Asunto(s)
Cloruros/farmacología , Histidina/química , Proteínas de la Membrana , Membranas Artificiales , Péptidos/aislamiento & purificación , Proteínas de Plantas/aislamiento & purificación , Compuestos de Zinc/farmacología , Colodión , Nylons , Péptidos/química , Permeabilidad , Proteínas de Plantas/química , PolivinilosRESUMEN
This article analyzes the implementation of a traditional Economic Grand Rounds (EGR) program in a teaching hospital. The conclusions are that the original concepts of EGR--presentations of treatment costs by clinicians in a grand rounds setting, reinforcement of agreed changes in practice patterns, and subsequent evaluation and participation--are still valid but are inadequate to ensure a successful program. Other factors must be added if EGR is to attain its goals. These factors are administrative and nursing involvement, a provision to make policy changes, and incentives for the medical staff. This article also outlines areas of potential savings achieved through an EGR program in laboratory testing, preoperative laboratory testing, and intravenous therapy with antibiotics.
Asunto(s)
Educación Médica Continua/organización & administración , Costos de la Atención en Salud , Hospitales de Enseñanza/economía , Cuerpo Médico de Hospitales/educación , Pautas de la Práctica en Medicina/economía , Técnicas de Laboratorio Clínico/economía , Control de Costos/métodos , Quimioterapia/economía , Hospitales con más de 500 Camas , Hospitales de Enseñanza/organización & administración , Cuerpo Médico de Hospitales/economía , Modelos Econométricos , Técnicas de Planificación , Desarrollo de Programa , Desarrollo de Personal , Estados UnidosRESUMEN
By using cloned Rhizobium meliloti, Rhizobium leguminosarum, and Rhizobium sp. strain MPIK3030 nodulation (nod) genes as hybridization probes, homologous regions were detected in the slow-growing soybean symbiont Bradyrhizobium japonicum USDA 110. These regions were found to cluster within a 25-kilobase (kb) region. Specific nod probes from R. meliloti were used to identify nodA-, nodB-, nodC-, and nodD-like sequences clustered on two adjacent HindIII restriction fragments of 3.9 and 5.6 kb. A 785-base-pair sequence was identified between nodD and nodABC. This sequence contained an open reading frame of 420 base pairs and was oriented in the same direction as nodABC. A specific nod probe from R. leguminosarum was used to identify nodIJ-like sequences which were also contained within the 5.6-kb HindIII fragment. A nod probe from Rhizobium sp. strain MPIK3030 was used to identify hsn (host specificity)-like sequences essential for the nodulation of siratro (Macroptilium atropurpureum) on a 3.3-kb HindIII fragment downstream of nodIJ. A transposon Tn5 insertion within this region prevented the nodulation of siratro, but caused little or no delay in the nodulation of soybean (Glycine max).
Asunto(s)
Genes Bacterianos , Rhizobiaceae/genética , Simbiosis , Secuencia de Aminoácidos , Secuencia de Bases , ADN Bacteriano/genética , Prueba de Complementación Genética , Hibridación de Ácido Nucleico , Regiones Promotoras Genéticas , Homología de Secuencia de Ácido Nucleico , Especificidad de la EspecieRESUMEN
The DNA region encoding early nodulation functions of Bradyrhizobium japonicum 3I1b110 (I110) was isolated by its homology to the functionally similar region from Rhizobium meliloti. Isolation of a number of overlapping recombinant clones from this region allowed the construction of a restriction map of the region. The identified nodulation region of B. japonicum shows homology exclusively to those regions of R. meliloti and Rhizobium leguminosarum DNA known to encode early nodulation functions. The region of homology with these two fast-growing Rhizobium species was narrowed to an 11.7-kilobase segment. A nodulation-defective mutant of Rhizobium fredii USDA 201, strain A05B-2, was isolated and found to be defective in the ability to curl soybean root hairs. Some of the isolated recombinant DNA clones of B. japonicum were found to restore wild-type nodulation function to this mutant. Analysis of the complementation results allows the identification of a 1.8-kilobase region as essential for restoration of Hac function.