Structure of the C-type lectin carbohydrate recognition domain of human tetranectin.

Tetranectin (TN) is a C-type lectin involved in fibrinolysis, being the only endogenous ligand known to bind specifically to the kringle 4 domain of plasminogen. TN was originally isolated from plasma, but shows a wide tissue distribution. Furthermore, TN has been found in the extracellular matrix of certain human carcinomas, whereas none or little is present in the corresponding normal tissue. The crystal structure of full-length trimeric TN (2.8 A resolution) has recently been published [Nielsen et al. (1997). FEBS Lett. 412, 388-396]. The crystal structure of the carbohydrate recognition domain (CRD) of human TN (TN3) has been determined separately at 2.0 A resolution in order to obtain detailed information on the two calcium binding sites. This information is essential for the elucidation of the specificity of TN towards oligosaccharides. TN3 crystallizes as a dimer, whereas it appears as a monomer in solution. The overall fold of TN3 is similar to other known CRDs. Each monomer is built of two distinct regions, one region consisting of six beta-strands and two alpha-helices, and the other region is composed of four loops harboring two calcium ions. The calcium ion at site 1 forms an eightfold coordinated complex and has Asp116, Glu120, Gly147, Glu150, Asn151, and one water molecule as ligands. The calcium ion at site 2, which is believed to be involved in recognition and binding of oligosaccharides, is sevenfold coordinated with ligands Gln143, Asp145, Glu150, Asp165, and two water molecules. One sulfate ion has been located at the surface of TN3, forming contacts to Glu120, Lys148, Asn106 of a symmetry-related molecule, and to an ethanol molecule.

The three-dimensional structure of mammalian ribonucleotide reductase protein R2 reveals a more-accessible iron-radical site than Escherichia coli R2.

The three-dimensional structure of mouse ribonucleotide reductase R2 has been determined at 2.3 A resolution using molecular replacement and refined to an R-value of 19.1% (Rfree = 25%) with good stereo-chemistry. The overall tertiary structure architecture of mouse R2 is similar to that from Escherichia coli R2. However, several important structural differences are observed. Unlike the E. coli protein, the mouse dimer is completely devoid of beta-strands. The sequences differ significantly between the mouse and E. coli R2s, but there is high sequence identity among the eukaryotic R2 proteins, and the identities are localized over the whole sequence. Therefore, the three-dimensional structures of other mammalian ribonucleotide reductase R2 proteins are expected to be very similar to that of the mouse enzyme. In mouse R2 a narrow hydrophobic channel leads to the proposed binding site for molecular oxygen near to the iron-radical site in the interior of the protein. In E. coli R2 this channel is blocked by the phenyl ring of a tyrosine residue, which in mouse R2 is a serine. These structural variations may explain the observed differences in sensitivity to radical scavengers. The structure determination is based on diffraction data from crystals grown at pH 4.7. Unexpectedly, the protein is not iron-free, but contains one iron ion bound at one of the dinuclear iron sites. This ferric ion is bound with partial occupancy and is coordinated by three glutamic acids (one bidentate) and one histidine in a bipyramidal coordination that has a free apical coordination position. Soaking of crystals in a solution of ferrous salt at pH 4.7 increased the occupancy on the already occupied site, but without any detectable binding at the second site.

Perceptions of the mammography experience.

The 1993 projections for breast cancer indicate a morbidity of 183,000 women with a mortality rate of 18%. Mammography is one of three approaches available for the early detection of breast cancer. However, underutilization has been reported and attributed to pain associated with the procedure, the expense to the consumer, and lack of referral by physicians. Other reasons for the low utilization rates include fears on the part of the woman of a positive diagnosis, radiation, and a possible mastectomy. This study provides an analysis of the responses of a convenience sample of 272 women, aged 30-90 years, to two open-ended questions about the mammography experience. The words and phrases women used to describe the mammography experience and the sensations experienced in their breasts during mammography were subjected to content analysis. The results of this study suggest that the word descriptors women use to describe their experience during mammography are highly individualistic and may not be totally captured by numeric or descriptive rating scales of pain intensity.

[Salmonella dublin]. / Salmonella dublin.

Salmonella dublin's natural host is cattle; it may cause acute disease in calves, while adult animals may be asymptomatic carriers. In humans S. dublin is the most invasive of the zoonotic Salmonella-bacteria found in Denmark. It is much more frequently isolated from the blood than from the faeces and may give rise to serous metastatic infections in practically all organs. The number of registered human infections rose from zero to 46 per year during the period 1980-1988, but has now stabilized at a level of about 20 per year. Outbreaks have been described abroad as being caused by unpasteurised milk and cheese; in Denmark beef and cow's liver must be viewed as the dominant source of infection. The direct routes of infection are, however, unknown. Tightening of regulations for the slaughtering of animals from S. dublin infected herds, optimal hygiene in the slaughterhouses and increased cooperation between the veterinary and medical professions concerning investigation of routes of infection are necessary measures to be taken in order to reduce the number of human S. dublin infections.

Mobile mammography: the technologist's role.

This article discusses the role of the radiologic technologist in a mobile mammography screening program targeted at the economically disadvantaged in Dade County, Fla. It describes the development of process, structure and outcome standards used to guide and evaluate both the program and the radiologic technologist within this setting, highlighting the technologists' valuable contributions to the program.

Instruments that measure beliefs about cancer from a cultural perspective.

Understanding beliefs about cancer from a cultural perspective is of great importance as the population mix of this country continues to shift and change. In order to assess the cancer beliefs held by diverse populations, culturally specific tools are needed. The purpose of this article is to identify and describe instruments that have been used to assess beliefs about cancer. Eight published and unpublished instruments were identified from a review of the literature. These tools address attitudes and beliefs toward cancer, cancer prevention, and cancer treatment within a variety of age groups and ethnic populations. One tool was related to adolescents, whereas the remainder focused on adults; three were translated into other languages; four tools involved questionnaire format and four interview format. Although it is encouraging to report that culturally specific tools are being developed, there is a demonstrated need to increase the expertise in developing such instruments.

Breast cancer screening.

Screening for breast cancer is receiving increased emphasis with the development of modern technology. Health care providers must inform the public that screening for breast cancer may increase survival. Legislation must be enacted to ensure that a screening examination is affordable and can be readily obtained upon referral. The message to both health care professionals and the public must be positive. Early detection is the best protection in breast cancer.

Increasing the cancer screening of the medically underserved in south Florida.

Diagnosis and treatment of cancers at advanced stages have contributed to a significantly lower survival rate among individuals of low socioeconomic status compared with those in higher brackets. In an effort to increase the accessibility and acceptability of cancer screening among such individuals in Dade County, Florida, the Cancer Control Division of the Sylvester Comprehensive Cancer Center at the University of Miami School of Medicine initiated a pilot early detection program in 1987. The program initially provided breast cancer screening for women, aged 40 and older, who attended ten community health care centers located in low-income neighborhoods. With the selection of Miami by the American Cancer Society as one of three sites for conducting a screening demonstration project for the socioeconomically disadvantaged, this program has recently been expanded to include pelvic screening for women, aged 40 and older, and prostate screening for men, aged 65 and older.

Fibroadenomatoid hyperplasia of the male breast.

A 69-year-old man with congestive heart failure who had been treated with digoxin for 27 years and spironolactone for 4 years developed bilateral gynecomastia. Excised tissue contained multiple nodules. Histologically, the nodules showed a structural pattern corresponding to fibroadenoma of the female breast. This lesion, called "fibroadenomatoid hyperplasia," is probably caused by treatment with spironolactone. The lesion has not previously been described in tissue from the male breast.

Advances in breast cancer. Implications for nursing care.

The role of the nurse in the care of patients with breast cancer is changing because of the many options available for medical management of the disease. Breast cancer is a treatable disease. Patients survive many years. Throughout the treatment process, patients and families may be faced with numerous decisions involving initial treatment and adjuvant therapy as well as the treatment of metastatic disease. Involvement of the patient and caregiver are crucial in this process, and they must be assisted and supported by nurses who are knowledgeable about the options and the rationale behind each of the treatment options. If this disease continues to occur in 1 out of 10 women, most nurses will be involved with some aspect of the disease either personally or professionally.

Certification for oncology nurses: maturing of a discipline.

Certification for oncology nurses shares many similarities with board certification in medicine. Within the specialty of oncology nursing, certification provides one measure of excellence and signals a commitment to oncology nursing practice. Since the beginning of oncology nursing certification in 1986, over 7,200 nurses have become certified. This article describes the certification process for oncology nurses and discusses ways in which physicians can assist in this process.

The nurse's role in mammography screening.

Black women in Dade Country have a substantially higher proportion of advanced breast cancer at diagnosis than white women. To shift the stage at diagnosis from later to earlier, a Cancer Early Detection Program was initiated in the fall of 1987. This program involves screening with low-cost mammography, physical breast examination, and instruction in self-breast examination as well as general cancer education about prevention, early detection, and health promotion. The educational programs are presented in conjunction with the local unit of the American Cancer Society. A mobile mammography van travels to Primary Health Care Centers to provide mammograms to a population with limited access to preventive health care. This article describes the development and implementation of the program. It focuses on the responsibilities of an oncology nurse who coordinates and directs the program. Recommendations are made for ways oncology nurses can assume expanded roles in cancer screening/early detection.

Applying andragogy in nursing continuing education.

Andragogy, a philosophical orientation for adult education, receives little attention in the nursing continuing education literature. Yet, the tenets of andragogy form the organizing framework for programming. This article defines andragogy and provides selected results of a research study designed to test andragogical concepts in long-term oncology nursing continuing education programs. The results of the study suggest a new way of viewing the goals of nursing continuing education activities.

Adenosis tumour of the breast--a clinicopathological investigation of 27 cases.

Twenty-seven cases of palpable and/or tumour-forming adenosis in the female breast, called adenosis tumour, have been investigated. It is a rare lesion, which most often presents as a breast mass that clinically and histologically is sometimes misinterpreted as carcinoma. The majority of patients were under the age of 45 years. Grossly, most tumours were firm or elastic and showed a grey or greyish-white cut surface. Furthermore, seven (26%) were granular and nine (34%) were microcystic, whereas none showed chalky streaks. Microscopically, 20 cases were poorly circumscribed and seven cases were well circumscribed. In contradistinction to the often uniform growth pattern of tubular carcinoma, the adenosis tumours characteristically showed adenosis arranged in a mixture of eight different growth patterns. The most frequent and also most extensive growth pattern was classical sclerosing adenosis and the least frequent was tubular adenosis. Another conspicuous feature in adenosis tumours was patchy growth in contrast to the stellate configuration of tubular carcinoma which is the most likely differential diagnosis. Other findings separating adenosis tumours from carcinomas were microcysts (93%), apocrine metaplasia (63%), luminal histiocytes (52%) and pseudopapillomas, called glomeruloid structures (48%). Epithelial changes that could cause anxiety about malignancy were frequently found and comprised epithelial hyperplasia (44%), epithelial atypia (26%) and fat or nerve infiltration (30%). Three patients were subjected to unnecessary mastectomy because of incorrectly diagnosed adenosis tumours. Adenosis tumours and non-infiltrating carcinoma were found together in five cases, but their association is probably over represented due to selection. None of 18 pure adenosis tumours solely treated by excision had recurred at follow-up 1-9 years later (mean 3.75 years).

Mammographic features of sclerosing adenosis presenting as a tumour.

A re-examination study was made of 18 cases of histologically verified adenosis tumour from 12 different hospitals in Denmark. Four mammographic appearances could be identified. No pathognomonic sign or appearance could be identified. The median age of the patients was 42 years. The mean diameter of the 'tumour' was 2.1 cm. The diagnostic problem of malignant and benign breast disease is discussed.