Identification of medically important molds by an oligonucleotide array

Infections caused by fungi have increased in recent years. Accurate and rapid identification of fungal pathogens is important for appropriate treatment with antifungal agents. On the basis of the internal transcribed spacer 1 (ITS 1) and ITS 2 sequences of the rRNA genes, an oligonucleotide array was developed to identify 64 species (32 genera) of clinically important filamentous (or dimorphic) fungi. These 64 species included fungi causing superficial, cutaneous, subcutaneous, and invasive infections. The method consisted of PCR amplification of the ITS regions using a pair of universal primers, followed by hybridization of the digoxigenin-labeled PCR products to a panel of species- or group-specific oligonucleotides immobilized on a nylon membrane. Of 397 fungal strains (290 target and 107 nontarget strains) tested, the sensitivity and specificity of the array was 98.3% (285/290) and 98.1% (105/107), respectively. Misidentified strains were usually those belonging to the same genus of the target species or having partial homology with oligonucleotide probes on the membrane. The whole procedure can be finished within 24 h starting from isolated colonies; reproductive structures, which are essential for the conventional identification methods, are not needed. In conclusion, the present array is a powerful tool for identification of clinically important filamentous fungi and may have the potential to be continually extended by adding further oligonucleotides to the array without significantly increasing the cost or complexity.     

Aging in the 21st century

In this introductory article, a rapid overview is presented of the recent increase of life expectancy and its limitations mainly by unhealthy living habits: overeating, fast food, lack of exercise. The strong increase of obesity worldwide with its metabolic consequences might well limit or even decrease human life expectancy. The part of the population over 65 who have access to “anti-aging medicine” represents however another challenge to experimental and clinical gerontology, further discussed in later articles of this issue.     

Embracing complexity: organicism for the 21st century.

Organicism (materialistic holism) has provided the philosophical underpinnings for embryology since the time of Kant. It had influenced the founders of developmental mechanics, and the importance of organicism to embryology was explicitly recognized by such figures as O. Hertwig, H. Spemann, R. Harrison, A. M. Dalq, J. Needham, and C. H. Waddington. Many of the principles of organicism remain in contemporary developmental biology, but they are rarely defined as such. A combination of genetic reductionism and the adoption of holism by unscientific communities has led to the devaluation of organicism as a fruitful heuristic for research. This essay attempts to define organicism, provide a brief history of its importance to experimental embryology, outline some sociologically based reasons for its decline, and document its value in contemporary developmental biology. Based on principles or organicism, developmental biology should become a science of emerging complexity. However, this does mean that some of us will have to learn calculus.     

Asthma treatment in the 21st century

Asthma treatment is evolving as we enter the 21st century. This review focuses on several different areas of asthma treatment now in evolution. These include: (1) the proper role of various asthma controllers--either already approved or under investigation--besides inhaled corticosteriods in asthma therapy; (2) the potential role for immune and cytokine modulation for asthma therapy; (3) the potential role for pharmacogenetics in asthma therapy; and (4) whether single-inhaler therapy with a combination of an inhaled corticosteriod and a long-acted beta-agonist could be used for both maintenance and rescue in patients with asthma.     

Complement analysis in the 21st century

Complement analysis in the clinic is usually associated with the quantification of C3 and C4, measurement of C1-inhibitor and screening for complement activity. These analyses have been available in routine diagnostic laboratories for decades. In recent years, however, the field of complement analysis has expanded considerably, with the introduction of novel assays to detect complement activation products, and spreading still further towards genetic analysis to reveal the basis of complement deficiencies and identify mutations and polymorphisms associated with defined diseases such as atypical haemolytic uraemic syndrome and age related macular degeneration. Here we review the current status of complement analysis, including assays for the quantification of complement activity and complement activation products, together with genetic methods for the detection of deficiencies, mutations and polymorphisms. This is an area where significant developments have been made recently, paralleling the research advances into the role of complement in human disease. It is clear, however, that there is a need for consensus and standardisation of analytical methods. This will be a major challenge for the complement society in the future.     

Clinical laboratory in the 21st century

Alvin Toffler has predicted that the "Third Wave" will be a society which be decentralized, diversified and customized, computer-dependent. Medical care and also clinical laboratory will be revolutionalized in a more or less similar direction to that predicted by him. Laboratory physicians and scientists should try to improve laboratory services, particularly establishment of adequate normal values, common expression of various laboratory results, introduction of medical decision making and recommended guideline for laboratory use in primary health care.