Robert M. Nalbandian, M.D.; Raymond L. Henry, Ph.D.; Garth Shultz, M.D.; Noyes L. Avery Jr., M.D.
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The use of urea in invert sugar for the treatment of sickling crisis has a molecular basis and is implicit in Murayama's recently modified hypothesis for the molecular mechanism of sickling in sickling hemoglobin. Murayama implicates the formation of specified, pathologic hydrophobic bonds between interacting tetramers as necessary for the sickling. Hydrophobic bonds are now recognized to be primarily responsible for the tertiary structure of protein molecules in aqueous systems. Urea, long known to attack hydrogen bonds, has recently been shown to break hydrophobic bonds as well. We have successfully used urea in invert sugar as a chemical agent both
Nalbandian RM, Henry RL, Shultz G, Avery NL. Sickling Crisis Treated Successfully by Urea in Invert Sugar.. Ann Intern Med. ;74:827. doi: 10.7326/0003-4819-74-5-827_4
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Published: Ann Intern Med. 1971;74(5):827.
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