bluuebunny/crossref_metadata_2025 huggingface dataset:
Twin–Twin Transfusion Syndrome Modeling
Authors: VAN DEN WIJNGAARD JEROEN P. H. M. , ROSS MICHAEL G. , VAN GEMERT MARTIN J. C.
Published: April 2007

Abstract:  The twin–twin transfusion syndrome (TTTS) is a severe complication occurring in monochorionic twins, and untreated, causes high rates of mortality and morbidity. In TTTS, five consecutive stages of increasing severity can be distinguished: first, the oligopolyhydramnios sequence; second, anuria in the donor twin; third, abnormal flow waves in either twin; fourth, a hydropic recipient, and finally the fifth stage, fetal demise of either twin. Recently, we developed a mathematical model of the Stages I–IV. In this report, we investigated the influence of amnioreduction and laser therapy at two different gestational ages on the resolution of TTTS Stage III. Simulations were performed for two gestational ages, at 22 and 28 weeks; that is, at the onset of a stuck donor twin and when TTTS has progressed to an anuric donor with abnormal umbilical flow waves and a hydropic recipient, respectively. Results indicate abnormal umbilical flow waves in the donor to resolve rapidly after both amnioreduction and laser therapy. TTTS and abnormal umbilical flows in the donor, however, return after amnioreduction. Laser therapy, leading to cessation of fetofetal transfusion, produces complete resolution of TTTS sequelae, however, with increased vascular stiffness in the donor. Amnioreduction and laser therapy both produce rapid resolution of abnormal umbilical flows in a mathematical model of TTTS. Laser ablation of all anastomoses, however, completely ceases the fetofetal transfusion, so that no TTTS redevelops. In the donor, vascular stiffness remains increased after laser, suggesting increased pulse wave velocities can be measured clinically.
Magnetic Resonance‐Based Female Pelvic Anatomy as Relevant for Maternal Childbirth Injury Simulations
Authors: HOYTE LENNOX , DAMASER MARGOT S.
Published: April 2007

Abstract:  The objectives of the study are to review the female pelvic floor anatomy relevant to childbirth simulations, to discuss available methods for clinical evaluation of female pelvic floor function, and to review the variation in pelvic floor changes after vaginal childbirth. A high‐resolution magnetic resonance (MR) data set from an asymptomatic nullipara was used to illustrate the MR anatomy of the female pelvic floor. Manual segmentation was performed and three‐dimensional reconstructions of the pelvic floor structures were generated, which were used to illustrate the 3D anatomy of the pelvic floor. Variation in the post partum appearance of the levator ani muscles is illustrated using other 2D MR data sets, which depict unilateral and bilateral disruptions in the puborectalis portion of levator ani, as well as shape variations, which may be seen in the post partum levator. The clinical evaluation of the pelvic floor is then reviewed. The female pelvis is composed of a bony scaffold, from which the pelvic floor muscles (obturator internus, levator ani) are suspended. The rectum fits in a midline groove in the levator ani. The vagina is suspended across the midline, attaching bilaterally to the obturator and levator ani. The vagina supports the bladder and urethra. MR studies have demonstrated disruptions in levator ani attachments after vaginal childbirth. Such disruptions are rare in women who have not given birth vaginally. Changes to the neuromuscular apparatus of the pelvic floor can also be demonstrated after vaginal delivery. The combination of childbirth‐related anatomic and neurological injury to the pelvic floor may be associated with pelvic floor dysfunction (PFD). These changes are difficult to study in vivo but may be studied through simulations. Appropriate consideration of clinical anatomy is important in these simulations.
Finite Element Studies of the Deformation of the Pelvic Floor
Authors: MARTINS J. A. C. , PATO M. P. M. , PIRES E. B. , JORGE R. M. NATAL , PARENTE M. , MASCARENHAS T.
Published: April 2007

Abstract:  This article describes research involving finite element simulations of women's pelvic floor, undertaken in the engineering schools of Lisbon and Oporto, in collaboration with the medical school of Oporto. These studies are motivated by the pelvic floor dysfunctions that lead namely to urinary incontinence and pelvic organ prolapse. This research ultimately aims at: (i) contributing to clarify the primary mechanism behind such disorders; (ii) providing tools to simulate the pelvic floor function and the effects of its dysfunctions; (iii) contributing to planning and performing surgeries in a more controlled and reliable way. The finite element meshes of the levator ani are based on a publicly available geometric data set, and use triangular thin shell or special brick elements. Muscle and soft tissues are assumed as (quasi‐)incompressible hyperelastic materials. Skeletal muscles are transversely isotropic with a single fiber direction, embedded in an isotropic matrix. The fibers considered in this work may be purely passive, or active with input of neuronal excitation and consideration of the muscle activation process. The first assumption may be adequate to simulate passive deformations of the pelvic muscles and tissues (namely, under the extreme loading conditions of childbirth). The latter may be adequate to model faster contractions that occur in time intervals of the same order as those of muscle activation and deactivation (as in preventing urinary incontinence in coughing or sneezing). Numerical simulations are presented for the active deformation of the levator ani muscle under constant pressure and neural excitation, and for the deformation induced by a vaginal childbirth.
Evaluation of the Dynamic Responses of Female Pelvic Floor Using a Novel Vaginal Probe
Authors: CONSTANTINOU CHRIS E. , OMATA SADAO , YOSHIMURA YASUKUNI , PENG QIYU
Published: April 2007

Abstract:  The female pelvic floor (PF) provides anatomical support to many visceral organs, such as uterus, bladder, urethra, vagina, and rectum. Physiologically, the PF is made up of a number of highly coordinated muscle groups organized to respond to postural and abdominal stresses to maintain continence. In this article, we describe a new methodology for the evaluation of PF strength using a novel vaginal probe design, having force and displacement sensors. This design was derived on the basis of imaging data showing that force/displacement characteristics are important determinants of the integrity of the PF function. The prototype probe used was constructed to evaluate the dynamic responses to slow voluntary contractions as well as reflex stress contractions. Initial clinical experiments were performed on nine healthy female subjects. The probe recorded the force and displacement signals on the anterior and posterior sides of the subjects' middle vaginal wall in voluntary PF muscle contraction and cough. The time domain and frequency domain characteristics of the dynamic responses, including the force and displacement responses, of the vaginal wall were measured and the power and energy associated with the dynamic responses of the PF were analyzed showing the differences between the dynamic characteristics of the voluntary PF muscle contraction and cough. Results show that voluntary PF muscle contractions have higher amplitudes, longer duration, and higher power than reflex contractions. The design of this probe enables the measurement of force and displacement during rapidly occurring events.
A Three‐Dimensional Model of the Penis for Analysis of Tissue Stresses during Normal and Abnormal Erection
Authors: LINDER‐GANZ ERAN , GEFEN AMIT , ELAD DAVID , CHEN JUZA
Published: April 2007

Abstract:  Approximately half of the males between the ages of 40 and 70 suffer erectile dysfunction. Because adequate mechanical interactions in the penis are necessary for functional erection it is important to analyze stresses in the erect penis. Previous penis models were limited to simplified or two‐dimensional geometry. Here we developed a three‐dimensional model for structural analysis of normal erection as well as erections of a penis with substantial asymmetry of the corporal bodies, and Peyronie's disease. The model was constructed based on anatomical images and included skin, tunica albuginea, corpus cavernosa, and spongiosum. The mechanical behavior of the tunica and skin were assumed to be three‐dimensional‐orthotropic, and other tissues as well as Peyronie's plaque was taken as linear elastic. Stresses and deformations during erection were analyzed using a commercial finite elements (FE) solver. Erection was simulated by raising blood pressure in the corporal bodies to 100 mmHg. The tunica was found to be the most highly loaded tissue in the erect penis. Peak von Mises stresses in the healthy tunica, tunica of the asymmetric corpora model, and tunica with Peyronie's disease were 114 kPa, 167 kPa, and 830 kPa, respectively. The angles of distortion of the penis with respect to the vertical axis were ∼4.5° and ∼2°, for the asymmetric and Peyronie's cases, respectively. The model's ability to determine internal stresses in the erect penis offers a new point of view on the mechanical factors involved with erection, and enables us to relate these data with different penile pathologies.
Uterine Contractility Evaluated on Cine Magnetic Resonance Imaging
Authors: TOGASHI KAORI
Published: April 2007

Abstract:  The inherent contractility of the uterus has attracted concern of researchers and exhibits two known patterns of contraction. One is focal and sporadic bulging of the myometrium, and the other is rhythmic and subtle stripping movement in the subendometrial myometrium, known as uterine peristalsis. Recent development in the ultrafast magnetic resonance imaging (MRI) techniques has enabled us to observe these uterine contractions directly and noninvasively. Although the mechanisms and relationship of these two kinds of myometrial contractions and their relations to age, pharmaceutical administration such as oral contraceptives (OCs), and a variety of gynecologic and obstetrical problems are still under debate, cine MRI can be applied for directly monitoring changes of the uterus related to important uterine functions such as fertility and menstrual problems.
Utero‐Tubal Sperm Transport and Its Impairment in Endometriosis and Adenomyosis
Authors: KISSLER STEFAN , ZANGOS STEPHAN , WIEGRATZ INKA , KOHL JOACHIM , RODY ACHIM , GAETJE REGINE , DOEBERT NATASCHA , WILDT LUDWIG , KUNZ GEORG , LEYENDECKER GERHARD , KAUFMANN MANFRED
Published: April 2007

Abstract:  The uterus is composed of different smooth muscle layers that serve various functions. First, menstrual debris is expulsed at the time of the menses. Second, sperm is transported in the preovulatory phase to maximize fertility, and third, the human embryo is placed in an adequate setting during implantation. Endometriosis is a gynecologic disorder leading to severe pain symptoms such as severe pain during menstruation (dysmenorrhea), chronic pelvic pain, pain during sexual intercourse (dyspareunia), and abnormal uterine bleeding. Besides, endometriosis is often associated with female infertility and exhibits a massive impairment in the physiology of uterine contractility that can be documented by the in vivo examination method of hysterosalpingoscintigraphy (HSSG). In addition, endometriosis is associated in 80–90% of subjects with adenomyosis and our data clearly indicate that sperm transport is disturbed by hyperperistalsis when at least one focus of adenomyosis can be detected via magnetic resonance imaging (MRI) and turns into dysperistalsis (a complete failure in sperm transport capacity) when diffuse adenomyosis affecting all myometrial uterine muscle layers is detected. Hence, dysperistalsis is significantly associated with reduced spontaneous pregnancy rates. We therefore recommend MRI and HSSG in every sterility workup.
Patient-Care Questions that Physicians Are Unable to Answer
Authors: Ely John W. , Osheroff Jerome A. , Maviglia Saverio M. , Rosenbaum Marcy E.
Published: April 2007

Objective: To describe the characteristics of unanswered clinical questions and propose interventions that could improve the chance of finding answers.

Design: In a previous study, investigators observed primary care physicians in their offices and recorded questions that arose during patient care. Questions that were pursued by the physician, but remained unanswered, were grouped into generic types. In the present study, investigators attempted to answer these questions and developed recommendations aimed at improving the success rate of finding answers.

Measurements: Frequency of unanswered question types and recommendations to increase the chance of finding answers.

Results: In an earlier study, 48 physicians asked 1062 questions during 192 half-day office observations. Physicians could not find answers to 237 (41%) of the 585 questions they pursued. The present study grouped the unanswered questions into 19 generic types. Three types accounted for 128 (54%) of the unanswered questions: (1) “Undiagnosed finding” questions asked about the management of abnormal clinical findings, such as symptoms, signs, and test results (What is the approach to finding X?); (2) “Conditional” questions contained qualifying conditions that were appended to otherwise simple questions (What is the management of X, given Y? where “given Y” is the qualifying condition that makes the question difficult.); and (3) “Compound” questions asked about the association between two highly specific elements (Can X cause Y?). The study identified strategies to improve clinical information retrieval, listed below.

Conclusion: To improve the chance of finding answers, physicians should change their search strategies by rephrasing their questions and searching more clinically oriented resources. Authors of clinical information resources should anticipate questions that may arise in practice, and clinical information systems should provide clearer and more explicit answers.
Ethnicity, Demography, and Estate Management in Sixteenth-Century Yucay
Authors: Covey R. Alan , Elson Christina M.
Published: April 2007

Yucay was a royal estate in the Inca heartland built by provincial laborers for Huayna Capac, the penultimate ruler. Permanent retainers staffed the estate, maintaining a palace and leisure facilities for the emperor and providing material support for his family following his death. After the Spanish invasion, Yucay and other royal estates changed hands frequently, and Inca patterns of labor tribute gradually gave way to the Spanish colonial tribute system. The tributary redefinition of permanent retainers (yanakuna) in the Yucay Valley led to the 1571 resettlement of over twenty-three hundred individuals into four colonial towns, an undertaking that involved recording the names, ages, and ethnic identities of these individuals, household by household. This essay considers how the management of the Yucay estate evolved in the early colonial period, then presents an ethnic and demographic overview of the retainer population identified in the documents.
The Medicare Approach: Political Choice and American Institutions
Authors: Jacobs Lawrence R.
Published: April 2007

The most significant health reform in American history was the passage of Medicare in 1965, but this was an accomplishment born of defeat. Medicare was designed and understood by its early promoters as an approach to health reform, not simply as a discrete program for a distinct target population. Although Medicare incrementalism has tended to be shunted aside when the opportunities for health reform are most promising, the final years of the Johnson administration reveal previously underappreciated efforts to expand Medicare eligibility to large new population groups and offer insights into the continuing potential of Medicare incrementalism in our own time.
Protecting Medicare: The Best Defense Is a Good Offense
Authors: White Joseph
Published: April 2007

Traditional Medicare is being threatened from two political directions. The current Republican coalition, on the right, simply dislikes social insurance in principle. It seeks privatization for its own sake. Another perspective, centrist and well established among political and economic elites, worries that the program is “unaffordable,” whatever its basic merits. Defenders of traditional Medicare need to address both threats by explaining why the budgetary fears are misconceived and why privatization is simply a bad idea. In order to do this, they need to take the budgetary high ground, argue more strenuously for short-term cost controls, and criticize the extra spending that the Bush administration has used to encourage private plans within Medicare. Defenders of social insurance should also seek good policy and political allies by proposing that Medicare's network of providers, prices, and administration be made available to employers (and other pools) in much the way that self-insured groups currently rent networks from private insurers.
Intranasal midazolam in piglets: pharmacodynamics (0.2 vs 0.4 mg/kg) and pharmacokinetics (0.4 mg/kg) with bioavailability determination
Authors: Lacoste L. , Bouquet S. , Ingrand P. , Caritez J. C. , Carretier M. , Debaene B.
Published: April 2007

Intranasal midazolam was studied in two series of piglets: series 1, n = 20 (18 ± 3 kg), a randomized double blind pharmacodynamic study to compare doses of 0.2 mg/kg and 0.4 mg/kg; series 2, n = 9 (42 ± 8 kg), a pharmacokinetic study with a 0.4 mg/kg dose administered either intravenously (i.v.) or intranasally (i.n.) in a cross-over protocol with a one-week wash-out period between each. In series 1, midazolam caused significant anxiolysis and sedation within 3 to 4 min, without a significant difference between 0.2 and 0.4 mg/kg doses for any of the studied parameters. In series 2, after intranasal midazolam administration of 0.4 mg/kg, plasma concentrations attained a maximum (Cmax) of 0.13 ± 0.04 mg/l at 5 min (median Tmax) and remained higher than 0.04 mg/l until 60 min. The bioavailability factor (F) in this study was F = 0.64 ± 0.17 by the intranasal route. The terminal half-life (T1/2 λz) = 145 ± 138 min was comparable with the i.v. administration half-life (158 ± 127 min). In conclusion, optimal intranasal midazolam dose in piglets was 0.2 mg/kg, which procures rapid and reliable sedation, adapted to laboratory piglets.
Effective eradication of pinworms (Syphacia muris, Syphacia obvelata and Aspiculuris tetraptera) from a rodent breeding colony by oral anthelmintic therapy
Authors: Zenner Lionel
Published: April 2007

An oral combination of piperazine and ivermectin was used over a 6-week period for treating three different colonies of mice or rats infested with Syphacia obvelata, Syphacia muris or Aspiculuris tetraptera. No acute toxic effect was found in transgenic lines of mice or rats with these products in a preliminary trial. The colonies were treated with piperazine, 2.1 mg/ml in tap water for 2 weeks, then with ivermectin, 0.007 mg/ml, in tap water for the third and fourth weeks, and finally with piperazine for two further weeks. Hygiene measures such as a complete cage change, thorough disinfection and cleaning of the rooms were associated with the treatment. All examinations subsequent to completion of treatment have proved negative for further parasites.
Ketorolac (Toradol®) as an analgesic in swine following transluminal coronary angioplasty
Authors: Andersen Hilda Emilia A. , Fosse Richard T. , Kuiper Karel K. J. , Nordrehaug Jan Erik , Pettersen Reidar J.
Published: April 2007

Post-procedure pain is a common complication in swine following survival angioplastic procedures. Ketorolac and buprenorphine have been used to control pain in these animals. Time from completion of procedure-extubation to onset of feeding was used as an indicator for analgesic effect. The onset of feeding following extubation occurs within 6 to 20 h in animals given ketorolac compared to 30 plus hours in animals given buprenorphine.
Investigations into the preferences of laboratory rats for nest-boxes and nesting materials
Authors: Manser C. E. , Broom D. M. , Overend P. , Morris T. H.
Published: April 2007

Nest-boxes and nesting materials were considered potentially useful items with which to enhance the environment of rats housed in standard laboratory cages. This study was carried out to determine whether such items are actually used by rats, and if so, what features are important in their design. Laboratory rats were allowed to choose between four commercially available nest-boxes. Nest-boxes were preferred to other parts of the cage but the nest-box most frequently selected was not suitable for routine laboratory use. Accordingly a new nest-box was designed, incorporating features apparently attractive to the animals. This was a simple structure of opaque perspex, consisting of a roof and three walls. Similarly, rats were exposed to six commercially available nesting materials and those consisting of long paper strips were most preferred.
Heterotopic polyodontia in a cynomolgus monkey
Authors: Yoshizawa K. , Oishi Y. , Fujii T.
Published: April 2007

A case of heterotopic polyodontia was detected in a 6-year-old male laboratory cynomolgus monkey. A heterotopic tooth had erupted through the right maxillofacial area at the side of the nose, with a crustated surface. Macroscopically, the tooth was not connected with the right parotid. Radiography and histopathology of the transverse section of the lesion showed almost normal propriodentium containing alveolar bone and partial continuity with the maxillary bone. We believe this is the first case description of heterotopic polyodontia in a monkey.
Reduction of fever by housing in small cages
Authors: Kuhnen G.
Published: April 2007

Housing conditions influence anatomy, physiology, and behaviour of animals. The aim of this study is to investigate whether the generation of fever, a defence response of the body, is also affected by housing conditions. Golden hamsters ( Mesocricetus auratus) were housed in small cages, large cages, or large and enriched cages. After 9 weeks of exposure to their respective environments, the fever response to the administration of lipopolysaccharide (50 μg/kg from Salmonella typhosa) was tested. One hundred and twenty experiments in 30 hamsters demonstrated that housing in small cages diminished the fever responses (increase in core temperature and fever index) significantly by approximately 20%, and is likely to be due to a higher stress level. The findings demonstrate that the results of physiological experiments are not only influenced by the experimental design, but also by pre-experimental housing conditions.
Reduction in animal numbers required for antisera production using the subcutaneous chamber technique in rabbits
Authors: Whary Mark T. , Carey D. D. , Ferguson F. G.
Published: April 2007

The purpose of this study was to determine if the subcutaneous chamber technique would reduce the number of rabbits required for antisera production by enabling serial use of individual animals for multiple antigens. Rabbits were assigned to immunization protocols against two antigens in series that involved combinations of chamber implantation, Freund's adjuvant and injection of antigen either by the subcutaneous route or by direct inoculation into the chamber. Results indicate the systemic immune response to both antigens achieved similar magnitude and duration by use of either Freund's adjuvant or direct inoculation of antigen into the chamber, suggesting that chamber use may be able to replace use of Complete Freund's adjuvant for many antigens. Rabbits re-used for a second antigen were equally successful in production of significant titres in both serum and chamber fluid without evidence of either a significant inflammatory response due to the chronic presence of the implant or a decrease in the yield of antisera harvested from the chamber. These results support the advantages of chamber use as reported by others and demonstrate that the chamber technique can significantly extend the productive life of an individual animal that would otherwise be euthanized following a single use in antisera production.
Effects of coprophagy on serum urea and the weight of the gastrointestinal tract of fed or fasted rats
Authors: Levine Seymour , Saltzman Arthur
Published: April 2007

Coprophagy can be minimized by fitting rat cages with metal grids which allow faecal pellets to pass through to the floor of the cage. When bedding was omitted overnight, the extent of coprophagy could be estimated from the weight of the droppings on the cage floor or the weight of the gastrointestinal (GI) tract removed from rats housed with or without grids. The effect of coprophagy was also demonstrated by the elevation of serum urea nitrogen in rats that consumed faeces. Therefore, precautions against coprophagy, or their absence, should be specified in all experimental protocols and reports.
Home cage presentation of complex discrimination tasks to marmosets and rhesus monkeys
Authors: Crofts H. S. , Muggleton N. G. , Bowditch A. P. , Pearce P. C. , Nutt D. J. , Scott E. A. M.
Published: April 2007

The study reported here demonstrates the feasibility of presenting cognitive tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB) to either marmosets or rhesus monkeys in their home cages. This location of testing offers opportunities for the measurement of additional indices, for example spontaneous behaviour (Prowse et al. 1995) and electrophysiology (Pearce et al. 1998) as well as facilitating repeated test presentation. Results from 12 marmosets and 4 rhesus monkeys which have completed several sequences of an eight-stage discrimination task involving simple discriminations, compound discriminations and reversals are reported. The paradigm developed has application in long-term studies. Tests from CANTAB have been used extensively in normal humans (Robbins et al. 1994) as well as a range of patient groups (Owen et al. 1992, Elliott et al. 1995) and to assess drug effects (Coull et al. 1996). Additionally some of these tests have been presented to marmosets (Roberts et al. 1988) to examine neuropsychological functioning. This comparative approach facilitates meaningful cross species comparison, particularly in the study of the effects of pharmacological intervention.
Evaluation of hypothalamo-pituitary-adrenal activity in the tree shrew (Tupaia belangeri) via salivary cortisol measurement
Authors: Ohl F. , Kirschbaum C. , Fuchs E.
Published: April 2007

Saliva sampling is frequently used in humans for adrenal glucocorticoid hormone analysis because of advantages such as non-invasiveness, the ease of collection, and storing of the samples. To transfer this advantageous method to laboratory mammals, potentially confounding factors such as stressful handling procedures have to be excluded. In the present study we established a method for collecting saliva for cortisol measurement in freely moving adult male tree shrews ( Tupaia belangeri). The practicability of the procedure was demonstrated (i) by stress-induced changes in cortisol levels revealing a significant increase during the stress phase (control = 0.91 nmol/l vs stress = 1.71 nmol/l), and (ii) by reporting no significant differences in salivary cortisol levels before and after performance of a learning task. The present study emphasizes the use of salivary cortisol analysis especially for monitoring acute changes in the hypothalamo-pituitary-adrenal axis activity in male tree shrews.
Bacterial counts in canine duodenal fluid after exposure to saline, sodium bicarbonate and hypertonic dextrose solutions used to maintain patency of chronically implanted catheters
Authors: Lynch T. M. , Morris T. H. , Dix J. , Nelson P. R.
Published: April 2007

Flushing of intestinal vascular access ports (VAPs) is commonly performed to prevent the problems of blockage and infection, and in this study four different flushing solutions were compared. The growth of bacteria from canine duodenal contents was compared in: 0.9% saline, 50% dextrose, 8.4% sodium bicarbonate (NaHCO3) and 0.01 M phosphate buffered saline (PBS). Duodenal contents from three laboratory beagles were serially diluted in these four solutions, spread plated onto agar at 24 h periods for 7 days and bacterial counts were performed. Immediately after the duodenal juices were added, no significant differences could be seen in bacterial counts with any of the solutions. Over the 7 day period, bacterial numbers greatly increased in saline and phosphate buffered saline, but greatly decreased in dextrose and sodium bicarbonate solutions. Dextrose and sodium bicarbonate appeared to be the most promising flushing solutions tested to minimize infections of associated intestinal VAPs.
Non-surgical catheterization of the jugular vein in young pigs
Authors: Carroll J. A. , Daniel J. A. , Keisler D. H. , Matteri R. L.
Published: April 2007

Current methods utilized for serial blood collection in the young pig are limited due to the stress and/or discomfort to which the pig is exposed. Thus, we have developed a non-surgical, minimally invasive cannulation technique which allows jugular vein catheter placement in the young pig without causing extended discomfort or stress. The procedure described is rapid (approximately 8 min/pig) and relatively simple, requiring only minimal anaesthesia for immobilization of the pig during the procedure. Routinely, 2-week-old piglets are standing in their pens within 15-20 min from initiation of the procedure. Piglets recover rapidly from the procedure and display no clinical indications of pain or discomfort. Serum concentrations of cortisol, a standard indicator of stress and/or discomfort, are asymptomatic within 2 h of completing the procedure ( x = 26.14 ± 3.03 ng/ml). Stress is limited to the initial immobilization of the piglets. With this technique of cannulation, we routinely maintain catheter patency for 2 days, and often for as long as 5 days.
Is carbon dioxide (CO2) a useful short acting anaesthetic for small laboratory animals?
Authors: Kohler I. , Meier R. , Busato A , Neiger-Aeschbacher G. , Schatzmann U.
Published: April 2007

The anaesthetic effect of carbon dioxide (CO2) was investigated under predetermined exposure times in rats, mice and guineapigs with admixture of 20% of oxygen (O2), and with 20% of ambient air in rats. In rats first symptoms (median) were detectable between 7 and 9.5 s, the induction time (median) varied between 16 and 20.5 s and the surgical tolerance (median) was 40 s (after 60 s of exposure) and 53.5 s (after 120 s of exposure) to 80% CO2/20% O2. When O2 was replaced by ambient air, a surgical tolerance of 53.5 s (after 60 s of exposure) and 77 s (after 120 s of exposure) was measured. In mice the induction time to 80% CO2/20% O2 was 10 s and the surgical tolerance 19.5 s (after 120 s of exposure). Guineapigs showed an induction period of 20 s and a surgical tolerance of 50 s (after 30 s of exposure) to 80% CO2/O2. Recovery was short and smooth in all species. This method of general anaesthesia seems to be suitable for short and painful interventions, mainly in rats, but also in guineapigs.
Serological relationship of some V-factor dependent Pasteurellaceae (Haemophilus sp.) from guineapigs and rabbits
Authors: Boot R. , Thuis H. C. W. , Veenema J. L.
Published: April 2007

Culture of guineapig and rabbit respiratory tracts for bacteria using X-(haemin) and V-(NAD) factor in agar media detected infection by V-factor dependent Pasteurellaceae ( Haemophilus sp.) in three colonies of guineapigs and a group of rabbits. The 12 Haemophilus strains comprised three API NH codes classed as Haemophilus parainfluenzae and two codes classed as Haemophilus aphrophilus/paraphrophilus. Six cell wall lipid profiles were detected, but these were not related to API NH codes. Both bacteriological properties were used to select strains for serological studies but any relationship between bacteriological and serological properties of the Haemophilus strains was not evident. Varying serological relationships occurred between the newly isolated Haemophilus strains, [ Pasteurella] pneumotropica NCTC 8284 and Haemophilus strains previously isolated from rats.
Arcobacter butzleri isolated from a diarrhoeic non-human primate
Authors: Higgins R. , Messier S. , Daignault D. , Lorange M.
Published: April 2007

The bacteriological examination of a faecal specimen from a 20-year-old female rhesus macaque ( Macaca mulatta) with diarrhoeal illness revealed the presence of a large number of a relatively new enteric pathogen, Arcobacter butzleri. The animal was from a closed colony of about 60 females, some of them were showing intermittent diarrhoea possibly related to Giardia spp. Conditions for the isolation and identification of A. butzleri are reported, as well as discussions about its role as a primary pathogen and its zoonotic potential.
Medicine and culture: transcultural needs in modern Western societies
Authors: Abímbólá Kólá
Published: April 2007

A distinction can be made between two types of cultural diversity in the practice of medicine: cultural diversity among the individuals involved in healthcare settings (i.e. doctors, nurses, patients, etc.), and diversity in the health paradigms now prevalent in contemporary modern societies (e.g. orthodox Western medicine, Chinese acupuncture, Indian ayurveda and Yorùbá medicine). In contrast to the received view, in which diversity is regarded as 'challenging' or 'problematic' for the provision and delivery of optimal healthcare, this paper argues that because health, wellbeing and wellness are themselves cultural goods in all paradigms of medicine, it is always possible to perform transcultural assessments of the methods, theories and practices adopted in specific paradigms of medicine.
Consent forms: an opportunity for improvement on implementation of the Mental Capacity Act?
Authors: Mulvaney Elizabeth
Published: April 2007

The author discusses some of the current risk management dilemmas related to ensuring informed consent. The aim is to encourage positive debate about the best means of handling patient's consent decisions through review of the territory, and the issues, before moving on to consider the responses to the challenges raised and their possible solutions.
Reverse shoulder arthroplasty for the treatment of three- and four-part fractures of the proximal humerus in the elderly
Authors: Bufquin T. , Hersan A. , Hubert L. , Massin P.
Published: April 2007

We used an inverted shoulder arthroplasty in 43 consecutive patients with a mean age of 78 years (65 to 97) who had sustained a three- or four-part fracture of the upper humerus. All except two were reviewed with a mean follow-up of 22 months (6 to 58).

The clinical outcome was satisfactory with a mean active anterior elevation of 97° (35° to 160°) and a mean active external rotation in abduction of 30° (0° to 80°). The mean Constant and the mean modified Constant scores were respectively 44 (16 to 69) and 66% (25% to 97%). Complications included three patients with reflex sympathetic dystrophy, five with neurological complications, most of which resolved, and one with an anterior dislocation. Radiography showed peri-prosthetic calcification in 36 patients (90%), displacement of the tuberosities in 19 (53%) and a scapular notch in ten (25%). Compared with conventional hemiarthroplasty, satisfactory mobility was obtained despite frequent migration of the tuberosities. However, long-term results are required before reverse shoulder arthroplasty can be recommended as a routine procedure in complex fractures of the upper humerus in the elderly.
Embolic phenomena during computer-assisted and conventional total knee replacement
Authors: Church J. S. , Scadden J. E. , Gupta R. R. , Cokis C. , Williams K. A. , Janes G. C.
Published: April 2007

Systemic emboli released during total knee replacement have been implicated as a cause of peri-operative morbidity and neurological dysfunction. We undertook a prospective, double-blind, randomised study to compare the cardiac embolic load sustained during computer-assisted and conventional, intramedullary-aligned, total knee replacement, as measured by transoesophageal echocardiography. There were 26 consecutive procedures performed by a single surgeon at a single hospital. The embolic load was scored using the modified Mayo grading system for echogenic emboli.

Fourteen patients undergoing computer-assisted total knee replacement had a mean embolic score of 4.89 (3 to 7) and 12 undergoing conventional total knee replacement had a mean embolic score of 6.15 (4 to 8) on release of the tourniquet. Comparison of the groups using a two-tailed t-test confirmed a highly significant difference (p = 0.004).

This study demonstrates that computer-assisted knee replacement results in the release of significantly fewer systemic emboli than the conventional procedure using intramedullary alignment.
A three-dimensional quantitative analysis of carpal deformity in rheumatoid wrists
Authors: Arimitsu S. , Murase T. , Hashimoto J. , Oka K. , Sugamoto K. , Yoshikawa H. , Moritomo H.
Published: April 2007

We have measured the three-dimensional patterns of carpal deformity in 20 wrists in 20 rheumatoid patients in which the carpal bones were shifted ulnarwards on plain radiography. Three-dimensional bone models of the carpus and radius were created by computerised tomography with the wrist in the neutral position. The location of the centroids and rotational angle of each carpal bone relative to the radius were calculated and compared with those of ten normal wrists.

In the radiocarpal joint, the proximal row was flexed and the centroids of all carpal bones translocated in an ulnar, proximal and volar direction with loss of congruity. In the midcarpal joint, the distal row was extended and congruity generally well preserved. These findings may facilitate more positive use of radiocarpal fusion alone for the deformed rheumatoid wrist.
Metal ion levels in a triathlete with a metal-on-metal resurfacing arthroplasty of the hip
Authors: De Haan R. , Campbell P. , Reid S. , Skipor A. K. , De Smet K.
Published: April 2007

A prospective study of serum and urinary ion levels was undertaken in a triathlete who had undergone a metal-on-metal resurfacing arthroplasty of the hip four years previously. The one month study period included the final two weeks of training, the day of the triathlon, and the two weeks immediately post-race. Serum cobalt and chromium levels did not vary significantly throughout this period, including levels recorded on the day after the 11-hour triathlon. Urinary excretion of chromium increased immediately after the race and had returned to pre-race levels six days later. The clinical implications are discussed.
Clinical outcome and rate of complications after primary total knee replacement performed with quadriceps-sparing or standard arthrotomy
Authors: Kim Y.-H. , Kim J.-S. , Kim D.-Y.
Published: April 2007

We performed a prospective, randomised study to compare the results and rates of complications of primary total knee replacement performed using a quadriceps-sparing technique or a standard arthrotomy in 120 patients who had bilateral total knee replacements carried out under the same anaesthetic. The clinical results, pain scales, surgical and hospital data, post-operative complications and radiological results were compared.

No significant differences were found between the two groups with respect to the blood loss, knee score, function score, pain scale, range of movement or radiological findings. In contrast, the operating time (p = 0.0001) and the tourniquet time (p < 0.0001) were significantly longer in the quadriceps-sparing group, as was the rate of complications (p = 0.0468).

We therefore recommend the use of a standard arthrotomy with the shortest possible skin incision for total knee replacement.
Long-term survivorship of the Charnley Elite Plus femoral component in young patients
Authors: Kim Y.-H. , Kim J.-S. , Yoon S.-H.
Published: April 2007

We studied prospectively the long-term results of the Charnley Elite-Plus femoral stem in 184 consecutive young patients (194 hips). There were 130 men and 54 women with a mean age of 49.1 years (21 to 60). The predominant diagnosis was osteonecrosis of the femoral head (63.6%, 117 patients). Clinical and radiological evaluation was undertaken at each follow-up. The mean follow-up was 11.2 years (10 to 12).

The mean pre-operative Harris hip score was 43.4 (12 to 49) which improved to 91 (59 to 100) at the final follow-up. The survival of the femoral stem at 12 years was 99% with revision as the end-point. The mean annual linear wear of the polyethylene liner was 0.17 mm (0.13 to 0.22). The prevalence of acetabular osteolysis was 10.8% (21 hips) and osteolysis of the calcar femorale 12.9% (25 hips).

A third-generation cementing technique, accurate alignment of the stem and the use of a 22 mm zirconia head were important factors in the prevention of aseptic loosening of the Elite Plus femoral stem in these high-risk young patients.
The effect of tourniquet padding on the efficiency of tourniquets of the upper limb
Authors: Rajpura A. , Somanchi B. V. , Muir L. T. S. W.
Published: April 2007

We report the effect of padding on the efficiency of the pneumatic tourniquet for the upper limb. Varying thicknesses of two commercially-available types of orthopaedic padding (Cellona and Velband) were applied to the arms of 20 volunteers, with three pressure transducers placed directly beneath the padding. A tourniquet was positioned over the padding and inflated to 220 mmHg.

Significant reductions in the transmitted pressure were recorded from the transducers with both padding materials. With eight layers of padding, reductions in pressure of 13% (1% to 26%) and 18% (7% to 35%) were seen with Cellona and Velband, respectively. The reduction in pressure with Velband padding correlated with increasing arm circumference (Pearson’s correlation coefficient 0.711, p < 0.001).

Studies to date have examined how arm circumference affects the required tourniquet inflation pressure. Our study is the first to investigate the effect of the padding and the findings suggest that using more than two layers results in a significant reduction in the transmitted pressure.
Social Activity and Healthy Aging: A Study of Aging Danish Twins
Authors: McGue Matt , Christensen Kaare
Published: April 2007

Although social and intellectual engagement have been consistently associated with late-life functioning, rather than true causation, these associations may reflect the experiential choices of high functioning individuals (i.e., selection effects). We investigated the association of social activity with late-life physical functioning, cognitive functioning, and depression symptomatology using data from 1112 pairs of like-sex twins who participated in the Longitudinal Study of Aging Danish Twins. Consistent with previous research, we found that social activity was significantly correlated with overall level of physical functioning, cognitive functioning, and depression symptomatology. We also found that social activity was significantly and moderately heritable (estimate of .36), raising the possibility that its association with late-life functioning might reflect selection processes. Further, social activity did not predict change in functioning and in monozygotic twin pairs discordant on level of social activity, the more socially active twin was not less susceptible to age decreases in physical and cognitive functioning and increases in depression symptomatology than the less socially active twin. These results are interpreted in the context of the additional finding that nonshared environmental factors, although apparently not social activity, are the predominant determinant of changes in late-life functioning.
The Psychological Benefits of Vigorous Exercise: A Study of Discordant MZ Twin Pairs
Authors: Johnson Wendy , Krueger Robert F.
Published: April 2007

The physiological benefits of vigorous exercise are well established. The existence of psychological benefits is less clear, however, due to methodological limitations common to investigatory studies. Two of these limitations are the difficulty of establishing appropriate control groups and the large variety of highly specific measures of psychological function available for consideration of effects. To address these limitations, we identified 63 pairs of monozygotic twins from the National Survey of Midlife Development in the United States who were discordant for the amount of vigorous exercise in which they engaged regularly. The twins who regularly engaged in vigorous exercise experienced greater positive psychological functioning than their nonexercising co-twins as measured by the latent factor representing the variance common to 8 measures of mood, optimism, control over life, and interpersonal aspects of personality. The magnitude of the difference was in excess of .4 standard deviations.
Evidence for Nonadditive Genetic Effects on Eysenck Personality Scales in South Korean Twins
Authors: Hur Yoon-Mi
Published: April 2007

While evidence supporting for nonadditive genetic influences on personality traits in Caucasian populations has been growing in recent years, twin studies that explored the existence of genetic nonadditivity in personality variation in Asian populations are still lacking. Seven hundred and sixty-five pairs of adolescent and young adult twins registered with the South Korean Twin Registry completed the 7 scales of the Eysenck Personality Scales through a mail survey. Maximum likelihood twin correlations were computed and model-fitting analyses were conducted. Monozygotic twin correlations were consistently higher than twice the dizygotic twin correlations for all 7 scales, suggesting pervasive influences of nonadditive genetic effects on personality traits in the South Korean population. Model-fitting analyses indicated that genetic nonadditivity is particularly important for the variation of Impulsivity, Venturesomeness, Empathy, Lie, and Psychoticism. According to the best fitting models, nonadditive genetic effects ranged from 34 to 49% for these scales. For Neuroticism and Extraversion, models that included an additive genetic component fit better than those including a nonadditive genetic variance component.
Comparison of Motor Development Between Twins and Singletons in Japan: A Population-Based Study
Authors: Yokoyama Yoshie , Wada Saeko , Sugimoto Masako , Saito Miyuki , Matsubara Miyoko , Sono Jun
Published: April 2007

This study was performed using population-based data to analyze whether motor development in early life is different between singletons and twins in Japan. For better comparison and investigation, we divided the 2 groups into a group with a birthweight of 2.5 kg or greater (subgroup A) and a group with a birthweight of less than 2.5 kg (subgroup B), respectively. We analyzed the database of medical check-ups for children aged 3 years between April 2001 and July 2004. They received medical checkups at 4 months, 1.5, and 3 years of age. Children who were suspected of having neurological abnormality or disability were referred to specialists and excluded from the database. The data of 14,132 children were analyzed. Among these, 13,040 (92.3%) children were singletons in subgroup A, 75 (0.5%) were twins in subgroup A, 866 (6.1%) were singletons in subgroup B and 151 (1.1%) were twins in subgroup B. The mean age at achieving milestones was slower in twins of subgroup A for each developmental outcome than singletons of subgroup A, and the difference between twins and singletons was significant after adjustment for rolling over. On the contrary, after adjusting for a confounding factor (gestational age), singletons of subgroup B attained motor development facilitating walking independently slower than twins of subgroup B. There were different tendencies in the results regarding the motor development of subjects of subgroup A and that of subjects of subgroup B.