Two-step Screening Procedure Research Articles

Early diagnosis of dementia via a two-step screening and diagnostic procedure.

We propose a two-step process for the assessment of dementia using standardized instruments. The family physician performs a screening consisting of taking a medical history, gathering information from relatives and friends of the patient, and administering the combined Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). Specialists examine patients with suspected dementia to confirm the diagnosis of dementia and, after a thorough differential diagnostic process, provide the family physician with recommendations for treatment. Specialists should perform neurological and psychiatric examinations, imaging (computer-assisted tomography [CT], magnetic resonance imaging [MRI]), and laboratory work-up. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) core neuropsychological battery is proposed to serve as a minimal data set that is internationally compatible. In addition, we recommend the Nurses' Observation Scale for Geriatric Patients (NOSGER) as a standard tool for functional assessment.

Regulation of immune responses by I-J gene products. I. Production and characterization of anti-I-J monoclonal antibodies.

Using a novel, two-step functional screening procedure, we have isolated hybridoma B cell lines secreting monoclonal antibodies directed against gene products of the I-Jb and I-Jk subregions of the mouse H-2 complex. These monoclonal antibodies act in vitro by allowing nonresponder spleen cells to respond to normally suppressive quantities of poly(Glu50Tyr50) (GT) (WF8 series of anti-I-Jk monoclonal antibodies) or to suboptimal concentration of poly(Glu60Ala30Tyr10) (WF9 series of anti-I-Jb monoclonal antibodies). Some of the culture supernates that show augmenting activity bind GT-specific T cell-derived suppressor factor (GT-TsF), indicating that some monoclonal antiantibodies display a nonspecific enhancing effect, or, more likely, that anti-I-J monoclonal antibodies have been produced against I-J determinants not found on TsF. It is this last possibility that is most intriguing and that might serve as a means for exploring the heterogeneity of the I-J subregion. It is also possible that some of our monoclonal anti-I-J antibodies might detect antigenic determinants selectively expressed on suppressor T cells, helper T cells, and/or macrophages. In addition, we have demonstrated that monoclonal anti-I-J antibodies should be useful in the biochemical characterization and purification of a monoclonal GT-TsF. These haplotype-specific anti-I-J monoclonal antibodies should prove to be powerful tools for future studies exploring the role of I-J gene products in the regulation of specific immune responses.