bluuebunny/crossref_metadata_2025 huggingface dataset:
α1‐Antitrypsin deficiency is not an important cause of childhood liver diseases in a multi‐ethnic Southeast Asian population
Authors: Lee Way Seah , Yap Sook Fan , Looi Lai Meng
Published: August 2007

Aim:  We conducted a prospective study to determine the role of α1‐antitrypsin (α1AT) deficiency in the pathogenesis of neonatal cholestasis and other childhood liver diseases in a multi‐ethnic Southeast Asian population.

Methods:  Prospective patients with neonatal cholestasis (group 1), other liver diseases (group 2) and children with other medical conditions (group 3) referred to the Paediatric Unit, University of Malaya Medical Centre, Malaysia, from May 2002 to June 2005, were screened for α1AT level and phenotype. α1AT level below 80 mg/dL was considered as low.

Results:  Of the 114 patients (group 1, n = 53; group 2, n = 42; group 3, n = 19) screened, seven patients (6% of total; group 1, n = 1; group 2, n = 4; group 3, n = 2) had a α1AT level below 80 mg/dL. All had marginally low level (range 57–79 mg/dL), but none had a clinical diagnosis of α1AT deficiency. One patient had PiZ‐ heterozygous phenotype (α1AT level 217 mg/dL) while another patient had PiMS heterozygous.

Conclusions:  α1AT deficiency is not an important cause of neonatal cholestasis and childhood liver diseases in Malaysian children. In Malaysian children with neonatal cholestasis or other liver diseases, routine assay for α1AT phenotype is not recommended if there is no family history of neonatal cholestasis of uncertain aetiology, or if α1AT level is above 80 mg/dL.
Identification of Aboriginal infants at an urban hospital
Authors: Comino Elizabeth J , Titmuss Angela , Harris Elizabeth , Craig Pippa , Pulver Lisa Jackson
Published: August 2007

Aim:  This study explored the accuracy of identification of Aboriginal infants at an urban hospital.

Methods:  Data on the Aboriginal status of all infants who were delivered at the hospital to mothers who resided in the surrounding Local Government Area during 2002 were extracted from the Obstetrics Data Package (ODP). These data were supplemented with local health worker knowledge about the Aboriginal status of infants and compared with NSW Birth Register data held by the Australian Bureau of Statistics.

Results:  There were 1739 deliveries at the hospital to mothers from the Local Government Area. Our study showed that 71.4% (n = 90) of Aboriginal and 77.5% (n = 1649) of non‐Aboriginal infants identified through ODP were included in the Birth Register. The proportion of Aboriginal infants identified through the ODP was 5.2% and the Birth Register was 5.6%. The 90 Aboriginal infants included 38 with an Aboriginal mother, 34 with an Aboriginal father, and 18 with two Aboriginal parents.

Conclusions:  This was the first use of these data to examine the accuracy of identification of Aboriginal infants born at this facility. The study highlighted the importance of systematically seeking information on the Aboriginal status of both parents by antenatal services; of providing opportunities for timely feedback on the data quality to maternity service providers; and ensuring that the data are used to inform development of culturally appropriate services. As a result of this study, services have implemented strategies to routinely identify infants with an Aboriginal father as well as those with an Aboriginal mother.
Responses to immunisation with Hib conjugate vaccine in Australian breastfed and formula‐fed infants
Authors: Hawkes Joanna S , Makrides Maria , Roberton Donal M , Gibson Robert A
Published: August 2007

Objective:  There are conflicting reports as to whether breastfed infants respond with higher antibody levels to conjugate Haemophilus influenzae type b (Hib) vaccine compared with formula‐fed infants. These observations prompted us to investigate the effect of feeding method on the antibody concentration to Hib polyribosylribitol (PRP) both prior to and 3 months after the primary course of immunisation with Hib (PRP‐OMP).

Methods:  We measured plasma concentrations of IgG antibody to Hib PRP by enzyme‐linked immunosorbent assay in blood samples from a total of 272 breastfed and formula‐fed infants prior to immunisation (7 weeks of age, n = 82 and n = 148, respectively) and again 3 months after completion of the primary course of immunisation with Hib PRP‐OMP (7 months of age, n = 88 and n = 132, respectively).

Results:  Breastfeeding was associated with lower plasma antibody titres at both times (P < 0.01, T‐test) with 49% of breastfed infants having anti‐PRP concentrations below 1.0 µg/mL at age 7 months. There was no reported invasive Hib disease in this cohort of infants, and nationally the effectiveness of the Hib vaccination programme remains high.

Conclusions:  These data suggest that breastfeeding may be associated with immunomodulation of infant Hib immunisation responses with this immunisation regime. Further research is needed to determine whether differences in antibody concentration described here are primarily determined by factors directly attributed to breastfeeding or whether other environmental factors may play a significant role.
Thrombotic thrombocytopenic purpura in childhood: An uncommon but life‐threatening cause of thrombocytopenia
Authors: Davis Amanda , Barnes Chris
Published: August 2007

Abstract:  Thrombotic thrombocytopenic purpura (TTP) is a life‐threatening disorder characterised by microangiopathic haemolytic anaemia, thrombocytopenia and signs of ischaemic organ dysfunction such as neurological or renal impairment and fever. The diagnosis of TTP should be considered in any child presenting with thrombocytopenia, in particular those children with microangiopathic haemolysis, atypical immune thrombocytopenia purpura or Evan’s syndrome. Distinguishing TTP from haemolytic uraemic syndrome is difficult, but where there is doubt about the diagnosis, a presumptive diagnosis of TTP should be made to allow potentially life‐saving therapy with therapeutic plasma exchange. Recent advances in the molecular basis of the disease have resulted in assays for ADAMTS‐13 activity, inhibitor levels and ADAMTS‐13 mutation analysis. These assays help to distinguish TTP from haemolytic uraemic syndrome. However, the performance characteristics of these assays in the diagnosis and management of TTP are yet to be defined.
SURVEY OF MANAGEMENT OF ACUTE, TRAUMATIC COMPARTMENT SYNDROME OF THE LEG IN AUSTRALIA
Authors: Wall Christopher J. , Richardson Martin D. , Lowe Adrian J. , Brand Caroline , Lynch Joan , De Steiger Richard N
Published: August 2007

Background:  Acute compartment syndrome is a serious and not uncommon complication of limb trauma. The condition is a surgical emergency and is associated with significant morbidity if not diagnosed promptly and treated effectively. Despite the urgency of effective management to minimize the risk of adverse outcomes, there is currently little consensus in the published reports as to what constitutes best practice in the management of acute limb compartment syndrome.

Methods:  A structured survey was sent to all currently practising orthopaedic surgeons and accredited orthopaedic registrars in Australia to assess their current practice in the management of acute, traumatic compartment syndrome of the leg. Questions were related to key decision nodes in the management process, as identified in a literature review. These included identification of patients at high risk, diagnosis of the condition in alert and unconscious patients, optimal timeframe and technique for carrying out a fasciotomy and management of fasciotomy wounds.

Results:  A total of 264 valid responses were received, a response rate of 29% of all eligible respondents. The results indicated considerable variation in management of acute compartment syndrome of the leg, in particular in the utilization of compartment pressure measurement and the appropriate pressure threshold for fasciotomy. Of the 78% of respondents who regularly measured compartment pressure, 33% used an absolute pressure threshold, 28% used a differential pressure threshold and 39% took both into consideration.

Conclusions:  There is variation in the management of acute, traumatic compartment syndrome of the leg in Australia. The development of evidence‐based clinical practice guidelines may be beneficial.
USE OF AUTOPSY IN GENERAL SURGERY: A COMPARISON OF PRACTICE AND OPINION
Authors: Stiven Peter N. , Frampton Chris M. , Lewis David R.
Published: August 2007

Objective:  To examine current practice regarding autopsy requests and assess consultant opinion regarding the role of autopsy in a general surgical department.

Methods:  One hundred deaths that occurred in a teaching hospital general surgical department, over a 2‐year period, were randomly selected. After review of the hospital notes, a brief summary of each admission was distributed to all 13 consultant general surgeons in the department. Surgeons were asked to comment whether each case should have been discussed with the coroner, whether a coroner’s autopsy should have been carried out, whether a hospital post‐mortem examination should have been carried out and whether it would be appropriate to complete a death certificate without a post‐mortem examination. Surgeon responses were compared with actual outcomes, and both were analysed for predictors of variation in practice.

Results:  The majority of patients were elderly (median age 79 years, 49% >80 years), were admitted acutely (92%) and did not undergo an operation (73%). Thirty‐three patients died of cardiac or respiratory causes. Patients who had undergone a recent operation were more likely to be referred to the coroner (P < 0.001) and more likely to undergo coroner’s autopsy (P = 0.011). Older patients and those admitted from a rest home were less likely to be referred to the coroner (P < 0.001 and 0.02, respectively) or undergo coroner’s autopsy (P = 0.002 and 0.011, respectively). The survey predicted more referrals to the coroner (44 vs 30, P = 0.001) and more hospital autopsies (21 vs 2, P < 0.001) and that the treating doctor would complete the certificate of death less often than actually happened (79 vs 91, P = 0.004). The survey suggested that surgeons were more likely to complete the certificate of death in patients with active malignancy (P = 0.01), but this was not observed in practice.

Conclusions:  General surgeons consider autopsy to be necessary more often than that is taking place in practice in our institution. The continued decline in autopsy rates may compromise the safety and quality of the service provided by general surgeons and result in a gap in the education of surgeons and trainees.
SQUAMOUS CELL CARCINOMA OF THE FLOOR OF THE MOUTH: TUMOUR THICKNESS AND THE RATE OF CERVICAL METASTASIS
Authors: Wallwork Ben D. , Anderson Shane R. , Coman William B.
Published: August 2007

Background:  Increased thickness of oral cavity squamous cell carcinoma (SCC) has been shown to be associated with higher rates of cervical metastasis. Most of the previous studies have focused on SCC of the oral tongue. There are few studies that have examined solely carcinoma of the floor of the mouth and these studies differ in the thickness of tumour that is associated with significantly increased rates of cervical metastasis.

Methods:  Patients with SCC of the floor of the mouth of all stages who were treated with excision and neck dissection were identified. Primary tumour thickness and other pathological features were determined in the pathological specimens and were correlated to the incidence of pathological cervical lymph node metastasis. Fisher’s exact test and the unpaired t‐test were used for statistical analysis.

Results:  Fifty‐three patients were studied (43 men and 10 women). The median age was 56.5 years (range 43—86 years). The median tumour thickness in patients with lymph node metastases (14.6 mm) differed significantly from those without metastases (8.6 mm) (P = 0.004). When T1 and T2 cases were looked at in isolation, the median tumour thickness of cases with lymph node metastases (11.1 mm) again was significantly greater than those without metastases (4.6 mm) (P = 0.04). Subgrouping tumours into those ≥7.5 mm or <7.5 mm showed a significantly increased rate of lymph node metastasis (57% compared with 12%, P = 0.001). There was no statistically significant association between perineural invasion or tumour differentiation and the presence of lymph node metastases.

Conclusion:  Tumour thickness has been shown to be directly related to rates of cervical lymph node metastasis in floor of mouth SCC. The primary tumour thickness associated with significantly increased rates of metastasis is similar to that shown in previous studies examining SCC of the oral tongue.
HAND‐ASSISTED LAPAROSCOPY ON A SHOESTRING
Authors: Antony Luke , Laim Eunice , Chung Sydney S. C.
Published: August 2007

Background:  Hand‐assisted laproscopic surgery is useful in difficult laproscopic operations. Expensive and cumbersome devices are necessary to ensure airtightness between the surgeon’s hand and the abdominal wall so that pneumoperitoneum can be maintained.

Method:  A simple method of maintaining pneumo‐peritoneum in hand‐assited laproscopic surgery was carried out by tying a strong nylon suture in a criss‐cross fashion on one end of the incision. Airtightness was maintained by tightening the suture around the wrist and wedging the dorsum of the hand against the abdominal wall.

Result:  The method was used successfully to remove a pyonephrotic left kidney in a 28‐year‐old man from Papua New Guinea.

Conclusion:  Hand‐assisted laproscopic operations can be carried out expediently and inexpensively without specialized equipment by simply tying a shoestring suture at one end of the wound.
MINIMALLY INVASIVE PARATHYROIDECTOMY USING SURGEON‐PERFORMED ULTRASOUND AND SESTAMIBI
Authors: Prasannan Subhita , Davies Giles , Bochner Melissa , Kollias James , Malycha Peter
Published: August 2007

Background:  Surgeon‐performed ultrasound (SPU) and 99mTc‐sestamibi (SM) scanning can be used alone or in combination in patients with primary hyperparathyroidism to select cases suitable for minimally invasive parathyroidectomy (MIP). The aim of the study was to evaluate SPU and SM and to determine the reliability they provide the surgeon in planning and carrying out MIP.

Methods:  The study was a prospective analysis of 130 patients with primary hyperparathyroidism who had preoperative localization with SPU and SM at a tertiary referral centre between 2003 and 2006. All ultrasound scans were carried out by one surgeon, followed by correlative sestamibi scan and a further ‘on operating table’ ultrasound to reassess the lesion and mark the operative site. Selection criteria for MIP were a positive SPU and SM, although a positive SPU or SM allowed the surgeon to focus on the nominated side. SPU and SM localizations were correlated to the operative findings.

Results:  One hundred and thirty patients underwent both SPU and SM. There were 97 women and 33 men, with a mean age of 59 years. SPU alone identified the abnormal parathyroid in 103 cases (sensitivity 82%; positive predictive value 96.3%). SM alone identified the abnormal gland in 102 cases (sensitivity 79%; positive predictive value 99%). In 88 patients, the SPU and SM were concordant, and 94% had successful MIP. SPU and SM were both negative in 13 patients, and all these patients had bilateral neck exploration.

Conclusion:  SPU in the hands of an experienced surgeon in association with sestamibi is a reliable tool for the preoperative localization of parathyroid adenomas and facilitates a minimally invasive procedure.
Elimination of HIV‐1 from semen and application of the processed semen to assisted reproductive technology
Authors: KUJI NAOAKI , MIZUSAWA YURI , NAGANISHI MIWA , HAMATANI TOSHIO , IWATA SOKICHI , YOSHIMURA YASUNORI
Published: August 2007

As HIV infection is becoming a controllable chronic infection after the introduction of the highly active antiretroviral therapy (HAART), patients with this infection are now able to make plans for the future. Numerous serodiscordant (HIV‐positive men and HIV‐negative women) couples seek medical assistance to have a child with minimum risk to the HIV‐negative female partner and the child using processed (washed) sperm. HIV‐1 elimination from the semen using density gradient centrifugation and the swim‐up procedure, which is a standard processing procedure, depends on both sperm motility and the physical properties of the virus‐containing particles. To establish a simple method for recovering sperm from poor quality semen, we developed the tilted‐tube rotation method to generate a continuous density gradient, and using this continuous density gradient we have succeeded in recovering motile sperm, even from the semen of seropositive males with severe male factors. This review aims to summarize the recent progress in the underlying principles and technical aspects of semen processing for elimination of HIV‐1. (Reprod Med Biol 2007; 6: 151–156)
Short‐term exposure of female rats to industrial metal salts: Effect on implantation and pregnancy
Authors: BATAINEH HAMEED N. , BATAINEH ZIAD M. , DARADKA HAYTHAM
Published: August 2007

Aim: The objective of this study was to characterize the adverse effects of industrial metal salts during the early stages of pregnancy.

Methods: Successfully mated female rats were exposed to the following metal salts via intragastric intubation; manganese sulfate, lead acetate, aluminum chloride, ferrous chloride and ferric chloride in doses of 50 mg/kg body weight and chromium chloride and potassium dichromate in doses of 25 mg/kg body weight on days l–3 or 4–6 of pregnancy. Female rats were killed on day 20 of gestation and the pregnancy outcome was determined.

Results: The administration of manganese sulfate, chromium chloride, potassium dichromate and ferric chloride to female rats on days 1–3 of pregnancy caused pregnancy failure. However, the administration of manganese sulfate and potassium dichromate reduced the number of implantations. The administration of manganese sulfate, potassium dichromate and ferric chloride reduced the number of viable fetuses. The total number of resorptions increased in the lead acetate, aluminum chloride, ferrous chloride and ferric chloride exposed groups. In contrast, the administration of manganese sulfate, aluminum chloride and ferric chloride on days 4–6 of pregnancy caused pregnancy failure. However, the administration of ferric chloride reduced the number of implantations. The administration of manganese sulfate, aluminum chloride, potassium dichromate, ferrous chloride and ferric chloride reduced the number of viable fetuses. The total number of resorptions increased in the manganese sulfate, lead acetate, aluminum chloride, potassium dichromate, ferrous chloride and ferric chloride exposed groups.

Conclusion: This work demonstrates that the short‐term exposure of female rats to industrial metal salts during the early stages of gestation would cause failure of pregnancy and produce fetotoxic or fetal resorptive potentials. (Reprod Med Biol 2007; 6: 179–183)
Posterior leukoencephalopathy syndrome as a cause of reversible blindness during pregnancy
Authors: Onderoglu Lutfu S. , Dursun Polat , Gultekin Murat , Celik Nilufer Y.
Published: August 2007

Cortical blindness is a rare and dramatic complication of pre‐eclampsia. The precise nature of the pathogenesis of this condition has not previously been understood. Three preeclamptic patients with unremarkable previous medical history presented with acute blindness between the 28th and 33rd weeks of pregnancy. They were all diagnosed as posterior leukoencephalopathy syndrome (PLES). In all these patients, MRI study revealed the typical feature of gray‐white matter edema localized to the temporo‐parieto‐occipital areas. Vision and MRI findings were restored in all patients after delivery. Although PLES has been described as a puerperal clinicoradiologic entity, it may be seen in preeclamptic‐eclamptic patients during the pregnancy. Therefore neuro‐imaging studies should be carried out in pregnant patients with visual disturbances in order to exclude PLES. Prompt diagnosis, immediate control of blood pressure, and elimination of possible causes resolves clinical and imaging findings.
Development of risk scoring scheme for prediction of cesarean delivery due to cephalopelvic disproportion in Lamphun Hospital, Thailand
Authors: Khunpradit Suthit , Patumanond Jayanton , Tawichasri Chamaiporn
Published: August 2007

Aim:  To develop a simple risk scoring scheme for the prediction of cesarean delivery due to cephalopelvic disproportion (CPD) in Lamphun Hospital, Thailand.

Methods:  A case‐control study was conducted including 116 pregnant women with cesarean delivery due to CPD and 307 pregnant women delivering by normal labor. Obstetric information was retrieved from medical records. Risk indicators measurable at the time of admission were analyzed by a stepwise logistic regression to obtain a set of statistically significant predictors. Regression coefficients were transformed into item scores and added up to a total score. Risk of cesarean delivery due to CPD was analyzed using total scores as the only predictor.

Results:  A risk scoring scheme was developed from five obstetric predictors: maternal age, height, parity, pregnancy weight gain and symphysis‐fundal height. Item scores ranged from 0 up to 3.5 and the total score from 0–14.5. The scheme explained, by the area under the receiver operating characteristic curve, 88% of cesarean delivery due to CPD. The likelihood of cesarean delivery due to CPD in pregnant women with low risk (scores below 5), moderate risk (scores 5–9.5) and high risk (scores 10 and over) were 0.09, 0.86 and 10.11, respectively.

Conclusions:  The risk of cesarean delivery due to CPD may be forecasted by a simple scoring scheme using five predictors that correctly identified women with low, moderate and high risk. This scheme may be applicable to physicians and midwives for identifying high‐risk pregnant women in order to take appropriate action.
Antenatal diagnosis of placenta previa accreta in patients with previous cesarean scar
Authors: Japaraj Robert P. , Mimin Tarmini S. , Mukudan Krishnan
Published: August 2007

Aim:  To determine the accuracy of transabdominal and transvaginal gray‐scale and color Doppler in diagnosing placenta previa accreta in patients with previous cesarean sections.

Methods:  Twenty‐one patients who had undergone previous cesarean sections and were confirmed to have partial or total placenta previa in the current pregnancy were subjected to ultrasound examinations after the 28th week of gestation. Specific ultrasound features were looked for on gray‐scale ultrasound and color Doppler examination of the placenta and its interphase with the uterus and the bladder.

Results:  Seven of the 21 patients had ultrasound evidence of placenta accreta and all were later confirmed to have placenta previa accreta intraoperatively. The gray‐scale positive findings were present in six out of the seven patients. The most prominent gray scale feature to suggest placenta accreta was the presence of multiple lakes that represent dilated vessels extending from the placenta through the myometrium. All seven patients had features of placenta accreta when examined with color Doppler. The most prominent color Doppler feature present in all seven patients was the presence of interphase hypervascularity with abnormal vessels linking the placenta to the bladder. The sensitivity and specificity of antenatal ultrasound diagnosis of placenta previa accreta was 100%.

Conclusion:  Antenatal diagnosis of placenta previa accreta can be made with a thorough ultrasound examination of the placenta in patients with previous cesarean scar and placenta previa.
B‐Lynch suture after the failure of hypogastric artery ligation to control post‐partum hemorrhage due to placenta increta in a patient with the factor V Leiden mutation
Authors: Somunkiran Asli , Ozdemir Ismail , Demiraran Yavuz , Yucel Oguz
Published: August 2007

Post‐partum hemorrhage may be a life‐threatening condition. A case of a patient receiving antithrombotic therapy for the factor V Leiden mutation, in whom post‐partum hemorrhage had occurred due to placenta increta, is described. In this case, the post‐partum hemorrhage did not respond to bilateral hypogastric artery ligation, while the B‐Lynch surgical technique was successful in obtaining hemostasis.
Blue rubber bleb nevus syndrome: Report of a patient with hemangiomas of the vaginal portion of the cervix appearing during pregnancy
Authors: Tanaka Norifumi , Tsuda Mikio , Samura Osamu , Miyoshi Hiroshi , Hara Tetsuaki , Kudo Yoshiki
Published: August 2007

Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder showing venous malformations in the skin and gastrointestinal tract, and other internal organs. We encountered a patient with BRBNS in whom hemangiomas of the uterine cervix appeared during pregnancy. This was apparently the first reported occurrence. To avoid unexpected bleeding from hemangiomas, patients with BRBNS should be examined repeatedly for hemangiomas of the birth canal, and special care should be taken in deciding the mode of delivery.
Fulminant type 1 diabetes during pregnancy: A case report and review of the literature
Authors: Yamamoto Nari , Fujita Yasuyuki , Satoh Shoji , Nakanami Naoyuki , Sonoda Noriyuki , Nakano Hitoo
Published: August 2007

Fulminant type 1 diabetes, classified as a subtype of nonautoimmune type 1 diabetes, may result in severe complications for both mother and fetus due to the sudden onset of diabetic ketoacidosis. Little is known about the clinical features of pregnancy with fulminant type 1 diabetes. We present a case of fulminant type 1 diabetes during pregnancy, along with a review of the published literature. A 31‐year‐old Japanese woman presented with sudden onset of nausea and vomiting at 36 weeks' gestation and was provisionally diagnosed with acute gastroenteritis. She was referred to us for investigation of exaggerated general fatigue and intrauterine fetal death. Based on blood and urinary examinations, she was diagnosed with diabetic ketoacidosis, caused by fulminant type 1 diabetes. Although her ketoacidosis was improved, insulin therapy was needed. Awareness of this disease can lead to prompt diagnosis and treatment and consequently, improved maternal and fetal prognosis.
Uterine artery embolization should not be recommended without careful consideration in the treatment of symptomatic uterine fibroids
Authors: Ohgi Shirei , Nakagawa Koji , Inoue Hiromi , Yasuda Masanobu , Saito Hidekazu
Published: August 2007

Aim:  To evaluate convalescence and the incidence of adverse symptoms associated with uterine artery embolization (UAE) in the treatment of uterine fibroids, several parameters after UAE were compared with those after laparoscopic surgery.

Methods:  For the treatment of uterine fibroids, 78 patients underwent UAE and 58 received laparoscopic surgery (31 were laparoscopic myomectomy [LM] and 27 were laparoscopy‐assisted myomectomy [LAM]) during the period July 2001 to July 2004. The length of hospitalization, and the periods until the beginning of a normal daily life, work and exercise, long‐term follow up data in the UAE and laparoscopy groups were compared, and the incidence of adverse symptoms after each procedure was compared.

Results:  The length of hospitalization for the UAE group 2.1 ± 0.1 (mean ± S.E) was significantly shorter than those for the LM and LAM groups (2.6 ± 0.1 and 3.8 ± 0.2 days, respectively; P < 0.0001 and P < 0.0001). The period until beginning of normal daily life and work were similar between the UAE and LM groups. The degree of improved symptoms after each procedure were similar among the three groups, but the incidence of adverse symptoms after UAE was significantly higher than after laparoscopic surgery.

Conclusions:  The UAE group showed a significantly shorter period of hospitalization, but the convalescence of the UAE group was similar to the LA group, with a higher incidence of adverse symptoms than laparoscopic surgeries. Therefore, UAE should not be recommended without careful consideration, in the treatment of symptomatic uterine fibroids.
Structure of the male reproductive system of Anoecia (Anoecia) corni Fabricius, 1775 (Hemiptera, Aphidoidea), a representative of the family Anoeciidae
Authors: Wieczorek Karina
Published: August 2007

The structure of the male reproductive system of Anoecia (Anoecia) corni Fabricius, 1775, is discussed. On the basis of histological sections and whole mount preparations, the following elements in the structure of the male reproductive system have been examined: the structure of testis and the stage of spermatogenesis; the connection of testis and vasa deferentia; the position and the histological structure of the wall of vasa deferentia; and the development of accessory glands and the ejaculatory duct as well as the structure of the external genitalia. These characters are discussed with reference to the higher classification of Aphidoidea and the taxonomic position of Anoeciidae.
WHY FINANCIAL MARKETS DO NOT USE ECONOMETRIC FORECASTING: FOREIGN EXCHANGE EXOTICS, CENTRAL BANKS AND POSITION TAKING
Authors: NEFTCI SALIH N.
Published: August 2007

Clients and market practitioners act based on very different sets of information. It is natural for a client to use the Wiener–Kolmogorov prediction theory. Market makers are different. They also use econometric forecasting. But these are not standard econometric forecasting techniques. The practitioner has to take into account various levels or barriers known to exist in the short run. In this paper, we argue that the presence of such levels changes the classical forecasting problem into a Bayesian one.
I. THE EFFECT OF METALS IN MILK AND MILK PRODUCTS
Authors: Waite R.
Published: August 2007

The presence of metals in milk and milk products can lead to spoilage by accelerating the development of oily, tallowy, fishy or putrid smells and tastes in addition to their specific metallic flavour; some metals may also increase the loss of Vitamin C.

The metals least likely to cause these effects are the stainless steel group followed by tin, heavily tinned copper, aluminium and magnesium‐aluminium alloys in that order; copper, iron, zinc and galvanised metals should be avoided.
SOME INFREQUENT BACTERIAL FAULTS OF MILK
Authors: McKenzie D. A.
Published: August 2007

Bacterial faults of the nature described, while they may be introduced to the dairy through the raw milk supplies, can generally be controlled readily by efficient pasteurising and cooling. On the other hand, bad plant management can readily aggravate contamination from the raw milk. The importance of adequate laboratory supervision, both of plant and the raw and processed milks, must therefore be stressed, and in this connection the use of a 30°C. incubator may be mentioned. It is now generally accepted by dairy bacteriologists that incubation at 30°C. will give more illuminating results for general control work.
A LABORATORY HIGH TEMPERATURE SHORT‐TIME PASTEURISER
Authors: Pascoe J. V.
Published: August 2007

A laboratory H.T.S.T. pasteuriser designed for routine work is described.

Where the heating, holding, and cooling times‐closely approximate those of the commercial plant comparable results can be obtained in a laboratory unit.
Scottish Milk Testing Scheme
Authors: Chalmers C.H.
Published: August 2007

A survey of the results of tests for chemical composition of the bulk milk of some 160 producers delivered to eight creameries in different parts of the Scottish Milk Marketing Board's area during a period of twelve months has yielded some interesting results. The conclusions drawn, however, are purely tentative and provide only pointers o differences in the composition of the supplies. The causes of the differences have not been investigated but they are probably related primarily to differences in feeding and herd management.

The first portion of the survey shows that in about eighty per cent of individual supplies the maximum variation in the fat content of four consecutive weekly samples was 0·60 per cent with an average of 0·30 per cent and that it would therefore appear reasonable to allow a tolerance of ±0·10 per cent from the average fat content of the four weekly samples when determining the monthly true mean fat content of a bulk supply of milk as delivered to a creamery. Similarly since 82·5 percent of individual supplies showed a maximum difference in any one month of 0·30 per cent in the solids‐not‐fat content a tolerance of ±0·05 per cent when four consecutive weekly samples are examined might reasonably be allowed.

The second portion of the survey shows that the average composition of bulk supplies as delivered to creameries varies widely in different areas. In the South Western area the fat content of the milk reached a higher level during the late summer and was maintained at this higher level for a longer period than in the East Central area. Although the trends of the fat and solids‐not‐fat contents were somewhat similar in the South West during the months of August to January this similarity was not continued during the remainder of the year, nor did it appear to be evident in the East Central area at any time of the year. The marked rise in the total solids content of the milk from the South Western area during the months of September to November contrasts markedly with the consistency of the total solids content of milk produced in the East Central area during September to February.

The results of the tests also show that on the whole producers in both areas should find no serious difficulty in complying with the Scottish Milk Marketing Board's standards of 3·5 per cent of fat during the months of August to January (inclusive) and 3·4 per cent during the remainder of the year.

Finally consideration might be given to basing any system of payment by quality on the total solids content of the milk rather than on the fat or solids‐not‐fat content alone.
AN INVESTIGATION OF THE EFFECT OF ULTRA‐HIGH‐TEMPERATURE TREATMENT ON THE FREEZING‐POINT AND COMPOSITION OF MILK
Authors: ASCHAFFENBURG R. , BURTON H. , ROWLAND S. J. , THIEL C. C.
Published: August 2007

The possible effects of UHT treatment on the freezing‐point, fat and solids‐not‐fat of milk were investigated by taking series of samples from three plants.

UHT treatment did not affect the freezing‐point. Some small, inconsistent, variations in the composition were found, and these are attributed to difficulties in ensuring uniformity of sampling.
MILK SAMPLING AT WEIGH TANKS—I
Authors: EDWARDS R. A. , SIMPSON M. E.
Published: August 2007

1. Samples were taken on three consecutive days from twenty‐two suppliers at three creameries. Six samples were taken at different levels and positions in the weigh tanks.

2. Details of two dippers for sampling at different depths in the tank are given.

3. Maximum differences between the six samples from each tank of milk ranged from 0·05 per cent to 0·61 per cent for fat and 0·07 per cent to 0·56 per cent for S.N.F., with means of 0·22 per cent and 0·21 per cent respectively.

4. Coefficients of variation have been calculated for each tank of milk together with mean figures for each supplier and each creamery.

5. Estimates have been made of the accuracy of the fat and S.N.F. content of a single sample taken from a tank of milk as a measure of the composition of the whole of the milk within the tank.

6. Maximum differences show that very large differences in composition can occur at different points in the weigh tank.

7. Comparison of the coefficients of variation for individual herds showed no correlation between variability within the tank with either the gallonage or the fat or S.N.F. content of the milk. A significant difference in variability was shown when the creameries were compared. This was attributed to the presence in one of the tanks of an obstacle in the shape of a foam breaker.

8. Single samples of milk taken from an unagitated weigh tank cannot be relied upon to give an accurate assessment of the quality of the milk within the tank. Some form of agitation must be practised if a reliable sample is to be taken.

9. The results of a pilot investigation carried out at one creamery in the winter months indicate very much greater variation in composition within unagitated tanks at this time of the year. The results of this investigation show that the variability of fat content can be considerably reduced by a reasonable plunging of the tank contents. The effect of plunging on S.N.F. variability was not so encouraging.
THE HYGIENIC CONDITION OF MISUSED MILK BOTTLES AFTER WASHING
Authors: DAVIS J. G.
Published: August 2007

(1) Twelve experiments in six dairies in various parts of England have shown that, when foreign matter in a milk bottle is impervious, the normal washing process delivers the ‘dirty bottle’ in an excellent hygienic condition, with a low colony count and absence of coli and milk‐souring organisms.

(2) When the foreign matter is pervious a high colony count is often obtained. However, the absence of coli in these bottles suggests that even these are hardly likely to be a daoger to public health.

(3) All such types of dirty bottles arise from deliberate misuse by members of the public, or at least failure to return and consequent neglect.

(4) In spite of all efforts by dairy firms a misused bottle occasionally escapes detection. It is probable that as long as glass bottles are used the occasional dirty bottle will get through on rare occasions.

(5) Present legislation bears harshly on dairies but ignores the real culprit. More positive measures should be adopted to prevent the misuse of milk bottles.

This investigation was not undertaken at the instigation of any dairy firm or organization. This paper is an attempt to present an objective survey of the problem.
THE DISTRIBUTION OF BACILLUS CEREUS AND OTHER BACTERIA IN CLEAN MILK CANS
Authors: BILLING EVE , BAKER LILY A. E.
Published: August 2007

The distribution of bacteria, including Bacillus cereus and mesophilic sporeformers surviving 100oC. for 2 minutes, was determined by swabbing different parts of milk cans from 2 dairies having a good record. In all, 288 cans were examined over a 12‐month period; 36 cans from a further 2 dairies were examined during July and August. Lid surfaces and the rim of the can yielded relatively high numbers of bacteria, compared with other parts; together they often yielded more than the whole of the rest of the can. There was no marked seasonal variation in the numbers except with B. cereus spores, which were found in larger numbers in the period July–October. It is concluded that while a rinse method will give useful information on the relatively efficiency of can cleansing, it does not give a complete picture of the can as a source of contamination.
COMPRESSED AIR SUPPLIES AND EQUIPMENT IN DAIRIES
Authors: BRISSENDEN C. H.
Published: August 2007

This article, which is submitted for publication in the Society's Journal by the Dairy Equipment and Standardization Committee, is the outcome of a series of discussions which have taken place during the past twelve months. The Committee wish to record their indebtedness to Mr. P. C. Bevis, of Broom & Wade Limited, who has been present at all these discussions and who has prepared numerous extended drafts which have provided the basis for the article. Mr. Bevis has also been responsible for preparing the illustrations and tables.

It is hoped that this article will fill a need in the industry, and with this in view it has been prepared in pamphlet form for general sale.
TWO SPECIAL PURPOSE BALANCES
Authors: HOUSE MARGARET
Published: August 2007

Two special purpose balances are described.

(i) For the rapid estimation of moisture in butter.

(ii) For weighing out 5 g cream directly into a cream butyrometer.

Experience under routine laboratory conditions has shown both instruments to be rapid and reliable.
THE DEFATTING OF NATURAL RUBBER MILKING MACHINE LINERS
Authors: COOPER J. H.
Published: August 2007

It has been shown that detergents in general are relatively poor fat removal agents from used liners. Alcohols and alcoholic alkalis are more efficient as cleaning agents judged by their power of removing fats and they are generally better than the commonly used aqueous caustic soda solution. Limited farm tests have in general confirmed laboratory test results. Liners are kept in good condition for periods longer than previously obtained when using other cleaning methods.
THE FUTURE OF DAIRY FARMING IN GREAT BRITAIN
Authors: GARNER FRANK H.
Published: August 2007

1. The consuming public will continue to want fresh milk, preferably produced in this country, and it is essential that farmers provide them with this daily.

2. Since the consuming public will want milk at a fairly constant level farmers must organize guaranteed level deliveries to dairies.

3. Farms will either become family farms or large units handling some 200 cows; these units belonging either to individual farmers or to small groups of farmers.

4. The pattern will develop to keep British Friesians in the main, Ayrshires in selected places and Chancel Island cows for special cream trade.

5. Farms will have a breeding plan with cowmen, instead of M.M.B., using artificial insemination.

6. Farms will rear their own replacements and the majority of steer calves for beef.

7. Milk will be paid for on level supply basis and also on butterfat percentage.

8. Milk will be stored cooled on the farm in bulk tanks.

9. All dairy equipment on the farm must be cleaned easily by circulation cleaning with suitable detergents.

10. Special cleanliness and disinfection will be necessary when rearing large numbers of young stock in a small compass.

11. If dairying is to continue, the cost of production must be reduced (a) by reducing labour, and (b) by reducing the cost of food production.
A LOOK AT NEW ZEALAND DAIRYING
Authors: Raftery T. F.
Published: August 2007

New Zealand has got an excellent climate for prolonged grazing and high output pastures.

To exploit this great natural asset fully, all cows are spring calved and manufacturing milk is produced exclusively from grass. The pattern of milk production is completely seasonal with a total shut down of milking sheds and manufacture for a period in the winter.

Herds are very large by European standards and there is almost complete standardization of milking sheds and systems and this, allied with almost complete specialization, results in low cost high‐output efficient units.

Low feed costs combined with low shed and equipment costs allied with high output/acre,/labour unit and /farm, enables New Zealand dairy farmers to make a relatively good living from milk (4 per cent fat) sold at 10p/gal.
THE DEVELOPMENT OF AN IN‐LINE REFRIGERATED MILK COOLER
Authors: Slade J. R.
Published: August 2007

A very simple but effective in‐line cooler is described comprising a stainless steel coil which may be lowered into an agitated chilled water bath for cooling, or raised clear for washing.

The coil is easy to clean and may be used in conjunction with pipeline milking installations or with a dump station.

In the experimental prototype the milk cooling capacity was limited to 70 gal/day by the quantity of ice which could be stored, but this quantity of milk could be cooled from 35° to 2·8°C (95° to 37°F).

A simple insulated tank of 70 gal capacity has been constructed from which the milk can be collected in bulk; on test, the mean temperature rise of 70 gal water at 5°C (41 °F) was 1·5°C (2·7°F) in 8 h in an ambient temperature of 32°C (90°F). This tank could be trolley‐mounted for roadside collection.
REVERSE OSMOSIS — CONCENTRATION APPLICATIONS
Authors: Donnelly J. K. , O'Sullivan A. C. , Delaney R. A. M.
Published: August 2007

An examination is made of the influence of the main processing variables in the reverse osmosis (RO) concentration of both whey and skim milk. Up to a solids concentration ceiling of ca. 25 per cent, RO offers an economic advantage over thermal evaporation as a concentration technique, in terms of lower operating costs. Furthermore, RO possesses the additional advantage that it concentrates without heat, thereby retaining the native properties of the original raw material before concentration. In particular, there is no heat denaturation of the thermolabile whey proteins and, hence, no reduction of valuable functional properties and no cooked flavour development.

Based on these inherent advantages of RO over thermal evaporation, various process and product applications of RO to whey and skim milk utilization have been suggested. Additional features of membrane processing by RO have also been discussed.
SUBJECT: DAIRYING IN THE EEC: PRODUCTION AND MARKETING OF MILK PRODUCTS IN THE EEC
Authors: DICKINSON B. H. B.
Published: August 2007

The paper outlines the position of the United Kingdom in relation to the production and marketing systems in the EEC. The structure of the dairy industry in the Community and points showing the distinction between the UK and other member states are discussed. The problems of import levies, intervention buying and the introduction of direct subsidies are considered. Tables giving comparative figures of the Nine with regard to average yields, production and deliveries, utilization and product consumption show the general marketing trend in the EEC. (Editor's summary.)
SUBJECT: ENERGY ‐ ITS EFFICIENT USE AND CONSERVATION IN THE FOOD AND DAIRY INDUSTRY: ENERGY AND THE PRODUCTIVITY OF AGRICULTURE
Authors: BLAXTER K. L.
Published: August 2007

The achievements of British agriculture in the last 100 years are considered and the remarkable increase in productivity evident during the last 30 years emphasized. It is shown that this was largely due to the increased reliance on inputs of resources from the industrial sector of the economy. Energy accounting methods are used to estimate this reliance, and an analysis is given of the energetics of British agriculture in terms firstly, of its biological efficiency and secondly, its industrial efficiency. These estimates are compared with those noted in other countries. The input of energy in terms of primary fuel equivalent to the industry is such that it takes 2–5 calories of fossil fuel to produce one calorie of food. The food industry is next considered and it is shown that this sector is even more expensive in terms of its dependence on fossil fuel reserves. The energy used in food provision and distribution is a large portion ‐ nearly 10 per cent of our national energy requirements and the manpower employed is probably well in excess of 15 per cent of total work force
FUEL‐ITS EFFICIENT USE: PRESENT AND FUTURE*
Authors: WESTON H. B.
Published: August 2007

The paper emphasizes the problem caused by escalating world‐energy demand calling for price increases as the regulator. In the UK, North Sea oil and gas are considered as valuable but small resources demanding high capital injection. A plea is made for intelligent use of coal and North Sea oil to reduce our dependence on imported oil but conservation of resources by efficient utilization is sound economic sense. Industrialists who wish to remain competitive will require to use energy efficiently. Greater attention must be given to the factors influencing boiler costs and recent surveys show that there is much room for improvement in this direction. Attention is drawn to the need for reducing primary heat losses, e.g. radiation losses, steam trap losses, condensate loss, etc. Greatest scope for economizing lies in the process side, i.e. in heat utilization and traditional methods must be challenged. In this connection the author suggests that there is no substitute for an in‐depth heat audit. The techniques are well established but a great deal depends on the will and enthusiasm at higher management level in the organization.