Labeling smokers' charts with a "smoker" sticker: results of a randomized controlled trial among private practitioners.

We randomly assigned private practitioners (n = 393) to receiving, by mail, a box of "Smoker" stickers and a recommendation to label smokers' charts with these stickers, or to no intervention. Twenty percent of the physicians reported using the stickers and applying them on 43% of their smoking patients' charts. The intervention had no impact on physician reports of the proportion of smokers advised to quit smoking, but physicians who reported using the stickers stated that they advised more smokers to quit after the intervention (89%) than before (80%, P =.02). Thus, self-reports by physicians indicated that use of the stickers was associated with an increased proportion of smokers advised to quit. However, overall, the intervention did not modify physicians' behavior.

Expression and modulation of surface antigens in cultured rat glomerular visceral epithelial cells.

This study, using immunocytochemical light and electron microscopy techniques, characterizes the distribution of three antibodies bound to the surface of rat glomerular visceral epithelial cells (GEC) in culture, and tests their ability to redistribute corresponding antigens under conditions appropriate for antigenic modulation (antigen disappearance). At 4 degrees C or after fixation, anti-renal tubular brush border vesicle (BBV) IgG bound diffusely to the surface of GEC and to coated pits. Anti-gp330 IgG had a discrete distribution on the surface of GEC and reacted with coated pits. Anti-podocalyxin IgG was bound diffusely to the surface of GEC but not to coated pits. At 37 degrees C, anti-BBV IgG induced marked redistribution of immune complexes with both shedding and internalization. Anti-gp330 IgG induced weaker redistribution, with internalization of immune complexes predominating. Anti-podocalyxin IgG induced rapid redistribution of immune complexes and antigenic modulation but minimal internalization. Experiments of differential redistribution indicated that anti-BBV IgG modulated the expression of both gp330 and podocalyxin; anti-gp330 IgG had a weaker effect on BBV antigens and podocalyxin; and anti-podocalyxin failed to redistribute BBV antigens or gp330. The relevance of these immunocytochemical studies of antibody-cell surface antigen interaction in cultured GEC to understanding the pathogenesis of Heymann glomerulonephritis (HG) is discussed.

Differences in glycocalyx composition between cells of the cortical thick ascending limb of Henle and the macula densa revealed by lectin-gold cytochemistry.

The glycocalyx composition of cells from the macula densa and the cortical thick ascending limb of Henle was examined in rabbit kidney by means of the lectin-gold technique. A quantitative evaluation at the ultrastructural level showed that macula densa cells had a considerably greater affinity for Helix pomatia lectin than adjacent cells of the thick ascending limb. Wheat germ lectin and concanavalin A bound equally well to both cell types. This difference in plasma membrane glycocalyx composition may be an important aspect of the functional differentiation of cell types in this specialized nephron segment.