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T Lang

Publications and source records attributed to T Lang.

At least 55 records · Page 3Linked to original sources
PubMed2001

Clinical and gait-analytical results of the modified Evans tenodesis in chronic fibulotalar ligament instability.

The present paper describes the medium-term results (mean follow-up period 3.01 years) achieved after surgical stabilisation of 79 patients using modified Evans tenodesis. The follow-up examination included a questionnaire for rating the subjective sense of stability, a clinical examination, stress X-rays, a modified 100-point score according to Zwipp, and kinetic gait analysis. Although joint instability was significantly improved in the radiological stress images, only 73.4% of the patients subjectively rated the stability achieved as excellent or good, compared with satisfactory in 22%, and even poor in 3.8%. In the overall result of the 100-point score, 51.9% of the patients achieved a very good, 35.4% a good, 11.4% a satisfactory, and 1.3% a poor result. Radiologically, an increase in the rate of arthrosis was verified in 17.4%. Significant deteriorations in mobility were observed for the supination. The kinetic gait analysis revealed statistically significant differences compared with the non-operated side for step length (P < 0.05), relative step length (P < 0.05), and in the symmetry of heel-to-toe movement (P < 0.005). The modified Evans repair can restore the mechanical stability of the ankle, but it leads to impaired kinematics of the ankle, with subjective and functional restrictions and radiologically detectable degenerative changes. For this reason, modified Evans tenodesis should only be performed if anatomically orientated stabilisation operations are not possible.

Adolescent↗
PubMed2001

Development of the membranous labyrinth of human embryos and fetuses using computer aided 3D-reconstruction.

The last detailed description of the development of the inner ear membranous labyrinth goes back to Streeter in 1918. This investigation can be regarded to be of outstanding scientific value. However, at that time no staging system of human embryos existed. In this respect, Streeter's work is outdated. It was the aim of this study to reinvestigate the development of the membranous labyrinth in human embryos and fetuses of which the developmental stages have been determined according to the Carnegie staging system and to compare the results with the literature. Serial histologic sections in the coronal or frontal plane of the heads of human embryos and fetuses of different developmental stages were used for computer aided 3D-reconstruction of the membranous labyrinth. From the obtained results, it is concluded that the endolymphatic duct develops earlier than previously described in the literature. The induction of the differentiation of the endolymphatic duct does not correspond with the superficial ectoderm because the endolymphatic duct develops medial of the otic vesicle. The membranous labyrinth determines the form of the petrosal bone as early as in stage 19 (47-48 days post conception).

Ear, Inner↗
PubMed2001

Kinetics of the intracellular differentiation of Leishmania amazonensis and internalization of host MHC molecules by the intermediate parasite stages.

The establishment of Leishmania in mammals depends on the transformation of metacyclic promastigotes into amastigotes within macrophages. The kinetics of this process was examined using mouse macrophages infected with metacyclic promastigotes of L. amazonensis. The appearance of amastigote characteristics, including large lysosome-like organelles called megasomes, stage-specific antigens, high cysteine protease activity and sensitivity to L-leucine methyl ester, was followed over a 5-day period. Megasomes were observed at 48 h but probable precursors of these organelles were detected at 12h p.i. The promastigote-specific molecules examined were down-regulated within 5 to 12h after phagocytosis whereas the amastigote-specific antigens studied were detectable from 2 to 12-24 h. An increase in the cysteine protease activity and in sensitivity to L-leucine methyl ester of the parasites was detected from 24 h. The data indicate that at 48 h p.i., parasites exhibit several amastigote features but that complete differentiation requires at least 5 days. The appearance of megasomes or of megasome precursors and the rise in cysteine protease activity correlate quite well with the capacity of parasites to internalize and very likely degrade host MHC molecules. The fact that internalization by the parasites of host cell molecules occurs very early during the differentiation process argues for a role of this mechanism in parasite survival.

Animals↗
PubMed2001

Do cardiovascular risk factors in men depend on their spouses' occupational category?

OBJECTIVE: To analyse the relationships between major cardiovascular risk factors in French men and their spouses' occupational category (OC), taking their own OC into account. DESIGN: A large sample of volunteers working in the French National Electricity and Gas Company (GAZEL). As a check of the robustness, the same analysis was performed in a population-based survey (French multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) registers). SETTING: Any site of the company in France. Representative sample from the population of the three registers (Lille, Strasbourg, Toulouse). PARTICIPANTS: 9486 and 534 men respectively, in working activity, living in couple and aged 40 to 50 years. MAIN OUTCOME MEASURES: Self-reported arterial hypertension, diabetes, hypercholesterolemia, leisure time sedentary lifestyle, smoking status, body mass index (BMI) and alcohol consumption. RESULTS: In the GAZEL study, diabetes, smoking status, and alcohol consumption in men were associated with their own OC. In contrast, spouses' OC was independently associated with men's hypertension, hypercholesterolemia, sedentary lifestyle, and BMI: men whose spouses were unoccupied or workers have higher risk factors levels. In the MONICA study, the results were mostly comparable, at least for hypercholesterolemia, sedentary lifestyle, smoking status and alcohol consumption. CONCLUSION: Spouses' OC was independently associated with several cardiovascular risk factors in men. These results might indicate that socioeconomic status of the couple, and not only individual characteristics, should be taken into account for a better understanding of cardiovascular risk.

Adult↗
PubMed2001

Simplified citrate anticoagulation for high-flux hemodialysis.

In a randomized crossover trial, we compared a simple citrate anticoagulation protocol for high-flux hemodialysis with standard anticoagulation by low-molecular-weight heparin (dalteparin). Primary end points were urea reduction rate (URR), Kt/V, and control of electrolyte and acid-base homeostasis. Secondary end points were bleeding time at vascular puncture sites and markers of activation of platelets, coagulation, and fibrinolysis. Solute removal during citrate dialysis was excellent (URR, 0.71 +/- 0.06; Kt/V, 1.55 +/- 0.3) and similar to results of conventional bicarbonate hemodialysis anticoagulation with dalteparin (URR, 0.72 +/- 0.04; Kt/V, 1.56 +/- 0.2). Electrolyte control was effective with both anticoagulation regimens, and total and ionized calcium, sodium, potassium, and phosphate concentrations at the end of dialysis did not differ. Alkalemia was less frequent after citrate than conventional dialysis (pH 7.5 in 25% versus 62% of patients; mean pH at end of dialysis, 7.46 +/- 0.06 versus 7.51 +/- 0.07; P < 0.01). Bleeding time at puncture sites was shorter by 30% after citrate compared with dalteparin anticoagulation (5.43 +/- 2.80 versus 7.86 +/- 2.93 minutes; P < 0.001). Activation of platelets, coagulation, and fibrinolysis was modest for both treatments and occurred mainly within the dialyzer during dalteparin treatment and in the vascular-access region during citrate anticoagulation. Citrate-related adverse events were not observed. We conclude that citrate anticoagulation for high-flux hemodialysis is feasible and safe using a simple infusion protocol.

Adult↗
PubMed2001

Balloon dilation is preferable to bougienage in children with esophageal atresia.

BACKGROUND AND STUDY AIMS: Esophageal strictures are a common problem after surgical repair in children with esophageal atresia. The traditional procedure in these patients is dilation using bougie dilators, usually controlled fluoroscopically or endoscopically. Nowadays, an alternative technique is balloon-catheter dilation. The aim of this study was to report our experience with pneumatic balloon dilation and to compare this method with previously performed bougienage with regard to efficacy. PATIENTS AND METHODS: Over 16 years, 34 patients who developed symptomatic strictures were encountered at our institution. In the first 9 years 12 patients underwent 178 bougienages (group C). In the last 7 years six patients who had undergone 202 previous bougienages (group B), and 16 patients who had undergone no bougienages (group A), underwent 52 dilations. The dilation was carried out under intravenous sedation using a combination of midazolam and etomidate. The balloon was placed in the stricture endoscopically and the procedure was performed under fluoroscopic and endoscopic control. RESULTS: In all patients the dilation was effective and involved minimal trauma. The strictures required 1 to 7 procedures (median 2) over a maximum of 18 months (median 3 months) for a good treatment result. The complications observed were two perforations, one of them with pneumothorax (both treated conservatively), and two compressions of the trachea (interruption of the procedure, but efficient dilation was eventually achieved). The method was more effective than bougienage (1 to 60 bougienages were required per patient, median 9). CONCLUSIONS: Compared with traditional bougienage, balloon dilation of esophageal strictures is less traumatic and more effective. Complications are rare and can be managed conservatively. In our opinion this procedure is the appropriate treatment for strictures, even in very small infants, after repair of esophageal atresia.

Catheterization↗
PubMed2001

Thromboelastography for monitoring prolonged hypercoagulability after major abdominal surgery.

UNLABELLED: Despite clinical and laboratory evidence of perioperative hypercoagulability, there are no consistent data evaluating the extent, duration, and specific contribution of platelets and procoagulatory proteins by in vitro testing. We tested the hypothesis that the parallel use of standard and abciximab-cytochalasin D-modified thromboelastography (TEG) can assess 7 days' postoperative hypercoagulability and can estimate the independent contribution of procoagulatory proteins and platelets. Thromboelastograms were performed before surgery, at the end of surgery, 6 h after surgery, and on postoperative days 1, 2, 3, and 7; they were analyzed for the reaction time and the maximal amplitude (MA). We calculated the elastic shear modulus of standard MA (G(t)) and modified MA (G(c)), which reflect total clot strength and procoagulatory protein component, respectively. The difference was an estimate of the platelet component (G(p)). There was a 10% perioperative increase of standard MA, corresponding to a 50% increase of G(t) (P < 0.0001) and an 86%-90% contribution of the calculated G(p) to G(t). We conclude that serial standard and modified thromboelastography may reveal prolonged postoperative hypercoagulability and the independent contribution of platelets and procoagulatory proteins to clot strength. IMPLICATIONS: Postoperative hypercoagulability, occurring for at least 1 wk after major abdominal surgery, may be demonstrated by standard and modified thromboelastography. This hypercoagulability is not reflected by standard coagulation monitoring and seems to be predominantly caused by increased platelet reactivity.

Abdomen↗
PubMed2001

Extensive genetic polymorphism in the human CYP2B6 gene with impact on expression and function in human liver.

The human cytochrome P450, CYP2B6, is involved in the metabolism of several therapeutically important drugs and environmental or abused toxicants. In this study, we present the first systematic investigation of genetic polymorphism in the CYP2B6 gene on chromosome 19. A specific direct sequencing strategy was developed based on CYP2B6 and CYP2B7 genomic sequence information and DNA from 35 subjects was completely analysed for mutations throughout all nine exons and their exon-intron boundaries. A total of nine novel point mutations were identified, of which five result in amino acid substitutions in exon 1 (C64T, Arg22Cys), exon 4 (G516T, Gln172His), exon 5 (C777A, Ser259Arg and A785G, Lys262Arg) and exon 9 (C1459T, Arg487Cys) and four are silent mutations (C78T, G216C, G714A and C732T). Polymerase chain reaction-restriction fragment length polymorphism tests were developed to detect each of the five nonsynonymous mutations in genomic DNA. By screening a population of 215 subjects the C64T, G516T, C777A, A785G and C1459T mutations were found at frequencies of 5.3%, 28.6%, 0.5%, 32.6% and 14.0%, respectively. Haplotype analysis revealed six different mutant alleles termed CYP2B6*2 (C64T), *3 (C777A), *4 (A785G), *5 (C1459T), *6 (G516T and A785G) and *7 (G516T, A785G and C1459T). By analysing a large number of human liver samples, significantly reduced CYP2B6 protein expression and S-mephenytoin N-demethylase activity were found in carriers of the C1459T (R487C) mutation (alleles *5 and *7). These data demonstrate that the extensive interindividual variability of CYP2B6 expression and function is not only due to regulatory phenomena, but also caused by a common genetic polymorphism.

Aryl Hydrocarbon Hydroxylases↗
PubMed2001

Prevalence and therapeutic control of hypertension in 30,000 subjects in the workplace.

-To assess blood pressure (BP) control in a French working population through the use of a careful assessment of BP based on 2 different visits in 1 month, 17 359 men and 12 267 women were evaluated from January 1997 to April 1998. The initial phase was a cross-sectional analysis of a cohort study designed to assess the incidence of arterial hypertension in a French working population. Information was collected by the work-site physician during the annual examination. BP was measured with a validated automatic device. Among subjects with BP >/= mm Hg, patients not treated with antihypertensive drugs were invited to have an additional BP measurement taken 1 month later. The prevalence of hypertension (BP >/= mm Hg) based on 2 visits was 16.2% in men and 9.4% in women. When the diagnosis of hypertension was based on 2 visits, its prevalence was 41% lower in men and 36% lower in women compared with that of a diagnosis based on a single visit. Accordingly, the awareness of hypertension was 49% higher in men and 40% higher in women. Overall, 12.5% of hypertensive men and 33.2% of hypertensive women taking antihypertensive medication had their BP levels lowered to < mm Hg by treatment. Although the percentage of hypertensive men and women under current treatment who were aware of their hypertension increased with age, BP control among treated subjects decreased with age. Ineffective BP control with treatment accounted for 33% of BP levels >/= mm Hg in men and 40% of those observed in women. In this large French working population, estimates of hypertension therapeutic control depend heavily on the number of BP measurements. Despite these methodological precautions, insufficient awareness of BP and insufficient BP control through treatment remain 2 major public health problems.

Adolescent↗
PubMed2001

High-throughput genotyping of thiopurine S-methyltransferase by denaturing HPLC.

BACKGROUND: The thiopurine S:-methyltransferase (TPMT) genetic polymorphism has a significant clinical impact on the toxicity of thiopurine drugs, which are used in the treatment of leukemia and as immunosuppressants. To date, 10 mutant alleles are known that are associated with intermediate or low TPMT activity. To facilitate rapid screening of clinically relevant TPMT mutations, we developed a strategy of high-throughput genotyping by applying denaturing HPLC (DHPLC). METHODS: To test the specificity and efficiency of the DHPLC method, 98 DNA samples from a selected population of patients receiving thiopurine therapy or with previous thiopurine withdrawal were analyzed for the most frequent mutant TPMT alleles, *2 and *3A, which contain key mutations in exons 5, 7, and 10 to identify clearly different elution profiles. All fragments were examined by direct sequencing. Additionally, to test the sensitivity of DHPLC analysis, genotyping for the *2 and *3A alleles of all 98 DNA samples was performed by PCR-based methods (PCR-restriction fragment polymorphism analysis and allele-specific PCR). RESULTS: The presence of mutations discriminating for alleles *2, *3A, *3C, and *3D, as well as various silent and intron mutations, were correctly predicted by DHPLC in 100% of the samples as confirmed by direct sequencing. Comparison with PCR-based methods for alleles *2 and *3 produced an agreement of 100% with no false-negative signals. CONCLUSIONS: DHPLC offers a highly sensitive, rapid, and efficient method for genotyping of the relevant TPMT mutations, discriminating at least for alleles *2 and *3, in clinical and laboratory practice. Additionally, DHPLC allows a simultaneous screening for novel genetic variability in the TPMT gene.

Antimetabolites, Antineoplastic↗
PubMed2001

[Cause of non-pertinent hospital stays: interobserver concordance using the French version of the Appropriateness Evaluation Protocol].

BACKGROUND: The modified French version of the Appropriateness Evaluation Protocol (AEPf) has been validated. Inappropriate days according to simple medical and technical criteria are identified with this tool. The aim of this study is to highlight the interest of investigating the reasons for inappropriate days and to assess the inter-observers reliability of the questionnaire developed for this purpose. METHODS: This questionnaire collects on one hand the needs of patients - distinguishing health care and accommodation needs - and on the other hand the reasons for inappropriate hospital days. The data were collected from January to September 1998 in nine voluntary medical and surgical departments. For each day of study randomly selected, each inappropriate hospital day according to AEPf has been included. Data were collected by two health professionals (a nurse and a physician), using a concurrent design. RESULTS: The reliability of the over-ride option of the appropriateness assessment of the 345 hospital days was good (overall Kappa coefficient: 0.66; 95% CI: 0.55-0.78). The comparison of the two expert judgments on health care needs fulfilled during the hospital day was acceptable; the Kappa coefficient was 0.62 (95% CI: 0.52-0.72). The reliability of expert assessment on patient accommodation needs (home, housing facilities or hospital) was good (Kappa coefficient: 0.67; 95% CI: 0.60-0.75). When hospital was not the accommodation the most adapted for patient, the reliability of the reasons for inappropriate days was high (Kappa coefficient: 0.75; 95% CI: 0.61-0.80). Kappa coefficients were different between hospitals, indicating a center effect. CONCLUSION: This instrument has been found to be reliable and should be used in complement of the first part of the AEPf which assess the prevalence of inappropriate days. It might help to detect dysfunctions within or outside the hospital and thus be used for evaluation or planning of health care.

Adult↗
PubMed2001

[Regional management of arterial hypertension in France. Report of a survey of general practitioners].

A survey was conducted in 14 regional samples of general practitioners (GPs) included in Gallup-up poll. 2,423 GPs contributed to the study and had to include all patients > 18 years old over a period of one week. Patients were considered hypertensives if the mean of two recorded BP measurements was > or = 140/90 mmHg and/or < 140/90 mmHg if they were under antihypertensive treatment. Hypertensives were considered as controlled if there BP levels were overall < 140/90 mmHg under treatment. The risk factors associated with hypertension were collected in order to evaluate the cardiovascular risk, according to 1999 ISH-OMS recommendations. 156,470 patients recruited by 2423 GPs were included in the study representing 14 different French regions: Ile-de-France I (1), Ile-de-France II (2), Ile-de-France-Pays-de-la-Loire (3), Bretagne (4), Normandie-Picardie (5), Nord-Pas-de-Calais (6), Alsace-Lorraine (7), Bourgogne-Franche Comté (8), Rhônes-Alpes (9), Provence-Côte d'Azur (10), Languedoc-Provence (11), Limousin-Auvergne (12), Midi-Pyrénées (13), Aquitaine (14). Among 70,073 hypertensives, 23,054 had never received antihypertensive treatment, and 32,059 (47%) had a high or a very high cardiovascular risk. 67% of hypertensives (47,019) were treated, and 32.8% of treated hypertensives (15,422) had a BP < 140/90 mmHg. The study illustrated few differences in prevalence and control of hypertension in the different French regions: BP control at the 140/90 mmHg threshold vary from 28.5 to 36.6% among treated hypertensives and % of patients at high cardiovascular risk from 42.1% (South-France) to 49.7% (East-France).

Cardiovascular Diseases↗
PubMed2001

[Aterial hypertension and cardiovascular risk factors associated with diabetes. Report of the PHARE survey in general practice].

OBJECTIVE: To evaluate the characteristics of diabetic hypertensive patients (Pts), in term of associated cardiovascular risk factors and blood pressure control in a representative population issued from a survey "PHARE" conducted in general practice in France in 1999. DESIGN AND METHODS: PHARE survey was conducted in a sample of 225 GPs representative of the French medical population included in a gallup poll. GPs had to include all patients > 18 years old over a period of one week. Pts were considered as hypertensives (HP) if the mean of two recorded BP measurements was = 140/90 mmHg and/or < 140/90 mmHg if they were under antihypertensive treatment. Patients were considered as diabetics if they were previously known and/or if they received a medication for diabetes. Hypertensives were considered as controlled if their BP levels were overall < 140/90 mmHg or at the recommended threshold < 130/85 mmHg under treatment. RESULTS: 877 diabetic Pts (7%) among 12.342 Pts and 5.190 HP were included in the study. When compared to normotensives, diabetic HP had more frequently associated risk factors with hypertension and diabetes: overweight 71% vs 45%, dyslipidemia 61% vs 34%, sendentarily 73% vs 63%, tobacco consumption 27% vs 20%. The BP control at 140/90 mmHg threshold among treated diabetic HP was 21%, and only 8% at 130/85 mmHg. Regarding WHO classification, 79% of these diabetics had a high or very high cardiovascular risk. The were no difference in antihypertensive drugs used in HP diabetics and non diabetics and 50% of them received ACEI. CONCLUSIONS: 8 from 10 diabetics taken in charge in general practice are hypertensives and 8 from 10 have a very high cardiovascular risk due to a poor BP control and associated cardiovascular risk factors.

Activities of Daily Living↗
PubMed2000

Molecular cloning, genomic organization, and mapping of PRKAG2, a heart abundant gamma2 subunit of 5'-AMP-activated protein kinase, to human chromosome 7q36.

5'-AMP-activated protein kinase (AMPK) acts as a major regulator of cellular ATP levels and protects cells against stresses that cause ATP depletion. AMPK is a protein heterotrimer composed of a catalytic alpha subunit and two regulatory subunits, beta and gamma. In the present study, a homologue of the AMPK gamma1-subunit cDNA with an open reading frame encoding 328 amino acids was identified. The putative protein sequence is about 76% identical to the 331-amino-acid gamma1 subunit and also has four consecutive cystathionine-beta-synthase (CBS) domains, a characteristic structure of AMPK gamma subunits from various species. This cDNA (tentatively termed PRKAG2-b) is identical to a recently reported cDNA (tentatively termed PRKAG2-a) of human AMPK gamma subunits except in their 5'-end regions, suggesting that these two cDNAs are two different transcripts of the same gene. To determine the expression pattern of the gene, two probes, one from the 3'-UTR of PRKAG2-b and the other from the 5'- unique region of PRKAG2-a, were used to hybridize MTN membranes. Three transcripts (3.8, 3.0, and 2.4 kb) were observed when the first probe was used, whereas only 3.8- and 3.0-kb transcripts were seen when the second probe was used. Thus, the PRKAG2-b corresponded to the 2.4-kb transcript, which is ubiquitously expressed except in liver and thymus. The highest level was detected in heart, while abundant expression also existed in placenta and testis. The expression pattern of PRKAG2-b is completely different from those of PRKAG2-a and PRKAG1, whose expression patterns were also determined in the current study. The PRKAG2 gene was located to human chromosome 7q36 between markers D7S2439 and D7S2462 by radiation hybrid mapping. The genomic organization of PRKAG2-b was identified by comparing its cDNA sequence with two genomic sequences AC006358 and AC006966, which showed that PRKAG2-b spanned an approximately 80-kb region and was composed of 12 exons.

AMP-Activated Protein Kinases↗
PubMed2000

Identification of residues important both for primary receptor binding and specificity in fibroblast growth factor-7.

Fibroblast growth factors (FGFs) mediate a multitude of physiological and pathological processes by activating a family of tyrosine kinase receptors (FGFRs). Each FGFR binds to a unique subset of FGFs and ligand binding specificity is essential in regulating FGF activity. FGF-7 recognizes one FGFR isoform known as the FGFR2 IIIb isoform or keratinocyte growth factor receptor (KGFR), whereas FGF-2 binds well to FGFR1, FGFR2, and FGFR4 but interacts poorly with KGFR. Previously, mutations in FGF-2 identified a set of residues that are important for high affinity receptor binding, known as the primary receptor-binding site. FGF-7 contains this primary site as well as a region that restricts interaction with FGFR1. The sequences that confer on FGF-7 its specific binding to KGFR have not been identified. By utilizing domain swapping and site-directed mutagenesis we have found that the loop connecting the beta4-beta5 strands of FGF-7 contributes to high affinity receptor binding and is critical for KGFR recognition. Replacement of this loop with the homologous loop from FGF-2 dramatically reduced both the affinity of FGF-7 for KGFR and its biological potency but did not result in the ability to bind FGFR1. Point mutations in residues comprising this loop of FGF-7 reduced both binding affinity and biological potency. The reciprocal loop replacement mutant (FGF2-L4/7) retained FGF-2 like affinity for FGFR1 and for KGFR. Our results show that topologically similar regions in these two FGFs have different roles in regulating receptor binding specificity and suggest that specificity may require the concerted action of distinct regions of an FGF.

3T3 Cells↗
PubMed2000

Regional patterns in prevalence of principal external diseases of dab Limanda limanda in the North Sea and adjacent areas 1992-1997.

The prevalence and spatial distribution of major diseases of dab Limanda limanda in the North Sea and adjacent areas were studied in the summers 1992 to 1997. Areas covered were the North Sea, Irish Sea, northern and northeastern British Waters and the English Channel. The diseases studied were lymphocystis, epidermal hyperplasia/papilloma and skin ulceration. To standardise data, results were analysed for females >15 cm (>3 yr old). Data were subjected to median polish, and additive, extended and additive plus multiplicative models were applied to best account for effects of region and year. Annual differences in disease prevalence were low whilst differences between areas were pronounced. For lymphocystis higher prevalence was observed in the northwestern sector of the North Sea, at the northern tip of Scotland and in an area south of Iceland. Prevalence was low in the Irish Sea, the English Channel and the southern North Sea, and intermediate in the German Bight. For epidermal hyperplasia/papilloma, levels were low at Icelandic stations, in the northern Irish Sea, in the southern North Sea and the English Channel, whilst levels were high in the northwestern part of the North Sea and the German Bight. Elevated levels of skin ulceration were found on the Dogger, at 1 station in the Irish Sea (off Sellafield) and at 1 station to the south of Iceland. Lower levels were detected west of Iceland. Prevalence in all other areas was intermediate. It is concluded that a detailed analysis of available data on disease prevalence and putative causative factors is desirable and, given the good availability of data, would be a promising step forward toward elucidating possible cause and effect relationships between diseases and anthropogenic factors.

Animals↗