Macrofaunal recovery following TBT ban. Long-term recovery of subtidal macrofaunal communities in relation to declining levels of TBT contamination

In the United Kingdom, the use of TBT-based anti-fouling paints on small vessels was banned in 1987, and a biological study of the Crouch Estuary, a yachting centre on the south-eastern coast of the UK, was conducted in order to determine the ecological improvements resulting from this legislation. We present the changes in the macro-infaunal communities along the estuary in relation to declining TBT concentrations between 1987 and 2005. Although the major changes in response to the ban were observed within the first 3 years (primarily an increase in the number of crustacean taxa and a shift in community structure), with changes still apparent between three and 5 years, the temporal duration of this study allowed the rapidity of the response to be truly determined.

Building comparative gene expression databases for the mouse preimplantation embryo using a pipeline approach to UniGene

To understand early mammalian development there is a need to compare profiles of gene expression from different stages of the preimplantation mouse embryo. We describe here a method that uses gene expression data held in the UniGene database of the National Institutes of Health (NIH). The full mouse UniGene database (build #151) contains 43,104 gene clusters generated from approximately 4.1 million sequences. The Expressed Sequence Tags (EST) used to build UniGene are derived from cDNA libraries that are archived separately in the database of Expressed Sequence Tags (dbEST) database, with their own catalogue numbers. The mouse dbEST database contains 32 non-normalized dbEST libraries constructed from preimplantation stages (unfertilized oocyte, fertilized oocyte, 2-, 4-, 8- and 16-cell embryo and blastocyst). These libraries contain 219,852 EST sequences mapping to 15,731 UniGene clusters. We have developed a computational pipeline approach that imports and aggregates inventories of gene expression contained in these dbEST libraries. It uses these data to build an annotated web-based database of preimplantation gene expression with an in-built capacity for comparison of expression profiles. Comparison of gene expression profiles obtained for each developmental stage show statistically significant changes in gene expression during preimplantation development. These in silico-generated profiles were validated using RT-PCR.

Use of tunnelled catheters for malignant pleural effusions in patients fit for pleurodesis

The aim of the present study was to examine the effectiveness of tunnelled pleural catheters (TPC) in patients with malignant pleural effusions who would otherwise be candidates for pleurodesis. Patients were selected from a previously reported database of 250 TPC insertions. The study group was selected based on lung re-expansion and survival as a surrogate maker of eligibility for pleurodesis procedure, as defined by survival of > or =90 days and lung re-expansion > or =80% post-drainage on a standard chest radiograph 2 weeks post TPC placement. There were 109 procedures in 97 patients that met the entry criteria. Spontaneous pleurodesis (SP) was achieved following 70% of procedures and correlated with symptom control. The mean time to SP was 90 days. There was no need for a repeat procedure in 87% of cases overall and in 92% of patients experiencing SP. There were few complications and no procedure-related deaths. Tunnelled pleural catheters are an effective way of controlling malignant pleural effusions when used as first-line treatment in patients who appear to be candidates for pleurodesis procedures.

Regenerative medicine. The industry comes of age

The regenerative medicine industry has moved into a new era in which commercialisation and not research is the number one priority. To achieve its new goal, much has had to change, including the introduction of expert business management, simpler but superior products and scalability of manufacture. Mass public and political support is supplying both long-term resources and the market demand to finally create a sustainable new health-care sector.

The Korean stem cell fiasco: shifting the focus

No one could have failed to have seen the dramatic headlines surrounding Professor Woo Suk Hwang of the Seoul National University. Hwang claimed first place in the race to create patient-specific stem cells from cloned human embryos, only to be discredited shortly afterwards. This article discusses whether such high-profile negative publicity has damaged the regenerative medicine industry in general or whether it has merely shifted the stem cell focus away from South Korea.

Ectodermal dysplasia--an unusual dental presentation

Ectodermal dysplasia (ED) is a rare group of disorders affecting the hair, teeth, nails and sweat glands to a variable degree. There is a wide range of clinical presentation of ED. Missing teeth or abnormal tooth form may be the first indicator of the presence of the disorder. There is typically hypodontia with microdontia. We present an unusual case of ED with severe hypodontia and macrodontia affecting all first permanent molar teeth. We also consider the classification and presentation of this disorder.

Other approaches to fighting cardiovascular disease: stem cells and engineered tissue

Technologies such as vessels and cardiac patches grown in the laboratory are being developed to treat heart disease. This article reviews the progress so far with these and other regenerative-medicine products.

Tissue engineering skin: a paradigm shift in wound care

Tissue-engineered skin for the treatment of burns and ulcers is a clinical success, but making it commercially viable is more problematic. This article examines the industry, its techniques and suggests the way forward.

Stem cells are big news, but are they big business?

Future health care will involve treatment with stem cells and tissue engineering. This article, the first in a series reporting on the scientific breakthroughs in this area and relating them to the medical device industry, describes the science.

Correlation between genotype, phenotype and sex of rearing in 111 patients with partial androgen insensitivity syndrome

OBJECTIVE

Partial androgen insensitivity syndrome (PAIS) is a heterogeneous group of intersex disorders characterized by a typical perineoscrotal hypospadias/micropenis phenotype, and a normal androgen-producing testis. Various mutations in the androgen receptor (AR) are known to cause PAIS. Phenotypic expression is widely variable and there are no agreed guidelines to determine the sex of rearing in individuals with borderline masculinization. We aimed to quantitatively assess the external genital phenotype in relation to AR genotype and sex of rearing and identify criteria that differentiate mutation positive (ARmt) from mutation negative (ARwt) PAIS patients.

PATIENTS AND DESIGN

Cases with a diagnosis of PAIS were identified from the Cambridge Intersex Database. An external masculinization score (EMS) was used to quantify the degree of undermasculinization. Family history of AIS and details of the sex of rearing were recorded. Androgen binding was analysed in fibroblasts obtained from genital skin biopsies and mutational analysis of the AR was performed on genomic DNA extracted from peripheral blood. EMS and sex of rearing were compared in cases with similar mutations reported on the McGill International Database.

RESULTS

Two hundred and sixty-three patients with PAIS were identified. Androgen receptor gene sequencing was performed in 111 patients. Twenty-seven (24%) had mutations. Family history of AIS was present in 61 and 21% of ARmt and ARwt patients, respectively. The median EMS was 3 in both groups. The majority of ARmt patients had abnormal binding and there was a tendency to a higher median testosterone rise on hCG stimulation in ARmt (9.3 nmol/l) compared with ARwt patients (6.9 nmol/l). All patients with EMS of 4 or more were raised as male but there was an overlap of sex of rearing in patients with an EMS less than 4. A wide variation of EMS in relation to genotype and sex of rearing was observed.

CONCLUSION

The phenotype in PAIS is extremely variable and is rarely predicted by the AR genotype. Apart from the family history, there are no specific criteria to differentiate ARwt from ARmt. Sex of rearing is not entirely dependent on the EMS. Cultural issues, other modifying genes and response to androgen trials might be influencing factors. Collaborative studies with uniform protocols are needed to investigate infants with PAIS. Documenting phenotype, surgical procedures and outcome criteria are necessary to enable decision-making on the sex of rearing in patients with a lower range EMS.

Doppler optical coherence tomography for measuring flow in engineered tissue

The engineering of human tissue represents a major paradigm shift in clinical medicine. Early embodiments of tissue engineering are currently being taken forward to the clinic by production methods that are essentially extensions of laboratory manual procedures. However, to achieve the status of routine large-scale clinical practice, automation and scale-out processes are required. This in turn will require the development of reliable on-line monitoring and control systems. This paper examines one demand of crucial importance, namely the real time in vitro monitoring of the flow characteristics through growing tissue since this has a complex interrelationship. Doppler optical coherence tomography (DOCT) is a recently developed imaging technique for studying the rheological properties of tissues in vivo. Capable of non-invasive imaging in real time with high resolution, it is potentially ideal for the continuous monitoring of engineered tissues in vitro. As a base line, the current status of DOCT in vivo is therefore reviewed. This paper also reports the first preliminary use of DOCT in tissue engineering. The application described involves the imaging of a fully developed laminar flow through a combined tissue fabrication/bioreactor with a tissue-engineered construct (substitute blood vessel) in situ.

Application of obesity treatment algorithms to Canadian adults

OBJECTIVE

The purpose of this study was to apply obesity treatment algorithms to a representative sample of Canadians to determine their potential impact on the population.

DESIGN

The Canadian Heart Health Surveys (1986-1992) were used to describe the prevalence of adults (18-64 y) that would be eligible for weight loss treatment according to the US NIH algorithm, which uses body mass index (BMI), waist circumference (WC), and the presence of two or more cardiovascular disease (CVD) risk factors. Similar algorithms based on CVD risk factors and a single measure of either BMI or WC alone were also evaluated.

RESULTS

Using the NIH algorithm, 24% of Canadians (28% men, 19% women) would be identified for weight loss treatment. Virtually, all subjects received the same treatment recommendations when using BMI and CVD risk factors only, while 22% (23% men, 21% women) would meet the criteria for treatment using WC and CVD risk factors only.

CONCLUSIONS

Approximately one in four Canadians would be eligible for weight loss treatment using the NIH obesity treatment algorithm. However, the algorithm may be improved through the incorporation of more sensitive WC thresholds.

The potential of optical coherence tomography in the engineering of living tissue

The better repair of human tissue is an urgent medical goal and in order to achieve a safe outcome there is a parallel need for sensitive, non-invasive methods of assessing the quality of the engineered tissues and organs prior to surgical implantation. Optical coherence tomography (OCT) can potentially fulfil this role. The current status of OCT as an advanced imaging tool in clinical medicine, developmental biology and material science is reviewed and the parallels to the engineering of living tissue and organs are discussed. Preliminary data are also presented for a tissue engineering bioreactor with in situ OCT imaging. The data suggest that OCT can be utilized as a real time, non-destructive, non-invasive tool to critically monitor the morphology of tissue-engineered constructs during their fabrication and growth.

Ergonomic Analysis of New York Apple Harvest Work Using a Posture-Activities-Tools-Handling (PATH) Work Sampling Approach

Although back, neck, and shoulder strains are common among migrant and seasonal orchard workers, little data currently exist regarding the ergonomic factors contributing to this problem. We adapted Posture-Activities-Tools-Handling (PATH) instruments and methods for ergonomic job analysis of apple harvest work in three New York orchards, and used the resulting protocol to quantify hazardous activities, loads, and postures. Using a prototype developed previously, we trained twelve contract orchard observers with classroom training and supervised orchard practice. The PATH data were then collected on 14 orchard workers over four days (2,900 observations). Mean coefficients of variation ranged from a low of 0.212 (standing leg neutral) to a high of 0.603 (trunk moderate flexion). Most frequently observed activities were: picking (62.9%), placing and moving apples in the bag (8. 7%), and walking (8.1%). Weight bearing (>10 lb, >4.54 kg) was observed 78.5% of the time throughout a range of activities. Apple harvest work is comparable with other ergonomically high-risk occupations. Future research should focus on low-cost interventions that reduce load and awkward postures.

Morbidity following dental treatment of children under intubation general anaesthesia in a day-stay unit

OBJECTIVES

To determine which variables were best related to the overall morbidity of a child undergoing dental general anaesthetic (GA) and then to use these variables to determine those factors that might influence the extent and severity of morbidity experienced by healthy children following dental GA.

SAMPLE AND METHODS

Data were collected on anxiety, pain and morbidity, GA procedure and dental procedure from 121 children attending a day stay GA unit for dental treatment. Patients were interviewed preoperatively, postoperatively before discharge then four further times over the next 148 h. Data were analysed using multivariate regression.

RESULTS

Thirty-one per cent of subjects had restorative work, 60% had at least one tooth extracted, 54% had a surgical procedure. Use of local analgesia reduced postoperative pain whilst an increase in the number of surgical procedures increased it. Increase in anaesthetic time was related to increased odds of feeling sleepy and nauseous, females were more likely to complain of sleepiness or weakness. Feelings of dizziness were increased if the patient was given local analgesia during the procedure.

CONCLUSIONS

Pain following dental GA was the most prevalent and long lasting symptom of postoperative morbidity in this study. Reductions in operating time and improvement in pain control have the potential to reduce reported morbidity following dental GA.