Notes on eclampsia

The following is a record of the cases of Eclampsia which I have attended over a period of twenty years, together with a suggestion as to the mode of origin of the disease, some observations on treatment,and a commentary on my analysis of 137 cases recently reported in New Zealand. The series of Eclampsias that occurs in a private practice not largely of an obstetrical character is naturally a small one; and it may reasonably be objected that no general conclusions should be made from such limited experience. Nevertheless, the actual experience of a small number is extraordinarily instructive, and suggestive information can be gained by careful study of the details of a few cases perhaps more easily than from large statistics in which detail is obscured by the mass of material, and personal contact is lacking. My personal experience covers 15 cases in which there has been a culmination of the disease in convulsions, and a number of cases of pre- eclamptic toxaemia of varying degrees of severity. I find I have preserved meagre notes of 22 such, but that is only a fraction of the number actually seen. Perfection of recording in general practice is too difficult an ideal to attain. It is opportune here to remark that a definition of Eclampsia is not really easy. It is too closely associated in our minds with fibs, and we regard fits as being a necessary feature. I am convinced that this is irrational and wrong. Convulsions are merely the terminal phase of a toxaemia occurring in pregnant women, which presents any other symptoms quite as essential and characteristic. It would, I think, be just as reasonable to regard coma as a disease entity, apart from the diabetes, or whatever else is the cause; or to think of septic peritonitis as a disease, apart from the perforation,or appendicitis producing it. Further, the syndrome of Eclampsia is very varied. Almost each individual common symptom of it may be absent in a given case. The common symptoms are albuminuria, oedema, headache, sensory disturbances, especially of sight, raised blood pressure, and fits, occurring in pregnancy. But on reference to my own cases, and to other recorded cases, I find Eclampsia without albuminuria, Eclampsia without oedema, Eclampsia without headache, Eclampsia without sensory disturbance, and even Eclampsia without fits. There remain only two constant features - pregnancy, and a blood pressure which seems to have been found invariably raised whenever it has been taken

Molecular-beam epitaxy of CrSi_2 on Si(111)

Chromium disilicide layers have been grown on Si(111) in a commercial molecular‐beam epitaxy machine. Thin layers (10 nm) exhibit two epitaxial relationships, which have been identified as CrSi_2(0001)//Si(111) with CrSi_2[1010]//Si[101], and CrSi_2(0001)//Si(111) with CrSi_2[1120]//Si[101]. The latter case represents a 30° rotation of the CrSi_2 layer about the Si surface normal relative to the former case. Thick (210 nm) layers were grown by four different techniques, and the best‐quality layer was obtained by codeposition of Cr and Si at an elevated temperature. These layers are not single crystal; the largest grains are observed in a layer grown at 825 °C and are 1–2 μm across

PREPARATION AND CHARACTERIZATION OF AN IMMUNOELECTRON MICROSCOPE TRACER CONSISTING OF A HEME-OCTAPEPTIDE COUPLED TO Fab

A heme-octapeptide (mol wt 1,550) has been obtained from cytochrome c by successive pepsin and trypsin hydrolysis and purified by gel filtration and countercurrent distribution. It possesses peroxidatic activity characterized by an apparent Km of 0.2 M, an apparent vmax of 4 mmol/min per mg of peptide, and a pH optimum of 7.0. Using a novel two-step conjugation procedure, the heme-octapeptide was coupled to rabbit Fab antibody fragments by first derivatizing it with the N-hydroxysuccinimide ester of p-formylbenzoic acid and subsequently allowing it to form a Schiff base with the amino groups of Fab. Stable covalent linkages were then obtained by reduction of the Schiff bases with sodium borohydride. The conjugate consists of ∼2 heme-octapeptides attached to each Fab molecule. The molecular weight is 45,000 daltons when coupled to sheep Fab and 50,000 daltons with a Stokes radius of 32 Å, when conjugated to rabbit Fab. Its peroxidatic activity is characterized by an apparent Km of 0.4 M, an apparent vmax of 0.4 mmol/min and per mg of attached heme-octapeptide and a pH optimum of 7.0. The conjugate has been used for the localization at the electron microscope level of secretory immunoglobulins in the mammary gland of lactating rabbits

Absorbent products for urinary/faecal incontinence: a comparative evaluation of key product designs

Background: The UK health service, nursing homes and public spend around £94 million per year on incontinence pads (absorbent products) to contain urine and/or faeces, but the research base for making informed choices between different product designs is very weak.Objectives: The aim of this trial was to compare the performance and cost-effectiveness of the key absorbent product designs to provide a more solid basis for guiding selection and purchase.A further aim was to carry out the first stage in the development of a quality of life instrument for measuring the impact of absorbent product use on users' lives.Design: The work involved three clinical trials focusing on the three biggest market sectors. Each trial had a similar crossover design in which each participant tested all products within their group in random order.Settings, participants and methods: In Trial 1, 85 women with light urinary incontinence living in the community tested three products from each of the four design categories available (total of 12 test products): disposable inserts (pads); menstrual pads; washable pants with integral pad; and washable inserts. In Trial 2a, 85 moderate/heavily incontinent adults (urinary or urinary/faecal) living in the community (49 men and 36 women) tested three (or two) products from each of the five design categories available (total of 14 test products): disposable inserts (with mesh pants); disposable diapers (nappies); disposable pull-ups (similar to toddlers' trainer pants); disposable T-shaped diapers (nappies with waist-band); and washable diapers. All products were provided in a daytime and a (mostly more absorbent) night-time variant. In these first two trials, the test products were selected on the basis of data from pilot studies. In Trial 2b, 100 moderate/heavily incontinent adults (urinary or urinary/faecal) living in 10 nursing homes (27 men and 73 women) evaluated one product from each of the four disposable design categories from Trial 2a. Products were selected on the basis of product performance in Trial 2a and, again, daytime and night-time variants were provided. The first phase of work to develop a quality of life tool for measuring the impact of using different pad designs was carried out by interviewing participants from Trials 1 and 2a.Outcome measures: Product performance was characterised using validated questionnaires, which asked the participants (in Trials 1 and 2a) or carers (all participants in Trial 2b, except for the few who could report for themselves) to evaluate various aspects of pad performance (leakage, ease of putting on, discreetness, etc.) using a five-point scale (very good–very poor) at the end of the week (or 2 weeks for Trial 2b) of product testing. In addition, participants/carers were asked to save individual used pads in bags for weighing and to indicate the severity of any leakage from them on a three-point scale (none, a little, a lot). These data were used to determine differences in leakage performance. Numbers of laundry items and pads used were recorded to estimate costs, and skin health changes were recorded by the participant or by the researchers (Trial 2b). At the end of testing, participants were interviewed and ranked their preferences (with and without costs), stated the acceptability of each design (highly acceptable–totally unacceptable) and recorded their overall opinion on a visual analogue scale (VAS) of 0–100 points (worst design–best design). This VAS score was used with product costs to estimate cost-effectiveness. In addition, a timed pad changing exercise was conducted with 10 women from Trial 2b to determine any differences between product designs.Results: Results presented are for statistically and clinically significant findings.<br/

Loss of APC induces polyploidy as a result of a combination of defects in mitosis and apoptosis

Mutations in the adenomatous polyposis coli (APC) tumor suppressor gene initiate a majority of colorectal cancers. Acquisition of chromosomal instability is an early event in these tumors. We provide evidence that the loss of APC leads to a partial loss of interkinetochore tension at metaphase and alters mitotic progression. Furthermore, we show that inhibition of APC in U2OS cells compromises the mitotic spindle checkpoint. This is accompanied by a decrease in the association of the checkpoint proteins Bub1 and BubR1 with kinetochores. Additionally, APC depletion reduced apoptosis. As expected from this combination of defects, tetraploidy and polyploidy are consequences of APC inhibition in vitro and in vivo. The removal of APC produced the same defects in HCT116 cells that have constitutively active β-catenin. These data show that the loss of APC immediately induces chromosomal instability as a result of a combination of mitotic and apoptotic defects. We suggest that these defects amplify each other to increase the incidence of tetra- and polyploidy in early stages of tumorigenesis

Disentangling the exchange coupling of entangled donors in the Si quantum computer architecture

We develop a theory for micro-Raman scattering by single and coupled two-donor states in silicon. We find the Raman spectra to have significant dependence on the donor exchange splitting and the relative spatial positions of the two donor sites. In particular, we establish a strong correlation between the temperature dependence of the Raman peak intensity and the interdonor exchange coupling. Micro-Raman scattering can therefore potentially become a powerful tool to measure interqubit coupling in the development of a Si quantum computer architecture.Comment: Title changed. Other minor change

Self-aligned fabrication process for silicon quantum computer devices

We describe a fabrication process for devices with few quantum bits (qubits), which are suitable for proof-of-principle demonstrations of silicon-based quantum computation. The devices follow the Kane proposal to use the nuclear spins of 31P donors in 28Si as qubits, controlled by metal surface gates and measured using single electron transistors (SETs). The accurate registration of 31P donors to control gates and read-out SETs is achieved through the use of a self-aligned process which incorporates electron beam patterning, ion implantation and triple-angle shadow-mask metal evaporation

Hydrodynamic object recognition using pressure sensing

Hydrodynamic sensing is instrumental to fish and some amphibians. It also represents, for underwater vehicles, an alternative way of sensing the fluid environment when visual and acoustic sensing are limited. To assess the effectiveness of hydrodynamic sensing and gain insight into its capabilities and limitations, we investigated the forward and inverse problem of detection and identification, using the hydrodynamic pressure in the neighbourhood, of a stationary obstacle described using a general shape representation. Based on conformal mapping and a general normalization procedure, our obstacle representation accounts for all specific features of progressive perceptual hydrodynamic imaging reported experimentally. Size, location and shape are encoded separately. The shape representation rests upon an asymptotic series which embodies the progressive character of hydrodynamic imaging through pressure sensing. A dynamic filtering method is used to invert noisy nonlinear pressure signals for the shape parameters. The results highlight the dependence of the sensitivity of hydrodynamic sensing not only on the relative distance to the disturbance but also its bearing

Modulation of the equilibrative nucleoside transporter by inhibitors of DNA synthesis.

Expression of the equilibrative, S-(p-nitrobenzyl)-6-thioinosine (NBMPR)-sensitive nucleoside transporter (es), a component of the nucleoside salvage pathway, was measured during unperturbed growth and following exposure to various antimetabolites at growth-inhibitory concentrations. The probe 5-(SAENTA-x8)-fluorescein is a highly modified form of adenosine incorporating a fluorescein molecule. It binds. with high affinity and specificity to the (es) nucleoside transporter at a 1:1 stoichiometry, allowing reliable estimates of es expression by flow cytometry. Using a dual labelling technique which combined the vital DNA dye Hoechst-33342 and 5-(SAENTA-x8)-fluorescein, we found that surface expression of es approximately doubled between G1 and G2 + M phases of the cell cycle. To address the question of whether es expression could be modulated in cells exposed to drugs which inhibit de novo synthesis of nucleotides, cells were exposed to antimetabolite drugs having different modes of action. Hydroxyurea and 5-fluorouracil (5-FU), which inhibit the de novo synthesis of DNA precursors, produced increases in the expression of es. In contrast, cytosine arabinoside (ara-C) and aphidicolin, which directly inhibit DNA synthesis, produced no significant increase in es expression. Thymidine (TdR), which is an allosteric inhibitor of ribonucleotide reductase that depletes dATP, dCTP and dGTP pools while repleting the dTTP pool, had no significant effect on es expression. These data suggest that surface expression of the es nucleoside transporter is regulated by a mechanism which is sensitive to the supply of deoxynucleotides. Because 5-FU (which specifically depletes dTTP pools) causes a large increase in expression whereas TdR (which depletes all precursors except dTTP) does not, this mechanism might be particularly sensitive to dTTP pools