Acute intrauterine infection results in an imbalance between pro- and anti-inflammatory cytokines in the pregnant rabbit.

PROBLEM: Intrauterine infection results in an increase in cytokines. This study compared the time courses for the pro- and anti-inflammatory cytokine responses in 33 pregnant rabbits at 70% gestation. Pro-inflammatory markers were activated nuclear factor-kappa B (NF-kappaB) in placenta and tumor necrosis factor-alpha (TNF-alpha) in amniotic fluid. These were compared to the anti-inflammatory cytokine, interleukin-1 receptor antagonist (IL-1ra), in placenta and uterus. METHOD OF STUDY: Does were endoscopically inoculated with Escherichia coli through their cervices and sacrificed at six intervals between 0 and 30 hr post-inoculation. RESULTS: Activated NF-kappaB, determined by electromobility gel shift assay, increased significantly 16 hr after bacterial inoculation (P < or = 0.05). This was directly mirrored by TNF-alpha concentrations, determined by bioassay, in the amniotic fluid. However, IL-1ra levels, determined by enzyme-linked immunosorbent assay, did not increase in response to infection. CONCLUSIONS: Intrauterine infection results in an imbalance between pro- and anti-inflammatory cytokines that may potentiate infection-induced preterm delivery.

Laboratory services in the context of health care in the 1990's.

Third in a series of articles on the Clinical Laboratory of the Future, this paper explores the trends affecting the human dimension of laboratory services. The role of the medical laboratory technologist will change along a number of predictable trends over the next five years. Each of these trends is discussed in light of the adjustments to be made over the next five years.

The clinical laboratory of the future: re-aligning the human resources.

The first article in this series focussed on the laboratory process as a complete entity. Reengineering this process results in a totally new way of delivering value to the user of the laboratory services. Current thinking and assumptions about an organization, roles, procedures and skills are set aside and a new framework developed. The people are a key component in any change process and their involvement is essential for the project to succeed. Communication, understanding, participation, skill development and ultimately new roles are all part of an exciting personal development opportunity.

The clinical laboratory of the future: re-engineering laboratory services.

Re-engineering of the process to deliver laboratory services to patients is essential to meet the pressures for patient-focussed care and cost control. Re-engineering requires that laboratory staff abandon their current thinking and assumptions about organization, roles, procedures, skills and tools to focus on a totally new way of delivering value to the patient. The rewards are high for the organization. The risks must be managed by following a proven approach. The opportunities for personal development are exciting.

The role of glial fibrillary acidic protein in the diagnosis of central nervous system tumors.

Eighty glial and non-glial brain tumors have been studied to date using an immunologically specific and highly sensitive method of staining GFA protein which is applicable to formalin fixed and paraffin embedded tissue. Eight of these cases have been described and illustrated in some detail. GFA protein was present in all astrocytes and astrocytomas studied and in a proportion of ependymal cells and ependymomas. Some tumor cells have been demonstrated by this method to be glial despite the complete lack of blue fibrillar staining with PTAH and the absence of all morphological similarity to glial cells. In such cases the demonstration of GFA protein by this method has been valuable in establishing a diagnosis. In addition to its diagnostic value in specific cases, the method promises to shed light on unsolved problems of tumor cytogenesis.