Resident-preceptor retreat for re-evaluating a pharmacy residency program

The organization of a resident-preceptor retreat as one component of a process to re-evaluate a pharmacy residency program is described. Changes in the ASHP standards for residency training and recommendations from a recent reaccreditation survey as well as recent changes in the health-care environment prompted a re-evaluation of the existing 24-month residency and degree program at The Ohio State University Hospitals. Three task forces were created to evaluate issues in seven areas of residency training. Members of the task forces, which consisted of current residents and staff members with preceptorial responsibilities, discussed the issues assigned to them during a retreat at a state park. Recommendations made at the retreat were assigned to individual task force members for implementation. Within nine months of the retreat, 15 of 17 recommendations had been implemented. A retreat involving both residents and preceptors can be an effective forum for discussing and critically evaluating a pharmacy residency program.     

Incidence of squamous metaplasia in large bronchi of Japanese lungs: relation to pulmonary carcinomas of various subtypes

The incidence of bronchial squamous metaplasia in Japanese lungs was investigated in order to clarify the significance of this lesion for the development of lung cancer of various histological subtypes. The bronchi of 104 and 32 lungs resected, respectively, for primary or metastatic tumors were step-sectioned and examined histologically. The incidence of squamous metaplasia was particularly high (83% of cases, 8-11% of sections) in male lungs bearing primary squamous or small cell carcinoma whereas it was low (43% of cases, 3% of sections) in lungs of both sexes with adenocarcinoma, the latter figures being about the same as those for lungs with secondary metastatic tumors. Although the overall incidence of lung squamous metaplasia in Japanese is much lower than in the U.S., the present data demonstrate a high level in association with squamous or small cell carcinoma, directly comparable to that of Americans. However, atypical metaplasia, or dysplasia, was encountered much less frequently than in the U.S. A topographical study of 7 minute or small squamous cell carcinomas revealed 3 to have adjacent and 2 to have nearby areas of squamous metaplasia. However, 2 cases were found to be completely free of squamous metaplastic lesion. Thus, squamous metaplasia may be associated with the development of squamous cell carcinoma but would appear not to be an obligatory step in the development of this neoplasm.     

Isolation of leukocyte-free platelets from standard platelet concentrates by centrifugation

We evaluated centrifugation techniques to isolate leukocyte-free platelets from standard platelet concentrates. Among various settings of centrifugation force and time, we found the setting at 300 X g for 10 minutes or 370 X g for 5 minutes to be efficient and reproducible for recovering sufficient quantities of platelets free of leukocytes.     

Ureteroenteric fistula after retrograde balloon dilatation of ureteral stricture.

Advances in endourology have made transluminal balloon dilatation a safe and effective procedure for the treatment of ureteral strictures. Bilateral ureteral stricture was treated with retrograde balloon dilatation and ureteral stenting in a 59-year-old-woman. The patient had previously undergone abdominoperineal resection and adjuvant radiotherapy due to rectosigmoid adenocarcinoma. Subsequently, unilateral ureteroenteric fistula was detected on follow-up retrograde ureteropyelography. To our knowledge, this is the first case of ureteroenteric fistula after balloon dilatation for ureteral stricture in a patient with predisposing factors for compromised vascularity of the ureter.     

The Sts proteins target tyrosine phosphorylated, ubiquitinated proteins within TCR signaling pathways

The T cell receptor (TCR) detects the presence of infectious pathogens and activates numerous intracellular signaling pathways. Protein tyrosine phosphorylation and ubiquitination serve as key regulatory mechanisms downstream of the TCR. Negative regulation of TCR signaling pathways is important in controlling the immune response, and the Suppressor of TCR Signaling proteins (Sts-1 and Sts-2) have been shown to function as critical negative regulators of TCR signaling. Although their mechanism of action has yet to be fully uncovered, it is known that the Sts proteins possess intrinsic phosphatase activity. Here, we demonstrate that Sts-1 and Sts-2 are instrumental in down-modulating proteins that are dually modified by both protein tyrosine phosphorylation and ubiquitination. Specifically, both naïve and activated T cells derived from genetically engineered mice that lack the Sts proteins display strikingly elevated levels of tyrosine phosphorylated, ubiquitinated proteins following TCR stimulation. The accumulation of the dually modified proteins is transient, and in activated T cells but not naïve T cells is significantly enhanced by co-receptor engagement. Our observations hint at a novel regulatory mechanism downstream of the T cell receptor.     

Anti-Helicobacter pylori activity of quinolone alkaloids from Evodiae fructus.

A biologically monitored fractionation of methanol extract of the fruit of Evodia rutaecarpa led to the isolation of six quinolone alkaloids, evocarpine (1), 1-methyl-2-[(4Z,7Z)-4,7-tridecadienyl]-4(1H)-quinolone (2), 1-methyl-2-[(6Z,9Z)-6,9-pentadecadienyl]-4(1H)-quinolo ne (3), 1-methyl-2-undecyl-4(1H)-quinolone (4), dihydroevocarpine (5), 1-methyl-2-pentadecyl-4(1H)-quinolone (6). They showed potent anti-Helicobacter pylori activity with the minimum inhibitory concentration (MIC) value of 10-20 microg/ml. However, they had no effect on Helicobacter pylori urease activity at the concentration of 300 microg/ml.     

Aortic dissection: review of value and limitations of two-dimensional echocardiography in a six-year experience

The utility of transthoracic two-dimensional echocardiography in patients with aortic dissection was assessed by retrospective analysis in 67 patients: 31 patients with DeBakey type I, 21 patients with type II, 10 patients with type III, and five patients with false-positive diagnoses. Aortic dissection was correctly identified by two-dimensional echocardiography in 49 patients; 13 had false-negative diagnoses. Therefore the sensitivity was 79%, and the positive predictive accuracy was 91%. Transthoracic two-dimensional echocardiography is a reasonable screening technique for diagnosis of aortic dissection.