The rise and fall of i-STAT point-of-care blood gas testing in an acute care hospital

In response to a $350,000 laboratory budget cut and closure of an intensive care unit-based laboratory and a desire to maintain turnaround times of 10 minutes or less, a multidisciplinary group developed and implemented point-of-care (POC) testing. Only blood gases (pH, PO2, and PCO2) and ionized calcium values were deemed essential stat tests. Three commercially available POC blood gas devices were evaluated; all yielded results comparable to in-house reference methods. The 1 device with a US Food and Drug Administration-approved method for ionized calcium testing and with an existing interface for laboratory information systems was selected. Fiscal analysis predicted annual savings of approximately $225,000. POC blood gas analysis was implemented in April 1996 coincident with closure of the intensive care unit-based laboratory. Clinical laboratories and POC blood gas test volumes remained constant through August 1998; in contrast, the number of ionized calcium tests decreased dramatically after April 1996. In August 1998, clinically significant (i.e., artificial ventilation parameters would have been altered based on test results) discrepant PCO2 values were observed sporadically and noted only with patient specimens, not with commercial controls or electronic simulators. Because investigation failed to identify the cause, use of the POC device was discontinued in September 1998.     

Micro-centrifugation of human spermatozoa: its effect on fertilization of hamster oocytes after micro-insemination spermatozoal transfer

Micro-centrifugation (MC) at 6500 r.p.m. (3352 g) has not beenused previously for spermatozoal concentration and subsequentfertilization. We investigated MC for micro-insemination spermatozoaltransfer (MIST) of human spermatozoa from normal donors intohamster oocytes. MC resulted in reduced penetration of hamsteroocytes, both after MIST [77.4% (41/53) versus 87.8% (43/49)for control; NS] and after exposure to zona-free hamster oocytes[60.8% (79/130) versus 72.7% (88/121) for control; P < 0.05].However, MIST under the zona resulted in better incorporationof sperm nuclei when compared with zona-free hamster oocytes,for spermatozoa exposed to micro-centrifugation (77.4 versus60.8%, P < 0.05) and controls (87.8 versus 72.7%, P <0.05). Polyspermy was higher after MIST [22.0% (9/41) versus13.9% (11/79); NS] for MC + , and [25.6% (11/43) versus 13.6%(12/88); NS] for MC-. We conclude that MC does have a negative,but minimal effect on the fertility of human spermatozoa withrespect to hamster oocytes.     

Seven new HLA-B alleles associated with antigens in the B7 CREG

This paper describes seven novel HLA-B alleles. Five of these new alleles contain polymorphic motifs previously reported in HLA-B alleles, suggesting an origin resultant from a gene conversion mechanism. B*0723 contains a polymorphism previously unreported in class I HLA molecules. B*4105 contains a nucleotide substitution previously unreported in class I HLA molecules, which encodes a protein sequence previously reported only in HLA-C locus alleles.     

Role of antigen density in immune lysis of interferon-treated human lymphoid cells: analysis with monoclonal antibodies to the HLA-A,B antigenic molecular complex and to Ia-like antigens

Cultured human lymphoid WI-L2 cells incubated with human leucocyte interferon (final concentration 500 and 2000 U/ml) for 16 h at 37 degrees C acquire increased susceptibility to complement and cell-dependent lysis mediated by monoclonal antibodies to HLA-A,B antigens and to human beta 2-microglobulin but do not change in their susceptibility to immune lysis mediated by monoclonal antibodies to human Ia-like antigens. Changes in susceptibility to immune lysis of interferon-treated lymphoid cells are likely to reflect changes in antigen density, since binding assays with monoclonal antibodies and quantitative absorption assays with alloantisera have shown that the expression of HLA-A,B antigens and beta 2-microglobulin is significantly increased on interferon-treated lymphoid cells, whereas that of Ia-like antigens in not changed.     

Ultrastructure of preimplantation human embryos co-cultured with human ampullary cells

Ova with two pronuclei were co-cultured with established human ampullary cell lines and various stages of preimplantation embryonic development were monitored by Nomarski optics and then assessed by transmission electron microscopy (TEM). Fifteen embryos ranging from the 2-cell stage to blastocyst hatching were examined for normal and abnormal features. Their ultrastructure was similar to that of embryos cultured in Whittingham's T6 medium, reported previously. Seven embryos were evidently morphologically normal and showed good organization of fine structure. Most cellular organelles underwent progressive changes during early development. There was evidence of enhanced embryonic genome activation at the 8-cell stage. Invariably, all embryos had few too many fragments, some internalized, which were later segregated into the blastocoele or found outside the trophoblast of the late morula and blastocysts. Six grossly 'normal' embryos assessed by Nomarski had multiple nuclei of various dimensions, which highlights the subjectivity of embryo assessment in the IVF laboratory. Incomplete incorporation of chromatin into nuclei and formation of micronuclei were evident in some blastomeres. The results are discussed in relation to early embryonic loss, prevalent in IVF. Significant events reported include the detection of centrioles at the 8-cell stage, cavitation of the early blastocyst and the initiation of blastocyst hatching visualized by TEM.     

Possible involvement of receptors in the entry of Kunjin virus into Vero cells

Summary The results obtained from electron microscopy, adsorbed and internalised virus assays and immunofluorescence studies supported that the most likely mode of entry of Kunjin virus into Vero cells was by receptor-mediated endocytosis. This was deduced indirectly from the time sequence of events that occurred. Electron microscopy revealed that endocytosis of the virus through coated vesicles had occurred. The adsorbed and internalised virus assay and immunofluorescence studies showed that there were two factors being recycled during endocytosis: the receptor for the virus and clathrin, the protein found on coated pits and vesicles. The study showed that clathrin was recycled first, followed by the receptor.     

Laser doppler imaging of menstrual symptoms

In this paper, the skin blood flow for the stomach and forehead regions of 36 female patients with menstrual symptoms was studied using a moorLDI laser Doppler imager in which the results of 6 typical patients are included. The patterns obtained at the two sites are common to all women in the sample who have menstrual symptoms. Cold stress testing was also investigated to see if it was effective in bringing out any skin blood flow fluctuation at these regions caused by menstrual symptoms. Each patient attended two scanning sessions: one before and the other during menstruation. During each session, the patient was scanned three consecutive times, each on the stomach and the forehead skin regions. For each region, the first measurement was a bare scanning whereas for the second and the third, 85% denatured ethanol (cold stress test) was applied onto the required scan areas. It was found that cold stress testing was able to bring out distinct differences in LDI perfusion images before and during menstruation. Results were best captured when perfusion images were taken approximately after 85% denatured ethanol had been applied in two layers for 30 s, allowed to evaporate over the next 5 min (approximately the time taken to obtain one image), reapplied for another 30 s and then finally over the next 30 s allowed to evaporate further. However, it was impossible to deduce conclusively any correlation regarding migraine and skin blood flow since all the patients for this work had menstrual cramps only.     

Drug demand reduction programmes for young people in Hong Kong

A wide range of drug demand reduction programmes are being carried out in Hong Kong. These include community involvement projects; preventive drug education and publicity through the use of mass media in the form of television and radio announcements and posters; and the production of educational and publicity materials. Most of these programmes are intended to reach young people. The local district campaigns are held every year to arouse awareness of the dangers of drug abuse and to encourage public support in combating such abuse. A selected volunteer group encourages young people to participate in the planning, organization and implementation of drug-abuse prevention projects. A programme called "Youth against drugs scheme", which was launched in 1981, is open to all youth groups, providing an opportunity for young people to plan and implement anti-narcotics publicity projects in their own way with limited supervision. These programmes have proved successful in involving the young in the fight against drug abuse and associated problems.     

Identification and order of sequential mutations in beta-actin genes isolated from increasingly tumorigenic human fibroblast strains.

We have sequenced the mutant beta-actin gene of a tumorigenic human fibroblast cell line (HuT-14T) and found that it carries three mutations that alter the amino acids at positions 36, 83, and 244 as well as a 22-base-pair "insertion" sequence, in the 5' intron, not present in a wild-type gene. The less tumorigenic cell line HuT-14, a progenitor of HuT-14T, has the same codon-244 mutation and the insertion sequence but not the other two mutations. A nontumorigenic cell line that is related to HuT-14 but that has no beta-actin mutations does carry the intron-length polymorphism. We conclude that the mutation at codon 244 occurred first in a beta-actin allele already bearing the 22-base-pair intron insert and that mutations at codons 36 and 83 arose subsequently during the selection for the HuT-14T phenotype. Rat-2 cells synthesize the appropriate charge-variant species of mutant actin protein when transfected with either the singly or the triply mutated beta-actin gene.