Specialised information systems: diabetes care.

This chapter describes some of the ways in which IT can be applied to the clinical management of diabetes, considering both clinical information management and decision support. At a methodological level issues addressed range from requirements analysis and specification to evaluation. From a clinical perspective the benefits that can arise and the challenges still to be faced are discussed.

Free radicals and hearing. Cause, consequence, and criteria.

Reactive oxygen and nitrogen species, including free radicals, are produced in the human body in both health and disease. In health, they may arise as regulatory mechanisms, intercellular signaling species, or as bacteriocidal agents. Their production is normally controlled by the antioxidant defense mechanisms that include intracellular enzymes--for example, glutathione peroxidase and superoxide dismutase--and low molecular-mass compounds such as vitamin E or ascorbic acid.

Determination of oxidative DNA base damage by gas chromatography-mass spectrometry. Effect of derivatization conditions on artifactual formation of certain base oxidation products.

GC-MS is a widely used tool to measure oxidative DNA damage because of its ability to identify a wide range of base modification products. However, it has been suggested that the derivatization procedures required to form volatile products prior to GC-MS analysis can sometimes produce artifactual formation of certain base oxidation products, although these studies did not replicate previously-used reaction conditions, e.g.

Conjugates of catecholamines with cysteine and GSH in Parkinson's disease: possible mechanisms of formation involving reactive oxygen species.

Oxidation of L-3,4-dihydroxyphenylalanine (L-DOPA) and dopamine (DA) to generate semiquinones/quinones, oxygen radicals, and other reactive oxygen species may play a role in neuronal cell death in Parkinson's disease (PD). In particular, semiquinones/quinones can form conjugates with thiol compounds such as GSH and cysteine. Exposure of L-DOPA, DA, and other catecholamines to a system generating O2.

Scavenging of hydroxyl radicals but not of peroxynitrite by inhibitors and substrates of nitric oxide synthases.

1. The nitric oxide synthase inhibitor NG-nitro-L-arginine methyl ester (L-NAME) is widely used to study the role of NO. in physiological and pathological processes, including its role in the generation of the cytotoxic species peroxynitrite (ONOO-) and of reactive oxygen radicals such as hydroxyl (OH.

Antioxidant action of ergothioneine: assessment of its ability to scavenge peroxynitrite.

The superoxide radical (O.2-) and nitric oxide (NO.) combine very rapidly to form peroxynitrite (ONOO-), a reactive tissue damaging nitrogen species thought to be involved in the pathology of several chronic diseases.

Scavenging of hypochlorous acid by carvedilol and ebselen in vitro.

1. The antihypertensive drug carvedilol and the antiinflammatory selenoorganic compound ebselen were tested for their ability to react with the reactive oxygen species hypochlorous acid (HOCl) in vitro. 2.

Antioxidant properties of S-adenosyl-L-methionine: a proposed addition to organ storage fluids.

Glutathione (GSH) depletion adversely affects the survival of organ grafts. Supplementation of commercial organ preservation solutions with GSH is complicated by the ease of oxidation of its thiol group and its ability to act as a pro-oxidant under certain conditions. Alternative sulphur-containing compounds such as S-adenosyl-L-methionine (SAM) can reduce ischaemia-reperfusion injury, possibly by acting as glutathione precursors, and are effective when added to preservation solutions.

Peroxyl radical scavenging activity of the antihypertensive drug carvedilol.

The antihypertensive drug carvedilol was tested for its ability to scavenge peroxyl radicals by use of the model radical trichloromethyl peroxyl (CC1(3)O(2)). Carvedilol scavenged CC1(3)O(2) with a calculated rate constant of 1.5 +- 0.

Base modification and strand breakage in isolated calf thymus DNA and in DNA from human skin epidermal keratinocytes exposed to peroxynitrite or 3-morpholinosydnonimine.

Exposure of isolated calf thymus DNA and human skin epidermal keratinocytes to peroxynitrite or the peroxynitrite generator, 3-morpholinosydnonimine (SIN-1), led to extensive DNA base modification. Large increases in xanthine and hypoxanthine, possible deamination products of guanine and adenine, respectively, and in 8-nitroguanine were observed, but only small changes in some oxidized base products were seen. This pattern of damage suggests that hydroxyl radicals were not major contributors to base modification caused by peroxynitrite, as OH is known to cause multiple oxidative modifications to all four DNA bases.

Oxidative DNA damage in human respiratory tract epithelial cells. Time course in relation to DNA strand breakage.

When human respiratory tract epithelial cells were exposed to 100 microM H2O2, there was rapid induction of DNA strand breakage and chemical modifications to all 4 DNA bases suggestive of attack by OH.. The major products were FAPy-adenine, FAPy-guanine, and 8-OH-guanine.

An evaluation of the antioxidant and antiviral action of extracts of rosemary and Provençal herbs.

Extracts of herbs and spices are increasingly of interest in the food industry because they retard oxidative degradation of lipids. There is also increasing interest in the antiviral activity of plant products. A liquid, deodorized rosemary extract and an oily extract of a mixture of Provençal herbs were tested for antioxidant and antiviral action in vitro.

Evaluation of the pro-oxidant and antioxidant actions of L-DOPA and dopamine in vitro: implications for Parkinson's disease.

The antioxidant and pro-oxidant properties of L-DOPA and dopamine were investigated in vitro. Both compounds inhibited the peroxidation of ox-brain phospholipids, with IC50 values of 8.5 microM for dopamine and 450 microM for L-DOPA.

Evaluation of the antioxidant activity of melatonin in vitro.

Melatonin is being increasingly promoted as a treatment for "jet lag" and insomnia and has been suggested to act as an antioxidant in vivo. The antioxidant and potential pro-oxidant activities of melatonin were investigated in vitro. Melatonin was able to scavenge hypochlorous acid (HOCl) at a rate sufficient to protect catalase against inactivation by this molecule.

Mechanisms involved in the generation of free radicals.

Free radicals are constantly formed in the human body, both by "accidents of chemistry" and for useful metabolic purposes. Their action is opposed by a balanced and co-ordinated system of antioxidant defences. Upsetting this balance causes oxidative stress, which can lead to cell injury and death.

Characterization of drugs as antioxidant prophylactics.

There is growing interest in the evaluation of drugs (prescription only medicines and over-the-counter medicines) as antioxidant prophylactics. Although free radical mechanism in human degenerative diseases is now generally recognised, the mechanisms of tissue injury in humans are very complex and it may not be possible to clearly identify the role played by free radicals in the process. This review examines the current evidence to support the notion that drugs for a particular therapeutic category might possess useful antioxidant capacity hence minimising tissue injury due to free radicals.

DNA damage in human respiratory tract epithelial cells: damage by gas phase cigarette smoke apparently involves attack by reactive nitrogen species in addition to oxygen radicals.

Treatment of human respiratory tract tracheobronchial epithelial cells with gas-phase cigarette smoke led to dose-dependent DNA strand breakage that was highly correlated with multiple chemical modifications of all four DNA bases. The pattern of base damage suggests attack by hydroxyl radicals (OH.).

DNA strand breakage and base modification induced by hydrogen peroxide treatment of human respiratory tract epithelial cells.

Treatment of human respiratory tract epithelial cells with H2O2 led to concentration-dependent DNA strand breakage that was highly-correlated with multiple chemical modifications of all four DNA bases, suggesting that damage is due to hydroxyl radical, OH. However, the major base damage occurred to adenine. Hence, conclusions made about the occurrence and the extent of oxidative DNA damage on the basis only of changes in 8-hydroxyguanine should be approached with caution.

The characterization of antioxidants.

The role of antioxidants in nutrition is an area of increasing interest. Antioxidants are used (1) to prolong the shelf life and maintain the nutritional quality of lipid-containing foods, and (2) to modulate the consequences of oxidative damage in the human body. This review discusses what an antioxidant is and how the properties of antioxidants may be characterized.

How to characterize an antioxidant: an update.

The term antioxidant is widely used but rarely defined. One suggested definition is that an antioxidant is 'a substance that, when present at low concentrations compared with those of an oxidizable substrate, significantly delays or prevents oxidation of that substrate'. Many substances have been suggested to act as antioxidants in vivo, but few have been proved to do so.

Side-effects of drugs used in the treatment of rheumatoid arthritis.

A number of anti-inflammatory and other drugs used in the treatment of rheumatoid arthritis have been screened for their ability to cause oxidative damage to lipids and proteins in vitro. Although many drugs exhibited an antioxidant profile, a few drugs tested were pro-oxidant, increasing peroxidation of arachidonic acid by mixtures of haem proteins and H2O2. This system may be an appropriate model to use in the inflammatory situation, since microbleeding to release haemoglobin occurs in the inflamed rheumatoid joint, where H2O2 is produced by invading neutrophils.

Promotion of oxidative damage to arachidonic acid and alpha 1-antiproteinase by anti-inflammatory drugs in the presence of the haem proteins myoglobin and cytochrome C.

A mixture of myoglobin and hydrogen peroxide (H2O2) causes peroxidation of arachidonic acid. This peroxidation is greatly accelerated by adding phenylbutazone, which is effective even in the absence of H2O2. A wide range of other drugs was examined for their ability to exert similar pro-oxidant effects.