Genomic structures of the human angiopoietins show polymorphism in angiopoietin-2.

The family of human angiopoietins comprises factors with important roles in vascular development and angiogenesis. All angiopoietins bind with similar affinity to the endothelial cell-specific receptor, Tie2. The mechanism by which they contribute to angiogenesis is thought to involve regulation of endothelial cell interactions with supporting perivascular cells. In this study the genomic structures of all three human angiopoietins were characterised by direct sequencing of human genomic DNA from the appropriate P1 artificial chromosome (PAC) clones. The exact positions at the intron/exon boundaries and the lengths of all eight introns were determined. As would be expected from the homology of these three proteins, the positions of the introns in the three genes are highly conserved. The putative RNA transcription start site for each angiopoietin gene was also determined. Intron-specific primers were used to amplify each exon of angiopoietin-1 and angiopoietin-2 from individual genomic DNAs. Although no polymorphism has been detected in the coding region of angiopoietin-1, three independent polymorphisms have been identified for angiopoietin-2.

The problem of stabilization after sacrectomy.

After sacrectomy, mobilization of the patient is only possible if a stable connection between the spine and pelvis can be obtained. We have developed an instrumentation to fix the pelvis to the spine. Two DHS screws connected to each other were implanted in the pelvis (one DHS screw into each ilium). An internal spine fixator, anchored in L3 and L4 through transpedicular Schanz screws, was attached to these DHS screws. Two patients were stabilized with this implant after sacrectomy. One patient was able to walk with crutches; the other patient was able to walk even without crutches.

The importance of lower limb injuries in car crashes when cost and disability are considered.

The United Kingdom Cooperative Crash Injury Study (CCIS) database has been used to produce a sample of restrained, front-seat car occupants who survived a frontal impact. The lower limb was found to be the most frequently injured body region in car crashes of all impact types and the second most injured region in frontal impacts. 67% of all lower limb fractures in this sample were found to occur below the knee. 31% of these fractures occurred at the ankle. A review of literature reveals that injury of the lower limb above the knee produces worse disabilities and longer recovery times than injury to below the knee. The costs incurred as a result of above knee injuries are estimated as being greater than those below the knee. A review of European type approval legislation reveals that car design is not regulated sufficiently to prevent lower limb injury. Further work is suggested using the CCIS database in order to get a better understanding of the mechanisms involved with a view to suggesting areas where changes could be made to improve this situation.

Computer linked apparatus for upper limb therapy: a new system of resistive exercise.

A need has been recognised for equipment that can be used to provide objective evaluation of exercise of the upper limb in occupational therapy while being motivational to the patient. The microcomputer was seen to be a suitable tool as part of a system that might satisfy this need. After consulting experienced hand therapists the criteria were established for equipment that would encourage and quantify exercise. Three systems were built that represented three methods of resistive exercise. These were presented to therapists in a structured assessment to determine the most suitable. As a result of this a system employing a dashpot and a potentiometer connected to a BBC microcomputer was designed. Software was written in the form of activities that could be controlled by the movements of exercise on the equipment. Dashpot resistance could be varied and graded and the range of software was of varied motivational content. This allowed the principal movements of the wrist and forearm to be objectively exercised. After suitably calibrating the system it was used to assess patient effort and ability, and hence progress of treatment.