A fibroadenoma with a t(4;12) (q27;q15) affecting the HMGI-C gene, a member of the high mobility group protein gene family.

An intracanalicular fibroadenoma of the breast showing a clonal chromosomal aberration t(4;12) (q27;q15) as the sole cytogenetic abnormality is described. In order to narrow down the breakpoint region on chromosome 12 on the molecular level we performed fluorescence in situ hybridization (FISH) analysis with a cosmid pool originating from a YAC-contig overspanning part of the region 12q14-15. We were able to narrow down the breakpoint to an approximately 230kb fragment belonging to the HMGI-C gene which maps within an area recently designated as MAR (Multiple Aberration Region). The chromosomal breakpoints of other frequent benign solid tumors, i.e. lipomas, uterine leiomyomas, and pleomorphic adenomas are clustered within the third intron of that gene.

CQI action team: responding to the detoxification patient.

BACKGROUND: The management of detoxification patients is a complex interdisciplinary effort requiring involvement, cooperation, and understanding from staff at all levels of the facility. In 1992-93, alcohol-related diagnoses were the highest admission diagnosis at the Royal C. Johnson Veterans Affairs Medical Center (VAMC). Yet only 44% of the detoxification patients admitted to the VAMC were placed in beds specifically designed for detoxification. Initially, the action team believed that the issues were apparent and that the problems were the result of uncooperative and noncompliant providers who were not following established policy. METHODS AND RESULTS: Data analysis of admission and discharge trends, laboratory results, and bed census revealed discrepancies with several widespread myths held by local health care workers. These misperceptions and attitudes often interfered with treatment. CONCLUSIONS: Recommended changes included the development of a clinical pathway for the detoxification patient, implementation of an alcohol withdrawal assessment tool to manage and treat the patient at risk for experiencing alcohol withdrawal, and hospitalwide education on management of the detoxification patient.

Quality improvement approach to nursing care planning: implementing practical computerized standards.

Care planning continues to be be an integral part of nursing, yet it is often criticized by professionals as time-consuming, repetitious, and inconsistent. This problematic situation prompted the development and implementation of an interdisciplinary automated care-planning system that interfaces with a preexisting data base. The advantages of the system include standardization of care, consolidated documentation, provision of patient education tools, shared responsibility during the patient's length of stay, and minimal cost. Evaluation of the system demonstrated quality improvement in the documentation of patient education and compliance in meeting JCAHO nursing process standards.

Informational needs and preferred time to receive information for phase II cardiac rehabilitation patients: what CE instructors need to know.

The purpose of this study was to determine the perceived importance of selected informational needs of cardiac rehabilitation patients and to determine the best time interval to provide this information. The findings of this study support previous studies showing that cardiac rehabilitation patients perceive all information as important and, as such, it is essential that patients and families receive daily information. Information should be provided simply and in nontechnical terms. With a trend toward shorter hospital stays, this study challenges the health care team to provide necessary information in less time. Implications for staff development are described.

Identification and treatment of acute myocardial infarction by electrocardiographic site classification.

The nature and severity of an acute myocardial infarction may be related to the region of myocardial involvement. Four possible sites of infarction are inferior, anterior, posterior, and lateral. Knowledge of ECG tracings common to each of these areas, the coronary artery source of each, clinical complications, and signs and symptoms is vital to subsequent nursing management.

Hepatic zinc content in patients with various stages of alcoholic liver disease and in patients with chronic active and chronic persistent hepatitis.

The hepatic zinc content was determined in liver biopsies of patients with alcoholic and nonalcoholic liver disease using proton-induced X-ray emission. The values obtained in postmortem specimens of the liver from 27 patients with no evidence of acute or chronic liver disease served as controls. The mean value and the range of the zinc content in the controls (75 +/- 24 ppm wet weight) are in good agreement with those reported in the literature. The hepatic zinc content in the control group showed no significant age or sex dependence. The mean zinc content was significantly decreased in all groups of patients with alcoholic liver disease. The decrease was comparable in biopsies from patients with alcoholic fatty liver (-56.7%, n = 12), mild alcoholic hepatitis (-50.5%, n = 6) and alcoholic cirrhosis (-45.6%, n = 10). The hepatic zinc content was also distinctly reduced in patients with chronic active hepatitis (-60.3%, n = 15) and in those with chronic persistent hepatitis (-44.9%, n = 8). The estimation of the zinc content in subcellular fractions of the liver performed in postmortem specimens from seven patients with alcoholic liver cirrhosis and in six controls revealed a significant reduction in the zinc content in the fraction containing cell nuclei and membranes and in the mitochondrial fraction. A similar decrease was seen in the 100,000 g supernatant; however, the difference did not attain statistical difference. The zinc content of the microsomal fraction in the controls was lower than in the other three cell fractions.(ABSTRACT TRUNCATED AT 250 WORDS)

Solid-phase sequence analysis of polypeptides eluted from polyacrylamide gels. An aid to interpretation of DNA sequences exemplified by the Escherichia coli unc operon and bacteriophage lambda.

An approach to sequencing proteins by the solid-phase method combined with isolation of proteins and polypeptides by gel electrophoresis is described. Mixtures of proteins or polypeptides resulting from digests are fractionated in the presence of dodecylsulphate in polyacrylamide gels. They are detected with Coomassie blue, eluted, selectively reacted with porous glass derivatives and sequenced in their amino-terminal regions with the aid of a new microsequencer. Alternatively they can be analysed or digested with enzymes and fingerprinted. It is a relatively rapid method of purifying proteins for sequence analysis which we have used to provide partial protein sequence data to complement DNA sequences. Nine genes, four from the unc operon of Escherichia coli encoding the alpha, beta, gamma and epsilon subunits of ATP synthase and five for capsid proteins of bacteriophage lambda, have been identified by this method.