Privacy Protection through pseudonymisation in eHealth

The ISO TC215 WG4 pseudonymisation task group has produced in 2008 a first version of a technical specification for the application of pseudonymisation in Healthcare Informatics 0. This paper investigates the principles set out in the technical specification as well as its implications in eHealth. The technical specification starts out with a conceptual model and evolves from a theoretical model to a real life model by adding assumptions on the observability of personal data.

Symptomatic cholelithiasis: a different disease in men? Connecticut Laparoscopic Cholesystectomy Registry

OBJECTIVE

To determine the importance of gender in the clinical presentation and subsequent clinical outcome (risk of conversion from laparoscopic to open technique and risk of postoperative mortality) for patients undergoing cholecystectomy.

SUMMARY BACKGROUND DATA

Age and clinical presentation have consistently been found to be important predictors of cholecystectomy outcomes; male gender has been cited in disparate studies as possibly having prognostic significance.

METHOD

A statewide cholecystectomy registry (30,145 cases between 1989-1993) was analyzed. Hierarchical log-linear modeling was used to identify associations between characteristics of clinical presentation. Multivariate logistic regression analysis was used to determine predictions of conversion and mortality.

RESULTS

Male gender was associated with twice the expected incidence of acute cholecystitis and pancreatitis in the elderly (> or = 65 years). Males had a significantly increased risk for conversion to open technique, but this decreased during the time frame of the study. Mortality was twice as high among males (confidence interval, 1.4-2.9, p = 0.0001).

CONCLUSIONS

Males presenting for cholecystectomy are more likely to have severe disease. Independent of clinical presentation, they face increased risks of conversion to open technique and of postoperative mortality.

Structure and function of L-glutamate decarboxylase

Membrane bound L-glutamate decarboxylase (GAD) has been solubilized and partially purified from hog brain. The solubilized GAD appears to exist in two forms, alpha and beta, differing in their size and electrophoretic mobility. The alpha form has similar mobility as that of the soluble GAD in 7.5% and 5-25% gradient polyacrylamide gel electrophoresis suggesting that they are similar in size and charge. In addition, gene encoding for mouse brain GAD has been cloned and characterized. Mouse brain GAD cDNA consists of two DNA fragments with 1.6 and 1.0 Kb. The 1.6 and 1.0 Kb fragments contain 1657 and 974 bP, respectively. The significance of multiple forms of GAD is also discussed.

Molecular cloning and amino acid sequence of brain L-glutamate decarboxylase

We used specific polyclonal antibodies against L-glutamate decarboxylase (GAD) to screen a mouse brain cDNA library that was constructed in the expression vector lambda gt11. We obtained 1.5 x 10(6) recombinant DNA clones in the mouse brain cDNA library. One of the clones was positively identified as a GAD clone on the basis of the following results: (i) the clone and its secondary and tertiary clones all reacted strongly with anti-GAD antibodies; (ii) the fusion protein obtained from lambda GAD-Y1089 showed good GAD enzyme activity as determined by both CO2 and gamma-aminobutyric acid methods. The GAD clone thus obtained contains GAD cDNA of approximately 2.6 kilobases that has one internal EcoRI site. After GAD cDNA was cut at the EcoRI site, two DNA fragments of about 1.6 and 1.0 kilobases were obtained at the 5' and 3' ends, respectively. The cDNA insert was found to be composed of 2632 base pairs, the translation initiation site was assigned to the methionine codon ATG, and the termination site was found to be TGA (positions 2216-2218). Furthermore, the coding region in 2169 base pairs was found to consist of 723 amino acids. The protein has a molecular weight of 83,207 and contains 83 strongly basic, 108 strongly acidic, 226 hydrophobic, and 221 polar amino acids with an isoelectric point of 5.355. The relationship of this GAD cDNA to other forms of GAD is discussed.

Complete cDNA sequence and chromosomal localization of mouse alpha 1-antitrypsin

A cDNA encoding the complete open reading frame of murine alpha 1-antitrypsin has been cloned and sequenced. The nucleic acid and predicted amino acid sequences show homology to human alpha 1-antitrypsin and demonstrate the preservation of critical structural determinants for intracellular targeting, carbohydrate attachment, and catalytic function. The alpha 1-antitrypsin gene locus (Aat) has been localized on murine chromosome 12E----F by in situ hybridization.

Molecular structure and sequence homology of a gene related to alpha 1-antitrypsin in the human genome

A 7.7-kb EcoRI genomic DNA fragment highly homologous to the human alpha 1-antitrypsin (AAT) gene has been cloned. This antitrypsin-related sequence is physically linked to the authentic AAT gene and both are present in a single cosmid clone. Nucleotide sequencing of the AAT-related genomic fragment demonstrated extensive homology with the authentic AAT gene in the introns as well as in the exons. The conservation of all RNA splice sites and lack of internal termination codons in the exonic regions suggest that it may not be a classical pseudogene. If expressed, it could result in a protein of 420 amino acid residues exhibiting a 70% overall homology with human alpha 1-antitrypsin. The signal peptide sequence is well conserved in the related gene, but the active site for protease inhibition of Met-Ser in alpha 1-antitrypsin has been changed to Trp-Ser. These data suggest that the putative protein encoded by the AAT-related gene is a secretory serine protease inhibitor with an altered substrate specificity. Interestingly, even the intronic regions in the related gene exhibit a 65% overall nucleotide sequence homology with those of the authentic AAT gene. These results suggest that the AAT-related gene is derived from a recent duplication of the authentic AAT gene and represents a new member of the serine protease inhibitor superfamily.