bluuebunny/crossref_metadata_2025 huggingface dataset:
Feeding groups, lifetypes and the global ecology of termites
Authors: Eggleton Paul , Tayasu Ichiro
Published: March 2003

Two termite functional classifications (Abe’s lifetypes and Donovan’s feeding groups) are evaluated, and then synthesized to make a single unified ‘lifeway’ matrix classification with eight categories. The systematics and biogeography of the lifeway groups are outlined. The lifeways are then tested against other relevant data on termite ecology (stable isotopes, molecular probes, survey data) to show that they consistently reflect real distinctions in termite biology. The advantages and disadvantages of each lifeway are discussed in the context of energy availability, nitrogen balance, foraging and nest‐building energetics, and biogeographical dispersal ability. Finally, an ecological evolutionary scheme is outlined for the global ecology of termites using the lifeway classification as a framework.
Quantitative food webs of dipteran leafminers and their parasitoids in Argentina
Authors: Valladares Graciela R. , Salvo Adriana , Godfray H. Charles J.
Published: March 2003

The quantitative structure of two host–parasitoid communities based on leaf‐mining flies (Diptera, Agromyzidae) in Argentina is described. The two communities consisted of 29 and 27 hosts, 46 and 40 parasitoids, and 193 and 179 recorded host–parasitoid associations. Also, food webs were constructed for one community based solely on samples taken in the wet and dry seasons. Data were expressed as quantitative food webs, and the manner in which food web properties, such as connectance and compartmentalization, were influenced by sampling intensity was explored. The potential importance of indirect effects between hosts mediated by parasitoids (e.g. apparent competition) was assessed using quantitative parasitoid overlap diagrams. The study’s results suggest that indirect effects are likely to be important in these highly connected communities. The limitations of the study’s analysis, and how the conclusions can be tested experimentally, are discussed.
Soil food web components affect plant community structure during early succession
Authors: Gange Alan C. , Brown Valerie K.
Published: March 2003

There is a growing awareness among ecologists of the strong links that exist between above‐ and belowground food webs. So far, the majority of studies have considered these links from the microbial point of view, usually with single plants or very simple plant communities. Here, we report the interactions between two components of the soil food web, root‐feeding insects and arbuscular mycorrhizal (AM) fungi, and their effects on the structure and development of early successional plant communities. We use long‐term field experiments that employ manipulations of these organisms, both singly and in combination. Both groups have strong effects on plant community structure, with root‐feeding insects increasing and AM fungi decreasing plant species richness. Root‐feeding insects appear to accelerate the process of early succession, while AM fungi retard it. There are strong interactions between the insects and fungi. The effect of insects is greatest when AM fungi are present. It is suggested that this is a consequence of plant physiology, rather than any direct interaction between the groups involved. Meanwhile, AM fungi have their greatest effect on plant communities when insects are absent, suggesting that there is some disruption of the symbiosis by the invertebrates. In developing plant communities, the rate and direction of the succession is therefore determined by the relative abundance of these two members of the soil food web. The next challenge will be to understand the roles of other members of the subterranean web in terms of their interactions with insects and AM fungi and effects on plant community development.
Prudent investment in rearing nestlings in bull‐headed shrikes
Authors: Takagi Masaoki
Published: March 2003

I investigated seasonal changes in the relationships between brood size, body mass of nestlings and body mass of parents of the bull‐headed shrike, Lanius bucephalus, in Ishikari, northern Japan. When the broods were 12 days old, the body mass of the heaviest nestling in a brood did not differ among brood sizes, or throughout the season. However, the body mass of the lightest nestlings in a brood was different among brood sizes. The body mass of the lightest nestling in five‐ and six‐nestling broods decreased throughout the season. The lightest nestling in four‐nestling broods, and the lightest and the second lightest nestlings in five‐nestling broods, were significantly lighter than the heaviest nestling in broods of this size. It is likely that pairs with six nestlings at 12 days old can feed at least five of these nestlings enough to ensure their survival . The standardized body mass of parents (SBM), which was defined as the body mass divided by the length of the tarsus, did not differ among brood sizes, or throughout the season. It is possible that the relationship between the constancy of the SBM and the seasonal decline in the body mass of nestlings indicates that bull‐headed shrikes have a limit to their parental efforts.
Dynamics of the internal soil nitrogen cycles under moder and mull forest floor types on a slope in aCryptomeria japonicaD. Don plantation
Authors: HIROBE MUNETO , KOBA KEISUKE , TOKUCHI NAOKO
Published: March 2003

To examine the influence of microbial carbon (C) availability on the internal soil nitrogen (N) cycles under moder and mull forest floor types within the same slope sequence, surface mineral soils (0–5 cm depth) taken at upper (moder‐type forest floor) and lower (mull‐type forest floor) positions on a slope in aCryptomeria japonicaD. Don plantation were incubated for 300 days. During the incubation, changes in net and gross N transformations, the organic C and N pools, and microbial respiration were monitored. Despite relatively small differences in net N mineralization in both soils, very rapid rates of gross N transformations were found in mull soil during the initial 15 days of the experiment. A rapid net nitrification occurred after days 150 and 100 in moder and mull soils, respectively, presumably because of decreased microbial C availability. However, a rapid net nitrification also occurred in the mull soil during the initial 15 days when microbial C availability was high, and gross nitrification was detected in both soils, except at day 0 in the moder soil. Changes in gross N transformations and in organic C and N pools over the experiment suggested that the start of rapid net nitrification might be influenced not only by microbial C availability, but also by the microbial availability of N relative to C.
New species of the Australian endemic wasp genus Notosigalphus van Achterberg and Austin (Hymenoptera: Braconidae) from Flinders Island, Tasmania
Authors: Iqbal Muhammad , Austin Andrew D
Published: March 2003

A new species of the braconid genus Notosigalphus is described from Flinders
Island, Tasmania (N. sophae Iqbal and Austin sp. n). This is the third species
recorded of this rare Australian endemic genus, and the first member of the subfamily
Sigalphinae to be recorded elsewhere than on the mainland. A key to separate species
of Notosigalphus is presented, as is a discussion of relationships, distribution and biology of the subfamily in Australia.
A comparison of the imposed work of breathing in continuous positive pressure ventilation mode between three different ventilators
Authors: Porges Kate J , Kelly Sean L
Published: March 2003

Abstract

Objective: To compare the work of breathing imposed and patient tolerance to the delivery of face mask continuous positive pressure ventilation by three different ventilators.

Methods: Eleven healthy volunteers were subject to continuous positive pressure ventilation at levels of 0, 5, 10 and 15 cmH2O on each of the three machines tested (Oxylog 2000, Drägerwerk AG, Lubeck, Germany; Puritan‐Bennett 7200, Puritan Bennett Corp., Carlsbad, CA, USA; Auspap, Ulco Engineering Pty Ltd, Marrickville, NSW, Australia). The work of breathing imposed by the machines was measured using the Bicore‐CP100 pulmonary function monitor (Allied Healthcare Products, CA, USA). After breathing on the three machines, volunteers rated the comfort of breathing on a visual analogue scale.

Results: The work of breathing imposed by the Oxylog 2000 was higher in all volunteers receiving face mask continuous positive pressure ventilation when compared with both the Puritan‐Bennett 7200 and the Auspap. The Oxylog 2000 was considered to be the least comfortable.

Conclusions: The provision of continuous positive pressure ventilation in the emergency department is becoming increasingly common, but the use of a transport ventilator, such as the Oxylog 2000, to provide this ventilatory support cannot currently be recommended.
Trauma scoring systems explained
Authors: Fani‐Salek Mohammed Hassan , Totten Vicken Y , Terezakis Stephanie A
Published: March 2003

Objective: To list, describe and classify the extant trauma scoring systems found in the English language literature from the vantage of utility to emergency medicine. Each system is illustrated by a table and a hypothetical case study.

Data Sources: Medline citations provided the data. The systems are classified as physiological, anatomical and combined trauma scoring systems.

Results: We reviewed the Glasgow Coma Scale, the Paediatric Glasgow Coma Scale, the Trauma Score and Revised Trauma Score, the Circulation, Respiration, Abdominal/Thoracic, Motor and Speech Scale, the Acute Physiology and Chronic Health Evaluation System, Abbreviated Injury Scale, the Injury Severity Score, the Anatomical Profile, A Severity Characterization of Trauma, Revised Trauma Score and Injury Severity Score and its revisions, the Paediatric Trauma Score and the Drug‐Rock Injury Severity Score.

Conclusions: This compendium should help emergency physicians become familiar with trauma scoring systems which evaluate the extent and severity of injuries, facilitate inter‐institutional comparisons and facilitate trauma research.
Practical issues in the design and execution of an emergency medicine research study
Authors: Taylor David McD
Published: March 2003

The planning and execution of a scientific research study can be a daunting prospect for the inexperienced investigator. This article attempts to break down the task into components, each of which can be conceptualized and executed independently, and makes recommendations for this structured approach. The article proceeds in a time‐sequential fashion, beginning with the conception of the study and ending with the final publication of the study manuscript. The article emphasizes the importance of adequate study preparation and most of the discussion is devoted to development of the research question and hypothesis, review of the literature, study design and methodology and ethics committee issues. Data collection, results analysis, manuscript preparation and the peer review process are also discussed. This article is meant as a guideline for the less experienced researcher and reference to authoritative text is recommended highly.
Knowing where to look: ‘Meningococcal’ septicaemia following a dog bite
Authors: Cheng Allen , Nack Zoltan , Graves Stephen , McDonald Malcolm
Published: March 2003

The patient presentation of septic shock and purpuric rash is commonly attributed to meningococcal septicaemia. We describe a case of similar presentation where initial cultures and antigen testing were negative for meningococcus and the isolation of an unusual organism, Capnocytophaga canimorsus, was only made after obtaining a history of a dog bite and liaison with the microbiology laboratory. The epidemiology and clinical features of Capnocytophaga canimorsus infection is discussed, together with the antibiotic management of dog bites.
Gamma hydroxybutyrate intoxication: The Gold Coast experience
Authors: Harraway Tim , Stephenson Lauren
Published: March 2003

Abstract

This paper describes two group presentations of intoxicated patients to the Emergency Department of Gold Coast Hospital in October 1996 and July 1997 respectively. A total of 14 patients received treatment. The clinical features, investigation findings and clinical course of each patient are outlined. A discussion is undertaken of the literature surrounding the emergence of gamma hydroxybutyrate (GHB) as a drug of abuse, and of the major issues involved in the emergency department management of such patients.
History, pathophysiology, clinical presentation and role of hyperbaric oxygen in acute carbon monoxide poisoning
Authors: Doherty Steven
Published: March 2003

Acute carbon monoxide poisoning remains a major cause of morbidity and mortality, both due to accidental and deliberate poisoning. This article reviews the current concepts of the pathophysiology of carbon monoxide poisoning and the historical evolution of these concepts. The clinical presentation is discussed as it relates to the various organ systems. Finally, the history and role of hyperbaric oxygen is also discussed. Hyperbaric oxygen remains an established, although inconclusively proven, treatment option.
Kava toxicity
Authors: Chanwai L Giles
Published: March 2003

Kava is a psychoactive drink widely used among people of the South Pacific nations. It is a non‐narcotic, non‐alcoholic, non‐addictive beverage. Kava is extracted from the pepper plant, Piper methysticum. The roots are used to prepare a beverage that is consumed for social and ceremonial purposes. A case illustrating the effects of acute kava intoxication upon heavy chronic consumption is presented with a discussion of the pharmacology, clinical manifestation and treatment of kava toxicity, followed by discussion of the health impact on society.
Noxious gas exposure in the outback: Two cases of hydrogen sulfide toxicity
Authors: Gunn Barry , Wong Robert
Published: March 2003

Two cases of toxicity from industrial exposure to hydrogen sulfide are presented. Both patients had neurological effects with loss of consciousness and amnesia along with respiratory symptoms and signs. Both were treated with hyperbaric oxygen therapy in addition to standard resuscitative techniques with rapid improvement. Sodium nitrite and hyperbaric oxygen therapy are suggested specific treatments. The literature and the two case reports support the use of hyperbaric oxygen therapy in the treatment of acute hydrogen sulfide toxicity. Hyperbaric oxygen therapy has also been reported to have a role in the prevention of both short‐ and long‐term neurological toxicity.
Survey of major chronic iIlnesses and hospital admissions via the emergency department in a randomized older population in Randwick, Australia
Authors: Chan Daniel KY , Chong Robert , Basilikas Jim , Mathie Merryn , Hung Wai Tak
Published: March 2003

Objective: To find out if patients with chronic illnesses living in the community are at risk of unplanned hospital admissions through emergency departments; what types of chronic illnesses may be putative risk factors; and if an increase in the number of chronic illnesses may be associated with increased risk.

Methods: The survey included the completion of a standardized questionnaire for medical illnesses in a random sample of older people dwelling in the community and analysis of admission records to our hospital. The principal diagnoses for admissions were recorded. The risk factors for admissions were analysed.

Results: Five hundred and twenty‐six (239 men and 287 women) people aged 55 years and over were interviewed. Musculoskeletal disorders, hypertension, gastrointestinal disorders and ischaemic heart disease were the most frequently reported of the chronic illnesses surveyed. A total number of 70 people from the survey group with a total of 115 admissions through emergency departments were recorded. Using logistic regression model, hypertension, ischaemic heart disease and age were found to be risk factors for emergency admissions amongst this group of community‐dwelling residents. The ratios were 2.03 (95% confidence interval (CI): 1.2–3.44), 2.02 (95% CI: 1.16–3.49) and 1.05 (95% CI: 1.02–1.09), respectively. Furthermore, multiple (three or more) chronic illnesses were found to be a strong predictor of hospital admission via emergency department (chi‐square = 16.647, DF = 1, P‐value < 0.001).

Conclusion: We conclude that there was significant association between multiple chronic diseases and emergency admissions for older people. Of these, hypertension and ischaemic heart disease were found to be significant predictors. Age per se was found to be of borderline significance.
Optic neuropathy resulting from indirect trauma
Authors: Ginifer Corinne , Scharapow David
Published: March 2003

Minor blunt injury to the head and face may result in optic nerve contusion with secondary optic atrophy. The resulting visual loss is devastating for the individual. We report an uncommon but important complication that may result from an apparently trivial injury. Early identification and initiation of appropriate management may restore the individual's vision. Emergency physicians are often the first to see patients at risk of this complication yet there is little discussion of this injury in the emergency medicine literature.
Lack of agreement in classification of the severity of acute asthma between emergency physician assessment and classification using the National Asthma Council Australia guidelines (1998)
Authors: Powell Colin VE , Kelly Anne‐Maree , Kerr Debra
Published: March 2003

Aims: To determine the level of agreement in classification of the severity of acute asthma at presentation to the emergency department, between emergency physician global assessment and severity classification according to the National Asthma Council Guidelines, Australia 1998 (NACG).

Methods: Prospective observational study in emergency departments throughout Australia, participating in the Asthma Snapshot 2000 project. Patients between the ages of one and 60 years presenting to participating emergency departments with acute asthma between 21 August and 3 September 2000 were included. Data collected were emergency physician global assessment of asthma severity and severity classification according to the National Asthma Council Guidelines and disposition.

Results: Five hundred and five subjects had completed data for emergency physician assessment of severity and for calculation of severity classification according to the National Asthma Council Guidelines. Weighted kappa for agreement in classification was 0.48 (95% confidence interval: 0.40, 0.56). Emergency physicians assess asthma as less severe compared to the National Asthma Council Guidelines assessment.

Conclusions: Agreement between physician assessment of severity of acute asthma and severity classification according to National Asthma Council Guidelines is only moderate. This may have implications in treatment and disposition. This also suggests that emergency physicians may be using other methods to classify acute asthma than the National Asthma Council Guidelines classification.
Guide for passing sections B and C of the FRCSEd/FCSHK: 2. Advice on the oral examination
Authors: Tong Christopher Wc
Published: March 2003

The FRCSEd/FCSHK is a significant hurdle for all basic surgical trainees in Hong Kong to overcome in order to proceed to higher surgical training. This paper contains a comprehensive analysis of section B and C of the FRCSEd/FCSHK and provides practical advice for candidates on how to pass the examination.
Guide for passing sections B and C of the FRCSEd/FCSHK: 3. Advice on the clinical examination *
Authors: Christopher Wc Tong
Published: March 2003

The FRCSEd/FCSHK is a significant hurdle for all basic surgical trainees in Hong Kong to overcome in order to proceed to higher surgical training. This paper contains a comprehensive analysis of section B and C of the FRCSEd/FCSHK and provides practical advice for candidates on how to pass the examination.
Sildenafil (Viagra®) and erectile dysfunction
Authors: Sang Leung Lok , Chun Yip Andrew Wai
Published: March 2003

Erectile dysfunction is a common benign disorder with significant impact on the quality of life of patients. Ten percent of the male adult population is affected. Sildenafil has been proven to be an effective and safe oral medication for the treatment of erectile dysfunction with a response rate of 78%. The incidence of side effects is low (10%) and side effects are usually mild and transient. The drug should be prescribed only after proper history taking, physical examination and basic investigations.
Clinical outcome of patients with initial diagnosis of acute self‐limiting colitis of unknown aetiology
Authors: Lam Tzit Yuen David , Choi Tat Fai , Lam Ching Wah , Kwok Samuel Po Yin
Published: March 2003

Objective: To investigate the clinical course and outcome of patients whose initial histological features were compatible with acute self‐limiting colitis (ASLC) of unknown aetiology.

Materials and Methods: We performed a computer search of our pathology registry for non‐specific inflammation of the colon and rectum for the years 1997–98. The histology reports and clinical notes were reviewed in detail.

Results: Thirty‐three suitable patients were identified (17 males) with a median age of 48 years (22–87 years). The commonest presenting symptoms were rectal bleeding and diarrhoea. The passage of mucus and abdominal pain were also commonly found symptoms. Physical examination was usually normal, although abdominal tenderness was occasionally elicited. Systemic upset was unusual. Three patients had complications at presentation: severe bleeding (n = 1), intestinal obstruction (probably unrelated, n = 1), sigmoid colon cancer (probably unrelated, n = 1). Of 30 patients who were observed only, 10 patients’ symptoms resolved and 8 patients improved symptomatically, one worsened and one had not returned for reassessment. Ten subsequently needed medical treatment. Together with the other 3, a total of 13 patients received medication at some stage in their disease and 3 patients eventually required long‐term therapy. Two patients developed ulcerative colitis after 7.5 and 12 years, respectively.

Conclusion: Patients with initial histological features of ASLC usually follow a self‐limiting clinical course and an initial period of observation is justified. Progression to a more protracted disease course occurs in one‐third and the diagnosis of ASLC should be revised. Salicylates and steroids are useful in refractory cases. Less than 6% progressed to chronic inflammatory bowel disease.
Primary peritonitis in children
Authors: Zhou H , Cheng W
Published: March 2003

Although primary peritonitis is relatively uncommon, failure of clinical recognition may result in unnecessary surgery and increased morbidity. While primary peritonitis can occur in healthy subjects, it tends to affect females and individuals with certain underlying conditions. Parencentesis and culture remain the key to diagnosis and to deciding modality of treatment. With the advent of antibiotics, surgical management is now reserved for complications or for patients with persistent signs.
Irreducible inguinal hernia: To reduce or not to reduce?
Authors: Lai Pbs , Leow Ck , Lau Wy
Published: March 2003

A case of irreducible inguinal hernia is reported. Successful reduction of the hernia resulted in delayed perforation of the sigmoid colon and faecal peritonitis. The question of whether one should attempt reducing an irreducible inguinal hernia is discussed.
Choriocarcinoma: An unusual cause of gangrene of the bowel
Authors: Prathiba D , Gopalan Tr , Rout D , Ramesh‐Rao K
Published: March 2003

Secondary involvement of the small intestine by choriocarcinoma is uncommon. Such cases usually present as a polyp or necrotic mass within the wall of the bowel. The clinical manifestations include abdominal pain and/or haematemesis. In this report, we present a rare case of gangrene of the small bowel caused by choriocarcinomatous embolization of mesenteric vessels.
Experience in colour‐flow duplex carotid imaging for extracranial carotid stenosis
Authors: Wu Lisa Lh , Ting Albert Cw , Cheng Stephen Wk
Published: March 2003

Carotid duplex scanning is a non‐invasive, cost‐effective method for the diagnosis of stability, progression or improvement of extracranial cerebral disease. It yields functional information that complements the anatomic information provided by angiography. It can localize the disease with B‐mode ultrasound and can determine the functional severity of the disease with spectral analysis and colour‐flow imaging. The diagnostic criteria are based on the peak systolic velocity and end diastolic velocity of the internal carotid artery. Carotid stenosis of 70% or greater is taken as significant. The texture and morphology of the plaque can be reported as either homogeneous, heterogeneous with ulceration or heterogeneous without ulceration. This distinction would not be detected readily by angiography. With a high degree of accuracy in identifying sig‐nificant stenoses in carotid arteries, duplex scanning can replace angiography prior to performing carotid endarterectomy.
Haemorrhoidectomy using harmonic scalpel: An initial report
Authors: Chung () Chi‐Chiu , Ha () Joe Ping‐Yiu , Tai () Yuk‐Ping , Tsang () Wilson Wen‐Chieng , Li () Michael Ka‐Wah
Published: March 2003

Objective: The objective of this study was to evaluate the surgical outcomes of haemorrhoidectomy using harmonic scalpel.

Method: From June to August 1999, 12 patients suffering from third degree piles were admitted for harmonic scalpel haemorrhoidectomy. The whole operation was performed entirely with the harmonic scalpel with the power set at level 3. The pedicles were coagulated with the harmonic scalpel rather than transfixed. Postoperatively, pethidine injection was given intramuscularly on demand for pain control. The postoperative pain score (0–10) from the first to the fifth postoperative day was assessed. Patients were followed up at 4, 8 and 12 weeks, and complications were recorded.

Results: Twelve patients with a median age of 48 years were studied. The median operation time was 15 min (range: 12–20), with a median blood loss of 15 mL (range: 2–25). The median postoperative stay was 2 days (range: 2–4). The median pain score was maximal at postoperative day one (score: 3). The pain score rapidly dropped over the next 2 days, and became zero by postoperative day 4. Only two patients required pethidine injections on the first postoperative day.

Conclusion: Preliminary evidence suggests harmonic scalpel haemorrhoidectomy is safe and expedious; it is associated with less pain compared with conventional scissors dissection, and is a good alternative to diathermy excision.

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Laparoscopic‐assisted D1 subtotal gastrectomy for intramucosal early gastric cancer: Report of a four‐port technique
Authors: Ng Enders Kwok‐Wai , Fung Terence Ming‐Kit , Chung Sydney Sheung‐Chee
Published: March 2003

We report a case of mucosal carcinoma of the stomach for which a laparoscopic‐assisted D1 subtotal gastrectomy was performed. The approach was a four‐port technique and the gastrointestinal continuity was reconstructed in a Roux‐en‐Y configuration. This case highlights the feasibility of laparoscopic surgery for early gastric cancer and the value of pre‐operative endoscopic ultrasound scan in selecting patients for minimal access operation.
Mesh plug hernioplasty of superior lumbar hernia
Authors: Lau Hung , Lee Francis
Published: March 2003

Superior lumbar hernia is a rare clinical entity. Techniques for the repair of lumbar hernia have evolved in the past few decades. The case of a 77‐year‐old woman presenting with a reducible left lumbar swelling for 3 months is reported. Repair of the hernia using a mesh plug technique was performed. The cone‐shaped prolene mesh plug maintained the inversion of the hernia and occluded the hernial defect, thereby conferring a mechanical advantage. The application of mesh plug hernioplasty for the repair of a superior lumbar hernia was simple and effective.

Chinese Abstract

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Always expect the unexpected in appendicectomy
Authors: Chan Tony Kam‐Tong , Lam David Tzit‐Yuen , Lam Steve Ching‐Wah , Kwok Samuel Po‐Yin
Published: March 2003

A 59‐year‐old Chinese man who presented with signs and symptoms of acute appendicitis is described. The patient received an appendicectomy, and the histology report of the appendix revealed villous adenoma with margin involved. Postoperatively, he developed a colocutaneous fistula and ended up having a right hemicolectomy and fistulectomy. The literature on villous adenoma and other tumours of the appendix is reviewed, and their surgical treatment is discussed.

Chinese Abstract

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Successful laparoscopic‐assisted treatment of ileal endometriosis with intestinal obstruction
Authors: Tsumura Hiroaki , Kagawa Tetsuya , Ichikawa Toru , Nishihara Masahiro
Published: March 2003

A patient in whom the laparoscopic procedure for intestinal endometriosis with small bowel obstruction was effective is reported. A 35‐year‐old woman who had complained of a stomach ache during menstruation had been followed up for 1 year at another hospital. She presented at Hiroshima Funairi Hospital with upper abdominal pain, and was admitted with suspected small bowel obstruction as a result of plain abdominal X‐ray showing abnormal intestine gas. Laparoscopic observation revealed marked adhesion and stenosis of the distal ileum, which were responsible for the obstruction. Mini‐laparotomy was selected and ilectomy and anastomosis were performed under laparoscopic‐assisted procedure. Histologically, endometriosis was confirmed and resection of the involved segment yielded excellent results, and the patient was discharged. This was an extremely rare case of intestinal obstructive involvement by endometriosis and we briefly discuss here the effectiveness of laparoscopic‐assisted operation.

Chinese Abstract

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Age and symptoms as a triage method for per‐rectal bleeding
Authors: Lam David Tzit‐Yuen , Choy Catherine Lai‐Yin , Lam Steve Ching‐Wa , Kwok Samuel Po‐Yin
Published: March 2003

Objective:

Per‐rectal bleeding is a common reason of surgical referral. The average waiting time in a busy clinic could be months, which should preferably be shortened for potentially serious cases. With little information on referral letters, other methods for triage have to be searched for. Age and symptoms as triage methods were evaluated.

Methods:

Data from patients attending the United Christian Hospital specialist clinic for per‐rectal bleeding were collected prospectively. The association between age and the prevalence of colorectal neoplasia was analysed. The most suitable cut‐off age was determined by a receiving operating characteristic (ROC) curve. For symptoms, a questionnaire to check for high‐risk features of per‐rectal bleeding was designed. Non‐medically trained volunteers were instructed to interview each patient before the surgical consultation. A positive result for the questionnaire is the presence of high‐risk features. The surgeons were unaware of the questionnaires’ findings. The results were compared with the final diagnosis. Positive diagnoses were defined as either malignancy or significant polyps. The sensitivity and specificity of age and the questionnaire were computed.

Results:

A total of 194 patients were interviewed. Twenty patients declined colonoscopy and were excluded, leaving 174 for analysis. The ROC curve showed 60 years to be the most suitable age for triage. The sensitivity and specificity of age (≥ 60 years old) was 73.1% and 62.8%, respectively. The sensitivity and specificity of the questionnaire was 65.4% and 55.4%, respectively. The positive predictive value of age was 25.7%, which was increased to 33.6% with a positive questionnaire result. The negative predictive value of 93.0% by age alone was increased to 95.5% with a negative questionnaire result.

Conclusion:

Age is a very effective triage criterion. Using 60 years of age as a cut‐off point screens out low‐risk patients effectively. A preconsultation‐structured interview designed to identify high‐risk symptoms has little additional triage benefit.

Chinese Abstract

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Metachronous multiple non‐anastomotic aneurysms in a bifurcated double velour knitted Dacron graft
Authors: Ting Albert Chi‐Wai , Ho Pei , Cheng Stephen Wing‐Keung
Published: March 2003

A case of metachronous non‐anastomotic aneurysms in a bifurcated double velour knitted Dacron aorto‐bifemoral graft is reported. The cause of non‐anastomotic graft aneurysms is most likely due to a basic structural failure in the graft, as a result of defects in fabrication, Dacron fibre deterioration or a combination of both. Local excision of the graft defect with interposition graft replacement is an accepted treatment for local graft failure. However, as fabrication defects and Dacron fibre deterioration are both factors affecting the whole graft, it is not surprising to find multiple aneurysms in the same graft synchronously or metachronously. Thus, a total graft replacement should be the treatment of choice for graft failure.
Factors affecting awareness and knowledge of glaucoma among patients presenting to an urban emergency department
Authors: Landers John A , Goldberg Ivan , Graham Stuart L
Published: March 2003

Background: Until advanced, glaucoma is asymptomatic. For early diagnosis to occur, patients may need to be aware of it and seek assessment regularly. People who have risk factors for glaucoma may have a greater awareness of the disease.

Methods: Patients presenting to an urban hospital emergency department were surveyed with a brief questionnaire to assess their knowledge of glaucoma. Data was collected about their gender, age, family history of glaucoma and presence of systemic hypertension, diabetes, Raynaud’s phenomenon, migraines and myopia.

Results: Women (Odds ratio 2.3; 95% CI
1.4−3.7; P < 0.01), people
who were 40 years or older (Odds ratio 2.2; 95% CI
1.1−4.4; P < 0.05) and
those who were aware of a family history of glaucoma (Odds ratio
15.7; CI 5.5−45.3; P < 0.01) knew significantly more about the disease than others. People with other risk factors did not demonstrate significantly greater knowledge despite 89% of all participants having had a previous eye examination.

Conclusion: This information may be useful to predict which patients may know about glaucoma when they present for an eye examination and who should be targeted in public health campaigns.
Control of the exotic bulb, Yellow Soldier (Lachenalia reflexa) invading a Banksia woodland, Perth, Western Australia
Authors: Brown Kate , Brooks Kris , Madden Sally , Marshall Janice
Published: March 2003

Summary In recent times managers have become increasingly aware of the South
African bulbous species Yellow Soldier (Lachenalia reflexa) becoming a serious
weed of bushland on the Swan Coastal Plain. In 1998, trials were implemented to investigate
control options for Yellow Soldier invading the understorey of a Banksia (Banksia
attenuata) Woodland west of Perth. Our trials showed that hand removal over two seasons left all natives intact but was very labour intensive, only reducing cover of Yellow Soldier by 44%. It also triggered germination by ephemeral weeds. Wiping the leaves of individual plants with a 10% glyphosate solution was not effective and was also highly labour intensive. Spot spraying with metsulfuron methyl at 0.2 g/15 L (5 g/ha) reduced the cover of Yellow Soldier by 65%, was easier to implement and appeared to have had insignificant effects on natives. We hope that this trial will encourage other workers in the field to undertake controlled trials to refine treatments at restoration sites.
Understanding local community preferences for wetland quality
Authors: Morrison Mark
Published: March 2003

Summary The results of a local community survey designed to estimate the value of improved wetland quality in the Macquarie Marshes are presented. The present survey parallels an earlier survey conducted in Sydney for the same purpose. The survey involves the use of a technique known as ‘choice modelling’, which was developed in the marketing literature but is now widely used in environmental economics. This technique allows for the estimation of the monetary value people place on improved wetland quality, as well as enabling estimation of the proportion of the community that would support a particular wetland management option. It was found that while the local community has different priorities for wetland improvement, overall per household willingness to pay for improved wetland quality was greater in the Macquarie Marshes community than for households in Sydney. The options that received the greatest and least local community support are described.

Key words choice modelling, non‐market valuation, wetlands.
Understanding landholder management of river frontages: The Goulburn Broken
Authors: Curtis Allan , Robertson Alistar
Published: March 2003

Summary In this paper we discuss the findings of research exploring landholder adoption of practices expected to improve the management of river frontages. This research was part of a larger project undertaken by the Goulburn Broken Catchment Management Authority (GBCMA) to assess the impacts of grazing on the condition of riparian zones in the GBCMA region. Our research employed a postal survey to a random selection of all river frontage owners in the GBCMA. Research findings highlighted the limited adoption of most current recommended practices (CRP) such as watering stock off‐stream and fencing to manage stock access to river frontages. Higher adoption of CRP (in particular fencing) was correlated with greater knowledge of river frontage function and factors affecting river frontage condition; higher importance attached to the environmental, social and economic values of frontages; non‐farming occupations; and higher confidence in the efficacy of CRP. These findings have important implications for managers and scientists. There has been a large investment in community education in the GBCMA and survey findings suggest this has been an effective strategy. At the same time, there should be changes in the approach to community education. It seems there is much to be done to improve the acceptability of fencing frontages along large rivers. Appeals to adopt CRP also need to move beyond a narrow focus on farmers and the benefits of increased agricultural production and embrace the range of landholders and the different values they attach to their frontages. Most respondents had no on‐property profit and survey data indicated that financial constraints were an important factor limiting the adoption of CRP, particularly among farmers. There was considerable interest in taking up a grant scheme that would provide a higher level of support than is usually offered by government. These findings highlight the important role of economic incentives in assisting private landholders undertake conservation work along river frontages.
Ants as indicators of minesite restoration: community recovery at one of eight rehabilitation sites in central Queensland
Authors: Andersen Alan N. , Hoffmann Ben D. , Somes Jenny
Published: March 2003

Summary Ants have been widely used as bioindicators of the success of minesite restoration throughout northern Australia. Our study describes ant species richness, species composition and functional group composition at eight sites undergoing rehabilitation (2–10 years old) at Callide Mine near Biloela, Queensland (680 mm mean annual rainfall) and compares them with those at three nearby, unmined reference sites. We address the extent to which ant communities at rehabilitation sites have converged with those at reference sites and, while we found convergence occurred at only one of the eight sites, we consider this highly noteworthy as it is the only case we are aware of where a rehabilitation minesite has achieved such convergence. Ants were sampled using pitfall traps (15 per site) during January 2001, the period of maximum ant activity. A total of 146 ant species from 34 genera were recorded. Species richness ranged from 36 to 48 (mean of 41) at reference sites, and from seven to 49 at rehabilitation sites (mean of 26). Species richness at rehabilitation sites increased systematically with rehabilitation age. Despite rapid colonization by ants, in most cases, ant communities at rehabilitation sites were markedly different from those at reference sites. However, one rehabilitation site (TH91) was an exception: it had the highest species richness of any site, it grouped with reference sites in multivariate analysis, it supported ‘reference’ rather than ‘rehabilitation’ species, and it supported a full range of functional groups. Ground‐layer conditions at TH91 were similar to those at reference sites and local, long‐lived woody plants had successfully established. We believe these are key factors leading to successful ant community restoration.
Laser‐induced chorioretinal venous anastomosis for non‐ischaemic hemi‐central vein occlusion
Authors: Eckstein Michael , McAllister Ian
Published: March 2003

Purpose: To assess the effectiveness and complications of laser‐induced chorioretinal venous anastomosis performed on eyes with non‐ischaemic hemi‐central retinal vein occlusions (hemi‐CRVO).

Methods: Fourteen eyes with a hemi‐CRVO which reduced the visual acuity to 6/24 or less were treated with argon laser photocoagulation in an attempt to create a chorioretinal venous anastomosis between a retinal vein and the choroidal circulation.

Results: Laser anastomoses were successfully created in six eyes (43%) and required a mean of 1.8 attempts in each eye. Of the eyes that developed an anastomosis, four had significant visual improvement. The distal retinal venous segment closed off in five eyes and these had prophylactic segmental argon pan‐retinal photocoagulation performed. Two eyes had localized fibrovascular proliferation. No permanent vision‐threatening complications were observed in any of the 14 eyes over the follow‐up period.

Conclusions: Successful anastomosis between the retinal and choroidal circulation in eyes with hemi‐vein occlusions may reduce macular oedema and improve vision. Complications of the technique are significant and a randomized clinical trial is due to commence which may clarify the suitability of this treatment.
Corynebacterium pseudodiphtheriticum keratitis and conjunctivitis: a case report
Authors: Li Amy , Lal Shishir
Published: March 2003

A case of keratitis and conjunctivitis in an 86‐year‐old man caused by Corynebacterium pseudodiphtheriticum is reported. Corynebacteria are uncommon causes of ocular surface infections. However, the presence of corneal and conjunctival epithelial defects in an immunocompromised patient can result in severe infection by a commensal organism such as C. pseudodiphtheriticum. The significance of a positive culture in these settings should not be overlooked.
Bilateral inferior insertion of lateral rectus muscles associated with schizencephaly
Authors: Wine Steven B , Saad Nick , Vella Meaghan E
Published: March 2003

A 5‐year‐old boy with a large V‐pattern exotropia is described. He has a background of congenital left hemiparesis associated with schizencephaly. At the time of surgery the lateral recti were found to be abnormally inferiorly positioned. Accordingly, both lateral rectus muscles were recessed 6.5 mm and supraplaced. A V‐pattern exotropia persisted postoperatively with clinical overaction of the inferior obliques. To our knowledge this is the first known case of extraocular muscle abnormalities associated with schizencephaly.
Staphylococcus aureus causes acute inflammatory episodes in the cornea during contact lens wear
Authors: Wu Pzj , Thakur A , Stapleton F , Willcox Mdp
Published: March 2003

The aim of this investigation was to determine the ability of Staphylococcus aureus to cause keratitis during contact lens wear in the rabbit. Rabbits were fitted with hydrogel lenses and wore them on an extended wear schedule for 7 weeks. At the end of each week of wear, one drop of S. aureus was added to the eyes, and the eyes were monitored using slit lamp bio‐microscopy, with subsequent microbial and histological studies of the cornea. In the presence of S. aureus, keratitis occurred after 3 weeks of lens wear, a condition that was characterized by diffuse infiltration of the peripheral cornea and limbal redness. In the absence of bacteria, there was no infiltration until week 6. Contact lens wear also prolonged the retention of bacteria in the eye. Extended contact lens wear and S. aureus caused non‐ulcerative keratitis in a rabbit model, and disturbances in the ability of the eye to remove bacteria.
Employing following eye movements to discriminate normal from glaucoma subjects
Authors: Severt Wl , Maddess T , Ibbotson Mr
Published: March 2003

We recorded optokinetic nystagmus (OKN) to see if slow phase velocity, duration or other measures were affected by glaucoma. Drifting grating patterns that either weakly or strongly evoked the spatial frequency doubling illusion were employed. Analysis of 68 variables characterizing the OKN revealed that small subsets of these variables were good at discriminating normal from primary open angle glaucoma subjects. The variables were related to the regularity of following eye movements. Models including the best five variables selected in two different ways classified about 90% of subjects correctly. Impaired accuracy of eye movements suggests that glaucoma changes the signal to noise ratio available to the brain. The gross changes observed permit the use of electro‐oculography or other simple methods in the clinic.
Age‐specific prevalence and causes of bilateral and unilateral visual impairment in older Australians: the Blue Mountains Eye Study
Authors: Wang Jie Jin , Foran Suriya , Mitchell Paul
Published: March 2003

Purpose: To report age‐specific prevalence and causes of bilateral and unilateral visual impairment in a representative older Australian population.

Methods: Participants in the Blue Mountains Eye Study (n = 3654) underwent a detailed eye examination. Any visual impairment was defined as best‐corrected visual acuity (VA) of 6/12 or worse, moderate impairment as VA 6/24–6/60 and severe impairment as VA worse than 6/60 (the Australian definition for legal blindness). Bilateral visual impairment was defined from the better eye and unilateral impairment from the worse eye. Proportional causes for visual loss were determined by the examining ophthalmologist.

Results: Prevalence of bilateral and unilateral visual impairment was strongly age related. Corresponding bilateral and unilateral visual impairment prevalence rates were, respectively, 0.6% and 3.6% for persons aged 49–59 years, 1.1% and 8.2% for ages 60–69, 5.4% and 20.1% for ages 70–79, and 26.3% and 52.2% for persons aged 80+ years. Overwhelmingly, age‐related maculopathy (ARM) was the predominant cause of bilateral blindness (13/17) and of moderate to severe bilateral visual impairment in persons aged 70+ years. However, cataract was the most frequent cause of mild bilateral visual impairment among persons aged 60+ years. Amblyopia was the most frequent cause of mild or worse unilateral visual impairment in persons aged 49–59 years. Cataract was the most common cause of mild unilateral visual impairment in people aged 60+ years, while ARM and cataract were jointly the most frequent causes of moderate to severe unilateral visual impairment in people aged 70+ years.

Conclusions: These findings indicate that around half of visually impaired persons aged 60 years or over had cataract, a cause amenable to treatment.