The LightTyper: high-throughput genotyping using fluorescent melting curve analysis.

Instrumentation, chemistry, and software for high-throughput genotyping using fluorescent melting curves are described. The LightTyper system provides post-amplification genotyping within 10 min using samples in 96- or 384-well microplate formats. The system is homogenous because all reagents are added at the beginning of the reaction and there is no sample manipulation between amplification and genotyping. High-resolution melting curves are achieved by slow and steady heating. As samples are heated, panels of blue light-emitting diodes excite the probes, and fluorescence emission is acquired with a cooled charge-coupled device camera. A variety of probe chemistries are compatible for genotyping on the LightTyper, including dsDNA dyes, single-labeled probes, and fluorescence resonance energy transfer systems. Genotyping is performed automatically, and each sample is given a score reflecting the similarity of the genotype to the standards provided. Standard genotypes can be selected from within the run or imported from other files. Samples and genotypes can be grouped to allow multiple-allele detection on one or many samples. The utility of the LightTyper is illustrated by genotyping samples for the Factor V Leiden mutation and for mutations in the CFTR gene.

The workforce in otolaryngology-head and neck surgery: moving into the next millennium.

OBJECTIVE: The goal was to examine the current scope of otolaryngologists' practices, their geographic distribution, and the roles otolaryngologists and other specialists play in caring for patients with otolaryngic and related conditions of the head and neck. STUDY DESIGN: A large national survey and administrative claims databases were examined to develop practice profiles and compile a physician supply for otolaryngology. A focus group of otolaryngologists provided information to model future scenarios. RESULTS: The current and predicted workforce supply and demographics are at a satisfactory level and are decreasing as a proportion of the increasing population. Empiric data analysis supports the diverse nature of an otolaryngologist's practice and the unique role for otolaryngologists that is not shared by many other providers. Together with the focus group results, the study points to areas for which more background and training are warranted. CONCLUSIONS: This study represents a first step in a process to form coherent workforce recommendations for the field of otolaryngology.

Academic progress of children who attended a preschool for abused children: a follow-up of the keepsafe project.

OBJECTIVE: This study was undertaken to assess academic progress of children 1 to 5 years after graduating from the C. Henry Kempe Center's Therapeutic Preschool Day Treatment Program. METHOD: Information was gathered through chart review; telephone surveys of care providers, relatives, and social service workers; as well questionnaires on all children who attended the therapeutic preschool day treatment program between 1984 and 1989, including the 24 children reported on by Oates, Gray, Schweitzer, Kempe, and Harmon, 1995. RESULTS: Classroom placement was determined for 27 of the 44 graduates (61.4%), 14 of whom (51.9%) were in a regular classroom, 10 (37.0%) in special education, two (7.4%) in residential treatment, and one (3.7%) was receiving home schooling. Twenty-two of the 27 children (81.5%) improved or remained in the same grade and type of classroom as they had been staffed into at the time of their graduation from the preschool day treatment program. Factors thought to affect stability of classroom placement were studied, of which frequency of family moves was the only significant variable. Its significance was in the direction opposite to that expected. The most effective method of locating families was to contact the Department of Social Services who provided information used to find 60% of them. CONCLUSIONS: Intervention in a therapeutic preschool day treatment program was found to be beneficial, as it enabled most of the children to progress appropriately in public school.

Life-threatening airway obstruction from rattlesnake bite to the tongue.

We describe the case of a 41-year-old man who suffered a bite to the tongue from the Western Diamondback rattlesnake (C atrox). Life-threatening obstruction of his upper airway secondary to massive edema of the tongue and other soft tissue structures quickly followed envenomation. Nasotracheal intubation, IV antivenin, and supportive care resulted in complete recovery with no permanent deficits. Rattlesnake bites to the tongue are rare and pose an unusual cause of airway obstruction.

Otolaryngologic manifestations of Hansen's disease.

A Mexican migrant farm worker whose condition was previously undiagnosed was examined at the University of Utah Medical Center. He had an unusual peripheral neuropathy, ulcerative and nodular skin lesions, and multiple head and neck complaints. Results of the history, physical examination, and multiple biopsies led to the diagnosis of lepromatous leprosy. Although an uncommon disease in the United States, leprosy remains a common cause of head and neck pathologic conditions in many parts of the world and must be considered in the appropriate clinical setting.