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181.
CA Campbell AR Horvath 《The Clinical biochemist. Reviews / Australian Association of Clinical Biochemists》2012,33(4):149-160
Timely release and communication of critical test results may have significant impact on medical decisions and subsequent patient outcomes. Laboratories therefore have an important responsibility and contribution to patient safety. Certification, accreditation and regulatory bodies also require that laboratories follow procedures to ensure patient safety, but there is limited guidance on best practices. In Australasia, no specific requirements exist in this area and critical result reporting practices have been demonstrated to be heterogeneous worldwide.Recognising the need for agreed standards and critical limits, the AACB started a quality initiative to harmonise critical result management throughout Australasia. The first step toward harmonisation is to understand current laboratory practices. Fifty eight Australasian laboratories responded to a survey and 36 laboratories shared their critical limits. Findings from this survey are compared to international practices reviewed in various surveys conducted elsewhere. For the successful operation of a critical result management system, critical tests and critical limits must be defined in collaboration with clinicians. Reporting procedures must include how critical results are identified; who can report and who can receive critical results; what is an acceptable timeframe within which results must be delivered or, if reporting fails, what escalation procedures should follow; what communication channels or systems should be used; what should be recorded and how; and how critical result procedures should be maintained and evaluated to assess impact on outcomes.In this paper we review the literature of current standards and recommendations for critical result management. Key elements of critical result reporting are discussed in view of the findings of various national surveys on existing laboratory practices, including data from our own survey in Australasia. Best practice recommendations are made that laboratories are expected to follow in order to provide high quality and safe service to patients. 相似文献
182.
Molecular evolution of olfactomedin 总被引:2,自引:0,他引:2
Olfactomedin is a secreted polymeric glycoprotein of unknown function,
originally discovered at the mucociliary surface of the amphibian olfactory
neuroepithelium and subsequently found throughout the mammalian brain. As a
first step toward elucidating the function of olfactomedin, its
phylogenetic history was examined to identify conserved structural motifs.
Such conserved motifs may have functional significance and provide targets
for future mutagenesis studies aimed at establishing the function of this
protein. Previous studies revealed 33% amino acid sequence identity between
rat and frog olfactomedins in their carboxyl terminal segments. Further
analysis, however, reveals more extensive homologies throughout the
molecule. Despite significant sequence divergence, cysteines essential for
homopolymer formation such as the CXC motif near the amino terminus are
conserved, as is the characteristic glycosylation pattern, suggesting that
these posttranslational modifications are essential for function.
Furthermore, evolutionary analysis of a region of 53 amino acids of fish,
frog, rat, mouse, and human olfactomedins indicates that an ancestral
olfactomedin gene arose before the evolution of terrestrial vertebrates and
evolved independently in teleost, amphibian, and mammalian lineages.
Indeed, a distant olfactomedin homolog was identified in Caenorhabditis
elegans. Although the amino acid sequence of this invertebrate protein is
longer and highly divergent compared with its vertebrate homologs, the
protein from C. elegans shows remarkable similarities in terms of conserved
motifs and posttranslational modification sites. Six universally conserved
motifs were identified, and five of these are clustered in the carboxyl
terminal half of the protein. Sequence comparisons indicate that evolution
of the N-terminal half of the molecule involved extensive insertions and
deletions; the C-terminal segment evolved mostly through point mutations,
at least during vertebrate evolution. The widespread occurrence of
olfactomedin among vertebrates and invertebrates underscores the notion
that this protein has a function of universal importance. Furthermore,
extensive modification of its N-terminal half and the acquisition of a
C-terminal SDEL endoplasmic-reticulum- targeting sequence may have enabled
olfactomedin to adopt new functions in the mammalian central nervous
system.
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183.
184.
185.
The molecular organization of the beta-globin complex of the deer mouse, Peromyscus maniculatus 总被引:1,自引:0,他引:1
Padgett RW; Loeb DD; Snyder LR; Edgell MH; Hutchison CA d 《Molecular biology and evolution》1987,4(1):30-45
Recombinant DNA clones have been isolated that contain 80 kb of the
beta-globin complex from the deer mouse, Peromyscus maniculatus.
Comparisons of this complex with that from the laboratory mouse, Mus
domesticus (with an order 5'-Hbby, Hbb-bhO, Hbb-bhl, Hbb-bh2, Hbb-bh3,
Hbb-bl, Hbb-b2 3') highlight organizational trends in the beta-globin
complex since the two species diverged. Unlike other mammals studied thus
far, the deer mouse possesses three adult genes. Partial sequence analysis
indicates that each of the three adult genes is intact and hence may be
functional. Hybridization of one of the two Mus pseudogenes, Hbb-bh3, to
genomic blots from Peromyscus reveals that it has a homologous counterpart
in Peromyscus. Homologous genes to the two gamma-like Mus genes, Hbb-bhO
and Hbb-bhl, are also found in Peromyscus. The strong hybridization between
the Hbb-bhl genes and significant nucleotide similarity between the Hbb-bhO
genes suggest that both pairs are important for the ontogeny of these mice
although no known product has been identified for the Hbb-bhO genes. The
presence of Hbb-bhO and Hbb-bhl in Peromyscus suggests that the duplication
that created this related gene set occurred before the two lineages
diverged. A single gene for Hbb-y has been isolated from Peromyscus. The
adult region in Peromyscus has undergone significant divergence from the
same region in Mus, having three rather than two adult genes, the
acquisition of at least 15 kb of extra DNA relative to Mus, and possibly
the loss of the Hbb-bh2 pseudogene. The nonadult region of the complex, in
contrast, contains the same set of genes apparently distributed over the
same amount of DNA as in the Mus beta- globin complex. This observation
suggests that the embryonic region of the complex is more evolutionarily
stable than the adult region.
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