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Spontaneous reporting of suspected adverse drug reactions (ADRs) is the cornerstone of pharmacovigilance. Despite this, it is believed that there is significant under-reporting in the veterinary setting. Low reporting rates delay marketing authorisation holders (MAHs) and regulators taking mitigating action in the case of safety concerns.We designed a survey to explore the perceptions, attitudes and experiences of UK veterinary professionals towards ADR reporting. The survey was advertised widely through conventional and social media and at several conferences.In total, 260 respondents completed the survey, including 210 veterinary surgeons, 49 veterinary nurses and one suitably qualified person. Respondents generally understood the need to report ADRs. The main barrier to reporting was the suspected ADR being well known, and the most popular potential facilitator identified was the ability to report via the practice management system. Facilitation via education in the form of a pharmacovigilance themed continuing professional development event was particularly popular among veterinary nurses, who reported time as being less of a barrier to reporting than their veterinary surgeon counterparts.Our findings suggest that technological interventions to facilitate reporting and empowerment of veterinary nurses to report through a tailored training event should be explored further.

This study aimed to describe the management of cases of suspected and confirmed canine multicentric lymphoma (ML) in first opinion practice (FOP) and investigate whether socioeconomic factors are associated with initial management.Clinical narratives from electronic health records collected by the Small Animal Veterinary Surveillance Network (SAVSNET) were searched to identify dogs with peripheral lymphadenomegaly in which ML was the major differential. Cases were grouped as either ML confirmed (ML-C) or ML suspected but not confirmed (ML-S). Associations between initial management and socioeconomic factors were assessed via multivariable logistic regression.Two hundred and sixty-four cases with ML-C and 410 with ML-S were identified. There was an increased probability that owners of ML-C cases resided in less deprived areas. Moreover, a diagnosis was made more commonly in insured dogs. Only insured pets were more likely to be treated with chemotherapy following diagnosis. The majority of dogs in both groups were treated with corticosteroids alone (ML-S, n = 256/410; ML-C, n = 123/264). A small minority were referred (n = 30/674).Socioeconomic inequalities appear to be associated with the diagnosis and management of dogs with suspected or confirmed ML in FOP. Most dogs with suspected multicentric lymphoma (in the UK) are managed in FOP (n = 644/674). Consequently, expanding the knowledge base relevant to this setting offers an opportunity to improve the management of canine lymphoma.

The EXO-200 experiment searched for neutrinoless double-beta decay of $^{136}$Xe with a single-phase liquid xenon detector. It used an active mass of 110 kg of 80.6%-enriched liquid xenon in an ultra-low background time projection chamber with ionization and scintillation detection and readout. This paper describes the design and performance of the various support systems necessary for detector operation, including cryogenics, xenon handling, and controls. Novel features of the system were driven by the need to protect the thin-walled detector chamber containing the liquid xenon, to achieve high chemical purity of the Xe, and to maintain thermal uniformity across the detector., Manuscript updated in response to JINST reviewer comments

Provision of supplementary food for garden birds is practiced on a large scale in multiple countries. While this resource has benefits for wild bird populations, concern has been expressed regarding the potential for contamination of foodstuffs by mycotoxins, and the implications this might have for wildlife health. We investigated whether aflatoxin (AF) and ochratoxin A (OA) residues are present in foodstuffs sold for wild bird consumption at point of sale in Great Britain using high pressure liquid chromatography analyses. The hypothesis that production of these mycotoxins occurs in British climatic conditions, or under storage conditions after the point of sale, was tested under experimental conditions but was not proved by our study. While the majority of peanut samples were negative for AF residues, 10% (10/98) of samples at point of sale and 11% (13/119) of those across the storage and climate exposure treatment replicates contained AFB1 that exceeded the maximum permitted limit of 20 μg/kg. No significant difference was found in the detection of either mycotoxin between branded and non-branded products. The clinical significance, if any, of exposure of wild birds to mycotoxins requires further investigation. Nevertheless, the precautionary principle should be adopted and best practice steps to reduce the likelihood of wild bird exposure to mycotoxins are recommended.

This article argues that the massive increase in transatlantic British and Irish emigration after 1840 was enabled by declining fares and ocean travel costs. New series of transatlantic steerage fares drawn from the unique Cope Line records at the Historical Society of Pennsylvania (HSP) show westward fares fell rapidly from 1830. Adjusted for British and US manual wages, westward travel costs, including provisions, almost halved between 1847 and 1851–3, when Irish migration peaked. Hence although the Irish had to leave Ireland, they might not otherwise have gone so extensively to North America. Eastward travel costs also fell after 1830, encouraging an unexpectedly large return migration to Britain in the late1850s, and maybe earlier.

In the 19(th) century, a devastating epidemic of visceral leishmaniasis (kala-azar) swept through northeast India. After identification of the pathogenic agent, Leishmania donovani, in 1903, the question of its transmission remained to be resolved. In 1904, thanks to work by L. Rogers on cultures of this parasite it became probable that a haematophagous arthropod was responsible for transmission. J.A. Sinton suggested, in 1925, the distribution of the sand fly Phlebotomus argentipes was similar to that of the disease and, thereafter, two independent teams led by H.E. Shortt in Assam and R. Knowles and L. Napier in Calcutta concentrated on this potential vector. Parallel work was in progress in China, directed by E. Hindle and W. S. Patton for the Royal Society Kala-azar Commission, on another species of sand fly. In 1942 the Assam workers transmitted L. donovani to five human volunteers by the bites of colonised P. argentipes and the race was over.

Disrupted in schizophrenia 1 (DISC1) is a multi-functional scaffolding protein that has been associated with neuropsychiatric disease. The role of DISC1 is to assemble protein complexes that promote neural development and signaling, hence tight control of the concentration of cellular DISC1 in neurons is vital to brain function. Using structural and biochemical techniques, we show for we believe the first time that not only is DISC1 turnover elicited by the ubiquitin proteasome system (UPS) but that it is orchestrated by the F-Box protein, FBXW7. We present the structure of FBXW7 bound to the DISC1 phosphodegron motif and exploit this information to prove that disruption of the FBXW7-DISC1 complex results in a stabilization of DISC1. This action can counteract DISC1 deficiencies observed in neural progenitor cells derived from induced pluripotent stem cells from schizophrenia patients with a DISC1 frameshift mutation. Thus manipulation of DISC1 levels via the UPS may provide a novel method to explore DISC1 function.

Hysterosalpingo-contrast-sonography (HyCoSy) is recommended by the National Institute for Health and Clinical Excellence (NICE) as the investigation of choice for otherwise asymptomatic women who need fallopian tube patency assessment as part of their investigation for subfertility. The technique requires the instillation of a positive contrast agent through the cervix, but after the commercial withdrawal of Echovist the only remaining agent, until very recently, was SonoVue, which is not licensed for intrafallopian use. A questionnaire was distributed to 16 units in the UK who were thought to perform HyCoSy in order to collate experience and opinion with this new contrast agent. Eight units replied to say that they had used SonoVue, giving a collective experience of 449 procedures. The opinion would seem to be that results are good and side-effects are rare, making the case to encourage a product licence application. Nevertheless, careful ongoing audit of results is essential and long-term endometrial effects need to be excluded.

BACKGROUND: Many hormone and ultrasound measurements have been assessed as possible markers of ovarian reserve and to identify potential poor responders to ovulation induction. The objective of this study is to determine whether multiple biomarkers measured in blood samples collected immediately before commencement of ovulation induction for IVF can predict the outcome of ovarian stimulation. METHODS: We conducted a prospective observational study, including 356 unselected women undergoing ovulation induction/IVF at two centers. Anti-Mullerian hormone (AMH), inhibin B and FSH were measured before commencement of ovulation induction. The main outcome measures were the number of oocytes retrieved and pregnancy outcome. RESULTS: Univariate analyses showed that age, FSH, inhibin B and AMH were significant predictors for poor oocyte yield. AMH presented the highest receiver operating characteristic area under the curve (ROC AUC ) of 0.827 indicating a good discriminating potential for predicting poor ovarian response, followed by FSH with an ROC AUC of 0.721. In the multivariate analysis, the variables age, FSH and AMH remained significant and the resulting model provided a high ROC AUC of 0.819. Women with an ovarian reserve test of

Polytene giant chromosomes of the Phlebotomine sandfly Lutzomyia longipalpis from two localities in Brazil were examined. They are preliminarily described and illustrated from larval salivary gland preparations. Polytenes in other tissues of larvae, pupae and adult flies were found to be unsuitable for detailed study. Salivary chromosome arms were long but thin (‘oligotene’) and given to much ectopic pairing. Despite their fragility and cross-linkage, patterning on these chromosomes was sufficiently well differentiated to be cytotaxonomically useful. The normal mitotic complement comprised 3 pairs of metacentrics and 1 pair of subacrocentrics. None of the chromosome pairs was sexually dimorphic. Meiotic chiasmata were seen in males and females. Characteristics of giant chromosomes in Phlebotominae and Psychodinae are compared and discussed in relation to other Diptera. Cytogenetic evidence supports inclusion of the Psychodidae with the Simuliidae, Ceratopogonidae, Culicidae and Chironomidae in the superfamily Culicoidea.

To evaluate the effects of long-term tibolone on the endometria of asymptomatic women over the age of 60 years.An observational study of the ultrasound appearance of the endometria of women aged 60 years or older taking long-term tibolone. Those found to have a double-layer endometrial thickness greater than 4 mm were offered endometrial biopsy.Seventeen asymptomatic patients with a mean age of 61 years (range 60-73 years) and an average duration of tibolone use of 5 years (range 3-12 years) were recruited. Seven patients (41%) showed a thickened endometrium of more than 4 mm. Three of these had an area of translucency in the subendometrial space. Of the ten women with an endometrial thickness of less than 4 mm, four showed the presence of subendometrial fluid. Hysteroscopy was performed in five out of the seven women, as two did not accept further investigations. In all five women, the endometrial cavity was reported as atrophic and the histology showed an inactive basal type. In two of the five cases examined histologically, there were additional changes suggesting endometrial polyp, although the samples were from macroscopically non-polypoid endometrium.Endometrial thickness is increased in 41% of elderly women on long-term treatment with tibolone. However, at hysteroscopy, the endometrium was uniformly atrophic. Similar finding have been described in women using selective estrogen receptor modulators and a similar mechanism of action of these drugs on the uterus should be considered.

BACKGROUND This paper explores recent developments in female contraception, using them to illustrate how adaptation of existing methods, improved service delivery and understanding contraceptive behaviour might increase contraceptive uptake and correct and consistent use, and how the development of new methods holds some promise for capitalizing on the potential non-contraceptive benefits. METHODS Searches were performed in Medline and other databases. Selection criteria included high-quality studies and studies relevant to clinical reproductive medicine. Summaries were presented and discussed by the European Society of Human Reproduction and Embryology (ESHRE) Workshop Group. RESULTS The topics discussed include: adapted regimens for combined oral contraceptive pills, non-invasive methods of female sterilization, the need to improve the awareness of pregnancy risk to increase the use of emergency contraception, improvements in the evidence base for the safety and service delivery of intrauterine methods, emphasis on the potential benefits of combined oral contraceptives for women with hirsutism and acne, the potential of female sterilization to prevent ovarian cancer, and the promise of anti-progesterones and new approaches to dual protection. CONCLUSIONS Although great strides have been made in recent years in increasing contraceptive use among women in many countries where contraceptive prevalence is low or there is a high unmet need for contraception, much more can, and needs to, be done.

BACKGROUND: In January 2001, emergency hormonal contraception was made available for women over the age of 16 years directly from a pharmacist without prescription. It is of interest whether this change in the UK has led to any improvements or deterioration in the service provided for the women who need it. METHODS: Self-completed, anonymous questionnaires were distributed to women requesting emergency hormonal contraception through a single group of pharmacies located throughout England, Wales and Scotland. RESULTS: A total 419 women returned completed questionnaires. A greater proportion of women were able to take emergency contraception within 24 h when they obtained their tablets directly from a pharmacy without a prescription (64% versus 46%, P = 0.029). Women who obtained their drugs directly from the pharmacist were just as well informed, just as likely to arrange regular follow-up and generally preferred this system, although they disliked having to pay. CONCLUSION: Making emergency hormonal contraception available without prescription has improved services to women who need them, but these improvements are quantitatively minimal, preventing only five additional pregnancies per 10 000 users.

OBJECTIVE: The purpose of this study was to compare cycle control and tolerability of the NuvaRing (NV Organon, Oss, The Netherlands), a novel combined contraceptive vaginal ring, with a standard combined oral contraceptive pill. STUDY DESIGN: Healthy women aged 18 to 40 years who requested contraception received either NuvaRing or a combined oral contraceptive containing 30 μg ethinyl estradiol and 150 μg levonorgestrel for 6 cycles in 3 similarly designed studies. Each cycle comprised 3 weeks of ring or pill use, followed by 1 ring- or pill-free week. RESULTS: Two hundred forty-seven women began the studies, 121 women with NuvaRing and 126 women with the combined oral contraceptive. Withdrawal bleeding occurred in virtually all cycles in both groups. In the NuvaRing groups, the incidence of irregular bleeding was ≤5% in all cycles; this was lower than the combined oral contraceptive groups (5.4%-38.8%). Furthermore, the incidence of a normal intended bleeding pattern was significantly higher in the NuvaRing groups than in the combined oral contraceptive groups ( P CONCLUSION: NuvaRing has excellent cycle control and is well tolerated. (Am J Obstet Gynecol 2002;186:389-95.)

Summary Ultrastructural observations are presented on Flabelliforma montana (type species) (Phylum Microsporidia) from sandflies Phlebotomus ariasi (Diptera, Psychodidae). All stages have isolated nuclei. The sporophorous vesicle (SV) arises by separation of a 5 nm layer, via small blisters, from the 15 nm surface membrane of sporonts. Sporoblasts form by deep invagination of the sporont surface, the SV at first folding inwards around the invaginations but later unfolding to form a rounded vesicle enclosing spores. The vesicle contains tubules with bulbous terminal expansions. Spores have a deeply domed anchoring disc within a polar sac which covers the anterior polaroplast, consisting of membranes acutely angled to the longitudinal axis around the straight section of the polar tube. Posterior polaroplast membranes, in the region where the polar tube changes course towards the periphery, appear almost transverse in sagittal section. The 130 nm thick endospore is overlain by several membrane-like layers, which together with amorphous material constitute the exospore. There are 3.5–4.0 coils of the polar tube. Flabelliforma ostracodae , Flabelliforma diaptomi and Flabelliforma magnivora conform well in morphology with the type species. However, when F. magnivora was included in parsimony and maximum likelihood analyses, using 16S rDNA sequences of 20 microsporidia, it emerged as unrelated to F. montana . Disparities were found between morphological characters and molecular groupings of several of the microsporidia investigated. Within clades, nuclei could be isolated or diplokaryotic, sporophorous vesicles present or absent and life cycles simple or complex.

ALTHOUGH BRITAIN had by far the largest mercantile marine in the early nineteenth century, American ships dominated most transatlantic trade, and were the largest and smartest vessels entering Liverpool. They sailed on schedule to capture the most passengers and high quality manufactured goods taken across the Atlantic. They also carried the largest bulk import - raw cotton from the Southern states and New York. These ships were mostly owned by wealthy merchants in the leading east coast seaports of Boston, New York, Philadelphia, and Baltimore, usually in alliance with leading British firms who superintended their interests in Liverpool.! This article examines the changing relationship between one such owner, Thomas Cope of Philadelphia, and his Liverpool agents for fifty years, the leading Liverpool merchants and bankers, William and James Brown [henceforth W&JB] later Brown-Shipley [BS]. It is based on the Cope collection in the Pennsylvania Historical Society [PHS] which holds all the Copes' out-letters including many to the Browns, and many letters from the Browns to Copes. The problem is to explain the origin and development of the relationship in a satisfactory factual and theoretical way.2 The Cope line was America's second packet line started in 1822 by Thomas Cope as Philadelphia's response to the New York to Liverpool Black Ball line. The Black Ball had been established in 1818 by New York and Leeds merchants in the Yorkshire woollen trade. The Black Ball and other lines were so successful that New York trade expanded at the expense of Philadelphia and the other east coast cities, 1815-60, and

Objective This study aimed to investigate the histology of the subendometrial halo, the junctional zone between the endometrium and myometrium. Methods Thirteen ex vivo uteri removed for treatment of menorrhagia were studied. In each case, the subendometrial halo, as seen by transvaginal ultrasound, was marked using a Nottingham breast location biopsy needle. A standard histological examination was performed. Full thickness blocks of the anterior uterine wall were taken and standard serial 5-µm tissue sections were prepared from each block. Subsequent morphometric analysis followed staining with Feulgen reagent, using a CAS 200D quantitative image analysis system. Additionally, anti-CD31, an antibody stain for vascular endothelium, was used. Results The histological examination showed the subendometrial halo to consist of apparently normal myometrium. Morphometric analysis demonstrated a greater total nuclear area in the subendometrial halo than the outer myometrium, but no difference in individual nuclear size between the two zones. CD31 stained a greater total area in the inner myometrium. Conclusions These results suggest that the subendometrial halo is a distinct compartment of the myometrium comprising tightly packed muscle cells with an increased vascularity. Such architecture would increase the density of this tissue layer, altering its acoustic impedance, and account for its echopenic appearance on ultrasound. Copyright © 1999 International Society of Ultrasound in Obstetrics and Gynecology

Objective: To evaluate the ease and timing of transcervical ET as risk factors for ectopic pregnancy (EP) after IVF. Design: Retrospective study. Setting: University-based IVF program in the United Kingdom. Patient(s): Eighteen consecutively seen patients with an EP after IVF and 314 patients with an intrauterine pregnancy after transcervical ET performed during the same period. Intervention(s): Additional manipulation with a transfer catheter or the use of other instruments to assist transfer. Embryo transfer on day 2 or 3 after oocyte retrieval. Main Outcome Measure(s): Risk factors for EP (day 2 ET, difficult transfer overall and on days 2 and 3, history of tubal subfertility, and previous EP) presented as odds ratios with 95% confidence intervals. Result(s): The risk of EP was 2.26 (0.64–8.01) after day 2 ET, 3.91 (1.49–10.23) after difficult ET, 3.88 (1.34–11.24) after difficult ET on day 2, 2.7 (0.20–13.99) after difficult ET on day 3, 5.73 (1.99–16.62) when there was a history of tubal subfertility, and 5.41 (1.96–14.91) when there was a previous EP. Conclusion(s): A difficult ET significantly increases the risk of an EP. The risk is particularly high when the patient has a history of tubal damage or previous EP. The timing of ET is important only if the ET is difficult.

Objective Despite the increasing popularity of endometrial resection for the treatment of menstrual problems, the long term sequelae of this procedure are poorly recognised. As diagnostic hysteroscopy following endometrial resection is frequently unrewarding and transvaginal ultrasound is incapable of detecting subtle changes in endometrial morphology, magnetic resonance imaging was employed to evaluate the uterus. Design Retrospective study of unselected post-operative women. Methods Fifty-nine women, of whom 22 were amenorrhoeic, were studied a mean number of 34 months after endometrial resection, using a 1.5 Tesla magnetic resonance imaging system with a pelvic phased array coil for signal reception. T2-weighted FSE images were acquired through the long and short uterine axis and volumetric assessment of each uterine layer performed using an ISG Allegro workstation. Main outcome measures The location and volume of residual endometrium, the volume of junctional zone and myometrial tissue, and the presence of additional intrauterine and pelvic pathology were recorded. Results Residual endometrium was demonstrated in all except three amenorrhoeic women, with a similar mean volume present in menstruating and amenorrhoeic groups. Additional findings included adenomyosis, haematometra, fallopian tube dilatation and free intraperitoneal fluid. Conclusions The majority of amenorrhoeic and all menstruating women have residual endometrium after endometrial resection. The lack of communication of islands of residual endometrium with the uterine cavity results in haematometra formation, fallopian tube dilatation and possibly free intraperitoneal fluid.

Polyclonal antibodies were raised in chickens to the glycosylated forms of the high (H), medium (M) and low (L) molecular mass (MM) mouse tectorins. In the mouse cochlea, all three antibodies stained the tectorial membrane. Antibodies raised to HMM tectorin also stained the hair bundles of both inner and outer hair cells. A number of other mouse tissues were screened with the anti-tectorin antibodies to look for similar or antigenically related molecules. Staining was not observed in any other tissue type with the antibodies directed against the MMM and LMM tectorins. In the nose, the anti-HMM tectorin antibodies stained Bowman's glands and the mucus layer overlying the olfactory epithelium. The surface of the adjacent respiratory epithelium was not stained by these antibodies. HMM tectorin can be specifically radiolabelled by injecting neonatal mice with 35SO4 and undergoes a shift in electrophoretic mobility following treatment with keratanase, an endo-beta-galactosidase from Pseudomonas. However, when centrifuged on shallow CsCl gradients HMM tectorin has a buoyant density similar to that of glycoproteins and does not behave as a typical cartilage type proteoglycan. HMM tectorin does not react with mab 5D4, a monoclonal antibody that recognises keratan sulphate glycosaminoglycan from corneal and skeletal muscle proteoglycan. Unlike antibodies to HMM tectorin, mab 5D4 selectively stains the upper surface of the tectorial membrane, Hensen's stripe and the mucus layer overlying the respiratory epithelium. These studies indicate that the MMM and LMM tectorins may be unique to the cochlea, and that HMM may be a "light' keratan sulphate proteoglycan that is antigenically related to either the mucins or a more specific component of the olfactory mucus layer.

Percy Cyril Claude Garnham was born in London on 15 January 1901 and died in Buckinghamshire on Christmas Day 1994, within three weeks of his 94th birthday and only seven days before he and his wife were to celebrate their 70th wedding anniversary. Sadly, his wife Esther died a few months later. His family life was as fruitful as his long and distinguished scientific career as arguably the foremost protozoologist of his day. He and Esther are survived by six children, 19 grandchildren and 30 great–grandchildren.

It is not uncommon to encounter young women who have the appearance of polycystic ovaries (PCO) on ultrasonography but are asymptomatic. This study asked whether these women take longer to conceive or are likelier to be subfertile than women with normal ovaries. Asymptomatic women with PCO and others with symptoms (menstrual disorder, obesity, acne, hirsutism), seen in a 17-month period, answered a questionnaire dealing with fertility, features of PCO syndrome, and gynecologic history. It also was completed by symptomatic and asymptomatic women having normal ovaries. Features diagnostic of PCO on transabdominal ultrasonography included enlarged ovaries with more than 10 cysts in a single plane, each of them less than 10 mm in diameter, scattered around or through a thickened, echo-dense stroma. Women with polycystic ovaries were younger than those with normal ovaries, had lower parity, and drank less alcohol, They were significantly more likely to have a history of subfertility (relative risk [RR], 2.6) menstrual disturbances (RR, 3.6), obesity (RR, 2.3), acne (RR, 6.9), and hirsutism (RR, 1.9). The PCO group also reported more health problems such as diabetes and hypertension (RR, 2.2) and were likelier to have a family history of subfertility (RR, 2.1). Their mean time to pregnancy (TTP) was twice that of women with normal ovaries (13.2 vs. 6.4 months). Approximately two thirds of women with apparent PCO were symptomatic, as were just over one third of women with normal ovaries. Fecundity was reduced only when symptoms occurred in women with the appearance of PCO. In these women, the average TTP was 5-fold greater than in asymptomatic women with PCO and 2.5-fold greater than in symptomatic women with normal ovaries. In the absence of symptoms, the TTP was similar in women with and those without PCO. Symptomatic women with PCO were 5.9-fold likelier than those with PCO but had no symptoms to be subfertile, and 2.8-fold likelier than symptomatic women whose ovaries were normal. The appearance of PCO by itself was not associated with subfertility, Among women with PCO, the risk of subfertility increased significantly with the number of symptoms, from 3.0-fold in those with 1 defining symptom to 8.4-fold in those with all 4. The finding of PCO in asymptomatic women does not significantly impair either fertility or fecundity.

This article aims to review in detail the current literature concerning the efficacy of, and problems associated with, the use of ultra-sonography and magnetic resonance imaging in predicting uterine receptivity and hence the outcome of assisted conception. Although the quality of the embryo and transportation to the uterine cavity are obvious requirements for in-vitro fertilization/embryo transfer treatment, attention has recently centred on the receptivity of the endometrium to the growing blastula. High resolution ultrasonography is currently the imaging modality of choice, but measurement of endometrial thickness is only associated with successful treatment outcome if ovarian stimulation includes clomiphene citrate. However, the ultrasonographic texture of the endometrium may have a greater prognostic value for implantation. The current literature is relatively unanimous that a 'triple' layered appearance of the uterus is associated with a 23-42% pregnancy rate and that endometrium is unreceptive when iso- or hyperechoic compared with myometrium. In an attempt to improve prediction rates, new techniques including magnetic resonance (MR) imaging are being used to determine uterine receptivity. Early results from MR imaging suggest that in patients treated with standard regimen of GnRHa, followed by human gonadotrophin (HMG), neither the endometrial thickness nor the volume is related to outcome. However, the relative signal intensity of the uterine layers provides good discrimination prior to embryo transfer, between pregnant and non-pregnant groups.

The tectorial membrane is an extracellular matrix lying over the apical surface of the auditory epithelium. Immunofluorescence studies have suggested that some proteins of the avian tectorial membrane, the tectorins, may be unique to the inner ear (Killick, R., C. Malenczak, and G. P. Richardson. 1992. Hearing Res. 64:21-38). The cDNA and deduced amino acid sequences for chick beta-tectorin are presented. The cDNA encodes a protein of 36,902.6 D with a putative signal sequence, four potential N-glycosylation sites, 13 cysteines, and a hydrophobic COOH terminus. Western blots of two-dimensional gels using antibodies to a synthetic peptide confirm the identity of the cDNA. Southern and Northern analysis suggests that beta-tectorin is a single-copy gene only expressed in the inner ear. The predicted COOH terminus is similar to that of glycosylphosphatidylinositol-linked proteins, and antisera raised to this region react with in vitro translation products of the cDNA clone but not with mature beta-tectorin. These data suggest beta-tectorin is synthesized as a glycosylphosphatidyl-inositol-linked precursor, targeted to the apical surface of the sensory epithelium by the lipid moiety, and then further processed. Sequence analysis indicates the predicted protein possesses a zona pellucida domain, a sequence that is common to a limited number of other matrix-forming proteins and may be involved in the formation of filaments. In the cochlear duct, beta-tectorin is expressed in the basilar papilla, in the clear cells and the cuboidal cells, as well as in the striolar region of the lagena macula. The expression of beta-tectorin is associated with hair cells that have an apical cell surface specialization known as the 275-kD hair cell antigen restricted to the basal region of the hair bundle, suggesting that matrices containing beta-tectorin are required to drive this hair cell type.

Objective: To test the hypothesis that, in couples with unexplained infertility, tubal flushing with an oil-soluble media (lipiodol) would increase the pregnancy rate within 6 months compared with expectant management. Design: A prospective, randomized, controlled study in which couples were allocated to either a single treatment with lipiodol or no further action. Setting: Two tertiary referral centers for assisted reproduction. Patient(s): Couples with a diagnosis of primary or secondary unexplained infertility based on a normal semen analysis according to World Health Organization criteria, patent fallopian tubes at hysterosalpingography or laparoscopy, and ovulatory menstrual cycles based on midluteal phase progesterone levels or ultrasonic follicle tracking. Intervention(s): In those patients randomized to lipiodol, a single treatment was performed. Main Outcome Measure(s): Biochemical (i.e., positive pregnancy test) and clinical (i.e., fetal heart on ultrasound scan) pregnancy rates. Result(s): Seventeen couples were randomized to lipiodol and 17 to expectant treatment. The higher pregnancy rate after lipiodol was statistically significant. There were no complications after lipiodol treatment. Conclusion(s): There was a statistically significantly higher pregnancy rate in couples with unexplained infertility randomized to a single tubal flush with lipiodol compared with no treatment.

There is increasing concern that environmental chemicals have a direct effect on fertility. Heavy metals such as mercury have been shown to affect various organ systems in humans including nervous system and skin, however they could also act as endocrine disrupting chemicals adversely affecting fertility. Metals such as zinc and selenium are essential micronutrients with diverse functions that may be important for reproductive outcomes. We measured mercury, zinc and selenium levels in the hair, a reliable reflection of long term environmental exposure and dietary status, to correlate with the outcome of ovarian hyperstimulation for in vitro fertilisation (IVF) treatment.We analysed the hair of 30 subfertile women for mercury, zinc and selenium using inductively coupled mass spectrometry. Each woman underwent one cycle of IVF treatment. Correlation between the levels of these trace metals and treatment outcomes was investigated.Thirty women were recruited with mean (±SD) age of 32.7(4.4) years and BMI of 25.4(5.0)kg/m(2). Hair mercury concentration showed a negative correlation with oocyte yield (p 0.05,βcoefficient 0.38) and follicle number (p = 0.03,β coefficient0.19) after ovarian stimulation. Zinc and selenium levels in hair correlated positively with oocyte yield after ovarian stimulation (p 0.05,β coefficient0.15) and (p = 0.03,β coefficient0.21) respectively. Selenium levels in hair correlated significantly with follicle number following stimulation (p = 0.04, βcoefficient0.22). There was no correlation between mercury, zinc and selenium in hair and their corresponding serum levels.These data suggest that mercury had a deleterious effect whilst there was a positive effect for zinc and selenium in the ovarian response to gonadotrophin therapy for IVF. Hair analysis offers a novel method of investigating the impact of long-term exposure to endocrine disruptors and nutritional status on reproductive outcomes.

Pregnant women are subject to an abnormal level of body size overestimation. Recent research has shown that such perceptual distortions are enhanced in women who are sensitive to their bodies (women who are eating-disordered or normal women who have abnormal attitudes to food and weight) by exposure to ‘real life’ pictures in fashion magazines. This small-scale pilot study examines whether the media's portrayal of the ideal woman's shape (as slim) affects pregnant women's body image distortion. The results suggest that pregnant women are affected by these media images, hut that the pattern of enhanced distortion changes throughout pregnancy. Potential further research and the clinical implications of these findings are discussed.

This study was designed to establish whether motile spermatozoa are released with pre-ejaculatory fluid and whether this fluid therefore poses a risk for unintended pregnancy. Forty samples of pre-ejaculatory fluid were examined from 27 volunteer men. Samples were obtained by masturbation and by touching the end of the penis with a Petri dish prior to ejaculation. Eleven of the 27 subjects (41%) produced pre-ejaculatory samples that contained spermatozoa and in 10 of these cases (37%), a reasonable proportion of the sperm was motile. The volunteers produced on up to five separate occasions and sperms were found in either all or none of their pre-ejaculatory samples. Hence, condoms should continue to be used from the first moment of genital contact, although it may be that some men, less likely to leak spermatozoa in their pre-ejaculatory fluid, are able to practice coitus interruptus more successfully than others.

Establishing pregnancy location is key to minimising the risks of abortion, and establishing gestational age optimises women's choice of procedure and timing. There is limited information in UK practice about the views of women having an ultrasound before an abortion with regards to whether they would wish to see the scan image of their fetus. We therefore surveyed the views of women having pre-abortion ultrasound scans and the views of ultrasonographers, using self-completed anonymous questionnaires. Responses were available for analysis from 191 women aged 16 to over 45. A total of 25 (13%) women had seen their scan. Of those who did not see their scan, 40 (24%) said they would have liked to see it, to aid their decision-making, as a right, or out of curiosity. Nine out of 17 ultrasonographers completed their questionnaires. Four ultrasonographers thought that women having scans before an abortion should see their scan images if they wished and another four thought they should not because of possible psychological effects. Their response also highlighted possible effects of such scans on those performing them. Given the choice, a larger number of women would like to see their scan images than actually ask. Women request to see their pre-abortion ultrasound images for their own individual reasons, which should be respected. Ultrasonographers may have conflict or ethical dilemmas when performing pre-abortion scans and they should be supported in identifying women for whom looking at their scan images would be of benefit.