Neutron stars as type-I superconductors.

In a recent paper by Link, it was pointed out that the standard picture of the neutron star core composed of a mixture of a neutron superfluid and a proton type-II superconductor is inconsistent with observations of a long period precession in isolated pulsars. In the following we will show that an appropriate treatment of the interacting two-component superfluid (made of neutron and proton Cooper pairs), when the structure of proton vortices is strongly modified, may dramatically change the standard picture, resulting in a type-I superconductor. In this case the magnetic field is expelled from the superconducting regions of the neutron star, leading to the formation of the intermediate state when alternating domains of superconducting matter and normal matter coexist.

Interactions of DNA with human DNA primase monitored with photoactivatable cross-linking agents: implications for the role of the p58 subunit.

Regulation of the p49-p58 primase complex during primer synthesis and the interaction of the primase subunits with DNA were examined. After primase synthesizes a primer that DNA polymerase alpha (pol alpha) can readily elongate, further primase activity is negatively regulated. This occurs within both the context of the four-subunit pol alpha-primase complex and in the p49-p58 primase complex, indicating that the newly generated primer-template species need not interact with pol alpha to regulate further primase activity. Photo-cross-linking of single-stranded DNA-primase complexes revealed that whereas the isolated p49 and p58 subunits both reacted with DNA upon photolysis, only the p58 subunit reacted with the DNA when photolysis was performed using the p49-p58 primase complex. After primer synthesis by the complex, p58 was again the only subunit that reacted with the DNA. These results suggest a model for regulation of primer synthesis in which the newly synthesized primer-template species binds to p58 and regulates further primer synthesis. Additionally, the ability of p58 to interact with primer-template species suggests that p58 mediates the transfer of primers from the primase active site to pol alpha.

Human DNA primase: anion inhibition, manganese stimulation, and their effects on in vitro start-site selection.

We examined the effects of Mn(2+) on eukaryotic DNA primase both in the presence and absence of 5 mM Mg(2+). In the absence of Mg(2+), Mn(2+)-supported primase activity to a level 4-fold greater than that obtained with Mg(2+) alone, and adding low levels of Mn(2+) (100 microM) to assays containing 5 mM Mg(2+) greatly stimulated primase. Increased activity was primarily due to more efficient utilization of NTPs, as reflected in a lower K(M) for NTPs. Under conditions of saturating NTPs, Mn(2+) had minimal effects on both the rate of initiation (i.e., dinucleotide synthesis) and processivity. The effects of Mn(2+) involve multiple metal binding sites on primase and may involve both the catalytic p49 subunit as well as the p58 subunit. Physiological levels of salt can inhibit primase activity due to the presence of an anion binding site and low levels of Mn(2+) significantly decreased this salt sensitivity. The implications of these results with respect to the biological role of primase are discussed.

Arg304 of human DNA primase is a key contributor to catalysis and NTP binding: primase and the family X polymerases share significant sequence homology.

Comparison of the amino acid sequences of eucaryotic DNA primase and the family X polymerases indicates that primase shares significant sequence homology with this family. With the use of DNA polymerase beta (pol beta) as a paradigm for family X polymerases, these homologies include both the catalytic core domain/subunit of each enzyme (31 kDa domain of pol beta and p49 subunit of primase) as well as the accessory domain/subunit (8 kDa domain of pol beta and p58 subunit of primase). To further explore these homologies as well as provide insights into the mechanism of primase, we generated three mutants (R304K, R304Q, and R304A) of the p49 subunit at an arginine that is highly conserved between primase and the eukaryotic family X polymerases. These mutations significantly decreased the rate of primer synthesis, due primarily to a decreased rate of initiation, and the extent of impairment correlated with the severity of the mutation (A > Q > K). R304 also contributes to efficient utilization of the NTP that will become the 5'-terminus of the new primer, and these effects are at least partially mediated through interactions with the phosphates of this NTP. The implications of these results with respect to the structure and biological role of primase, as well as its relationship to the family X polymerases, are discussed.

Eucaryotic DNA primase does not prefer to synthesize primers at pyrimidine rich DNA sequences when nucleoside triphosphates are present at concentrations found in whole cells.

The critical role of NTP concentration in determining where calf thymus DNA primase synthesizes a primer on a DNA template was examined. Varying the concentration of NTPs dramatically altered the template sequences at which primase synthesized primers. At the low NTP concentrations typically used for in vitro experiments (100 microM), primase greatly preferred to synthesize primers at pyrimidine rich DNA sequences. However, when the concentrations of NTPs were increased to levels typically found in whole cells, primers were now synthesized in all regions of the template. Importantly, synthesis of primers in all regions of the DNA template, not just the pyrimidine rich sequences, is the pattern of primer synthesis observed during DNA replication in whole cells. With low concentrations of NTPs (i.e., Vmax/K(M) conditions), primers are only synthesized at the most preferred synthesis sites, namely, those that are pyrimidine rich. In contrast, under conditions of high NTP concentrations, primer synthesis will occur at the first potential synthesis site to which primase binds. Now, the primase x DNA complex will be immediately converted to a primase x DNA x NTP x NTP complex that is poised for primer synthesis.

Sleep in postpolio syndrome.

Post-polio patients may develop additional neuromuscular and respiratory symptoms decades after the acute attack, the post-polio syndrome. We hypothesize some post-polio symptoms may be due to breathing disorders occurring during sleep. We performed polysomnography on 13 post-polio patients: group 1 (five patients) were those already on ventilatory assistance (rocking beds) and group 2 (eight patients), those without any assistance. Patients requiring new treatment were then evaluated on nasal CPAP or nasal mask ventilation. Group 1 patients, on rocking beds, demonstrated consistently poor sleep quality with decreased total sleep time, sleep efficiency, percentage stage 2, slow wave sleep, rapid eye movement sleep and an increase in the number of arousals and percentage stage 1 sleep. Respiratory abnormalities were also present and in all cases caused significant O2 desaturation. These patients did not respond to CPAP with the rocking bed. Repeat night-time polysomnography on nasal mask ventilation demonstrated an improvement in sleep structure and gas exchange. Three group 2 patients, (group 2a) had sleep within normal limits. The five remaining (group 2b) had poor sleep quality that was similar to but not as disrupted as group 1 patients. All but one patient demonstrated obstructive or mixed apnea and were treated effectively with nasal CPAP. One patient required nasal mask ventilation (due to mixed apnea and marked hypoventilation) to which there was a dramatic response. These patients demonstrated improved sleep quality and an improvement in daytime symptomatology. Sleep studies should be performed on post-polio patients with excessive daytime sleepiness and respiratory complaints. Those with obstructive and mixed apnea can often be treated with nasal CPAP. Those with hypoventilation syndrome and sleep apnea attributable to sleepiness and respiratory complaints. Those with obstructive and mixed apnea can often be treated with nasal CPAP. Those with hypoventilation syndrome and sleep apnea attributable to respiratory muscle weakness can be treated with nasal mask ventilation. Individuals already on respiratory assistance such as rocking beds who have features of respiratory failure can also be treated effectively with long-term nasal mechanical ventilation.

Evaluation of hospital-based cardiac resuscitation, 1973--77.

The resuscitation experience of a large teaching hospital during 1973-77 was reviewed. Resuscitation was attempted on 2091 victims of cardiac arrest; 261 patients (12.5%) survived to be discharged from hospital.Coronary heart disease caused about one half of all the cardiac arrests, but was associated with a better survival rate (14.4%) than the other causes. Cardiac arrest following multiple trauma had the worst prognosis; only 3% of the patients survived to be discharged from hospital. However, the main factor influencing outcome was the site of arrest. The survival rates of patients on whom resuscitation was initiated in the emergency room or an intensive care area were triple and double the rate for patients in hospital wards, although one third of all the cardiac arrests induced by a coronary event and occurring in hospital were on the wards. Patients whose arrest occurred outside hospital, where only basic life support was available, had a survival rate of just 6.3%, whereas those whose arrest occurred in the emergency room had a survival rate of 31.9%. Since these two patient groups were similar in terms of age and diagnosis, we believe that the potential survival rate for victims of cardiac arrest outside of hospital that are optimally treated is close to 30%.These data suggest that increased survival from cardiac arrest can be expected with extension of the resuscitation services both inside and outside of hospital, but particularly with increased emphasis on emergency cardiac care outside of hospital.

Balloon catheter re-expansion of atelectatic lung.

Selective re-inflation of the lung with lobar atelectasis was carried out in four patients who were receiving mechanical ventilation. The increased pressure and volume were delivered mainly to the atelectatic lung by momentary obstruction of mainstem bronchus of the uninvolved lung with a balloon-tipped catheter. Blood gases and chest x-rays following the procedure showed improvement in oxygenation with prompt re-expansion of the atelectatic lung. The described procedure is recommended in atelectasis involving major portions of the lung with severe hypoxemia not responding to aggressive conventional treatment.

A simplified method for determining the P50 of blood.

A method to determine the P50 of whole blood is described using a modified American Optical reflectance oximeter, pump, and membrane tonometer, together with PO2, PCO2, and pH measurements in a standard blood gas machine. Determinations of P50 were made in 66 patients and normal subjects and in two situations where P50 was very low and very high. The results were compared to oxygen saturations calculated from measured oxygen content. The directly determined oxygen saturation agreed with the assumed saturation of 50 per cent in the oximeter within 0.5 per cent. The apparatus appears to be a simple and relatively inexpensive method to obtain P50 as long as blood carboxyhemoglobin or methemoglobin contents are not elevated.