Hunger strikers: historical perspectives from the emergency management of refugee camp asylum seekers.

The treatment of hunger strikers is always contentious, chaotic and complex. The management is particularly difficult for health professionals as it raises unprecedented clinical, ethical, moral, humanitarian, and legal questions. There are never any easy answers. The current situation of prisoners from the Iraq and Afghanistan Wars currently at the Guantanamo Bay Detention Center in Cuba demands unprecedented transparency, accountability and multilevel coordination to ensure that the rights of the strikers are properly met. There are scant references available in the scientific literature on the emergency management of these tragedies. This historical perspective documents the complex issues faced by emergency physicians in Hong Kong surrounding refugee camp asylum seekers from Vietnam in 1994 and is offered as a useful adjunct in understanding the complex issues faced by emergency health providers and managers.

Structure and function of palladin's actin binding domain.

Here, we report the NMR structure of the actin-binding domain contained in the cell adhesion protein palladin. Previously, we demonstrated that one of the immunoglobulin domains of palladin (Ig3) is both necessary and sufficient for direct filamentous actin binding in vitro. In this study, we identify two basic patches on opposite faces of Ig3 that are critical for actin binding and cross-linking. Sedimentation equilibrium assays indicate that the Ig3 domain of palladin does not self-associate. These combined data are consistent with an actin cross-linking mechanism that involves concurrent attachment of two actin filaments by a single palladin molecule by an electrostatic mechanism. Palladin mutations that disrupt actin binding show altered cellular distributions and morphology of actin in cells, revealing a functional requirement for the interaction between palladin and actin in vivo.

Receptor reserve reflects differential intrinsic efficacy associated with opioid diastereomers.

Structure-activity relationships built around receptor binding or cell-based assays are designed to reveal physiochemical differences between ligands. We hypothesized that agonist receptor reserve may provide a unique approach to distinguish structurally-related agonists exhibiting similar functional characteristics. An intracellular calcium activation assay in Chinese Hamster Ovary (CHO) cells expressing cloned human mu-opioid receptors was developed. We examined two isomers exhibiting indistinguishable receptor binding and in vitro potency profiles. Oxymorphone, a clinically-available congener of codeine has at least two active diastereomeric metabolites (6alpha- and 6beta-oxymorphols) found to be similar for mu-opioid receptor binding affinity (K(d) = 15 versus 14 nM) and calcium activation (EC(50) = 22 versus 14 nM). Calcium activation was then inhibited in CHO cells in a concentration-dependent manner using the irreversible mu-opioid receptor antagonist, beta-funaltrexamine (beta-FNA). Under these conditions, approximately 10-fold greater receptor reserve was found for 6alpha-oxymorphol compared to 6beta-oxymorphol. This difference between the oxymorphols corresponded to a rank order of intrinsic efficacy (Emax): DAMGO > oxymorphone = 6alpha-oxymorphol = oxycodone > 6beta-oxymorphol. In addition, 6alpha-oxymorphol exhibited greater relative potency than the 6beta-oxymorphol in mouse tail-flick, hot-plate and phenylquinone writhing antinociceptive assays, regardless of route of administration. Thus the beta-FNA/calcium model provides a novel, cell-based approach to distinguish structurally related mu-opioid agonists, and in the specific case of the oxymorphols, receptor reserve differences provided a means to bridge functional in vitro and in vivo models.

Palladin is an actin cross-linking protein that uses immunoglobulin-like domains to bind filamentous actin.

Palladin is a recently described phosphoprotein that plays an important role in cell adhesion and motility. Previous studies have shown that palladin overexpression results in profound changes in actin organization in cultured cells. Palladin binds to the actin-associated proteins alpha-actinin, vasodilator-stimulated phosphoprotein, profilin, Eps8, and ezrin, suggesting that it may affect actin organization indirectly. To determine its molecular function in generating actin arrays, we purified palladin and asked if it is also capable of binding to F-actin directly. In co-sedimentation and differential sedimentation assays, palladin was found to both bind and cross-link actin filaments. This bundling activity was confirmed by fluorescence and electron microscopy. Palladin fragments were then purified and used to determine the sequences necessary to bind and bundle F-actin. The Ig3 domain of palladin bound to F-actin, and a palladin fragment containing Ig3, Ig4, and the region linking these domains was identified as a fragment that was able to bundle F-actin. Because palladin has multiple Ig domains, and only one of them binds to F-actin, this suggests that different Ig domains may be specialized for distinct biological functions. In addition, our results suggest a potential role for palladin in generating specialized, actin-based cell morphologies via both direct actin cross-linking activity and indirect scaffolding activity.

1H, 15N, and 13C NMR chemical shift assignments for the Ig3 domain of palladin.

As part of our NMR structure determination of the palladin Ig3 domain, we report nearly complete NMR chemical shift assignments for the (1)H, (13)C, and (15)N nuclei.

New insights into FAK signaling and localization based on detection of a FAT domain folding intermediate.

Mounting evidence suggests that the focal adhesion targeting (FAT) domain, an antiparallel four-helix bundle, exists in alternative conformations that may modulate phosphorylation, ligand binding, and the subcellular localization of focal adhesion kinase (FAK). In order to characterize the conformational dynamics of the FAT domain, we have developed a novel method for reconstructing the folding pathway of the FAT domain by using discrete molecular dynamics (DMD) simulations, with free energy constraints derived from NMR hydrogen exchange data. The DMD simulations detect a folding intermediate, in which a cooperative unfolding event causes helix 1 to lose helical character while separating from the helix bundle. The conformational dynamic features of helix 1 in the intermediate state of the FAT domain are likely to facilitate Y926 phosphorylation, yet interfere with paxillin binding. The presence of this intermediate state in vivo may promote FAK signaling via the ERK/MAPK pathway and by release of FAK from focal adhesions.

Yolk protein endocytosis by oocytes in Drosophila melanogaster: immunofluorescent localization of clathrin, adaptin and the yolk protein receptor.

The process of yolk protein (YP) uptake by developing oocytes in Drosophila melanogaster has been investigated by immunofluorescent localization of the endocytosis proteins, clathrin, alpha-adaptin and the putative yolk protein receptor (YP receptor). Data suggests that YPs from the follicle cells are trafficked into the oocyte during early stages of vitellogenesis, and that hemolymph YPs are sequestered by nurse cells adjacent to the developing oocyte during late stages of vitellogenesis. Yolk proteins were immunolocalized to both follicle cells and nurse cells during these processes. Diapausing female Drosophila melanogaster undergo a pre-vitellogenic arrest of ovarian development associated with the absence of ovarian alpha-adaptin, clathrin and putative YP receptor. Diapause termination by transfer of whole animals from 11 degrees C to 25 degrees C, or by 20-hydroxyecdysone injection, results in the appearance of immunopositive material in the nurse cells for all three proteins between 12 h and 16 h post upshift and within four days of injection. Immunopositive material was not noted in the follicle cells during diapause termination. In vitro warming of diapausing ovaries, or incubation in the presence of 1 &mgr;M 20-hydroxyecdysone failed to initiate early vitellogenic development suggesting that diapause termination requires factor(s) external to the ovary. Western blotting analysis of extracts of 24 h post-eclosion wild type and ap(56f) females identified putative yolk protein receptor with a molecular weight of 208 kDa and clathrin with a molecular weight of 178 kDa.

Ecdysteroids regulate yolk protein uptake by Drosophila melanogaster oocytes.

Juvenile hormones (JHs) are thought to drive the regulation of yolk protein uptake by ovaries in Drosophila melanogaster. However, the level of JH production in a mutant stock (ap(56f)) is depressed yet the flies are normally vitellogenic. The production of ecdysteroids by these ap(56f) ovaries in vitro is elevated above that of wild-type ovaries. The incubation of wild-type ovaries in the presence of 0.1mM JHB(3) increased ecdysteroid biosynthesis only during the first 18h following eclosion. Female Drosophila melanogaster undergo a pre-vitellogenic reproductive diapause when exposed to low temperature (11 degrees C) and a short-day photoperiod (L12:D12). The rate of ecdysteroid synthesis by the ovaries, but not JH production, increased within 12h of a temperature upshift to 25 degrees C from a basal level of 20+/-1pg/10 pair of ovaries/5h to a sustained level of 150+/-20pg/10 pair/5h. Vitellogenic oocytes were noted in all females within 12h of this temperature upshift. Diapause was also terminated by the injection of 1&mgr;g of 20-hydroxyecdysone into the abdomens of diapausing females as determined by an increase in ovary size, and the appearance of vitellogenic oocytes as compared to controls. These results are consistent with a revised model for the regulation of yolk protein uptake by ovaries in which ecdysteroids, and not JHs, play the prominent role.

A reappraisal of the hormonal regulation of larval fat body histolysis in female Drosophila melanogaster.

The histolysis of larval fat body cells in adult female Drosophila melanogaster was examined in wild type and mutant animals. The fat body cells of wild type (Canton-S), apterous56f homozygotes, apterous78jts homozygotes and heterozygotes, apterous4/+, ecdysoneless1 homozygotes and heterozygotes all underwent histolysis normally during the 72 h following adult eclosion. Only in the case of ap4/ap4 adults did the cells fail to histolyze normally. The fat body cells of both diapausing and non-diapausing wild type females underwent histolysis at the same rate. Attempts to demonstrate histolysis in vitro were unsuccessful, even in the presence of juvenile hormones (JHs), larval ring glands, or adult ovaries. In all strains other than the ap4 homozygotes, a significant proportion of larval fat body cells were dead at any time while the ap4/ap4 animals, almost all cells remained viable. It is postulated that fat body cell lysis following eclosion is not a JH-mediated event, but is elicited by an as yet unidentified factor(s), possibly originating in the ovary.

Reversible juvenile hormone inhibition of ecdysteroid and juvenile hormone synthesis by the ring gland of Drosophila melanogaster.

Juvenile hormone bisepoxide (JHB3) and juvenile hormone III (JH III) both inhibited the in vitro production of ecdysteroids by ring glands and brain-ring gland complexes from third instar post-feeding larvae of Drosophila melanogaster in a reversible manner, although JHB3 had greater efficacy. The JH III and JHB3 precursor, methyl farnesoate, did not affect ecdysteroid production. The in vitro synthesis of total detectable JH (JHB3 + JH III + methyl farnesoate) by the corpus allatum portion of the isolated ring gland was also inhibited reversibly in the presence of exogenous JHB3 and JH III, but not by methyl farnesoate. These data indicating negative feedback are in agreement with the accepted dogma of endocrine gland regulation.

Regulation of juvenile hormone synthesis in wild-type and apterous mutant Drosophila.

Juvenile hormone (JH) is a major regulator of insect development and reproduction and its titer is determined largely by central nervous system regulation of JH synthesis by the corpora allata. To establish the basis for a molecular genetic dissection of the neuroendocrine system responsible for modulating JH titer, a radiochemical assay was utilized to examine JH synthesis in vitro by the isolated corpus allatum as well as the regulation of this synthesis by brain extracts of wild-type and apterous mutant Drosophila melanogaster females during reproductive maturation. JH production by glands of wild-type females increases in parallel with the progress of ovarian maturation, the major product of the adult corpus allatum being juvenile hormone 3 bis-epoxide (JHB3). Gland activity appears to be regulated by both the availability of JH precursors and the level of terminal oxidase(s) in the JH biosynthetic pathway. The brain contains an allatostatic factor, that is transmitted to the glands via nervous connections. Allatostatin production in the brain appears to be positively regulated by JHB3. Adult corpora allata from the mutants ap4 and ap56f synthesize very low levels of JH; additionally, brains of ap56f homozygotes lack allatostatic activity.

Photoperiodic diapause in Drosophila melanogaster involves a block to the juvenile hormone regulation of ovarian maturation.

Females of Drosophila melanogaster held under short-day photoperiods at a moderately low temperature (12 degrees) enter a state of ovarian diapause in which yolk deposition in the oocytes is suspended (D. S. Saunders, V. C. Henrich, and L. I. Gilbert, Proc. Natl. Acad. Sci. USA 86, 3748-3752, 1989). An enzyme-linked immunosorbent assay (ELISA) using polyclonal antibodies raised against D. melanogaster yolk polypeptides (YPs) showed that diapausing flies synthesize and accumulate YPs in the hemolymph, but very little in the ovary. Nondiapausing females at the same temperature but at long days, and short-day flies in which diapause was broken by an upshift in temperature or topical application of juvenile hormone (JH), showed enhanced titers of YPs in the ovaries, suggesting stimulating uptake. Determinations of juvenile hormone bisepoxide (JHB3) and JH III synthesis in vitro by single excised corpora allata showed that glands from nondiapausing flies or corpora allata from flies in which diapause had been broken synthesized JH at a rate about four times higher than glands from diapausing flies. Corpora allata incubated in medium supplemented with farnesoic acid showed an increase in the rate of JH synthesis, but the increase was relatively greater with corpora allata from nondiapausing flies. Glands from diapausing flies presented the appearance of newly emerged or "immature" glands. Ovarian diapause is terminated at 12 degrees LD 10:14 in 7 days following topical application of either JH III or JHB3 at a concentration of about 0.5 micrograms per fly, diapause termination being expressed by an increased rate of vitellogenesis and by an increase in the number of fully developed eggs per vitellogenic female. It is concluded that the short-day-elicited diapause in D. melanogaster results from a "block" to the JH-stimulated uptake of yolk proteins from the hemolymph, caused by a reduced rate of JH synthesis by the corpus allatum. Photoperiodic regulation of the corpus allatum may be mediated via the brain.

Allatostatic regulation of juvenile hormone production in vitro by the ring gland of Drosophila melanogaster.

A factor(s) extracted from the third instar larval brains of the dipteran species Sarcophaga bullata and Drosophila melanogaster causes a dose-dependent reduction of juvenile hormone (JHB3) biosynthesis by isolated ring glands in vitro. In situ, this factor is presumably neuronally transmitted from the brain to ring gland. The allatostatic effect of the brain factor is reversible in vitro and may be overcome partially by the JHB3 precursor farnesoic acid. Agents which act to increase the intracellular levels of cAMP (3-isobutyl-1-methylxanthine (MIX), forskolin, 8-benzoyl cAMP) all caused the reduction of JHB3 synthesis in vitro in a reversible manner. The inhibitory effect of increased levels of cAMP was overcome by the addition of farnesoic acid to the culture medium. The dependence of JHB3 synthesis on extracellular calcium was demonstrated by incubation of ring glands in the presence of the Ca2+ channel blocker lanthanum chloride, and in Ca2(+)-free medium containing EGTA. The inclusion of farnesoic acid abolished the zero Ca2+ effect completely. However, the Ca2+ ionophore A23187 inhibited JHB3 production in medium containing Ca2+, suggesting that elevated intracellular levels of Ca2+ also suppress JHB3 production. This latter inhibition could not be reversed completely by farnesoic acid.

Juvenile hormone bisepoxide biosynthesis in vitro by the ring gland of Drosophila melanogaster: a putative juvenile hormone in the higher Diptera.

The in vitro production of juvenile hormone (JH) was investigated by using isolated ring glands from third instar Drosophila melanogaster. A JH-like molecule is secreted that comigrates with a synthetic sample of methyl 6,7;10,11-bisepoxy-3,7,11-trimethyl-(2E)-dodecenoate (JHB3) during TLC, liquid chromatography, and GC analysis. Purified product from farnesoic acid-stimulated ring glands was analyzed by electron impact GC/MS and gave a mass spectrum identical to synthetic JHB3. Additional structure confirmation was obtained following conversion of product from unstimulated biosynthesis to a derivative that comigrated on liquid chromatography with the derivative prepared from synthetic JHB3. Physiological studies revealed that JHB3 is produced solely by the corpus allatum portion of the ring gland in vitro. Isolated ring glands from other cyclorrhaphous dipteran larvae also produce JHB3 almost exclusively in vitro. Corpora allata from mosquito larvae, however, produce only JH III, indicating that JHB3 production may be restricted to the higher Diptera. Topically applied synthetic JHB3 caused developmental responses in newly formed D. melanogaster white puparia similar to those obtained with JH III. The data suggest that JHB3 is a fly juvenile hormone.

Developmental regulation of juvenile hormone biosynthesis by the ring gland of Drosophila melanogaster.

The synthesis in vitro of the putative dipteran juvenile hormone (JHB3) by ring glands isolated from third instar Drosophila melanogaster larvae was quantified by a radiochemical assay. The data indicate that JHB3 synthesis is developmentally regulated during the period prior to wandering until after puparium formation. The highest level of basal production occurred during the postfeeding stage, and synthesis declined after pupariation. Similar relative profiles of synthesis were obtained upon the addition of the JHB3 precursor, farnesoic acid, although the absolute levels of production were elevated considerably. Basal JHB3 production by brain-ring gland complexes in vitro was also highest during the postfeeding stage, although the synthetic rates were much lower than displayed by isolated ring glands. Further analysis revealed that methyl farnesoate, a JHB3 precursor, was synthesized by brain-ring gland complexes in significant quantity. A dual mechanism of brain-centered control of JHB3 biosynthesis is proposed.