bluuebunny/crossref_metadata_2025 huggingface dataset:
Vegetative Compatibility Grouping of the Fusarium Wilt Pathogen of Paris Daisy (Argyranthemum frutescens L.)
Authors: Pasquali M. , Marena L. , Gullino M. L. , Garibaldi A.
Published: May 2004

Fusarium oxysporum isolates, pathogenic on Paris daisy (Argyranthemum frutescens), were classified by vegetative compatibility grouping analysis. They were compared with isolates of the formae speciales chrysanthemi and tracheiphilum, and with f. sp. dianthi as a genetically distant control. The results show the uniformity of the pathogenic isolates from Paris daisy, except for one which was of a different geographic origin. They were classified as a new VC group (0052). We report also the efficacy of different media in obtaining nit mutants.
Control of Postharvest Diseases of Sweet Cherry with Ethanol and Hot Water
Authors: Karabulut O. A. , Arslan U. , Kuruoglu G. , Ozgenc T.
Published: May 2004

Complete inhibition of the germination of spores of Penicillium expansum occurred after 10 s exposure to 40% ethanol or more at ambient temperature, while spores of Botrytis cinerea were completely inhibited by 30% ethanol or more. Mortality of the spores of P. expansum and B. cinerea in heated 10% ethanol was higher than in water at the same temperatures. Immersion of naturally inoculated fruit in 20, 30, 40, or 50% ethanol reduced the decay present after storage for 10 days at 20°C similarly and by approximately 60–85%. Immersion of fruit that had been inoculated with the spores of P. expansum and B. cinerea reduced decay by both pathogens after storage for 30 days at 0°C and 5 days at 20°C when 30% or higher concentrations of ethanol were used. The incidence of decay after immersion in water alone for 30 s at 24, 50, 55, or 60°C was 57.7, 44.7, 46.2, and 35.7%, respectively, while 10% ethanol at these temperatures the decay incidence to 52.2, 33.9, 32.8, or 14.7%, respectively. Water treatments at 50, 55, or 60°C alone were not effective against P. expansum, while their efficacies were significantly increased by the addition of 10% ethanol. The most effective treatment was immersion in 10% ethanol at 60°C. Ethanol treatments at 20, 30, 40, or 50% and water treatments at 55 or 60°C significantly reduced natural fungal populations on the surfaces of fruit in all of the experiments. Addition of 10% ethanol to water significantly increased the efficacy of water in reducing the fungal populations at elevated temperatures. None of these treatments caused surface injuries to the fruit or adversely affected stem colour.
Population Structure of Magnaporthe grisea from North‐western Himalayas and its Implications for Blast Resistance Breeding of Rice
Authors: Rathour R. , Singh B. M. , Sharma T. R. , Chauhan R. S.
Published: May 2004

Neutral and pathogenicity markers were used to analyse the population structure of Magnaporthe grisea rice isolates from the north‐western Himalayan region of India. Random amplified polymorphic DNA (RAPD)‐based DNA fingerprinting of 48 rice isolates of M. grisea with five primers (OPA‐04, OPA‐10, OPA‐13, OPJ‐06 and OPJ‐19) showed a total of 65 RAPD bands, of which 54 were polymorphic. Cluster analysis of 48 rice isolates of M. grisea on the basis of these 65 RAPD bands revealed the presence of high genotypic diversity and continuous DNA fingerprint variation in the pathogen population. No correlation was observed between RAPD patterns and virulence characteristics of the pathogen. The observed population structure contrasted with presumed clonal reproductive behaviour of the pathogen and indicated the possibility of ongoing genetic recombination in the pathogen population. Analysis of the virulence organization of five RAPD groups (RG1–RG5) using 20 rice genotypes comprising at least 15 resistance genes revealed that no combination of resistance genes would confer resistance against all RAPD fingerprint groups present in the M. grisea rice population. The possible implications of the observed population structure of M. grisea for blast resistance breeding have been discussed.
Impact of exotic fish removal on native communities in farm ponds
Authors: MAEZONO Yasunori , MIYASHITA Tadashi
Published: May 2004

Introduced largemouth bass (Micropterus salmoides spp.) and bluegill (Lepomis macrochirus spp.) are thought to threaten native aquatic organisms worldwide and hence their eradication has recently begun in Japan. Our previous studies suggested that the removal of largemouth bass increases native fish, shrimp, dragonflies, and exotic crayfish, but decreases macrophytes. To test this prediction, we removed the exotic fishes by draining farm ponds and compared the numbers of these organisms before and after the drain, as well as between drained and undrained ponds. The number of dragonfly Pseudothemis zonata, crayfish, shrimp, and goby increased rapidly after the drain, but the coverage of macrophyte declined. The reduction in macrophyte is assumed to be caused by increased herbivory by crayfish. The number of exuviae of damselfly Cercion calamorum and the total number of species of odonate also decreased after the drain. These decreases can be due to the reduction of macrophyte because reduced odonate species are known to use macrophytes as oviposition sites. Therefore, the removal of largemouth bass has a potential to cause negative effects on some native organisms. We propose that reduction of exotic crayfish should be considered when eradicating the exotic fishes.
Diet mixing and its effect on polyphagous grasshopper nymphs
Authors: MIURA Kazumi , OHSAKI Naota
Published: May 2004

We examined the effects of diet mixture on the nymphal performance of a polyphagous grasshopper Parapodisma subastris Huang by developing the first‐stadium nymphs with either single or various combinations of plants occurring in their natural habitat. Intrinsic quality in terms of nymphal survival differed largely across the 16 plant species. However, even combinations of the six worst quality plants (survival 10% or less in each) greatly improved nymphal survival when compared to that of superior quality plants (more than 70% survival). In contrast, the addition of either of two inferior plants (more than 10% and less than 40% survival) to the superior plant affected neither the survival nor the adult mass. Thus, diet mixture can be particularly important when only low quality plants are available. The adaptive significance of diet mixture was discussed in relation to the habitat flora and foraging habits of the grasshopper in the present study.
Efficiency of herbivore exclusion by ants attracted to aphids on the vetch Vicia angustifolia L. (Leguminosae)
Authors: SUZUKI Nobuhiko , OGURA Kazuhiro , KATAYAMA Noboru
Published: May 2004

The efficiency of herbivore exclusion by ants on the vetch Vicia angustifolia L. (Leguminosae) with extrafloral nectary, mediated by ant attraction to aphids was investigated in a field census and laboratory experiments. In the field, workers of Lasius japonicus Santschi and Tetramorium tsushimae Emery frequently visited plants of the vetch parasitized by aphids of Aphis craccivora Koch, but only a few workers visited plants without aphids. An increase in the number of ants visiting a plant with increasing numbers of aphids caused a decrease in the number of larvae of the weevil, Hypera postica Gyllenhal. Therefore, the efficiency of herbivore exclusion by ants was higher on plants parasitized by Ap. craccivora aphids than that on plants unparasitized by aphids. In the laboratory experiments, L. japonicus workers frequently patrolled not only shoots with Ap. craccivora aphids but also shoots without them. However, T. tsushimae workers visited mainly shoots with Ap. craccivora aphids but less frequently on shoots without aphids. Therefore, L. japonicus workers excluded herbivores more efficiently on plants of the vetch than T. tsushimae workers. Consequently, the efficiency of herbivore exclusion by ants on the vetch can be influenced directly by differences in ant species and indirectly by the presence of aphids on plants. The present study highlights the significance of indirect interactions between ants and plants with extrafloral nectary, mediated by ant attraction to aphids for herbivore exclusion of plants.
Effects of forestry on the thermal habitat of Dolly Varden (Salvelinus malma)
Authors: KISHI Daisuke , MURAKAMI Masashi , NAKANO Shigeru , TANIGUCHI Yoshinori
Published: May 2004

Forestry activities in riparian areas are known to affect stream communities considerably. Not only do riparian deforestation resulting from agriculture or urbanization developments affect stream communities but extensive commercial plantation and forestry practices can alter stream environments adjacent to remaining, intact or secondary forests. Because forestry often includes the construction of logging roads through the riparian zone, this can directly degrade stream environments. Twelve streams in the Shiretoko Peninsula, Hokkaido were investigated so as to determine the effects of forestry practices on stream temperature, periphyton biomass, grazer (benthic invertebrates) biomass and Dolly Varden (Salvelinus malma Walbaum) biomass. The greater the proportion of planted area in the catchment, the higher the stream temperature. Stream temperature directly affects periphyton biomass and Dolly Varden biomass negatively. Neither stream temperature nor periphyton biomass predicted grazer biomass, whereas a positive correlation was found between grazer biomass and Dolly Varden biomass that forage on invertebrates. The overall results indicated that Dolly Varden in the Shiretoko streams were negatively affected by forestry practices and the resultant stream temperature increases. Without effective future riparian forest management, the complex effects of both riparian disturbance and ongoing global warming could further reduce Dolly Varden populations in the region.
Effects of sika deer on tree seedlings in a warm temperate forest on Yakushima Island, Japan
Authors: TSUJINO Riyou , YUMOTO Takakazu
Published: May 2004

High‐density herbivore species often play an important role in forest regeneration. Native sika deer (Cervus nippon yakushimae) inhabit a high density (51.5–63.8 head/km2, estimated by a pellet count method) area in the western part of a lowland natural forest on Yakushima Island, Japan. To test experimentally the impact of sika deer on the mortality and the survivability of current‐year seedlings, which are at a more vulnerable stage than the later stages, we constructed fenced exclosures, planted seeds of nine sapfruit tree species and compared the mortality and the survivability of current‐year seedlings between fenced and unfenced quadrats. Large seeded species had significantly greater survivability in fenced quadrats than in unfenced quadrats. However, the survivability disagreed with feeding preferences. Sika deer activity increased seedling mortality of large‐seeded species more than that of small‐seeded species, and did not decrease much seedling survivability of not‐preferred species. We found that the physical disturbance by the high density of sika deer resulted in mortality for both preferred and not‐preferred species, and that deer herbivory was important for preferred species.
Stand and self‐thinning dynamics in naturalAbiesstands in northern Hokkaido, Japan
Authors: SHIBUYA Masato , HAGA Norikuni , SASAKI Takehito , KIKUCHI Shun‐ichi , HARUKI Masahiro , NODA Masato , TAKAHASHI Kunihide , MATSUDA Kyo
Published: May 2004

Stand dynamics and self‐thinning were analyzed in relation to the dynamics of above‐ground biomass in naturalAbies sachalinensisstands growing on sand dunes in northern Hokkaido, Japan. This was done in order to examine wave‐type regeneration in the stands. Fifty‐two plots were established in almost pureAbiesstands that ranged from saplings to the mature and collapsing growth stages. Above‐ground biomass and tree height reached asymptotic levels prior to the collapsing phase, unlike wave‐regenerationAbiesstands in central Japan and North America. Stand density was high in the young growth stages, but the self‐thinning rate, that is, the density decrease per biomass growth in the study stands was greater than in wave‐regeneration stands in central Japan, as indicated by a large self‐thinning exponent (−1.26 by reduced major axis regression). The range of tree height distribution was very narrow, and the stands’ vertical structure was typically single‐layered. The slenderness ratio of trees was large, except in young stands. In mature and collapsing stands, advanced seedling density increased markedly. These stand and tree characteristics were considered to be correlated with the wave‐type regeneration in the study stands, and it is assumed that prevailing winds affect tree mortality.
Early post‐fire vegetation regeneration in Larix kaempferi artificial forests with an undergrowth of Sasa senanensis
Authors: GOTO Yoshiaki
Published: May 2004

Post‐fire vegetation regeneration was studied for a 6‐year period in a 13‐year‐old‐artificial forest consisting of Larix kaempferi with a dense undergrowth of Sasa senanensis. The study site was classified into three fire severity categories according to the degree of Sasa senanensis scorching, that is, a high‐severity category, a mid‐severity category, and a low‐severity category. Study plots were established in areas which fitted the criteria for each category, and in nearby unburned sites. A total of 41 woody species were newly emerged during the 6‐year study period in the burned and unburned plots. Only a few seedlings and resprouts emerged in the unburned plots, while many seedlings emerged in the high‐severity plots from the first year after fire onward. A high‐severity fire that burns the rhizomes of Sasa is necessary for the vegetation recovery by germination of seed. Whereas the establishment of seedlings was restricted to a few years after fire, the regeneration through resprouting continued into the last year of observation. The survival time of resprouts was longer than that of seedlings, and the survival time of shade‐tolerant species was longer than that of shade‐intolerant species. In contrast, shade‐intolerant species grew more rapidly than shade‐tolerant species. The plants’ ability to exceed the maximum height of the Sasa before the bamboo recovers can be critical to the survival of shade‐intolerant species. Because resprouts have a stronger resistance to the shade of Sasa than seedlings, the resprouts of shade‐tolerant species play a major role in the re‐establishment of woody species after fire in sites with considerable Sasa ground‐cover.
Differences in response to simulated herbivory between Quercus crispula and Quercus dentata
Authors: HATTORI Kouhei , ISHIDA Takahide A. , MIKI Kaori , SUZUKI Mayuko , KIMURA Masahito T.
Published: May 2004

To evaluate the responses of Quercus crispula and Quercus dentata to herbivory, their leaves were subjected to simulated herbivory in early spring and examined for the subsequent changes in leaf traits and attacks by chewing herbivores in mid summer. In Quercus crispula, nitrogen content per area was higher in artificially damaged leaves than in control leaves. This species is assumed to increase the photosynthetic rate per area by increasing nitrogen content per area to compensate leaf area loss. In Quercus dentata, nitrogen content per area did not differ between artificially damaged and control leaves, while nitrogen content per mass was slightly lower in artificially damaged leaves. The difference in their responses can be attributable to the difference in the architecture of their leaves and/or the severeness of herbivory. The development of leaf area from early spring to mid summer was larger in artificially damaged leaves than in control leaves in both species, suggesting the compensatory response to leaf area loss. Leaf dry mass per unit area was also larger in artificially damaged leaves in both species, but the adaptive significance of this change is not clear. In spite of such changes in leaf traits, no difference was detected in the degree of damage by chewing herbivores between artificially damaged and controlled leaves in both species.
Morphological and Physiological Acclimation Responses to Contrasting Light and Water Regimes in Primula sieboldii
Authors: NODA Hibiki , MURAOKA Hiroyuki , WASHITANI Izumi
Published: May 2004

The effects of the availability of light (high, medium and low) and soil water (wet and dry) on morphological and physiological traits responsible for whole plant carbon gain and ramet biomass accumulation were examined in a splitter‐type clonal herbaceous species Primula sieboldii, a spring plant inhabiting broad range of light environments including open grassland and oak forest understory. Growth experiments were conducted for three genets originated from natural microhabitats differing in light and soil water availability. Ramets of a genet from high light and wet microhabitat, which were grown in low light (relative photon flux density: R‐PPFD of 5%) showed 41% less light‐saturated photosynthetic rate, 50% less dark respiration rate and earlier defoliation than the ramets in high light (R‐PPFD of 61%). The estimation of daily photosynthesis revealed that the light acclimation response in leaf gas exchange contributes to efficient carbon gain of whole plants, irrespective of experimental light conditions. Water stress increased root weight ratio, decreased ramet leaf area, petiole length and photosynthetic capacity. These morphological effects of water stress were larger in high and medium light regimes than in low light regime. The consequence of the above responses was recognized in the relative growth rate of the ramets. The relative growth rate of the ramets in high light with wet regime was four‐fold of that in low light plus wet regime, and was 1.5‐fold of that in high light plus dry regime. However, even in low light and/or dry regimes, ramets kept positive relative growth rates and produced gemma successfully. We could not detect significant variation in growth responses among genets. The high photosynthetic plasticity revealed in the present study should enable Primula sieboldii to inhabit in a broad range of light and soil water availability.
Sprouting traits and population structure of co‐occurring Castanopsis species in an evergreen broad‐leaved forest in southern China
Authors: NANAMI Satoshi , KAWAGUCHI Hideyuki , TATENO Ryunosuke , LI Changhua , KATAGIRI Shigeo
Published: May 2004

The role of sprouting in regeneration was compared betweenfour co‐occurring Castanopsis species in an evergreen broad‐leavedforest in southern China. We considered the largest stem of an individualto be the main stem, while all of the other stems were consideredto be sprouts. To evaluate the degree of dependence on sproutingin the regeneration of each species, we measured the ratio of thenumber of all sprouts to the number of main stems in a population.The ratio was 4.3 in Castanopsis fordii and > 1in Castanopsis fabri and Castanopsis carlesii, althoughit was < 1 in Castanopsis fargesii. The ratioof the number of all sprouts to the number of main stems in a populationwas represented by the product of two factors of sprouting ability:the proportion of sprouting individuals among all individuals andthe number of sprouts per sprouting individual. The proportion ofsprouting individuals among all individuals differed significantlyamong the four species, while the number of sprouts per sproutingindividual did not. Specific variations in sprouting traits werein agreement with the population structure of each species. Specieswith fewer small individuals in the size distribution had a higherratio than species with L‐shaped distribution. Furthermore, specieswith a clumped distribution had a larger ratio than species thatwere randomly distributed. These results suggested that specieswhose recruitment by seedlings was temporally and spatially restrictedwere relatively more dependent on sprouting in the regeneration.The specific gradient of sprouting ability and the relative dependencyon sprouts to maintain a population can enhance the coexistenceof these four congeneric species.
Effects of scale‐dependent factors on herbaceous vegetation patterns in a wetland, northern Japan
Authors: TSUYUZAKI Shiro , HARAGUCHI Akira , KANDA Fusayuki
Published: May 2004

Herbaceous vegetation was examined in an Otanoshike wetland in northern Japan to clarify the relationships between vegetation patterns and environmental factors with different scales. Alders (Alnus japonica) have recently invaded and might modify the herbaceous vegetation. In total, 150 50 × 50 cm plots were established on the transitional areas between alder thickets and grassy marshland. Cover was measured for the vascular plant taxa, and canopy area, number of stumps, number of mounds, water depth, elevation difference, litter thickness, soil organic matter, and soil pH were measured in each plot. TWINSPAN cluster analysis classified four vegetation groups: (i), grasslands represented by Phragmites australis, Trientalis europaea, Lythrum salicaria, and Hosta rectifolia; (ii), Calamagrostis langsdorfii, and Polygonum thunbergii grasslands with Spiraea salicifolia; (iii), reed swamp dominated by Phragmites australis, and (iv), marshland dominated by Carex lyngbyei. Canonical correspondence analysis indicated that water depth primarily divided vegetation groups 1–2 and 3–4. Alder established in drier sites mostly by re‐sprouting, and the canopy affected light and soil conditions on the ground surface. The second axis of canonical correspondence analysis was related to the canopy area and soil pH, and explained the vegetation differentiation between groups 1 and 2, and groups 3 and 4. In conclusion therefore, scale‐dependent or hierarchical variables affected the vegetation patterns in different ways, that is, the herbaceous vegetation was first differentiated by water depth that was corresponding to alder establishment on a large scale, and subsequent light and soil conditions were second determinants on a small scale.
Temporal and spatial variation of forest biomass in relation to stand dynamics in a mature, lowland tropical rainforest, Malaysia
Authors: HOSHIZAKI Kazuhiko , NIIYAMA Kaoru , KIMURA Katsuhiko , YAMASHITA Tamon , BEKKU Yukiko , OKUDA Toshinori , QUAH Eng Seng , Noor Nur SUPARDI Md.
Published: May 2004

To clarify consistency in the size of carbon pool of a lowland tropical rainforest, we calculated changes in above‐ground biomass in the Pasoh Forest Reserve, Peninsular Malaysia. We estimated the total above‐ground biomass of a mature stand using tree census data obtained in a 6‐ha plot every 2 years from 1994 to 1998. The total above‐ground biomass decreased consistently from 1994 (431 Mg ha−1) to 1998 (403 Mg ha−1) (1 Mg = 103kg). These are much lower than that in 1973 for a 0.2 ha portion of the same area, suggesting that the the total above‐ground biomass reduction might have been consistent in recent decades. This trend contrasted with a major trend for neotropical forests. During 1994–1998, the forest gained 23.0 and 0.88 Mg ha−1of the total above‐ground biomass by tree growth and recruitment, respectively, and lost 51.9 Mg ha−1by mortality. Overall, the biomass decreased by 28.4 Mg ha−1(i.e. 7.10 Mg ha−1·year−1), which is almost equivalent to losing a 76‐cm‐diameter living tree per hectare per year. Analysis of positive and negative components of biomass change revealed that deaths of large trees dominated the total above‐ground biomass decrease. The forest biomass also varied spatially, with the total above‐ground biomass density ranging 212–655 Mg ha−1on a 0.2‐ha basis (n= 30 subplots, 1998) and 365–440 Mg ha−1on a 1 ha basis. A large decrease of the total above‐ground biomass density (> 50 Mg per ha per 2 years) in several 0.2‐ha subplots contributed to the overall decrease in the 6‐ha total above‐ground biomass. In the present study, we discuss the association between forest dynamics and biomass fluctuation, and the implication for carbon cycling in mature forests with emphasis on forest monitoring and assessments of soil and decomposition systems.
Early in‐hospital management of burn injuries in Australia
Authors: Wong Kenneth , Heath Timothy , Maitz Peter , Kennedy Peter
Published: May 2004

Background:  The accurate initial assessment and management of burn injuries influences subsequent clinical outcome. The purpose of the present study was to evaluate, over a 12‐year period (1989−2001), changes in the practices of referring hospitals in terms of early management of patients with burn injuries prior to transfer to a burns unit.

Methods:  The details of all consecutive patients over two separate 12‐month periods between June 1989 to May 1990 and between April 2000 and March 2001 who were transferred to the Burns Unit, Concord Repatriation General Hospital, Sydney, were prospectively recorded and retrospectively reviewed. In particular, the referral procedure, the accuracy of the referring hospital's assessment of burn size and initial fluid resuscitation were compared between the two time frames.

Results:  There were 51 patients in the initial 12‐month period and 57 patients in the latter 12‐month period. Regarding the transfer of the latter group of patients, the referring hospital liaised directly by telephone with the Burns Unit registrar or consultant significantly more often (77%vs 45%, respectively, P < 0.05). Similar proportions of patients in the two time periods received correct initial assessment of burn size (39% in the 1989−1990 group vs 42% in the 2000−2001 group, P = 0.76). The latter group of patients was significantly more likely to receive the correct choice of fluid for initial resuscitation at the referring hospital (98%vs 61%, respectively, P < 0.05).

Conclusions:  Over this 12‐year period, there has been marked improvement in referral practices and appropriate initial fluid resuscitation for patients with burn injuries. Referring hospitals’ assessment of burn size has not improved. Possible reasons for the observed changes include: increased postgraduate education programmes by the Royal Australasian College of Surgeons and the Australian and New Zealand Burns association; the formalization of emergency medicine training programmes by the Australasian College of Emergency Medicine and increasing awareness within the medical community of the presence of dedicated burns units.
Trends in the management of severe acute pancreatitis: interventions and outcome
Authors: Flint Richard , Windsor John , Bonham Martin
Published: May 2004

Background:  Severe acute pancreatitis (SAP) in the intensive care unit (ICU) is a complex and challenging problem. The aim of the present study was to identify trends in management of SAP patients admitted to a tertiary level ICU, and to relate these to changes in interventions and outcome.

Methods:  Patients admitted to the Department of Critical Care Medicine (DCCM), Auckland Public Hospital with SAP from 1988 to 2001 (inclusive) were identified from the DCCM prospective database, and data were extracted from several sources.

Results:  One hundred and twelve patients (men 69, women 43, mean age (±SD) 57.3 years ± 14.3) were admitted with SAP to DCCM in the 13‐year period. Aetiology was gallstones (42%), alcohol (29%), or idiopathic (29%). At admission to DCCM the median duration of symptoms was 7 days (range 1−100) and the mean (±SD) Acute Physiology and Chronic Health Evaluation II score was 19.9 ± 8.2. Ninety‐nine patients (88%) had respiratory failure and 79 (71%) had circulatory failure. The number of necrosectomies peaked between 1991 and 1995 (17/35 patients (49%) compared to 4/22 (18%) prior 1991; χ2 = 6.90, P = 0.032). Abdominal decompression, enteral nutrition, percutaneous tracheostomy, and the use of stents in endoscopic retrograde cholangiopancreatography were introduced over the study period. The length of stay in DCCM did not alter (median 4 days, range 1−60) but there was a reduction in the length of hospital stay (median 36 days to 15 days; anova= 6.16, P = 0.046). The overall mortality was 31% (35/112) and did not alter over the study period.

Conclusions:  SAP remains a formidable disease with a high mortality despite a number of changes in intensive care and surgical management.
Congenital coronary artery fistulas: clinical considerations and surgical treatment
Authors: Hong Gou‐Jieng , Lin Chih‐yuan , Lee Chung‐yi , Loh Shin‐Hurng , Yang Hou‐Sheng , Liu Kuang‐Yi , Tsai Yi‐Ting , Tsai Chien‐Sung
Published: May 2004

Background:  Coronary artery fistulas are uncommon abnormalities that can cause significant cardiac morbidity. Indications for operation vary, particularly, for asymptomatic patients. Early surgical correction is indicated because of the high incidence of late symptoms and complications.

Methods:  From January 1981 to December 2001, all 15 patients who underwent surgical management of congenital coronary artery fistulas at the Tri‐Service General Hospital, Taipei, Taiwan, China were included in the present retrospective study.

Results:  Twelve patients were symptomatic at the time of the diagnosis. Coronary artery fistulas involved the right coronary artery in five patients, left coronary artery in nine, and both the right and the left coronary arteries in one. Coronary artery fistula drained into the right ventricle in seven patients, right atrium in three, pulmonary artery in two, left ventricle in one, left atrium in two, and coronary venous sinus in one. The value of pulmonary blood flow/systemic blood flow ranged from 0.98 to 2.1. Six patients had associated cardiac anomalies. All patients received surgical correction. Nine patients received cardiopulmonary bypass during operation. There was zero operative mortality and operative morbidity was low. All patients had a stable condition and were asymptomatic during a mean postoperative follow‐up of 13.3 years.

Conclusions:  Early surgical treatment for coronary artery fistulas is safe and effective. The risk of operative correction appears to be considerably less than the potential for development of serious and potentially fatal complications, even in asymptomatic patients.
Unusual locations of hydatid disease and surgical approach
Authors: Hamamci Enver O. , Besim Hasan , Korkmaz Atila
Published: May 2004

Background:  Hydatid disease is an endemic parasitic disease of the Mediterranean countries. Although the liver is the most commonly involved organ, the disease can be seen anywhere in the body. In the present study, we present our experience with uncommonly located hydatid disease diagnosed and treated between 1983 and 1999 in the Sixth Surgical Department of Ankara Numune Training and Research Hospital, Ankara, Turkey.

Methods:  Forty‐nine patients with unusually located hydatid disease were retrospectively analysed. There were 21 men and 28 women in the present series. Of those, 26 patients were harbouring both hepatic and extrahepatic cysts, while 23 had only extrahepatic cysts. Peritoneal cavity, spleen, retroperitoneum, thyroid gland, anterior abdominal wall, thigh, kidney, presacral space and pancreas were the organs or tissues involved in the cases. Spleen and peritoneal cavity were the two most frequent locations in the present series.

Results:  Partial or total cystectomy with or without tube drainage or omentopexy was the operation of choice for hydatid cyst of the peritoneal cavity. Splenectomy was performed for splenic hydatidosis. Mean postoperative stay was 7 days (4−23). Three diaphragmatic and one inferior vena cava lacerations occurred during operations that were repaired successfully in the same sessions. No mortality occurred in the present series.

Conclusion:  Hydatid disease can affect any organ or area throughout the body and suspicion of this disease should be justified in patients presenting with a cystic mass in endemic areas.
Minimal access thyroid surgery: technique and report of the first 25 cases
Authors: Gosnell Jessica E. , Sackett Wendy R. , Sidhu Stan , Sywak Mark , Reeve Tom S. , Delbridge Leigh W.
Published: May 2004

Background:  Minimal access thyroid surgery, using various techniques, is increasingly being reported. The present study reviews our experience with thyroid surgery using a lateral focused mini‐incision approach, and assesses its safety and feasibility.

Methods:  The study group comprised all patients undergoing minimal access thyroid surgery (MATS) during the period May 2002−May 2003. Data were prospectively gathered, including patient demographics, indication for surgery, operation performed, nodule size, final pathology, and complications. Exclusion criteria for this procedure included: family history of thyroid cancer, previous neck irradiation or surgery, carcinoma on fine needle aspiration, presence of significant thyroiditis, multinodular goitre, and nodule size >3 cm. The operation was carried out through a 2.5‐cm lateral incision placed directly over the nodule, with exposure gained by dissecting the plane between the sternomastoid muscle and the lateral edge of the strap muscles.

Results:  Twenty‐five patients underwent MATS, 22 women and three men. Nineteen patients underwent hemithyroidectomy, five underwent isthmectomy, and one underwent local nodule excision. The average measured incision size was 2.63 cm at the end of the procedure. The average nodule size was 2.2 cm, and the average thyroid lobe resected measured 4.7 cm in maximal length. Final pathology revealed benign nodules in 21 patients and four thyroid cancers (two follicular and two papillary). There was one wound infection and two patients had temporary recurrent laryngeal nerve neuropraxia.

Conclusion:  Minimal access thyroid surgery is a safe and feasible alternative to open thyroid surgery in selected cases.
An in‐vivo paradigm for the evaluation of stimulating electrodes for use with a visual prosthesis
Authors: Chowdhury Vivek , Morley John W. , Coroneo Minas T.
Published: May 2004

Background:  Electrical stimulation of the visual cortex with surface electrodes is able to elicit basic visual perceptions in blind patients. The development of a visual prosthesis for the blind will require an in‐vivo model for the optimization of cortical neurostimulation with multielectrode arrays.

Methods:  In anaesthetized cats a bilateral craniotomy was performed and the dura was removed to expose the cerebral cortex. A prototype stimulating electrode array was placed on a gyrus in one hemisphere, and the transcallosal evoked response (TER) to cortical stimulation by this electrode array was recorded at a homologueous region in the contralateral hemisphere.

Results:  The stimulating electrode array elicited TER of short latency (6.9 ms) in the contralateral hemisphere. Bipolar stimulation of adjacent electrodes on the array evoked similar TER regardless of the polarity of stimulation. Electrodes spread apart on the array caused higher amplitude TER than electrodes placed close together. Multielectrode stimulation evoked lower amplitude TER than bipolar stimulation.

Conclusions:  This transcallosal model of cortical neurostimulation is a useful method to evaluate electrode arrays and stimulation techniques in the development of a visual prosthesis.
Evaluation of level 1 care facilities for vascular patients
Authors: Norwood Michael G. A. , Bown Matthew J. , Bell Peter R. F. , Spiers Paul , Leslie Apsara , Sayers Robert D.
Published: May 2004

Background:  A surgical acute care unit (SACU) was established within our hospital to specifically provide level 1 care to surgical patients. We assess the impact that this has had on outcome in vascular patients.

Methods:  All patients undergoing carotid endarterectomy (CEA) and elective abdominal aortic aneurysm repair (AAA) during the first year of SACU were included in the present study. A control group was compiled from patients undergoing the same two procedures in the year preceding the opening of the SACU. Data were collected on admission time, time spent in critical care, outcome and operative cancellations.

Results:  During the first year of the SACU there were 28 CEA and 42 AAA repairs performed. In the control group there were 18 CEA and 34 AAA repairs performed. There were no significant differences in death rate or length of hospital stay between the two groups for either AAA repair or CEA. CEA patients in the study group had a significantly reduced level 2 stay (P < 0.001 Mann−Whitney U‐test), with 71% of patients being admitted directly to the level 1 facility from theatre. There were less CEA cancelled because of critical care bed shortages among the cases (n = 0) compared to the control group (n = 2), although this did not reach statistical significance (P = 0.15 Fisher's exact test).

Conclusions:  Designated level 1 care has reduced the need for the postoperative admission of CEA patients to level 2 care facilities. It has had no discernible impact on admission time or mortality, but might reduce the number of cancelled operations caused by a lack of level 2 beds.
Early oral feeding after colorectal resection: a randomized controlled study
Authors: Feo Carlo V. , Romanini Barbara , Sortini Davide , Ragazzi Riccardo , Zamboni Paolo , Pansini Gian C. , Liboni Alberto
Published: May 2004

Background:  Nasogastric (NG) intubation is widely used following elective abdominal operations although it is associated with morbidity and discomfort. The present study is a randomised controlled trial on the effect of early oral feeding without NG decompression following elective colorectal resection for cancer.

Methods:  One hundred patients were randomized to group A (NG catheter and fasting until passage of flatus, followed by liquid diet advanced to soft‐solid) or group B (no NG tube, clear liquids the day after surgery, followed by soft‐solid food). The endpoints were: (i) morbidity; (ii) resumption of intestinal function; (iii) length of hospital stay; and (iv) patients’ well being evaluated by short‐form health survey [36 items] (SF‐36).

Results:  Twelve complications occurred in group A (50 patients) and 13 in group B (50 patients) (P = NS). Seven patients developed vomiting in group A as compared to 16 in group B (P < 0.05). Twenty per cent of patients required NG decompression in group B hence 80% did not need NG tubes. Resumption of intestinal function occurred after 4 days, and length of hospital stay was 7 days in both groups. No significant difference was detected between groups (P = NS) in the SF‐36 score change before and after the operation.

Conclusion:  Patients undergoing elective colorectal resection can be managed without postoperative NG catheters, starting oral feeding on the first postoperative day. Albeit, no reduction in postoperative hospital stay or patients’ well being could be detected, abolition of postoperative NG intubation with early oral feeding was a safe approach, with only 20% of patients requiring NG decompression because of repeated episodes of vomiting.
Sentinel node biopsy in breast cancer and melanoma requires adequate self‐audit
Authors: Spillane Andrew
Published: May 2004

Background:  Sentinel node biopsy (SNB) is an evolving technique with potential for improving staging. Melanoma and breast cancer are the two most commonly used applications. The present study relates the author's validation data in both diseases.

Methods:  Review of a prospective database.

Results:  Between January 2000 and December 2001 92 cases of breast cancer were offered SNB. The first 48 had completion axillary dissection. The identification rate was 92%. There were 28 true negative, 15 true positive and one false negative case. A mean of 2.0 nodes were removed (range 1−4). Completion axillary dissection removed a mean of 15.1 nodes. The following 44 cases were offered a choice of SNB alone, axillary dissection or a combination of techniques. Thirty‐seven women chose SNB alone. There was one technical failure, 28 negative SNB and eight positive SNB results. A mean of 3.1 lymph nodes were removed (range 1−9) applying a 10% rule. At 24−36 months follow up there have been no cases of locoregional recurrence.

From January to December 2001 36 cases of melanoma ≥1 mm were managed with SNB. Twenty‐eight SNB were negative and eight were positive (22%). At follow up (range 12−24 months) there were three locoregional recurrences, but only one of these were in the node basin determined to be previously negative by SNB (3.5%).

Discussion:  Sentinel node biopsy in breast cancer is a valid alternative to full axillary dissection for staging the axilla. Patients can make an informed choice to have SNB alone if they understand the limitations of the technique and possible consequences of these limitations. In melanoma SNB provides valuable prognostic information most melanoma patients prefer to have. Adequate self‐audit is necessary before a patient can make an informed decision to have SNB in either disease.
Single surgeon experience with bilayer polypropelene mesh repair of inguinal hernia
Authors: Yew Ming Khoon , Steinberg David
Published: May 2004

Background:  Open mesh repair of inguinal hernia has been shown to be an effective and safe method of hernia repair. In search of the ‘ideal’ method of open mesh hernia repair, many different methods of mesh placement have been developed. Laparoscopic hernia repair is reported to be superior to open repair in terms of postoperative pain and rehabilitation. These improved functional outcomes could be the result of placement of mesh in the preperitoneal space (underlay), rather than the laparoscopic method per se. A bilayer polypropylene mesh implant has been developed that provides onlay and underlay (preperitoneal) mesh layers. The present study reports the singular experience of a general surgeon with this bilayer polypropylene mesh implant.

Methods:  A retrospective audit of the first 169 consecutive inguinal hernia repairs was conducted by mailed questionnaire and telephone interview. Data was collected on patient demographics, postoperative pain scores and complications. Patients with potential recurrences at the time of follow up were invited for clinical review.

Results:  One hundred and three patients (71%) participated in the audit. Thirteen per cent of cases were for recurrent hernia. Median age was 60 years (range 21−99). Median length of follow up was 19 months (range 8−27). No recurrences were detected in the patients who underwent primary repair of inguinal hernia.

Conclusion:  Inguinal hernia repair with bilayer polypropylene mesh is safe and has low complication and recurrence rates.
Do elective surgery patients use the internet to look for information about their condition?
Authors: Proude Elizabeth M. , Shourie Swati , Conigrave Katherine M. , Wutzke Sonia E. , Ward Jeanette E. , Haber Paul S.
Published: May 2004

Background:  As 54% of Australians have access to the internet, it might be expected that people scheduled for surgery would look for information on it. No reported Australian studies have quantified internet use by patients before surgery.

Methods:  Patients scheduled for elective surgery in two Sydney teaching hospitals were asked to complete self‐administered questionnaires while waiting in preadmission clinics. Detail on sources of information consulted about their condition was requested. A small sample was asked about the sites visited and the self‐reported usefulness of the information found.

Results:  Ten per cent (95% CI: 8.5−11.5) of 1571 patients who participated had searched the internet for information relating to their condition. Logistic regression showed that these patients were significantly more likely to be younger than 60 years (P < 0.001; OR: 3.28; CI: 1.99−5.4), to be employed (P < 0.001; OR: 2.27; CI: 1.52−3.4), and to have a higher level of education (P = 0.001; OR: 1.9; CI: 1.28−2.83). Patients of Hospital 1 were significantly more likely to access the internet for information on their condition than those at Hospital 2 (P = 0.002; OR: 1.85; CI: 1.28−2.7). The most nominated sources of information were friends and relatives (20%) and books or magazines (15%).

Conclusion:  In contrast to anecdote, use of the internet to access information prior to elective surgery appears low. Its absolute use compared with other sources of information is also low. More traditional forms of communication appear to still pay an important role in this setting.
Accuracy of mandatory surgeon recording of unplanned return to theatre
Authors: De La Costa Ricaredo , Muir Fiona , Harris Ian
Published: May 2004

Background:  Unplanned return to theatre (URTT) is a common performance indicator in surgery. The aim of this study is to determine the accuracy of recording URTT in orthopaedic surgery, and whether it is improved when recorded by the operating surgeon.

Methods:  All orthopaedic URTT at St. George Hospital (Kogarah, Australia), as recorded by nursing staff, from 1 January 2001 to 31 December 2001 were reviewed. The results were compared to a similar review for the period from 1 June 2002 to 31 May 2003, when data was entered by the operating surgeon.

Results:  In 2001, the true URTT rate was 68 out of a total of 2250 cases. Only 39 of these were recorded as URTT (sensitivity = 57%). Of the 2182 remaining cases, 34 were incorrectly reported as URTT (specificity = 98.4%). In the period June 2002−May 2003, the true URTT rate was 25 out of 2119 cases. Of these, 22 were correctly recorded (sensitivity = 88%). Of the 2094 remaining cases, 16 were incorrectly recorded as URTT (specificity = 99.2%). The differences in sensitivity and specificity between the two periods were statistically significant.

Conclusions:  Unplanned return to theatre cases need to be reviewed individually to assess clinical significance. Mandatory surgeon reporting significantly increases the accuracy of data.
Morbidity associated with axillary surgery for breast cancer
Authors: Taylor Kim O.
Published: May 2004

Aim:  To determine the prevalence of long‐term complications of axillary surgery for breast cancer and whether preservation of the intercostobrachial nerve (ICBN) reduces this morbidity.

Methods:  A self‐administered questionnaire was mailed to all patients who had undergone breast cancer and axillary surgery 2.5−6 years previously. The questions addressed symptoms of arm pain, numbness, weakness, stiffness and swelling. The operation notes were reviewed to ascertain the type and extent of surgery and whether the ICBN was preserved or sacrificed.

Results:  One hundred and seventy of 208 (82%) questionnaires were returned completed. At least one symptom was reported by 130 (76.5%) of patients. Numbness was the most common symptom, present in 60% overall. Patients who had had the ICBN preserved reported significantly less numbness (37.5%vs 71.7% (P < 0.001)). Pain was present in 45.3% of patients and those with the ICBN preserved had significantly less pain (31.3%vs 58.5% (P = 0.02)). Weakness was present in 40%. Swelling was reported in 26.4% and stiffness in 12.2%.

Conclusion:  Axillary lymph node dissection for breast cancer has a high long‐term morbidity. Preservation of the ICBN during the axillary procedure significantly reduces this morbidity.