Structure of the major carbohydrate fragment of the Leishmania donovani lipophosphoglycan.

The major carbohydrate fragment from the lipophosphoglycan of Leishmania donovani was generated by mild acid hydrolysis (0.02 N HCl, 5 min, 100 degrees C) and purified by chromatography on DE-52 cellulose and thin layer. By a combination of analyses including gas-liquid chromatography-mass spectrometry and 1H NMR, the structure of the fragment was elucidated as PO4----6Gal(beta 1----4)Man. Approximately 16 of these phosphorylated disaccharide units occur in the overall glycoconjugate structure. NMR analysis of an alkaline phosphatase treated phosphorylated tetrasaccharide generated from lipophosphoglycan showed that the phosphorylated disaccharide units are linked together via alpha-glycosidic linkages. Complete characterization of the phosphorylated disaccharide units of lipophosphoglycan provides the first example of a defined carbohydrate anchored in membranes by a derivative of phosphatidylinositol.

Graduate primary care training: a collaborative alternative for family practice, internal medicine, and pediatrics.

The Residency Program in Social Medicine at Montefiore Medical Center is a collaborative, integrated training program for primary care pediatricians, internists, and family physicians within one interdisciplinary organization. Since 1970 we have trained more than 200 physicians, prepared them for board certification in their specialty, emphasized the psychosocial aspects and social determinants of health and illness, and shared a faculty, curriculum, and commitment to provide medical care for inner-city, underserved populations. We discuss the program's history and curriculum, administrative and academic structure, shared "cross-track" faculty units (psychosocial; social medicine; and research, education, and evaluation), and graduates' practice outcomes. The interdisciplinary character of the Residency Program in Social Medicine helps physicians successfully serve the underserved and exemplifies that interdisciplinary medical education succeeds when interdisciplinary health care teams are organized for optimal patient care. Only the federal government has the perspective and power to foster more interdisciplinary collaboration and strengthen primary care education in a period of shrinking resources.