bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibitory effects of diclofenac on the endotoxin shock response in relation to endothelin turnover in the pig
Authors: Weitzberg E. , Lundberg J. M. , Rudehill A.
Published: September 2011

During sepsis vasoactive arachidonic acid metabolites of the cyclo‐oxygenase pathway and the endothelium‐derived vasoconstrictor endothelin‐1 (ET‐1) are released. The effects of cyclo‐oxygenase pathway inhibition by diclofenac on the endotoxin shock response and ET‐1 turnover, were investigated in five groups of pigs. In the first group (n = 7; controls) endotoxin (15μg·kg−1·h−1 i.v.) was infused for two hours. In a second endotoxin group (n = 7), the animals were pretreated with diclofenac (3 mg·kg−1 i.v.). In a third group (n = 7), high‐dose ET‐1 was infused (20 pmol·kg−1·min−1 i.v.) and in a fourth group (n = 7), the ET‐1 infusion was preceded by diclofenac. In a fifth group (n = 4), a low and intermediate dose of ET‐1 (0.2 and 4 pmol· kg−1·min−1) was infused.

A significant increase in ET‐1‐like immunoreactivity (LI) plasma levels was observed in both endotoxin groups, but in the diclofenac group the increase was comparatively delayed. Furthermore, this group showed a more stable haemodynamic course and in the biphasic increase of pulmonary vascular resistance seen in endotoxin controls, the initial peak was abolished by diclofenac. Exogenous ET‐1 infusion indicated that not only locally released but possibly also circulating ET‐1 could be a mediator of vascular responses to endotoxin. Indications of release from the lungs were seen during endotoxin infusion. Diclofenac had no effect on basal ET‐1‐LI plasma levels or on the disappearance rate from plasma of ET‐1‐LI and the haemodynamic changes seen on ET‐1 infusion.

The inhibition of cyclo‐oxygenase pathway by diclofenac resulted in prevention of the initial pulmonary hypertension and a delayed increase in plasma ET‐1‐LI levels in porcine endotoxin shock and this latter effect is not due to an increased rate of disappearance from plasma but rather to a decreased release of ET‐1.
Comparison of parenteral diclofenac and ketoprofen for postoperative pain relief after maxillofacial surgery
Authors: Niemi L. , Tuominen M. , Pitkänen M. , Rosenberg P. H.
Published: September 2011

Non‐steroidal anti‐inflammatory drugs (NSAID) effectively reduce the need for opioid analgesia after various types of surgery. The efficacy of diclofenac and ketoprofen to relieve pain after maxillofacial surgery was compared in the present study. In a randomized and double‐blind fashion, 90 ASA I–II patients (16–60 yrs) were studied, divided into three groups:

Thirty patients received 1.0 mg · kg−1 diclofenac i.v. after general anaesthesia induction, before surgical incision, and four hours later the same dose was given i.m. Thirty patients received ketoprofen 1.35 mg · kg−1 i.v. and i.m., as above, and a third group of 30 patients received a comparable volume of saline i.v. and i.m. The patients received supplemental analgesia using a patient controlled analgesia apparatus; the rescue medication consisted of 0.03 mg · kg−1 oxycodone i.v. (four‐hour maximum dose was 0.4 mg · kg−1) during the 24‐hour follow‐up.

The three groups were comparable regarding the type of maxillofacial surgery (osteotomies vs. soft tissue surgery). Overall, there was a lower need for i.v. oxycodone during the 24‐hour period in the diclofenac group (269 doses) than in the ketoprofen group and in the saline group (388 doses, each) (P<0.01). The significantly lower number of oxycodone administrations in the diclofenac group was a result of a distinguishable difference, particularly during the first four hours after surgery. There was no statistically significant difference in the incidence of side effects of the analgesic therapy between the three groups.
Reexpansion of atelectasis during general anaesthesia may have a prolonged effect
Authors: Rothen H. U. , Sporre B. , Engberg G. , Wegenius G. , Hedenstierna G.
Published: September 2011

Pulmonary atelectasis, as found during general anaesthesia, may be reexpanded by hyper‐inflation of the lungs. The purpose of this study was to determine whether such a recruitment is maintained and whether this is accompanied by an improved gas exchange.

We studied a consecutive sample of twelve lung healthy adults, scheduled for elective surgery. After induction of intravenous anaesthesia, the lungs were hyperinflated manually. The ventilationperfusion relationship (Va/Q) was estimated with the multiple inert gas method, and in six patients atelectasis was assessed by computed x‐ray tomography.

The mean pulmonary shunt was 7.5% of cardiac output after induction of anaesthesia and this decreased to 1.0% and 2.8% at 20 and 40 min after the recruitment manoeuvre. Perfusion of poorly ventilated lung regions (low Va/Q), however, increased from 3.7% to 10.6% and 7.8% at 20 and 40 min after the recruitment, respectively. The mean alveolar‐arterial oxygen tension difference (PA‐ao2) was 14.3 kPa after induction of anaesthesia and 11.1 kPa immediately after recruitment. Forty minutes later PA‐ao2 was still 2.0 kPa lower than after induction of anaesthesia (95% conficence interval [CI] 0.3 to 3.8 kPa). PA‐ao2 decreased more in obese patients. The mean area of atelectasis decreased from 9.0 cm2 after induction of anaesthesia to 0.1 cm2 immediately after recruitment, and there was a slow increase to 1.9 cm2 (95% CI 0.0 to 3.9 cm2) 40 min later.

During general anaesthesia in lung healthy patients, most of the reexpanded atelectatic lung tissue remains inflated for at least 40 min. The recruitment manoeuvre decreases pulmonary shunt, but increases low Va/Q. The net effect on gas exchange is a small reduction of PA‐ao2.
Maintained unilateral analgesia
Authors: Sala‐Blanch X. , Izquierdo E. , Fita G. , de Maria B. José , Nalda M. A.
Published: September 2011

We describe a case of a patient subjected to what proved to be an epidural puncture with catheter placement resulting in persistent unilateral analgesia. The epidurographic study by contrast medium injection through the catheter showed unilateral distribution of the contrast following the cranio‐caudal axis in the anterior epidural space.
A standardized immunofluorescence test method with human neutrophil antigen‐expressing cell lines to enhance antibody detection
Authors: Lopez G. H. , Dean M. M. , Yasui K. , Schuller R. M. , Hirayama F. , Fung Y. L.
Published: September 2011

There is an international need for a large‐scale human neutrophils antigen (HNA) antibody screening platform to minimize the risk of antibody‐mediated transfusion‐related acute lung injury. However, sourcing a substantial, reliable source of HNA, as well as the scarcity of well‐characterized HNA antisera for validating new screening platforms, remain as major obstacles. This short communication presents an improved protocol for the effective use of HNA‐expressing KY cells as a screening platform using eight well‐characterized HNA antisera of a single defined specificity.
Abscisic acid‐regulated responses of aba2‐1 under osmotic stress: the abscisic acid‐inducible antioxidant defence system and reactive oxygen species production
Authors: Ozfidan C. , Turkan I. , Sekmen A. H. , Seckin B.
Published: September 2011

We investigated the interaction among abscisic acid (ABA), reactive oxygen species (ROS) and antioxidant defence system in the transduction of osmotic stress signalling using Arabidopsis thaliana WT (Columbia ecotype, WT) and an ABA‐deficient mutant (aba2‐1). For this, 50 μm ABA and osmotic stress, induced with 40% (w/v) polyethylene glycol (PEG8000; −0.7 MPa), were applied to WT and aba2‐1 for 6, 12 or 24 h. Time course analysis was undertaken for determination of total/isoenzyme activity of the antioxidant enzymes, superoxide dismutase (SOD; EC 1.15.1.1), catalase (CAT; EC 1.11.1.6), ascorbate peroxidase (APX; EC 1.11.1.11), NADPH oxidase (NOX; EC 1.6.3.1) activity; scavenging activity of the hydroxyl radical (OH˙), hydrogen peroxide (H2O2); endogenous ABA and malondialdehyde (MDA). The highest H2O2 and MDA content was found in PEG‐treated groups of both genotypes, but with more in aba2‐1. ABA treatment under stress reduced the accumulation of H2O2 and MDA, while it promoted activity of SOD, CAT and APX. APX activity was higher than CAT activity in ABA‐treated WT and aba2‐1, indicating a protective role of APX rather than CAT during osmotic stress‐induced oxidative damage. Treatment with ABA also significantly induced increased NOX activity. Oxidative damage was lower in ABA‐treated seedlings of both genotypes, which was associated with greater activity of SOD (Mn‐SOD1 and 2 and Fe‐SOD isoenzymes), CAT and APX in these seedlings after 24 h of stress. These results suggest that osmotic stress effects were overcome by ABA treatment because of increased SOD, CAT, APX and NOX.
Exclusive conservation of mitochondrial group II intron nad4i548 among liverworts and its use for phylogenetic studies in this ancient plant clade
Authors: Volkmar U. , Groth‐Malonek M. , Heinrichs J. , Muhle H. , Polsakiewicz M. , Knoop V.
Published: September 2011

Liverworts occupy a pivotal position in land plant (embryophyte) phylogeny as the presumed earliest‐branching major clade, sister to all other land plants, including the mosses, hornworts, lycophytes, monilophytes and seed plants. Molecular support for this earliest dichotomy in land plant phylogeny comes from strikingly different occurrences of introns in mitochondrial genes distinguishing liverworts from all other embryophytes. Exceptionally, however, the nad5 gene – the mitochondrial locus hitherto used most widely to elucidate early land plant phylogeny – carries a group I type intron that is shared between liverworts and mosses. We here explored whether a group II intron, the other major type of organellar intron, would similarly be conserved in position across the entire diversity of extant liverworts and could be of use for phylogenetic analyses in this supposedly most ancient embryophyte clade. To this end, we investigated the nad4 gene as a candidate locus possibly featuring different introns in liverworts as opposed to the non‐liverwort embryophyte (NLE) lineage. We indeed found group II intron nad4i548 universally conserved in a wide phylogenetic sampling of 55 liverwort taxa, confirming clade specificity and surprising evolutionary stability of plant mitochondrial introns. As expected, intron nad4i548g2 carries phylogenetic information in its variable sequences, which confirms and extends previous cladistic insights on liverwort evolution. We integrate the new nad4 data with those of the previously established mitochondrial nad5 and the chloroplast rbcL and rps4 genes and present a phylogeny based on the fused datasets. Notably, the phylogenetic analyses suggest a reconsideration of previous phylogenetic and taxonomic assignments for the genera Calycularia and Mylia and resolve a sister group relationship of Ptilidiales and Porellales.
Skeleton Pattern and Joint Formation in Chorioallantoic Grafts Containing the Distal Parts of the Chick Wing Bud
Authors: Rizgeliene R. , Tutkuviene J.
Published: September 2011

With 13 figures

Skeleton pattern formation was examined in chick wing bud grafts using the chorioallantoic grafting method. The distal parts of the wing bud were excised from the donor wing and transplanted onto the chorioallantoic membrane (the experimental groups). Transplants with intact limb bud material served as the control group. The skeleton pattern formation in the grafts depended on the amount of transplanted material and donor’s limb bud stage. The younger the donor’s stage and the bigger the piece of the transplanted material the more proximal parts grafts had, more retarded growth and abnormal skeleton in the zeugopod and autopod was. The percentage of the signs of insufficient blood supply in the experimental groups was less than that in the control group. As the amount of the transplanted limb bud material decreased and donor’s limb bud aged, post‐axial polydactyly changed to the pre‐axial one.
A method for the prediction of multitrait breeding values for use in stochastic simulation to compare progeny‐testing schemes, with large progeny groups for proven sires
Authors: Eikje L.S. , Schaeffer L.R. , Ådnøy T. , Klemetsdal G. , Ødegård J.
Published: September 2011

A method of approximating estimated breeding values (EBV) from a multivariate distribution of true breeding values (TBV) and EBV is proposed for use in large‐scale stochastic simulation of alternative breeding schemes with a complex breeding goal. The covariance matrix of the multivariate distributions includes the additive genetic (co)variances and approximated prediction error (co)variances at different selection stages in the life of the animal. The prediction error (co)variance matrix is set up for one animal at a time, utilizing information on the selection candidate and its offspring, the parents, as well as paternal and maternal half‐ sibs. The EBV are a regression on TBV taking individual uncertainty into account, but with additional ‘free’ variation drawn at random. With the current information included in the calculation of the prediction error variance of a selection candidate, it is concluded that the method can be used to optimize progeny‐testing schemes, where the progeny‐tested sires are utilized with large progeny groups, e.g. through artificial insemination.
Effect of alternate day feeding strategy of sub‐optimal protein level on haemato‐biochemical responses in Labeo rohita (Hamilton) juveniles
Authors: Kumar P. , Jain K. K. , Munilkumar S. , Sahu N. P. , Siddaiah G. M. , Saha H.
Published: September 2011

A feeding trial was conducted for 60 days to delineate the effect of alternate day feeding strategy of sub‐optimal protein level on haematological parameters, serum parameters and phagocyte respiratory burst activity (NBT) in Labeo rohita juveniles. One hundred and thirty‐five fingerlings (1.87 ± 0.01–2.26 ± 0.05 g) were distributed in triplicate groups of each treatment, and fish were fed at 5% body weight daily. Three experimental isocaloric (401.32–410.28 kcal/100 g) diets of 30%, 25%, and 20% crude protein designated as diet A, diet B, and diet C respectively, were prepared, using locally available feed ingredients. Three different feeding schedules of normal protein diet continuously (diet A‐30%), alternate feeding of 1‐day diet A followed by 1‐day diet B (1A/1B) and alternate feeding of 1‐day diet A followed by 1‐day diet C (1A/1C) were tested. The total erythrocyte count and haemoglobin content was significantly (p < 0.05) enhanced in the group T1 fed (1A/1B), and the lowest count was recorded in the group T2 fed (1A/1C). Total leucocyte counts, total serum protein, and serum globulin were higher in the group T1 fed (1A/1B) and lower in the group T2 fed (1A/1C) as compare to control. The respiratory burst activity (NBT) of blood phagocytes and serum A‐to‐G ratio was recorded significantly difference in among the treatment groups. Based on the results of the present study, it is concluded that alternate feeding of 1‐day diet A followed by 1‐day diet B (1A/1B) is equally effective and promote the immunity in Labeo rohita juveniles.
Effects of Seasons on Some Semen Parameters and Bacterial Contamination of Awassi ram Semen
Authors: Azawi OI , Ismaeel MA
Published: September 2011

Contents

The objectives of the present study were to determine the effects of season on some semen parameters and bacterial contamination of Awassi ram semen. Semen samples from six mature Awassi rams were used in this study. Semen collection was performed with artificial vagina every week, from September 2009 to October 2010. Volume, sperm concentration, mass motility, individual motility, percentage live sperm and sperm abnormalities were evaluated. Moreover, determination of viable bacterial count of the rams was also recorded weekly. Higher (p < 0.05) semen volume in the hot summer and spring months was observed of August (1.55 ± 0.08 ml) and March (1.27 ± 0.15 ml). Sperm concentration was highest (p < 0.05) in the breeding season (late summer to early autumn) of September (4.21 ± 0.86 × 109 sperm/ml). Sperm individual motility and percent of live sperm observed in August (summer) and May (end of spring) when the environmental temperature started to increase were recorded highest values and differed significantly (p < 0.05) from December and January (winter). The highest value of the mean sperm acrosomal defects (13.33 ± 0.63%) was recorded in December. The highest value of the mean viable bacterial count (138.3 ± 21.6) was recorded in July (summer). A significant decrease (p < 0.01) in the mean viable bacterial count was observed from the middle of winter towards the end of spring. The lowest bacterial count was noted in January (60.5 ± 2.98). It could be concluded from the results of the present study that there is an effect of season on ram semen quality, and summer high temperature in northern Iraq has no effect on Awassi ram semen. There is a significant effect of season on bacterial count on Awassi ram semen.
Ultrasonography and Progesterone Concentration at a Single Time Point for the Detection of Puberty in Dairy Heifers
Authors: Archbold H , Buckley F , Pierce KM , Begley N , Mee JF
Published: September 2011

Contents

Data were available from 1657 heifers across 48 dairy farms which were visited once, on average 9 days (±5.2) prior to the mating start date (23 April, ±12.6). Blood samples were collected via coccygeal venepuncture for progesterone (P4) analysis, and animals were scanned for the presence or absence of corpora lutea (CL), to determine the luteal status. A comparison of luteal status between ultrasound (CL identified) and P4 (≥1 ng/ml), based on a single measurement point, showed poor agreement (K = 0.32). The majority of animals were classified as luteal (76%) using both ultrasonography and P4. There was excellent agreement between luteal status detected by ultrasonography alone and luteal status assigned by a combination of ultrasonography and P4 (K = 0.93). The agreement between luteal status assigned by P4 and luteal status assigned by the combination of ultrasonography and P4 was poor (K = 0.37). These results indicate that at a single examination, ultrasonography is the preferred modality to determine the luteal status of maiden heifers.
Weakness of expiratory muscles and pulmonary complications in malnourished patients undergoing upper abdominal surgery
Authors: LUNARDI ADRIANA C. , MIRANDA CAMILA S. , SILVA KAROLINE M. , CECCONELLO IVAN , CARVALHO CELSO R.F.
Published: September 2011

Background and objective:  Malnutrition is prevalent in hospitalized patients and causes systemic damage including effects on the respiratory and immune systems, as well as predisposing to infection and increasing postoperative complications and mortality. This study aimed to assess the impact of malnutrition on the rate of postoperative pulmonary complications, respiratory muscle strength and chest wall expansion in patients undergoing elective upper abdominal surgery.

Methods:  Seventy‐five consecutive candidates for upper abdominal surgery (39 in the malnourished group (MNG) and 36 in the control group (CG)) were enrolled in this prospective controlled cohort study. All patients were evaluated for nutritional status, respiratory muscle strength, chest wall expansion and lung function before surgery. Postoperative pulmonary complications (pneumonia, tracheobronchitis, atelectasis and acute respiratory failure) before discharge from hospital were also evaluated.

Results:  The MNG showed expiratory muscle weakness (MNG 65 ± 24 vs CG 82 ± 22 cm H2O; P < 0.001) and decreased chest wall expansion (P < 0.001), whereas inspiratory muscle strength and lung function were preserved (P > 0.05). The MNG also had a higher incidence of postoperative pulmonary complications compared with the CG (31% and 11%, respectively; P = 0.05). In addition, expiratory muscle weakness was correlated with BMI in the MNG (r = 0.43; P < 0.01). The association between malnutrition and expiratory muscle weakness increased the likelihood of postoperative pulmonary complications after upper abdominal surgery (P = 0.02).

Conclusions:  These results show that malnutrition is associated with weakness of the expiratory muscles, decreased chest wall expansion and increased incidence of pulmonary complications in patients undergoing elective upper abdominal surgery.
Airway dimensions and pulmonary function in chronic obstructive pulmonary disease and bronchial asthma
Authors: KURASHIMA KAZUYOSHI , HOSHI TOSHIKO , TAKAYANAGI NOBORU , TAKAKU YOTARO , KAGIYAMA NAHO , OHTA CHIE , FUJIMURA MASAKI , SUGITA YUTAKA
Published: September 2011

Background and objective:  COPD and bronchial asthma are chronic airway diseases with a different pathogenesis. Comparisons of differences in airway calibre by bronchial generation between these diseases and their importance to pulmonary function have not been fully studied. We investigated airway calibre and wall thickness in relation to pulmonary function in patients with asthma, COPD, asthma plus emphysema and normal subjects using CT.

Methods:  Sixty‐three asthmatic patients, 46 COPD, 23 patients with asthma plus emphysema and 61 control subjects were studied cross‐sectionally. We used a software with curved multiplanar reconstruction to measure airway dimensions from 3rd‐ to 6th‐generation bronchi of the right lower posterior bronchus.

Results:  Patients with COPD had increased wall thickness, but the airway was not narrow from the 3rd‐(subsegmental) to 6th‐generation bronchi. Mean bronchial inner diameter (Di) of 3rd‐ to 6th‐generation bronchi in patients with asthma or asthma plus emphysema was smaller than that of COPD patients and normal subjects. Airway luminal area (Ai) of 5th‐generation bronchi most closely correlated with pulmonary function in patients with stable asthma. Although Di was similar in patients with asthma and asthma plus emphysema, the Ai of 6th‐generation bronchi correlated significantly with pulmonary function in patients with asthma plus emphysema.

Conclusions:  Airway calibre in asthma may be smaller than in COPD. Airflow limitations correlated more closely with peripheral Ai in patients with asthma plus emphysema than in patients with asthma alone.
Congenital heart disease in a Chinese hospital: pre‐ and postnatal detection, incidence, clinical characteristics and outcomes
Authors: Yu Zhangbin , Xi Yangyang , Ding Wenxiao , Han Shuping , Cao Li , Zhu Chun , Wang Xuejie , Guo Xirong
Published: September 2011

Background:  The pre‐ and postnatal detection rate, incidence, clinical characteristics and outcomes of congenital heart disease (CHD) have been studied in developed countries for many years, but rarely have large‐scale studies been reported in Chinese populations. The aim of the present study was to investigate the pre‐ and postnatal detection rates, incidence, clinical characteristics and outcomes of CHD in a Chinese hospital in order to improve the future screening and treatment of CHD.

Methods:  Fetuses without risk factors for CHD were screened using basic cardiac ultrasound examination (BCUE). Fetuses with suspected cardiac malformation revealed by BCUE and fetuses with risk factors were screened using extended cardiac ultrasound examination. Outcomes recorded from fetal, neonatal and postmortem records over 4 years (2006–2009) included: therapeutic termination of pregnancy, spontaneous abortions or stillbirths, deaths at birth or in the neonatal period (before 28 days of age), and rate of birth and clinical characteristics of newborns.

Results:  A total of 34 071 fetuses were screened for CHD during a period of 4 years, of which 173 fetuses were screened for CHD using BCUE and 301 fetuses were screened using extended cardiac ultrasound examination. The incidence of fetal CHD increased from 1.1% in 2006 to 2.4% in 2009 (P < 0.05), yielding an overall incidence of 1.5% (523/34 071). Of the fetuses with CHD, 48.2% (252/523) died before 28 days of age (including intra‐uterine death and termination of pregnancy), 51.8% (271/523) lived more than 28 days and the incidence of live newborns with CHD was 0.80% (271/34071).

Conclusions:  The prevalence of CHD was quite common in this Chinese hospital. Detailed profiles of CHD suggest that, while training programs in obstetric screening at this hospital were beneficial, prenatal intervention, treatment and care of fetal CHD were inefficient and should be strengthened in China.
Importance of urinary flow studies after hypospadias repair: A systematic review
Authors: González Ricardo , Ludwikowski Barbara M
Published: September 2011

A systematic review was performed of publications relating to the results of urinary flow studies after hypospadias repair dating back to 1978, when what appears to be the first publication on this topic was found. The literature search was performed using the key words “hypospadias” combined with “urinary flow”, “urine flow”, “uroflow”, “uroflowmetry”, and “long‐term”. We also reviewed the abstracts and full‐length articles cited in the reference list of selected articles. Criteria for inclusion in the present systematic review included descriptions of patient selection, surgical technique, the severity of disease (proximal vs distal), and the method used to determine uroflow, as well as a definition of urethral obstruction. In all, 339 article titles were found. Of these, 25 abstracts appeared relevant and the full text of these articles were reviewed, with 22 of the papers included in this review. Sixteen reports had appeared in the literature since 2001, compared with six between 1978 and 2000, suggesting an increasing interest in this topic. On the basis of the results of the present systematic review, we recommend that asymptomatic children operated on for hypospadias in infancy should have one flow study after toilet training, with that study repeated if the results are abnormal. It appears that early abnormal flows improve spontaneously, so that children operated on after toilet training who are asymptomatic should undergo their first uroflow measurement 1 year after surgery. Children with obstructed flow parameters or borderline flows should be followed until adulthood, until long‐term follow up studies clarify the significance of abnormal flow parameters. Given the present findings, we anticipate that in the next two decades urologists will need to treat a number of men with strictures resulting from hypospadias repairs performed in childhood.
Does testosterone deficiency exaggerate the clinical symptoms of Peyronie's disease?
Authors: Nam Hyung Jong , Park Hyun Jun , Park Nam Cheol
Published: September 2011

Serum testosterone (T) influences wound healing and levels are decreased in the age group at risk of Peyronie's disease (PD). The aim of the present study was to evaluate the severity of penile deformity in men with PD in relation to T levels. One‐hundred and six patients with PD and T deficiency (serum T <3.5 ng/mL; Group 1) and those with normal T levels (Group 2) were compared according to the duration of PD, the size and location of the plaques, penile curvature, pain on erection, and the severity of erectile dysfunction. The mean degree of penile curvature in Group 1 was significantly greater than in Group 2 (32.0 ± 15.9°vs 21.8 ± 15.4°, respectively). The mean Group 1 score on the International Index of Erectile Function (IIEF)‐5 was lower than the score for Group 2 (7.4 ± 3.7 vs 10.8 ± 4.8, respectively). The percentage of patients who complained of pain on erection did not differ between the two groups. Plaque size in Group 1 was larger than in Group 2 (3.0 ± 1.2 vs 2.0 ± 1.2 cm, respectively), whereas there was no significant difference in plaque location. Although there was a lower percentage of responders to medical treatment in Group 1, there were no differences in surgical outcomes between the two groups. These findings suggest that the presence of T deficiency in patients with PD exaggerates the severity of PD by affecting penile deformity, plaque size, and erectile dysfunction. Further studies are needed to confirm this relationship.
Perioperative management of the hypothalamic‐pituitary‐adrenal axis in patients with pituitary adenomas: an Australasian survey
Authors: Joseph S. P. , Ho J. T. , Doogue M. P. , Burt M. G.
Published: September 2011

Background

There is limited consensus regarding optimal glucocorticoid administration for pituitary surgery to prevent a potential adrenal crisis.

Aim

To assess the investigation and management of the hypothalamic–pituitary–adrenal (HPA) axis in patients undergoing trans‐sphenoidal hypophysectomy in Australasia.

Methods

A questionnaire was sent to one endocrinologist at each of 18 centres performing pituitary surgery in Australasia. Using hypothetical case vignettes, respondents were asked to describe their investigation and management of the HPA axis for a patient with a: non‐functioning macroadenoma and intact HPA axis, non‐functioning macroadenoma and HPA deficiency and growth hormone secreting microadenoma undergoing trans‐sphenoidal hypophysectomy.

Results

Responses were received from all 18 centres. Seventeen centres assess the HPA axis preoperatively by measuring early morning cortisol or a short synacthen test. Preoperative evaluation of the HPA status influenced glucocorticoid prescription by 10 centres, including 2/18 who would not prescribe perioperative glucocorticoids for a patient with a macroadenoma and an intact HPA axis. Tumour size influenced glucocorticoid prescribing patterns at 7/18 centres who prescribe a lower dose or no glucocorticoids for a patient with a microadenoma. Choice of investigations for definitive postoperative assessment of the HPA axis varied with eight centres requesting an insulin tolerance test, four centres a 250 µg short synacthen test and six centres requesting other tests.

Conclusions

There is wide variability in the investigation and management of perioperative glucocorticoid requirements for patients undergoing pituitary surgery in Australasia. This may reflect limited evidence to define optimal management and that further well‐designed studies are needed.
Preliminary analysis of the cost‐effectiveness of the National Bowel Cancer Screening Program: demonstrating the potential value of comprehensive real world data
Authors: Tran B. , Keating C. L. , Ananda S. S. , Kosmider S. , Jones I. , Croxford M. , Field K. M. , Carter R. C. , Gibbs P.
Published: September 2011

Background/Aim:  The complexity and cost of treating cancer patients is escalating rapidly and increasingly difficult decisions are being made regarding which interventions provide value for money. BioGrid Australia supports collection and analysis of comprehensive treatment and outcome data across multiple sites. Here, we use preliminary data regarding the National Bowel Cancer Screening Program (NBCSP) and stage‐specific treatment costs for colorectal cancer (CRC) to demonstrate the potential value of real world data for cost‐effectiveness analyses (CEA).

Methods:  Data regarding the impact of NBCSP on stage at diagnosis were combined with stage‐specific CRC treatment costs and existing literature. An incremental CEA was undertaken from a government healthcare perspective, comparing NBCSP with no screening. The 2008 invited population (n= 681 915) was modelled in both scenarios. Effectiveness was expressed as CRC‐related life years saved (LYS). Costs and benefits were discounted at 3% per annum.

Results:  Over the lifetime and relative to no screening, NBCSP was predicted to save 1265 life years, prevent 225 CRC cases and cost an additional $48.3 million, equivalent to a cost‐effectiveness ratio of $38 217 per LYS. A scenario analysis assuming full participation improved this to $23 395.

Conclusions:  This preliminary CEA based largely on contemporary real world data suggests population‐based faecal occult blood test screening for CRC is attractive. Planned ongoing data collection will enable repeated analyses over time, using the same methodology in the same patient populations, permitting an accurate analysis of the impact of new therapies and changing practice. Similar CEA using real world data related to other disease types and interventions appears desirable.
Effects of the relative time of emergence and the density of common lambsquarters (Chenopodium album) on corn (Zea mays) yield
Authors: SARABI VAHID , MAHALLATI MEHDI NASSIRI , NEZAMI AHMAD , MOHASSEL MOHAMMAD HASAN RASHED
Published: September 2011

Common lambsquarters (Chenopodium album) is one of the world's worst weeds. In order to study the competitive potential of single‐cross 704 corn (Zea mays) in competition with common lambsquarters at different relative times of emergence and density levels of the weed, an experiment was conducted in 2006 at the farm of the Faculty of Agriculture, Ferdowsi University of Mashhad, Mashhad, Iran. This experiment was designed as a split plot based on a randomized complete block design with three replications. The emergence time of the weed was considered at three levels (7 days and 14 days earlier than corn and simultaneously with corn) as the main plot, while the density of the weed was considered at six levels (0, 4, 8, 12, 16, and 20 plants per m2) as the subplot. The results showed a decrease in the grain yield and biomass of corn, as the emergence time of corn was delayed in comparison with the weed in a way that the maximum reduction was observed at the earlier emergence of the weed, compared to corn, and also at a high density of the weed. As the weed emerged earlier than corn, the rate of yield loss resulting from the first flush of weeds was not that high. However, with every few days that the weed emerged earlier than corn, the rate of yield loss became higher as the density of the weed increased to its maximum. The maximum reduction in the yield components was observed at 14 days earlier emergence of the weed, compared to corn, and at high densities, as the corn plants were overshadowed by the weed canopy and no ear was produced.
Evaluation of novel sulfonylurea derivatives with a fused heterocyclic moiety as paddy herbicides that control sulfonylurea‐resistant weeds
Authors: IKEDA HAJIME , YAMATO SEIJI , KAJIWARA YUKARI , NISHIYAMA TAKAYUKI , TABUCHI TAKANORI , TANAKA YASUSHI
Published: September 2011

Herbicidal activity and acetolactate synthase (ALS) inhibition of sulfonylurea derivatives with a fused heterocyclic moiety bonded to a sulfonyl group were investigated. Some compounds that had an imidazo[1,2‐b]pyridazine moiety substituted at the 2‐position by chlorine or methyl controlled sulfonylurea‐resistant (SU‐R) weeds and showed inhibitory activity to ALS prepared from SU‐R Schoenoplectus juncoides shoot. There was a correlation between in vitro and whole‐plant herbicidal activity of the compounds mentioned above against SU‐R Schoenoplectus juncoides. Among them 1‐(2‐chloro‐6‐propylimidazo[1,2‐b]pyridazin‐3‐ylsulfonyl)‐3‐(4,6‐dimethoxypyrimidin‐2‐yl)urea, propyrisulfuron, was selected for further evaluation. Propyrisulfuron effectively controlled paddy weeds at doses of 70 and 140 g a.i. ha−1 with good rice selectivity in a field trial.
Biologically threatened dolphins and whales
Authors: Di Guardo Giovanni , Mazzariol Sandro , Fernández Antonio
Published: September 2011

Among the several threats to which free‐ranging cetaceans are exposed, a number of biological noxae are believed to represent a serious hazard to their health and conservation on a global scale, with special emphasis on the Mediterranean Sea. These pathogens include viral agents such as Morbillivirus, which during the last 25 years have caused dramatic epidemics and die‐offs among several aquatic mammal species and populations worldwide, as well as Herpesvirus, protozoan agents such as Toxoplasma gondii and bacterial pathogens such as Brucella spp.
Demonstration of erectile management techniques to men scheduled for radical prostatectomy reduces long‐term regret: a comparative cohort study
Authors: Kinsella Janette , Acher Peter , Ashfield Anna , Chatterton Kathryn , Dasgupta Prokar , Cahill Declan , Popert Rick , O’Brien Tim
Published: September 2011

Study Type – Outcomes (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

Patients with localized prostate cancer face a bewildering number of treatment choices. Modern technology and innovation in treatment techniques have seen patient expectations rise exponentially, leading to an increase in regret of treatment choice.

This study has shown that the demonstration of erectile function techniques helps inform decision‐making and reduce long‐term regret of treatment choice in localized prostate cancer.

OBJECTIVE

• To determine whether preoperative demonstrations of intracavernosal and vacuum therapies for erectile dysfunction (ED) influence the decision of treatment choice, reducing long‐term regret.

PATIENTS AND METHODS

• In all, 82 consecutive men with localized prostate cancer, scheduled for radical prostatectomy and reporting an International Index of Erectile Function score of >21, were prospectively enrolled at a single cancer centre.

• Following standard preoperative counselling, half of the men were invited to attend a further consultation for intracavernosal and vacuum therapy demonstrations.

• All patients were evaluated pretreatment and then 3 monthly using the five‐point International Index of Erectile Function score and the 14‐item Hospital Anxiety and Depression scale.

• At 12 months treatment choice changes were recorded and patients were assessed for treatment choice regret using Clark’s validated two‐item regret questionnaire. Statistical analysis was performed using the Mann–Whitney and Fisher’s exact tests. Results were compared with a control population of 41 men who did not undergo additional ED counselling.

RESULTS

• In all, 8/41 men (19%) changed their treatment choice, opting for brachytherapy rather than radical prostatectomy.

• Only 1/41 in the control population changed their decision before surgery.

• At 1 year, one patient (2%) in the intervention group expressed regret at his treatment choice (radical prostatectomy) compared with eight (20%) in the control group (P= 0.03, two‐sided Fisher’s exact test); ED was identified as the major cause of this regret.

CONCLUSION

• Preoperative demonstrations of ED therapies can optimize decision making in prostate cancer and help reduce long‐term regret.
Prevalence of hesitancy in 30–80‐year‐old Finnish men: Tampere Ageing Male Urological Study (TAMUS)
Authors: Pöyhönen Antti , Häkkinen Jukka T. , Koskimäki Juha , Hakama Matti , Tammela Teuvo L.J. , Auvinen Anssi
Published: September 2011

Study Type – Therapy (symptom prevalence)

Level of Evidence 2a

What's known on the subject? and What does the study add?

In several population‐based studies the prevalence of hesitancy has varied from 20% to 52%. Studies concern mostly older men ≥50‐years‐old. Knowledge of troublesomeness that hesitancy causes is very scarce.

This is a large population‐based study on hesitancy in men with a wide age range. This study reports the prevalence of hesitancy from 30‐year‐old men to 80‐year‐old men. The bother of hesitancy is reported and this is also presented in different age groups.

OBJECTIVE

To estimate the prevalence and bother of hesitancy by age group.

MATERIALS AND METHODS

In this population‐based study, the target population was 30‐ to 80‐year‐old men from Pirkanmaa County, Finland.

Information was collected by means of a mailed self‐administered questionnaire in 2004. The overall participation proportion was 58.7% (4384 men out of 7470).

The Danish Prostatic Symptom Score (DAN‐PSS‐1) questionnaire was used to evaluate urinary symptoms, particularly hesitancy. Logistic regression was used for multivariate analysis.

RESULTS

Almost half of the men (46.8%, 95% CI 45.3–48.3%) reported hesitancy at least occasionally, but only 0.5% (95% CI 0.3–0.7%) had hesitancy every time they urinated. The prevalence of any hesitancy was 42.3% at 30 years and 50.5% at 80 years of age (trend P < 0.001). Only a few men reported hesitancy often or always, prevalence increasing with age from 2.6% to 11.4% (trend P < 0.001).

Hesitancy caused a small problem for 18.3% of the men and a moderate or major problem for 0.9–5.3%. Only 3% of the men with infrequent hesitancy reported more than a small problem, whereas 59% of the men with hesitancy often or always reported a small problem and 32% reported a moderate or major problem.

Two other voiding symptoms, straining and weak stream, were strongly associated with hesitancy (with odds ratios exceeding 80).

CONCLUSIONS

Mild hesitancy is very common in men of all ages.

Severe cases are rare, but the prevalence increases with age.

Hesitancy is a well‐tolerated urinary symptom.
Sentinel node detection in renal cell carcinoma. A feasibility study for detection of tumour‐draining lymph nodes
Authors: Sherif Amir M. , Eriksson Elisabeth , Thörn Magnus , Vasko Janos , Riklund Katrine , Öhberg Lars , Ljungberg Börje J.
Published: September 2011

Study Type – Therapy (case series)

Level of Evidence 4

What's known on the subject? and What does the study add?

Sentinel node detection in renal cell carcinoma (RCC) is a completely new field. This method of nodal detection can be utilized as a starting point for adoptive immunotherapy, only previously described in colon cancer and in advanced urothelial cancer of the urinary bladder. The study adds a description of available methods and techniques for sentinel node detection in RCC.

OBJECTIVE

To evaluate the feasibility of performing sentinel node detection in patients with renal cell carcinoma (RCC).

MATERIALS AND METHODS

An open series of 13 arbitrarily selected patients with T1b–T3b RCC scheduled for radical nephrectomy at a single Tertiary Academic Centre were examined with different modalities of sentinel node detection.

Preoperative ultrasonography‐guided injection of radioactive isotope, lymphoscintigram and single photon emission computed tomography/computed tomography, followed by intraoperative gamma‐probe detection and Patent Blue detection, as well as postoperative scintigram of the main specimen were the planned interventions.

These investigations were performed in conjunction with intended open radical nephrectomy.

RESULTS

In 10 of the 13 patients sentinel node detection was achieved with 32 sentinel nodes displayed.

Radio‐guided surgery using an intraoperative gamma‐probe resulted in the highest realtive detection rate with detection of sentinel nodes in nine patients.

In total, nine metastatic sentinel nodes were detected in three patients.

One patient, preoperatively staged as N+, was restaged after sentinel node detection and histopathology as pN0.

CONCLUSIONS

Sentinel node detection in renal tumours is feasible although evaluation of different modes of detection needs further refinement and standardization.

All nodes preoperatively detected by routine computed tomography as suspicious metastatic lesions were confirmed as sentinel nodes, including two nodes considered as metastatic by preoperative routine imaging but ultimately staged as non‐metastatic sentinel nodes.
Chemotherapy for advanced adrenal cancer: improvement from a molecular approach?
Authors: Costa Renata , Wesolowski Robert , Raghavan Derek
Published: September 2011

What's known on the subject? and What does the study add?

Adrenal cancer is classically a silent tumour that is often advanced at presentation. Conventional approaches to systemic therapy have been associated with relatively low objective tumour response rates, and modest survival benefit. More recent approaches have implemented targeted therapies focused on gene expression of these tumours, with some sustained remissions reported.

This review assesses the utility of conventional and novel systematic therapies for adrenal carcinoma, and points the way to future implementation of molecular biology in the design and execution of clinical trails for advanced adrenal carcinoma.

Advanced adrenal carcinoma remains a significant therapeutic challenge, with conventional approaches to systemic therapy having failed to achieve sustained objective remissions or major survival benefit in most instances. Several systemic therapies, including mitotane, suramin and gossypol, as well as cytotoxic agents, such as cisplatin and etoposide, have produced responses of ≈15–30%, with median survival figures of ≈6–15 months, depending on case selection bias, with only <10% 5‐year survival rates. Recent preclinical and pathological studies have indicated a range of potential targets for drugs, including WNT/beta‐catenin, epidermal growth factor receptor, RAF and k‐RAS; similar applications in melanoma and renal carcinoma have achieved significant gains, and these targets are worthy of further, structured investigation. Advanced adrenal carcinoma constitutes an orphan disease, with a high mortality rate, and merits investment in clinical trials.
Is joint hypermobility associated with vesico‐ureteral reflux? An assessment of 50 patients
Authors: van Eerde Albertien M. , Verhoeven Virginie J.M. , de Jong Tom P.V.M. , van de Putte Elise M. , Giltay Jacques C. , Engelbert Raoul H.H.
Published: September 2011

Study Type – Aetiology (individual cohort)

Level of Evidence 2b

What's known on the subject? and What does the study add?

Recent studies have already shown associations between generalized joint hypermobility (GJH) and voiding and defecation dysfunction and/or slow transit constipation. Changes in extracellular matrix composition in vesico‐ureteric junction of vesico‐ureteral reflux (VUR) patients were also observed previously.

This study is the first to assess joint mobility as a parameter for connective tissue composition in vesico‐ureteral reflux. We convincingly demonstrate that VUR patients have significantly more hypermobile joints compared to controls and this provides a new angle to the intriguing subjects of development of VUR and susceptibility to VUR.

OBJECTIVE

To assess whether there is an increased prevalence of joint hypermobility in patients with vesico‐ureteric reflux (VUR).

MATERIALS AND METHODS

We studied 50 patients with primary VUR and matched controls drawn from a reference population.

Joint mobility was assessed using the Bulbena hypermobility score.

RESULTS

We identified significantly more patients with VUR with generalized joint hypermobility than controls (24% vs 6.7%, P= 0.007).

CONCLUSION

Our findings confirm our clinical observation of an increased rate of joint hypermobility in patients with VUR. We speculate that an altered composition of the connective tissue may contribute to the severity of the (pre‐existing) VUR phenotype.