Contribution of arterial blood lactate measurement to the care of critically ill patients.

Arterial blood samples from 202 critically ill patients were studied. Lactate concentration, PO2, PCO2, pH, oxygen saturation, total CO2, and toe temperature were measured. Base excess, buffer base, actual bicarbonate, and standard bicarbonate were calculated. Analysis of the initial data obtained from each patient revealed that lactate concentration alone could not be used to predict survival. Elevations in lactate concentrations were observed in all types of acid-base disturbances. Survival was lowest (30%) for patients in metabolic acidosis with respiratory compensation, mean lactate concentration 10.5 mEq/l (mmol/l), and highest (65%) for patients in uncompensated respiratory alkalosis, mean lactate concentration, 2.57 mEq/l (mmol/l). Knowing the type of acid-base disturbance is necessary to evaluate the significance of elevated blood lactate values.     

The 11q13 amplicon of a mammary carcinoma cell line

Fifteen to 20% of breast carcinomas show amplification of genes located at 11q13. The HST/FGFK and INT2 fibroblast growth factor (FGF)-related genes and the BCL1 locus are usually present in the amplification units. We have investigated the structure and chromosomal location of the 11q13 amplicon of the MDA-MB-134 mammary carcinoma cell line by using in situ chromosomal and pulsed field gel hybridizations. The results indicate that a limited number of amplification units are involved in the constitution of an extended chromosomal region located on 11q. These units do not show any important rearrangement over rather large distances around the HST/INT2 and BCL1 loci.     

Effect of dry cleaning on mite allergen levels in blankets

Since one of the greatest reservoirs of allergens is the blanket, we assessed mite allergen levels in dust collected from five blankets by vacuuming before and after dry cleaning with perchlorethylene and compared the results with five control blankets. Assays with monoclonal antibodies showed that group I ( Der p I and Der f I) mite allergen levels per g dust were 78%, lower after dry cleaning. Group 1 allergen levels per m² of dry-cleaned blankets were 98% lower. RAST inhibition showed that total allergen levels decreased 70% after dry cleaning. Mite allergens were not denatured by perchlorethylene. The effect of dry cleaning resulted from physical washing out of dust and allergens.     

The family of Caenorhabditis elegans tyrosine kinase receptors: similarities and differences with mammalian receptors

Transmembrane receptors with tyrosine kinase activity (RTK) constitute a superfamily of proteins present in all metazoans that is associated with the control and regulation of cellular processes. They have been the focus of numerous studies and are a good subject for comparative analyses of multigene families in different species aimed at understanding metazoan evolution. The sequence of the genome of the nematode worm Caenorhabditis elegans is available. This offers a good opportunity to study the superfamily of nematode RTKs in its entirety and to compare it with its mammalian counterpart. We show that the C. elegans RTKs constitute various groups with different phylogenetic relationships with mammalian RTKs. A group of four RTKs show structural similarity with the three mammalian receptors for the vascular endothelial growth factors. Another group comprises RTKs with a short extracellular region, a feature not known in mammals; the genes encoding these RTKs are clustered on chromosome II with other gene families, including genes encoding chitinase-like proteins. Most of the C. elegans RTKs have no direct orthologous relationship with any mammalian RTK, providing an illustration of the importance of the separate evolution of the different phyla.     

Localization of the HST/FGFK gene with regard to 11q13 chromosomal breakpoint and fragile site

The HST/FGFK gene, a member of the fibroblast growth factor gene family and a protooncogene, is localized on chromosomal band 11q13. Genes in this region are frequently involved in hematopoietic and solid tumors. Here we show that the HST gene lies telomeric to the BCL1 gene, the t(11;14)(q13;q32) breakpoint, and the FRA11A rare fragile site.     

The bottom line is outcome-based assessment

The message being delivered to hospitals through the Joint Commission's Agenda for Change is that today's bottom line is not based on a listing of activities done, but rather, on what outcomes, what impact on community problems, what benefits these activities have achieved. It is important to see that outcome-based evaluation methods, once adopted, do not degenerate into habitual production of largely ignored morbidity and mortality rates. Materiel managers must contribute a business-oriented understanding of costing and entrepreneurship while embracing a clinical-oriented goal of caring.