CD44 is associated with proliferation in normal and neoplastic human colorectal epithelial cells.

Flash-frozen biopsies obtained from surgical specimens of three adenomatous polyps and 22 colorectal adenocarcinomas (19 primary and three metastatic) were tested by immunohistochemistry for CD44 expression using F10-44-2 monoclonal antibody. CD44 positivity was correlated with proliferative status defined by Ki-67 monoclonal antibody reactivity. In normal colonic mucosa, CD44 was expressed in the proliferative zone of crypts. In tumours, CD44 expression was associated with proliferative areas irrespective of tumour stage or differentiation. Non-proliferating areas of the carcinomatous epithelium did not express CD44 although non-proliferating stromal lymphoid tissue did. There was no apparent association with tumour progression. F10-44-2-defined CD44 is consistently expressed during proliferation by normal colorectal epithelial cells and by both benign and malignant colorectal tumour cells.

An exploratory study of the adequacy of residency education in geriatrics: a methodological description.

This study describes a method to evaluate the educational strengths and needs in a family practice residency program. Patient encounter data and a detailed questionnaire to elicit perceptions of residents and faculty were used, followed by site visit meetings using a standardized protocol to discuss the results. These separate data sets validate each other and together triangulate the support of the conclusions. The results of this study indicate that both faculty and residents in a university-affiliated residency program can benefit from increased development in geriatrics. Although this method of studying the adequacy of residency education involved geriatrics, a similar process could be applied equitably to other curricular domains.

Monolayer properties of chloroplast lipids.

The properties of seven monogalactosyldiacylglycerols and six digalactosyldiacylglycerols, isolated from photosynthetic membranes and possessing different levels of fatty acid unsaturation, have been studied by the monolayer technique and compared with those of the fully saturated compounds. In addition, the monolayer properties of sulphoquinovosyldiacylglycerols and phosphatidylglycerols from higher plant chloroplasts, and several hexadecenoic acids have been measured. Monogalactosyldiacylglycerols containing saturated fatty acids form a condensed monolayer similar to that of saturated phosphatidylcholines. The naturally occurring monogalactosyldiacylglycerols, of which the double bond index ranged from 0.6 to 3.9, possessed comparable force-area curves suggesting that headgroup interactions play a more important role in packing behaviour than in phosphatidylcholines. Although digalactosyldiacylglycerols containing fully saturated fatty acids form a more expanded monolayer than the corresponding monogalactosyldiacylglycerols, the degree of expansion of the monolayer due to the presence of unsaturated fatty acids in the naturally occurring digalactosyldiacylglycerols is much less than in monogalactosyldiacylglycerols. Monogalactosyldiacylglycerols and digalactosyldiacylglycerols from a single species have very similar monolayer properties, and the presence of sulphoquinovosyldiacylglycerols and phosphatidylglycerols in the proportions in which they occur in higher plant chloroplasts does not have any condensing effect on a monolayer of galactolipids.

Convenience and the occurrence of births: induction of labor in the United States and Canada.

This paper, using data for the United States and Canada on number of births by day of the week, presents indirect evidence for the widespread incidence of the practice of elective induction. For both the United States and Canada, it is found that substantially fewer births occur on Saturdays, Sundays, and holidays than on weekdays. Controlling for such factors as prenatal care, race, education, legitimacy, birth weight, and time trend strongly suggests that the induction of labor is responsible for the patterns found. The paper concludes by discussing the framework within which the practice of elective induction of labor should be evaluated and justified.

The development and application of indices of health: general methods and a summary of results.

A multidisciplinary group has developed a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The strategy has been found to be generally applicable, capable of application by lay interviewers, acceptable to interviewees, and amenable to index construction. Furthermore, initial evaluations of the resulting health indices suggest that they are biologically and clinically valid. These health indices have been successfully applied in a randomized trial of innovative primary care services. The comceptualization of individual sections of the health index questionnaire for each of these three functional areas, the generation of the instrument, and the evaluation of questionnaire responses for their biologic and clinical validity are summarized here.

Technique evaluation of foster care in chronic psychiatric disorders.

Foster care received by 178 patients with chronic psychiatric disorders discharged from Hamilton Psychiatric Hospital in the years 1966 through 1969 was studied by technique evaluation. Residents were followed for 3 years by means of health records. The achievement of operational objectives of the program (Homes for Special Care) was compared with two types of outcome--emergency readmission to hospital and discharge to the community. Emergency readmission was associated with rural location of the foster home, inferior quality of the home operator and smaller size (i.e., fewer residents) of the home. Discharge to the community was more common among younger, female residents whose previous psychiatric hospitalization had been relatively brief. In general, prescription audit was not a fruitful way of evaluating quality of health care.

Development and application of an index of social function.

Brief indexes of social function were constructed in a project to develop a health index questionnaire designed to measure the social, emotional, and physical function of free-living populations. The social function items have been found to be generally applicable, capable of application by lay interviewers, and acceptable to interviewees. Initial evaluations to form composite scores for social function items have demonstrated their validity against concurrent assessments of a health professional. These social function indexes have been successfully applied in two randomized trials of innovative primary care services. The criteria for inclusion of items in the social function index questionnaire, the generation of the instrument, and the evaluation of questionnaire responses for their validity are summarized here.