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Abstract: The incidence of aplastic anemia is reported to be higher in Asia than elsewhere. We studied the frequency of human leukocyte antigen (HLA) DRB1 alleles in aplastic anemia patients from 2 genetically similar aboriginal groups, the Kadazan and the Dusun, and compared them with genetically matched community and hospital controls. HLA-DRB1*15 was significantly higher in the patients compared with controls (p = 0.005), confirming similar findings in Japanese and Caucasian studies. Further testing indicated a significantly higher frequency of HLA-DRB1*1501 in patients compared with controls (p = 0.0004) but no significant difference in the frequency of HLA-DRB1*1502. The high frequency of HLA-DRB1*15 in the Kadazan and Dusun population combined with the wide variety of environmental factors associated with aplastic anemia could be the reason for the elevated incidence of aplastic anemia in the Kadazan and Dusun in Sabah. [Copyright &y& Elsevier]

Abstract: Elective cosmetic surgeries are increasing in the American population with reasons linked to body image disturbance and body dysmorphic disorder (BDD). Little research exists documenting the continuum of body image disturbance and its relationship to seeking surgery. The present research examined data from 544 participants, 55 of whom were diagnosable with BDD. Using assessments for body image disturbance, problematic coping strategies, and BDD symptomatology, results provided evidence for a continuum of body image distress. Logistic regression analysis supported the hypothesis that increased levels of body image disturbance and one type of problematic coping strategy (Appearance Fixing) predicted consideration of cosmetic surgery. Of participants diagnosable with BDD, those who considered cosmetic surgery showed more severe body image disturbance and problematic coping than those who did not consider surgery. These results have implications for pre-surgical assessment as well as psychological interventions rather than invasive medical interventions. [Copyright &y& Elsevier]

Summary: The aim of this study was to describe factors affecting the sleep of parents of critically ill children and to determine strategies used to improve their sleep. One hundred and eighteen parents of 91 children recruited during their child''s paediatric intensive care unit stay responded in writing to open-ended questions assessing their experiences with sleep and eliciting ideas for strategies to promote sleep to be used by parents and provided by hospital staff. Patterns and concepts were coded and organised into themes using a qualitative descriptive approach. Seven themes emerged related to influences on and strategies to improve sleep: (1) the child''s condition; (2) being at the bedside or not; (3) difficult thoughts and feelings; (4) changes to usual sleep; (5) caring for self and family; (6) the hospital environment and (7) access to sleep locations. Parents described multiple, often competing, demands that affected their ability to achieve sleep, regardless of location. Many more factors that influenced sleep were described than strategies to improve sleep, highlighting the need for nurses to explore with parents the unique barriers and facilitators to sleep they encounter and to develop and rigorously test interventions to improve sleep. [Copyright &y& Elsevier]

Treatment rates with intravenously administered tissue plasminogen activator (IV-tPA) in acute ischemic stroke (IS) remain low in Asian populations. Various logistic obstacles and higher anticipated bleeding risk in Asians are major concerns. We report on the feasibility and safety of IV-tPA therapy at our tertiary care center. Consecutive acute IS patients eligible for thrombolysis were treated with low-dose (maximum 50 mg) IV-tPA between January 2000 and September 2006 and with standard-dose (maximum 90 mg) IV-tPA between October 2006 and May 2008. The efficacy of IV-tPA was assessed by the modified Rankin Scale (mRS) score at 3 months and by absolute changes in the National Institute of Health Stroke Scale (NIHSS) score at hospital discharge and 3 months. The safety of IV-tPA was assessed by the rate of symptomatic intracranial hemorrhage (SICH). A total of 130 patients were included (mean age, 60 ± 13years; 60% males; median NIHSS score, 14). A total of 48 patients received low-dose IV-tPA, and 82 patients received standard-dose IV-tPA. The median onset to treatment time was 160 minutes. Some 59% of the patients achieved functional independence (mRS score 0-1) at 3 months with standard-dose tPA, compared with 35% in the low-dose group (P = .011). SICH occurred more frequently with the low dose (14.5%) than with the standard dose (1.2%; P = .004). In a multivariate logistic regression model, lower admission NIHSS score (odds ratio [OR] = 0.78 per 1-point increase; 95% confidence interval [CI] = 0.70-0.88), lower pretreatment blood glucose level (OR = 0.76 per 1 mmol/L increase; 95% CI = 0.60-0.95), shorter time from symptom onset to IV-tPA bolus (OR = 0.97 per 1-minute increase; 95% CI = 0.94-1.0), and standard-dose IV-tPA (OR = 12.49; 95% CI = 2.9-53.89) were associated with a higher likelihood for functional independence at 3 months. Our data indicate that standard-dose IV-tPA (0.9 mg/kg) was feasible and safe for treating acute IS in our multiethnic Asian population in Singapore. [Copyright &y& Elsevier]

Autoinhibition plays a key role in the control of protein kinase activity. ErbB2 is a unique receptor-tyrosine kinase that does not bind ligand but possesses an extracellular domain poised to engage other ErbBs. Little is known about the molecular mechanism for ErbB2 catalytic regulation. Here we show that ErbB2 kinase is strongly autoinhibited, and a loop connecting the αC helix and β4 sheet within the kinase domain plays a major role in the control of kinase activity. Mutations of two Gly residues at positions 776 and 778 in this loop dramatically increase ErbB2 catalytic activity. Kinetic analysis demonstrates that mutational activation is due to ∼10- and ∼7-fold increases in ATP binding affinity and turnover number, respectively. Expression of the activated ErbB2 mutants in cells resulted in elevated ligand-independent ErbB2 autophosphorylation, ErbB3 phosphorylation, and stimulation of mitogen-activated protein kinase. Molecular modeling suggests that the ErbB2 kinase domain is stabilized in an inactive state via a hydrophobic interaction between the αC-β4 and activation loops. Importantly, many ErbB2 human cancer mutations have been identified in the αC-β4 loop, including the activating G776S mutation studied here. Our findings reveal a new kinase regulatory mechanism in which the αC-β4 loop functions as an intramolecular switch that controls ErbB2 activity and suggests that loss of αC-β4 loop-mediated autoinhibition is involved in oncogenic activation of ErbB2. [ABSTRACT FROM AUTHOR]

The epidermal growth factor receptor (EGFR) kinase catalyzes phosphorylation of tyrosines in its C terminus and in other cellular targets upon epidermal growth factor (EGF) stimulation. Here, by using peptides derived from EGFR autophosphorylation sites and cellular substrates, we tested the hypothesis that ligand may function to regulate EGFR kinase specificity by modulating the binding affinity of peptide sequences to the active site. Measurement of the steady-state kinetic parameters, Km and kcat, revealed that EGF did not affect the binding of EGFR peptides but increased the binding affinity for peptides corresponding to the major EGFR- mediated phosphorylation sites of the adaptor proteins Gab1 (Tyr-627) and Shc (Tyr-317), and for peptides containing the previously identified optimal EGFR kinase substrate sequence EEEEYFELV (3-7-fold). Conversely, EGF stimulation increased heat ∼5-fold for all peptides. Thus, ligand changed the relative preference of the EGFR kinase for substrates as evidenced by EGF increases of ∼5-fold in the specificity constants (kcat/Km) for EGFR peptides, whereas ∼15-40-fold increases were observed for other peptides, such as Gab1 Tyr-627. Furthermore, we demonstrate that EGF (i) increased the binding affinity of EGFR to Gab1 Tyr-627 and Shc Tyr- 317 sites in purified GST fusion proteins ∼4-6-fold, and (ii) EGF significantly enhanced the phosphorylation of these sites, relative to EGFR autophosphorylation, in cell lysates containing the full-length Gab1 and Shc proteins. Analysis of peptides containing amino acid substitutions indicated that residues C-terminal to the target tyrosine were critical for EGF-stimulated increases in substrate binding and regulation of kinase specificity. To our knowledge, this represents the first demonstration that ligand can alter specificity of a receptor kinase toward physiologically relevant targets. [ABSTRACT FROM AUTHOR]

Spermiogenesis is characterized by a profound morphological differentiation of the haploid spermatid into spermatozoa. The testis-specific serine/threonine kinases (TSSKs) comprise a family of post-meiotic kinases expressed in spermatids, are critical to spermiogenesis, and are required for male fertility in mammals. To explore the role of heat shock protein 90 (HSP90) in regulation of TSSKs, the stability and catalytic activity of epitope-tagged murine TSSKs were assessed in 293T and COS-7 cells. TSSK1, -2, -4, and -6 (small serine/threonine kinase) were all found to associate with HSP90, and pharmacological inhibition of HSP90 function using the highly specific drugs 17-AAG, SNX-5422, or NVP-AUY922 reduced TSSK protein levels in cells. The attenuation of HSP90 function abolished the catalytic activities of TSSK4 and -6 but did not significantly alter the specific activities of TSSK1 and -2. Inhibition of HSP90 resulted in increased TSSK ubiquitination and proteasomal degradation, indicating that HSP90 acts to control ubiquitin-mediated catabolism of the TSSKs. To study HSP90 and TSSKs in germ cells, a mouse primary spermatid culture model was developed and characterized. Using specific antibodies against murine TSSK2 and -6, it was demonstrated that HSP90 inhibition resulted in a marked decrease of the endogenous kinases in spermatids. Together, our findings demonstrate that HSP90 plays a broad and critical role in stabilization and activation of the TSSK family of protein kinases. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this study is to examine the glycemic response to common Chinese foods in patients with type 2 diabetes. Twenty-four Chinese adults with type 2 diabetes participated. Subjects were allocated to eat a pair of test meals in random order. Test meals included plain porridge with lean pork (meal 1A), plain porridge and Shrimp Shao Mai (Doll Brand, Winner Food Products Limited, Hong Kong) (meal 1B), boiled rice with boiled egg white (meal 2A), fried rice with whole egg (meal 2B), plain noodles in clear soup (meal 3A), and Pickled Vegetable and Pork-flavored Instant Bowl Noodles (Doll Brand, Winner Food Products Limited) (meal 3B). Nutritional content of the meals was calculated from the nutritional label on the food package and the food composition table. Plasma glucose was checked before the meal and in 30-minute intervals for up to 4 hours after the meal. Significant differences in the area under the curve of glucose up to 2 hours after the meal were detected between meal 1A and 2A (P=.044), 1A and 3A (P=.001), and 3A and 3B (P=.017). The results suggest that fat alone does not alter the glycemic response to rice or porridge. Porridge produces a higher glycemic response than rice and noodles despite similar carbohydrate contents, and different noodles lead to differences in glycemic excursion, suggesting that the glycemic index of common Chinese foods is affected by cooking methods and food processing. [Copyright &y& Elsevier]