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trial and funding should be recorded; that the registries should befreely accessible; and that registries should be updated and wellmaintained. The group suggested that the requirements for

registration should include information about design, rationale,treatment, outcome measures, stage of execution, and details of anypublications. Potential difficulties that emerged included thedefinition of a clinical trial, updating of data, storage and access,funding, terminology, and identification of duplicate trial entries.

Does Dad matter?

Mitochondrial DNA, we used to be taught, was inherited strictlythrough the maternal line, and fathers didn’t get a look-in at thisparticular bit of the generation game. But new evidence fromback-cross experiments in mice suggests that this law is notimmutable: "leakage" of paternal mtDNA can occur, if only on aminute scale.l

Using polymerase chain reaction techniques to amplifyselectively any paternally derived mtDNA, Gyllensten et allback-crossed two species of mice, Mus spretus and M domesticus(whose mtDNAs are easily distinguished), for 26 generations tobuild up paternally inherited mtDNA to detectable levels. Theeventual yield was 1 molecule of paternal mtDNA for every 1000 inthe C57B1 (M domesticus) back-crosses and 1 per 10 000 in theM spretus back-crosses. Leakage of paternal-specific mtDNA hasbeen demonstrated in Drosophila by means of Southern blots and ina mussel, Mytilus edulis, with restriction digestion procedures.Gyllensten and colleagues are the first to demonstrate the

phenomenon in a vertebrate, but they warn that paternalinheritance of mtDNA in inter-species crosses does not prove that itoperates within a single species. The large genetic differencesbetween the two mouse species studied might, they suggest, haveenabled the paternal mtDNA to escape mechanisms that normallyinactivate it.

Nevertheless, Gyllensten’s findings do have some intriguingimplications. First, they offer an explanation for those puzzlingmitochondrial disorders for which biparental inheritance cannot beconvincingly ruled out. Secondly, they give rise to some tantalisingspeculation that human phylogenies constructed from mtDNAcomparisons may be way off the mark. Gyllensten et al suggest, forinstance, that the most recent common ancestor for all

contemporary maternal lineages could be younger than the 200 000years previously estimated? There is also the possibility that,because mtDNA numbers probably go through "bottlenecks"during oogenesis, paternal mtDNA may occasionally slip throughand take over a maternal lineage.

1. Gyllensten U, Wharton D, Josefsson A, Wilson AC. Paternal inheritance ofmitochondrial DNA in mice. Nature 1991; 352: 255-57.

2. Cann RL, Stoneking M, Wilson AC. Mitochondrial DNA and human evolution.Nature 1987: 325: 31-36.

Royal Pharmaceutical Society1991 is an auspicious year for both the Royal Pharmaceutical

Society (RPS) and its journal. The Pharmaceutical Society of GreatBritain was founded on April 15, 1841, amid conflict betweenchemists and those who supported a Parliamentary Bill thatintended to control and regulate their affairs.1 This perceivedinterference in the professional lives of druggists, together with theirlack of representation on the proposed regulatory authority, led tothe formation of a London committee to oppose these changes.Although this group was successful-the Bill failed at its secondreading-the need for regulation was clear. In the unlikely setting ofthe Crown and Anchor tavern on The Strand, Jacob Bell and hiscolleagues held the inaugural meeting of the PharmaceuticalSociety. A Royal Charter followed in 1843.

Scandal surrounded the society in these early years. Jacob Bellhad been a focus for unity among members during the foundation ofthe society, and his political ambitions were to be realised in 1850,when he became a Member of Parliament for St Albans. However,his parliamentary career came to an untimely end when an inquiryestablished that he and his business partner had bribed electors.

Bell’s reputation survived the scandal and he later became presidentof the Pharmaceutical Society. Further difficulties arose when thesociety was accused of being elitist. A rival body, the United Societyof Chemists and Druggists, was formed, which claimed to be morerepresentative of the profession. After several years of internecinedisagreements, a merger took place in 1867. During the nextcentury, the RPS established uniform standards of both

pharmaceutical education and services throughout the UK. Thesociety now flourishes as the voice of all pharmacists and hasbroadened its scope to include, for instance, the publication ofMartindale: the extra pharmacopoeia. Despite this progress,

vigorous and often ill-tempered debates still take place within theportals of the RPS. A former director of public relations recentlycriticised the society’s council of management, only to elicit a causticresponse referring to his "unhelpful remarks" and urging him to be"more careful with the facts".

In 1990, the British Medical Journal celebrated its 150th

anniversary. This year the Pharmaceutical Journal does the same.2For a short time after 1842, both The Lancet and the P3‘ (edited bynone other than Jacob Bell) shared the same publisher. Our pathshave since separated, and the P has now established itself as astrong force for change within the pharmacy community.

1. The Royal Pharmaceutical Society of Great Britain 1841-1991. By S. W. F. Holloway.London: The Pharmaceutical Press. 1991. Pp 464. £35. ISBN 0-853692440.

2. 150 years of the Pharmaceutical Journal 1841-1991. An anniversary supplement to thePharmaceutical Journal, July 6,1991.

Organ transplantationShortage of organ donors is a major cause of frustration to

transplant teams, who still at times have to stand by helplessly as apatient dies for lack of a suitable donor. Despite spectacularadvances in surgical techniques, organ preservation,immunosuppressive therapy, and life-support technology, the livesof patients waiting for transplant surgery depend ultimately on thegift of an organ. In the UK, as in many other developed countries,organ supply is the main limiting factor in transplantation. In littleover two years (from December, 1988, to January, 1991) thenumber of patients waiting for a kidney transplant in the UK grewfrom 2813 to 3804, according to figures published in a report fromthe Office of Health Economics. The fastest growth in demand hasbeen for heart and heart-lung transplantation. Patients have to waitup to seven months for a heart-lung transplant, and a quarter ofthem die before the operation can take place. The OHE report, thehundredth in a series of briefmg papers on current health issues, ispublished this week to coincide with National Transplant Week.

Several European countries have augmented the supply of donororgans by adopting "presumed consent" policies, whereby doctorscan remove organs unless the deceased carries a card that prohibitsthis or the next of kin object. In the UK, however, removal of organsstill depends on positive consent, which may, however, be overridenby the wishes of close relatives. Nearly half of potential donors in theUK do not become actual donors, says the report, the main reasonbeing refusal by relatives to allow the dead person’s organs to beused.

In answer to sceptics who say that money spent, for instance, onheart transplants would be better used for preventive measures, thereport’s author, Richard West, replies that preventive measures areof uncertain value, whereas transplants have been economicallyevaluated. At present kidney transplants, which result in an average5-year survival of 83%, give the best value for money (transplantcosts 10 000, recurrent costs C3000 a year), followed by hearttransplants (82%, £ 15 000, 3000). A kidney transplant is the mostcost-effective treatment for renal failure, the comparative costs forhospital haemodialysis being 18 000 a year, for continuous

ambulatory pertioneal dialysis C13 000, and for home

haemodialysis c 11000. The advent of cyclosporin has led tosignificantly more expense in terms of anti-rejection therapy butalso to fewer failed transplants. In West’s assessment, kidney graftsare the most successful transplants, as well as the cheapest, becausethe recipients enjoy a high quality of life, many of them being able toreturn to full-time work.