Extent of lymph node resection does not increase perioperative morbidity and mortality after surgery for stage I lung cancer in the elderly.

BACKGROUND & OBJECTIVES: Pathologic evaluation of > 10 lymph nodes (LNs) is considered necessary for accurate lung cancer staging. However, physicians have concerns about increased risk in perioperative mortality (POM) and morbidity with more extensive LN sampling, particularly in the elderly. In this study, we compared the outcomes in elderly patients with stage I non-small cell lung cancer (NSCLC) undergoing extensive (> 10 nodes) and limited (≤ 10 nodes) LN resections. METHODS: Using data from the Surveillance, Epidemiology and End Results registry linked to Medicare records, we identified 4975 patients ≥ 65 years of age with stage I NSCLC who underwent a lobectomy between 1992 and 2002. Risk of perioperative morbidity and POM after the evaluation of ≤ 10 vs. >10 LNs was compared among patients after adjusting for propensity scores. RESULTS: Multiple regression analysis showed similar POM between the two groups (OR, 1,01; 95% CI, 0,71-1,44). Other postoperative complications were similar across groups except for thromboembolic events, which were more common among patients undergoing resection of > 10 LNs (OR, 1,72; 95% CI, 1,12-2,63). CONCLUSIONS: These data suggest that evaluation of > 10 LNs, which allows for more accurate staging, appears to be safe in the elderly patients undergoing lobectomy for stage I NSCLC without compromising postoperative recovery.

Biodiesel production from waste cooking oil: 2. Economic assessment and sensitivity analysis.

The economic feasibilities of four continuous processes to produce biodiesel, including both alkali- and acid-catalyzed processes, using waste cooking oil and the 'standard' process using virgin vegetable oil as the raw material, were assessed. Although the alkali-catalyzed process using virgin vegetable oil had the lowest fixed capital cost, the acid-catalyzed process using waste cooking oil was more economically feasible overall, providing a lower total manufacturing cost, a more attractive after-tax rate of return and a lower biodiesel break-even price. On the basis of these economic calculations, sensitivity analyses for these processes were carried out. Plant capacity and prices of feedstock oils and biodiesel were found to be the most significant factors affecting the economic viability of biodiesel manufacture.

Biodiesel production from waste cooking oil: 1. Process design and technological assessment.

Four different continuous process flowsheets for biodiesel production from virgin vegetable oil or waste cooking oil under alkaline or acidic conditions on a commercial scale were developed. Detailed operating conditions and equipment designs for each process were obtained. A technological assessment of these four processes was carried out to evaluate their technical benefits and limitations. Analysis showed that the alkali-catalyzed process using virgin vegetable oil as the raw material required the fewest and smallest process equipment units but at a higher raw material cost than the other processes. The use of waste cooking oil to produce biodiesel reduced the raw material cost. The acid-catalyzed process using waste cooking oil proved to be technically feasible with less complexity than the alkali-catalyzed process using waste cooking oil, thereby making it a competitive alternative to commercial biodiesel production by the alkali-catalyzed process.

A Fourier-transform infrared study of the interaction between germ-cell specific sulfogalactosylglycerolipid and dimyristoylglycerophosphocholine.

In this study, we investigated structural and dynamic changes of sulfogalactosylglycerolipid (SGG) and dimyristoylglycerophosphocholine (DMPC) in a liposomal system (SGG+DMPC, molar ratio 2:3) by Fourier-transform infrared (FTIR) spectroscopy. Cooling of the preheated SGG liposomes (5-65 degrees C) revealed that the liquid crystalline-to-gel phase transition was centered at 45 degrees C. SGG+DMPC liposomes showed a single phase transition at 28 degrees C. Spectral changes of the ester C&z. dbnd6;O groups of SGG and DMPC in the mixed liposomes indicated a decrease in their interfacial hydrogen bonding intermolecularly and with water. Analysis of SGG's symmetric and antisymmetric CH(2) stretching bands revealed that the insertion of DMPC into SGG bilayers increased the number of gauche conformers in SGG's hydrocarbon chains. Overall, the SGG+DMPC liposomes were homogeneous, with reduced interfacial hydrogen bonding and increased orientational and conformational disorder of SGG's hydrocarbon chains.

FTIR study of the monosialoganglioside GM1 in perdeuterated dimyristoylglycerophosphocholine (DMPCd54) multilamellar bilayers: spectroscopic evidence of a significant interaction between Ca2+ ions and the sialic acid moiety of GM1.

Fourier transform infrared (FTIR) spectroscopy was employed to study bovine brain GM1 and perdeuterated dimyristoylglycerophosphocholine (DMPCd54) multilamellar dispersions (mole fractions of GM1 in DMPCd54: 0.12, 0.15, 0.19, 0.26, 0.34, 0.41, and 0.58), in the absence and presence of 10 mM CaCl2. GM1 micelles did not display a thermal phase transition in the temperature range 5-60 degrees C. Moreover, the ceramide moiety of GM1 inserted into the hydrophobic core of DMPCd54 bilayers and was capable of undergoing a single, cooperative phase transition (Tm = 22-28 degrees C, depending on GM1 content) in a bilayer system. This suggested that the mixed bilayers consisted of a homogeneous mixture and that GM1 was uniformly dispersed in the bilayer plane rather than segregated into regions of relative enrichment. The coexistence of GM1 and DMPCd54 in a bilayer environment induced a rearrangement of the interfacial hydrogen bonding network of the amide I and ester C=O groups, relative to GM1 micelles and DMPCd54 bilayers, respectively. The modifications induced by GM1 might ultimately modulate surface events such as lipid-lipid and/or lipid-protein interactions. The spectroscopic results also suggested that the glycolipid's headgroup surface location and conformation in bilayers allow GM1 to act as a receptor for Ca2+ via its sialic acid moiety.

A novel glycolipid and phospholipid in the purple membrane.

A novel glycolipid of mass 1935 and a phospholipid of mass 1522 are the main residual lipids (along with traces of PGP-Me, S-TGD-1, and PG) specifically associated with "delipidated" bacteriorhodopsin fractions BR I and BR II, prepared by Triton X-100 treatment of purple membrane (PM), from a genetically engineered strain (L33) of Halobacterium salinarum, and chromatography on phenyl-Sepharose CL-4B. The novel glycolipid and phospholipid are components of the PM matrix not previously described. The TLC isolated and purified novel glycolipid and phospholipid were shown, by chemical degradation, mass spectrometry, and NMR analyses, to have the structure, respectively, of a phosphosulfoglycolipid, 3-HSO(3)-Galp-beta1,6Manp-alpha1,2Glcp-alpha1,1-[sn-2, 3-di-O-phytanylglycerol]-6-[phospho-sn-2,3-di-O-phytanylglycero l], and of a glycerol diether analogue of bisphosphatidylglycerol (cardiolipin), sn-2,3-di-O-phytanyl-1-phosphoglycerol-3-phospho-sn-2, 3-di-O-phytanylglycerol.

Structural diversity of membrane lipids in members of Halobacteriaceae.

This minireview gives an updated and consolidated summary of taxonomic classification correlated with membrane phospholipid, glycolipid, and core lipid structural diversity within the family Halobacteriaceae. We also point out that the recently reported diversity in the membrane core lipid structure of a putative strain of Halobacterium (Halobacterium halobium strain IAM 13167) (Morita et al., Biosci. Biotechnol. Biochem., 62, 596-598, 1998) is not correct since the strain used by the authors has for some time been recognized not to be a member of the genus Halobacterium but a member of halobacteria group 2 (Grant and Larsen, Bergey's Manual of Systematic Bacteriology, Vol.3, pp. 2216-2233, 1989), which has recently been designated as a new genus, Natrinema (McGenity et al., Int. J. Syst. Bacteriol. 48, 1187-1196, 1998).

Interaction between sulfogalactosylceramide and dimyristoylphosphatidylcholine increases the orientational fluctuation of their lipid hydrocarbon chains.

The objective of this study was to investigate the interaction between sulfogalactosylceramide (SGC) and dimyristoylphosphatidylcholine (DMPC) in a mixed model liposomal system (molar ratio SGC:DMPC, 2:3). Structural and dynamic changes of the liposome components were monitored by Fourier-transform infrared spectroscopy (FTIR). Thermotropic FTIR analysis of the mixed liposomes showed a single gel/liquid crystalline phase transition, centered at approximately 42 degrees C. Spectral changes of the amide and ester C = O bands arising from functional groups at the interfacial region indicated a reduced hydrogen bonding of these groups in the mixed liposomes. Pressure-tuning FTIR of mixed liposomes showed that the methylene chains of SGC and DMPC were more orientationally disordered than those of the individual lipid SGC liposomes or DMPC liposomes. These results suggest that the mixed liposomes (molar ratio SGC:DMPC, 2:3) consisted of a homogeneous mixture of SGC and DMPC molecules in which mutual shielding reduced hydrogen bonding in the interfacial region, with a concurrent increase in the orientational disorder of the hydrocarbon chains of both SGC and DMPC.

Diversity of alkaliphilic halobacteria: proposals for transfer of Natronobacterium vacuolatum, Natronobacterium magadii, and Natronobacterium pharaonis to Halorubrum, Natrialba, and Natronomonas gen. nov., respectively, as Halorubrum vacuolatum comb. nov., Natrialba magadii comb. nov., and Natronomonas pharaonis comb. nov., respectively.

The 16S rRNA genes of three species of the genus Natronobacterium (Natronobacterium gregoryi, Natronobacterium pharaonis, and Natronobacterium vacuolatum) were sequenced and compared to that of the previously sequenced species Natronobacterium magadii. The sequences revealed that Natronobacterium pharaonis was phylogenetically distinct from the other members of the genus and also from other recognized genera of the family Halobacteriaceae. However, Natronobacterium vacuolatum and Natronobacterium magadii were found to be most closely related to the genera Halorubrum and Natrialba, respectively. An unidentified haloalkaliphile, strain SSL1, was also closely related to Natronobacterium magadii and Natrialba asiatica. On the basis of phylogenetic tree reconstructions, signature bases specific for individual genera, and sequences of spacer regions between 16 and 23S rRNA genes, we propose the following changes: Natronobacterium pharaonis to be transferred to Natronomonas gen. nov. as Natronomonas pharaonis gen. nov., comb. nov.; Natronobacterium vacuolatum to be transferred to the genus Halorubrum as Halorubrum vacuolatum comb. nov.; and Natronobacterium magadii to be transferred to the genus Natrialba as Natrialba magadii.

Combination of dobutamine and myocardial contrast echocardiography to differentiate postischemic from infarcted myocardium.

OBJECTIVES: This study tested whether the combination of dobutamine echocardiography (DE) and myocardial contrast echocardiography (MCE) was superior to either technique alone in identifying postischemic myocardium and in differentiating it from necrotic myocardium. BACKGROUND: Wall motion abnormalities at rest occur in postischemic myocardium in the presence of infarction, stunning or hibernation, alone or in combination. Various investigators have suggested that either DE or MCE can be used to identify the presence of myocardial viability. METHODS: We studied a total of 53 mongrel dogs in an open chest model of coronary occlusion of various durations followed by reperfusion and dobutamine administration (10 microg/kg body weight per min). MCE with aortic root injections of Albunex (area under the curve) and DE (percent thickening fraction) were performed at the different stages. Postmortem triphenyltetrazolium chloride (TTC) staining was used to identify myocardial necrosis. RESULTS: Thirteen dogs underwent brief (15 min) occlusions and developed no necrosis (Group I). Of 40 dogs that underwent prolonged (30 to 360 min) occlusions, 14 had no infarction (Group II), whereas 26 did (Group III: 12 papillary muscle, 7 subendocardial, 7 transmural). MCE (expressed as percent change from baseline) demonstrated changes that paralleled the blood flow changes observed by radiolabeled microspheres at all interventions (r = 0.67, p < 0.0001). Regional ventricular function improved with dobutamine administration in the ischemic region in all three groups. The sensitivity (88%) for detecting myocardial viability was superior when the two techniques were combined; however, a poor specificity (61%) was observed. CONCLUSIONS: Contractile reserve and perfusion data are complementary when assessing regional wall motion abnormalities in postischemic myocardium. DE alone cannot differentiate postischemic from infarcted myocardium; simultaneous data on myocardial perfusion are required. The combination of DE and MCE is superior to either technique alone for identifying the absence of myocardial necrosis.

Endovascular stenting for treatment of an adult patient with pulmonary artery stenosis with 1-year follow-up.

This report describes the occurrence of symptomatic proximal left main pulmonary artery stenosis in a 58-yr-old man that was successfully treated with endovascular stenting with 1-yr follow-up. The technique and pitfalls of this procedure are described. Endovascular stenting provided a well-tolerated, nonsurgical approach to alleviating isolated pulmonary artery stenosis in this patient.

Potential clinical implications of abnormal myocardial perfusion patterns immediately after reperfusion in a canine model: a myocardial contrast echocardiography study.

During myocardial infarction, lack of myocardial opacification after reperfusion has been associated with poor or no recovery of function. We have previously documented the presence of perfusion abnormalities after brief coronary occlusions without infarction and the absence of perfusion abnormalities after prolonged occlusions with infarction. To characterize myocardial perfusion patterns immediately after reperfusion, we studied 53 animals in two groups in a coronary occlusion-reperfusion model. Temporary occlusions (group 1, 15 minutes; group 2, 30 to 360 minutes) were performed, followed by reperfusion with and without dobutamine. Myocardial contrast echocardiography was performed with aortic root injections of sonicated 5% serum human albumin (Albunex) during each intervention. Group 1 dogs showed no evidence of myocardial infarction. In group 2, 26 of 40 dogs had infarctions. After reperfusion, no perfusion abnormalities were seen in 13 of 26 group 2 dogs with infarctions; perfusion abnormalities were identified after reperfusion in 2 of 13 group 1 and in 8 of 14 group 2 dogs without infarctions. In animals subjected to prolonged ischemia, the absence of perfusion abnormalities after reperfusion did not rule out the presence of necrosis. Similarly, in animals without infarction subjected to ischemia, the presence of a perfusion defect after reperfusion did not represent the presence of necrosis but an abnormal microvascular reserve. These results suggest that early after reperfusion, assessment of perfusion by myocardial contrast echocardiography has significant limitations in the evaluation of myocardial viability and salvage.

Cholesterol and phospholipid levels of washed and percoll gradient centrifuged mouse sperm: presence of lipids possessing inhibitory effects on sperm motility.

Levels of DNA, cholesterol, and phospholipids of mouse caudal epididymal and vas deferens sperm that were processed through simple washing and Percoll gradient centrifugation were measured. The DNA and cholesterol contents of washed sperm and Percoll gradient centrifuged (PGC) sperm (DNA = 3.6 +/- 0.3 pg/sperm and 3.4 +/- 0.3 pg/sperm, respectively; cholesterol = 0.219 +/- 0.057 nmole/microgram DNA and 0.224 +/- 0.030 nmole/microgram DNA, respectively, for washed and PGC sperm) were not significantly different from each other; however, the phospholipid level of PGC sperm was only one half of that of washed sperm (0.315 +/- 0.071 nmole/microgram DNA versus 0.720 +/- 0.075 nmole/microgram DNA, respectively). The presence of 0.3% bovine serum albumin (BSA) in the culture medium used in sperm washing did not change the cholesterol and phospholipid contents of washed sperm. Similarly, the cholesterol and phospholipid levels of washed sperm and PGC sperm that were further incubated in BSA-containing medium for 30 min remained the same. Interestingly, substantial amounts of lipids, as determined by the cholesterol and phospholipid levels, were released into the supernatants of the sperm washes, and sperm needed to be washed at least twice to ensure their stable levels of cholesterol and phospholipids. The lipid mixture in the first sperm wash supernatant was shown to have inhibitory effects on PGC sperm motility.

Predictive model to assess risk for cardiac allograft vasculopathy: an intravascular ultrasound study.

OBJECTIVES: This study was performed to assess the influence and interdependence of immunologic and nonimmunologic risk factors in the development of cardiac allograft vasculopathy. Another primary objective was to establish a clinically useful model for risk assessment of cardiac allograft vasculopathy that would facilitate identifying those heart transplant recipients likely to have severe intimal proliferation and thereby at greater risk for adverse clinical events. BACKGROUND: To our knowledge, no comprehensive intravascular ultrasound study has assessed the relative influences of both nonimmunologic and immunologic factors in the development of cardiac allograft vasculopathy, currently the major limitation to long-term cardiac allograft survival. METHODS: Using a computer-assisted model of stepwise logistic regression, immunologic and nonimmunologic risk factors were evaluated to help identify the development of severe intimal thickening in 101 subjects who underwent intravascular ultrasound. Prospective validation of the findings was performed in a separate consecutive cohort of 37 heart transplant recipients, and the accuracy of this model to predict a relative risk > 1 for the development of severe intimal hyperplasia was assessed. RESULTS: Significant independent predictors of severe intimal hyperplasia in this model included a donor age > 35 years, a first-year mean biopsy score > 1 (a measure not only of severity of rejection, but also of frequency of insidious rejection) and hypertriglyceridemia at two incremental levels of risk (150 to 250 mg/dl [1.70 to 2.83 mmol/liter] and > 250 mg/dl [2.83 mmol/liter]). Based on the absence (0) or presence (1) of these factors, 12 individual categories of risk were ascertained with increasing relative risks and predicted probabilities for severe intimal hyperplasia. Prospective validation of this model revealed a sensitivity and specificity of 70% and 90%, respectively, and the positive and negative predictive values were 85% and 80%, respectively. Additionally, subjects with severe intimal thickening had a four-fold higher cardiac event rate than those without severe intimal proliferation on intravascular ultrasound. CONCLUSIONS: This study establishes a clinically useful predictive model that can be applied to individual heart transplant recipients to assess their risk for developing significant cardiac allograft vasculopathy and, thus, aids in the identification of patients at risk for cardiac events in whom closer surveillance and risk factor modification may be warranted.

Studies on new acidic azoles as glucose-lowering agents in obese, diabetic db/db mice.

Bioisosteric substitution was used as a tool to generate several new structural alternatives to the thiazolidine-2,4-dione and tetrazole heterocycles as potential antidiabetic agents. Among the initial leads that emerged from this strategy, a family of acidic azoles, isoxazol-3- and -5-ones and a pyrazol-3-one, showed significant plasma glucose-lowering activity (17-42% reduction) in genetically obese, diabetic db/db mice at a dose of 100 mg/kg/day x4. Structure-activity relationship studies determined that 5-alkyl-4-(arylmethyl)pyrazol-3-ones, which exist in solution as aromatic enol/iminol tautomers, were the most promising new class of potential antidiabetic agent (32-45% reduction at 20 mg/kg/d x4). Included in this work are convenient syntheses for several types of acidic azoles that may find use as new acidic bioisosteres in medicinal chemistry such as the antidiabetic lead 5-(trifluoromethyl)pyrazol-3-one (hydroxy tautomer) and aza homologs of the pyrazolones, 1,2,3-triazol-5-ones (hydroxy tautomer) and 1,2,3,4-tetrazol-5-one heterocycles. log P and pKa data for 15 potential acidic bioisosteres, all appended to a 2-naphthalenylmethyl residue so as to maintain a similar distance between the acidic hydrogen and arene nucleus, are presented. This new data set allows comparison of a wide variety of potential acid mimetics (pKa 3.78-10.66; log P -0.21 to 2.76) for future drug design.

Acylation of proteins of the archaebacteria Halobacterium cutirubrum and Methanobacterium thermoautotrophicum.

Although the membrane lipids of extremely halophilic archaebacteria are exclusively derived from diphytanylglycerol diether, which is non-acylated, small amounts of fatty acids have been detected in these organisms. These fatty acids are formed by the action of a fatty acid synthase (FAS), shown to be present in the extreme halophile Halobacterium cutirubrum, despite the fact that only a fraction of the activity of FAS remains at the high salt concentration (> 4 M) present in the cytoplasm. It has now been demonstrated that fatty acids do not occur in lipid-bound form but largely in the form of acylated proteins in the red membrane of H. cutirubrum. In contrast, the bacteriorhodopsin of the purple membrane of this extreme halophile does not appear to be acylated. The thermophilic methanogen, Methanobacterium thermoautotrophicum had a much higher fatty acid synthase activity than the extreme halophile, and the synthase activity of the methanogen was optimal under its normal (anaerobic) growth conditions. The methanogen also utilized the resulting fatty acids to acylate its membrane proteins. The major fatty acids in both organisms were palmitic and stearic acids with small amounts of myristic and 18:1 acids, and these were bound to protein through both ester and amide linkages.

Interaction of divalent cations with germ cell specific sulfogalactosylglycerolipid and the effects on lipid chain dynamics.

Sulfogalactosylglycerolipid (SGG) is a sulfoglycolipid found ubiquitously in the plasma membrane of mammalian male germ cells. Although its exact cellular function(s) is unknown, it is speculated that SGG may play a role in cation transport, which may be important in sperm-egg interaction. Given the significant role of Ca2+ in many fertilization-related events, the purpose of this study was to determine whether Ca2+ interaction with the negatively charged sulfate group of SGG results in changes to the SGG lipid chain molecular dynamics and to compare these lipid dynamics with those resulting from Na+, Mg2+, or Sr2+ interaction with SGG. Pressure-tuning Fourier transform infrared spectroscopy was used in this study. The results obtained showed that all three divalent cations interacted electrostatically with the sulfate moiety of hydrated SGG, although with varying degrees of strength. It was found that the hydrocarbon chains of hydrated SGG-Na+ multilamellar bilayers were interdigitated, thus increasing disorderedness of the terminal CH3 group of the hydrocarbon chains. The presence of each of the three divalent cations abolished this interdigitation state. Presumably, this is through the cross-linking interaction of each divalent cation with the sulfate groups of neighboring lipid molecules. Moreover, divalent cation interaction was found to increase the lipid chain dynamics of SGG, with Mg2+ inducing the greatest chain disorder followed by Ca2+ and then Sr2+. An increase in chain disorder would increase the bilayer fluidity. Such a phenomenon may prove relevant to the changes observed in the sperm plasma membrane during fertilization-related events.

Polar lipids of a non-alkaliphilic extremely halophilic archaebacterium strain 172: a novel bis-sulfated glycolipid.

Extremely halophilic archaebacteria which require high salt concentrations for growth and survival contain glycerol diether analogues of phospholipids and sulfated glycolipids as major membrane polar lipids. A non-alkaliphilic, non-pigmented rod-shaped extreme halophile, isolated from sea sand in Japan and designated 'strain 172', was found to contain two phospholipids, phosphatidylglycerol (PG) and phosphatidylglyceromethylphosphate (PGP-Me), derived from both C20-C20- and C20-C25-glycerol diethers, and a novel major glycolipid (designated SGL-X). This glycolipid has been identified as a bis-sulfated diglycosyl C20-C20- or C20-C25-glycerol diether, on the basis of its TLC mobility, positive-staining behavior with sugar and sulfate-staining reagents, its mole ratio sulfate/glycolipid = 2.2, and by spectrometric analysis (IR and FAB-MS) of the intact and the desulfated SGL-X. The sugars were identified as mannose and glucose, after acid hydrolysis of SGL-X, by paper chromatography of the free sugars and GC-MS of the derivatized sugars (alditol acetates). Permethylation analysis and 1H- and 13C-NMR analysis established the position and configuration of the sugar linkages and the positions of the sulfate groups. The final structure of SGL-X (now designated S2-DGD-1) is proposed to be: 2,3-diphytanyl- or phytanyl-sesterterpenyl-1-[2,6-(HSO3)2-alpha-Manp-1--> 2- Glcp]-sn-glycerol. This lipid is the first bis-sulfated glycolipid to be reported in extremely halophilic archaebacteria, and is the first in the biosphere that possesses two sulfate groups attached to the same monosaccaride.