Genomic organization of the human alpha-adducin gene and its alternately spliced isoforms

The cDNA for the human alpha-adducin gene has been cloned, and different alternately spliced forms have been identified. We report the complete genomic organization of the human alpha-adducin gene and these alternately spliced forms. The human alpha-adducin gene, spanning approximately 85 kb, consists of 16 exons ranging in size from 34 to 1892 bp. One of the spliced forms of the human alpha-adducin gene results from alternate use of the 5' splice donor site for exon 10, while another results in a truncated protein following insertion of 34 bp comprising exon 15, followed by a premature stop codon. This alternate spliced form of alpha-adducin is predicted to result in an altered carboxyl terminus that would eliminate a protein kinase and calmodulin binding site. Seven nucleotide substitutions and 4 insertion/deletions were also identified. The 5' region of the human alpha-adducin gene contains one Sp1 site, two AP2 sites, and two CAAT boxes. No TATA box was apparent, consistent with features of a housekeeping gene. We have mapped another cDNA within the first intron of the human alpha-adducin gene, suggesting overlapping genes in this 4p16.3 genomic region.

Processing of fusion proteins with immobilized factor Xa

Factor Xa, with a cellulose-binding domain (CBD) fused to the C-terminus of the heavy chain (FXa-CBD), is active in solution and when immobilized on cellulose. A second derivative of factor Xa in which a hexahistidine tail is fused to the C-terminus of the heavy chain (FXa-H6) also retains activity when immobilized, in this case on Ni(2+)-NTA agarose. The stabilities and activities of of FXa-CBD and FXa-H6 immobilized on cellulose and Ni(2+)-NTA agarose, respectively, are similar. Immobilized factor Xa derivatives can be used to remove affinity tags from appropriate fusion proteins without contaminating the desired product with factor Xa.

The feasibility and reliability of using a home screening test to detect gingival inflammation

The purpose of this study was to evaluate the feasibility and reliability of using a home screening occult blood test to detect the presence of gingival inflammation. Fifty (50) healthy male and female subjects participated in this study. Pre- and post-stimulation saliva samples were obtained and tested for occult blood. Subjects brushed for one minute to stimulate gingival bleeding associated with inflammation. Saliva samples were obtained and tested for occult blood using a commercial screening kit. Following the screening test, a bleeding index (BOP) was determined and used as an indicator of gingival inflammation. Those with a BOP > 50% were assigned to the high group. Those with a BOP of 31 to 50% were assigned to the middle group, and those with a BOP of < or = 30% were assigned to the low group. Twelve subjects in the high group, 10 subjects in the mid group, and 2 subjects in the low group tested positive for occult blood following stimulation. A chi-square analysis showed an association between the screening test for occult blood and the groups (P = 0.0001). The test sensitivity was 75.9% and the specificity was 90.5%.

Polynesian women are also at risk for hyperuricaemia and gout because of a genetic defect in renal urate handling

The prevalence of asymptomatic hyperuricaemia among Polynesian women (Maoris, Cook Islanders, Samoans, Tongans) was high--44%. This hyperuricaemia resulted from a reduced fractional uric acid clearance (FEur: uric acid clearance factored by creatinine clearance x 100--6.7 +/- 1.5%) compared with the FEur in healthy UK women (12.8 +/- 2.9%). This reduction in FEur was not as great as that in young UK women with familial juvenile hyperuricaemic nephropathy (FJHN: 5.1 +/- 1.5%) and was not associated with impaired renal function. The FEur in the normouricaemic Polynesians (9.7 +/- 1.9%) was also lower than that in healthy UK women (12.8 +/- 2.9%). The reduced FEur in these Polynesian women supports the hypothesis that indigenous Pacific races share a similar genetic defect in renal urate handling to that reported as the basis for the susceptibility to hyperuricaemia in Maori men. Neither alcohol nor hypertension contributed to this. This study also confirmed that, compared with their European counterparts, Polynesian women have a high purine intake and a strong tendency to obesity which increases with age. These factors, together with the reduced FEur, put them at added risk for gout. However, the reduction in FEur was not as great as that reported for the normouricaemic or asymptomatic hyperuricaemic Maori male (4.9 +/- 1.5% and 3.9 +/- 1.4%, respectively), confirming the same sex difference in renal urate handling in adult Polynesians as in caucasians.

Entry of US medical school graduates into family practice residences: 1993-1994 and 3-year summary

This is the 13th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each US medical school's graduates entering family practice residency programs. Approximately 12.3% of the 15,564 medical school graduates between July 1992 and June 1993 were first-year family practice residents in October 1993, compared with 10.8% the previous year. This is the highest percentage since 1983-1984. Medical school graduates from publicly funded medical schools were more than twice as likely to be first-year family practice residents in October 1993 as were residents from privately funded schools, 15.9% compared with 7.1%. The Mountain region again reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1993 at 19.1%; the Middle Atlantic and New England regions continued with the lowest percentages at 7.7% and 6.6%, respectively. At least one in four graduates from nine medical schools during the reporting period was in a family practice residency program in October 1993; only two medical schools had this distinction in 1992. Approximately one in two medical school graduates entering a family practice residency program as first-year residents in October 1993 entered a program in the same state where they graduated from medical school. The percentages for each medical school have varied substantially from year to year since the AAFP began reporting this information. The average percentage for each medical school for the last 3 years is reported.(ABSTRACT TRUNCATED AT 250 WORDS)

Results of the 1994 National Resident Matching Program: family practice

The 1994 National Resident Matching Program results reveal a 14% increase in positions filled in family practice residencies, compared with 1993 (2,293 vs 2,002) and a 13% increase in positions filled by US seniors (1,850 vs 1,636). Similarly, 9% more positions were filled on July 1, 1994, than 1993 (3,040 vs 2,798). For the first time, in 1994 more than 3,000 first-year residency positions were filled in family practice. One hundred more US seniors matched in internal medicine, and 74 more US seniors matched in pediatrics. Given the anticipated career choices of students entering residency training in the generalist disciplines, it is expected that 31% of the class of 1994 (Liaison Committee on Medical Education (LCME)-accredited medical schools) will practice as generalists. An 8% increase in first-year positions offered, and the development of 10% new Accreditation Council for Graduate Medical Education-accredited family practice residency programs could accommodate 20% of the nation's graduates of LCME- and American Osteopathic Association-accredited medical schools. With increasing interest in family practice careers, increased support for the nation's family practice residency programs is critical.

Failed validation of a clinical decision rule for the use of radiography in acute ankle injury

AIM

To validate the Ottawa clinical decision rule for the use of radiography in acute ankle injuries.

METHOD

A prospective, multicentre trial of 350 adult patients presenting with acute ankle injuries consisting of correlation of the features of the Ottawa clinical decision rule with the results of x-rays.

RESULTS

There were 75 fractures in 350 patients, five of which would have been missed by the clinical decision rule. The sensitivity of the rule was 93% with a specificity of 11%. The positive predictive value was 22%, the false negative rate 14%. Fractures that would have been missed by the clinical decision rule included one unstable fracture of the ankle, one fracture of the talus, one calcaneal fracture and one fracture each of the cuboid and navicular.

CONCLUSION

The Ottawa clinical decision rule for the use of radiography in acute ankle injuries is unacceptable for application in emergency departments in New Zealand due to a high false negative rate.

Preparative in situ hybridization: selection of chromosome region-specific libraries on mitotic chromosomes

We have developed preparative in situ hybridization (Prep-ISH) of complex DNA populations to mitotic chromosomes as a means of generating chromosome region-specific DNA subpopulations. Prep-ISH is a combination of two cytogenetic techniques: in situ hybridization of DNA molecules to mitotic chromosomes and chromosome microdissection. Here, we present test cases demonstrating the feasibility of this approach on mouse and human genomes, using single nuclei, single chromosomes, or single chromosomal subregions to assess sensitivity, specificity, and representation of the Prep-ISH technique. Prep-ISH has a number of applications in studies of gene expression and genome organization, including efficient cytogenetic sorting of tissue-specific cDNAs and genomic DNA libraries. In addition, Prep-ISH is likely to dramatically reduce the number of candidate genes to aid in gene discovery efforts and to improve efficiency of developing transcription maps and YAC and cosmid contigs through defined cytogenetic regions.

Precise mapping of the brain alpha 2-adrenergic receptor gene within chromosome 4p16

The gene encoding the brain alpha 2-adrenergic receptor (ADRA2C) is located on human chromosome 4. It has been circumstantially associated with a number of human disorders, including Parkinson disease, panic disorders, and Huntington disease (HD). Using somatic cell hybrids, we localized the gene to chromosome 4p16 distal to P8 (D4S62). To investigate this locus further, we isolated several cosmid clones covering the entire gene. The gene was found to be intronless. Two (GT)n repeats in close proximity to the ADRAC2 gene were analyzed and used to define its precise location. Linkage disequilibrium studies of one microsatellite in HD families showed strong nonrandom association to the HD mutation, indicating its tight linkage to the HD gene. The investigation of families carrying recombinant chromosomes, pulsed-field analysis, and genomic walking mapped the ADRA2C gene adjacent to D4S81, 500 kb proximal to the HD gene. The newly defined microsatellites at the ADRAC2 locus, its precise localization within 4p16, and the detailed PCR conditions facilitate the identification of any defect caused by this gene.

Results of the 1993 National Resident Matching Program

The 1993 NRMP results reveal a 19% increase in positions filled in family practice residencies compared to 1992 (2,002 versus 1,658) and a 17% increase in positions filled by US seniors (1,636 versus 1,398). Similarly, 11% more positions were filled on July 1, 1993, than 1992 (2,798 versus 2,530). This confirms a trend begun in 1992 of increased interest in careers in family practice, reversing four years of declining interest from 1988 to 1991. Two hundred one fewer US seniors matched in internal medicine, while 36 more chose pediatrics. Of students entering residency training in the generalist disciplines, it is expected that 27% of the class of 1993 (LCME-accredited medical schools) will practice as generalists. An increase of 9% of first-year positions offered, and the development of 15% new ACGME-accredited family practice residency programs, could accommodate 20% of the nation's graduates of LCME- and AOA-accredited medical schools. With increasing interest in careers in family practice, increased support for the nation's family practice residency programs is critical.

Entry of US medical school graduates into family practice residencies: 1992-1993 and three-year summary

This is the 12th report prepared by the American Academy of Family Physicians (AAFP) on the percentage of each medical school's graduates entering family practice residency programs. Approximately 10.8% of the 15,466 graduates of LCME-accredited US medical schools between July 1991 and June 1992 were first-year residents in family practice in October 1992. This compares to 10.3% the previous year. This is the first increase since 1989. Medical school graduates from publicly funded medical schools were more than twice as likely to be first-year residents in family practice in October 1992 than were residents from privately funded schools, 13.8% compared to 6.4%. The Mountain region reported the highest percentage of medical school graduates who were first-year residents in family practice programs in October 1992 at 18.3%; the Middle Atlantic and New England regions continued with the lowest percentages, 5.6% and 7.8%, respectively. Approximately one in two medical school graduates entering a family practice residency program as a first-year resident in October 1992 entered a program in the same state as that of his or her medical school of graduation. The percentages for each medical school have varied substantially from year to year since the AAFP has reported this information. The average percentage for each medical school for the last three years is reported. In addition, the number and percentage of graduates from colleges of osteopathic medicine who entered ACGME-accredited family practice residency programs are reported.