[Bone substitutes used for sinus lift]. / Knochenersatzmaterialien zur Sinusbodenelevation.

In dental surgery today a variety of bone substitutes are used for sinus lift. After the increased application of synthetics during the last decade there has now been a move back to autologous bone transplants, combined with allogenic and xenogenic augmentation materials. The effects of transforming growth factors and recombinant equivalents of bone morphogenetic proteins remain to be seen. Covering the augmented area with a collagen membrane is the basic standard in many cases. Concomitant illnesses of dental origin or of the maxillary sinus have to be assessed prior to any sinus lift. Once complications such as laceration of the Schneiderian membrane, infection or adverse reaction have occurred, early and consistent therapy is required.

Cerebellar ataxia and Purkinje cell dysfunction caused by Ca2+-activated K+ channel deficiency.

Malfunctions of potassium channels are increasingly implicated as causes of neurological disorders. However, the functional roles of the large-conductance voltage- and Ca(2+)-activated K(+) channel (BK channel), a unique calcium, and voltage-activated potassium channel type have remained elusive. Here we report that mice lacking BK channels (BK(-/-)) show cerebellar dysfunction in the form of abnormal conditioned eye-blink reflex, abnormal locomotion and pronounced deficiency in motor coordination, which are likely consequences of cerebellar learning deficiency. At the cellular level, the BK(-/-) mice showed a dramatic reduction in spontaneous activity of the BK(-/-) cerebellar Purkinje neurons, which generate the sole output of the cerebellar cortex and, in addition, enhanced short-term depression at the only output synapses of the cerebellar cortex, in the deep cerebellar nuclei. The impairing cellular effects caused by the lack of postsynaptic BK channels were found to be due to depolarization-induced inactivation of the action potential mechanism. These results identify previously unknown roles of potassium channels in mammalian cerebellar function and motor control. In addition, they provide a previously undescribed animal model of cerebellar ataxia.

A molecular switch for specific stimulation of the BKCa channel by cGMP and cAMP kinase.

The cGMP and the cAMP pathways control smooth muscle tone by regulation of BK(Ca) (BK) channel activity. BK channels show considerable diversity and plasticity in their regulation by cyclic nucleotide-dependent protein kinases. The underlying molecular mechanisms are unclear but may involve expression of splice variants of the BK channel alpha subunit. Three isoforms, BK(A), BK(B), and BK(C), which were cloned from tracheal smooth muscle, differed only in their C terminus. When expressed in HEK293 cells, cGMP kinase (cGK) but not cAMP kinase (cAK) stimulated the activity of BK(A) and BK(B) by shifting the voltage dependence of the channel to more negative potentials. In contrast, BK(C) was exclusively stimulated by cAK. BK(C) lacks a C-terminal tandem phosphorylation motif for protein kinase C (PKC) with Ser(1151) and Ser(1154). Mutation of this motif in BK(A) switched channel regulation from cGK to cAK. Furthermore, inhibition of PKC in excised patches from cells expressing BK(A) abolished the stimulatory effect of cGK but allowed channel stimulation by cAK. cAK and cGK phosphorylated the channel at different sites. Thus, phosphorylation/dephosphorylation by PKC determines whether the BK channel is stimulated by cGK or cAK. The molecular mechanisms may be relevant for smooth muscle relaxation by cAMP and cGMP.

Grief communication, grief reactions and marital satisfaction in bereaved parents.

This study examined if attitudes about grief communication are related to grief reactions and marital satisfaction in bereaved parents. The sample consisted of 36 couples who experienced the loss of a child. For the couple as a unit, the relation between attitudes about communication and grief changed over time, and the nature of the change was related to the level of communication; positive attitudes about open communication were related to high grief in the early stages of bereavement and to low grief in later stages. No relation to marital satisfaction was found. Spouses were correlated in their attitudes about communication, but women valued open communication significantly more than men. Positive attitudes about grief communication were related to men's grief reactions but not marital satisfaction; whereas for women, positive attitudes were related to marital satisfaction but not grief.

Identification of the amino acid sequences responsible for high affinity activation of cGMP kinase Ialpha.

The cGMP-dependent protein kinases (cGK) Ialpha and Ibeta have identical cGMP binding sites and catalytic domains. However, differences in their first 100 amino acids result in 15-fold different activation constants for cGMP. We constructed chimeras to identify those amino acid sequences that contribute to the high affinity cGK Ialpha and low affinity cGK Ibeta phenotype. The cGK Ialpha/Ibeta chimeras contained permutations of six amino-terminal regions (S1-S6) including the leucine zipper (S2), the autoinhibitory domain (S4), and the hinge domain (S5, S6). The exchange of S2 along with S4 switched the phenotype from cGK Ialpha to cGK Ibeta and vice versa, suggesting that the domains with the highest homology between the two isozymes determine their affinity for cGMP. The high affinity cGK Ialpha phenotype was also obtained by a specific substitution within the hinge domain. Chimeras with the sequence of cGK Ialpha in S5 and cGK Ibeta in S6 were activated at up to 6-fold lower cGMP concentrations than cGK Ialpha. Based on the activation constants of all chimeras constructed, empirical weighting factors have been calculated that quantitatively describe the contribution of the individual amino-terminal domains S1-S6 to the high affinity cGK Ialpha phenotype.

A cGMP kinase mutant with increased sensitivity to the protein kinase inhibitor peptide PKI(5-24).

Synthetic peptides corresponding to the active domain of the heat-stable inhibitor protein PKI are very potent inhibitors of cAMP-dependent protein kinase, but are extremely weak inhibitors of cGMP-dependent protein kinase. In this study, we tried to confer PKI sensitivity to cGMP kinase by site-directed mutagenesis. The molecular requirements for high affinity inhibition by PKI were deduced from the crystal structure of the cAMP kinase/PKI complex. A prominent site of interaction are residues Tyr235 and Phe239 in the catalytic subunit, which from a sandwich-like structure with Phe10 of the PKI(5-24) peptide. To increase the sensitivity for PKI, the cGMP kinase codons at the corresponding sites, Ser555 and Ser559, were changed to Tyr and Phe. The mutant cGMP kinase was stimulated half maximally by cGMP at 3-fold higher concentrations (240 nM) than the wild type (77 nM). Wild type and mutant cGMP kinase did not differ significantly in their Km and Vmax for three different substrate peptides. The PKI(5-24) peptide inhibited phosphotransferase activity of the mutant cGMP kinase with higher potency than that of wild type, with Ki values of 42 +/- .3 microM and 160 +/- .7 microM, respectively. The increased affinity of the mutant cGMP kinase was specific for the PKI(5-24) peptide. Mutation of the essential Phe10 in the PKI(5-24) sequence to an Ala yielded a peptide that inhibited mutant and wild type cGMP kinase with similar potency, with Ki values of 160 +/- 11 and 169 +/- 27 microM, respectively. These results suggest that the mutations Ser555Tyr and Ser559Phe are required, but not sufficient, for high affinity inhibition of cGMP kinase by PKI.

Cyclic GMP-dependent protein kinase blocks pertussis toxin-sensitive hormone receptor signaling pathways in Chinese hamster ovary cells.

cGMP-dependent protein kinase (cGMP kinase) has been implicated in the regulation of the cytosolic calcium level ([Ca2+]i). In Chinese hamster ovary (CHO) cells stably transfected with the cGMP kinase I alpha (CHO-cGK cells), cGMP kinase suppressed the thrombin-induced increase in inositol 1,4,5-trisphosphate and [Ca2+]i (Ruth, P., Wang, G.-X., Boekhoff, I., May, B., Pfeifer, A., Penner, R., Korth, M., Breer, H., and Hofmann, F. (1993) Proc. Natl. Acad. Sci. U. S. A. 90, 2623-2627). Cholecystokinin activated intracellular calcium release via a pertussis toxin (PTX)-insensitive pathway in CHO-cGK cells. cGMP kinase did not attenuate the CCK-stimulated [Ca2+]i. In contrast, cGMP kinase suppressed calcium influx stimulated by insulin-like growth factors 1 and 2 (IGF-1 and IGF-2) via PTX-sensitive pathways. The effects of PTX and cGMP kinase on [Ca2+]i were not additive. 8-Bromo-cGMP had no effect on [Ca2+]i stimulated by IGF-1 or IGF-2 in wild type CHO cells. These results suggested that cGMP kinase inhibited the different signaling pathways by the phosphorylation of a PTX-sensitive G protein. cGMP kinase phosphorylated the alpha subunits of Gi1, Gi2, and Gi3 in vitro. Phosphorylation stoichiometry was 0.4 mol of phosphate/mol of G alpha i1 after reconstitution of heterotrimeric Gi1 in phospholipid vesicles. The alpha subunit of Gi was also phosphorylated in vivo. These results show that cGMP kinase blocks transduction of distinct hormone pathways that signal via PTX-sensitive Gi proteins.

Knowledge representation in pharmacology. A possible application area for the Arden Syntax?

In 1990 the Arden Syntax was proposed as a first version of a standardized syntax for the representation of medical knowledge. For the evaluation of the practicability of this first release we have analyzed the medical and pharmacological knowledge applied in the process of drug prescription. The separation of declarative (e.g. in a semantic network) and procedural knowledge is a basic issue of our research. We therefore propose to further extend the Arden syntax with declarative knowledge representation facilities. One way to do this may be the incorporation of a standardized medical data dictionary (e.g. the UMLS Metathesaurus) which promotes the representation of medical terms in a semantic network. Furthermore the problem of 'institution-specific knowledge', which is especially important for the issue of knowledge sharing between different institutions, is analyzed based on examples of knowledge modules for monitoring drug allergies and drug-drug-interactions.