Calidad del registro escrito del médico anestesiólogo durante la transferencia de pacientes postoperados: influencia de la aplicación de una herramienta de comunicación estructurada / Quality of the anesthesiologist written record during the transfer of postoperative patients: Influence of implementing a structured communication tool

Objetivo. La falta de comunicación es una de las principales causas de errores asistenciales, especialmente durante la transferencia de pacientes entre profesionales y/o unidades asistenciales; la normalización de la comunicación es una práctica recomendada. En nuestro estudio hemos querido valorar si la aplicación de la herramienta estructurada de comunicación SBAR podría influir sobre la calidad de la información escrita en la hoja de evolución por el anestesiólogo implicado en la transferencia del paciente posquirúrgico. Material y métodos. Se trata de un estudio observacional, retrospectivo, aleatorizado, de revisión de la calidad del registro escrito realizado por el médico anestesiólogo durante la transferencia de pacientes desde el área quirúrgica a la unidad de reanimación postoperatoria, mediante la aplicación de un listado validado. Se evaluaron 3 periodos de observación: un periodo control de 2 meses del año 2011 (preSBAR) y un segundo periodo de 2 meses en 2012 (postSBAR), en este último con 2 grupos de pacientes transferidos con (postSBAR+) o sin SBAR (postSBAR−). Resultados. La fuerza de concordancia entre los evaluadores obtuvo un coeficiente de correlación interclase de 0,8459 (p < 0,001). Existían diferencias significativas en función del grupo estudiado, con mayor puntuación media en el grupo con SBAR (grupo postSBAR+: media ± DE 7,56 ± 1,20 frente a grupo postSBAR−: 5,41 ± 2,98; p < 0,001) y en función de que el anestesiólogo responsable de la intervención participara en el estudio (media ± DE: 7,00 ± 1,99; frente a 4,81 ± 3,24 en los no participantes; p < 0,001) (AU)

Objective. The lack of communication is a major cause of health care errors, especially during patient transfer between practitioners and/or healthcare units, when standardization of communication is a recommended practice. In our study we wanted to assess whether the application of the structured communication SBAR tool could influence the quality of the information written on the progress sheet by the anesthesiologist involved in the transfer of the patient after surgery. Material and methods. This is an observational, retrospective, randomized, quality review of the written record made by the anesthesiologist during the transfer of patients from the surgical area to the postoperative recovery unit, by applying a validated list. We evaluated three observation periods: a control period of two months in 2011 (preSBAR) and a second period of two months in 2012 (postSBAR); in the latter two groups of patients were transferred (postSBAR +) or without SBAR (postSBAR−). Results. The strength of agreement between raters obtained an intraclass correlation coefficient of 0.8459 (p <0.001). There were significant differences in the study group, with highest average score in the group with SBAR (postSBAR + group: mean ± SD 7.56 ± 1.20 versus postSBAR-group: 5.41 ± 2.98, p <0.001) and depending on the anesthesiologist responsible for the intervention participated in the study (mean ± SD: 7.00 ± 1.99, compared to 4.81 ± 3.24 in the non-participants, p <0.001). Conclusions. There was an improvement in the quality of written records made in 2012 during the implementation of the SBAR, without the actual application of this instrument appearing to influence it. The anesthesiologists that were involved in new forms of patient safety were also those who made written records of highest quality (AU)

[Quality of the anesthesiologist written record during the transfer of postoperative patients: Influence of implementing a structured communication tool]. / Calidad del registro escrito del médico anestesiólogo durante la transferencia de pacientes postoperados: influencia de la aplicación de una herramienta de comunicación estructurada.

OBJECTIVE: The lack of communication is a major cause of health care errors, especially during patient transfer between practitioners and/or healthcare units, when standardization of communication is a recommended practice. In our study we wanted to assess whether the application of the structured communication SBAR tool could influence the quality of the information written on the progress sheet by the anesthesiologist involved in the transfer of the patient after surgery. MATERIAL AND METHODS: This is an observational, retrospective, randomized, quality review of the written record made by the anesthesiologist during the transfer of patients from the surgical area to the postoperative recovery unit, by applying a validated list. We evaluated three observation periods: a control period of two months in 2011 (preSBAR) and a second period of two months in 2012 (postSBAR); in the latter two groups of patients were transferred (postSBAR +) or without SBAR (postSBAR-). RESULTS: The strength of agreement between raters obtained an intraclass correlation coefficient of 0.8459 (p <0.001). There were significant differences in the study group, with highest average score in the group with SBAR (postSBAR + group: mean ± SD 7.56 ± 1.20 versus postSBAR-group: 5.41 ± 2.98, p <0.001) and depending on the anesthesiologist responsible for the intervention participated in the study (mean ± SD: 7.00 ± 1.99, compared to 4.81 ± 3.24 in the non-participants, p <0.001). CONCLUSIONS: There was an improvement in the quality of written records made in 2012 during the implementation of the SBAR, without the actual application of this instrument appearing to influence it. The anesthesiologists that were involved in new forms of patient safety were also those who made written records of highest quality.

An effective night slimming topical treatment.

So-called 'sex-specific fat' appears to be physiologically advantageous, but it has a cosmetic downside as well. A pool of functional ingredients, principally represented by botanical extracts, was selected to treat this condition, specifically for people intimidated by other more invasive approaches. The topical product was formulated using ingredients aimed at two specific actions; adipolysis and microcirculation stimulation [1-4]. The product was conceived for night-time application because during the night the body releases Growth Hormone, which activates adipolysis and blood flow, and the skin barrier function and metabolic rate are also more active. We aimed at assessing the effect of the topical product vs. placebo through an in vivo evaluation protocol, performed using a skin bioengineering method, namely ultrasonography, and clinical evaluation. The protocol was conducted as a double-blind, active vs. placebo trial (form. N°690 vs. form. N°1362), on 100 subjects enrolled by two research centres (Pavia and Rome, Italy), over a 4 week period, during which volunteers were checked four times, both clinically and instrumentally. At the end of the trial, both centres agreed on the slimming effects of the topical product. Tolerability was good. The enrolled volunteers expressed their full satisfaction regarding the product under study.

Valoración de la satisfacción materna con la analgesia epidural para el trabajo del parto / Assessment of maternal satisfaction with epidural analgesia during labour

Objetivos. Conocer el grado de satisfacción de las pacientes obstétricas a las que se les realiza la técnica epidural para el trabajo de parto. Material y métodos. Encuestas realizadas durante tres meses a las pacientes ingresadas en el Hospital Universitario Virgen de las Nieves (HUVN) a las que se les aplicó la técnica epidural para control del dolor para el parto. Resultados. Se recogieron 100 encuestas de un total de 105. La satisfacción media global de las pacientes (puntuación SERVQHOS) fue de 3,98 con una desviación estándar, DE±0,64 con mejor resultado en las cuestiones subjetivas: 4,10 con DE±0,68 y menor en las objetivas con 3,86 y DE±0,73. El 92% de las pacientes se mostraron satisfechas con la analgesia epidural, con un intervalo de confianza, IC al 95% entre 87-97%. El análisis de los factores demográficos no mostró asociación estadísticamente significativa entre la edad de las pacientes y un mayor grado de satisfacción; tampoco se encontraron diferencias estadísticamente significativas entre la nacionalidad y la valoración de la satisfacción con la técnica epidural. El grado de recomendación posterior fue de 98% en las pacientes satisfechas y 85,7% en las no satisfechas. Conclusiones. La proporción de pacientes satisfechas con la técnica fue muy elevada, siendo los aspectos subjetivos los mejor valorados (trato y confianza en profesionales)(AU)

Objective. To measure the overall satisfaction of obstetrics patients with epidural analgesia during labour, and in particular, with the technique and other subjective factors. Material and methods. An anonymous questionnaire was administered over a three-month period to patients who received analgesia to control pain during labour and who had vaginal delivery, in order to obtain information of the satisfaction with technique and their care. Results. Of the 100 patients who responded to the questionnaire, 92% were satisfied with the technique. The mild satisfaction measured by SERVQHOS score was 3.98 (SD±0.64). The score for the subjective aspects was 4.10 (± 0.68), which was better than objective ones. The recommendation rate was 98% for satisfied patients and 85.7% for those who were not satisfied. There were no differences between Spanish and foreign patients in their evaluation of the satisfaction. Conclusions. The proportion of patients satisfied with the technique was very high, and was the top rated subjective aspect (treatment and public confidence)(AU)

[Assessment of maternal satisfaction with epidural analgesia during labour]. / Valoración de la satisfacción materna con la analgesia epidural para el trabajo del parto.

OBJECTIVE: To measure the overall satisfaction of obstetrics patients with epidural analgesia during labour, and in particular, with the technique and other subjective factors. MATERIAL AND METHODS: An anonymous questionnaire was administered over a three-month period to patients who received analgesia to control pain during labour and who had vaginal delivery, in order to obtain information of the satisfaction with technique and their care. RESULTS: Of the 100 patients who responded to the questionnaire, 92% were satisfied with the technique. The mild satisfaction measured by SERVQHOS score was 3.98 (SD ± 0.64). The score for the subjective aspects was 4.10 (± 0.68), which was better than objective ones. The recommendation rate was 98% for satisfied patients and 85.7% for those who were not satisfied. There were no differences between Spanish and foreign patients in their evaluation of the satisfaction. CONCLUSIONS: The proportion of patients satisfied with the technique was very high, and was the top rated subjective aspect (treatment and public confidence).

Ventilación dirigida contrastada y entrenamiento muscular aeróbico-anaeróbico mejoran un paciente con EPOC severo por enfisema pulmonar / Comprehensive directed breathing and aerobic-anaerobic muscle training strongly improve a patient with severe COPD by pulmonary emphysema

ObjetivoAnalizar los efectos de la asociación de ventilación dirigida contrastada con entrenamiento Square Wave Endurance Exercise Test (SWEET), 4-minutos aeróbicos y 1-minuto anaeróbico, repetido 9 veces en 45min, con oxigenoterapia al ejercicio, en un paciente (73 años) con EPOC severo, hiperinflación e hipoxemia al ejercicio.MetodologíaExamen clínico y funcional, y 4 pruebas de ejercicio: 6 min marcha, «escabel», ejercicio incremental y SWEET controlando la disnea (Borg), la SpO2 y la FC. La gasometría arterial (PaO2, PaCO2, pH, ácido láctico), el metabolismo (O2, CO2), el patrón ventilatorio (E, FR, VT) y la frecuencia cardiaca (FC) se comparan antes y después de 11 sesiones de 120min «personalizadas», vigiladas por el fisioterapeuta y rehabilitador especializados, y 6 meses después de autotratamiento a domicilio.ResultadosSe corrigen la asincronía tóraco abdominal, la ventilación paradójica y se mejora la espirometría discretamente, pero los flujos y las presiones respiratorias máximas aumentan mucho más (+132 y +119%), así como la capacidad aeróbica (+111%), la deambulación (+32%) y escabel (+119%). La eficacia ventilatoria aumenta, y el metabolismo disminuye en reposo. La disnea de esfuerzo (DE) se reduce en un 35%, y el volumen residual en un 33%.ConclusiónEl protocolo de ventilación dirigida contrastada más el entrenamiento Square Wave Endurance Exercise Test realizado ha sido efectivo para reducir la disnea de esfuerzo, aumentar la capacidad de ejercicio máximo, los flujos y las presiones respiratorias máximas en este paciente con enfisema pulmonar y EPOC severo (AU)

ObjectiveTo analyze the effects of the combination of Comprehensive Directed Breathing (CDB) with training Square Wave Endurance Exercise Test (SWEET), 4-min aerobic and 1-min anaerobic repeated nine times in 45min, with oxygen therapy during exercise, in a patient (73 years) with severe COPD, hyperinflation and hypoxemia during exercises.MethodologyClinical examination, functional testing and 4 exercise testing: 6-min walking test (6MWT), two step stool, incremental exercise and the SWEET, with control of exertional Dyspnea (Borg’ scale), SpO2 and heart rate (HR). Arterial blood gases (PaO2, PaCO2, pH, lactic acid), metabolism (O2, CO2), ventilatory pattern (E, FR, VT) and heart rate (HR) were compared before and immediately after 11 tailored sessions of 120-min supervised by the respiratory physiotherapist and the physiatrist specialists. Then, he continued at home applying himself the full learning protocol and a fast-control was made six months later.ResultsThe thoraco-abdominal asynchrony and paradoxical ventilation were corrected and the spirometry improved discreetly, but the maximal flows and respiratory pressures increase strongly (+132 and +119%), as well as aerobic capacity (+111%), ambulation (32%) and the two step stool (+119%). The ventilatory efficiency increases and the resting metabolism decreases. Exertional dyspnea is reduced by 35% as the residual volume by 33%.ConclusionThe protocol CDB plus SWEET has been made effective in reducing exertional Dyspnea, increased MVV, maximum exercise capacity and maximal respiratory flows and pressures in this patient with severe emphysema and COPD (AU)

Disnea de esfuerzo, deterioro del patrón ventilatorio y mala tolerancia al ejercicio: ¿ signos precoces de insuficiencia respiratoria? / Exertional dyspnea, rapid shallow breathing and poor exercise toleran Early signs of respiratory impairment?

IntroducciónLa disnea de esfuerzo (DE) es frecuente entre fumadores a pesar de una espirometría normal.ObjetivosDeterminar si el test de ejercicio y la observación de posibles alteraciones del patrón ventilatorio pueden reflejar una insuficiencia respiratoria precoz.Material y métodoSe ha comparado a 24 varones fumadores que presentaban DE con 31 varones fumadores sin DE. En ambos grupos se realizó espirometría, pletismografía, estudio del patrón ventilatorio, gasometría arterial y test de ejercicio incremental (30W/3min), empezando por 40W×10min. La se evaluó mediante la escala de Borg.ResultadosLa espirometría era normal en ambos grupos. Los sujetos con DE presentaron un aumento de la frecuencia respiratoria (fB) y un volumen corriente (VT) significativamente reducido (p<0,001), con un patrón respiratorio más superficial. Además, mostraban una reducción superior al 30% del consumo máximo del VÿO2pico y de la potencia máxima tolerada (Wmáx) (p<0,01). Se observó una disminución de la ventilación alveolar (VÿA/VÿE), la PaO2 y el pulso de O2 (p<0,01), mientras que la ventilación (VÿE), la relación ventilación (VE)/ventilación máxima minuto (MVV), el espacio muerto (VD), la lactatemia (AL) y la frecuencia cardiaca (FC) fueron, para un mismo nivel de ejercicio, significativamente mayores (p<0,01) en el grupo de disneicos.ConclusionesSujetos aparentemente sanos, cuya espirografía es normal, presentan DE, junto con una combinacion de efectos adversos durante el ejercicio (aumento de la demanda ventilatoria central, importantes alteraciones del patrón ventilatorio, con hipoventilación e importante reducción de la máxima cantidad de ejercicio). Tales alteraciones frecuentemente no se exploran, pero se podrían corregir mediante un elaborado tratamiento fisioterapéutico y entrenamiento muscular(AU)

AbstractExertional dyspnea (ED) is common among smokers despite a normal spirometry.ObjectivesThis study aimed to determine whether exercise testing, overbreathing and altered breathing pattern can reflect early respiratory impairment.Material and methodTwenty-four active ED male smokers aged 33–60 years, with no background of muscular, cardiac or respiratory disease, were compared to 31 healthy smokers (with no ED). Spirometry, plethysmography, ventilatory pattern and arterial blood gases were assessed in both groups and dyspnea was estimated using a Borg scale at every 30W/3min step of incremental maximal exercise, starting with 40W for 10min.ResultsSpirometry data was normal in both groups. Compared to healthy subjects, the respiratory pattern was significantly (p<0.001) more rapid and shallow with smaller tidal volume (VT) (p<0.001) and less alveolar ventilation (VÿA/VÿE) and PaO2 while ventilation (VÿE), the ratio VÿE/MVV, ventilatory frequency (fB), dead space ventilation (VD), lactic acidemia, and cardiac frequency (fC) were significantly higher (p<0.01) in the ED group. The significant differences (p<0.05) observed at rest were amplified during exercise and VÿO2 pico and maximal power load were 30% lower (p<0.001) in ED subjects.ConclusionsApparently healthy subjects, whose spirometry are normal, complain of exertional dyspnea associated with a combination of adverse effects of: increased central ventilatory demand, overbreathing, impairments of ventilatory pattern, hypoventilation, and severe reduction of the maximal levels of exercise. These changes are not often explored, although they are potentially susceptible to correction corrected with sophisticated respiratory physiotherapy and exercise training(AU)

Effects of topical gluco-oligosaccharide and collagen tripeptide F in the treatment of sensitive atopic skin.

Sensitive skin is a dermatological problem of increasing incidence in western countries and is sometimes associated with atopic condition and bacterial sovrainfection. The purpose of this study is to evaluate in a double blind, randomized, placebo controlled trial the efficacy of gluco-oligosaccharide and collagen tripeptide F in controlling the signs and symptoms of sensitive atopic skin. Forty female subjects (age, 30-59 years) affected by non-lesional atopic sensitive skin entered the study. Skin sensitivity was determined by a dermatologist on the basis of medical history, stinging test, dermatological examination and a questionnaire. A treatment with the test products (active and placebo) was carried out for 4 weeks. Measurements and clinical evaluation were carried out at baseline and at the end of the study. The following objective parameters investigated were bacterial count, skin pH and colour, transepidermal water loss (TEWL), stratum corneum hydration, skin roughness and mechanical properties. Clinical assessment included also a scoring system for dryness, desquamation, irritation, erythema and papules. Significant differences were found in the active treated group when compared with the placebo and in particular for instrumental parameters of roughness (P < 0.02), volume (P < 0.01), TEWL (P < 0.02), erythema (P < 0.0006) and clinical parameters of dryness, desquamation and irritation (P < 0.001). Moisturization levels and skin colour improved significantly in both the active and placebo groups. In conclusion, the study shows that the modulation of bacterial proliferation and normalization of skin barrier properties and stratum corneum moisturization can improve the symptoms of sensitive skin.

E-field assessment errors associated with RF dosemeters for different angles of arrival.

In this paper, an analysis of the surface electric field on a human body based on finite-difference time-domain simulations is presented. A statistical analysis of the dosemeter interaction with the human body has been made by means of the variations of the relative orientation of the human body from the RF source. Variations of the RF source frequency have also been made, by comparing three different services FM, GSM-900 and DCS-1800. Three different scenarios have been simulated where the angle of arrival of the main RF contribution impinges on the human body with a certain probability. Despite the differences between the scenarios, the variations in the electric field strength at each frequency are negligible where the dosemeter would be located.

High rates of tuberculosis infection among children from Ciutat Vella District, Barcelona, 1996-1997.

With tuberculosis (TB) rates of over 160/100,000 in 1997, Ciutat Vella District, Barcelona, is the main community focus of TB in the city. For the purpose of TB screening, 415 children >2 years old from that district received a tuberculin skin test (TST); 27 (6.6%) (95%CI 4.5-9.3) were found to be infected but disease-free. The frequency of a positive TST increased significantly with age, from 0% in the 2-4 year age group to 14.6% in 10-14 year olds. Three culture-positive source adults, two of them sputum smear-positive, who were not previously known were traced from six TST-positive children. Previous BCG vaccination was not associated with a positive TST. These data support the use of universal TST screening in children living in Ciutat Vella District, Barcelona, as a means of identifying and treating TB cases.

Differential effect on U937 cell differentiation by targeting transcriptional factors implicated in tissue- or stage-specific induced integrin expression.

The inhibition of transcription factor functions was used to define their role in phorbol ester-induced cellular differentiation of a monocytic cell line, U937. We demonstrate a differential effect on cell adhesion and differentiation: antisense or competitive binding with double-stranded oligonucleotides antagonized the functions of AP-1, NF-kappaB, and PU.1 transcriptional factors. In the presence of phorbol 12-myristate 13-acetate (PMA), U937 cells attached to the plastic surface and cells were characterized by marked expression of beta2-integrin molecules on the cell surface. We show that the in vivo differentiation of U937 cells appears to occur normally in the absence of AP-1 activity. In contrast, the addition to the cell culture of phosphorothioate oligonucleotides that contained the NF-kappaB or PU.1 binding sites significantly inhibited U937 differentiation. The absence of NF-kappaB led to pleiotropic effects with a clear reduction in the expression of integrin and other lineage-specific myeloid antigens on the cell surface. In contrast, the absence of PU.1 had a more restricted effect on integrin expresion on the cell surface, probably as a result of blockage of CD18 gene expression.

Teleradiology as a seed of the regional health care Intranet in a rural region in Spain.

Castilla y León is a rural region with a very sparse population of about 2,560,000 habitants. Special health care challenges appear due to this region's very aged population and large dimensions. A theoretical model of services of Telemedicine is proposed and an experimental teleradiology trial is carried out between a rural Health Care Centre and its Reference Hospital to make easier the planning of future projects. The total number of studies was increased due to availability of specialised support and higher skills of physicians, but the percentage of studies consulted to specialists diminished. Continuing education through physicians communication was highly improved.

Unresponsiveness to interferon associated with STAT1 protein deficiency in a gastric adenocarcinoma cell line.

HC class I expression can be up-regulated by interferons (IFN) and other cytokines. Both IFNalpha and IFNgamma have been shown to exert their effects via a recently discovered signalling pathway by inducing tyrosine phosphorylation of their receptors. Receptors for interferons and other cytokines signal through the action of associated protein tyrosine kinases of the JAK family (Janus kinase) and latent cytoplasmic transcriptional activators from the STAT family (signal transducers and activators of transcription). Here we report a gastric adenocarcinoma cell line, AGS, that is defective in its response to either IFNalpha or IFNgamma. AGS cells display selective alterations only in MHC class I inducibility and not in constitutive MHC class I expression. In nuclear extracts of AGS cells, no binding activity to interferon-responsive elements (GAS/ISRE) was observed. We found that AGS cells showed an extremely low level of STAT1 expression, which may be responsible for the absence of biological response to IFN. Because STAT1-deficient cells are highly sensitive to infection by virus, the absence of these proteins may also contribute to the tumor phenotype, giving the tumor a selective advantage, by inhibiting cell growth suppression mediated by IFN and abetting escape from the T cell antitumor response.

In vivo and in vitro generation of a new altered HLA phenotype in melanoma-tumour-cell variants expressing a single HLA-class-I allele.

A new HLA-class-I altered phenotype is described in melanoma. This phenotype is the result of a combination of HLA-B-locus down-regulation and HLA-haplotype loss. The alteration was found in 2 melanoma cell lines generated from 2 patients; one was derived from an in vivo lesion (FM37) and the other was obtained after in vitro immunoselection (R22.2). The R22.2 cell line was isolated from FM55P, a cell line derived from a primary melanoma, after in vitro treatment with a heterologous HLA-A2-restricted cytotoxic-T-lymphocyte (CTL) clone. Two additional cell lines from patient 55 were obtained from 2 s.c. metastases (FM55M1 and FM55M2). Iso-electric focusing and flow-cytometric studies showed a significant reduction in the expression of both HLA-B alleles in all cell lines studied. The expression of HLA-B-locus products recovered completely after IFN-gamma treatment of FM55P, M1 and M2. In contrast, FM37 and R22.2 tumour cells showed an additional HLA defect: the absence of one HLA haplotype. Simple tandem-repeat polymorphism markers spanning chromosome 6 showed that DNA from the 2 samples (FM37 and R22.2) showed loss of heterozygosity (LOH). In both cases, homozygosity was observed on 6p, which maps the HLA region, the final consequence being a tumour cell that expressed a single HLA-class-I allele (HLA-A3 and HLA-A1 respectively). FM37 cells may thus reflect the in vivo counterpart of resistance to lysis by HLA-A2-restricted tumour-infiltrating lymphocytes.

Microsatellite instability in cervical intraepithelial neoplasia.

We studied the incidence of microsatellite instability (MI) in lesions defined as cervical intraepithelial neoplasia (CIN). The human papillomavirus (HPV) status of the tissues was also determined. DNA from tissue samples and autologous lymphocytes were studied for five loci located within or adjacent to the DNA mismatch repair genes. Replicate errors were detected in 7 out of 47 (14.8%) samples of cervical tissue from 24 women. Our results indicate that the defect in DNA repair-associated genes does not appear to be necessary for the selection of clones which progress from dysplasia to carcinoma. Although HPV DNA of highly oncogenic types (16/18) was detected in most cervical lesions and may be an important factor for MI, we also detected MI in two loci in HPV-negative normal tissue, indicating that further events can also be involved in mismatch repair defects.

Method of achieving phase delay with wide optical bandwidth in multimode interference devices.

A completely passive method of achieving phase delays inside multimode interference devices is presented. The desired relative phase is obtained by adjustment of the width of the waveguides in conjunction with the tapers to avoid interference inside the multimode section. One can generally apply the delay lines to avoid the use of active elements, and they are less sensitive to changes in wavelength than the traditional method with bends. Using this method, we have designed and analyzed a zero-to-one mode converter. The converter exhibits minimum excess loss of 0.100 and 0.102 for TE and TM polarization, respectively. A very large 1-dB bandwidth exceeding 350 nm is achieved.

Modulation of Kupffer cell and peripheral blood monocyte activity by in vivo treatment of rats with all-trans-retinol.

Previous studies have shown that large doses of vitamin A potentiate chemical-induced liver injury and that the Kupffer cell is directly involved in this potentiation. Therefore, these studies were designed to determine if Kupffer cells isolated from vitamin A treated male Sprague-Dawley rats (75 mg/kg/day for 3-7 days as all- trans-retinol) had altered activity and function. Respiratory activity of Kupffer cells isolated from rats treated with vitamin A for 3 to 7 days markedly increased. Similarly, phagocytic activity was significantly elevated (up to 9-fold) after exposure to vitamin A for 3 to 7 days. Production of reactive oxygen species, measured by luminol-enhanced chemiluminescence of Kupffer cells isolated after 7 days of vitamin A exposure, was significantly higher than that of control cells when stimulated with opsonized zymosan. Also, the release of superoxide anion by individual Kupffer cells isolated from vitamin A treated rats was nearly three times greater than that of control cells. Basal production of tumor necrosis factor-alpha (TNF-alpha) and prostaglandin E2 (PGE2) production were significantly elevated in Kupffer cells isolated from rats treated with vitamin A. Lastly, peripheral blood monocytes (PBMC) isolated from rats treated with vitamin A for 7 days had a significantly greater respiratory activity, as well as TNF-alpha and PGE2 production, than PBMC isolated from control rats. Our data suggest that large doses of vitamin A enhance both Kupffer cell and PBMC function. Upregulation of the activity by these phagocytic cells may play a role in the vitamin A potentiation of chemical-induced liver injury.

Methylated CpG points identified within MAGE-1 promoter are involved in gene repression.

The MAGE-1 gene, expressed in some tumors of different histological origins, codes for a tumor antigen recognized by cytotoxic T lymphocytes. The gene is not expressed in normal tissues with the exception of testes. The present study was designed to investigate the relationship between methylation of the MAGE-1 promoter and inactivation of the MAGE-1 gene. We examined the extent to which MAGE-1 B'B promoter sequences are methylated in tumor-cell lines, in order to determine whether methylation correlates with MAGE-1 expression. Using methylation-sensitive restriction analysis followed by polymerase chain reaction (PCR), we found an inverse correlation between methylation of the MAGE-1 B'B region and MAGE-1 expression. An unmethylated state was identified in DNA from sperm and some tumor-cell lines of different origins. In contrast, a hypermethylation state was found in leukocytes and other MAGE-1 non-expressing cells. Furthermore, treatment with 5-aza-2'-deoxycytidine, a demethylating agent, induced MAGE-1 expression in tumor-cell lines in which we found no direct relation between transcriptional activity of the B'B region and MAGE-1 expression. Binding of the nuclear factors to the B'-methylated probe was strongly inhibited, indicating that methylation of cytosine interferes directly in the binding of transcriptional factors.

Characterization of a gastric tumor cell line defective in MHC class I inducibility by both alpha- and gamma-interferon.

Alpha/beta and gamma type interferons (IFN), act through distinct cell surface receptors and induce transcription of an overlapping sets of genes. MHC class I genes are inducible by both type of interferons. We have analyzed a gastric tumor cell line, AGS, which was completely defective in MHC class I response to interferon-alpha and gamma. Northern blot analysis demonstrated that the lack of IFN response was related with the absence of up-regulation of specific HLA class I mRNA. Electrophoretic mobility shift assays in various tumor cell lines after IFN-alpha and IFN-gamma treatment showed differential binding of the transcriptional factors to MHC class I regulatory elements. Comparison of kappa-B binding activity showed that IFN-alpha and IFN-gamma induced opposite changes in NF-kappa B binding activity in AGS cells, indicating that the absence of MHC class I response in AGS appears to be independent of kappa-B activity. In contrast, there were remarkable differences in the level of transcriptional factor binding to an interferon-responsive sequence element (IRSE), between AGS and other interferon-responsive tumor cell lines. This result suggests that the low level of transcriptional factor binding to IRSE in AGS cells was responsible of the lack of induction of MHC class I antigens. In this context, overlapping factors in the signal transduction pathway of both type I and II interferons may be involved in the non-responsiveness of this gastric carcinoma tumor cell line.