A description of the nature and dynamics of coping following coronary artery bypass surgery.

The purpose of this study was to explore the nature and dynamics of coping following coronary artery bypass surgery (CABS). The coping strategies of 129 subjects recovering from (CABS) were assessed at 1 and 6 weeks following surgery using the Revised Ways of Coping Checklist. The most frequently used coping strategy was seeks social support, followed, in descending order of frequency, by problem focused coping and the emotion-focused coping strategies of blamed self, wishful thinking, and avoidance. There was an overall decrease in coping between 1 and 6 weeks following CABS. Seeks social support, blamed self, and wishful thinking coping were used significantly less frequently at 6 weeks than at 1 week following CABS. The decreases in problem focused and avoidance coping, however, were not statistically significant. This study provides insight into the process of coping following CABS and supports the need for development of nursing strategies to promote coping in this population.     

Evaluation of anti-HBc IgM estimation by radioimmunoassay for anti-HBc on column separated IgM

Tests for Igm antibody to hepatitis B core antigen (anti-HBc IgM) are useful diagnostic tools in the evaluation of patients with hepatitis B virus (HBV) infection. A method is described for detecting anti-HBc IgM based on application of a commercially available radioimmunoassay for total anti-HBc to column separated serum IgM and the technique is evaluated in patients with acute and chronic HBV infection. Our test is both sensitive and specific for diagnosing acute hepatitis B, although duration of positivity is highly variable. This technique is simple, inexpensive, and might be particularly useful for laboratories performing limited numbers of examinations, or with limited resources. A 45 percent savings in reagent costs is realized in our laboratory.     

Dendritic cells process synthetic long peptides better than whole protein,improving antigen presentation and T‐cell activation

The efficiency of antigen (Ag) processing by dendritic cells (DCs) is vital for the strength of the ensuing T‐cell responses. Previously, we and others have shown that in comparison to protein vaccines, vaccination with synthetic long peptides (SLPs) has shown more promising (pre‐)clinical results. Here, we studied the unknown mechanisms underlying the observed vaccine efficacy of SLPs. We report an in vitro processing analysis of SLPs for MHC class I and class II presentation by murine DCs and human monocyte‐derived DCs. Compared to protein, SLPs were rapidly and much more efficiently processed by DCs, resulting in an increased presentation to CD4⁺ and CD8⁺ T cells. The mechanism of access to MHC class I loading appeared to differ between the two forms of Ag. Whereas whole soluble protein Ag ended up largely in endolysosomes, SLPs were detected very rapidly outside the endolysosomes after internalization by DCs, followed by proteasome‐ and transporter associated with Ag processing‐dependent MHC class I presentation. Compared to the slower processing route taken by whole protein Ags, our results indicate that the efficient internalization of SLPs, accomplished by DCs but not by B or T cells and characterized by a different and faster intracellular routing, leads to enhanced CD8⁺ T‐cell activation.     

Viral inoculum dose impacts memory T‐cell inflation

Memory T‐cell inflation develops during certain persistent viral infections and is characterized by the accumulation and maintenance of large numbers of effector‐memory T cells, albeit with varying degrees in size and phenotype among infected hosts. The underlying mechanisms that control memory T‐cell inflation are not yet fully understood. Here, we dissected CMV‐specific memory T‐cell formation and its connection to the initial infectious dose by varying the inoculum size. After low dose inoculum with mouse CMV, the accumulation of inflationary memory T cells was severely hampered and correlated with reduced reservoirs of latent virus in nonhematopoietic cells and diminished antigen‐driven T‐cell proliferation. Moreover, lowering of the initial viral dose turned the characteristic effector memory‐like inflationary T cells into more central memory‐like cells as evidenced by the cell‐surface phenotype of CD27^high, CD62L⁺, CD127⁺, and KLRG1^?, and by improved secondary expansion potential. These data show the impact of the viral inoculum on the degree of memory T‐cell inflation and provide a rationale for the observed variation of human CMV‐specific T‐cell responses in terms of magnitude and phenotype.