Analysis of HLA-G expression in renal tissue in lupus nephritis: a pilot study.

BACKGROUND: The study aimed to investigate whether HLA-G antigen is expressed in the kidneys of patients affected by lupus nephritis (LN) and whether its detection in renal biopsies could be adopted as a marker of treatment response and prognosis. METHODS: Thirty renal biopsies from patients with LN were selected and analyzed through immunohistochemistry. Laboratory and clinical data were retrospectively collected at baseline, 6 and 12 months and at the latest clinical appointment. A number of patients (63.3%) were treated with rituximab (RTX) +/- methylprednisolone in the induction phase. The expression of HLA-G in glomeruli, tubules and infiltrating cells was examined and compared between lupus patients who achieved either complete or partial renal response and those who did not respond to treatment. RESULTS: HLA-G staining was observed in the glomeruli of 20 of 30 samples from patients with LN. The expression of the antigen was detected in podocytes, along glomerular capillary walls, on parietal glomerular epithelial cells and within the juxtaglomerular apparatus. Seventy per cent of patients whose glomeruli expressed HLA-G achieved partial or complete response at 6 months and 75% at the latest available follow up compared with 30% and 40%, respectively, of those who did not show any expression. The pattern of staining in tubules and infiltrating cells was highly variable precluding any clinical correlation. CONCLUSION: This study demonstrates that HLA-G is expressed in renal tissue in LN. Our retrospective data suggest that its expression could correlate with response to treatment.

Race differences in the relationships between dietary nutrients and overweight in women.

Increasingly overweight is a health problem in the United States, especially for African American (AA) women. Height, weight, and 24-hour dietary recall measurements from 46 European American (EA) and 44 AA women were used to assess the relationships between nutrients and overweight and the possible modifying effects of race. Significant race interactions were found when assessing the relationships between overweight and fats and mineral supplements. More EA women were overweight who had excessive fat intake, whereas more AA women were overweight who had appropriate fat intake. This reversed pattern for AA women was unexpected. Another unexpected finding was that overweight EA women used mineral supplements more frequently than nonoverweight EA women. These results were discussed in terms of energy imbalances, metabolic differences, and cultural differences. Additional studies of overweight assessing race and other biological factors that also include measures of energy expenditure and more precise measures of dietary energy intake are recommended.

Measures of body size based on height, weight, and reported ideal weight: conceptual distinctions and empirical demonstrations.

Using height, weight, and self-reported weight, eight additional measures of body size were computed. The purpose of this paper was to specify conceptual distinctions and test hypothesized relationships among those newly constructed measures. Using a sample of healthy African American and European American women, correlations among the measures and race differences were assessed. High correlations suggested only two independent constructs, but theoretical considerations would suggest retaining, in addition to the traditional measure of body mass index, three new constructs: ideal body mass, a discrepancy measure, and a desirability measure. The only significant race difference was on ideal body mass. African American women reported a larger ideal body mass index than European American women. The use of actual versus self-report measures of height and weight, different conceptualizations of ideal weight, and clinical implications also were discussed.

The effectiveness of inpatient case management. Fact or fiction?

Production processes and service delivery in acute care hospitals can be fragmented. Inpatient case management has the potential to improve both processes and outcomes of hospital care. The author reports on 18 research studies that used inpatient case management as the treatment variable. These outcome studies, using case management, did not provide the evidence needed to address deficiencies in inpatient settings. However, these studies do provide clear direction for nurse administrators and nurse researchers to take concerning the next steps needed to address this critical issue.

Quantification of the skin's topography by skin profilometry.

Synopsis A method of skin profilometry is presented. The data generated using this method are used to (a) uncover sources of variation in skin profilometry, (b) provide information regarding the choice of roughness parameters best suited for characterizing the skin's topography, and (c) determine if skin profilometry is a valuable tool for quantitatively assessing changes in the skin's surface pattern. The data show the roughness parameter values to be dependent on the orientation of the tracings with regard to the major grooves and ridges present in the surface patterns. Large variabilities of roughness parameter values obtained for multiple scans within small areas of replicas are indicative of the nonhomogeneity of the skin's surface. The number of peaks, mean peak size, mean depth of roughness, depth of smoothness, and residual profile length appear to be the most utile roughness parameters for quantifying changes in the skin's topography. The ability of skin profilometry to detect subtle changes in the skin's surface pattern due to hydration indicates the method is a sensitive means of quantifying the skin's topography.

Accounting for natural tension in the mechanical testing of human skin.

A low-pressure suction device has previously been used to obtain quantitative information on the mechanical properties of human skin. Reducing the raw data from this technique was complicated by the fact that the skin is already biaxially loaded in the natural state and a rational basis on which to compare results obtained from different subjects was not available. Using a strain gauged pretension device, a procedure for determining the natural state tension and extension fields in the skin has been developed. The natural tension was then relaxed in the direction of testing and the suction device used to determine the two-dimensional skin tension-extension ratio response of the skin at a constant testing rate. The data from a number of subjects have been used to develop a new multidimensional stress-strain theory in terms of two material constants that are related to basic material characteristics of the dermis and are uniquely determinable regardless of the natural state stress field. Tests performed on the upper backs of 23 healthy adult males were used to investigate the variations in the material constants with age and sun-exposure habits. Age variations were found to corroborate earlier studies, and variations with sun exposure habits were related to known dermal collagen and elastin changes due to ultraviolet radiation. The apparent sensitivity of the testing procedure to physiologic state variables holds out the hope that mechanical properties characterization will be a useful tool in the evaluation of the severity of certain pathologic states and the effect of therapy.