Description of four new HLA alleles in the Finnish population: A*03:283N, A*68:167, C*03:327, C*03:361.

New HLA alleles found in the Finnish population: A*03:283N, A*68:167, C*03:327 and C*03:361.

Conflicting HLA assignment by three different typing methods due to the apparent loss of heterozygosity in the MHC region.

Loss of heterozygosity (LOH) has been reported to cause false human leukocyte antigen (HLA) homozygous typing results in pre-transplant patients suffering from haematological malignancies, who in fact are HLA heterozygous. This poses a challenge for histocompatibility testing, as a stem cell graft from a genuinely HLA homozygous donor to a mistyped patient may lead to acute life-threatening graft-vs-host disease. LOH in the HLA region on chromosome 6 is known to be quite common in solid tumours, helping malignant cells to escape T-cell surveillance, but the incidence in haematological malignancies is less well known and the estimates vary. Here we report LOH in the HLA region of five patients with haematological malignancy. We found considerable differences in sensitivity between the three different HLA typing methods used in our laboratory: SSP was clearly the most sensitive method for detecting the lost haplotype, followed by rSSO, while SBT was the least sensitive technique. A subsequent, retrospective genotyping of 65 HLA homozygous haematological patients by SSP method showed no mistyped LOH cases in our laboratory in the past 10 years. The frequency of HLA homozygosity was found to be similar between haematological patients and control groups. It is important for an HLA laboratory to be aware of the differences in various HLA typing techniques' sensitivity for detecting an under-represented haplotype between HLA typing techniques when genotyping patients with haematological diseases. It is advisable for HLA laboratories to have at least two different methods with different sensitivities in their repertoire to be able to retype samples when a false homozygous result is suspected.

Difficulties in changing the diet in relation to dietary fat intake among patients with coronary heart disease.

OBJECTIVE: To study barriers in following nutritional advice among coronary heart disease patients in relation to dietary fat intake. DESIGN: A cross-sectional study using 4-day food records and a questionnaire with regard to barriers to or difficulties in following dietary advice. SUBJECTS: Altogether, 362 male subjects with coronary heart disease from two separate patient populations (91 + 271) were included in the study, with the mean age of 50 years and 60 years, respectively. The patients were classified into low (< or = 30 E%) or high (> 30 E%) fat intake groups. The patients with low dietary fat intake obtained on an average 10 E% less energy from fat as compared to the high dietary fat intake group. RESULTS: Overall, most patients with coronary heart disease reported difficulties in following nutritional advice when eating in social situations. Patients with high dietary fat intake reported more frequently than patients with low fat intake that they eat like other people without thinking about what they eat. On the other hand, there were no differences between the high and low fat intake groups in the barriers: eating at work, food price, shopping, taste or knowledge of nutrition. CONCLUSIONS: Our results suggest that the sensitivity to social influence is an important factor explaining noncompliance with dietary advice among patients with high dietary fat intake.

Shoot density of Carex rostrata Stokes in relation to internal carbon:nitrogen balance.

Initiation of new shoots originating from basal meristems of older shoots of Carex rostrata was studied in relation to the internal carbon/nitrogen balance. In a greenhouse experiment, individual shoots with a vigorous formation of a new shoot contained the highest concentrations of free amino acids (FAA) and the lowest concentrations of total nonstructural carbohydrates (TNC), resulting in a low TNC/FAA ratio. Thus shoots with high availability of nitrogenous compounds in relation to carbohydrates started growing a new shoot. The results suggest that TNC/FAA ratios could affect shoot densities. Field measurements supported this view: TNC/FAA ratios were lower in a mesotrophic site with a high density of shoots than in an oligotrophic site with a low density of shoots. Compared with roots, TNC/FAA ratios of shoots seemed to be more decisive both in the greenhouse experiment and in the field. In the greenhouse experiment, initiation of new shoots was measured in fragmented shoots of Carex having no intraclonal connections. Even if physiological integration was lacking due to fragmentation, shoot initiation was efficiently controlled in relation to the internal carbon/nitrogen balance.

Components of Type A behavior and the first-year prognosis of a myocardial infarction.

This study examined prospectively the role of Type A behavior and its subcomponents in the first-year prognosis of myocardial infarction (MI). Anger expression, irritability, and cynicism were assessed as traits related to the hostility component of the construct. The sample comprised 92 patients, less than 65 yr old, who survived the acute phase of their first MI. Psychological data was collected by self-report questionnaires during the initial hospital stay. Type A behavior was measured by the Jenkins Activity Survey and by the Finnish Type A Scale. Factors were controlled for age, sex, social status, and the MI severity. The results showed that patient who had a reinfarction or died during the first year reported more irritability and experienced anger more often than patients surviving without any complications. From the standard subcomponents only the Speed-Impatience factor of the JAS predicted poor prognosis. Our results indicated that the global Type A scores were not associated with the prognosis of MI.

Frequent attender profiles: different clinical subgroups among frequent attender patients in primary care.

Psychiatric and physical morbidity among frequently attending patients in primary care is high. However, very few efforts have been made to sort out the complex patterns of problems these patients have. We developed a clinical grouping of these patients. Our sample consisted of 67 frequent attenders. The measures included physical and psychiatric illnesses, presenting symptoms, sociodemographic data, psychosocial situation, level of distress, global functioning, experienced life satisfaction, illness attribution, and current psychiatric treatment. We identified five groups with different profiles: (1) patients with entirely physical illnesses; (2) patients with clear psychiatric illnesses; (3) crisis patients; (4) chronically somatizing patients; and (5) patients with multiple problems. The grouping was based on multidimensional operational criteria. The majority in all groups attended for solely physical illnesses or symptoms suggesting different forms of somatization. Only a few patients were undergoing any psychiatric treatment. Differences between groups were found regarding sociodemographic factors, physical illnesses, global functioning, and satisfaction.

Diagnosis of Mycoplasma pneumoniae pneumonia in children.

We evaluated a commercial immunoglobulin M (IgM)-capture immunoassay for the detection of Mycoplasma pneumoniae infections in 278 pediatric patients with community-acquired, radiographically defined pneumonia. Acute- and convalescent-phase serum samples were collected from all patients and were tested for M. pneumoniae-specific IgM and IgG antibodies by Platelia enzyme immunoassays (Sanofi Diagnostica Pasteur, Marnes la Coquette, France). Nasopharyngeal aspirates (NPAs) were collected at the time of admission to the hospital. A total of 227 NPAs were subjected to the detection of M. pneumoniae DNA by PCR, and 191 NPAs were cultured by using the Pneumofast kit (International Mycoplasma, Signeswere, France). Southern hybridization of PCR products and the IgM test with solid-phase antigen (Serion Immunodiagnostica, Würzburg, Germany) were used for additional confirmation of a positive result, which required agreement of at least two different methods. A total of 24 (9%) confirmed diagnoses of mycoplasma infection were made, 5 (21%) of which were in children <5 years of age. Of the positive children, 24 of 24 (sensitivity, 100%) were positive by the IgM-capture test with convalescent-phase serum, 19 of 24 (79%) were positive by the IgM-capture test with acute-phase serum, 19 of 24 (79%) were positive by IgG serology, 10 of 20 (50%) were positive by PCR, and 8 of 17 (47%) were positive by culture. An additional 5 (of 254) children were positive by the Platelia IgM test alone (specificity, 98%). When the PCR with Southern hybridization result was combined with the IgM-capture test result with the acute-phase sera, the sensitivity of rapid laboratory diagnosis increased to 95%. In conclusion, the IgM serology test was the single most valuable tool for the diagnosis of M. pneumoniae pneumonia in children of any age.

Spatial and temporal performance of the miniface (free air CO2 enrichment) system on Bog Ecosystems in northern and Central Europe.

The Bog Ecosystem Research Initiative (BERI) project was initiated to investigate, at five climatically different sites across Europe, the effects of elevated CO2 and N deposition on the net exchange of CO2 and CH4 between bogs and the atmosphere, and to study the effects of elevated CO2 and N deposition on the plant biodiversity of bog communities. A major challenge to investigate the effects of elevated CO2 on vegetation and ecosystems is to apply elevated CO2 concentrations to growing vegetation without changing the physical conditions like climate and radiation. Most available CO2 enrichment methods disturb the natural conditions to some degree, for instance closed chambers or open top chambers. Free Air CO2 Enrichment (FACE) systems have proven to be suitable to expose plants to elevated CO2 concentrations with minimal disturbance of their natural environment. The size and spatial scale of the vegetation studied within the BERI project allowed the use of a modified version of a small FACE system called MiniFACE. This paper describes the BERI MiniFACE design as well as its temporal and spatial performance at the five BERI field locations. The temporal performance of the MiniFACE system largely met the quality criteria defined by the FACE Protocol. One minute average CO2 concentrations measured at the centre of the ring stayed within 20% of the pre-set target for more than 95% of the time. Increased wind speeds were found to improve the MiniFACE system's temporal performance. Spatial analyses showed no apparent CO2 gradients across a ring during a 4 day period and the mean differences between each sampling point and the centre of the ring did not exceed 10%. Observations made during a windy day, causing a CO2 concentration gradient, and observations made during a calm day indicated that short term gradients tend to average out over longer periods of time. On a day with unidirectional strong winds, CO2 concentrations at the upwind side of the ring centre were higher than those made at the centre and at the downwind side of the ring centre, but the bell-shaped distribution was found basically the same for the centre and the four surrounding measurement points, implying that the short term (1 sec) variability of CO2 concentrations across the MiniFACE ring is almost the same at any point in the ring. Based on gas dispersion simulations and measured CO2 concentration profiles, the possible interference between CO2-enriched and control rings was found to be negligible beyond a centre-to-centre ring distance of 6 m.