bluuebunny/crossref_metadata_2025 huggingface dataset:
Multiple sugar: phosphotransferase system permeases participate in catabolite modification of gene expression in Streptococcus mutans
Authors: Zeng Lin , Burne Robert A.
Published: August 2008

Streptococcus mutans is particularly well adapted for high‐affinity, high‐capacity catabolism of multiple carbohydrate sources. S. mutansenzyme II (EIILev), a fructose/mannose permease encoded by the levDEFG genes, and fruA, which encodes a hydrolase that releases fructose from fructan polymers, are transcriptionally regulated by the LevQRST four‐component signal transduction system. Here, we demonstrate that: (i) levDEFGX are co‐transcribed and the levE/F intergenic region is required for optimal expression of levFGX; (ii) D‐mannose is a potent inducer of the levD and fruA operons; (iii) CcpA regulates levD expression in a carbohydrate‐specific manner; (iv) deletion of the genes for the fructose/mannose‐EII enzymes of S. mutans (manL, fruI and levD) enhances levD expression; (v) repression of the LevQRST regulon by EII enzymes depends on the presence of their substrates and requires LevR, but not LevQST; and (vi) CcpA inhibits expression of the manL and fruI genes to indirectly control the LevQRST regulon. Further, the manL, ccpA, fruI/fruCD and levD gene products differentially exert control over the cellobiose and lactose operons. Collectively, the results reveal the existence of a global regulatory network in S. mutans that governs the utilization of non‐preferred carbohydrates in response to the availability and source of multiple preferred carbohydrates.
A degree‐day simulation model for the population dynamics of the rice bug, Leptocorisa acuta (Thunb.)
Authors: Reji G. , Chander S.
Published: August 2008

The rice bug, Leptocorisa acuta (Thunb.) is a major pest of the rice crop in India. A computer simulation model of the bug's population dynamics was formulated using the information generated on the thermal requirements of development stages. It is a mechanistic model which follows the state variable–rate variable approach. The model works based on the accumulation of heat units over stage‐specific thresholds of development. Validation using light trap catches has shown that the model has satisfactory predictive value. Simulated population dynamics over the years were compared and the influence of global warming on bug population dynamics was predicted. The model can forecast the pest population in the field and help in timely adoption of management practices.
Influence of temperature on life‐table parameters ofStethorus gilvifrons(Mulsant) (Coleoptera: Coccinellidae) fed onTetranychus urticaeKoch
Authors: Taghizadeh R. , Fathipour Y. , Kamali K.
Published: August 2008

The influence of temperature on life‐table parameters, fecundity and survivorship of the predatory ladybird,Stethorus gilvifrons, fed onTetranychus urticaewas determined at seven constant temperatures of 15°C, 20°C, 25°C, 28°C, 30°C, 35°C and 40°C. No development was observed at 40°C, thus being regarded as the threshold for the development ofS. gilvifrons. The results indicate a significant decrease in male and female longevity with increasing temperature from 15°C to 35°C. The longest and shortest longevity were 18.40 and 12.75 days for males and 17.40 and 8.80 days for females, respectively. The intrinsic rate of natural increase (rm) and the net reproductive rate (R0) ofS. gilvifronslinearly increased with increasing temperatures from 15°C to 35°C, while the mean generation time (T) and doubling time (DT) decreased linearly within this temperature range. The highest values ofrm(0.240 females/female/day) andR0(59.27 females/female) and the lowest mean generation time (17.01 days) and DT (2.88 days) were recorded at 35°C. The maximum (185.50 eggs) and minimum (25.50 eggs) measurement of total fecundity was also recorded at 35°C and 15°C, respectively. The results indicate that temperature greatly affected fecundity, survivorship and life‐table parameters ofS. gilvifrons, and that 35°C is a suitable temperature for population growth of this predator.
Kairomonal responses of Tomicus destruens (Col., Scolytidae) to host volatiles α‐pinene and ethanol
Authors: Gallego D. , Galián J. , Diez J. J. , Pajares J. A.
Published: August 2008

The Mediterranean pine shoot beetle Tomicus destruens is one of the most damaging bark beetles attacking Mediterranean pine forests in southern Europe and north Africa. We studied the attractiveness of the host volatiles α‐pinene and ethanol at a range of release rates, alone or in combination, to T. destruens, in order to develop an attractive lure for the management of this beetle. T. destruens was attracted slightly to the host volatile α‐pinene, but a strong synergistic effect was found in the attraction towards monoterpene when ethanol was added to the bait. The highest catches of T. destruens were obtained by the optimal blend releasing 300 mg/day of α‐pinene and 900 mg/day of ethanol. In contrast to data reported for the related species T. piniperda, Mediterranean pine shoot beetles were clearly attracted to baits releasing ethanol alone (1350 mg/day). trans‐Verbenol, which was also added to host volatiles in some tests, did not affect the response. The use of the attractive blend proposed would have a low impact on the natural enemy population of Thanasimus formicarius because of asynchronies in flight periods. Other non‐target insects, such as the facultative predator or competitor Oxipleurus nodieri, were also significantly attracted. These results allow the development of an operative lure for the effective monitoring of T. destruens, although improvements by the addition of other host volatiles should be studied.
Small‐scale dispersal of the European corn borer and its relevance for resistance management in Bt maize
Authors: Engels H. , Sinha A. , Schuphan I. , Eber S.
Published: August 2008

The small‐scale dispersal of the European corn borer (ECB) was studied in a release–recapture experiment using reared dye‐marked adults. Thereby, six light trap cages were set up across two maize fields at 50‐m intervals. In total, 736 marked ECBs were released, of which 10.2% were recaptured together with 212 unmarked naturally occurring adults after a period of 48 h. All marked–released individuals left the release point, with a mean dispersal distance of 195 m. Eighty‐two per cent of the recaptured ECBs moved to the second maize field across a ditch and associated shrubs. The spatial and temporal patterns of incidence of naturally occurring ECBs in the traps were consistent with those of the marked moths and showed an inhomogeneous distribution. There was a highly significant relationship between male and female densities in the cages. No ECBs were caught during a period of adverse weather conditions. Dispersal distances may be influenced by plant size, weather conditions during the flight, pheromonal patterns in the field and the timing of the flight.
Fitness‐related traits in a parasitoid fly are mediated by effects of plants on its host
Authors: Caron V. , Myers J. H. , Gillespie D. R.
Published: August 2008

Plants can affect parasitoids directly, by reducing or enhancing their ability to locate hosts, or indirectly by affecting the fitness of herbivores and thus of parasitoids. Tritrophic interactions between three host plants (cucumber, tomato, sweet pepper), a polyphagous herbivore Trichoplusia ni and a generalist parasitoid Compsilura concinnata were assessed. Plants had a strong effect on T. ni larval survival, as well as on C. concinnata fitness‐related traits: cucumber‐fed hosts yielded parasitoids with shorter larval development time and females had heavier pupal weights than parasitoids from host larvae that were fed tomato. Furthermore, C. concinnata was more efficient at finding cucumber‐fed than tomato‐fed T. ni. These results suggest that C. concinnata has different efficiency and potential as a biocontrol agent on the different crops. This highlights the importance of assessing tritrophic interactions in systems where an inundative biological control agent may be released against generalist targets on more than one crop plant.
Novel visual‐cue‐based sticky traps for monitoring of emerald ash borers,Agrilus planipennis(Col., Buprestidae)
Authors: Lelito J. P. , Fraser I. , Mastro V. C. , Tumlinson J. H. , Baker T. C.
Published: August 2008

We examined various methods of trapping emerald ash borers (EAB),Agrilus planipennisFairmaire, using solely visual cues based on previous work that has documented the importance of visual cues in EAB mate location. Here, we give the results of two of these methods, coloured sticky cards (yellow or blue), or live ash leaves covered with spray‐on adhesive to which dead male EAB visual lures had been pinned. Feral male beetles were captured effectively on the sticky traps made from dead male EAB on ash leaves. These sticky‐leaf‐traps captured more male EAB when deployed in high‐population density areas than low‐density areas, but did capture EAB even at lower population densities. More feral males were captured on these traps when they were placed higher in the trees, regardless of the population density of EAB. Very few feral female EAB were captured using the sticky‐leaf‐traps. This novel method of EAB trapping may allow ‘real‐time’ population detection and monitoring of EAB adults during the active flight period rather than locating larval galleries during the autumn and winter after adult flight and attack. Feral male beetles were also captured using standard yellow‐ or blue‐coloured sticky cards to which male EAB had been affixed with adhesive; however, this type of trap was much less effective overall than using the sticky‐leaf‐traps. Furthermore,Agrilus cyanescens, a species similar in colour to EAB but smaller in size, showed a strong response to blue‐coloured sticky traps to which dead male EAB had been affixed with adhesive, suggesting a general use of visual cues in the mating systems of some of the other Buprestidae as well.
Ontogenetic and gender‐modulated behavioural rhythms in the deep‐water decapods Liocarcinus depurator (Brachyura: Portunidae), Munida tenuimana and Munida intermedia (Anomura: Galatheidae)
Authors: Aguzzi Jacopo , Company Joan Baptista , García José Antonio
Published: August 2008

The regulation and expression of biological rhythms with respect to sex and ontogeny in deep‐water benthic decapod crustaceans constitutes an exciting field in marine biology that is far from understood. Liocarcinus depurator, Munida intermedia and Munida tenuimana are ecologically key crustacean decapod species of the Atlantic and Mediterranean shelves and slopes, and their activity rhythms in the field are poorly known. Our aim was to measure the behavioural rhythms of these species, while at the same time defining their type of displacement (i.e. endobenthic, nektobenthic or benthopelagic). Whether gender and ontogeny modulate the rhythmic behaviour of these decapods is unknown, and we sought to clarify this issue. A temporally scheduled series of trawl hauls and light intensity measures was performed on the western Mediterranean shelf (100–110 m depth) and slope (400–430 m), close to the autumn equinox and the summer solstice. The sex and the size of animals in the catches were analysed. Catch patterns were evaluated through waveform and periodogram analyses. Liocarcinus depurator was captured at night on the shelf, whereas on the slope, animals displayed peaks both in the middle of the day and night. Size‐related differences (but no gender differences) were found in its rhythmic behaviour, possibly due to intra‐specific competition (e.g. fighting) between juveniles and adults. Munida intermedia were weakly diurnal in October and both diurnal and nocturnal in June. Munida tenuimana presented no discernible rhythmicity in October, but was nocturnal in June. Both species showed no evident sex or size modulation of their behaviour. Data were interpreted assuming that all tested species present an endobenthic behaviour (i.e. animals emerge from the substrate during the active phase of their behavioural cycle).
Distribution patterns of interstitial polychaetes in sandy beaches of southern Brazil
Authors: Di Domenico Maikon , Da Cunha Lana Paulo , Garraffoni André R. S.
Published: August 2008

This study describes the distribution patterns of interstitial polychaetes along morphodynamic gradients on six exposed sandy beaches in Santa Catarina and Paraná (South Brazil). Three random transects were sampled at two points on each beach, one at the swash and another at the surf zone, in winter and summer conditions. Six sediment replicates were collected at each sampling point using a corer of 4.6 cm internal diameter that removed 10 cm into the sediment. Abundance and composition of interstitial polychaete were correlated to wave height, slope, grain size, CaCO3, chlorophyll a, omega indexes, temperature and relative tide range using a canonical correspondence analysis (CCA). A factorial ANOVA showed that taxa richness, mean density and Shannon’s diversity were significantly higher at the reflective beaches, but average values differ significantly between transects and these differences change according to the beach zones on both sampling dates. PERMANOVA showed that polychaete associations differ among transects according to the beach zones. The composition of interstitial polychaete associations was significantly correlated to beach morphodynamics and features (P < 0.01). Polychaete associations of reflective beaches were more diverse than in other morphodynamic states. Intermediate beaches may also sustain diverse associations due to temporal variability of the morphodynamic patterns. Beaches presenting extreme dissipative morphodynamics and compacted sediments appear to be unfavourable for the occurrence of interstitial polychaetes.
Peritoneal dialysis in pregnancy: A case series
Authors: JEFFERYS ANDREW , WYBURN KATE , CHOW JOSEPHINE , CLELAND BRUCE , HENNESSY ANNEMARIE
Published: August 2008

SUMMARY:  Patients with significant renal impairment have difficulties maintaining a viable pregnancy due to maternal and fetal complications. Both peritoneal dialysis and hemodialysis support throughout pregnancy has been reported to assist in these pregnancies. We report our experience with the use of peritoneal dialysis in five cases leading to successful deliveries with minimal complications.
Murine renal ischaemia‐reperfusion injury (Methods in Renal Research Paper)
Authors: KENNEDY SEAN E , ERLICH JONATHAN H
Published: August 2008

SUMMARY:  Ischaemia/reperfusion is a major cause of acute kidney injury in native and transplant kidneys and is associated with significant morbidity and mortality. Murine models of renal ischaemia/reperfusion injury have great potential to improve understanding of the underlying processes and are an important focus of ongoing research into therapeutic and preventative strategies. Like all experimental models, murine models of renal ischaemia/reperfusion are prone to significant variability and results may be influenced by a number of technical and design factors. In this article we review the factors that may influence experimental results and provide a guide to conducting reproducible experiments in murine renal ischaemia/reperfusion.
Lymphomatoid granulomatosis mimicking interstitial lung disease
Authors: BRAHAM Emna , AYADI‐KADDOUR Aïda , SMATI Belhassen , BEN MRAD Sonia , BESBES Mohammed , EL MEZNI Faouzi
Published: August 2008

Lymphoid granulomatosis is a rare form of pulmonary angiitis. This case report presents a patient with lymphoid granulomatosis in whom the clinical presentation, radiological features and the partial response to corticosteroid therapy mimicked interstitial lung disease. Lymphoid granulomatosis was only diagnosed at post‐mortem examination. The range of reported clinical presentations, diagnostic approaches and outcomes are described.
Lung cyst: An unusual manifestation of Niemann–Pick disease
Authors: BALDI Bruno G. , SANTANA Alfredo N.C. , TAKAGAKI Teresa Y. , FUJITA Carmem , KAIRALLA Ronaldo A. , CARVALHO Carlos R.R.
Published: August 2008

Abstract:  Niemann–Pick disease is a rare inherited autosomal recessive disorder, currently classified into six subtypes and characterized by the intracellular accumulation of sphingomyelin in the liver, spleen, lungs, bone marrow or brain. The main pulmonary abnormalities described in high‐resolution computed tomography (HRCT) of the chest consist of thickening of the interlobular septa and ground‐glass opacities. This case report describes a patient with subtype B Niemann–Pick disease characterized by cysts and ground‐glass opacities that were detected on HRCT of the chest.
Impaired spermatogenesis by testicular sarcoidosis
Authors: TAKIGUCHI Yuichi , MATSUNO Daisuke , KUROSU Katsushi , OKADA Osamu , TATSUMI Koichiro , OHTA Sho , ICHIKAWA Tomohiko , KURIYAMA Takayuki
Published: August 2008

Testicular involvement by sarcoidosis is a rare condition. A 23‐year‐old Japanese man had asymptomatic bilateral testicular lesions, which were detected by gallium scintigram, together with lesions located bilaterally in the uvea, lungs and hilar, and mediastinal lymph nodes and unilateral supraclavicular lymph nodes. Semen analysis demonstrated severely impaired spermatogenesis. Treatment with corticosteroid dramatically improved these lesions and restored spermatogenesis. This case report suggests that testicular sarcoidosis may cause male infertility.
Obesity in aspirin‐tolerant and aspirin‐intolerant asthmatics
Authors: JANG An‐Soo , PARK Jong‐Sook , PARK Sung‐Woo , KIM Do‐Jin , UH Soo‐Taek , SEO Ki‐Hyun , KIM Yong Hoon , PARK Hae‐Sim , PARK Choon‐Sik
Published: August 2008

Background and objective:  Obesity is an important factor in the development of asthma. Aspirin hypersensitivity affects 5–10% of asthmatics. The association between obesity and aspirin hypersensitivity in asthma is unclear. This study evaluated the association of BMI and asthma in patients with aspirin‐tolerant asthma (ATA) and aspirin‐intolerant asthma (AIA).

Methods:  Aspirin provocation tests were performed in 667 asthmatic patients and changes in FEV1 were used to categorize patients as ATA or AIA. The BMI of asthmatics was graded using the percentile BMI of 406 normal controls.

Results:  Aspirin‐induced changes in FEV1% ranged from 15% to 68%. Compared with the controls, the ATA group had a higher BMI (24.5 ± 0.1 vs 23.8 ± 0.2 kg/m2, P = 0.001). The AIA group had a lower BMI. The aspirin‐induced percentage fall in FEV1 was inversely correlated with BMI in asthmatic patients (r = −0.094, P = 0.016). BMI was correlated with age and PC20, but not with FEV1 in asthmatic patients. In a logistic regression adjusted for age, gender, and smoking status, FEV1 and PC20 were associated with AIA with odds ratios of 0.986 and 0.586, respectively. BMI was associated with AIA with an odds ratio of 0.916.

Conclusions:  Aspirin intolerance in asthmatics explains the lesser association with obesity. Obesity is not a risk factor in the development of asthma in patients with AIA.
Altered expression of antimicrobial molecules in cigarette smoke‐exposed emphysematous mice lungs
Authors: SHIBATA Yoko , ABE Shuichi , INOUE Sumito , TAKABATAKE Noriaki , IGARASHI Akira , TAKEISHI Yasuchika , SATA Makoto , KUBOTA Isao
Published: August 2008

Background and objective:  The natural history of COPD, a disease usually caused by cigarette smoking, is associated with frequent respiratory infections. Consistent with human COPD, bacterial clearance in the lungs has been reported to be impaired in mice exposed to cigarette smoke. In the airways, several antimicrobial molecules such as surfactant proteins (SP), beta‐defensins (BD), secretory leucocyte protease inhibitor (SLPI) and lysozyme play important roles in the defence against invading pathogens. This study evaluated the expression of antimicrobial molecules in mice lungs with cigarette smoke‐induced emphysematous changes.

Methods:  Six B6C3F1 mice were exposed to cigarette smoke (2 cigarettes/day/mouse for 6 months) or room air. Gene expression within the lungs of mice in both groups was assessed by RT‐PCR.

Results:  The expression of SP‐A, BD2, BD3 and SLPI was significantly elevated in the lungs of cigarette smoke‐exposed mice compared with air‐exposed mice. BD1 expression decreased in the smoke‐exposed mice and lysozyme expression was unchanged.

Conclusions:  Chronic cigarette smoke exposure did not suppress the expression of antimicrobial molecules in the lung. Altered expression of antimicrobial molecules in this mouse model does not explain the impaired host defence against respiratory microbes seen in patients with COPD.
Enhanced levels of prostaglandin E2 and matrix metalloproteinase‐2 correlate with the severity of airflow limitation in stable COPD
Authors: CHEN Yan , CHEN Ping , HANAOKA Masayuki , DROMA Yunden , KUBO Keishi
Published: August 2008

Background and objective:  Cyclooxygenase‐2 (COX‐2) and its product prostaglandin E2 (PGE2) have been demonstrated to play critical roles in inflammation in respiratory diseases. However, the role of COX‐2 in airway remodelling in COPD remains to be elucidated. Matrix metalloproteinase‐2 (MMP‐2) is associated with both inflammation and airway remodelling in COPD. The objective of this study was to measure the expression of COX‐2 and the concentrations of PGE2 and MMP‐2, and to investigate the role of COX‐2 and PGE2 in airflow limitation mediated by MMP‐2, in the pathogenesis of COPD.

Methods:  Forty‐three patients with stable COPD, twelve smoking control subjects and ten non‐smoking control subjects were enrolled. Induced sputum was obtained for measurement of the concentrations of PGE2 and MMP‐2 by ELISA. COX‐2 protein expression was assessed by western blotting.

Results:  PGE2 and MMP‐2 concentrations were significantly higher in both smoking control subjects and patients with COPD than in non‐smoking control subjects (P < 0.01). Moreover, the levels of PGE2 and MMP‐2 were inversely correlated with FEV1% predicted in COPD patients (PGE2: r = −0.748, P < 0.01; MMP‐2: r = −0.801, P < 0.01). Levels of PGE2 were also positively correlated with those of MMP‐2 in patients with COPD (r = 0.775, P < 0.01). Expression of COX‐2 protein was significantly higher in COPD patients than in non‐smoking control subjects.

Conclusions:  COX‐2 and its product PGE2 are not only involved in airway inflammation, but may also contribute to the severity of airflow limitation mediated by MMP‐2 during progression of COPD.
Obstructive sleep apnoea and nocturnal gastroesophageal reflux are common in lung transplant patients
Authors: SHEPHERD Kelly L. , CHAMBERS Daniel C. , GABBAY Eli , HILLMAN David R. , EASTWOOD Peter R.
Published: August 2008

Background and objective:  Gastroesophageal reflux (GOR) has been implicated in the pathogenesis of bronchiolitis obliterans syndrome (BOS), possibly due to pulmonary aspiration of refluxed acid. Risk of aspiration of gastric contents is increased during sleep due to decreased oesophageal clearance mechanisms and may be further increased by the presence of OSA. This study investigated the relationship between nocturnal GOR, OSA and BOS in a group of lung transplant patients.

Methods:  Fourteen lung transplant patients underwent overnight polysomnography with simultaneous dual oesophageal pH monitoring.

Results:  Patients had an FEV1 of 84 ± 15% of their best post‐transplant FEV1. Six of the 14 patients were in various stages of BOS. The average proportion of time spent overnight with a pH of <4 was 1.7 ± 3.1%. Increased GOR was evident in 8/14 patients during the postprandial period and/or overnight in the distal and/or proximal oesophagus. All patients had OSA (AHI >5 events per hour). There were no relationships between severity of OSA or GOR and severity of BOS.

Conclusion:  Both nocturnal GOR and OSA were common in this group of patients but their occurrences were not related. Neither was there any relationship between the presence of nocturnal GOR or OSA and severity of BOS.
Risk factors and outcome of community‐acquired pneumonia due to Gram‐negative bacilli
Authors: FALGUERA Miquel , CARRATALÀ Jordi , RUIZ‐GONZALEZ Agustín , GARCIA‐VIDAL Carolina , GAZQUEZ Isabel , DORCA Jordi , GUDIOL Francesc , PORCEL José M.
Published: August 2008

Background and objective:  Several sets of guidelines have advocated initial antibiotic treatment for community‐acquired pneumonia due to Gram‐negative bacilli in patients with specific risk factors. However, evidence to support this recommendation is scarce. We sought to identify risk factors for community‐acquired pneumonia due to Gram‐negative bacilli, including Pseudomonas aeruginosa, and to assess outcomes.

Methods:  An observational analysis was carried out on prospectively collected data for immunocompetent adults hospitalized for community‐acquired pneumonia in two acute‐care hospitals. Cases of pneumonia due to Gram‐negative bacilli were compared with those of non‐Gram‐negative bacilli causes.

Results:  Sixty‐one (2%) of 3272 episodes of community‐acquired pneumonia were due to Gram‐negative bacilli. COPD (odds ratio (OR) 2.4, 95% confidence interval (CI): 1.2–5.1), current use of corticosteroids (OR 2.8, 95% CI: 1.2–6.3), prior antibiotic therapy (OR 2.6, 95% CI: 1.4–4.8), tachypnoea ≥30 cycles/min (OR 2.1, 95% CI: 1.1–4.2) and septic shock at presentation (OR 6.1, 95% CI: 2.5–14.6) were independently associated with Gram‐negative bacilli pneumonia. Initial antibiotic therapy in patients with pneumonia due to Gram‐negative bacilli was often inappropriate. These patients were also more likely to require admission to the intensive care unit, had longer hospital stays, and higher early (<48 h) (21% vs 2%; P < 0.001) and overall mortality (36% vs 7%; P < 0.001).

Conclusions:  These results suggest that community‐acquired pneumonia due to Gram‐negative bacilli is uncommon, but is associated with a poor outcome. The risk factors identified in this study should be considered when selecting initial antibiotic therapy for patients with community‐acquired pneumonia.
A pilot study to evaluate Australian predictive equations for the impulse oscillometry system
Authors: NEWBURY Wendy , CROCKETT Alan , NEWBURY Jonathan
Published: August 2008

Background and objective:  Impulse oscillometry (IOS) measures respiratory function during normal breathing by transmitting mixed frequency rectangular pressure impulses down the airways and measuring the resultant pressure and flow relationships, which describe the mechanical parameters of the lungs. Respiratory impedance and its components, airways resistance and reactance, at a range of frequencies from 0.1 to 150 Hz are calculated by computer analysis. The IOS software generates predictive normal values for each of the parameters measured, including total airway resistance (R5), proximal airway resistance (R20) and peripheral capacitive reactance (X5). However, these values are based on German data and no other Caucasian data or Australian normative data exist.

Methods:  This was a cross‐sectional study of over 100 community dwelling adults, with about 10 men and 10 women per 10‐year cohort. Inclusion criteria were age between 25 and 74 years and apparently good respiratory health. Exclusion criteria were smoking, asthma and acute or chronic respiratory disease. IOS and spirometry were performed on all participants.

Results:  Australian predictive normal equations were generated and compared with current published equations. The IOS parameters were correlated with the spirometric data. Results were analysed by gender, age, height and weight, and compared with the predicted normal values for each parameter provided by the German manufacturer of the IOS instrument.

Conclusions:  A preliminary set of Australian predictive equations have been produced for the IOS. These have been compared with international equations. IOS has potential applications in a range of respiratory diseases and in population screening for occupational health assessment.
Effects of inhaled fluticasone propionate on CTLA‐4‐positive CD4+CD25+ cells in induced sputum in mild asthmatics
Authors: KAWAYAMA Tomotaka , KINOSHITA Takashi , IMAOKA Haruki , GAUVREAU Gail M. , O'BYRNE Paul M. , AIZAWA Hisamichi
Published: August 2008

Background and objective:  Cytotoxic T‐lymphocyte antigen 4 (CTLA‐4) signalling of regulatory T cells regulates mucosal lymphocyte tolerance and differentiation, and may therefore have a beneficial effect in allergic diseases such as asthma. The aim of this study was to evaluate the effects of fluticasone propionate (FP) on CD4+CD25+ T cell co‐expression of CTLA‐4 in the sputum of mild asthmatic subjects.

Methods:  Eleven mild, stable asthmatic subjects completed a double‐blind, randomized, cross‐over, placebo‐controlled study to compare the effects of 14 days 200 µg twice daily FP and placebo. Before and after treatment, airway hyperresponsiveness was measured, and sputum was induced for measurements of CTLA‐4+CD4+CD25+ cells, eosinophils and levels of IL‐10, IL‐13 and transforming growth factor (TGF)‐β

Results:  FP treatment increased co‐expression of CTLA‐4 on sputum CD4+CD25+ cells from a mean (SEM) of 7.9% (1.8) to 12.7% (3.3) after 14 days treatment (P < 0.05) compared with placebo. FP treatment also significantly increased IL‐10 levels, reduced per cent sputum eosinophils, and reduced airway hyperresponsiveness (P < 0.05). There was a significant negative correlation between the change in airway hyperresponsiveness and per cent sputum eosinophils (P < 0.01), but no correlation with changes in CTLA‐4+CD4+CD25+ cells (P > 0.05). There was no change in the levels of sputum IL‐13 or TGF‐β

Conclusions:  The percentage of airway CTLA‐4+CD4+CD25+ cells increased after FP treatment, coincident with improvements in airway inflammation and hyperresponsiveness. Whether improved asthma assessments are related to the increase in CTLA‐4+CD4+CD25+ cells and thus improved regulation of T‐cell tolerance and differentiation will require a larger sample size to determine. The normalization of CTLA‐4+CD4+CD25+ cells in asthma may contribute to the management of this disease.
Clinicopathological analysis of multifocal micronodular pneumocyte hyperplasia associated with tuberous sclerosis in Japan
Authors: KOBASHI Yoshihiro , SUGIU Tadaaki , MOURI Keiji , IREI Tsutomu , NAKATA Masao , OKA Mikio
Published: August 2008

Background and objective:  This study investigated the clinical and pathological findings of lung disease in tuberous sclerosis complex (TSC) as previously reported in Japan.

Methods:  The clinical and pathological findings in 15 patients diagnosed as having multifocal micronodular pneumocyte hyperplasia (MMPH) with TSC were analysed.

Results:  The majority of patients (80%) were women and the mean age was 37 years. Three patients had a family history of TSC. The radiological findings were small multiple nodular shadows with ground‐glass opacity randomly distributed in the bilateral whole‐lung fields in most patients. Differentiation from multiple atypical adenomatous hyperplasia or metastatic lung cancer was necessary in most patients. In 11 patients, the diagnostic method used to identify pulmonary lesions of MMPH with TSC was VAT. Among the complications of MMPH with TSC, lymphangioleiomyomatosis was recognized in 53% of patients. The prognosis was comparatively good because only one patient died of respiratory failure. The histological findings were papillary or tubular proliferation of type II pneumocytes without nuclear atypia lining the thickened alveolar septa and lymphocyte infiltration. Immunohistochemical staining for cytokeratin, and surfactant proteins A and B was positive in alveolar lining cells of all MMPH lesions. However, staining for HMB‐45, α‐smooth muscle actin, p53, carcinoembryonic antigen and hormonal receptor was negative in most patients.

Conclusions:  Surgical investigation and immunohistochemical staining for pathological markers are useful for diagnosing MMPH when the radiological findings indicate multiple micronodules with ground‐glass opacity in patients with TSC.
Clinical outcome of chemoradiotherapy for T1G3 bladder cancer
Authors: Inoue Masaharu , Ishioka Jun‐ichiro , Fukuda Hiroshi , Kageyama Yukio , Saito Yoshihiro , Higashi Yotsuo
Published: August 2008

Abstract:  The aim of this study was to determine the clinical outcome of a bladder‐sparing approach using chemoradiotherapy (CRT) for T1G3 bladder cancer. Between May 2000 and August 2007, 11 patients with T1G3 bladder cancer and who were negative for macroscopic residual tumor were treated by CRT after transurethral resection of bladder tumor (TUR‐Bt). Pelvic irradiation was given at a dose of 40 Gy in 4 weeks. Intra‐arterial administration of cisplatin and systemic administration of methotrexate were carried out in the first and third weeks of radiotherapy. One month after CRT, response was evaluated by restaging TUR‐Bt. For persistent tumor after CRT or tumor recurrence, patients received additional treatment. Median follow‐up was 21.2 months. Complete response was achieved in 10 of 11 patients (90.9%). Local recurrence for the entire group of 11 patients was 22.1% at both 2 and 5 years. Tumor progression was 0% at 5 years. Disease‐specific survival rates were 100% at 5 years. All of survivors retained functioning bladders. Bladder preservation by CRT is a curative treatment option for T1G3 bladder cancer and a reasonable alternative to intravesical treatment or early cystectomy.
Unusual presentation of right‐side accessory spleen mimicking a retroperitoneal tumor
Authors: Kim Myung K , Im Chang M , Oh Sang H , Kwon Dong D , Park Kwangsung , Ryu Su B
Published: August 2008

Abstract:  An unusual case of right‐side retroperitoneal accessory spleen is presented. A 68‐year‐old man visited our hospital for the management of incidentally detected retroperitoneal mass. The computed tomography scan of the abdomen revealed the presence of a retroperitoneal tumor (4.0 × 3.8 cm) at the right suprarenal space. Laparoscopic excision was carried out with excellent results. On histological examination, the tumor exhibited a structure typical of splenic tissue. This accessory spleen was unusual in its size and location. Though it existed at the right side, surgeons should be aware of the possible existence of accessory spleens for the differential diagnosis of retroperitoneal tumors.
Penile malignant melanoma in a hemodialysis patient
Authors: Maeda Yoshiko , Ito Fumio , Nakazawa Hayakazu , Tomoe Hikaru , Aiba Motohiko , Tanabe Kazunari
Published: August 2008

Abstract:  A patient who was receiving hemodialysis treatment developed melanotic macules on the surface of the penis in 2002 and showed a tumor‐like mass in the same region in July 2006. The patient presented with a pedunculated tumor of 3 cm in diameter on the right side of his penis. The tumor was resected for biopsy and was diagnosed as malignant melanoma. The melanoma was in stage IIIB with pT4 N1 M0. The patient received interferon‐β for a total of three courses. A computed tomography scan in the 10th postoperative month did not find any additional metastatic foci or recurrence of the tumor. In the present case, side effects caused by interferon were not observed. Therefore, particularly in dialysis patients, immune therapy might be favored over anticancer drug treatment.
Robot assisted laparoscopic pyeloplasty in patients of ureteropelvic junction obstruction with previously failed open surgical repair
Authors: Hemal Ashok K , Mishra Saurabh , Mukharjee Satydip , Suryavanshi Manav
Published: August 2008

Abstract:  To review our experience of robotic redo pyeloplasty as a salvage procedure in previously failed repair of ureteropelvic junction (UPJ) obstruction. In one year, robot‐assisted laparoscopic pyeloplasty was performed in nine patients for previously failed open pyeloplasty. Four of these patients had undergone additional retrograde endopyelotomy following failed repair, prior to being referred to us. The mean age was 16.4 years. All patients presented with persistent flank pain and an obstructive pattern on diuretic renogram. Robotic redo pyeloplasty could be performed successfully in all patients without any technical problems. Intraoperative findings for cause of UPJ obstruction were peri‐ureteral fibrosis, narrow ureter, anterior crossing vessels, and redundant pelvis. The mean hospital stay was 3.4 days (2–5 days). All patients had improvement in symptoms and the nuclear scan showed non‐obstructive drainage. Robot assisted redo pyeloplasty enables complex repair in patients with previous failed cases of UPJ obstruction repair. Three‐dimensional magnified vision, and a dynamic articulated endowrist, allows fine dissection in the fibrosed area and precise suturing in an ergonomic fashion with a success equivalent to open surgery.
ENDOVASCULAR MANAGEMENT OF LIFE‐THREATENING RETROPERITONEAL BLEEDING
Authors: Akpinar Erhan , Peynircioglu Bora , Turkbey Baris , Cil Barbaros E. , Balkanci Ferhun
Published: August 2008

Background:  The aim of this study was to evaluate efficiency of embolotherapy in management of retroperitoneal bleedings.

Methods:  A total of 16 patients with retroperitoneal bleeding who underwent angiography followed by transcatheter embolization within a 4‐year period in a single centre were reviewed retrospectively. Electronic charts as well as procedural reports were reviewed to assess immediate angiographic findings and results of embolization.

Results:  Computed tomography was carried out in eight patients. All computed tomography scans showed retroperitoneal haematoma. In addition, contrast material extravasation consistent with active bleeding was seen in two patients and pseudoaneurysm in one. In the remaining eight patients, diagnosis of retroperitoneal bleeding was established based on combined ultrasound and clinical findings. The technical success rate for selective embolotherapy was 100%. Five of these 16 patients (three women and 13 men) had lumbar artery injury; 10 patients were associated with renal artery injury and one had bilateral internal iliac artery injury. Angiography showed active extravasation, pseudoaneurysm and arteriovenous fistula. For embolization, coils were used in six patients and N‐butyl‐2‐cyanoacrylate in the remaining 10 patients. Four patients died within 1 month of embolotherapy.

Conclusion:  Transcatheter embolotherapy appears to be a life‐saving, safe and effective treatment for retroperitoneal bleedings that may be carried out in emergency situations in haemodynamically unstable patients.
ABDOMINAL COMPARTMENT SYNDROME AFTER RUPTURED ABDOMINAL AORTIC ANEURYSM
Authors: Choi John Y. S. , Burton Paul , Walker Stuart , Ghane‐Asle Soheil
Published: August 2008

Abdominal Compartment Syndrome (ACS) is an increasingly recognized syndrome of intra‐abdominal hypertension and generalized physiological dysfunction in critically ill patients. Patients suffering a ruptured abdominal aortic aneurysm (rAAA) are at risk of developing ACS. The objective of the study was to compare the current views on the importance, prevalence and management of ACS after rAAA among Australian vascular surgeons and intensivists. A questionnaire was mailed to 116 registered vascular fellows from the Royal Australasian College of Surgeons and 314 registered fellows of the Joint Faculty of Intensive Care Medicine. Data were collected on the prevalence and importance of ACS after rAAA and whether prophylactic measures were or should be taken to prevent ACS. Hypothetical clinical scenarios representing a range of ACS after rAAA were also presented. The responses were compared using χ2‐test and t‐test. Sixty‐seven per cent (78 of 116) of surgeons and 39% (122 of 314) of intensivists responded. Both groups estimated the prevalence of ACS after rAAA as between 10 and 30% and considered it an important entity. Only 30% of surgeons and 50% of intensivists suggested routine intra‐abdominal pressure (IAP) monitoring. In patients with borderline IAP (18 mmHg), both groups believed that surgical intervention was unnecessary. Intensivists were more inclined to suggest surgical intervention for clinically deteriorating patients with an increased IAP (30 mmHg) compared with surgeons. Forty‐three per cent of intensivists and 17% of surgeons suggested prophylactic (leaving the abdomen open) measures to prevent ACS in high‐risk patients. Surgeons and intensivists have similar views on the prevalence and clinical importance of ACS after rAAA. Intensivists more frequently monitored IAP and suggested both early prophylactic and therapeutic intervention for ACS based on physiological and IAP findings.
TISSUE COMPATIBILITY OF BIOMATERIALS: BENEFITS AND PROBLEMS OF SKIN BIOINTEGRATION
Authors: Stynes Gil , Kiroff George K , Morrison Wayne A. J. , Kirkland Mark A
Published: August 2008

The integration of biomaterials with skin is necessary to enable infection‐free access to vasculature and body cavities. Also, integrating plastics and metals with skin increases options for the reconstruction of surgical and traumatic defects and enables the permanent implantation of robotic and electronic devices. Until now, attempts to integrate biomaterials with skin permanently have failed because of epidermal marsupialization and infection. This article reviews the general properties required of biomaterials to optimize integration with body tissues, the modifications that increase biocompatibility, focusing particularly on surface functionalization and the specific requirements for biomaterial integration into skin. Critical pathophysiological processes relating to biocompatibility are discussed with particular emphasis on the skin–biomaterial interface. Future directions are speculated on, in particular, the specific utility of subatmospheric pressure dressings in facilitating tissue integration into biomaterials.
LIMB ISCHAEMIA IN A STANFORD B AORTIC DISSECTION INTO AN ABDOMINAL AORTIC ANEURYSM
Authors: Lakshmanan Radhika , Aung Myint , Hoong Chia Kok
Published: August 2008

Aortic dissection presenting with acute lower limb ischaemia is not uncommon. However, stanford B dissection into a pre‐existing abdominal aortic aneurysm resulting in bilateral lower limb ischaemia has not been reported in the literature.1 This patient underwent unsuccessful revascularisation of the lower limbs with an axillo‐bifemoral bypass procedure.
PAEDIATRIC SURGERY CARRIED OUT BY GENERAL SURGEONS: A RURAL NEW ZEALAND EXPERIENCE
Authors: Peng Szelin , Fancourt Michael , Gilkison William , Kyle Stephen , Mosquera Damien
Published: August 2008

Background:  There are increasing moves towards centralization in paediatric surgery. With only four paediatric tertiary centres in New Zealand, many general surgeons still routinely carry out paediatric surgery. We present an audit of paediatric surgical patients admitted to our general surgical unit.

Methods:  Data were prospectively recorded using a standardized pro forma on all children aged 15 years and below, who presented to general surgery between 11 December 2005 and 11 December 2006.

Results:  There were 209 admissions (194 children); the median age was 8 years (range 6 weeks to 15 years) with 153 (73%) acutes. Male : female ratio was 3:2 and 37 children (18%) were less than 2 years of age. Procedures (n = 119) comprised appendicectomy (35), inguinal herniotomy (30), skin procedures (29), endoscopy (10), testicular (10) and others (5). The commonest acute and elective operations were appendicectomy and inguinal herniotomy, respectively, with 51% of all operations carried out acutely. There were 10 tertiary hospital transfers (5%) for burns (4), pyloric stenosis (3), intussusception (1), neonatal inguinal hernia (1) and pyoderma gangrenosum (1). Median age of transfers was 11 months (range 6 weeks to 14 years). Complications were wound infection (1), postoperative ileus (2) and infarcted ovary (1).

Conclusion:  A large number of children presented to our surgical department. Approximately half required surgery and half of the operations were acute. There is still a significant need for general paediatric surgery in the provinces and hence close collaboration with specialist paediatric surgeons.
TRENDS IN SURGICAL TREATMENT OF YOUNGER PATIENTS WITH BREAST CANCER IN AUSTRALIA AND NEW ZEALAND
Authors: Wang Jim , Boult Margaret , Tyson Sarah , Babidge Wendy , Zorbas Helen , Kollias James , Roder David , Maddern Guy
Published: August 2008

Background:  The optimal surgical treatment of early breast cancer in young women is not fully determined, while past reports indicate a trend to the increased use of breast‐conserving surgery (BCS). This study aims to assess the trend in Australia and New Zealand of BCS use between 1999 and 2006 and to determine pathological factors associated with it.

Methods:  Data on cancer characteristics and surgical procedures in younger patients with early breast cancer reported to the National Breast Cancer Audit have been analysed.

Results:  There was little change in the rate of BCS over the last 7 years with an overall rate of 53%. The main factors associated with the use of BCS are low histological grade, absence of extensive intraductal carcinoma (EIC), negative lymph node involvement, unifocal tumour and small tumour size.

Conclusion:  Between 1999 and 2006, the use of BCS for early breast cancer treatment in younger women was stable. These results show that surgeons contributing data to the National Breast Cancer Audit appear to use pathological factors that are known to increase the risk of local recurrence after BCS, in selecting mastectomy for younger women.
LAPAROSCOPIC OOPHORECTOMY IN THE MANAGEMENT OF BREAST DISEASE
Authors: Willsher Peter , Ali Ahmad , Jackson Lee
Published: August 2008

Background:  Oophorectomy is being increasingly carried out in the management of breast disease, as either adjuvant treatment for breast cancer or for prevention of ovarian and fallopian tube cancer in BRCA gene mutation carriers. The aims of this study were to determine the surgical outcome of laparoscopic oophorectomy when carried out by breast surgeons and whether laparoscopic oophorectomy can be safely carried out during the same anaesthesia as breast surgery.

Methods:  Patients who had laparoscopic oophorectomy carried out by two breast surgeons were reviewed with regard to the indication, surgical outcome and concurrent procedures. Salpingectomy was also carried out when the indication was prevention.

Results:  Seventy patients with breast disease had laparoscopic oophorectomy between January 2000 and June 2007. Forty‐three patients had laparoscopic oophorectomy for adjuvant endocrine treatment of early breast cancer, 13 for prophylaxis, 7 for endocrine and prophylactic reasons and 7 for treatment of metastatic breast cancer. Sixteen patients had laparoscopic oophorectomy and breast surgery at the same time, without complication. Of note, four BRCA mutation carriers had prophylactic mastectomies, bilateral breast reconstruction and bilateral laparoscopic salpingo‐oophorectomy. No patient required conversion to an open procedure, including 29 patients with previous abdominal surgery. There were no significant complications. Three patients had ovarian cancer or breast cancer detected in an ovary.

Conclusion:  Laparoscopic oophorectomy can be safely and efficiently carried out by breast surgeons with expertise in laparoscopic surgery. Previous abdominal surgery did not prevent a successful laparoscopic approach. Breast oncological and/or reconstructive surgery and laparoscopic oophorectomy can be reliably carried out as a combined procedure.