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.     

A second locus (GLC3B) for primary congenital glaucoma (Buphthalmos) maps to the 1p36 region

Primary congenital glaucoma (gene symbol: GLC3) is an ocular disorder that occurs for 0.01-0.04% of blind people. In the majority of familial cases reported so far, this condition is inherited as an autosomal recessive trait. We have recently used a group of 17 GLC3 families with a minimum of two affected offspring and consanguinity in most of the parental generation and mapped the first GLC3 locus (GLC3A) to the 2p21 region. Six families did not show any linkage to the GLC3A locus and thus provided evidence for genetic heterogeneity of this disorder. A total of eight families unlinked to the 2p21 region were used to search for the chromosomal location of the second GLC3 locus. Herein, we describe mapping of a new locus (designated GLC3B) for primary congenital glaucoma to the short arm of chromosome 1 (1p36.2-36.1) that is situated centromeric to the neuroblastoma and Charcot-Marie-Tooth type 2A (CMT2A) loci. A total of 17 DNA markers were genotyped from this region of chromosome 1. Four families showed no recombination with the two markers D1S2834 and D1S402 with a maximum lod score of 4.510 and 4.157 respectively. Pairwise and multipoint linkage analysis and inspection of the haplotypes revealed that the remaining four families are not linked to this part of chromosome 1, thus providing further evidence that at least one more locus for the autosomal recessive form of GLC3 must exist in the genome. Based on the recombination events, the overall linkage map of this region is: tel-D1S1192-D1S1635-D1S1193 - (D1S1597/-D1S489/D1S228)- [GLC3B/D1S2834/D1S402] - (D1S1176/D1S507/D1S407) - D1S2728-(MFAP2/D1S170) - D1S1368 - D1S436- D1S1592-cen.      

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.     

Stress proteins: their role in the normal central nervous system and in disease states, especially multiple sclerosis

Summary Stress proteins are constitutively expressed in normal CNS tissues, in a variety of cell types (oligodendrocytes, astrocytes and neurons). Their function is uncertain but they may be critical during nervous system development and may protect cells from various stresses, such as hypoxia, anoxia, and excessive excitatory stimulation. Increased amounts of stress proteins are expressed in various cells of the CNS during acute toxic-metabolic states and in more chronic degenerative diseases. Increased expression of stress proteins may constitute a sensitive marker of cell injury.Antibodies to mycobacterial stress proteins bind to normal human myelin and to oligodendrocytes in regions of MS demyelination. Cellular immune responses to stress proteins occur with increased frequency and magnitude in persons with MS, especially those with recent onset of disease. In addition, there are populations of T cells expressing / T cells in the brains and CSF of persons with MS, suggesting an in situ immune response to hsp. Humoral immune responses to stress proteins are found in CSF, but no disease specificity has been documented. Some myelin proteins have sequence homology with particular stress proteins. One instance is the homology between a peptide of mycobacterial hsp65 and the myelin protein CNP. Preliminary observations suggest that immune responses to such cross-reactive epitopes modify the course of EAE.All in all, these data support the hypothesis that an immune response to the stress proteins of an infectious agent could result in a cross-reactive immune response to CNS myelin, resulting in demyelination. This may be an especially important mechanism in MS.     

Systems are changing: where can they be improved?

Wide-ranging changes of unprecedented scale throughout the delivery of healthcare services are producing consequences we cannot ignore. A need to collaborate to improve healthcare systems is evident. The Society for Healthcare Epidemiology of America (SHEA) and the Health Care Division of the American Society for Quality are responding in jointly sponsoring this symposium concerning problems with medical devices. This presentation and those that follow will explore the quality of management of managed-care corporations; the important threat to out primary source of innovation in medical technology posed by behaviors of consolidated corporations; the impact of these changes on roles of hospital epidemiologists; and measures to ensure proper design, production, delivery, and use of safe medical products. Our profession and SHEA have made significant research-based contributions that document their potential value, but we have not always done as well as we could to market epidemiology as an important asset for sound management decisions in this era of change. We should ally ourselves with related disciplines in order to succeed as we undertake new challenges on a broadening field.