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A genetic linkage map of 27 loci from PND to FY on the short arm of human chromosome I.

A genetic linkage map of 27 loci on the short arm of human chromosome 1 has been developed by analysis of the 40 families in the Centre d'Etude du Polymorphisme Humain (CEPH) reference panel. Probes that recognize 14 novel RFLPs at loci designated D1S9-D1S22 were isolated from a flow-sorted chromosome 1 library. A linkage map of chromosome 1p was constructed from the genotypic data at these 14 loci, RFLPs at eight cloned genes (PND, ALPL, FUCA1, SRC2, MYCL, GLUT, TSHB, and NGFB), two previously identified RFLPs (D1S2 and D1S57), two blood group antigens (RH and FY), and the isozyme PGM1. All 27 loci form a continuous linkage group, from FY to PND, of 102 cM in males and 230 cM in females. This map provides a basis for highly informative multipoint mapping studies for most of the short arm of chromosome 1.

Animals↗

Etiological heterogeneity in X-linked spastic paraplegia.

We describe a large family (K313) having 12 males affected with X chromosome-linked recessive hereditary spastic paraplegia (HSP). The disease phenotype in K313 is characterized by hyperreflexia and a spastic gait, but intelligence is normal. Carrier females have normal gait and unremarkable neurologic profiles. Eight widely spaced X-linked DNA markers were used to genotype 43 family members. In contrast to a published study of another family, in whom complete linkage of X-linked recessive HSP to distal chromosome Xq markers DXS15 and DXS52 was reported, we observed complete linkage with two DNA markers, pYNH3 and DXS17, located on the middle of the long arm of the X chromosome. These data have been combined with linkage data from a large reference panel of normal families to localize the new X-chromosome marker, pYNH3, and to provide evidence of significant locus heterogeneity between phenotypically distinct forms of X-linked recessive HSP.

Adult↗

[Attempt at evaluating the HL-A system relationship with Rh-D antigen-stimulalated immunological response].

In 96 subjects immunized artificially with antigen D HLA system antigens were determined. In 21 cases antibodies were not produced, in 70 good response to antigen D was observed, in 5 cases antibodies were produced with considerable delay. The method of two-step lymphocytotoxicity test of Terasaki was used. The reference panel included 90 sera with antibodies to antigens: 1, 2, 3, 11, W23, W24, W25, W26, W28, W29, W30, W31 from first sublocus, and 7, 8, 12, 13, W5, W10, W14, W15, W16, W17, W18, W21, W22, W27 from second sublocus. Seventy of the immunized volunteers responded by production of antibodies (group I). and 21 failed to respond (group II). The frequency of different HLA antigens was analysed statistically in both groups using the chi square test and comparing the results with the frequency in a random population of healthy non-immunized subjects. Statistically significant differences were found in antigens 2, 3 and W24 from sublocus HLA-A (LA) and W16 from sublocus HLA-B (Four). In the non-responding group antigens HL-A3 and W24 were more frequent than in the group producing anti-D antibodies. In the latter group antigen HL-A2 prevailed. It seems that the gene determining rapid recognition of antigen D is connected with presence of HL-A2 antigen.

Antibody Formation↗

Malignant mesothelioma--clinical and epidemiological features. A report of 80 cases.

The clinical and epidemiological features of 80 cases of malignant mesothelioma (as proved by examination of biopsy specimens) referred to the clinic at the National Centre for Occupational Health between January 1977 and June 1983 are reviewed. There was a positive history of asbestos exposure in 89% of cases. The mean survival time from diagnosis to death was 8,6 months and from the onset of symptoms to death 13,6 months. Survival time was unaffected by stage of the tumour, treatment, histological features, smoking status, presenting symptoms, presence or absence of effusion and asbestosis, side of the lesion, source of exposure and lag period from first exposure to diagnosis. The duration of survival was significantly affected by age at diagnosis, duration of asbestos exposure and the number, rather than the type, of treatment regimens used. Caution is advocated in interpreting these data since the number of cases was small and the study design was retrospective. A reference group of 546 cases notified over the same period was drawn from the records of the South African Asbestos Tumour Reference Panel. The incompleteness of national mesothelioma incidence data was noted, and an incidence figure of 7,2 per million per year was calculated from the best-available data for South Africa. This figure is an underestimate because not all diagnosed cases are reflected and, more important, significant numbers of cases are never diagnosed. The extent to which the compensation machinery functions is mentioned.

Adult↗

Use of cholera toxoid in an enzyme-linked immunosorbent assay for antitoxin.

A glutaraldehyde-inactivated toxoid was evaluated as a coating antigen in an ELISA for cholera antitoxin. A reference panel of 36 human sera with antitoxin levels determined by several other assay systems and 58 sera from an outbreak of illness due to Vibrio cholerae were studied. Toxoid compared favorably with two purified cholera toxins, and the microtiter assay using all three antigens was effective in detecting antibody in known convalescing cholera patients.

Animals↗

Breakpoint analysis: precise localization of genetic markers by means of nonstatistical computation using relatively few genotypes.

Placing new markers on a previously existing genetic map by using conventional methods of multilocus linkage analysis requires that a large number of reference families be genotyped. This paper presents a methodology for placing new markers on existing genetic maps by genotyping only a few individuals in a selected subset of the reference panel. We show that by identifying meiotic breakpoint events within existing genetic maps and genotyping individuals who exhibit these events, along with one nonrecombinant sibling and their parents, we can determine precise location for new markers even within subcentimorgan chromosomal regions. This method also improves detection of errors in genotyping and assists in the observation of chromosome behavior in specific regions.

Algorithms↗

[Refraction in childhood as a risk factor for the development of amblyopia and/or strabismus. Recording a round table discussion at the 89th Congress of the German Society of Ophthalmology 25 September 1991 in Leipzig].

The members of the panel refer to the recent literature. As has been shown by several groups of authors (Atkinson et al., Abrahamsson et al., Ingram et al.) hypermetropia of 3 diopters or more as well as astigmatism of 1 or more dpt at the age of 12 months, especially oblique astigmatism, increase the rate of amblyopia/strabism until the age of 4 years. The risk rises too, if the refractive error deteriorates. The authors conclude that the prescription of glasses in non-squinters should be based on these new findings.

Amblyopia↗

Development of lymphocytotoxic antibodies among lung transplant recipients: preliminary results.

The aim of this study was to evaluate the incidence of postoperative lymphocytotoxic antibodies (LA) formation and to assess their potential utility in immunologic monitoring after lung transplantation. We determined prospectively the percentage LA against a reference panel reactive antibody in a complement-dependent microlymphocytotoxicity test in 137 sequential serum samples obtained from 14 consecutive lung transplant recipients who survived over the first postoperative year. Four patients developed high titers of LA (greater than 10% panel reactive antibody reactivity in at least 3 consecutive samples) by 2 to 24 months after surgery. Antibodies were mostly immunoglobulin M isotype, without any specificity against the donor's human leukocyte antigen and were correlated with the development of bronchiolitis obliterans syndrome (p=.01) and with chronic bronchial infectious colonization (p=.03). In conclusion, a polyclonal immunoglobulin M antibody production can be detected in serum samples from lung transplant recipients and seems to be involved in the progression of chronic rejection process. These preliminary results incline to carry on the cytotoxicity screening of a panel of lymphocytes to better understand the significance of such reactivity.

Adenosine Triphosphate↗

Collaborative evaluation of the micro-media systems anaerobe susceptibility panel: comparisons with reference methods and test reproducibility.

The Micro-Media Systems (MMS) anaerobe susceptibility testing panel results from four laboratories were compared for interlaboratory and intralaboratory variations and for the results with the reference agar dilution and a broth microdilution method. The interlaboratory agreement was 98.0% and intralaboratory agreement was 97.3% (+/- 1 log2 dilution). When interpretive criteria for each antimicrobial agent (susceptible, intermediate, and resistant) were assigned, the MMS anaerobic minimum inhibitory concentration data showed an interpretive accuracy of 91.0 and 95.5% for comparisons to the reference agar dilution and the broth methods, respectively. Most significant interpretive errors were considered minor, and nearly half of all errors involved tetracycline, a drug rarely used for serious anaerobic infections. The MMS anaerobe panels appear to be acceptable for selected use in clinical microbiology laboratories.

Anaerobiosis↗

Commercial broth microdilution panel validation and reproducibility trials for NVP PDF-713 (LBM 415), a novel inhibitor of bacterial peptide deformylase.

NVP PDF-713 (LBM 415) is a peptide deformylase inhibitor being progressed into clinical trials. Dry-form broth microdilution panels of NVP PDF-713 were compared to reference MIC panels of 552 recent clinical isolates. Most (99.2%) dry-form MIC results were within +/- 1 log(2) dilution of the reference panel MICs. Of the bacteria tested, Streptococcus pneumoniae and Haemophilus influenzae showed a bias towards higher and lower MICs, respectively. Same-day and between-day reproducibility tests showed that 98.9% and 96.7% of MIC values, respectively, were within +/- 1 log(2) dilution step, thereby demonstrating a high degree of reliability of the dry-form MIC product for clinical studies.

Amidohydrolases↗

Development and characterization of genetic mapping resources for the turkey (Meleagris gallopavo).

The development and partial characterization of turkey genomic libraries enriched for TG, GAT, and CCT simple sequence repeats (SSR) are described. The primary library, established using conventional methods, was enriched for each of the three SSR by single-primer polymerase chain reaction (PCR). The three enriched libraries were screened by standard hybridization and washing protocols under moderate to high stringency conditions. The utility of a fraction of the markers was evaluated based on the polymorphism of PCR-amplified products in a backcross reference DNA panel. The panel consisted of genomic DNA samples from three backcrossed families developed from a cross of a wild male turkey to three inbred Orlopp line C females. A total of 181 sequences from positive clones have been characterized and deposited in GenBank. About 60% of the 60 primer pairs designed from SSR-containing sequences detected polymorphism in the reference DNA panel. The turkey genomic DNA reference panel, the enriched libraries, and the markers described here provide an opportunity to begin to characterize the turkey genome and to develop a useful public genetic map for this economically important species.

Animals↗

Clinical evaluation of a frozen commercially prepared microdilution panel for antifungal susceptibility testing of seven antifungal agents, including the new triazoles posaconazole, ravuconazole, and voriconazole.

A commercially prepared frozen broth microdilution panel (Trek Diagnostic Systems, Westlake, Ohio) was compared with a reference microdilution panel for antifungal susceptibility testing of two quality control (QC) strains and 99 clinical isolates of Candida spp. The antifungal agents tested included amphotericin B, flucytosine, fluconazole, itraconazole, posaconazole, ravuconazole, and voriconazole. Microdilution testing was performed according to NCCLS recommendations. MIC endpoints were read visually after 48 h of incubation and were assessed independently for each microdilution panel. The MICs for the QC strains were within published limits for both the reference and Trek microdilution panels. Discrepancies among MIC endpoints of no more than 2 dilutions were used to calculate the percent agreement. Acceptable levels of agreement between the Trek and reference panels were observed for all antifungal agents tested against the 99 clinical isolates. The overall agreement for each antifungal agent ranged from 96% for ravuconazole to 100% for amphotericin B. The Trek microdilution panel appears to be a viable alternative to frozen microdilution panels prepared in-house.

Antifungal Agents↗

Managing otitis media with effusion in young children. American Academy of Pediatrics The Otitis Media Guideline Panel.

This reference guide contains highlights from the Clinical Practice Guideline, Otitis Media with Effusion in Young Children. The Otitis Media Guideline Panel, a private-sector panel of health care providers, developed the Guideline after comprehensively analyzing the research literature and current scientific knowledge of the development, diagnosis, and treatment of otitis media with effusion in young children. Specific recommendations are given for the management of otitis media with effusion in young children age 1 through 3 years with no craniofacial or neurologic abnormalities or sensory deficits. The natural history of otitis media with effusion, the functional impairments that may result from otitis media with effusion, and the difficulty of measuring the effects of medical and surgical interventions on long-term outcomes are included. The medical interventions studied involve antibiotic, steroid, and antihistamine/decongestant therapies. The surgical interventions studied involve myringotomy with insertion of tympanostomy tubes, adenoidectomy, and tonsillectomy. Short-term outcomes addressed are resolution of effusion and restoration of hearing.

Algorithms↗

Use of molecular and reference susceptibility testing methods in a multicenter evaluation of MicroScan dried overnight gram-positive MIC panels for detection of vancomycin and high-level aminoglycoside resistances in enterococci.

Modified MicroScan gram-positive MIC no. 8 panels (PM-8) were analyzed for their improved ability to detect vancomycin resistance (VR) and high-level aminoglycoside resistance (HLAR) in enterococci. A validation study design that utilized selected challenge strains, recent clinical isolates, and reproducibility experiments in a multicenter format was selected. Three independent medical centers compared the commercial panels to reference broth microdilution panels (RBM) and Synergy Quad Agar (QA). Resistance was verified by demonstration of VR and HLAR genes by PCR tests. The study was conducted in three phases. (i) In the challenge phase (CP), two well-characterized sets of enterococci were obtained from the Centers for Disease Control and Prevention; one set contained 50 isolates for VR testing and one contained 48 isolates for HLAR testing. In addition, a set of 47 well-characterized isolates representing diverse geographic areas, obtained from earlier national surveillance studies, was tested at the University of Iowa College of Medicine (UICM). (ii) In the efficacy phase (EP), each laboratory tested 50 recent, unique clinical isolates by all methods. (iii) In the reproducibility Phase (RP), each laboratory tested the same 10 strains by all methods in triplicate on three separate days. All isolates from the EP were sent to the UICM for molecular characterization of vanA, -B, -C1, -C2-3, and HLAR genes. In the CP, the ranking of test methods by error rates (in parentheses; very major and major errors combined, versus PCR results) were as follows: for high-level streptomycin resistance (HLSR), QA (12.0%) > PM-8 (5.2%) > RBM (1.6%); for high-level gentamicin resistance (HLGR), RBM (3.7%) > PM-8 (3.1%) > QA (2.6%); and for VR, RBM = QA (3.0%) > PM-8 (1.2%). In the EP, agreement between all methods and the reference PCR result was 98.0% for HLSR, 99.3% for HLGR, and 98. 6% for VR. In the RP, the percentages of results +/- 1 log2 dilution of the all-participant mode were as follows: for VR, 100% (PM-8), 98.9% (QA), and 90.0% (RBM); for HLSR, 99.6% (RBM), 98.5% (PM-8), and 82.2% (QA); and for HLGR, 99.6% (RBM), 99.3% (PM-8), and 98.1% (QA). The ability of the PM-8 to detect VR and HLAR in enterococci was comparable to those for reference susceptibility and molecular PCR methods and was considered acceptable for routine clinical laboratory use.

Anti-Bacterial Agents↗

Collaborative evaluation of the microbial profile system for quantitative antimicrobial susceptibility testing.

This three-center collaborative study was conducted to evaluate samples of the Microbial Profile System (MPS) antimicrobial microdilution panels [previously produced by Minnesota Mining & Manufacturing Co., (3M Co.), St. Paul, Minn. and currently produced by Flow Laboratories, Inc., Rockville, Md.). This was a three-phase study. In phase I, the inter- and intralaboratory agreement was determined by using strains with selected ranges of susceptibility. The MPS and reference microdilution minimum inhibitory concentrations were within acceptable variation, +/- 1 dilution for 97.7% for the MPS and 98.8% for the reference microdilution panels for the intralaboratory comparisons. The percentage of strains with minimum inhibitory concentrations in the acceptable range for the interlaboratory variation was 96.2% for the MPS and 96.0% for the reference microdilution panels. The phase II studies used strains with known resistance mechanisms. The percent agreement with these strains was: Enterobacteriaceae, 94.5%; nonenteric gram-negative rods, 95.4%; staphylococci, 92.3%; and streptococci, 96.6%. The overall agreement within acceptable limits was 94.7% with these strains. When testing 359 clinical isolates, the frequency of strains within the acceptable range of agreement between the two methods was 97.3%. The MPS panels gave results in each of the three study phases equivalent to those obtained with the reference microdilution panels.

Anti-Bacterial Agents↗

Clinical importance of identifying coagulase-negative staphylococci isolated from blood cultures: evaluation of MicroScan Rapid and Dried Overnight Gram-Positive panels versus a conventional reference method.

We evaluated the clinical usefulness of species identification of blood isolates of coagulase-negative staphylococci as a predictor of the clinical significance of the isolates. In addition, we compared results of species identification obtained with MicroScan Rapid Gram-Positive Identification panels and Dried Overnight (Conventional) Gram-Positive Identification panels with those obtained by a tube reference method. Two hundred eighty-five blood isolates were tested, including 92 judged to represent true bacteremia and 193 judged to represent contamination. The most common species detected were Staphylococcus epidermidis, Staphylococcus hominis, and Staphylococcus haemolyticus. These three species accounted for nearly 98% of the clinically significant isolates and 89% of the contaminants. The isolation of other species almost always represented contamination. However, identification of the three most common species did not help distinguish pathogens from contaminants. Both the Rapid and the Dried Overnight Gram-Positive panels identified S. epidermidis strains accurately, but the panels performed less well for the other species. Analysis revealed that S. hominis was frequently misidentified due to the presence of a previously unknown subspecies. Based on the initial results, revised investigational Dried Overnight Gram-Positive Identification panels (CPID-2) were prepared and tested. The CPID-2 panels identified 85 to 95% of S. epidermidis strains, 76 to 86% of S. hominis strains, and 88 to 92% of S. haemolyticus strains with high probability (>85%) and, overall, represented a significant improvement over the other panels for identification of these staphylococcal species.

Bacteremia↗

[ELISA identification of agents causing light cytopathic effect isolated during the neuropathy outbreak in Cuba, 1991].

Using as a reference the strain 44/93 isolated during the neuropathy epidemic in 1991 and characterized as a producer of a light cytopathic effect (L-CPE), it was possible the standardization of an ELISA for the fast identification of other strains with similar effect. The assay consisted in a sandwich-type ELISA where the conditions selected for each reactive (10 micrograms/mL for the coating antibody, 1 mg/mL for the antigen, and dilution 1/2,000 for the conjugate) allowed to have an adequate discrimination between the antigen and the antigen control for the reference strain used. The evaluation of a panel of reference viral strains and of other L-CPE producing strains showed a 100% of coincidence between this method and the isolation in cellular culture. The results obtained permit us to recommend the use of this assay as a more precise alternative to identify these agents.

Cuba↗