Two monoclonal antibodies, KA 1 and KA 4, raised against human epidermis, were biochemically and immunologically characterized and were shown to react with specific cytokeratin polypeptides. On frozen sections of human mammary gland, these antibodies distinguish between myoepitheial and luminal epitheial cells. We present evidence that in these cells KA 1 antibody recognized cytokeratm 5 and KA 4 antibody cytokeratin 19. In normal mammary tissue, KA 4 antibody invariably reacted with the epitheial cells lining the lumina of acini, ductules, ducts, and sinus. In contrast, KA 1 antibody decorated only the myoepitheial and basal epitheial cells of acini, ducts, and sinus. In ductules, however, KA 1 also stained the luminal cells. All 73 invasive lobular and ductal carcinomas studied I Supported by the Deutsche Forschungsgemeinschaft (grant Ja 219/ 4-2 to E-DJ).

ABSTRACT. Compliance, or adherence, as it relates to health care is the extent to which a person's behavior coincides with medical or health advice. Medication compliance is critical for all aspects of pediatrics, specifically in successful treatment, disease prevention, and health promotion. Compliance depends on the patient's and physician's committing to the same objectives. It is unfortunate that numerous studies and physician accounts reveal difficulties in achieving compliance with pediatric medication therapy. Medication compliance in pediatric patients ranges from 11% to 93%. At least one third of all patients fail to complete relatively short-term treatment regimens. Poor compliance places children at risk for problems such as continued disease, complicates the physician-patient relationship, and prevents accurate assessment of the quality of care provided. This article presents the issue in the context of its incidence of and barriers to compliance and provides general principles to improve compliance in pediatrics by improving communication and characteristics of the practice setting. A oneon-one relationship between physician and patient is needed for communication and improved compliance. T his article is based on reviews of medical literature concerning compliance issues, on information gathered by the American Academy of Pediatrics (AAP) Taskforce on Medication Compliance, the AAP Periodic Survey (no. 44), and personal clinical experiences of the authors.As we begin the 21st century, the average medication compliance is ϳ50% in the pediatric population. 1 The range is from 5% to 15% for urban adolescent medication compliance to 85% to 95% for suburban newborn immunization compliance. There are a host of factors that affect medication compliance, but key among them include social and economic circumstances, particularly health literacy, patient belief systems, patient education, acceptability and palatability of the medication, and adverse effects of the medication. The costs of noncompliance to the health care are not trivial. Although not pediatric specific, the National Pharmaceutical Council estimated that $8.5 billion is unnecessarily spent annually on hospitalizations and physician visits caused by noncompliance to prescription regimens. 2 In pediatrics, it is necessary to deal with not only the issues of the patient but also the issues of the parent or other caregiver, which adds to the complexity of medication compliance.Medication compliance was well reviewed by Jones 3 in 1983, and little has changed since then in terms of medication issues. However, compliance issues are changing because dramatic shifts in the financing and organizing of health care already exert a negative effect on medication compliance. In response to increasing health care costs, particularly for prescription drugs, employers are instituting more restrictive formularies and shifting more of the costs to the employee through such innovations as multitiered copay systems. It remains to be seen whether parents who are f...

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Three mouse monoclonal anti-human cytokeratin antibodies were made against human sole epidermis. One of these (KA4) was shown to react with a variety of human simple epithelium, including eccrine and apocrine sweat glands and the luminal cells of the breast ducts and lobules, but failed to decorate interfollicular stratified squamous epithelium. This antibody reacted by the immunoblot technic with cytokeratins of Mr values 54, 46, and 40 kdaltons. KA4 reacted strongly with clear cells found in 11% of breast epithelium in clinically uninvolved nipples and with all Paget's cells in four cases of mammary and five cases of extramammary Paget's disease. These findings suggest a common cellular phenotype for Paget's cells and relates them to a population of cells found in breast epithelium.