Royston Hospital

#### Case scenario A 19 year old female student consulted her general practitioner about two recent episodes of syncope, both of which occurred while playing hockey. Her team mates reported that she collapsed suddenly with little warning, recovering rapidly within 30 seconds without confusion. She was otherwise well, although she was taking erythromycin for an infected leg abrasion at the time of the events. As part of the routine evaluation for syncope, her general practitioner performed a 12 lead electrocardiogram, which showed a prolonged corrected QT interval of 510 ms. Congenital long QT syndrome is a potential cause of avoidable sudden cardiac death. Affected individuals may have ventricular arrhythmias, leading to palpitations, syncope, and, if sustained, cardiac arrest.1 The syndrome is inherited in an autosomal dominant fashion, with variable disease expression: those severely affected may die in fetal or neonatal life, but others remain asymptomatic throughout their life. At a cellular level, genetically encoded abnormalities in sodium and potassium ion channels within the cell membrane lengthen cardiac repolarisation, which manifests as a prolongation of the QT interval in the electrocardiogram. QT prolongation may be acquired secondary to certain medications, metabolic disturbance, cerebral injury, myocardial disease, and hypothermia—factors that may also unmask the congenital syndrome in a previously asymptomatic individual. #### How common is long QT syndrome? Syncope is highly prevalent in young adults. Among 394 students, 154 reported at least one episode of syncope.4 In a young, fit adult (such as outlined in the scenario box), important differential diagnoses include the most common and benign cause of …

Biotechnology start-up companies are dependent on investment to discover and develop their products, and often get that investment from venture capital groups (VCs). VCs almost always invest in liquidation preference shares, which provides them with upside enhancement and downside protection, and they impose detailed management controls on the company through shareholder veto provisions. This has been suggested as laying the company open to “investor opportunism”, actions which drive the company to actions or strategies which, while enhancing the investor's short-term shareholding value, damages the company as a whole and restricts its long-term prospects in the US. This paper reports on an analysis of the effect of the combination of complex share structures with multiple levels of liquidation preference (the norm in UK biotechnology companies) and of comprehensive investor control over the company's management. We find the same problems occurring in UK biotechnology companies as Fried and Ganor found in the US, with examples of companies being prevented from achieving exits, raising investment rounds and being driven to mergers which add no value to the enterprise. This both reduces the value of investee companies (an issue that VCs should address) and reduces the willingness of entrepreneurs and business angels to create new companies for VCs to invest in. This is made worse by the chronic underinvestment in UK high-tech start-ups. Examination of a number of potential solutions finds few of them are workable, but that requiring companies to disclose contracts that effectively transfer the power of directors to non-director shareholders could have some benefit.

Upper II aborted hydropic twins and was subsequendy sterilized.

MEGALOBLASTIC ANAEMIA BRmTs

International Journal of Clinical PracticeVolume 11, Issue 9 p. 665-671 Clinical Articles The Problem of Renal Tuberculosis Walter M. Borthwick MB. CA.M, Walter M. Borthwick MB. CA.M Robroyston Hospital, GlasgowSearch for more papers by this authorJohn C. Dick MD, FRFPS(Glas.), John C. Dick MD, FRFPS(Glas.) Robroyston Hospital, GlasgowSearch for more papers by this author Walter M. Borthwick MB. CA.M, Walter M. Borthwick MB. CA.M Robroyston Hospital, GlasgowSearch for more papers by this authorJohn C. Dick MD, FRFPS(Glas.), John C. Dick MD, FRFPS(Glas.) Robroyston Hospital, GlasgowSearch for more papers by this author First published: 01 September 1957 https://doi.org/10.1111/j.1742-1241.1957.tb02419.xRead the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Volume11, Issue9September 1957Pages 665-671 RelatedInformation