Evaluation and implementation of strategies to reduce the intravenous admixture returns

Background and objectivesPharmaceutical sterile wastes are not only environmental hazard but an economical loss. There are many strategies employed in various parts of the world for minimizing the parenteral admixture returns in hospitals, however, they are not practiced in Saudi Arabia. Therefore, this study was done to assess the impact of a) intravenous (IV) pharmacy round and b) twice daily batching, as reduction strategies on the number of IV admixture returns and the associated cost of medication wastage.MethodThis study was conducted at the central IV room of the in-patient pharmacy unit at King Fahad Medical City, Riyadh, Saudi Arabia for general intensive care unit (ICU) IV returns. Phase 1 of the study was intended to measure the baseline parameters, while the Phase 2 and 3 were measured with the application of IV pharmacy round plan, and twice-daily batching strategies, respectively. Comparison of IV returns were done in each of the phases and economical loss was calculated.ResultsOut of number of IV admixtures prepared and supplied to ICU during a month, 4.85% of the items were deemed wasted during baseline phase with as estimated cost of IV wasted items to be 2,128.02 USD. In the IV pharmacy round and twice-daily batching strategies, the percentage of the wasted items decreased to 4.27% and 3.73%, respectively. Moreover, there is 13.84% and 42. 48% reduction in the estimated cost in the wasted items in, pharmacy round and twice-daily batching strategies, respectively, compared to baseline phase.ConclusionImplementation of interventions caused reduction in total recycled, wasted items and the associated cost of medication wastage of sterile pharmaceutical preparations. Twice daily batching strategy has better effect in decreasing the IV returns and its associated cost.     

The expression of T-cell surface antigens CTLA-4, CD26, and CD28 is modulated by inhibition of dipeptidylpeptidase IV (DPP IV,CD26) activity in murine stress-induced abortions

Inhibition of DPP IV has been shown to abrogate the stress-related increase in murine abortions and a concomitant increase in gamma-interferon. The aim of the present study was to investigate a potential impact of the DPP IV inhibitor Isoleucine Cyanopyrrolidide on the expression of surface antigens involved in T-cell responses. DBA/2-mated CBA mice were stressed on day 5.5 of pregnancy and received injections of a DPP IV inhibitor. On day 13 of gestation, the animals were sacrificed and the percentage of abortions was determined. As shown before, stress failed to boost the abortion rate in mice receiving the DPP IV inhibitor. In stressed animals, a lower surface density of CTLA-4 on decidual CD26-positive lymphocytes was observed than in non-stressed animals. Inhibition of DPP IV restored CTLA-4 surface density to normal and decreased surface expression of CD26 and CD28 on decidual lymphocytes irrespective of stress exposure. These observations suggest that a modulation of T-cell surface antigens expression due to inhibition of DPP IV activity may contribute to the potent anti-abortogenic effect observed here.     

A new fluorescence assay for dipeptidyleptidase IV using tripeptide l-prolyl-l-prolyl-l-alanine as substrate

We have developed a new fluorescence assay for dipeptidylpeptidase IV using a tripeptide, l-prolyl-l-prolyl-l-alanine, which might be one of the potential natural substrates. The principle of the assay is based on the measurement of fluorescent adduct between alanine liberated from the tripeptide by enzymatic hydrolosis and o-phthaldialdehyde in the presence of 2-mercaptoethanol in aqueous alkaline medium. This new assay is sensitive enough to measure the enzyme activity in as little as 0.01 μl of human serum and in crevicular fluid obtained from human gingival sulcus. The K_m value for the tripeptide was 1.7 · 10^?5 M which is less than one-tenth of that obtained with other chromogenic or fluorogenic substrates. The interference by serum was overcome by simply incorporating the same amount of serum in the standards.     

Twitching motility in Legionella pneumophila

Twitching motility is a form of bacterial translocation over solid or semi-solid surfaces mediated by the extension, tethering, and subsequent retraction of type IV pili. These pili are also known to be involved in virulence, biofilm formation, formation of fruiting bodies, horizontal gene transfer, and protein secretion. We have characterized the presence of twitching motility on agar plates in Legionella pneumophila , the etiological agent of Legionnaires' disease. By examining twitching motility zones, we have demonstrated that twitching motility was dependent on agar thickness/concentration, the chemical composition of the media, the presence of charcoal and cysteine, proximity to other bacteria, and temperature. A knockout mutant of the pilus subunit, pilE , exhibited a total loss of twitching motility at 37 °C, but not at 27 °C, suggesting either the existence of a compensating pilus subunit or of another twitching motility system in this organism.     

Comparison of the susceptibility of porcine and human dipeptidyl-peptidase IV to inhibition by protein-derived peptides

The enzyme dipeptidyl-peptidase IV (DPP-IV) is recognized to be a promising target for the management of type 2 diabetes. Over the last decade, numerous synthetic molecules and more recently, peptides from dietary proteins, have been reported to be able to inhibit DPP-IV activity. Most studies that have investigated the in vitro effect of these inhibitors have used porcine or human DPP-IV. Although structurally alike, it is unclear whether these two species display similar inhibition patterns. Therefore, the objective of this study was to compare the effects of protein-derived peptides on the activity of porcine and recombinant human DPP-IV. The two species showed different inhibition susceptibility to 43 of the 62 peptide sequences investigated. While 37 protein-derived peptides were more effective at inhibiting the porcine DPP-IV, only six caused a stronger inhibition of the activity of the human enzyme. Although the peptides WR, IPIQY and WCKDDQNPHS were found to be among the most potent inhibitors of both species, the inhibitory effect was greater on the porcine enzyme than on human DPP-IV (αK_i or K_i = 11.5, 13.4, 13.3 μM and 31.4, 28.2, 75.0 μM for porcine and human DPP-IV, respectively). Investigation into the mode of action of the most effective inhibitory peptides revealed that both species were inhibited in a similar manner by short fragments (≤5 amino acid residues), but that some of the longer peptides acted differently on the enzymes. This study shows that porcine DPP-IV is generally inhibited with greater potency by protein-derived peptides than is the human enzyme.     

Towards a systems biology approach to study type II/IV secretion systems

Many gram-negative bacteria produce thin protein filaments, named pili, which extend beyond the confines of the outer membrane. The importance of these pili is illustrated by the fact that highly complex, multi-protein pilus-assembly machines have evolved, not once, but several times. Their many functions include motility, adhesion, secretion, and DNA transfer, all of which can contribute to the virulence of bacterial pathogens or to the spread of virulence factors by horizontal gene transfer. The medical importance has stimulated extensive biochemical and genetic studies but the assembly and function of pili remains an enigma. It is clear that progress in this field requires a more holistic approach where the entire molecular apparatus that forms the pilus is studied as a system. In recent years systems biology approaches have started to complement classical studies of pili and their assembly. Moreover, continued progress in structural biology is building a picture of the components that make up the assembly machine. However, the complexity and multiple-membrane spanning nature of these secretion systems pose formidable technical challenges, and it will require a concerted effort before we can create comprehensive and predictive models of these remarkable molecular machines.     

碳酸酐酶Ⅳ与人类疾病

碳酸酐酶4（carbonic anhydrase 4,CAIV）是12种人类相关碳酸酐酶中的一员,主要通过糖基磷脂酰基醇锚定在细胞质膜上。哺乳动物的多个器官有CAIV的表达。CAIV高效催化CO2的水化和HCO3–的脱水反应,在尿液酸化、肺泡换气等生理反应中起重要作用。CAIV基因表达的变化、结构稳定性的破坏和活性的改变等均与人类多种疾病的发生发展密切相关。CAIV还可以作为药物治疗靶点应用于疾病治疗。为此,该文就CAIV与人类相关疾病发生的病理生理机制作一综述。     

前列腺细胞REGⅣ基因功能的初步研究

目的:探讨人再生基因Ⅳ(REGIV)在前列腺细胞中的表达及意义.方法:构建REGIV基因的全序列过表达质粒.将全序列过表达质粒采用脂质体转染的方式转入前列腺细胞系PC-3中.应用Real-time-PCR方法检测REGIV基因mRNA表达,Westembloting检测REGIV基因蛋白质表达,MTT法分析细胞增殖活性.结果:通过荧光显微镜观察计数,细胞转染成功.REGIV基因的全序列过表达使REGIV基因mRNA的表达,蛋白表达提高,细胞增殖能力增强.结论:应用全序列过表达技术可以使前列腺癌REGIV表达水平特异性增高.前列腺癌增值能力的增强说明REGW可能与肿瘤快速增长有关.     

Design and synthesis of potent amido- and benzyl-substituted cis-3-amino-4-(2-cyanopyrrolidide)pyrrolidinyl DPP-IV inhibitors

The cis-3-amino-4-(2-cyanopyrrolidide)-pyrrolidine template has been shown to afford low nanomolar inhibitors of human DPP-IV that exhibit a robust PK/PD profile. An X-ray co-crystal structure of 5 confirmed the proposed mode of binding. The potent single digit DPP-IV inhibitor 53 exhibited a preferred PK/PD profile in preclinical animal models and was selected for additional profiling.     

Restriction fragment length polymorphism analysis of major histocompatibility complex class IV (B-G) genotypes in meat-type chickens

Restriction fragment length polymorphism (RFLP) was used as a molecular genotyping approach to characterize differences in major histocompatibility complex class IV genes in meat-type chickens. A high level of polymorphism was observed following digestion with each of the two restriction endonucleases PvuII and BglII. Examination of DNA from 54 chickens revealed 23 polymorphic fragments. Application of RFLP techniques in the analysis of family groups should make possible the determination of B-G genotypes in the meat type chickens.     

An efficient cloning of DNA fragments by a method based on uracil-DNA glycosylase and endonuclease IV

We introduced a novel method to clone random DNA fragments independent of ligation reaction. The method involves the generation of long protruding ends on PCR amplification DNA. Both oligonucleotides used for the amplification of the vector DNA carried one uracil residue at the tenth position from the 5′ end and this made the creation of the 3′ protruding ends of linearized vector possible by uracil-DNA glycosylase (UDG) and endonuclease IV (Endo IV). 76 groups of annealed oligonucleotides that had ten-nucleotides protruding at 3′-end, which were complementary to those at 3′-end of the linearized vector, were designed. The linearized vector and the annealed oligonucleotide were mixed together to transform E.coli directly without ligation reaction. The number of the clone that grew on the plates had been demonstrated to reach 1 × 10⁵ transformants/μg and 96.1% of transformants harbored the cloned fragments. From the results of transformation, we can confirm that the efficiency of the creation of 3′ protruding ends in our method is high and our cloning method is benefit to produce recombinants easily and efficiently.     

Ⅳ型菌毛可视化方法及其在菌毛功能研究中的应用

Ⅳ型菌毛(type Ⅳ pili, TFP)作为细菌表面的重要蛋白结构，是细菌的感知器官及运动器官，在细菌生理学、细胞黏附、宿主细胞入侵、DNA摄取、蛋白质分泌、生物被膜形成、细胞运动和电子传递等方面发挥着多种作用。近年来，随着研究方法的深入和技术设备的发展，尤其是随着多种菌毛可视化工具的开发，越来越多的研究揭示了它在生命活动中的各种功能，大大加快了微生物单细胞领域的研究步伐。本文重点讨论了TFP可视化方法及在菌毛功能研究中的应用，为更好地研究和利用TFP功能提供更多的思路，为其未来在生物学、医学以及生态学中的应用提供一定的理论基础。     

Cytochrome c oxidase subunit IV is essential for assembly and respiratory function of the enzyme complex

Cytochrome c oxidase or complex IV, catalyzes the final step in mitochondrial electron transfer chain, and is regarded as one of the major regulation sites for oxidative phosphorylation. This enzyme is controlled by both nuclear and mitochondrial genomes. Among its 13 subunits, three are encoded by mitochondrial DNA and ten by nuclear DNA. In this work, an RNA interference approach was taken which led to the generation of mouse A9 cell derivatives with suppressed expression of nuclear-encoded subunit IV (COX IV) of this complex. The amounts of this subunit are decrease by 86% to 94% of normal level. A detail biosynthetic and functional analysis of several cell lines with suppressed COX IV expression revealed a loss of assembly of cytochrome c oxidase complex and, correspondingly, a reduction in cytochrome c oxidase-dependent respiration and total respiration. Furthermore, dysfunctional cytochrome c oxidase in the cells leads to a compromised mitochondrial membrane potential, a decreased ATP level, and failure to grow in galactose medium. Interestingly, suppression of COX IV expression also sensitizes the cells to apoptosis. These observations provide the evidence of the essential role of the COX IV subunit for a functional cytochrome c oxidase complex and also demonstrate a tight control of cytochrome c oxidase over oxidative phosphorylation. Finally, our results further shed some insights into the pathogenic mechanism of the diseases caused by dysfunctional cytochrome c oxidase complex.     

AT4 receptor structure-binding relationship: N-terminal-modified angiotensin IV analogues

The effect of structural changes in the N-terminal amino acid of AIV, with respect to AT₄ receptor binding, was examined by competition with [¹²⁵I]AIV in bovine adrenal membranes. Analogues with modifications of the first residue -amino group possessed lower affinities than the primary amine-containing parent compound. Peptides with a residue 1 -carbon in the conformation exhibited poor affinity for the AT₄ receptor. Modifications of the residue 1 R-group demonstrate that a straight chain aliphatic moiety containing four carbons is optimal for receptor-ligand binding, as evidenced by the extremely high affinity of [Nle¹]AIV (K_i = 3.59±0.51 pM). Replacement of the 1–2 peptide bond of AIV with the methylene bond isostere Ψ (CH₂-NH), increased the K_i approximately fivefold, indicating that the peptide bond may be replaced wihle maintaining relatively high-affinity receptor binding.     

A novel biotransformation of astragalosides to astragaloside IV with the deacetylation of fungal endophyte Penicillium canescens

Under the deacetylation of fungal endophyte Penicillium canescens, which was isolated from pigeon pea, a novel and highly efficient biotransformation method of astragalosides to astragaloside IV in Radix Astragali was investigated. After single factor tests of the biotransformation procedure, the optimum biotransformation conditions were confirmed as the liquid solid ratio 20:1, the biotransformation temperature 30 °C, time 36 h and pH 7, respectively. Final content of astragaloside IV in Radix Astragali reached 7.66 ± 0.44 mg/g, which was 5.51-fold to that of untreated one and contents of astragaloside I and astragaloside II significantly decreased. The immobilized Ca-alginate gel beads with P. canescens could be reused at least for 13 runs. This is the first report that fungal endophyte was applied for the biotransformation of astragalosides to astragaloside IV in Radix Astragali and this novel high-efficiency biotransformation method will be an alternative to enhance the content of astragaloside IV in Radix Astragali in commercial process.     

The metaeffector MesI regulates the activity of the Legionella effector SidI through direct protein–protein interactions

To create an intracellular niche permissive for its replication, Legionella pneumophila uses hundreds of effectors to target a wide variety of host proteins and manipulate specific host processes such as immune response, and vesicle trafficking. To avoid unwanted disruption of host physiology, this pathogen also imposes precise control of its virulence by the use of effectors called metaeffectors to regulate the activity of other effectors. A number of effector/metaeffector pairs with distinct regulatory mechanisms have been characterized, including abrogation of protein modifications, direct modification of the effector and direct binding to the catalytic pocket of the cognate effector. Recently, MesI (Lpg2505) was found to be a metaeffector of SidI, an effector involved in inhibiting host protein translation. Here we demonstrate that MesI functions by inhibiting the activity of SidI via direct protein–protein interactions. We show that this interaction occurs within L. pneumophila and thus interferes with the translocation of SidI into host cells. We also solved the structure of MesI, which suggests that this protein does not have an active site similar to any known enzymes. Analysis of deletion mutants allowed the identification of regions within SidI and MesI that are important for their interactions.     

Specific binding of collagen type IV to Streptococcus pyogenes

Many strains of Streptococcus pyogenes are capable of binding type IV collagen. In the present study, all 50 S. pyogenes strains isolated from patients with acute glomerulonephritis showed high or moderate affinity for radiolabelled type IV collagen. A majority of strains of other sources, such as reference strains of various M-types and strains isolated from patients with pharyngeal infections also bound type IV collagen; however, a number of weak binders or non-binders were found among those. The collagen type IV binding component(s) on S. pyogenes were susceptible to proteinase K digestion, partially sensitive to trypsin but insensitive to pepsin treatment at pH 5.5. According to tests with three M-positive strains and their M-negative derivatives, the binding was not dependent on M-protein. The binding was saturable with time and inhibited by unlabelled type IV collagen. Partially inhibition was found with type II collagen, gelatin and fibrinogen but not with a number of other serum proteins.     

IV estimation without distributional assumptions

It is widely known that Instrumental Variable (IV) estimation allows the researcher to estimate causal effects between an exposure and an outcome even in face of serious uncontrolled confounding. The key requirement for IV estimation is the existence of a variable, the instrument, which only affects the outcome through its effects on the exposure and that the instrument–outcome relationship is unconfounded. Countless papers have employed such techniques and carefully addressed the validity of the IV assumption just mentioned. However, less appreciated is that fact that the IV estimation also depends on a number of distributional assumptions in particular linearities. In this paper, we propose a novel bounding procedure which can bound the true causal effect relying only on the key IV assumption and not on any distributional assumptions. For a purely binary case (instrument, exposure, and outcome all binary), such boundaries have been proposed by Balke and Pearl in 1997. We extend such boundaries to non-binary settings. In addition, our procedure offers a tuning parameter such that one can go from the traditional IV analysis, which provides a point estimate, to a completely unrestricted bound and anything in between. Subject matter knowledge can be used when setting the tuning parameter. To the best of our knowledge, no such methods exist elsewhere. The method is illustrated using a pivotal study which introduced IV estimation to epidemiologists. Here, we demonstrate that the conclusion of this paper indeed hinges on these additional distributional assumptions. R-code is provided in the Supporting Information.     

GM2-Ganglioside Metabolism In Situ in Mucolipidosis IV Fibroblasts

Mucolipidosis IV (ML IV) is an inherited lysosomal disorder for which the primary biochemical defect has not been identified. In order to detect any defect in glycosphingolipid metabolism, we have examined the metabolism of sphingosine-labeled (³H)G_M2 in situ in fibroblasts from patients diagnosed with ML IV. Fibroblasts were exposed for 10 days in medium containing (³H)G_M2 (15 uM; Sp. Act. 35000 cpm/nmole), washed, harvested and analyzed for radioactivity in extracted lipids. Control cells metabolized about half of the internalized ganglioside, mostly to ceramide. In ML IV fibroblasts, 70–80% of the cellular radioactivity was present as G_M2 indicating reduced degradation. This is not as severe as in G_M2 gangliosidosis as a small amount of G_M2 was metabolized in ML IV cells to ceramide. Since there is no defect in the lysosomal enzyme profile in these cells, it is possible that an abnormality in the translocation of membrane constituents to the lysosomes may explain the slower ganglioside metabolism.