivity correlated with AJCC tumor stage: T1, 3.6 percent; T2, 8.1 percent; T3, 27.4 percent; T4, 44 percent. By univariate logistic regression, Breslow's thickness (p = 0.003, continuous variable), ulceration (p = 0.003), mitotic index > or = 6 mitoses per high power field (p = 0.008), and Clark's level (p = 0.04) were significantly associated with sentinel lymph node biopsy result. By multivariate analysis, only Breslow's thickness (p = 0.02), tumor ulceration (p = 0.02), and mitotic index (p = 0.02) were significant predictors of biopsy positivity. Classification table analysis showed the Breslow cutpoint of 1.2 mm to be the most efficient cutpoint for sentinel lymph node biopsy result (p = 0.0004). Completion lymphadenectomy was performed in 46 sentinel node-positive patients; 12 (26.1 percent) had at least one additional positive nonsentinel node. Nonsentinel node positivity was marginally associated with the presence of multiple positive sentinel nodes (p = 0.07). At mean follow-up of 13.8 months, four of 241 sentinel node-negative basins demonstrated same-basin recurrence (1.7 percent). Sentinel lymph node biopsy is highly reliable in experienced hands but is a low-yield procedure in most thin melanomas. Patients with melanomas thicker than 1.2 mm or with ulcerated or high mitotic index lesions are most likely to have occult lymph node metastases by sentinel lymph node biopsy. Completion therapeutic lymphadenectomy is recommended after positive biopsy because it is difficult to predict the presence of positive nonsentinel nodes.

Adolescent↗

The Tulip classification of perinatal mortality: introduction and multidisciplinary inter-rater agreement.

OBJECTIVE: To introduce the pathophysiological Tulip classification system for underlying cause and mechanism of perinatal mortality based on clinical and pathological findings for the purpose of counselling and prevention. DESIGN: Descriptive. SETTING: Tertiary referral teaching hospital. POPULATION: Perinatally related deaths. METHODS: A classification consisting of groups of cause and mechanism of death was drawn up by a panel through the causal analysis of the events related to death. Individual classification of cause and mechanism was performed by assessors. Panel discussions were held for cases without consensus. MAIN OUTCOME MEASURES: Inter-rater agreement for cause and mechanism of death. RESULTS: The classification consists of six main causes with subclassifications: (1) congenital anomaly (chromosomal, syndrome and single- or multiple-organ system), (2) placenta (placental bed, placental pathology, umbilical cord complication and not otherwise specified [NOS]), (3) prematurity (preterm prelabour rupture of membranes, preterm labour, cervical dysfunction, iatrogenous and NOS), (4) infection (transplacental, ascending, neonatal and NOS), (5) other (fetal hydrops of unknown origin, maternal disease, trauma and out of the ordinary) and (6) unknown. Overall kappa coefficient for agreement for cause was 0.81 (95% CI 0.80-0.83). Six mechanisms were drawn up: cardio/circulatory insufficiency, multi-organ failure, respiratory insufficiency, cerebral insufficiency, placental insufficiency and unknown. Overall kappa for mechanism was 0.72 (95% CI 0.70-0.74). CONCLUSIONS: Classifying perinatal mortality to compare performance over time and between centres is useful and necessary. Interpretation of classifications demands consistency. The Tulip classification allows unambiguous classification of underlying cause and mechanism of perinatal mortality, gives a good inter-rater agreement, with a low percentage of unknown causes, and is easily applicable in a team of clinicians when guidelines are followed.

Cause of Death↗

An otolaryngology surgical coding and reporting system.

A computerized information-gathering system has been developed at The University of Texas Health Science Center at Dallas for otolaryngologic head and neck surgery. Surgeons enter data on operations by answering multiple-choice questions at computer terminals situated near the operating rooms of each hospital. The system's main functions are to ensure completeness in the collection of operation data, allow easy review of such data for weekly conferences, and increase availability of such information for future comprehensive analysis. The scheme for data input, the logics of classifications, and the benefits of such a system are described.

Information Systems↗

Elevated expression of valosin-containing protein (p97) in hepatocellular carcinoma is correlated with increased incidence of tumor recurrence.

PURPOSE: Valosin-containing protein (VCP; also known as p97) has been shown to be associated with antiapoptotic function and metastasis via activation of the nuclear factor-kappaB signaling pathway. In this study, association of VCP expression with recurrence of hepatocellular carcinoma (HCC) and patient survival was examined. PATIENTS AND METHODS: VCP expression in 170 patients (139 male and 31 female) with ages ranging from 31 to 81 years (median, 61 years) was analyzed by quantitative reverse-transcription polymerase chain reaction (RT-PCR) and immunohistochemistry, in which staining intensity in tumor cells was categorized as weaker (level 1) or equal to or stronger (level 2) than that in endothelial cells. RESULTS: Immunohistochemically, 57 patients (35.2%) showed level 1, and 105 patients (64.8%) showed level 2, VCP expression. Quantitative RT-PCR analysis revealed higher VCP mRNA expression in level 2 patients (n = 7) than level 1 (n = 4) (P <.05). Patients with VCP-level 2 HCC showed higher rate of portal vein invasion in the tumor (P <.01) and poorer disease-free and overall survival (P <.0001 and P <.05, respectively) compared with level 1 patients. Multivariate analysis revealed VCP expression level, tumor multiplicity, and degree of fibrosis in the noncancerous liver tissue to be independent prognosticators for disease-free and overall survival. VCP level was an indicator for disease-free survival in each early- (I and II) and advanced- (III and IV) stage group of pathologic tumor-node-metastasis classification (P <.001 and P <.01, respectively). CONCLUSION: VCP expression level has prognostic significance for disease-free and overall survival of patients with HCC.

Adenosine Triphosphatases↗

Practice parameter: evaluating a first nonfebrile seizure in children: report of the quality standards subcommittee of the American Academy of Neurology, The Child Neurology Society, and The American Epilepsy Society.

OBJECTIVE: The Quality Standards Subcommittee of the American Academy of Neurology develops practice parameters as strategies for patient management based on analysis of evidence. For this practice parameter, the authors reviewed available evidence on evaluation of the first nonfebrile seizure in children in order to make practice recommendations based on this available evidence. METHODS: Multiple searches revealed relevant literature and each article was reviewed, abstracted, and classified. Recommendations were based on a three-tiered scheme of classification of the evidence. RESULTS: Routine EEG as part of the diagnostic evaluation was recommended; other studies such as laboratory evaluations and neuroimaging studies were recommended as based on specific clinical circumstances. CONCLUSIONS: Further studies are needed using large, well-characterized samples and standardized data collection instruments. Collection of data regarding appropriate timing of evaluations would be important.

Adolescent↗

Diagnostic airway pressure recording in sleep apnea syndrome.

A comparison was made between polysomnographic recordings and recordings of airflow pressures in the pharynx and respiratory pressures in the esophagus of 10 adult sleeping subjects with differing degrees of apnea. Pressure measurements were obtained by microsensors mounted on a 7F gauge flexible catheter which sited them in the epi-, meso- and hypopharynx and the esophagus. Digitized overnight pressure data were stored on a PC memory card and subsequently displayed for analysis by means of a notebook computer. In 2 patients examination of 200 obstructive, mixed and central apneic events showed no significant differences in recordings of their incidence, duration of classification between polysomnographic and either pharyngeal or esophageal pressure techniques. Onset of apnea was demonstrated with particular clarity by computer integration of the pressure tracings. The multiple pressure sensor method offered a further important advantage in detecting the caudal limits of pharyngeal obstructions by steep elevation of the pressure gradient in the pharyngeal segment between adjacent sensors in which the caudal limit of the obstruction was sited. The multiple pressure sensor technique provided reliable and comprehensive diagnostic information of breathing disorders in sleeping subjects and together with its miniaturized recording equipment the method commends itself as suitable for home monitoring.

Adult↗

Langerhans cells in human papillomaviruses types 6/11 associated laryngeal papillomas.

Some studies have shown a reduced density of Langerhans cells (LCs) within epithelium infected by human papillomaviruses (HPV) types 16/18. However, data on a correlation between HPV types 6/11 infection and LCs have been missing. To solve this problem, we analysed 24 biopsy specimens of laryngeal papillomas, selected randomly, 20 multiple and 4 solitary. The presence of HPV 6 and 11 was proven by polymerase chain reaction (PCR) using 2 different sets of primers in 23 biopsy specimens. Abnormalities of the covering stratified squamous epithelium were graded according to the Kambic-Gale classification. LCs were immunohistochemically labelled with 2 different antibodies, CD1a and S100. Quantitative analysis was performed to determine the density of LC per mm2 in different grades of epithelial abnormalities covering laryngeal papillomas. Although no statistically significant differences in the mean number of LCs per mm2 of the cross-sectioned epithelium covering laryngeal papillomas were observed comparing simple, abnormal and atypical hyperplasia groups, the mean number of LCs per mm2 in laryngeal papillomas associated with HPV types 6/11 infection substantially exceeded that of the vocal cord surface epithelium in patients with chronic laryngitis.

Adolescent↗

Development of the professional role behaviors survey (PROBES).

BACKGROUND AND PURPOSE: This study examined the content validity, internal consistency, and underlying dimensions of the Professional Role Behaviors Survey (PROBES) for its use in future research. METHODS: Using the 26-item PROBES, 253 clinical managers reported on the direction and magnitude of change in the role behaviors of physical therapists following hospital restructuring. RESULTS: Descriptive and correlational statistics of the responses indicated that the nature of the role behavior changes was consistent with those identified in the literature and that the survey instrument had good internal consistency. A principal component factor analysis yielded 5 underlying role behavior dimensions: "evaluating and planning," "productivity," "interacting," "information sharing," and "administration/clinical." This factor structure was found to provide a good fit with role classification schemes and a clear differentiation of physical therapist role behaviors. In addition, the finding supports viewing the professional role behaviors as a single construct rather than as multiple constructs. DISCUSSION AND CONCLUSION: The PROBES was found to have good content validity and internal consistency. It provides a useful tool for the study of the changing roles of professional practitioners and a link in the study of the effect of organizational change on organizational outcomes such as job satisfaction and organizational commitment.

Behavior↗

Relationship between occupational risk factors and severity markers of systemic sclerosis.

OBJECTIVE: To investigate a potential association between occupational risk factors and severity markers of systemic sclerosis (SSc) defined by diffuse cutaneous extent, pulmonary involvement, and immunologic profile, i.e., presence of antitopoisomerase I antibody (anti-topo I). METHODS: Occupational exposures were assessed in 105 patients with SSc from 1998 to 2002. Exposures to silica dust, welding fumes, solvents, and epoxy resins were investigated. A group of 39 exposed SSc patients and a group of 66 unexposed ones were identified and compared according to severity markers of SSc. The stage of cutaneous extent was defined according to the classification of Leroy, as limited scleroderma (lSSc) or diffuse scleroderma (dSSc). Respiratory status was defined by pulmonary function tests and high resolution computed tomography. Immunological profile was determined by the presence of anti-topo I or anticentromere antibodies (ACA). Statistical relationships between occupational exposures and severity markers of SSc were evaluated using a multiple correspondence analysis and Fisher's exact test. RESULTS: Diffuse scleroderma affected mainly patients exposed during their occupational life to toxic agents. There were significant or close to significant associations between toxic exposure and dSSc (p = 0.06), pulmonary involvement (p = 0.10), and negative ACA (p = 0.03). The most incriminated products seemed to be epoxy resins (p = 0.06), white spirit (p = 0.07), aromatic solvents (p = 0.07), and silica coupled to welding fumes (p = 0.10). CONCLUSION: Our results indicate that occupational toxic factors have an influence on the severity of SSc.

Adult↗