HLA-DR17 and Mooren's ulcer in South India.

OBJECTIVE: To investigate the association between Mooren's ulcer and human leucocyte antigen (HLA) type DR17(3) in patients from the Tamil Nadu State of South India. METHODS: Blood samples from 38 patients with Mooren's ulcer and 45 age- and sex-matched controls were obtained prospectively. HLA-DR and HLA-DQ typing was performed by PCR using sequence-specific primers. RESULTS: Fifteen (40%) of the patients with Mooren's ulcer tested positive for HLA-DR17(3) compared with seven (16%) of the controls (p = 0.01). Seventeen (45%) of the patients also tested positive for the closely linked HLA-DQ2 compared with 11 (24%) of controls (p = 0.05). When adjusted for multiplicity, the correlation between HLA-DR17(3) and Mooren's ulcer remained significant (p = 0.03). CONCLUSIONS: These data demonstrate an association between HLA-DR17(3) and Mooren's ulcer in South Indian patients, supporting autoimmune theories about the pathogenesis of the disorder.

HLA-DRB1 and multiple sclerosis in Malta.

BACKGROUND: By comparison with the neighboring island of Sicily, the frequency of multiple sclerosis (MS) in Malta is remarkably low. METHODS: To explore whether the relative rarity of MS in Malta might be the result of lower population frequencies of major histocompatibility complex susceptibility alleles, we genotyped the HLA-DRB1 locus in 77 Maltese-born patients (97% of the prevalent unrelated native cases) and 206 Maltese controls. We made comparisons with previously published data for Sicily and other European countries. RESULTS: The anticipated association with HLA-DRB1*15, the main susceptibility allele in most other populations, was confirmed (p(c) = 0.009) but, in addition, we also observed an equally strong, and apparently protective, effect of the HLA-DRB1*11 allele (p(c) = 0.016). In comparison with previously published data from Sicily, we found that all HLA-DRB1 risk alleles were more common in Malta, whereas HLA-DRB1*11 was slightly less common. CONCLUSIONS: The difference in prevalence seen between the neighboring islands of Malta and Sicily cannot be explained by differences in background HLA-DRB1 population allele frequencies, which if anything would predict a higher rate of disease in Malta than in Sicily.

Donor CD31 genotype and its association with acute graft-versus-host disease in HLA identical sibling stem cell transplantation.

CD31 gene polymorphisms are implicated in the pathogenesis of graft-versus-host disease (GvHD) following haematopoietic stem cell transplantation (HST). We investigated the influence of CD31 genotype on the incidence of GvHD following HST from an human leukocyte antigen (HLA)-identical sibling donor. Donor and recipient CD31 codons 125, 563 and 670 DNA polymorphisms were determined in 85 cases of HLA identical sibling HST from two transplant centres. A correlation between CD31 genotype and acute GvHD was considered significant if observed in patients from both transplant centres independently. A strong correlation was identified between donor CD31 codon 125 genotype and the incidence of acute GvHD. Acute GvHD grades II-IV occurred in 27 of 46 (59%) recipients with a CD31 codon 125 leucine / valine heterozygous donor compared to nine of 39 (23%) recipients with a CD31 codon 125 homozygous donor (P=0.0019, relative-risk 2.45, 95% confidence interval 1.3-4.5). This correlation was significant in patients from both transplant centres (P=0.015 and P=0.019). We suggest that CD31 genotype may influence the function of donor-derived leukocytes and may be informative when there is a choice of comparable donors.

"Gearing up" for summer. Quick tips and biking essentials.

With any luck, at about the time this appears in print I'll be appearing on the street in my favorite part of my fitness program: bicycling. I don't claim to be an expert--my family thinks I'm Miguel Indurain because I can ride 20 miles at a time, and I think I'm Marco Pantani because I'm short, bald, and good on hills--but I've learned a fair amount in my last three years of riding. If you're an experienced rider you probably know at least as much as I do, but if you're a beginner--or beginning over after a long hiatus, as I did--then I have some suggestions for you.

Malpractice and the National Practitioner Data Bank: what OR nurses need to know.

The National Practitioner Data Bank will record any payments made for any reason related to a malpractice suit in a central data bank available to a number of designated parties. Hospitals will be required to request this information to screen applicants and at least every 2 years for appointment renewals. The data bank may also be consulted by hospitals and state licensing boards as they deem necessary and by professional societies when reviewing membership applications. It is in the best interests of all malpractice defendants to insist on adequate representation of their personal, professional, and financial interests, which may necessitate insurance carriers providing each defendant with individual counsel.

Caught between law & nursing.

Nursing has entered a new era. It is no longer accountable only to tribunals that measure scientific and technical accuracy. As health-care providers, nurses must also be able to document and justify risks, costs, complications, diagnostic and therapeutic choices, and any other decision made in the course of practicing their profession. Additionally, acceptance and adjustment must be made for working within the new parameters established by the law. James Laughlin said, "A fox was crossing a meadow and the sheep went running, but the fox has no interest in them. He is interested in a field mouse or a chipmunk. People also have such problems." The third parties and government agencies are looking for mice. As competent nurses, you must ensure that the fox has no interest in you.

Image synthesis from nonimaged laser-speckle patterns.

We demonstrate that unspeckled images of coherently illuminated, diffuse objects can be formed from measurements of backscattered laser-speckle intensity. The theoretical basis for this imaging technique is outlined, and results of computer experiments that successfully construct images from digitally simulated laser-speckle measurements are presented.

Frey's syndrome: secondary to condylar fracture.

Frey's syndrome, or gustatory sweating, is most commonly seen as a sequela of superficial parotidectomy. It can also be caused by other forms of trauma, including blunt trauma, but rarely does it occur without trauma.