Reflections on research at the College of Medicine: Excellence yesterday, today, tomorrow

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Spanish for optometrists: A curriculum developed for the elective course, Optometry 725

This project is a compilation of the class notes developed for the elective course, Optometry 725: Basic Spanish for Optometrists. The topics include basic Spanish pronunciation and grammar, as well as a simple-as-possible translation of the instruction sets for the most common tests in a comprehensive optometric vision exam

Clinical features and the factors associated with poor outcome of measles patients at Queen Elizabeth Central Hospital

In the twelve month period from March 1992 to February 1993. 266 consecutive children with measles were admitted to the children's unit at Queen Elizabeth Central Hospital (QECH). Blantyre. During the 12 month period the overall mortality was 10.9%; mortality was highest (22.5%) in children 12-23 months age. One-third of the children admitted were under 9 months of age. not eligible for measles vaccination. Pneumonia complicated illness of 30% of cases and was the greatest clinical predictor of mortality. Among infants under 9 months of age, who were receiving inappropriate food supplementation before 4 months of age the risk of death was 6.4 times the risk of death in children who were not receiving food supplementation. Other aspects of measles epidemiology are discussed

The College of Medicine in the Republic of Malawi: towards sustainable staff development

BACKGROUND: Malawi has a critical human resources problem particularly in the health sector. There is a severe shortage of doctors; there are only few medical specialists. The College of Medicine (COM) is the only medical school and was founded in 1991. For senior staff it heavily depends on expatriates. In 2004 the COM started its own postgraduate training programme (Master of Medicine) in the clinical specialties. METHODS: We explore to what extent a brain drain took place among the COM graduates by investigating their professional development and geographical distribution. Using current experience with the postgraduate programme, we estimate at what point all senior academic positions in the clinical departments could be filled by Malawians. We demonstrate the need for expatriate staff for its most senior academic positions in the interim period and how this can be phased out. Lastly we reflect on measures that may influence the retention of Malawian doctors. RESULTS: Since the start of the COM 254 students have graduated with an average of 17 students per year. Most (60%) are working in Malawi. Of those working abroad, 60% are in various postgraduate training programmes. In 2015, adequate numbers of Malawi senior academics should be available to fill most senior positions in the clinical departments, taking into account a 65% increase in staff to cope with increasing numbers of students. CONCLUSION: There seems to be no significant brain drain among graduates of the COM. The postgraduate programme is in place to train graduates to become senior academic staff. In the interim, the COM depends heavily upon expatriate input for its most senior academic positions. This will be necessary at least until 2015 when sufficient numbers of well trained and experienced Malawian specialists may be expected to be available. Improved pay structure and career development perspectives will be essential to consolidate the trend that most doctors will remain in the country

K-infinite trends with burnup, enrichment, and cooling time for BWR fuel assemblies

This report documents the work performed by ORNL for the Yucca Mountain project (YMP) M and O contractor, Framatome Cogema Fuels. The goal of this work was to obtain k{sub inf} values for infinite arrays of flooded boiling-water-reactor (BWR) fuel assemblies as a function of various burnup/enrichment and cooling-time combinations. These scenarios simulate expected limiting criticality loading conditions (for a given assembly type) for drift emplacements in a repository. Upon consultation with the YMP staff, a Quad Cities BWR fuel assembly was selected as a baseline assembly. This design consists of seven axial enrichment zones, three of which contain natural uranium oxide. No attempt was made to find a bounding or even typical assembly design due to the wide variety in fuel assembly designs necessary for consideration. The current work concentrates on establishing a baseline analysis, along with a small number of sensitivity studies which can be expected later if desired. As a result of similar studies of this nature, several effects are known to be important in the determination of the final k{sub inf} for spent fuel in a cask-like geometry. For a given enrichment there is an optimal burnup: for lower burnups, excess energy (and corresponding excess reactivity) is present in the fuel assembly; for larger burnups, the assembly is overburned and essentially driven by neighboring fuel assemblies. The majority of the burnup/enrichment scenarios included in this study were for some near-optimum burnup/enrichment combinations as determined from Energy Information Administration (EIA) data. Several calculations were performed for under- and over-burned fuel to show these effects

An interesting diagnosis for a presacral mass: case report

A presacral mass can present a diagnostic dilemma for the surgical oncologist. Differential diagnoses include congenital causes such as teratoma or chordoma, neurological causes such as neurilemoma or neurofibroma or other malignancies such as lymphoma or sarcoma. Diagnosis usually requires imaging such as CT and MRI and tissue biopsy. We present an unusual cause of a presacral mass being extramedullary haematopoiesis, found incidentally in a 71 year old female. Extramedullary haematopoiesis is defined as the production of myeloid and erythroid elements outside of the bone-marrow. This diagnosis is extremely rare in the presacral area especially in a patient with no haematological abnormalities. A review of the literature is presented

Osteosarcoma: From Molecular Biology to Mesenchymal Stem Cells

Osteosarcoma is the most common primary malignant tumour of bone. Currently, despite treatment with multi-agent chemotherapy and limb salvage surgery, the five-year survival rate for osteosarcoma remains at 70%. The pathogenesis of osteosarcoma is complex and involves alterations in cellular apoptosis, adhesion, migration, invasion and molecular signalling. Research most recently has focused on the molecular basis of the disease with the goal of identifying novel therapeutic targets. To this end, mesenchymal stem cells (MSCs) have been identified to play a role in sarcomagenesis. MSC transformation may give rise to tumours, whereas interactions of MSCs with osteosarcoma cells in the tumour microenvironment may cause increased cell proliferation. This is in stark contrast to the role of MSCs as a promising source for tissue repair and regeneration. In order to utilize MSCs for biological reconstruction in the setting of osteosarcoma, further research is necessary to delineate the role of MSCs in osteosarcoma transformation and progression

Efficacy of Continuously Administered PEDF-Derived Synthetic Peptides against Osteosarcoma Growth and Metastasis

The potent antiangiogenic pigment epithelium-derived factor (PEDF) has shown promise against osteosarcoma, a tumour that originates in the bone and metastasises to the lungs. Neurotrophic, antiangiogenic, antiproliferative, and antimetastatic properties of PEDF have been attributed to a number of functional epitopes on the PEDF glycoprotein. StVOrth-2 (residues 78–102) and StVOrth-3 (residues 90–114) are two PEDF-derived peptides based on these functional epitopes. StVOrth-2 has previously been shown to inhibit osteosarcoma cell proliferation, while StVOrth-3 increased osteosarcoma cell adhesion to collagen I in vitro. In this paper, we have evaluated systemically and continuously delivered StVOrth-2 and StVOrth-3 using a clinically relevant murine model of osteosarcoma with spontaneous metastasis. Treatment with StVOrth-2 or StVOrth-3 with microosmotic pumps was initiated after primary osteosarcoma was established in the tibia. While treatment with StVOrth-2 and StVOrth-3 did not appear to affect local tumour invasion, tumour necrosis or apoptosis, StVOrth-2 predominantly restricted the growth of primary tumours, while StVOrth-3 restricted the burden of pulmonary metastatic disease. No peptide caused gross toxicity in mouse tissues as assessed by measuring weight of animals, serum biochemistry, and gross tissue observation. The differential effects exhibited by StVOrth-2 and StVOrth-3 in this orthotopic model of osteosarcoma may be related to the functional epitopes on the PEDF glycoprotein that they represent

Impact of Pre-and Postpartum Nutrition on March-calving Cow and Progeny Productivity

March-calving cows were fed hay or grazed corn residue prepartum, and then either fed hay or grazed subirrigated meadow postpartum. Combinations of these different feeding strategies impacted body weight (BW) and body condition score (BCS) during the pre-and postpartum period; however, resulted in similar pregnancy rates. Although differences were not observed in cow pregnancy rates, a benefit in pre-weaning growth was observed for calves from the dams in postpartum meadow treatment. A tendency for an improvement in marbling score was observed for steers born to cows fed hay prepartum, perhaps indicating a higher plane of nutrition prepartum may improve quality grade