RESUMO
This study evaluated the effectiveness of topically applied clindamycin hydrochloride and clindamycin phosphate in two, nonprescription, antiacne hydroalcoholic products for the treatment of acne vulgaris. Two percent concentrations of these clindamycin compounds were compared with the hydroalcoholic products in patients with moderate to severe acne who were attending a private dermatology office practice during a three-month period. Statistical analysis revealed a significantly greater clinical effectiveness for the clindamycin formulations compared with the hydroalcoholic products after eight weeks. The effectiveness of clindamycin compared with the hydroalcoholic products was not significantly greater after four and 12 weeks. The following are the possible reasons for this nonsignificant difference: a placebo effect within the first month, relative ineffectiveness of one type of clindamycin formulation tested, and the impressive clinical effectiveness of the antiacne hydroalcoholic products when combined with a consistent cleansing program.
Assuntos
Acne Vulgar/tratamento farmacológico , Adstringentes/administração & dosagem , Clindamicina/administração & dosagem , Administração Tópica , Adolescente , Adulto , Criança , Avaliação de Medicamentos , Feminino , Humanos , Masculino , Distribuição Aleatória , Fatores de TempoRESUMO
Although the nature of ruminant evolution is still disputed, current theory based on physiology and genetic analysis suggests that the abomasum is the evolutionarily oldest stomach compartment, the rumen evolved some time after the abomasum, and the omasum is the evolutionarily youngest stomach compartment. In addition, there is some evidence of relaxed selective constraint in the stomach-like organ and the foregut shortly after the foregut formation event. Along with the assumption of a mean, stochastic rate of evolution, analysis of differences in genetic profiles among digestive body organs can give clues to the relationships among these organs. The presence of large numbers of uniquely expressed entries in the abomasum and rumen indicates either a period of relaxed selective constraint or greater evolutionary age. Additionally, differences in expression profiles indicate that the abomasum, rumen, and intestine are more closely related to each other, while the reticulum and omasum are more closely related to the rumen. Functional analysis using Gene Ontology (GO) categories also supports the proposed evolutionary relationships by identifying shared functions, such as muscle activity and development, lipid transport, and urea metabolism, between all sections of the digestive tract investigated.
Assuntos
Medicaid/legislação & jurisprudência , Casas de Saúde/economia , Centers for Medicare and Medicaid Services, U.S. , Casas de Saúde/legislação & jurisprudência , Métodos de Controle de Pagamentos/legislação & jurisprudência , Planos Governamentais de Saúde/legislação & jurisprudência , Estados UnidosRESUMO
Pulmonary surfactant protein B (SP-B) is a 79 amino acid peptide that is intimately associated with surfactant phospholipids in the alveolar airspace. Mutations of the SP-B gene that result in complete absence of SP-B are invariably fatal in the neonatal period. The pathology associated with SP-B deficiency suggests that SP-B plays a critical role in integrating the synthesis, assembly and metabolism of the surfactant complex. A strategy is described to elucidate the role of SP-B in surfactant homeostasis by characterizing the pathophysiology associated with cell specific expression of SP-B constructs in vivo. Human SP-B constructs, under control of lung cell-specific promoters, were expressed in SP-B knockout mice in order to achieve expression of the human transgene in a null background. The effect of transgene expression on lung structure and function was assessed by biochemical, morphological and physiological analyses of the surfactant system in fetal and postnatal offspring.
Assuntos
Camundongos Knockout , Proteolipídeos/química , Proteolipídeos/fisiologia , Surfactantes Pulmonares/química , Surfactantes Pulmonares/fisiologia , Animais , Dimerização , Humanos , Pulmão/fisiologia , Camundongos , Camundongos Transgênicos , Mutagênese , Proteolipídeos/genética , Surfactantes Pulmonares/genéticaRESUMO
The 79-amino acid, mature SP-B peptide contains three intramolecular disulfide bonds shared by all saposin-like proteins. This study tested the hypothesis that the disulfide bond formed between cysteine residues 35 and 46 (residues 235 and 246 of the SP-B proprotein) is essential for proper function of SP-B. To test the role of this bridge in SP-B function in vivo, a construct was generated in which cysteine residues 235 and 246 of the human SP-B proprotein were mutated to serine and cloned under the control of the 3.7-kilobase hSP-C promoter (hSP-B(C235S/C246S)). In two transgenic mouse lines, expression of the mutant peptide in the wild-type murine SP-B background was invariably lethal in the neonatal period. In four additional lines, survival was inversely related to the level of transgene expression. To test the ability of the mutant peptide to functionally replace the wild-type protein, transgenic mice were crossed into the SP-B null background. No animals that expressed hSP-B(C235S/C246S) in the murine SP-B-/- background survived the neonatal period. hSP-B(C235S/C246S) proprotein accumulated in the endoplasmic reticulum and was not processed to the mature, biologically active peptide. The results of these studies demonstrate that the intramolecular bridge between residues 235 and 246 is critical for intracellular trafficking of SP-B and suggest that overexpression of mutant SP-B in the wild-type background may be lethal.
Assuntos
Apoproteínas/química , Proteínas Associadas a Surfactantes Pulmonares , Surfactantes Pulmonares/química , Animais , Apoproteínas/genética , Apoproteínas/metabolismo , Dissulfetos , Humanos , Camundongos , Camundongos Transgênicos , Mutação , Surfactantes Pulmonares/genética , Surfactantes Pulmonares/metabolismo , Relação Estrutura-AtividadeRESUMO
Allergen challenge in the lung of humans and animals is associated with surfactant dysfunction, but the mechanism of this effect has not been established. By using a murine model of asthma we now report the effect of allergen-induced airway inflammation on the expression of transgenes regulated by the human surfactant protein (hSP)-C promoter. The hSP-C 3.7-kilobase pair promoter was used to direct the expression of eotaxin, an eosinophil-selective chemokine, into the lungs of several transgenic lines. As expected, the transgenic mice expressed increased amounts of eotaxin mRNA and protein compared with wild-type mice. Surprisingly, following allergen challenge, there was a marked down-regulation of transgene mRNA in three independent transgenic lines. The down-regulation was in contrast to other related proteins such as endogenous eotaxin and surfactant protein D levels, which were both increased following allergen challenge. Consistent with specific down-regulation of the eotaxin transgene, there was no increase in pulmonary eosinophil levels in the transgenic mice above that found in wild-type mice. Analysis of hSP-C transgenic mice with distinct reporter genes and 3'-untranslated regions revealed that allergen challenge was directly affecting the hSP-C promoter. We hypothesized that allergen-induced down-regulation of the hSP-C promoter was related to the eosinophilic inflammation. To test this, we blocked eosinophilic inflammation in the lungs by treating mice with neutralizing antiserum against interleukin-5. Interestingly, this treatment also blocked allergen-induced inhibition of the hSP-C promoter. These results establish that allergic airway inflammation is associated with up-regulation of the surfactant proteins primarily involved in immunity, whereas down-regulation of the surfactant protein primarily involved in maintaining airway patency. Furthermore, the marked down-regulation of the hSP-C promoter is interleukin-5-dependent, implying a critical role for eosinophilic inflammation. These results suggest that alterations in surfactant protein levels may contribute to immune and airway dysfunction in asthma.
Assuntos
Asma/metabolismo , Quimiocinas CC , Citocinas/fisiologia , Interleucina-5/fisiologia , Regiões Promotoras Genéticas , Proteolipídeos/genética , Surfactantes Pulmonares/genética , Regiões 3' não Traduzidas/fisiologia , Animais , Asma/etiologia , Quimiocina CCL11 , Regulação para Baixo , Camundongos , Camundongos Transgênicos , Proteolipídeos/fisiologia , Surfactantes Pulmonares/fisiologia , TransgenesRESUMO
Two children were thought to have an atypical gastroduodenal motility disorder because of the history and clinical course; both had received parenteral alimentation because of claims of inability to tolerate enteral feedings, and both continued to have unusual medical problems during parenteral alimentation. Both children had motility studies that were interpreted by a pediatric gastroenterologist to be "abnormal" and "diagnostic" of a motility disorder, but each was eventually shown to have a behavioral abnormality related to Munchausen syndrome by proxy.
Assuntos
Gastroenteropatias/diagnóstico , Motilidade Gastrointestinal , Síndrome de Munchausen Causada por Terceiro/diagnóstico , Pré-Escolar , Erros de Diagnóstico , Gastroenteropatias/etiologia , Gastroenteropatias/terapia , Humanos , Lactente , Masculino , Manometria , Síndrome de Munchausen Causada por Terceiro/complicações , Nutrição Parenteral Total , Valores de ReferênciaRESUMO
Surfactant protein B (SP-B) is detected in the airways as a sulfhydryl-dependent dimer (M(r) approximately 16,000). To test the hypothesis that formation of homodimers is critical for SP-B function, the cysteine residue reported to be involved in SP-B dimerization was mutated to serine (Cys(248) --> Ser) and the mutated protein was targeted to the distal respiratory epithelium of transgenic mice. Transgenic lines which demonstrated appropriate processing, sorting, and secretion of human SP-B monomer were crossed with SP-B +/- mice to achieve expression of human monomer in the absence of endogenous SP-B dimer (hSP-B(mon), mSP-B-/-). In two of three transgenic lines, hSP-B(mon), mSP-B-/- mice had normal lung structure, complete processing of SP-C proprotein, well formed lamellar bodies, and normal longevity. Pulmonary function studies revealed an altered hysteresis curve for hSP-B(mon), mSP-B-/- mice relative to wild type mice. Large aggregate surfactant fractions from hSP-B(mon), mSP-B-/- mice resulted in higher minimum surface tension in vitro compared with surfactant from wild type mice. Surfactant lipids supplemented with 2% hSP-B monomer resulted in slower adsorption and higher surface tension than surfactant with 2% hSP-B dimer. Taken together, these data indicate a role for SP-B dimer in surface tension reduction in the alveolus.
Assuntos
Apoproteínas/metabolismo , Proteínas Associadas a Surfactantes Pulmonares , Surfactantes Pulmonares/metabolismo , Animais , Apoproteínas/química , Apoproteínas/genética , Dimerização , Humanos , Camundongos , Camundongos Transgênicos , Mutação , Surfactantes Pulmonares/química , Surfactantes Pulmonares/genética , Relação Estrutura-AtividadeRESUMO
Purified DNA from the liver of rats, mice, rabbits, and guinea pigs, from guinea pig lymph nodes, from hyperplastic nodules induced in rat liver by feeding with 2-(acetylamino)fluorene, and from Escherichia coli cells was made apurinic by reaction with diphenylamine. After chromatographic separation of pyrimidine tracts (isostichs or isoplyths) according to the number of contiguous pyrimidines, semilog plots of tract frequency vs. the number of contiguous pyrimidines were linear, plots for DNA from several sources differed from one another, and all deviated significantly from randomness. Similar semilog plots for coding sequences among 60 mammalian genomes or 28 rat tissue genomes were intermediate among slopes for isolated DNA. Individual isostichs were hydrolyzed, and their constituent pyrimidine bases were analyzed by high-pressure liquid chromatography. Among isostichs from isolated DNAs, the distribution of Thy and Cyt contents differed markedly from the distribution of 5-methylcytosine (5-Me-Cyt); e.g., although isostich 1 contained 45-49% of 5-Me-Cyt, amounts of Thy or Cyt did not exceed 25%. Semilog plots of normalized values for tract frequency or the content of 5-Me-Cyt vs. isostich number were essentially superimposable; thus, among the first five pyrimidine tracts of a particular tissue or E. coli DNA, the number of tracts per 5-Me-Cyt moiety was essentially constant. The data showed that 5-Me-Cyt and/or dCyd-dGuo dinucleotides have a distribution throughout DNA structure that superimposes the distribution of pyrimidine tract frequency and suggests that regulatory 5-Me-Cyt moieties are principally located at 3' termini of pyrimidine tracts.