Localization of the Alz-50 epitope in recombinant human microtubule-associated protein tau.

Alz-50 is a monoclonal antibody that stains the neurofibrillary pathology of Alzheimer's disease, as well as apparently normal nerve cells that are at risk of developing neurofibrillary tangles. On immunoblots it recognizes microtubule-associated protein tau and proteins of 60-68 kDa that are associated with Alzheimer's disease. We have used recombinant tau proteins expressed in E. coli to map the Alz-50 epitope to amino-terminal residues 2-10, a region common to all known human tau isoforms. A direct correspondence between immunoblots and histological staining was established by the abolition of Alz-50 staining following adsorption with recombinant tau proteins retaining amino-terminal sequences. This suggests that tau pathology represents an early event in the development of the neurofibrillary pathology of Alzheimer's disease.     

Risk of T-cell lymphomas in persons with AIDS

Lymphomas in persons with AIDS are mostly B-cell types, but T-cell lymphomas have also been reported. We examined T-cell lymphoma risk in the 2-year period after AIDS onset by linking 302,834 adults with AIDS to cancer registry data. Of 6,788 cases of non-Hodgkin's lymphoma (NHL) with specified histologies, 96 (1.4%) were T-cell lymphomas. Assessment was based on clinical diagnosis and histology because T-cell marker data were inadequate, but when present, marker data supported the T-cell diagnosis. The relative risk of T-cell lymphoma, estimated by standardized incidence ratio, was 15.0 (95% confidence interval: 10.0--21.7). Risks were increased for all subtypes, including mycosis fungoides, peripheral lymphomas, cutaneous lymphomas, and adult T-cell leukemia/lymphoma (ATLL). HIV-related immunodeficiency could be important, but differences between the population developing AIDS and the general population (e. g., immigration from the Caribbean region for ATLL) might independently increase T-cell lymphoma risk.     

The incidence of Kaposi sarcoma among injection drug users with AIDS in the United States

Some studies report increased prevalence of human herpesvirus 8 (HHV-8), the causative agent of Kaposi sarcoma (KS), among injection drug users (IDUs), suggesting that HHV-8 may be transmitted through blood-borne or other exposures common in this population. Since an elevated HHV-8 prevalence in IDUs would likely lead to increased KS incidence, KS incidence was studied in IDUs and non-IDU's with AIDS. AIDS-related KS cases were identified using linked US AIDS and cancer registry data for 25,891 women, 47,782 heterosexual men, and 90,616 men who have sex with men (MSM). KS arose in 7099 persons with AIDS. KS incidence was highest for MSM (5.7 per 100 person-years), substantially lower for heterosexual men (0.7 per 100 person-years), and lowest for women (0.4 per 100 person-years). After adjustment for age, race, registry location, and year of AIDS onset, relative risks for KS associated with injection drug use were 1.3 (95% CI, 0.9-1.8) among women, 1.1 (0.7-1.6) among heterosexual men, and 0.9 (0.8-0.9) among MSM. It is concluded that injection drug use was not associated with an increased risk of AIDS-related KS. Thus, these data suggest that IDUs' risk of acquiring HHV-8, through needle sharing or other behaviors related to injection drug use, is low.     

Measuring the movement to electronic claims

Congressional inaction on health care reform during 1994 spelled a temporary halt to efforts to enact government mandates for the use of automated transactions. But even without the added pressure of government mandates, the steady shift to automated health care transactions continued during the year. Now that more of the nation's 1,500 health care payers and 700,000 providers are linked to regional and national electronic data interchange networks, more than one-third of all health care claims are transmitted electronically.