Cross-reactive cytotoxic T lymphocytes against human immunodeficiency virus type 1 protease and gamma interferon-inducible protein 30.

The gamma interferon (IFN-gamma)-inducible protein 30 (IP-30) signal peptide -11 to -3 (LLDVPTAAV) is a prominent self peptide expressed with the class I human histocompatibility leukocyte antigen A2 (HLA-A2). Stimulation of peripheral blood mononuclear cells (PBMC) from HLA-A2 human immunodeficiency virus type 1 (HIV-1)-infected individuals with an HLA-A2-restricted HIV protease (PR) peptide 76-84 (LVGPTPVNI) activated cytotoxic T lymphocytes (CTL) against the IP-30 signal peptide. Since HIV-1 PR 76-84 stimulated CD8+ T cells from these individuals to secrete IFN-gamma, we tested whether the activation of IP-30-specific CTL in vitro resulted from T-cell cross-reactivity or from up-regulation of IP-30 by IFN-gamma. Neither high levels of exogenous IFN-gamma nor incubation of PBMC with other HIV peptides triggering substantial IFN-gamma release activated IP-30-specific CTL. Although the IP-30 signal peptide did not stimulate IFN-gamma release from freshly isolated PBMC, it activated CTL in vitro against itself and HIV PR 76-84. Peptide-stimulated IFN-gamma release, cold target inhibition, and HLA-A2/immunoglobulin dimer-mediated binding and depletion of effector cells all indicated that in vitro stimulation with HIV PR 76-84 or the IP-30 signal peptide activated a comparable population of cross-reactive effector cells. Neither IP-30 nor HIV PR 76-84 activated CTL against themselves following in vitro stimulation of PBMC from non-HIV-infected HLA-A2 individuals. Peptide titrations indicated higher-avidity T-cell interactions with HIV PR 76-84 than with the IP-30 signal peptide. These data indicate that HIV PR 76-84 is a heteroclitic variant of the IP-30 signal peptide -11 to -3, which has implications for immune memory and autoimmunity.

Participating dentists' assessment of the pilot regional online videoconferencing in dentistry (PROVIDENT) project.

OBJECTIVE: To assess the educational effectiveness of delivering continuing professional education (CPE) from dental schools to small groups of dentists at distant sites via videoconferenced links using relatively inexpensive equipment and ISDN2 links. DESIGN: 41 videoconferences between the four campuses of London Dental Schools and postgraduate centres in South East England were assessed using a pre-piloted questionnaire which contained open and specific questions. The questionnaire was given to all participants at the end of each videoconference. Answers to the specific questions were graded using the Likert scale. RESULTS: 40 of the 41 videoconferences were completed satisfactorily and were attended by 257 participants, all of whom completed questionnaires. However, no individual question was answered by all the participants. Of the responses 90% were positive on the topics of appropriateness of the teaching material for delivery by videoconference and of its educational level. 90% of responses also indicated a wish to attend further videoconferences and satisfaction at avoiding the need to travel to London for similar educational activity. 87% rated the lecturers as good or excellent in their use of the medium. 85% of responses indicated that the question and answer sessions within the videoconferences were useful and 82% that the visual aids enhanced the sessions. The technical aspects of the videoconferences were rated positively but to a lesser extent than the educational aspects with 69% of positive responses for visibility of visual aids, 54% for sound quality and 76% for the lecturers use of the technology. The technical aspects of the videoconferences improved during the pilot study. In response to the open questions, participants stated that they found the most useful aspects of the videoconferences were not having to travel, access to first rate lecturers, the discussions and the opportunity to interact with experts. CONCLUSIONS: The participants in this pilot study were positive about the use of videoconferencing to deliver educational material from dental schools to small groups. Once the technology has improved, this medium has the potential to provide CPE for dentists at work or at home in response to their specific needs.

A study of videoconferencing for postgraduate continuing education in dentistry in the UK--the teachers' view.

Videoconferencing is an established method for providing medical education over long distances. Our aims were to assess the feasibility of videoconferencing in dental postgraduate education, to evaluate its practicability, teacher satisfaction and evaluate equipment. Twenty-seven teachers from the 4 London Dental Schools provided 41 postgraduate dental education sessions on a range of topics to regional postgraduate centres and dental practices as part of the Thames Health Region's programme. Videoconferencing was carried out using a relatively inexpensive personal computer system link using ISDN2 telephone lines and Z350 protocol. Presenter views and assessment were obtained by questionnaire, interview and videotape. Teachers felt that minimal additional preparation time was required for videoconferencing and 21/27 preferred it to in-person teaching, most noting the saving in travel time. Only 3 of the teachers were dissatisfied with their ability to communicate, 4 were equivocal and 20 were either pleased or very pleased. The teachers largely enjoyed the experience and performed well in the new medium. However, sound quality proved inadequate in 5/41 links and most sessions included some periods of suboptimal sound. Only 4 teachers were satisfied with their ability to perform question and answer interaction with the audience. We conclude that experienced teachers adapt readily to videoconferencing and learn to communicate effectively very quickly. Teachers were positive about the medium despite its shortcomings and improvements in sound quality would allow a rapid expansion of postgraduate dental education by videoconference.

The Indian Health Service approach to alcoholism among American Indians and Alaska Natives.

The transfer to the Indian Health Service (IHS) of 158 alcohol treatment programs that had been administered by the National Institute on Alcohol Abuse and Alcoholism began in 1978. Today, approximately 300 alcohol and substance abuse treatment programs offer services to American Indians, among them primary residential treatment, halfway houses, outreach, and aftercare. This system provides a national network upon which additional activities may be established. Along with increasing its attention to health promotion and disease prevention, the IHS has moved toward the prevention of alcoholism. A variety of preventive programs are in place that emphasize improved self-image, value and attitude clarification, decision-making, and physical and emotional effects of alcohol and substance abuse. Many begin as Head Start programs and continue through adulthood. In 1986, after consulting with both academic and tribal experts, the IHS devised a strategic plan for alcoholism control that stresses comprehensive care and prevention activities; it serves as a guide for further program development. The Secretary of Health and Human Services created a Task Force on Indian Alcoholism in 1986 to serve as a coordinating body for activities carried out by the IHS and other agencies and units of the Department. Passage of the Anti-Drug Abuse Act in 1986 added resources for the development of adolescent treatment centers and, more importantly, for community-based pre- and post-residential care for youths and their families. Concomitant with these initiatives have been several instances of increased attention by various tribes to the problem of alcoholism. The IHS strategic plan, together with the Secretary's initiative, the Anti-Drug Act, and tribal actions, has added substantial momentum to efforts directed at controlling alcoholism among American Indians. Although the mortality rate from alcoholism is about four times greater for the American Indian population than for the entire U.S. population, it decreased from 54.5 per 100,000 population to 26.1 between 1978 and 1985-a reduction of 52 percent.The philosophy of the IHS in emphasizing prevention of disease and promotion of wellness provides an opportunity for continuing the considerable progress already made. The critical and decisive role played by the Indian communities themselves will determine whether ultimate success can be achieved.

Fluorophores as visualization aides in agar growth media.

A survey of 26 fluorophores revealed 5 which were non-inhibitory to Staphylococcus aureus and Escherichia coli and produced low background and high colony fluorescence.