Mapping of the three species of polyoma mRNA.

The polyoma mRNA's present in the cytoplasm of primary cultures of mouse kidney cells during lytic infection were characterized by sedimentation velocity analysis and by hybridization to polyoma DNA fragments generated by a specific endonuclease of Hemophilus parainfluenzae (Hpa II).     

What AMHA does and what AMHA should do: Results from the 1985 affiliate poll

We obtained opinions about the services and programs of the Association of Mental Health Administrators from a sample of 242 affiliates. The study showed that the most important reasons for joining the association were professional development, education, and to support the profession. Also important was the desire for interaction with other executives. Apart from individual benefits, affiliates endorsed the standard setting functions of the association: setting educational standards, creating a certification credential, disseminating new ideas and, to a lesser extent, conducting research. Finally, AMHA affiliates believe the association should act as a spokesperson to the government. In the future, AMHA’s greatest area of growth will be to create a favorable public opinion. PETER A. WEIL, PH.D., is director of the Division of research and Development at the American College of Healthcare Executives (formerly the American College of Hospital Administrators), Chicago, IL.     

A Novel Interferon-Inducible Gene Expressed during Myeloid Differentiation

ABSTRACT: The acute promyelocytic leukemia cell line, NB4, can be induced to differentiate to mature granulocytes by retinoic acid treatment. A novel retinoic acid-inducible cDNA clone, designated RI58, was isolated from a cDNA library constructed from retinoic acid-treated NB4 cells by differential hybridization. RI58 cDNA encodes a protein of 58kDa which has a similarity in its amino acids sequence to interferon (IFN)-inducible proteins. In addition, RI58 was induced by recombinant human IFN-α (rhIFN-α) in NB4 cells. RI58 was detectable within 4 hours post-stimulation with rhIFN-α, while it took as long as 1day after retinoic acid stimulation. Culture supernatant from retinoic acid-treated NB4 cells also induced RI58 expression similarly as rhIFN-α. This activity in culture supernatant was inhibited by anti-leukocyte IFN antiserum which showed specific reactivity to rhIFN-α. These results indicate that RI58 is induced by retinoic acid stimulation through autocrinally secreted IFN-α from NB4 cells. In the retinoic acid-treated NB4 cells, the expression of RI58 was increased along the process of differentiation. On the other hand, it was expressed constitutively in untreated non-hematopoietic cell lines and mature hematopoietic cell lines.     

The cholera epidemic in Ecuador: towards an endemic in Latin America.

We present an epidemiological study of the first wave of cholera in Ecuador in 1991. One month after the 7th cholera pandemic hit the Pacific coast of Peru, the disease reached the coast of Ecuador and spread to the rest of the country within a few weeks. One year later, 46,320 cases have been notified, giving an incidence of 481 cases per 100,000 inhabitants. The overall mortality rate has been low (697 deaths, i.e. 1.50%), although there have been large differences between the various provinces: in the Andes (Sierra), for example, rates above 8% have been recorded. The first wave peaked about eight weeks after the first case, with 3400 new cases per week throughout the country. This was followed by a gradual decrease towards a baseline of 250-500 new cases per week. A resurgence was observed in most coastal and Andean provinces from November 1991 onwards. The kinetics of the epidemic are compatible with an endemic implantation of the disease in Ecuador, as is probably the case in the entire intertropical Pacific coast region of Latin America. From the data presented, the latin-american episode of the 7th pandemic starting on the Pacific coast, is characterized by a very high attack rate and a low mortality rate as compared to Africa, and the unexpected involvement of populations living on the high Andean plateaux. It is probable from the results collected in Ecuador that cholera will become endemic in Latin America.     

Truth-telling to cancer patients in the western european context

The meaning and the practice of truth-telling have undergone many changes throughout western European history. Although Plato noted the conflict between the idea of protecting individuals from information which could frighten them and the idea of respecting their autonomy and freedom to know, Greek physicians displayed a more pragmatic attitude. In contrast, the Catholic church has always condemned any form of lying. The emergence in the Middle Ages of the notion that Catholics had to receive the sacrament of extreme unction in order to ensure salvation made it necessary to inform patients of the approach of death. But the gradual decline of the Church's influence since the eighteenth century led to the increasing practise of telling medical ‘white lies’. Rapid changes are occurring, however, in light of medical progress, evolving ethical beliefs and major sociological changes, especially the increasing role of the media. In fact, the medical ‘secret’ is shared by many people and the problem is no longer whether physicians must tell the truth but how to tell it. Patients often do not understand the information they are given because the words are too esoteric. Failures in physician/patient communication arise also because of the phenomenon of denial, which is a part of the normal adaptation process. The physician has the responsibility of making the decision and of imparting to the patient a sense of innovation and progress.     

Stereopsis testing in 18- to 35-month-old children using operant preferential looking

Forced choice operant preferential looking (OPL) was used to evaluate stereopsis in children between 18 and 35 months of age. Eighty-three children who passed a vision screening were tested with a ring-shaped random dot target that stood out in depth. Food was used to reinforce looking at the target. Children were also administered the Random Dot E (RDE) as a comparison measure. Four children were unable to complete testing with OPL compared with 31 who were unable to complete testing with the RDE. This difference was most apparent in children under 24 months of age. This new procedure appears to be a useful technique to evaluate stereopsis in very young children.     

An American macromanaged health care system?

The implementation of President Clinton's proposed health reform plan that ensures universal access and relatively comprehensive health insurance benefits to over 250 million Americans would have a significant impact on their hospitals, physicians, and other health care providers. With this projected coverage, the 36.7 million Americans now uninsured would demand an additional volume of services. It is doubtful, because of this nation's trade and budget deficits, that any significant increases in expenditures for health will be made available from the public sector. Therefore, providers in the US will need to deliver significantly more care with a minimal increase in total reimbursement. These conclusions are further supported by the experiences of the Canadian and the German macromanaged health care systems that provide considerably more hospital and physician services per person per year than the US at a lesser cost per discharge and percentage of their respective nation's gross domestic product. America may be heading toward macromanaged global budget targets, but for political and other reasons President Clinton's health reform plan will be implemented with a multi-payer, managed competition approach.