Indirect carrier detection of canine haemophilia A using factor VIII microsatellite markers

A panel of factor VIII microsatellite markers was developed for indirect carrier detection of canine haemophilia A (factor VIII deficiency). A total of 78 dogs, representing 14 different breed variants of haemophilia A, were genotyped at six intragenic factor VIII marker loci. The markers spanned approximately 110 kb and were located in the 5' UTR of the factor VIII (F8) gene and within introns 6, 10, 12, 14 and 21. The observed heterozygosity (n = 39 females) for these markers was 0.675, 0.82, 0.868, 0.692, 0.473 and 0.775 respectively. The affected males of each breed variant had unique marker haplotypes. In addition, the marker haplotypes varied for two unrelated haemophilic Jack Russell terriers, compatible with independent mutation events causing haemophilia in different breeds and different families. A three-marker panel (markers within introns 6, 10 and 21) was informative for 37 of the 39 females. The haemophilia-associated haplotype was defined for six breed variants based on the genotypes of an affected male and a clear male sibling, with successful carrier detection of female siblings in each pedigree. Our results demonstrate an apparent allelic heterogeneity in canine haemophilia A; however, an indirect method based on a three-marker panel is feasible to facilitate carrier detection and genetic counselling.

A dynamic model of simulating stress distribution in the distal femur after total knee replacement

The aim of this study has been to develop a dynamic model of the knee joint after total knee replacement (TKR) to analyse the stress distribution in the distal femur during daily activities. Using MSC/ADAMS and MSC/MARC software, a dynamic model of an implanted knee joint has been developed. This model consists of the components of the knee prosthesis as well as the bones and ligaments of the knee. The femur, tibia, fibula, and patella have been modelled as mixed cortico-cancellous bone. The distal part of femur has been modelled as a flexible body with springs used to simulate the ligaments positioned at their anatomical insertion points.

With this dynamic model a gait cycle was simulated. Stress shielding was identified in the distal femur after TKR, which is consistent with other investigators' results. Interestingly, higher stresses were found in the bone adjacent to the femoral component peg.

This dynamic model can now be used to analyse the stress distribution in the distal femur with different load conditions. This will help to improve implant designs and will allow comparison of prostheses from different manufacturers.

Tracheal intubation in the emergency department: the Scottish district hospital perspective

BACKGROUND

Tracheal intubation is the accepted gold standard for emergency department (ED) airway management. It may be performed by both anaesthetists and emergency physicians (EPs), with or without drugs.

OBJECTIVE

To characterise intubation practice in a busy district general hospital ED in Scotland over 40 months between 2003 and 2006.

SETTING

Crosshouse Hospital, a 450-bed district general hospital serving a mixed urban and rural population; annual ED census 58,000 patients.

METHODS

Prospective observational study using data collection sheets prepared by the Scottish Trauma Audit Group. Proformas were completed at the time of intubation and checked by investigators. Rapid-sequence induction (RSI) was defined as the co-administration of an induction agent and suxamethonium.

RESULTS

234 intubations over 40 months, with a mean of 6 per month. EPs attempted 108 intubations (46%). Six patients in cardiac arrest on arrival were intubated without drugs. 29 patients were intubated after a gas induction or non-RSI drug administration. RSI was performed on 199 patients. Patients with trauma constituted 75 (38%) of the RSI group. 29 RSIs (15%) were immediate (required on arrival at the ED) and 154 (77%) were urgent (required within 30 min of arrival at the ED). EPs attempted RSI in 88 (44%) patients and successfully intubated 85 (97%). Anaesthetists attempted RSI in 111 (56%) patients and successfully intubated 108 (97%). Anaesthetists had a higher proportion of good views at first laryngoscopy and there was a trend to a higher rate of successful intubation at the first attempt for anaesthetists. Complication rates were comparable for the two specialties.

CONCLUSIONS

Tracheal intubations using RSI in the ED are performed by EPs almost as often as by anaesthetists in this district hospital. Overall success and complication rates are comparable for the two specialties. Laryngoscopy training and the need to achieve intubation at the first (optimum) attempt needs to be emphasised in EP airway training.

Medullary microvessel degeneration in multiple system atrophy

Multiple system atrophy (MSA) is a rare and fatal early-onset autonomic disorder which is characterised by Parkinsonism and orthostatic hypotension (OH). The pathophysiology of MSA is not fully understood but key features include the depletion of medullary autonomic neurons and presence of glial cellular inclusions. We hypothesise that the degeneration of medullary autonomic microvessels is an additional finding in MSA. Using digital pathology we quantified basement membrane collagen (Coll IV), smooth muscle actin (alpha-actin) and endothelial glucose transporter (Glut 1) expression in medullary autonomic nuclei of 8 MSA and 8 OH cases, compared with 12 controls with no autonomic dysfunction. We found decreased Coll IV (p=0.000) and Glut 1 (p=0.000) but not alpha-actin expression, in medullary autonomic nuclei of MSA, but not OH cases compared with control subjects. Medullary microvessel degeneration in MSA may be secondary to the primary neuro-glial pathogenesis of the disorder, and could accelerate its ageing-related progression.

Engineering and public health at CDC

Engineering is the application of scientific and technical knowledge to solve human problems. Using imagination, judgment, and reasoning to apply science, technology, mathematics, and practical experience, engineers develop the design, production, and operation of useful objects or processes. During the 1940s, engineers dominated the ranks of CDC scientists. In fact, the first CDC director, Assistant Surgeon General Mark Hollis, was an engineer. CDC engineers were involved in malaria control through the elimination of standing water. Eventually the CDC mission expanded to include prevention and control of dengue, typhus, and other communicable diseases. The development of chlorination, water filtration, and sewage treatment were crucial to preventing waterborne illness. Beginning in the 1950s, CDC engineers began their work to improve public health while developing the fields of environmental health, industrial hygiene, and control of air pollution. Engineering disciplines represented at CDC today include biomedical, civil, chemical, electrical, industrial, mechanical, mining, and safety engineering. Most CDC engineers are located in the National Institute for Occupational Safety and Health (NIOSH) and the Agency for Toxic Substances and Disease Registry (ATSDR). Engineering research at CDC has a broad stakeholder base. With the cooperation of industry, labor, trade associations, and other stakeholders and partners, current work includes studies of air contaminants, mining, safety, physical agents, ergonomics, and environmental hazards. Engineering solutions remain a cornerstone of the traditional "hierarchy of controls" approach to reducing public health hazards.

New approaches to package integrity testing

An important goal for packagers is the ability to demonstrate the integrity and sterility of each pack and determine its oxygen content with the minimum of wasteful destruction. Two nondestructive inspection systems are described.

Fertility outcomes in women with hypopituitarism

BACKGROUND

Women with hypopituitarism are known to have a poor outcome once pregnancy has been achieved by ovulation induction. There are no data, however, recording the efficacy of ovulation induction and pregnancy rates in this group of subfertile women.

METHODS

The outcome of fertility treatments in all 19 women with hypopituitarism attending the fertility clinics of University College London Hospitals over the past 20 years was audited.

RESULTS

Ovulation was achieved in almost all women (95%) but occurred in only 60% of treatment cycles. Pregnancy was achieved in 47% of women or 11% of cycles resulting in a live birth rate of 6.7% per cycle. Seven of the 18 pregnancies (39%) miscarried. Only 42% of women treated achieved a live birth.

CONCLUSION

Ovulation induction in women with hypopituitarism yields relatively low pregnancy rates in comparison to other causes of anovulation and a high miscarriage rate. Pituitary hormone deficiency beyond gonadotrophins has a major adverse effect on achieving pregnancy.

Development of ocular disease in patients with mucous membrane pemphigoid involving the oral mucosa

AIM

To determine the rate of development of ocular disease in patients presenting with mucous membrane pemphigoid (MMP) involving their oral mucosa.

METHODS

Diagnosis of oral MMP was made on the basis of clinical signs, histology, and direct and indirect immunofluorescence. Age, race, sex, age at diagnosis, progression of eye signs, duration of follow up, and time to progression of ocular disease were recorded.

RESULTS

30 patients with established oral MMP were reviewed. The mean age at diagnosis was 65.2 years (range 46-84 years) and 16/30 (53%) were male. At initial ocular review nine (30%) patients showed ocular signs of pemphigoid, of whom two had mild (IIA IIIB), four moderate (IIB IIIC), and three severe (IIC IIID) disease. The mean interval between diagnosis of oral MMP and first ophthalmic review was 19.3 months (range 0-144). Over the period of follow up two (7%) patients developed ocular disease at 19 months and 48 months, respectively, despite having had no evidence of ocular involvement at presentation. In total, 11 (37%) patients with oral disease eventually showed ocular disease with a calculated incidence rate for the development of ocular disease of 0.03 per person year over 5 years.

CONCLUSIONS

MMP may affect different tissues at different stages, often separated by many years. Patients with MMP involving their oral mucosa are at significant risk of developing ocular disease and should remain under ophthalmic review.

Disclosure Regulation and Accounting Education in the UK: Moving Towards Corporate Accountability 252 and Transparency

This paper was motivated by the current debate over the voluntary approach to environmental disclosures in corporate annual reports and assesses the effectiveness of the current policy of voluntarism in the UK. A brief review of the relevant theories, which explain why managers might choose to voluntarily provide environmental responsibility information to parties outside the organisation, is presented. With this background, the paper then questions whether the UK government’s faith in voluntarism and the pursuit of best practice will be enough to generate any real change in current environmental reporting practices. We argue that voluntarism is not effective and that there is an urgent need to introduce strict governmental regulations on the information that must be disclosed and the form in which it should be presented in corporate annual reports as have been established in several other countries. In addition, further consideration is needed to achieve reforms in academic accounting education in order to improve corporate accountability and transparency in corporate annual reports. Organisations need to respond to the growing demands for corporate social and environmental responsibility and this will be possible with the support of an accounting profession that takes a more proactive approach to engaging with stakeholders. For this to happen, we need to rethink the focus of accounting and business education. We must move away from the dominant model, which treats accountancy as a set of techniques, towards a more holistic approach which recognises the social and environmental impacts of organisational activity.

Packaging issues: avoiding delamination

Manufacturers can minimise delamination occurrence by applying the appropriate packaging design and process features. The end user can minimise the impact of fibre tear and reduce subsequent delamination by careful package opening. The occasional inconvenient delamination is a small price to pay for the high level of sterility assurance that comes with the use of Tyvek.

A role for matrix metalloproteinases in the pathology and attenuation of Theileria annulata infections

Upon infection with Theileria annulata, bovine leukocytes are induced to express eight novel metalloproteinase activities. In this article, Rachel Adamson and Roger Hall suggest that these enzymes are virulence factors and their presence may explain some of the features of the pathology of the disease. Specifically, they discuss the possibility that the metastatic properties of infected cells, the 'cigarette burn' ulcers and the cachexia characteristic of tropical theileriosis are associated with metalloproteinase expression. Furthermore, they propose that loss of metalloproteinase activity during the generation of a vaccine line could explain the attenuated phenotype.

A rapid method for illustrating features in both coding and non-coding regions of a genome

A bitmap display of the Fourier spectra has been developed which allows convenient whole chromosome scanning for genes and other features. Use of a limited sliding window gives rapid visualization and localization of coding regions in the chromosomes, as well as non-coding features such as repetitive DNA. The method works particularly well on organisms with a skewed base composition, to provide an overview of genomic features.