Cloning of the cDNA for a hematopoietic cell-specific protein related to CD20 and the beta subunit of the high-affinity IgE receptor: evidence for a family of proteins with four membrane-spanning regions

We report the cloning of the cDNA for a human gene whose mRNA is expressed specifically in hematopoietic cells. A long open reading frame in the 1.7-kb mRNA encodes a 214-aa protein of 25 kDa with four hydrophobic regions consistent with a protein that traverses the membrane four times. To reflect the structure and expression of this gene in diverse hematopoietic lineages of lymphoid and myeloid origin, we named the gene HTm4. The protein is about 20% homologous to two other "four-transmembrane" proteins; the B-cell-specific antigen CD20 and the beta subunit of the high-affinity receptor for IgE, Fc epsilon RI beta. The highest homologies among the three proteins are found in the transmembrane domains, but conserved residues are also recognized in the inter-transmembrane domains and in the N and C termini. Using fluorescence in situ hybridization, we localized HTm4 to human chromosome 11q12-13.1, where the CD20 and Fc epsilon RI beta genes are also located. Both the murine homologue for CD20, Ly-44, and the murine Fc epsilon RI beta gene map to the same region in murine chromosome 19. We propose that the HTm4, CD20, and Fc epsilon RI beta genes evolved from the same ancestral gene to form a family of four-transmembrane proteins. It is possible that other related members exist. Similar to CD20 and Fc epsilon RI beta, it is likely that HTm4 has a role in signal transduction and, like Fc epsilon RI beta, might be a subunit associated with receptor complexes.

Self-disclosure and nursing students: the replication of a Jourard study

A person's willingness to disclose things about him or herself is an important facet of all social interaction. In professional helping relationships effective management of treatment and therapy may depend ultimately on a person's self-disclosures. Sidney Jourard claimed in 1971 that "disclosure begets disclosure". It is important therefore to explore professional helpers' willingness to disclose things about themselves, as this may influence the dialogue which they have with their clients and patients. In this paper we describe a replication of a small study carried out by Sidney Jourard in 1961. An opportunistic sample of 25 undergraduate nursing students was asked to complete Jourard's self-disclosure questionnaire. Analysis of the findings suggested that, overall, the students in this study were more self-disclosing than was the case in the earlier study. Other findings are noted as are the limitations of this form of exploration of self-disclosure.

A clinical application of the multiple sorting technique

The interview technique is a common method of collecting data in human research. This paper provides an example of the use of the multiple sorting technique for structuring and analysing qualitative interviews. The technique is described around a recently completed study which explored practising nurses' perception of their work in a German hospital. A multiple sorting technique was employed to structure interviews with 11 nurses. Nursing tasks were sorted into categories and labelled by respondents. The frequencies with which each task was paired with all of the other tasks were calculated and this allowed us to produce a similarity matrix which was entered as input into a multidimensional scaling procedure (Smallest Space Analysis SSA-1). The SSA-1 procedure was used to analyse and interpret the data. The results of the analysis indicated that the nurses conceptualized their work into four separate domains including basic care skills, indirect care, technical skills and administration. The example of the multiple sorting technique described here shows how it is possible to develop an insight into the nurses' world in a structured yet flexible way.

Role of threonine residues in regulation of the epidermal growth factor receptor by protein kinase C and mitogen-activated protein kinase

Epidermal growth factor (EGF) receptor tyrosine kinase activity is down-regulated by a number of growth-modulating agents that activate protein kinase C and/or mitogen-activated protein (MAP) kinases. Although the mechanism is unclear, it has been hypothesized that phosphorylation of specific threonine residues leads to inhibition of the EGF receptor tyrosine kinase. Two sites phosphorylated on the EGF receptor in response to phorbol esters are possible mediators of this effect: threonine 654, the target of protein kinase C, and threonine 669, the target of MAP kinase and the major site of phosphorylation on the EGF receptor. In order to investigate the role of these residues in receptor regulation, we substituted glutamic acid to mimic the negative charge introduced by phosphorylation at these sites. The wild-type and mutant receptor cDNAs were then transfected into CHO cells that lack endogenous EGF receptor. The EGF binding properties of the mutant receptors were similar to those of the wild-type EGF receptors. EGF stimulated tyrosine kinase activity and DNA synthesis in cells expressing both mutant receptors, indicating that the mutant EGF receptors are biologically active. Treatment of cells with phorbol esters inhibited the high affinity EGF binding and tyrosine kinase activities of both mutant and wild-type EGF receptors. These results indicate that acidic residues at either the Thr-654 or Thr-669 site modulate but do not block EGF receptor signalling. Furthermore, this data demonstrates that the mutant EGF receptors are still a target for inhibition by phorbol esters. Thus, events other than phosphorylation of Thr-654 or Thr-669 appear to be required for receptor down-regulation by protein kinase C or MAP kinase.

Teaching psychology: the Australian view

Teaching psychology to student nurses has assumed great importance in recent years. Making the course applicable to clinical practice, however, remains a challenge. The authors discusses techniques being used in Australia to make psychology relevant to nursing and highlights aspects which could be adopted in the UK.

Patient participation: its meaning and significance in the context of caring

The ideal that patients should be participants in their own care has found wide acceptance amongst nurses. Yet within the academic discipline of nursing little has been done to clarify the nature of participation. In this paper, a phenomenology of participation is presented as it applies to the caring work of nursing. Participation requires: (a) attunement to a mutual 'stock of knowledge at hand'; (b) emotional and motivational attunement to the other's concerns; (c) taking for granted (and implicitly assuming the other takes it for granted) that one can contribute worthily; (d) feeling that one's identity is not under threat. Though it is difficult to attain, participation appears to embody many of the ideals central to current thinking in nursing. Moreover, the attempt to build participatory relationships with patients is ethically required of members of a 'caring' profession.

Students' and lecturers' preferred teaching strategies

A survey of lecturers (n = 47) and students (n = 110) was undertaken to explore their preferred teaching strategies, using a questionnaire based on Heron's (1977) Dimensions of Facilitator Styles (Human potential research project, University of Surrey, Guildford). Overall it was found that the students tended to prefer a teacher-centred approach to teaching, whilst the lecturers preferred a student-centred approach. These findings are discussed in the light of current educational trends in the nursing profession.

Towards a model of acidification effects on waterfowl in Eastern Canada

Data from 212 lakes in central Ontario were used to examine the relationship between presence of breeding waterfowl and loons and the following lake characteristics: pH, presence of fish, lake area, dissolved organic carbon (DOC) and total phosphorus (TP) concentration. In univariate analyses, the two fish-eating species preferred large, high pH lakes with fish, while insectivorous species showed little consistent pattern of lake association. Logistic regression analyses confirmed that large lake size and presence of fish were important determinants of presence of piscivores, though the residual effect of pH differed between the two species. Broods of three of the four insectivorous species avoided lakes with fish, and independently showed a positive response to pH. By calculating the probability that fish will be present on a lake of given area and pH, it is possible to estimate the net effect of pH change on these waterfowl. Relationships such as those presented here can, with some assumptions, be linked to models of lake acidification to estimate response of waterfowl to predicted changes in acidic deposition.

Absence of drug interaction between temafloxacin and low dose heparin

An open 5-day study was conducted in 12 healthy male volunteers to determine the potential for drug interaction between low dose standard heparin and temafloxacin, a new fluorinated quinolone antibiotic. Heparin 5000IU was administered subcutaneously on the morning of the first and last study days and temafloxacin 600mg was administered twice daily for 4 days. The mean change in activated factor X (antifactor Xa) concentration relative to baseline 2h after coadministration was similar to that after heparin alone. Likewise, changes in activated partial prothrombin time, prothrombin time and thrombin time were similar after either heparin alone or concomitant temafloxacin administration, indicating the absence of interaction between temafloxacin and low dose standard heparin in healthy volunteers.

The lack of interaction between temafloxacin and combined oral contraceptive steroids

In view of the considerable debate concerning the possible failure of contraception in women taking broad spectrum antibiotics, we have examined a group of 12 women aged 22-32 in a controlled study. Each woman had been on long-term therapy with oral contraceptive steroids (OCS) containing ethynylestradiol (EE2) and levonorgestrel (Ng) for at least 6 months and all were in good general health. Blood samples were taken about 11.0 hours after dosing with their OCS on days 5, 6, 7 and 8 of their contraceptive cycle, for measurement of EE2, Ng, FSH and LH by radioimmunoassay. In addition blood samples were taken on days 19, 20 and 21 of the contraceptive cycle for assay of progesterone concentrations in plasma. The study was repeated in the next cycle of use of their OCS during which they took temafloxacin, a broad spectrum quinolone antibiotic in a dose of 600 mg twice daily for 7 days starting on day 1 of the cycle. All women completed the study satisfactorily as judged by diary cards, tablet counts and plasma temafloxacin concentrations. In the early part of the study some nausea and headaches were seen due to taking temafloxacin on an empty stomach but these effects were not seen when the antibiotic was later given with food. There was no evidence of any interaction between temafloxacin and the OCS. The plasma concentration of EE2 was 61.4 +/- 21.1 pg/ml in the control cycle and 68.5 +/- 26.6 pg/ml in the temafloxacin cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical pharmacology of moclobemide, a new reversible monoamine oxidase inhibitor

The clinical pharmacology of the new reversible monoamine oxidase (MAO) inhibitor, moclobemide, was examined in three separate studies in healthy male volunteers. In a single oral dose study, moclobemide (25-150 mg) was rapidly absorbed from the gastrointestinal tract and had a relatively short plasma half-life (mean 1.3 h after 150 mg). A decrease in the plasma concentrations of the noradrenaline metabolite 4- hydroxy-3-methoxyphenylglycol (HMPG), however, indicated a longer time to peak pharmacodynamic effect and longer duration of activity. Assay of platelet MAO activity did not reveal any evidence of irreversible inhibition of the B form of the isoenzyme. Single oral doses of moclobemide (150 and 300 mg) significantly lowered the threshold to the cardiovascular effects ('cheese reaction') of intravenous tyramine. However, after repeated administration of 100 mg three times daily for over 2 weeks, moclobemide caused significantly less potentiation than did phenelzine (15 mg three times per day) on the cardiovascular effects of oral tyramine, a clinically more relevant model. The MAO-B inhibitor, selegiline (5 mg once daily), also lowered the oral tyramine threshold significantly. Moclobemide was generally well tolerated by these healthy volunteers.

Emery-Dreifuss muscular dystrophy

Emery-Dreifuss syndrome is a rare form of muscular dystrophy associated with cardiac complications that lead to sudden death. The disorder and its potential anaesthetic implications in the management of a patient who presented for orthopaedic surgery is described.

585 nm for the treatment of port-wine stains

Although the flashlamp-pulsed-dye laser has been successfully used for the treatment of port-wine stains (PWS) at 577 nm, a number of adult patients had incomplete clearance of their birthmarks with this treatment modality because of residual vessels lying beyond the 0.75-mm penetration depth of 577-nm irradiation. Fifteen adult patients, of whom nine were previously treated with limited success at 577 nm (group A), and six untreated patients (group B) were included in the study. For the group A patients, treatment with 585 nm produced successful clearance of the birthmark. For the six patients in group B, parallel treatment of different sites of the same lesion coupled with skin biopsies and histologic examination revealed that a change in the wavelength from 577 to 585 nm allowed the laser light to penetrate from the midreticular dermis into the subcutaneous fat. This explained the clearance achieved at 585 nm and not at 577 nm.

Gadopentetate dimeglumine clearance in renal insufficiency in rabbits

The total body clearance of gadopentetate dimeglumine (Gd-DTPA) was evaluated in 17 normal rabbits and 11 rabbits with renal insufficiency induced by angioinfarction. Serial measurements of the serum spin lattice relaxation rate (1/T1) were compared with actual gadolinium concentrations as determined by mass spectroscopy. Gadopentetate dimeglumine concentrations measured by both mass spectroscopy and magnetic resonance (MR) relaxometry decreased by two logs in both normals and rabbits with renal impairment by 24 hours and were highly correlated with each other (r = .98). The estimated total body clearance of gadopentetate dimeglumine was 14.1 +/- 0.56 cc/minute for the normal animals and 3.78 +/- 0.19 cc/minute for the impaired rabbits. These results indicate that gadopentetate dimeglumine is excreted rapidly, usually within 24 hours, even in the presence of renal insufficiency.

Counselling attitudes in health visiting students

All health visitors have a counselling function as part of their jobs. When visiting people in their homes they are frequently asked to discuss personal problems and emotional difficulties. It would be helpful if all health visitors developed specific counselling skills say Philip Burnard and Paul Morrison who here describe the results of a piece of research into counselling skills among a group of health visiting students.

Electrical dysrhythmias in the Roux jejunal limb: cause and treatment

Electrical dysrhythmias in the Roux limb after Roux gastrojejunostomy are associated with upper gut stasis of food. The aim of this study was to determine the cause of the dysrhythmias and whether they could be eliminated with pacing. A set of four dogs (Group A) underwent three sequential operations: placement of jejunal electrodes at sites corresponding to the Roux limb; construction of a Roux limb without vagotomy, gastrectomy, or gastrojejunostomy; and transthoracic truncal vagotomy. A second set of five dogs (Group B) underwent truncal vagotomy, distal gastrectomy, and Roux gastrojejunostomy with recording electrodes placed on the Roux limb and a pacing electrode situated at the proximal end of the limb. Electrical recordings were obtained on four separate occasions after each operation. In Group A dogs, orad and disordered propagation of jejunal pacesetter potentials occurred in the Roux limb 56 +/- 5% of the time after limb construction but never before construction. The pattern was not changed with vagotomy. In Group B dogs, electrical dysrhythmias in the Roux limb also occurred and were corrected with electrical pacing. We concluded that electrical dysrhythmias in the canine Roux limb are secondary to the jejunal transection done during Roux limb construction, and are not due to gastrectomy, gastroenterostomy, or vagotomy. The dysrhythmias can be corrected with pacing.