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Human paraoxonase: a promising approach for pre-treatment and therapy of organophosphorus poisoning.

The limited efficiency of medical countermeasures against poisoning by nerve agent justifies efforts to find new prophylactic means and new antidotes. The concept of bioscavengers has emerged as an alternative approach to pharmacological pre- and post-exposure treatments. Catalytic scavengers are enzymes displaying a turnover with OPs as substrates, allowing rapid and efficient protection using administration of small doses. Several reasons have endorsed human paraoxonase (PON1) to be a pertinent candidate as catalytic bioscavenger. The physiological function of PON1 has not yet been unambiguously identified. Considered as a promiscuous enzyme, PON1 appears to be primarily a lactonase and also displays an anti-atherogenic activity closely linked to its localization on HDL particles. A HDL-associated phosphate transporter termed human phosphate binding protein (HPBP) was found to be a partner of natural human PON. In the absence of its natural environment (or mimicry by detergents), human PON1 is unstable and tends to aggregate. Converging data indicate that both the activity and the stability of PON1 are dramatically dependent on the HDL component molecular environment, including HPBP. Therefore, biochemical and physiological characterization of PON1-HPBP complexes, the environment allowing retaining functional enzyme state(s), and the thermal and storage stability of PON1 are mandatory. Synergistic efforts on characterization of recombinant hybrid PON1 expressed in E. coli and natural human PON1 provide information for the future rational design of stable mutants of PON1-based catalytic scavengers to be used as safe and effective countermeasures to OP intoxication.

Amino Acid Sequence↗

A comparison of intermittent and continuous support during labor: a meta-analysis.

Our goal was to contrast the influence of intermittent and continuous support provided by doulas during labor and delivery on 5 childbirth outcomes. Data were aggregated across 11 clinical trials by means of meta-analytic techniques. Continuous support, when compared with no doula support, was significantly associated with shorter labors (weighted mean difference -1.64 hours, 95% confidence interval -2.3 to -.96) and decreased need for the use of any analgesia (odds ratio.64, 95% confidence interval.49 to.85), oxytocin (odds ratio.29, 95% confidence interval.20 to.40), forceps (odds ratio.43, 95% confidence interval.28 to.65), and cesarean sections (odds ratio.49, 95% confidence interval.37 to.65). Intermittent support was not significantly associated with any of the outcomes. Odds ratios differed between the 2 groups of studies for each outcome. Continuous support appears to have a greater beneficial impact on the 5 outcomes than intermittent support. Future clinical trials, however, will need to control for possible confounding influences. Implications for labor management are discussed.

Cesarean Section↗

Lipoxins inhibit Akt/PKB activation and cell cycle progression in human mesangial cells.

Lipoxins (LX) are endogenously produced eicosanoids with a spectrum of bioactions that suggest anti-inflammatory, pro-resolution roles for these agents. Mesangial cell (MC) proliferation plays a pivotal role in the pathophysiology of glomerular inflammation and is coupled to sclerosis and tubulointerstitial fibrosis. We have previously reported that LXA4 acts through a specific G-protein-coupled-receptor (GPCR) to modulate MC proliferation in response to the proinflammatory mediators LTD4 and platelet-derived growth factor (PDGF). Further investigations revealed that these effects were mediated by modulation of receptor tyrosine kinase activity. Here we have explored the underlying mechanisms and report inhibition of growth factor (PDGF; epithelial growth factor) activation of Akt/PKB by LXA4. LXA4 (10 nmol/L) modulates PDGF-induced (10 ng/ml, 24 hours) decrements in the levels of cyclin kinase inhibitors p21Cip1 and p27Kip1. PDGF-induced increases in CDK2-cyclin E complex formation are also inhibited by LXA4. The potential of LXA4 as an anti-inflammatory therapeutic is compromised by its degradation; this has been circumvented by synthesis of stable analogs. We report that 15-(R/S)-methyl-LXA4 and 16-phenoxy-LXA4 mimic the native compound with respect to modulation of cell proliferation and PDGF-induced changes in cell cycle proteins. In vivo, MC proliferation in response to PDGF is associated with TGFbeta1 production and the subsequent development of renal fibrosis. Here we demonstrate that prolonged (24 to 48 hours) exposure to PDGF is associated with autocrine TGFbeta1 production, which is significantly reduced by LXA4. In aggregate these data demonstrate that LX inhibit PDGF stimulated proliferation via modulation of the PI-3-kinase pathway preventing mitogen-elicited G1-S phase progression and suggest the therapeutic potential of LX as anti-fibrotic agents.

Blotting, Western↗

12E2: a cloned murine dermal cell with features of dermal dendrocytes and capacity to produce pathologic changes resembling early Kaposi's sarcoma.

Factor XIIIa-positive dendrocytes are abundant within the dermis and have been implicated in the pathogenesis of various disorders, including AIDS-related Kaposi's sarcoma. Purified cultures of factor XIIIa-positive normal dermal dendrocytes have not as yet been achieved. 12E2 is a cloned cell line derived from superficial murine dermis where factor XIIIa-positive dendrocytes are abundant. Subconfluent cultures of 12E2 demonstrate polydendritic cell contours with thin, elongated membranous projections. These cells express Factor XIIIa and VCAM-1 by immunohistochemistry and by Western blot analysis of 12E2 cell lysates. 12E2 cells also constitutively express the Langerhans-cell-related epitope DEC-205, detected by NLDC-145 antibody and the CD80 co-stimulatory molecule, as well as Ia antigen on exposure to interferon-gamma. Cells so treated exhibit significant ability to present alloantigens in vitro. 12E2 cells are shown to express mRNA for numerous cytokines, including interleukin (IL)-1alpha, IL-1beta, IL-5, IL-6, IL-7, tumor necrosis factor-alpha and granulocyte macrophage-colony stimulating factor, by reverse-transcriptase polymerase chain reaction followed by Southern blot hybridization. Microinjection of 12E2 cells, but not 3T3control fibroblasts, into footpads of syngeneic and SCID mice results in lesions that mimic the histology and immunohistochemistry of human Kaposi's sarcoma. In aggregate, these data indicate that 12E2 cells 1) share lineage characteristics with factor XIIIa-positive dermal dendrocytes, 2) produce mRNA for numerous cytokines and are cytokine responsive to interferon-gamma, and 3) behave in vivo in a manner that resembles Kaposi's sarcoma, a condition known to involve proliferation of human dermal dendrocytes.

3T3 Cells↗

Light scattering analysis of fibril growth from the amino-terminal fragment beta(1-28) of beta-amyloid peptide.

beta-Amyloid protein (beta-A/4) is the major protein component of Alzheimer disease-related senile plaques and has been postulated to be a significant contributing factor in the onset and/or progression of the disease. In the senile plaque, beta-A/4 appears as bundles of amyloid fibrils. The biological activity of beta-A/4 may be related to its state of aggregation. In this work, self-assembly, fibril formation, and interfibrillary aggregation of beta(1-28), a synthetic peptide homologous with the amino-terminal fragment of beta-A/4, were investigated. The predominant form of beta(1-28) detected by size-exclusion chromatography and polyacrylamide gel electrophoresis was apparently a tetramer which does not bind Congo red. Aggregates containing cross-beta sheet structures which bind Congo red and thioflavin T were observed at concentrations of approximately 0.3 mg/ml or greater. Concentrations of 0.5-1 mg/ml were necessary for aggregation into fibrils to be detectable by classical or quasielastic light scattering. Both fibril elongation and fibril-fibril aggregation occur over the time scale investigated. The kinetics of aggregation were much faster at physiological salt concentrations than at lower ionic strength. Ionic strength also appeared to influence the morphology of the fibril aggregates. The data indicate that sample preparation method and sample history influence fibril size and number density.

Amino Acid Sequence↗

Charge variance of ionic micelles: a significant parameter to account for and to predict changes in degrees of micelle ionization and in aggregation numbers.

In the context of the thermodynamics of self-assembling systems, which predicts that both the number-average number of aggregation, N(n), of the ionic surfactants and the number-average degree of ionic dissociation of the micelles, alpha(n), depend on the concentrations of micellized surfactant and counterion in the bulk, it is shown that a key parameter is the ratio between sigma(Q), the standard deviation of the micelle charge distribution of the micelles, and sigma(N), that of the aggregation numbers. In the case of hexadecyltrimethylammonium acetate-acetic acid (1:1) solutions, this ratio is calculated as ca. 0.1 from conductivity and aggregation number data.

Journal Article↗

Statistical analysis of the lacI transgenic mouse mutagenicity assay.

The transgenic mouse assay is now widely used to test chemicals for genotoxic potential. In this article, we consider statistical tests for increasing trend in mutant frequency with increasing dose, along with statistical models that may be used to describe the observed dose-response relationships. The application of these methods is illustrated using data on 2-acetylaminofluorene, di(2-ethylhexyl)phthalate, heptachlor, and sodium phenobarbital. No strong evidence of extra-binomial variation was detected at the plate level, but greater evidence was noted when the data were aggregated to the package or animal level in liver, necessitating the use of statistical methods that allow for overdispersion relative to binomial variation. Clear increase on mutant frequency induced by 2-acetylaminofluorene was detected in both liver and bladder, but no apparent trends were noted with di(2-ethylhexyl)phthalate, heptachlor, and sodium phenobarbital. The exponential model provides a good fit to the observed dose-response relationship in liver, whereas a Weibull model provides a better fit for bladder.

2-Acetylaminofluorene↗

The UPA score and teenage pregnancy.

Teenage motherhood is often said to be the result of deficient contraceptive and abortion services. Using data from the Public Health Common Data Set (PH CDS) we demonstrate two important effects in a Regional Health Authority: higher rates of conception are related to a live birth rather than an abortion pregnancy outcome; District Health Authorities (DHAs) with high underprivileged area scores (UPA) are more likely to have high rates of conception in the teenage years than those districts with low scores.

Abortion, Induced↗

Evaluation of methods for calculating census health indicators for GP practices.

The patients registered with a general practice are usually spread over many census areas and overlap with the distribution of neighbouring practices, so a validated method of aggregating census data to describe the characteristics of practice patients is required. Four methods were used to provide estimates of the percentage of patients aged 75 years and over from census data for 81 practices in Suffolk, England, and these were compared with values derived from the FHSA patient register. Census values for practice areas produced better estimates than those based on the location of the surgery, but the best methods were based on patient-weighted averages of ward and enumeration district data. The finer geographical detail of enumeration districts did not produce substantially more accurate estimates than the ward-level data: both gave estimates with limits of agreement within 2% of the patient register values. Errors in the census, errors in patient registers and selective geographical distributions of practice patients prevent close matching of census and register measures, but two of the methods tested produced estimates that allow broad comparisons between practices.

Aged↗

Immunohistochemical demonstration of phosphorylated and nonphosphorylated forms of human neurofilament subunits in human pulmonary carcinoids.

Using immunohistochemical tests and monoclonal antibodies specific for phosphorylated isoforms of the high-molecular-weight human neurofilament subunit (NF-H) or for nonphosphorylated isoforms of NF-H and the middle-molecular-weight NF protein, we detected phosphorylated and nonphosphorylated NF protein isoforms in typical central bronchial carcinoids but not in atypical or peripheral carcinoids or in small cell undifferentiated carcinomas of the lung. Immunoreactive NF protein was seen largely in juxtanuclear globular aggregates which may correspond to cytoplasmic whorls of intermediate filaments observed in one of the tumors by electron microscopy. A monoclonal antibody to low-molecular-weight keratin polypeptides immunostained similar aggregates in central bronchial carcinoids. The precursor cells of human pulmonary carcinoids and the mechanisms leading to abnormal aggregates of NF and keratin immunoreactivity are unknown. However, the preponderance of phosphorylated NF epitopes as compared with nonphosphorylated forms in the cell bodies of carcinoid tumor cells implicates abnormal phosphorylation states in the formation of these intermediate filament aggregates. Our data do not confirm that antibodies to NF-H are helpful for the diagnosis of undifferentiated lung carcinomas, but they can distinguish subsets of bronchial carcinoids with different biological behaviors and growth potentials.

Adult↗

Fabrication, characterization and evaluation of bioceramic hollow microspheres used as microcarriers for 3-D bone tissue formation in rotating bioreactors.

Novel bioactive ceramic hollow microspheres with an apparent density in the range 0.8-1.0 g cm(-3) have been developed as microcarriers for 3-D bone tissue formation in rotating-wall vessels (RWV). Hollow ceramic microspheres with a composition of 58-72% SiO2, 28-42% Al2O3 (wt%) and an apparent density 0.8-1.0 g cm(-3) were pretreated in 1.0 N NaOH for 2 h before being coated with synthesized calcium hydroxyapatite (HA) particulate sol. The HA-coated hollow microspheres were sintered for 1 h at 600, 800 and 1000 degrees C. SEM analysis revealed that the grain size and pore size of the calcium phosphate coating increased with the sintering temperature. FTIR analysis showed that crystalline calcium hydroxyapatite was present in the coatings sintered at 600 and 800 degrees C. When sintered at 1000 degrees C, the coating consisted of alpha-tricalcium phosphate. All the coatings adhered well, independent of sintering temperature. The trajectory analysis revealed that the hollow microsphere remained suspended in a rotating-wall vessel (RWV), and experienced a low shear stress (approximately 0.6 dyn cm(-2)). Cell culture studies using rat bone marrow stromal cells and osteosarcoma cells (ROS 17/2.8) showed that the cells attached to and formed 3-D aggregates with the hollow microspheres in a RWV. Extracellular matrix was observed in the aggregates. These data suggest that these hollow bioactive ceramic microspheres can be used as microcarriers for 3-D bone tissue formation in vitro, as well as for the study of the effects of microgravity on bone cell functions.

Animals↗

Psychometric evaluation of the 12-item short-form health survey (SF-12) in osteoarthritis and rheumatoid arthritis clinical trials.

BACKGROUND: The psychometric properties of the 12-Item Short-Form Health Survey (SF-12), a subset of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), have been tested in the general population and certain disease states. OBJECTIVE: The purpose of this study was to evaluate the psychometric properties of the SF-12 as a generic measure of health-related quality of life (HRQoL) in osteoarthritis (OA) and rheumatoid arthritis (RA) patient populations in clinical trials. METHODS: Data were aggregated from 5 clinical trials evaluating the efficacy of non-steroidal anti-inflammatory drugs in OA (n = 651) and RA (n = 693) patients. Patient assessments in these trials were made using the SF-36 and commonly used clinical measures of OA and RA at baseline and after up to 6 weeks of treatment. For the items of the SF-36 contained in the SF-12, the item missing rate, computability of scores, floor and ceiling effects, factor structure, and item-component correlations were evaluated. Clinical variables and correlations of physical component summary (PCS-12) and mental component summary (MCS-12) scores of the SF-12 with the corresponding SF-36 component summary scores (PCS-36 and MCS-36) were also examined. Analyses were conducted separately for OA and RA patients. RESULTS: A low individual SF-12 item missing rate (0.29% to 2.30%) and a high percentage score computability (90.9%-94.3%) were observed at baseline. No floor or ceiling effects at baseline were observed. The scree plot confirmed the 2-factor structure of the SF-12 items. Items belonging to the physical component correlated more strongly with the PCS-12 than with the MCS-12; similarly, items belonging to the mental component correlated more strongly with the MCS-12 than with the PCS-12. The correlations between the PCS-12 and PCS-36 and between the MCS-12 and MCS-36 ranged from 0.92 to 0.96 (P < 0.001) at baseline and at week 2, 4, or 6. Significant correlations ranging from -0.09 to -0.58 (P < 0.05) were observed between the SF-12 scores and clinical variables. CONCLUSION: The SF-12 appears to be a psychometrically sound tool for the assessment of HRQoL in OA and RA patients.

Anti-Inflammatory Agents, Non-Steroidal↗

A prespore-specific gene of Dictyostelium discoideum encodes the small subunit of ribonucleotide reductase.

We have isolated the gene. rnrB, that encodes the ribonucleotide reductase small subunit of Dictyostelium discoideum. The deduced amino acid sequence of rnrB exhibits about 60% sequence identity with its homologues in other eukaryotes. As demonstrated by RNA blot analysis the rnrB transcript is detected in growing cells and decreases dramatically at the onset of development. The rnrB transcript reappears after the cells have formed multicellular aggregates. To further examine the pattern of expression, we have fused the rnrB promoter and part of its coding sequence to lacZ. The transgenic strain bearing such a reporter construct expresses the fusion gene with a biphasic profile, which is indistinguishable from that of the endogenous rnrB. The multicellular aggregates of Dictyostelium are differentiated along the anterior-posterior axis. Cells in the anterior give rise to the stalk of the fruiting body while cells in the posterior are precursors of spores. Results from histochemical staining show that beta-galactosidase activity is detected exclusively in the posterior two-thirds of the aggregates. These data suggest that rnrB is expressed in prespore cells during postaggregative development and in vegetative cells.

Amino Acid Sequence↗

Managed competition and consumer price sensitivity in social health insurance.

This paper examines whether the introduction of managed competition in Dutch social health insurance has resulted in effective price competition among insurance funds. We find evidence of limited price competition, which may be caused by low consumer price sensitivity. Using aggregate panel data from all insurance funds over the period 1996-1998, estimated premium elasticities of market share are -0.3 for compulsory coverage and -0.8 for supplementary coverage. These elasticities are much smaller than in managed competition settings in US group insurance. This may be explained by differences in switching experience and higher search costs associated with individual insurance.

Actuarial Analysis↗

Modeling zero-inflated count series with application to occupational health.

A zero-inflated Poisson mixed autoregression model is presented for analyzing time series of count events with excess zeros. The model is motivated by the evaluation of a participatory ergonomics intervention intended to reduce manual handling workplace injuries over a specified time period. Random effects are introduced into the linear predictor of the model to account for serial correlation between successive observations. Parameter estimation is achieved by maximizing an appropriate log-likelihood function to obtain approximate residual maximum likelihood estimates. The method enables the evaluation of occupational intervention using population level aggregated count data series containing extra zeros.

Occupational Health↗

Interactions of lipopolysaccharides, glycolipid, lipid A with acid soluble basement membrane collagen during thermal aggregation.

Lipopolysaccharides derived from a number of Escherichia coli and Salmonella species were incorporated into thermal aggregates acid soluble basement membrane collagens. Although most of these endotoxins were noted to inhibit basement membrane collagen aggregation, some lipopolysaccharides possessed little or no inhibitory properties. However, the lipid A derived from all of the latter lipopolysaccharides and the glycolipid from Salmonella minnesota R595 were noted to be significant inhibitors of acid soluble basement membrane collagen aggregation. These data suggest that the nonpolar region of the endotoxin molecule is responsible for the inhibition of acid soluble basement membrane collagen assemblies and that these intermolecular interactions probably occur with the hydrophobic globular domain of acid soluble basement membrane collagens.

Animals↗

Implications of health care provision on acute lower respiratory infection mortality in Bangladeshi children.

This study uses a geographic information system to evaluate the effects of health care provision on acute lower respiratory infection (ALRI) mortality in very young children in rural Bangladesh. Since 1988, an ALRI control program has been operating in a rural area of Bangladesh in an effort to decrease morbidity and mortality of children suffering from ALRI. ALRI-specific mortality data for very young children (<2 years of age) were obtained from a surveillance system of the area from 1988 to 1993. The ALRI mortality data were aggregated by clusters of households called baris. In order to avoid bias in the population size of haris, spatial moving averages of ALRI-specific death rates were calculated. The relationships between ALRI death rates and several environmental and health service provision variables were measured using regression analysis. The results show that the ALRI mortality rate was 54% lower in the community-based ALRI control program area than in a comparison area where there was no intervention. Greater access to allopathic practitioners was related to lower ALRI mortality rates while access to indigenous practitioners was related to higher mortality. In conclusion, the benefit of the community-based ALRI control program, using a simple case management strategy and improved access to allopathic practitioners, should be replicated in other rural areas of Bangladesh in an effort to reduce child ALRI mortality.

Demography↗

Strong correlation between imaging response and survival among patients with primary central nervous system lymphoma: a secondary analysis of RTOG studies 83-15 and 88-06.

PURPOSE: Primary central nervous system lymphoma (PCNSL) is the brain tumor with the most rapidly increasing incidence, yet little is known about its radiographic response to cranial irradiation. If traditionally used doses of radiotherapy ( approximately 60 Gy) are associated with low rates of complete response and poor survival, then an argument can be made to consider dose escalation of radiotherapy. Alternatively, if poor survival rates are associated with high rates of complete response, there would be no reason to subject patients to higher radiation doses with increased risks of treatment-related morbidity. The purpose of this analysis is to provide a detailed review of response following cranial irradiation. Based on these findings, recommendations are offered for future protocol design. METHODS AND MATERIALS: Patients were treated on either RTOG 83-15 (whole brain irradiation to 40 Gy followed by a 20 Gy boost to the tumor plus 2-cm margin) or RTOG 88-06 (induction cyclophosphamide, doxorubicin, vincristine, dexamethasone [CHOD] followed by whole brain irradiation to 41.4 Gy and an 18 Gy tumor boost). Imaging surveillance (CT, MR) was required following surgery, prior to the initiation of RT and following completion of RT. Complete response referred to the absence of enhancement on follow-up scans in comparison to the pretherapy study. A tumor size reduction of at least 50% in the product of the largest cross-sectional diameter and its largest perpendicular diameter was scored as a partial response. RESULTS: Seventy-nine patients had scans available for central review. Complete response was achieved in 83% and 85% of patients treated on RTOG 83-15 and 88-06, respectively. The rates of partial response (14%, 11%) and radiographic progression (3%, 4%) also were comparable between the studies. For survival analyses, data were aggregated from the two studies. The 4-year survival rates were 24% for complete responders versus 11% for other patients (p = 0.0006). In multivariate analysis, only complete radiographic response (p < 0.0007), and high Karnofsky performance status (KPS >/= 70) (p < 0.005) were independently associated with increased rates of 4-year survival. CONCLUSION: A high rate of complete radiographic response was observed following moderate doses of cranial irradiation (alone or in combination with CHOD chemotherapy). Although complete responders had a statistically significant survival advantage at 4 years when compared with partial responders and nonresponders, the majority of patients who achieved complete response were dead of disease by 4 years following treatment. Based on this analysis of the RTOG database, there is no rationale for radiation dose escalation as a therapeutic strategy to combat PCNSL. Consequently, the radiotherapy component of the current RTOG Phase II trial (RTOG 93-10) now includes relatively low total doses of hyperfractionated irradiation for patients without residual disease (36 Gy/1.2 Gy, twice a day) as well as a more aggressive chemotherapy regimen.

Adult↗