Neurological manifestations and molecular genetics of acute intermittent porphyria in North Western Russia

Acute intermittent porphyria (AIP, MIM #176000) is an inherited metabolic disease due to a partial deficiency of the third enzyme, hydroxymethylbilane synthase (HMBS, EC: 4.3.1.8), in the haem biosynthesis. Neurological symptoms during an acute attack, which is the major manifestation of AIP, are variable and relatively rare, but may endanger a patient's life. In the present study, 12 Russian and two Finnish AIP patients with severe neurological manifestations during an acute attack were studied prospectively from 1995 to 2006. Autonomic neuropathy manifested as abdominal pain (88%), tachycardia (94%), hypertension (75%) and constipation (88%). The most common neurological sign was acute motor peripheral neuropathy (PNP, 81%) often associated with neuropathic sensory loss (54%) and CNS involvement (85%). Despite heterogeneity of the neurological manifestations in our patients with acute porphyria, the major pattern of PNP associated with abdominal pain, dysautonomia, CNS involvement and mild hepatopathy could be demonstrated. If more strict inclusion criteria for biochemical abnormalities (>10-fold increase in excretion of urinary PBG) are applied, neurological manifestations in an acute attack are probably more homogeneous than described previously, which suggests that some of the neurological patients described previously may not have acute porphyria but rather secondary porphyrinuria. Screening for acute porphyria using urinary PBG is useful in a selected group of neurological patients with acute PNP or encephalopathy and seizures associated with pain and dysautonomia. Clinical manifestations and the outcome of acute attacks were used as a basis for developing a 30-score scale of the severity of an acute attack. This scale can easily be used in clinical practice and to standardise the outcome of an attack. Degree of muscle weakness scored by MRC, prolonged mechanical ventilation, bulbar paralysis, impairment of consciousness and hyponatraemia were important signs of a poor prognosis. Arrhythmia was less important and autonomic dysfunction, severity of pain and mental symptoms did not affect the outcome. The delay in the diagnosis and repeated administrations of precipitating factors were the main cause of proceeding of an acute attack into pareses and severe CNS involvement and a fatal outcome in two patients. Nerve conduction studies and needle EMG were performed in eleven AIP patients during an acute attack and/or in remission. Nine patients had severe PNP and two patients had an acute encephalopathy but no clinically evident PNP. In addition to axonopathy, features suggestive of demyelination could be demonstrated in patients with severe PNP during an acute attack. PNP with a moderate muscle weakness was mainly pure axonal. Sensory involvement was common in acute PNP and could be subclinical. Decreased conduction velocities with normal amplitudes of evoked potentials during acute attacks with no clinically evident PNP indicated subclinical polyneuropathy. Reversible symmetrical lesions comparable with posterior reversible encephalopathy syndrome (PRES) were revealed in two patients' brain CT or MRI during an acute attack. In other five patients brain MRI during or soon after the symptoms was normal. The frequency of reversible brain oedema in AIP is probably under-estimated since it may be short-lasting and often indistinguishable on CT or MRI. In the present study, nine different mutations were identified in the HMBS gene in 11 unrelated Russian AIP patients from North Western Russia and their 32 relatives. AIP was diagnosed in nine symptom-free relatives. The majority of the mutations were family-specific and confirmed allelic heterogeneity also among Russian AIP patients. Three mutations, c.825+5G>C, c.825+3_825+6del and c.770T>C, were novel. Six mutations, c.77G>A (p.R26H), c.517C>T (p.R173W), c.583C>T (p.R195C), c.673C>T (p.R225X), c.739T>C (p.C247R) and c.748G>C (p.E250A), have previously been identified in AIP patients from Western and other Eastern European populations. The effects of novel mutations were studied by amplification and sequencing of the reverse-transcribed total RNA obtained from the patients' lymphoblastoid or fibroblast cell lines. The mutations c.825+5G>C and c.770T>C resulted in varyable amounts of abnormal transcripts, r.822_825del (p.C275fsX2) and [r.770u>c, r.652_771del, r.613_771del (p.L257P, p.G218_L257del, p.I205_L257del)]. All mutations demonstrated low residual activities (0.1-1.3 %) when expressed in COS-1 cells confirming the causality of the mutations and the enzymatic defect of the disease. The clinical outcome, prognosis and correlation between the HMBS genotype and phenotype were studied in 143 Finnish and Russian AIP patients with ten mutations (c.33G>T, c.97delA, InsAlu333, p.R149X, p.R167W, p.R173W, p.R173Q, p.R225G, p.R225X, c.1073delA) and more than six patients in each group. The patients were selected from the pool of 287 Finnish AIP patients presented in a Finnish Porphyria Register (1966-2003) and 23 Russian AIP patients (diagnosed 1995-2003). Patients with the p.R167W and p.R225G mutations showed lower penetrance (19% and 11%) and the recurrence rate (33% and 0%) in comparison to the patients with other mutations (range 36 to 67% and 0 to 66%, respectively), as well as milder biochemical abnormalities [urinary porphobilinogen 47±10 vs. 163±21 mol/L, p<0.001; uroporphyrin 130±40 vs. 942±183 nmol/L, p<0.001] suggesting a milder form of AIP in these patients. Erythrocyte HMBS activity did not correlate with the porphobilinogen excretion in remission or the clinical of the disease. In all AIP severity patients, normal PBG excretion predicted freedom from acute attacks. Urinary PBG excretion together with gender, age at the time of diagnosis and mutation type could predict the likelihood of acute attacks in AIP patients.

Western medicine and Australian Indigenous healing practices

Most projects undertaken by government health organisations are formulated on values and beliefs about health and illness that are derived from Anglo/Celtic culture. Health beliefs differ between cultures and it has been identified that the differences in the Indigenous and non-Indigenous constructs of health impacts negatively on the effectiveness of mainstream healthcare provided to Indigenous peoples [2]. This implies that strategies that incorporate, or better still are derived from, Indigenous health beliefs have a greater potential to be effective. This article introduces a prospective survey project asking how western medicine and traditional treatments interface with each other.

Road kills of amphibians in different land use areas from Sharavathi river basin, central Western Ghats, India

A survey of amphibian mortality on roads was carried out in the Sharavathi river basin in the central Western Ghats. Road kills in three different land use areas: agricultural fields, water bodies and forests were recorded for four days along three 100m stretches in each type of area. One-hundred-and-forty-four individuals belonging to two orders, eight families, 11 genera and 13 species were recorded in the survey. Kills/km observed were: in forest 55, agricultural fields 38 and water bodies 27, for an overall average of 40 kills/km. Kill species compositions varied significantly between land use areas, but not overall kill rates.

Knowledge Transfer within Western Multinationals' Subsidiary Units in China and Finland - The Impact of Headquarter Control Mechanisms, Subsidiary Location and Social Capital (summary section only)

It is suggested that the ability and practices of how the multinational corporation (MNC) manages knowledge transfer among its geographically dispersed subsidiary units are crucial for the building and development of firm competitive advantage. However, cross-border transfer of valuable organizational knowledge is likely to be problematic and laborious, especially within diversified and differentiated MNCs. Using data collected from 164 western multinational companies’ subsidiary units located in China and Finland, this study aims to investigate cross-border knowledge transfer within the MNC. It explores a number of factors that influence the transfer of knowledge among units in the differentiated MNC. The study consists of five individual papers. Paper 1 investigates a range of organizational mechanisms that may positively influence a subsidiary’s propensity to undertake knowledge transfers to other parts of the corporation. Paper 2 explores the impact of subsidiary location on the motivational dispositions of knowledge receiving units to value and accept knowledge from subsidiaries located in economically less advanced countries. Paper 3 examines the influence of social capital variables on knowledge transfer in dyadic relationships between foreign-owned subsidiaries and their sister and patent units. Paper 4 provides some initial insights into potentially different effects of trust and shared vision in intra-organizational vs. inter-organizational relationships. Using a case study setting, Paper 5 explores means and mechanisms used in transferring human resource management practices to Western MNCs’ business units in China from a cultural perspective. The results of the study show that MNC management through choices regarding organizational controls can encourage and enhance corporate-internal knowledge transfer. It also finds evidence that more knowledge is transferred from subsidiaries located in an industrialized country (e.g., Finland) than subsidiaries located in a developing country (e.g., China). While the study has highlighted the importance of social capital in promoting knowledge transfer, it has also uncovered some new findings that the effect of trust and shared vision may be contingent upon different contexts. Finally, in Paper 5, a number of mechanisms used in transferring selected HRM practices and competences to the Chinese business units have been identified. The findings suggest that cultural differences should be taken into consideration in the choice and use of different transfer mechanisms.

Hills, dams and forests. Some field observations from the Western Ghats

Man’s attempts to intensify the use of natural resources can often result in the exhaustion of the resource or deterioration of other interacting resources. The single-minded pursuit of the development of the water resources of the rivers of the Western Ghats shows many examples of this view, particularly in the unnecessary destruction of the dwindling forest resources. This destruction may be caused by (i) problems o f rehabilitation, e.g. the Ramanagar settlement of the Kalinadi project (ii) the impact of labourers, e.g. the destruction of evergreen sholas on the Upper Nilgiri plateau (iii) the access to encroachers and poachers, e.g. Panshet and Kalinadi (iv) faulty planning, e.g. Linganamakki and Kalinadi. This destruction of forest cover has had a number of deleterious consequences in (i) worsening the shortages of forest resources, (ii) hastening the siltation of the reservoirs, (iii) ecological imbalances as in the rapid spread ofEupatorium in the Kalinadi project area and (iv) the decimation of biological diversity, as in the great reduction of evergreen forests in the Western Ghats, threatening the survival of lion-tailed macaque and the extinction of grass species,Hubbardia heptaneuron. It is stressed that the only sustainable and therefore true development is environmentally sound development. The interests of the weaker sections of the society often provide a good index of the soundness of the development from an environmental point of view. The planning of the development process with this perspective is a great scientific and technological challenge that must be taken up.

Ecology of the swampy relic forests of Kathalekan from central Western Ghats, India

Introduction of agriculture three millennia ago in Peninsular India’s Western Ghats altered substantially ancient tropical forests. Early agricultural communities, nevertheless, strived to attain symbiotic harmony with nature as evident from prevalence of numerous sacred groves, patches of primeval forests sheltering biodiversity and hydrology. Groves enhanced heterogeneity of landscapes involving elements of successional forests and savannas favouring rich wildlife. A 2.25 km2 area of relic forest was studied at Kathalekan in Central Western Ghats. Interspersed with streams studded with Myristica swamps and blended sparingly with shifting cultivation fallows, Kathalekan is a prominent northernmost relic of southern Western Ghat vegetation. Trees like Syzygium travancoricum (Critically Endangered), Myristica magnifica (Endangered) and Gymnacranthera canarica (Vulnerable) and recently reported Semecarpus kathalekanensis, are exclusive to stream/swamp forest (SSF). SSF and non-stream/swamp forest (NSSF) were studied using 18 transects covering 3.6 ha. Dipterocarpaceae, its members seldom transgressing tropical rain forests, dominate SSF (21% of trees) and NSSF (27%). The ancient Myristicaceae ranks high in tree population (19% in SSF and 8% in NSSF). Shannon-Weiner diversity for trees is higher (>3) in six NSSF transects compared to SSF (<3). Higher tree endemism (45%), total endemic tree population (71%) and significantly higher above ground biomass (349 t/ha) cum carbon sequestration potential (131 t/ha) characterizes SSF. Faunal richness is evident from amphibians (35 species - 26 endemics, 11 in IUCN Red List). This study emphasizes the need for bringing to light more of relic forests for their biodiversity, carbon sequestration and hydrology. The lives of marginal farmers and forest tribes can be uplifted through partnership in carbon credits, by involving them in mitigating global climatic change through conservation and restoration of high biomass watershed forests.

Geochemistry and petrology of the ferropicrite dikes and associated rocks of Vestfjella, western Dronning Maud Land, Antarctica

This study provides insights into the composition and origin of ferropicrite dikes (FeOtot = 13 17 wt. %; MgO = 13 19 wt. %) and associated meimechite, picrite, picrobasalt, and basalt dikes found at Vestfjella, western Dronning Maud Land, Antarctica. The dikes crosscut Jurassic Karoo continental flood basalts (CFB) that were emplaced during the early stages of the breakup of the Gondwana supercontinent ~180 Ma ago. Selected samples (31 overall from at least eleven dikes) were analyzed for their mineral chemical, major element, trace element, and Sr, Nd, Pb, and Os isotopic compositions. The studied samples can be divided into two geochemically distinct types: (1) The depleted type (24 samples from at least nine dikes) is relatively depleted in the most incompatible elements and exhibits isotopic characteristics (e.g., initial εNd of +4.8 to +8.3 and initial 187Os/188Os of 0.1256 0.1277 at 180 Ma) similar to those of mid-ocean ridge basalts (MORB); (2) The enriched type (7 samples from at least two dikes) exhibits relatively enriched incompatible element and isotopic characteristics (e.g., initial εNd of +1.8 to +3.6 and initial 187Os/188Os of 0.1401 0.1425 at 180 Ma) similar to those of oceanic island basalts. Both magma types have escaped significant contamination by the continental crust. The depleted type is related to the main phase of Karoo magmatism and originated as highly magnesian (MgO up to 25 wt. %) partial melts at high temperatures (mantle potential temperature >1600 °C) and pressures (~5 6 GPa) from a sublithospheric, water-bearing, depleted peridotite mantle source. The enriched type sampled pyroxene-bearing heterogeneities that can be traced down to either recycled oceanic crust or melt-metasomatized portions of the sublithospheric or lithospheric mantle. The source of the depleted type represents a sublithospheric end-member source for many Karoo lavas and has subsequently been sampled by the MORBs of the Indian Ocean. These observations, together with the purported high temperatures, indicate that the Karoo CFBs were formed in an extensive melting episode caused mainly by internal heating of the upper mantle beneath the Gondwana supercontinent. My research supports the view that ferropicritic melts can be generated in several ways: the relative Fe-enrichment of mantle partial melts is most readily achieved by (1) relatively low degree of partial melting, (2) high pressure of partial melting, and (3) melting of enriched source components (e.g., pyroxenite and metasomatized peridotite). Ferropicritic whole-rock compositions could also result from accumulation, secondary alteration, and fractional crystallization, however, and caution is required when addressing the parental magma composition.

Novel reproductive mode in a torrent frog Micrixalus saxicola (Jerdon) from the Western Ghats, India

Reproductive modes in anurans are highly diverse despite external fertilization being a constraint. There are 39 reproductive modes documented so far (Wells, 2007). An apparently new reproductive mode is reported in a torrent frog, Micrixalus saxicola, an endemic and ancient anuran frog of the Western Ghats, considering the type of cavity made inside the lotic water body, involvement of the female in digging the cavity and concealing the eggs.

The problem of conserving amphibians in the Western Ghats, India

Habitat distruction and hunting for dissection specimens have taken their toll. But there may be other, subtle factors causing loss of amphibian populations.

Geographical Distribution Patterns of Amphibians in the Western Ghats, India

The Western Ghats of India are very rich in amphibian species with 117 species of frogs, toads and caecilians. Eighty-nine species are endemic to this biogeographical region. Analysis of ranges and patterns of geographical distribution of amphibians on the Western Ghats suggest that the southern half of the Western Ghats and the low-medium elevation hills are more diverse in species than the northern half and higher hills. This is attributed to the more widespread rainfall and the less variable climatic conditions in the south. About half the species are apparently localized. Of those species with wider ranges, a majority show patchy distribution. Species preferring the moist evergreen forests as habitats tend to have patchy distributions. This appears to be a result of habitat destruction and fragmentation. The overall patterns of species richness and local endemism are rather different from those of the angiosperms and birds. In birds and angiosperms, a significant proportion of endemics are found on the higher hills. On the contrary, endemic amphibian species are found in the lower altitudinal range of 0-1000 m, with a majority between 800 and 1000 m.

Nestedness pattern in stream diatom assemblages of central Western Ghats

Community diversity and the population abundance of a particular group of species are controlled by immediate environment, inter-and intra-species interactions, landscape conditions, historical events and evolutionary processes. Nestedness is a measure of order in an ecological system, referring to the order in which the number of species is related to area or other factors. In this study we have studied the nestedness pattern in stream diatom assemblages in 24 stream sites of central Western Ghats, and report 98 taxa from the streams of central Western Ghats region. The communities show highly significant nested pattern. The Mantel test of matrix revealed a strong relationship between species assemblages and environmental conditions at the sites. A significant relationship between species assemblage and environmental condition was observed. Principal component analysis (PCA) indicated that environmental conditions differed markedly across the sampling sites, with the first three components explaining 78% of variance. Species composition of diatoms is significantly correlated with environmental distance across geographical extent. The current pattern suggests that micro-environment at regional levels influences the species composition of epilithic diatoms in streams. The nestedness shown by the diatom community was highly significant, even though it had a high proportion of idiosyncratic species, characterized with high numbers of cosmopolitan species, whereas the nested species were dominated by endemic species. PCA identifies ionic parameters and nutrients as the major features which determine the characteristics of the sampling sites. Hence the local water quality parameters are the major factors in deciding the diatom species assemblages.