Compensatory Increase in Choline Acetyltransferase Activity in Salivary Glands and Diaphragm Muscle of the Rat

When the function of salivary glands was abolished by applying ligatures to their ducts and the function of one half of the diaphragm muscle was abolished by sectioning of its phrenic nerve, the choline acetyltransferase activity was found to be increased in not duct-ligated glands and in the intact hemidiaphragm 4 weeks later. The increase was not seen within the first week. The increase in activity appears to be particularly manifested in the nerve endings, since it was seen in the hemidiaphragm but not in the phrenic nerve. Increased stream of impulses in the efferent nerves is thought to be the cause of this increase in choline acetyltransferase activity.     

Mutations in Conserved Amino Acids in the KCNQ1 Channel and Risk of Cardiac Events in Type-1 Long-QT Syndrome

Background: Type-1 long-QT syndrome (LQT1) is caused by mutations in the KCNQ1 gene. The purpose of this study was to investigate whether KCNQ1 mutations in highly conserved amino acid residues within the voltage-gated potassium channel family are associated with an increased risk of cardiac events.
Methods and Results: The study population involved 492 LQT1 patients with 54 missense mutations in the transmembrane region of the KCNQ1 channel. The amino acid sequences of the transmembrane region of 38 human voltage-gated potassium channels were aligned. An adjusted Shannon entropy score for each amino acid residue was calculated ranging from 0 (no conservation) to 1.0 (full conservation). Cox analysis was used to identify independent factors associated with the first cardiac event (syncope, aborted cardiac arrest, or death). Patients were subcategorized into tertiles by their adjusted Shannon entropy scores. The lowest tertile (score 0–0.469; n = 146) was used as a reference group; patients with intermediate tertile scores (0.470–0.665; n = 150) had no increased risk of cardiac events (HR = 1.19, P = 0.42) or aborted cardiac arrest/sudden cardiac death (HR = 1.58, P = 0.26), and those with the highest tertile scores (>0.665; n = 196) showed significantly increased risk of cardiac events (HR = 3.32, P <0.001) and aborted cardiac arrest/sudden cardiac death (HR = 2.62, P = 0.04). The increased risk in patients with the highest conservation scores was independent of QTc, gender, age, and beta-blocker therapy.
Conclusions: Mutations in highly conserved amino acid residues in the KCNQ1 gene are associated with a significant risk of cardiac events independent of QTc, gender, and beta-blocker therapy.     

An Inheritable B-like Character in Persons of Blood Group A

In a previous paper the author reported investigations of a blood sample(Co) whose blood cells contained, in addition to a normal A antigen, a weak,atypical B-like antigen. The present paper deals with two blood samples, Eland Do, which probably possessed the same weak, atypical B-like character.A study of El’s family showed that this blood group character, provisionallydesignated as A^b, may be inheritable, as it was found in two children and onegrandchild of El’s.

The serologic studies of the 5 A^b samples are reported, and on the basis ofthe family material the possible origin of the A^b character is discussed.

Submitted on November 5, 1959 Accepted on January 28, 1960     

Medical specialization in Europe: the way forward Promotion of educational quality

Summary. The medical specialties are being intensively reconsidered in the countries of Europe. The important need is for promoting improvement of educational training programmes. Evaluation and improvement of specialist training programmes is the priority and not the setting up of qualifying examinations. The first necessity is to safeguard 20 years of evolution in postgraduate training. Support for the educational process is essential, to a much greater extent than occurs at present, if standards are to be improved and the confidence of the public is to be retained. The EC medical education system is the only existing international structure in medical education which is controlled by law, and is on that basis alone of the greatest interest.     

ACCIDENTAL ASPIRATION OF TALC

A case of talc inhalation in a two-year-old girl with alarming clinical symptoms was successfully treated with steroids and artificial ventilation. In only one of four previously published cases the child survived.     

Evaluation and consequences of teaching competence: Scandinavian developments

Provision of health care, research and teaching are three major activities common to all medical schools. In spite of the fact that most medical schools emphasize the importance of basic education in their programme, both teachers and students point out that in reality teaching ability and experience are of little significance when academic positions are filled. A common objection to attaching a higher value to teaching competence is that teaching skills cannot be systematically and reliably evaluated. However, experience throughout the world shows that there are various methods of evaluating and considering teaching ability. Activities initiated in Scandinavia highlight concrete methods of considering the qualitative aspects of teaching skills with the basic point of view that there are great similarities between the processes of evaluating scientific and teaching competence. In this article the results of a survey of medical schools in Scandinavia on the relative importance of scientific and teaching merit are reported. Subsequent developments are provided from a task force working under the auspices of the Nordic Federation for Medical Education as well as from the Karolinska Institute in Stockholm. Suggestions are included for evaluation of teaching skills, including qualitative and subjective considerations. Arguments for increasing the value accorded to such skills are advanced and discussed.     

Importance of detailed adjustment for smoking when comparing hospitalization and mortality in men and women in a Danish population study

Mortality from smoking-related diseases is rising steeply amongwomen. Although most studies recognize that smoking habits differbetween men and women, this knowledge is seldom applied whenstudying gender differences. Based on two large population studiescomprising almost 16, 000 study subjects, we illustrate theimportance of adjusting for smoking in detail when comparinghospitalization and mortality between men and women. Adjustingfor smoking as a dichotomous variable, age-adjusted mortalityrisk during 16 years follow-up was 80% higher for men than women.Adjusting for smoking in detail significantly reduced men'sexcess risk to 50%. The risk of hospitalization for chronicobstructive pulmonary disease was 50% higher for men when adjustingfor smoking as a dichotomous variable, whereas with full adjustmentthe risk was reversed to a significantly increased risk forwomen of 20%. We conclude, that when comparing smoking-relatedmorbidity in men and women, smoking habits must be adjustedfor in more detail than is usually the case.     

Reflections on possible virtues of European medical education

Political and social development in Europe will lead to increased mobility of doctors between countries as well as opening up new possibilities and horizons for educational institutions. In this emerging process the charge that universities are too traditional to change may not be valid when the virtues of academic traditions in Europe are considered. When those virtues are taken into account, they are seen to facilitate the integration of more current goals for future development into undergraduate medical curricula. The use of external examiners between different countries in Europe will promote greater quality in European medical education.