Loss of FUBP1 expression in gliomas predicts FUBP1 mutation and is associated with oligodendroglial differentiation, IDH1 mutation and 1p/19q loss of heterozygosity.

AIMS: The Far Upstream Element [FUSE] Binding Protein 1 (FUBP1) regulates target genes, such as the cell cycle regulators MYC and p21. FUBP1 is up-regulated in many tumours and acts as an oncoprotein by stimulating proliferation and inhibiting apoptosis. Recently, FUBP1 mutations were identified in approximately 15% of oligodendrogliomas. To date, all reported FUBP1 mutations have been predicted to inactivate FUBP1, which suggests that in contrast to most other tumours FUBP1 may act as a tumour suppressor in oligodendrogliomas. METHODS: As no data are currently available concerning FUBP1 protein levels in gliomas, we examined the FUBP1 expression profiles of human glial tumours by immunohistochemistry and immunofluorescence. We analysed FUBP1 expression related to morphological differentiation, IDH1 and FUBP1 mutation status, 1p/19q loss of heterozygosity (LOH) as well as proliferation rate. RESULTS: Our findings demonstrate that FUBP1 expression levels are increased in all glioma subtypes as compared with normal central nervous system (CNS) control tissue and are associated with increased proliferation. In contrast, FUBP1 immunonegativity predicted FUBP1 mutation with a sensitivity of 100% and a specificity of 90% in our cohort and was associated with oligodendroglial differentiation, IDH1 mutation and 1p/19q loss of heterozygosity (LOH). Using this approach, we detected a to-date undescribed FUBP1 mutation in an oligodendroglioma. CONCLUSION: In summary, our data indicate an association between of FUBP1 expression and proliferation in gliomas. Furthermore, our findings present FUBP1 immunohistochemical analysis as a helpful additional tool for neuropathological glioma diagnostics predicting FUBP1 mutation.

Quality with a human face? The Samuels Planetree model hospital unit.

BACKGROUND: Hospitals across the country are seeking to restructure the delivery of care. Planetree, an international consumer health care organization, works with hospitals to cultivate educated health care consumers and to create caring inpatient environments. This article gives an overview of Planetree's philosophy, examines staff and patient satisfaction, and contrasts Planetree with total quality management (TQM)/continuous quality improvement (CQI) as practiced at one hospital. PLANETREE'S PHILOSOPHY: Planetree's model differs from other patient-centered or patient-focused care models because of its emphasis on educating patients and making them active partners in the care process. To help make the hospital environment less forbidding, more homelike, and more conducive to social interaction, Planetree physically redesigns the hospital space. STUDY RESULTS: Planetree hopes to achieve many goals with its restructuring of patient care, two of which are staff and patient satisfaction. Preliminary surveys indicate that nurses and nursing assistants on Planetree are more satisfied than are staff on comparable units. The results of patient surveys, however, are more ambiguous. Planetree patients are no more, or no less, satisfied with their care than patients on comparable units. DISCUSSION: Both Planetree and TQM/CQI have goals of improving the delivery of patient care, and there are times when these approaches work in concert. There are times, however, when the different vantage points of TQM/CQI and Planetree may raise different questions and foster different solutions. Questions are also raised regarding whether Planetree benefits all patients in the same way. Furthermore, since it is not clear if Planetree's vision of humanizing patient care brings the results it hopes for, a long-term multifaceted research program is called for.

Impact of socioeconomic status on hospital use in New York City.

This DataWatch examines the potential impact of socioeconomic differences on rates of hospitalization, based on patterns of hospital use in New York City in 1988. The research suggests that lack of timely and effective outpatient care may lead to higher hospitalization rates in low-income areas. For certain conditions identified as ambulatory care sensitive, hospitalization rates were higher in low-income areas than they were in higher-income areas where appropriate outpatient care was more readily available. Further study is needed to determine the relative impact of various economic, structural, and cultural factors that affect access to care.