Effect of organizational change on the individual employee.

Increasing market pressures force companies to implement drastic organizational changes in order to remain competitive. Budget decreases, reduction efforts, and similar changes create significant morale and job-satisfaction concerns. This study assesses the effects of budget reductions and other organizational changes on the morale of hospital employees. A survey dealing with employee perceptions of stress, workload, and performance was given to hospital employees. Not surprisingly, the survey found that morale problems resulted from the organizational changes. Employees' gender and job classification showed little significant effect on the survey results, while respondents' length of employment with the organization influenced the results slightly. The findings provide information useful for dealing with challenges of employee satisfaction, morale, and trust during times of budget limitations.

Synovial osteochondromatosis and pseudogout.

A middle aged male developed recurrent episodic inflammatory effusions of the right knee associated with radiographic findings consistent with osteochondromatosis. Calcium pyrophosphate dihydrate (CPPD) crystals were identified by polarized light and electron microscopy, although chondrocalcinosis was not demonstrated radiographically in this joint or any other locations. Analysis of noninflammatory fluid from the left knee demonstrated apatite crystals. The unique association of CPPD crystals and synovial osteochondromatosis without evidence of chondrocalcinosis and the relationship of these 2 entities is discussed.

Immunohistochemical identification of the AA protein in lattice dystrophy.

We examined the amyloid deposits of lattice dystrophy type I for common components of primary and secondary amyloid using the sensitive unlabelled antibody peroxidase-antiperoxidase technique. Tissue sections of formalin-fixed, paraffin-embedded specimens from three patients with lattice dystrophy were reacted with antisera specific for free immunoglobulin light chains, prealbumin, amyloid A (AA) protein, and amyloid P (AP) protein. The lattice amyloid was positive for the AA protein associated with secondary amyloid. The deposits were also stained with the protein AP antiserum in each case. We were unable to detect the presence of immunoglobulin light chains associated with primary amyloid or prealbumin associated with another heredofamilial form of amyloid. Sera from two patients with lattice dystrophy were tested for the presence of the serum amyloid A related protein, the apparent precursor of AA amyloid, by immunoelectrophoresis and immunodiffusion. The sera showed no reaction with the AA antiserum with these techniques. Lattice amyloid differed from secondary systemic amyloid in the reaction with potassium permanganate. Congo red staining of lattice deposits was not abolished by treatment with potassium permanganate. Our findings suggest that the amyloid proteins in lattice dystrophy are antigenically similar to those of secondary amyloid and the hereditary form associated with familial Mediterranean fever.

Nonobstructive gastroparesis in amyloidosis improved with metoclopramide.

Patients with systemic amyloidosis often have symptoms related to impaired gastrointestinal motility. Delayed gastric emptying may result from autonomic nerve and/or smooth-muscle infiltration with amyloid. In two patients with gastroparesis secondary to amyloidosis, metoclopramide hydrochloride therapy quantitatively enhanced gastric emptying. We suggest that metoclopramide treatment may be useful in the supportive therapy of patients with delayed gastric emptying due to amyloidosis.

The effects of the trinitrophenylation of the amino groups of glucagon on its conformational properties and on its ability to activate rat liver adenylyl cyclase.

Trinitrophenyl groups have been specifically introduced into the alpha- and/or the epsilon-NH2 groups of glucagon by reaction with trinitrobenzenesulfonic acid. Introduction of this group into the epsilon-NH2 position of the hormone leads to an apparant increase in the helical content as measured by circular dichroism, while substitution on the alpha-NH2 position causes little change in this property. The usefulness of the trinitrophenyl group for the study of intramolecular singlet excitation transfer from tryptophan is suggested. The pK and reactivity of the amino groups, as measured by the pH dependence of the rate of reaction with trinitrobenzenesulfonic acid, showed that the two amino groups of glucagon have similar properties to those of small model peptides. The trinitrophenyl-glucagon derivatives have little or no activity in stimulating adenylyl cylase of rat liver. By comparison with previously reported results, this demonstrates that the effect of chemical modifications of the amino group on the biological activity of glucagon depends critically on the group which is introduced.