Participation in continuing professional development by dental practitioners in Victoria, Australia in 2007.

BACKGROUND: Mandatory continuing professional development (CPD) was introduced in 2005 in Victoria, Australia to ensure that dental practitioners maintained their skills, knowledge and kept up-to-date with current topics in dentistry. The aim of this study was to investigate the participation, impact on practice and attitudes of Victorian dentists and dental specialists to CPD activities since the commencement of mandatory CPD. METHODS: A cross-sectional survey of a random sample of registered dentists and dental specialists (n = 895) was conducted from May to August 2008 using an anonymous, postal, self-administered questionnaire. RESULTS: The response rate was 66%. More than three quarters of practitioners believed mandatory CPD is a reasonable requirement for continued registration. Dentists reported attending an average of 30.9 h of certifiable clinical CPD whilst specialists attended an average of 33.2 h of certifiable clinical CPD over a 12-month period. Nearly three quarters of respondents reported changing their practice as a result of CPD activities, whilst one quarter attended CPD mainly to meet the mandatory requirements. CONCLUSIONS: Overall there was a positive attitude towards mandatory CPD and a high level of participation in CPD activities by Victorian dentists and specialists in 2007, although nearly half of the respondents attended <20 h of certified clinical CPD during 2007. A number of barriers exist, particularly for rural and female practitioners in accessing CPD, and further research is required to examine the benefits derived from mandatory CPD.

In situ determination of the static inductance and resistance of a plasma focus capacitor bank.

The static (unloaded) electrical parameters of a capacitor bank are of utmost importance for the purpose of modeling the system as a whole when the capacitor bank is discharged into its dynamic electromagnetic load. Using a physical short circuit across the electromagnetic load is usually technically difficult and is unnecessary. The discharge can be operated at the highest pressure permissible in order to minimize current sheet motion, thus simulating zero dynamic load, to enable bank parameters, static inductance L(0), and resistance r(0) to be obtained using lightly damped sinusoid equations given the bank capacitance C(0). However, for a plasma focus, even at the highest permissible pressure it is found that there is significant residual motion, so that the assumption of a zero dynamic load introduces unacceptable errors into the determination of the circuit parameters. To overcome this problem, the Lee model code is used to fit the computed current trace to the measured current waveform. Hence the dynamics is incorporated into the solution and the capacitor bank parameters are computed using the Lee model code, and more accurate static bank parameters are obtained.

The role of carotid endarterectomy in the endovascular era.

OBJECTIVE: Carotid artery angioplasty and stenting (CAS) has been proposed as an alternative to surgery for patients with high-grade symptomatic carotid disease. The purpose of this study was to determine the proportion of patients that were suitable for each type of intervention and to analyse the reasons that precluded stenting. MATERIALS AND METHODS: This was a prospective observational study. All patients considered for intervention for carotid artery disease during an 18-month period were analysed. The management decision was recorded, as were the reasons for unsuitability for stenting. RESULTS: Two hundred and sixty-eight patients' data were analysed, 224 had complete records. Forty-seven patients did not require intervention and received best medical treatment alone. One hundred and seventy-seven patients required intervention, 113 were suitable for stenting and 64 were not. In 51 patients stenting was preferred. Sixty-two patients were suitable for either stent or surgery. Sixty-four patients were unsuitable for stenting. Carotid tortuosity and proximal disease accounted for 70% of this group. CONCLUSIONS: Current enthusiasm for carotid stenting might well be supported by the results of ongoing randomised-controlled clinical trials. However, this study highlights a significant proportion (64/177; 36%) of our patients is presently unsuitable for stenting. The common technical difficulties and limitations of stenting encountered in our unit are related predominantly to carotid anatomy.

Geometrical properties of gel and fluid clusters in DMPC/DSPC bilayers: Monte Carlo simulation approach using a two-state model.

In this paper the geometrical properties of gel and fluid clusters of equimolar dimyristoylphosphatidylcholine/distearoylphosphatidylcholine (DMPC/DSPC) lipid bilayers are calculated by using an Ising-type model (Sugar, I. P., T. E. Thompson, and R. L. Biltonen. 1999. Biophys. J. 76:2099-2110). The model is able to predict the following properties in agreement with the respective experimental data: the excess heat capacity curves, fluorescence recovery after photobleaching (FRAP) threshold temperatures at different mixing ratios, the most frequent center-to-center distance between DSPC clusters, and the fractal dimension of gel clusters. In agreement with the neutron diffraction and fluorescence microscopy data, the simulations show that below the percolation threshold temperature of gel clusters many nanometer-size gel clusters co-exist with one large gel cluster of size comparable with the membrane surface area. With increasing temperature the calculated effective fractal dimension and capacity dimension of gel and fluid clusters decrease and increase, respectively, within the (0, 2) interval. In the region of the gel-to-fluid transition the following geometrical properties are independent from the temperature and the state of the cluster: 1) the cluster perimeter linearly increases with the number of cluster arms at a rate of 8.2 nm/arm; 2) the average number of inner islands in a cluster increases with increasing cluster size, S, according to a power function of 0.00427 x S(1.3); 3) the following exponential function describes the average size of an inner island versus the size of the host cluster, S: 1 + 1.09(1 - e(-0.0072xS)). By means of the equations describing the average geometry of the clusters the process of the association of clusters is investigated.

Fluorescence properties of pyrylretinol.

A fluorescent analog of retinol, 3,7-dimethyl-9-(1-pyryl)-2E,4E,6E,8E-nonatetr aene-1-ol (referred to as pyrylretinol, or 1) has been synthesized. The fluorescence properties (e.g. quantum yield, lifetime, steady-state anisotropy, and excitation/emission spectra) of this compound in various organic solvents and in dimyristoylphosphatidylcholine (DMPC) liposomes have been studied, and the results are compared with those obtained from 3-methyl-5-(1-pyryl)-2E,4E-pentadiene-1-ol (2), which has the same fused aromatic ring system but a much shorter acyclic chain. 1 and 2 form excimer in aqueous media and fluorescence anisotropies of both 1 and 2 in DMPC liposomes exhibit an abrupt decrease at approximately 21-23 degrees C, which coincides with the main phase transition temperature of DMPC liposomes, indicating that both compounds may be a useful membrane probe. In addition, the binding and quenching capability of pyrylretinol (1) to bovine serum albumin has been investigated. Pyrylretinol (1) binds with BSA with a binding constant of 3.6 x 10(4) M-1, although the value is somewhat lower than that obtained for retinol (3.06 x 10(5) M-1). Pyrylretinol (1) also quenches the BSA intrinsic fluorescence with the quenching rate constant of 1.67 x 10(13) M-1 s-1 and the value is lower than that obtained for retinol (4.06 x 10(13) M-1 s-1). The binding and quenching studies suggest that pyrylretinol (1) may serve as a useful fluorescence probe for structure/function studies of different retinoid binding proteins.

Two-photon fluorescence microscopy studies of bipolar tetraether giant liposomes from thermoacidophilic archaebacteria Sulfolobus acidocaldarius.

The effects of temperature and pH on Laurdan (6-lauroyl-2-(dimethylamino)naphthalene) fluorescence intensity images of giant unilamellar vesicles (GUVs) ( approximately 20-150 microm in diameter) composed of the polar lipid fraction E (PLFE) from the thermoacidophilic archaebacteria Sulfolobus acidocaldarius have been studied using two-photon excitation. PLFE GUVs made by the electroformation method were stable and well suited for microscopy studies. The generalized polarization (GP) of Laurdan fluorescence in the center cross section of the vesicles has been determined as a function of temperature at pH 7.23 and pH 2.68. At all of the temperatures and pHs examined, the GP values are low (below or close to 0), and the GP histograms show a broad distribution width (> 0.3). When excited with light polarized in the y direction, Laurdan fluorescence in the center cross section of the PLFE GUVs exhibits a photoselection effect showing much higher intensities in the x direction of the vesicles, a result opposite that previously obtained on monopolar diester phospholipids. This result indicates that the chromophore of Laurdan in PLFE GUVs is aligned parallel to the membrane surface. The x direction photoselection effect and the low GP values lead us to further propose that the Laurdan chromophore resides in the polar headgroup region of the PLFE liposomes, while the lauroyl tail inserts into the hydrocarbon core of the membrane. This unusual L-shaped disposition is presumably caused by the unique lipid structures and by the rigid and tight membrane packing in PLFE liposomes. The GP exhibited, at both pH values, a small but abrupt decrease near 50 degrees C, suggesting a conformational change in the polar headgroups of PLFE. This transition temperature fully agrees with the d-spacing data recently measured by small-angle x-ray diffraction and with the pyrene-labeled phosphatidylcholine and perylene fluorescence data previously obtained from PLFE multilamellar vesicles. Interestingly, the two-photon Laurdan fluorescence images showed snowflake-like lipid domains in PLFE GUVs at pH 7.23 and low temperatures (<20 degrees C in the cooling scan and <24 degrees C in the heating scan). These domains, attributable to lipid lateral separation, were stable and laterally immobile at low temperatures (<23 degrees C), again suggesting tight membrane packing in the PLFE GUVs.

Molecular modeling of archaebacterial bipolar tetraether lipid membranes.

Membranes composed of glycerol dialkylnonitol tetraether (GDNT) lipids from the thermoacidophilic archaebacterium Sulfolobus acidocaldarius have been studied by molecular modeling. GDNT membranes containing eight cyclopentane rings in the molecule are packed much tighter than those without rings. When containing eight cyclopentane rings, the beta-D-galactosyl-D-glucose head-group of GDNT runs almost parallel to the membrane surface. However, when containing no rings, the head-group is oriented perpendicular to the membrane surface. Using molecular dynamics calculations, we have also conducted comparative studies of membrane packing between GDNT and various non-archaebacterial membranes. Compared to gel state dipalmitoylphosphatidylcholine (DPPC) and gel state distearoylphosphatidylcholine (DSPC) bilayers, the GDNT membrane with eight cyclopentane rings has a more negative interaction energy, thus a tighter membrane packing, while the GDNT without rings is less tightly packed than gel state DSPC. Based on the calculated interaction energies, the GDNT membranes (with and without rings) are much more tightly packed than DPhPC (an ester-linked diphytanyl PC) and DPhyPC (an ether-linked diphytanyl PC) bilayers. This suggests that the branched methyl group in the phytanyl chain is not the major contributor of the tight packing of GDNT membranes. The biological implication of this study is that the cyclopentane ring could increase GDNT membrane thermal stability. This explains why the number of cyclopentane rings in archaebacterial lipid increases with increasing growth temperature. Perhaps, through the ring-temperature compensation mechanism the plasma membrane of thermoacidophilic archaebacteria is able to maintain a tight and rigid structure, consequently, a constant proton gradient between the extracellular (pH 2.5) and intracellular compartment (pH 6.5), over a wide range of growth temperatures.

Studies of archaebacterial bipolar tetraether liposomes by perylene fluorescence.

Membrane packing and dynamics of bipolar tetraether liposomes composed of the polar lipid fraction E (PLFE) from the thermoacidophilic archaebacterium Sulfolobus acidocaldarius have been studied by perylene fluorescence. At a probe-to-PLFE lipid ratio of 1:400, we have detected an unusual fluorescence intensity increase with increasing temperature, while the fluorescence lifetime changed little. As the ratio was decreased, the intensity anomaly was diminished. At 1:3200 and 1:6400, the anomaly disappeared. A remarkable perylene intensity anomaly was also observed in bilayers composed of saturated monopolar diester phosphatidylcholines at their main phase transition temperatures. These results suggest that the intensity anomaly may be due to probe aggregation caused by tight membrane packing. At the same probe-to-lipid ratio (1:400), however, 1, 2-diphytanoyl-sn-glycero-3-phosphocholine (DPhPC) and 1, 2-diphytanoyl-sn-glycero-3-phosphoglycerol (DPhPG) liposomes did not exhibit any intensity anomaly with increasing temperature. This suggests that DPhPC and DPhPG liposomes are more loosely packed than PLFE liposomes; thus the branched methyl groups are not the contributing factor of the tight membrane packing found in PLFE liposomes. Using a multiexcitation method, we have also determined the average (R), in-plane (R(ip)), and out-of-plane (R(op)) rotational rates of perylene in PLFE liposomes at various temperatures (20-65 degrees C). R and R(ip), determined at two different probe-to-lipid ratios (1:400 and 1:3200), both undergo an abrupt increase when the temperature is elevated to approximately 48 degrees C. These data suggest that PLFE liposomes are rigid and tightly packed at low temperatures, but they begin to possess appreciable "membrane fluidity" at temperatures close to the minimum growth temperature ( approximately 50 degrees C) of thermoacidophilic archaebacteria.

Evidence for a regulatory role of cholesterol superlattices in the hydrolytic activity of secretory phospholipase A2 in lipid membranes.

We have conducted a detailed study of the effect of membrane cholesterol content on the initial hydrolytic activity of Crotalus durissus terrificus venom phospholipase A2 (sPLA2) in large unilamellar vesicles of cholesterol/dimyristoyl-L-alpha-phosphatidylcholine (DMPC) and cholesterol/1-palmitoyl-2-oleoyl-L-alpha-phosphatidylcholine (POPC) at 37 degrees C. The activity was monitored by using the acrylodan-labeled intestinal fatty acid binding protein and HPLC. In contrast to conventional approaches, we have used small cholesterol concentration increments ( approximately 0.3-1.0 mol %) over a wide concentration range (e.g., 13-54 mol % cholesterol). In both membrane systems examined, the initial hydrolytic activity of sPLA2 is found to change with cholesterol content in an alternating manner. The activity reaches a local minimum when the membrane cholesterol content is at or near the critical cholesterol mole fractions (e.g., 14.3, 15.4, 20.0, 22.2, 25.0, 33.3, 40.0, and 50.0 mol % cholesterol) predicted for cholesterol regularly distributed in either hexagonal or centered rectangular superlattices. According to the sterol regular distribution model [Chong, P. L.-G. (1994) Proc. Natl. Acad. Sci. U.S.A. 91, 10069-10073; Liu et al. (1997) Biophys. J. 72, 2243-2254], the extent of lipid superlattices is maximal at the critical cholesterol mole fractions, at which the membrane free volume is minimal. Thus, our present data can be taken to indicate that the initial hydrolytic activity of sPLA2 is governed by the extent of cholesterol superlattice. These data provide the first functional evidence for the formation of cholesterol superlattices in both saturated (e.g., DMPC) and unsaturated (e.g., POPC) liquid-crystalline phospholipid bilayers. The data also illustrate the functional importance of cholesterol superlattice and demonstrate a new type of regulation of sPLA2. Furthermore, upon binding to cholesterol/POPC large unilamellar vesicles, the intrinsic fluorescence intensity of sPLA2 shows an alternating variation with cholesterol content, exhibiting a minimum at the critical cholesterol mole fractions. This result suggests that either the number of sPLA2 bound to lipid vesicles or the conformation of membrane-bound sPLA2 or both vary with the extent of the cholesterol superlattice in the plane of the membrane.

Role of the sterol superlattice in the partitioning of the antifungal drug nystatin into lipid membranes.

Nystatin isolated from Streptomyces is a polyene antibiotic that is frequently used in the treatment and prophylaxis of fungal infections. Here, the fractional sterol concentration dependencies of the partition coefficient for partitioning of nystatin into ergosterol/dimyristoyl-L-alpha-phosphatidylcholine (DMPC), cholesterol/DMPC, ergosterol/1-palmitoyl-2-oleoyl-L-alpha-phosphatidylcholine (POPC), and ergosterol/POPC/1-palmitoyl-2-oleoyl-L-alpha-phosphatidylethano lam ine (POPE) multilamellar vesicles have been determined fluorometrically at 37 degrees C using approximately 0.3-1.0 mol % sterol concentration increments over a wide concentration range (e.g., 18-54 mol % sterol). This unconventional approach of varying membrane sterol content, in contrast to previous studies using large sterol concentration increments (e.g., 10 mol %), leads to a striking observation. The partition coefficient of nystatin changes dramatically with membrane sterol content in a well-defined alternating manner, displaying a local minimum at or very close to the critical sterol mole fractions (e.g., 20.0, 22.2, 25.0, 33.3, 40.0, and 50.0 mol % sterol) predicted for sterols regularly distributed in either hexagonal or centered rectangular superlattices. In ergosterol/DMPC bilayers, for example, there is a >3-fold increase in nystatin partitioning with a minute change (approximately 1 mol %) in sterol content on either side of the critical sterol mole fraction, 25.0 mol %. These results provide semifunctional evidence supporting the sterol regular distribution model [Chong, P. L.-G. (1994) Proc. Natl. Acad. Sci. U.S.A. 91, 10069-10073]. More importantly, these results reveal a new membrane phenomenon, that is, that nystatin partitioning is affected by the extent of sterol regular distribution in the plane of the membrane. This phenomenon occurs not only in saturated (e.g., DMPC) but also in unsaturated (e.g., POPC) lipid membranes, and persists in the presence of polar headgroup heterogeneity (e.g., POPC/POPE). This membrane property points to a new method for studying the interactions of polyene antibiotics with sterol-containing membranes, and the need to consider the membrane sterol content of the target cells when administering nystatin or other polyene antibiotics.

Reversible folding of Ada protein (O6-methylguanine-DNA methyltransferase) of Escherichia coli.

The multifunctional 39 kDa Escherichia coli Ada protein (O6-methylguanine-DNA methyltransferase) (EC 2.1.1.63), product of the ada gene, is a monomeric globular polypeptide with two distinct alkylacceptor activities located in two domains. The two domains are of nearly equal size and are connected by a hinge region. The Ada protein accepts stoichiometrically the alkyl group from O6-alkylguanine in DNA at the Cys-321 residue and from alkyl phosphotriester at the Cys-69 residue. This protein functions in DNA repair by direct dealkylation of mutagenic O6-alkylguanine. The protein methylated at Cys-69 becomes a transcriptional activator of the genes in the ada regulon, including its own. Each of the two domains functions independently as an alkyl acceptor. The purified homogeneous protein is unstable at 37 degrees C and spontaneously loses about 30% of its secondary structure in less than 30 min concomitant with a complete loss of activity. However, sedimentation equilibrium studies indicated that the inactive protein remains in the monomeric form without aggregation. Furthermore, electrospray mass spectroscopic analysis indicated the absence of oxidation of the inactive protein. This temperature-dependent inactivation of the Ada protein is inhibited by DNA. In the presence of increasing concentrations of urea or guanidine, the protein gradually loses more than 80% of its structure. The two alkyl acceptor activities appear to be differentially sensitive to unfolding and the phosphotriester methyltransferase activity is resistant to 7 M urea. The partial or complete unfolding induced by urea or guanidine is completely reversed within seconds by removal of the denaturant. The heat-coagulated protein can also be restored to full activity by cycling it through treatment with 8 M urea or 6 M guanidine. These results suggest that the nascent or unfolded Ada polypeptide folds to a metastable form which is active and that the thermodynamically stable structure is partially unfolded and inactive.

Low permeability of liposomal membranes composed of bipolar tetraether lipids from thermoacidophilic archaebacterium Sulfolobus acidocaldarius.

The physical origin of the extremely high thermal stability of tetraether liposomes composed of the polar lipid fraction E (PLFE) from the thermoacidophilic archaebacterium Sulfolobus acidocaldarius has been investigated. The leakage rate of trapped 5, 6-carboxyfluorescein (5(6)CF) and the proton permeability in PLFE liposomes have been measured using fluorescence probe techniques in the temperature range of 25-85 degrees C. The results are compared with those obtained from nonarchaebacterial liposomes. Egg yolk phosphatidylglycerol (eggPG) and PLFE liposomes exhibit similar large negative zeta-potentials (-31 to -34 mV) and low permeability coefficients for 5(6)CF, indicating that membrane surface charge is responsible for the low leakage rate of 5(6)CF in PLFE liposomes. This assertion is confirmed by the observation of an increased leakage rate of 5(6)CF with decreasing membrane surface negative charge via varying the content of egg yolk phosphatidylcholine (eggPC) in eggPC/eggPG binary mixtures. Gel-state dipalmitoylphosphatidylcholine bilayers and PLFE liposomes exhibit similar permeability coefficients for 5(6)CF, suggesting that lipid packing also plays an important role in the low leakage rate of 5(6)CF. PLFE liposomes, especially those approximately 60 nm in diameter, are remarkably thermally stable in regard to proton permeability, which increases by less than 2 x 10(-10) cm/s from 25 to 82 degrees C. The proton permeability comparison of various liposomes reveals that the tight and rigid lipid packing is the major contributor of the extremely low proton permeation in PLFE liposomes; the inositol moiety and the branched methyl groups may also contribute, but to a much lesser extent.

Cholesterol and ergosterol superlattices in three-component liquid crystalline lipid bilayers as revealed by dehydroergosterol fluorescence.

We have examined the fractional sterol concentration dependence of dehydroergosterol (DHE) fluorescence in DHE/cholesterol/dimyristoyl-L-alpha-phosphatidylcholine (DMPC), DHE/ergosterol/DMPC and DHE/cholesterol/dipalmitoyl-L-alpha-phosphatidylcholine (DPPC) liquid-crystalline bilayers. Fluorescence intensity and lifetime exhibit local minima (dips) whenever the total sterol mole fraction, irrespective of the DHE content, is near the critical mole fractions predicted for sterols being regularly distributed in hexagonal superlattices. This result provides evidence that all three of these naturally occurring sterols (e.g., cholesterol, ergosterol, and DHE) can be regularly distributed in the membrane and that the bulky tetracyclic ring of the sterols is the cause of regular distribution. Moreover, at the critical sterol mole fractions, the steady-state anisotropy of DHE fluorescence and the calculated rotational relaxation times exhibit distinct peaks, suggesting that membrane free volume reaches a local minimum at critical sterol mole fractions. This, combined with the well-known sterol condensing effect on lipid acyl chains, provides a new understanding of how variations in membrane sterol content change membrane free volume. In addition to the fluorescence dips/peaks corresponding to hexagonal superlattices, we have observed intermediate fluorescence dips/peaks at concentrations predicted by the centered rectangular superlattice model. However, the 22.2 mol% dip for centered rectangular superlattices in DHE/ergosterol/DMPC mixtures becomes diminished after long incubation (4 weeks), whereas on the same time frame the 22.2 mol% dip in DHE/cholesterol/DMPC mixtures remains discernible, suggesting that although all three of these sterols can be regularly distributed, subtle differences in sterol structure cause changes in lateral sterol organization in the membrane.

Fluorescence studies on the molecular action of amphotericin B on susceptible and resistant fungal cells.

The molecular action of amphotericin B (AmB) on the cell membranes of both AmB-susceptible and AmB-resistant fungal cells was investigated through the use of the fluorescent membrane probe trimethylammonium diphenylhexatriene (TMA-DPH). AmB, the most effective drug for the treatment of systemic fungal infections, is known to interact specifically with membrane sterols, especially ergosterol (the major sterol in fungal cells). Treatment of AmB-susceptible Candida albicans and Cryptococcus neoformans cells with AmB induced a novel biphasic change in TMA-DPH fluorescence intensity over time. The initial decrease in fluorescence intensity results from energy transfer between AmB and TMA-DPH when AmB binds to the fungal cell membrane. The second phase of increasing fluorescence intensity is interpreted in terms of a combination of probe repartitioning and probe segregation as a result of the formation of membrane pores via the aggregation of AmB-ergosterol complexes. An AmB-resistant strain of C. neoformans, containing 94% of aberrant delta-8 double-bonded ergosterol precursors and only 4% of ergosterol (74% ergosterol in wild-type cells), exhibited the first phase of AmB binding but not the second phase of increasing fluorescence intensity. This result suggests that AmB's antifungal activity lies in its ability to form membrane pores due to aggregation of AmB-ergosterol complexes. The AmB-Induced biphasic fluorescence intensity profile may lead to further elucidation of the molecular action of AmB on fungal cells and may provide a sensitive method for screening the development of drug resistance in fungal cells.