Identification of the CD32/FcgammaRIIc-Q13/STP13 polymorphism using an allele-specific restriction enzyme digestion assay.

We have recently reported that in addition to FcgammaRIIIa (CD16), approximately 45% of normal individuals also express FcgammaRIIc (CD32) on their natural killer (NK) cells. We found this expression to be regulated by an allelic polymorphism localized in the first extracellular exon (EC1) of the FcgammaRIIC gene, corresponding to aa 13. This is determined by a single nucleotide substitution, which results in either a functional open reading frame (glutamine-Q) or a premature stop codon (STP). Identification of this polymorphism provided a good explanation for the lack of CD32 expression previously observed with NK cells in some normal individuals. Here, we describe a new method for detection of FcgammaRIIc allelism based on RT-PCR amplification followed by an allele-specific restriction enzyme digestion. This method is rapid, reliable and time saving, as compared to the currently available allele-specific oligo-nucleotide probe-based Southern Blotting.

Carry the fire.

Materiel managers of today have survived the initial cuts brought about through mergers, closures, and acquisitions. Continued survival requires embracing change, practicing instant alignment, and leveraging effectiveness. This case study provides an example of taking a new approach to the old problem of product standardization and utilization reduction, and challenges all of us to bear the torches and "carry the fire."

Comparison of Nasometer and listener judgments of nasality in the assessment of velopharyngeal function after pharyngeal flap surgery.

This study examined the relationship between nasalance scores as derived from the Model 6200 Nasometer and listener judgments of perceived nasality for individuals with pharyngeal flaps. Sixteen individuals with pharyngeal flaps read a speech sample consisting of seven sentences for which associated nasalance scores were obtained. In addition, 10 trained listeners were asked to judge the subjects' audiorecorded speech samples for the degree of both hypernasality and hyponasality using two 6-point scales. The mean judges' ratings of hypernasality did not increase systematically with increasing nasalance scores or with decreasing hyponasality ratings. However, as the nasalance scores associated with nasal loaded sentences increased, a systematic decrease in listener perception of hyponasality occurred.

A healthy bottom line and quality patient care: can they coexist?

In summary, it is the writer's opinion that a healthy bottom line and quality patient care can coexist. With today's economic pressures and with more and tighter controls and regulations being imposed by the government and regulatory agencies, providers (especially hospitals) need to be cost efficient and cost effective. Will the cost-containment measures necessary to maintain a healthy bottom line reduce the quality of patient care? They needn't. In point, such measures might actually increase the quality of care by avoiding wasteful clinical practices. Quality patient care comprises three basic elements: value, service, and compassion. To omit any one of these ingredients is to remove the quality from patient care. Should this happen, no cost-containment measure will be enough to sustain a hospital. Financial accountability is essential; quality care is imperative. Blended together thoroughly, they are the recipe to survival--for the hospital and for the patient.