Proton n.m.r. spectroscopic evidence for sulfur-aromatic interactions in peptides

The downfield shift of the tyrosyl proton resonances and an increased chemical shift difference between the resonances for the 2′, 6′ and 3′,5′ hydrogens in a series of deamino-oxytocin analogs modified in the disulfide bridge provide evidence for aromatic-sulfur interactions in d₆ -dimethylsulfoxide solutions.     

A Special Outpatient Clinic for Following Patients with Implanted Tachyarrhythmia Devices

Implantable anti-tachycardia devices have become an additional therapeutic option for those patients afflicted with life-threatening tachyarrhythmias. Follow-up of these complex devices are time-consuming and, if mismanaged, may be dangerous to the patient. For these reasons, a special anti-tachycardia device clinic was started at Newark Beth Israel Medical Center in July 1984. From the inception of the clinic to September 1985, 24 patients were followed. Seventy-five percent had antitachycardia devices (ATDs) implanted for treatment of ventricular tachyarrhythmias (VT/VF) with the remaining 25% for supraventricular tachycardias. All patients were seen every 3 months or more often if clinically required. Of 112 clinic examinations, 102 (91%) were scheduled appointments (group I) while the remaining 10 visits (group II) were unscheduled and preceded by symptomatic episodes. The problems detected in clinic (groups I and II) ranged from sudden failure of an AICD to apprehension. Appropriate nonoperative treatment was given during clinic evaluation for 60% of the problems detected in group II, while the remaining 40% required eventual surgical intervention. Compliance throughout the 15-month follow-up period was 100%. Major benefits of the clinic cited by patients and their families were continuity of care, the time allotted to meet the individual needs, and management of most problems on an out-patient basis.     

Synthetic glucagon antagonists and partial agonists

This paper reports the synthesis and the biological activities of six new glucagon analogues. In these compounds N-terminal modifications of the glucagon sequence were made, in most cases combined with changes in the C-terminal region which had been shown previously to enhance receptor affinity. The design of these analogues was based on [Lys^17.18,Glu²¹]glucagon,¹ a superagonist, which binds five times better than glucagon to the glucagon receptor, and on the potent glucagon antagonist [d -Phe⁴,Tyr⁵,Arg¹²]glucagon, which does not stimulate adenylate cyclase system even at very high concentrations. The N-terminal modifications involved substitution of His¹ by the unnatural conformationally constrained residue, 4,5,6,7-tetrahydro-1H-imidazo[c]pyridine-6-carboxylic acid (Tip) and by desaminohistidine (dHis). In addition we prepared two analogues (6 and 7), in which we deleted the Phe⁶ residue, which was suggested to be part of a hydrophobic patch and involved in receptor binding. The following compounds were synthesized: [Tip¹, Lys^17.18,Glu²¹]glucagon (2); [Tip¹,d -Phe⁴,Tyr⁵,Arg¹²,Lys^17.18,Glu²¹ glucagon (3); [dHis¹,d -Phe⁴,Tyr⁵,Arg¹², Lys^17.18,Glu²¹ glucagon (4); [dHis¹,Asp³,d -Phe⁴,Tyr⁵,Arg¹²,Lys^17.18,Glu²¹]glucagon (5); des-Phe⁶-[Tip¹,D-Phe⁴,Tyr⁵Arg¹²,Glu²¹ glucagon (6); des-Phe⁶-[Asp³,d -Phe⁴,Tyr⁵,Arg¹²,Glu²¹]glucagon (7) The binding potencies of these new analogues relative to glucagon (= 100) are 3.2 (2), 2.9 (3), 10.0 (4), 1.0 (5), 8.5 (6), and 1.7 (7). Analogue 2 is a partial agonist (maximum stimulation of adenylate cyclase (AC) approximately 15% and a potency 8.9% that of glucagon, while the remaining compounds 3-7 are antagonists unable to activate the AC system even at concentrations as high as 10^?5m . In addition, in competition experiments, analogues 3-7 caused a right-shift of the glucagon stimulated adenylate cyclase dose-response curve. Hence these compounds are glucagon receptor antagonists with respect to the glucagon receptor coupled to the adenylate cyclase system.     

Comparative biological activities of potent analogues of α-melanotropin

Several α-melanotropin (α-MSH) analogues with para substituted aromatic and nonaromatic amino acids in the 7-position of the hormone were prepared and their melanotropic activities determined in the frog (Rana pipiens) and lizard (Anolis carolinensis) skin bioassays. D and L-Phe(p-NO₂), D- and L-Tyr, D- and L-Ala, and Gly were substituted in the 7-position. The use of substituted D or L-aromatic amino acids in the 7th position of the central Ac-[Nle⁴] -α-MSH_4–11 - NH₂ fragment resulted in a loss in potency relative to the corresponding phenylalanine-containing analogue. The loss in potency cannot be due entirely to steric hindrance at the melanophore receptor, since nonaromatic amino acids substituted in the 7th position of this octapeptide fragment also generally led to a loss in biological activity. We reported previously that replacement of phenylalanine-7 by its D enantiomer led to a marked increase in potency in each fragment analogue tested. Analogues containing other D amino acids in the 7th position also were more potent than their L amino acid-containing analogues with one exception: Ac-[Nle⁴, Ala⁷]-α-MSH_4–11-NH₂ was more potent than Ac-[Nle⁴, D-Ala⁷]-α-MSH_4–11-NH₂ in the frog skin bioassay. Replacement of phenylalanine-7 by glycine resulted in a large decrease in potency in both bioassays, illustrating the importance of the side chain group, in this position of α-MSH, to biological potency of the hormone.     

Screening for breast cancer in Catalonia: Which policy is to be preferred?

Background: the effects and costs of different policies forbreast cancer screening in Catalonia (Spain) were analysed,to give a basis for setting priorities and deciding on the introductionof a screening programme. Methods: the MISCAN (MIcrosimulationSCreening ANalysis) model of the natural history of breast cancerwas used. The epidemiology of breast cancer in Catalonia andthe demography of the Catalan population was taken into accountas well as the results on mortality reduction from a Swedishoverview of breast cancer screening trials. Results: the reductionin breast cancer mortality in the total female population dueto a screening programme for the age group 50–64 yearswould be 16, 12 and 9%, with screening intervals of one, twoand three years respectively. The cost-effectiveness ratios(CE ratios) for these scenarios were 924,000, 730,000 and 719,000pesetas (P_t) per life-year gained respectively (5% discounting).The most cost-effective screening scenario is the one in whichwomen aged 50–69 years are screened with an interval ofthree years with a mortality reduction of approximately 12%in the total female population (CE ratio = 694,000 P_t). Screeninguntil the age of 69 years (two year interval) was almost ascost-effective as screening the age group 50–64 yearswith a two year interval, with a reduction in breast cancermortality of 15%. Extension to under the age of 50 years resultedin diverging results depending on the assumptions for improvementin prognosis for younger women (40–49 years). Conclusion:if the extension of a two yearly screening programme for womenaged 50–64 years is considered (mortality reduction of12%), extension to older women would be more advisable, basedon proven benefits and costs, than extension to younger agegroups.     

Atypical Case of Pott's Disease

An unusual case of Pott's Disease in an adult, Australian born, Caucasian male is reported. The typical and atypical radiological features of spinal tuberculosis are reviewed.