bluuebunny/crossref_metadata_2025 huggingface dataset:
An anterior urethral stitch improves urinary incontinence following radical prostatectomy
Authors: Sugimura Yoshiki , Hioki Takuichi , Yamada Yasushi , Fumino Miki , Inoue Takahiro
Published: March 2003

Objective: To determine the effects of an anterior urethral stitch, referred to as an endopelvic anterior urethral stitch (EAUS), in reducing recovery time for post‐prostatectomy urinary incontinence.

Methods: The urinary continence recovery time for 24 patients, who received a retropubic radical prostatectomy with the EAUS procedure, was compared to that of a historical control series of 22 patients without EAUS. The EAUS is a simple 2‐0 polyglactin stitch placed between the bunched dorsal vein complex and the anterior urethra. This procedure was performed at the time of urethro‐vesical anastomosis. Continence recovery time was defined as the day after removal of the urethral catheter when the patient no longer required pads for incontinence.

Results: A significantly shorter time for continence recovery (median 8.5 days) was obtained in EAUS patients compared with that of the control series (median 72 days) (P < 0.0001). Early recovery of continence was observed in 12/24 patients (50%) within 1 week and 18/24 patients (75%) within 1 month in EAUS patients. No adverse effects or complications were observed in the EAUS patients.

Conclusion: A surgical procedure, the EAUS, has been developed that reduces urinary incontinence in patients who have undergone a radical prostatectomy. This procedure is simple and quick and improves recovery of continence without any side‐effects.
Recovery of sexual function after nerve‐sparing radical prostatectomy or cystectomy
Authors: Miyao Noriomi , Adachi Hideki , Sato Yoshikazu , Horita Hiroki , Takahashi Atsushi , Masumori Naoya , Kitamura Hiroshi , Tsukamoto Taiji
Published: March 2003

Background: The recovery of sexual function (erectile function and frequency of sexual intercourse) over time after nerve‐sparing radical prostatectomy or cystoprostatectomy was evaluated.

Methods: Forty‐nine consecutive patients with clinically localized prostate cancer and muscle‐invasive bladder cancer were treated with radical prostatectomy and radical cystoprostatectomy with a nerve‐sparing procedure. Erectile function was evaluated by the circumferential change of the penis during nocturnal penile tumescence (NPT value) with an erectometer before and after surgery. Erectile function and the frequency of sexual intercourse were also evaluated with a self‐administered questionnaire before and after surgery. Multivariate analysis by Cox's proportional hazards model was used to evaluate the factor(s) that affected the recovery of erectile function and sexual intercourse.

Results: The recovery rates of erectile function were 49% at 3 years and 79% at 5 years. For recovery of sexual intercourse the rates were 36% at 3 years and 57% at 5 years. Multivariate analysis revealed that the preoperative NPT value was the only independent factor which significantly affected the recovery of erectile function. The age at surgery was a significant factor for recovery of sexual intercourse.

Conclusion: Nerve‐sparing operations can often, but not always, provide preservation or recovery of erectile function for patients who receive radical prostatectomy or cystoprostatectomy. Recovery of erectile function depends upon the preoperative NPT value and recovery of sexual intercourse depends upon the age of the patient.
Prophylactic intravesical instillation of mitomycin C and cytosine arabinoside for prevention of recurrent bladder tumors following surgery for upper urinary tract tumors: A prospective randomized study
Authors: Sakamoto Naotaka , Naito Seiji , Kumazawa Joichi , Ariyoshi Asami , Osada Yukio , Omoto Tetsuo , Fujisawa Yasuhito , Morita Ichikirou , Yamashita Hiroshi , The Kyushu University Urological Oncology Group
Published: March 2003

Abstract Background: A recurrence of bladder tumors following surgery for transitional cell carcinoma of the upper urinary tract is not rarely observed. A prospective randomized study was conducted to examine the significance of prophylactic intravesical instillation of mitomycin C (MMC) and cytosine arabinoside (Ara‐C) to prevent recurrent bladder tumors after surgery for superficial transitional cell carcinoma of the upper urinary tract.

Methods: The patients were randomized into an instillation group, who received postoperative intravesical instillation of MMC (20 mg) and Ara‐C (200 mg) 28 times over a period of 2 years, and a non‐instillation group. The non‐recurrence rate was then compared between the groups.

Results: Of the 27 patients registered, 25 patients (13 with instillation and 12 without instillation) were able to be evaluated, with a median follow‐up period of 45 months. The non‐recurrence rate of bladder tumors in the instillation group was higher than that in the non‐instillation group. Although the difference was not statistically significant, the P‐value (P = 0.079) demonstrated a strong trend. When any possible bias was allowed for a multivariate analysis, the difference was almost significant (P = 0.0567). No patients withdrew from this study due to any side‐effects.

Conclusion: The postoperative instillation of MMC and Ara‐C may be a useful approach for reducing the recurrence of bladder tumors after surgery for upper urinary tract tumors.
A new portable measuring cup for voided volume
Authors: Yamada Masashi , Tanaka Katsura , Yamaguchi Osamu , Kawabe Kazuki
Published: March 2003

Abstract When recording daily urine volumes for the frequency–volume chart, a patient must measure voided urine volume throughout the whole day. Unless the patient stays at home, the conventional 500‐mL paper or plastic cup must be carried with at all times, which can be very embarrassing and troublesome for the patient, so a collapsible, portable measuring cup has been developed. To determine the measuring accuracy of the new cup, the visual estimate was compared with the actual volume. The cup was found to be a highly accurate and useful container for measuring voided urine volume.
Endoscopic treatment of a long fibroepithelial ureteral polyp
Authors: Yagi Shizuo , Kawano Yukihiro , Gotanda Takenari , Kitagawa Toshihiro , Kawahara Motoshi , Nakagawa Masayuki , Higashi Youitirou
Published: March 2003

Abstract A case is reported of a 30‐year‐old woman with a long fibroepithelial polyp in the middle ureter treated with the Ho‐YAG laser endoscopically. She presented with an intermittent macroscopic hematuria and lower abdominal pain lasting for 1 year. The filling defect on urography occupying one‐third of the ureter was migratory depending on the patient position. Transurethral flexible ureterorenoscopy showed a large pedunculated tumor with a small base at the middle ureter. About 1 month after the endoscopic irradiation of the Ho‐YAG laser to the base of tumor, the tumor was spontaneously discharged and pathologic examination revealed it to be a fibroepithelial polyp without malignant component. Postoperatively, the patient remained asymptomatic and follow‐up excretory urographs showed no abnormal findings.
Sarcomatoid transitional cell carcinoma originating from a duplicated renal pelvis
Authors: HISATAKI TOSHIHIRO , TAKAHASHI ATSUSHI , TAGUCHI KEISUKE , SHIMIZU TOSHIAKI , SUZUKI KAZUHIRO , TAKATSUKA KEIJI , IWAKI HIROYUKI
Published: March 2003

Abstract A case of sarcomatoid transitional cell carcinoma of the renal pelvis is reported. It was distinguished from carcinosarcoma by immunohistochemical study. The tumor was difficult to distinguish from a renal parenchymal tumor in imaging studies because it originated from a duplicated renal pelvis.
Dendritic cell immunotherapy for patients with metastatic renal cell carcinoma: University of Tokyo experience
Authors: Azuma Takeshi , Horie Shigeo , Tomita Kyoichi , Takahashi Tsuyoshi , Tanaka Yuji , Kashiwase Koichi , Nieda Mie , Takeuchi Takumi , Ohta Nobutaka , Shibata Yoichi , Hirai Hisamaru , Kitamura Tadaichi
Published: March 2003

Background : Dendritic cells (DC) are the most potent antigen‐presenting cells and induce host antitumor immunity through the T‐cell response. A clinical study of immunotherapy using cultured DC loaded with tumor antigen, for patients with metastatic renal cell carcinoma (RCC) was performed.

Methods : Dendritic cells were generated by culturing monocytes from peripheral blood for 7 days in the presence of granulocyte–macrophage colony‐stimulating factor and interleukin‐4. On day 6 the DC were pulsed with lysate from autologous tumor as the antigen and with keyhole limpet hemocyanin (KLH) as immunomodulator. The patients were given four doses of lysate‐pulsed DC by intradermal injection with a 2‐week interval between doses. Clinical effect and immune response were, respectively, evaluated by radiological examination and delayed‐type hypersensitivity (DTH) test.

Results : Three patients were enrolled and the immunotherapy was well tolerated without significant toxicity. The vaccination induced a positive DTH reaction to tumor lysate in two patients and to KLH in all patients. Clinical responses consisted of one case of no change and two cases of progression of disease. However, we did not see a significant reduction of tumor volume in any case.

Conclusion : Dendritic cell vaccination can safely induce an immunological response against RCC. Further trials are needed to fully evaluate its efficacy.
Advances in the cryopreservation of mammalian oocytes and embryos: Development of ultrarapid vitrification
Authors: Kasai Magosaburo
Published: March 2003

The cryopreservation of embryos has become a powerful tool in assisted reproduction in several mammalian species. Embryos are cryopreserved by slow freezing or by vitrification. However, consistently high survival has not been obtained in most oocytes and in some embryos. The main reasons for the low survival would be sensitivity to low temperatures, which leads to chilling injury, and low permeability of the cell membrane, which leads to the formation of intracellular ice. As a strategy aiming to overcome these injuries, modified vitrification methods have been devised in which the cooling and warming rate is markedly increased by minimizing the volume of the solution and the container. The modified methods use electron microscope grids, open‐pulled straws, cryoloops, or container‐less microdrops. In this article, recent developments in the ultrarapid vitrification of mammalian oocytes and embryos are reviewed based on the understanding of the mechanisms of cell injury in cryopreservation. (Reprod Med Biol 2002; 1: 1–9)
Fertility reduced by immunization with p84: A human sperm‐coating antigen in the mouse
Authors: Sato Itaru , Mukai Toshiji
Published: March 2003

Background: p84 is an 84‐kDa protein with the ABO (H) antigenic epitope, and it is also a member of the family of sperm‐coating antigens. In order to investigate whether the antibodies against p84 reduce fertility in mice, p84 and lactotransferrin (Lf), whose N‐terminal sequence is similar to that of p84, were injected into female mice.

Results: When p84 was used as the immunogen, the fertilization ratio was 37.5% lower than that of female mice immunized with no antigen (control group;P < 0.01). When Lf was used as the immunogen, there was no significant difference in the fertilization ratio between the Lf and control groups. Sera from female mice immunized with these antigens showed no agglutination against human erythrocytes, suggesting that the ABO(H) determinant site on p84 is not the factor reducing fertility. Although the titer of antibody (IgG) against p84 in serum from female mice immunized with p84 was generally higher than that against Lf, the titer was not related to the reduction of fertility.

Conclusion: We conclude that an injection of p84 can reduce the fertility of female mice by inducing antibodies against p84. Our results suggest that the antibodies may act to inhibit the sperm–egg interaction, and that the binding site is the carbohydrate chain of p84, excluding the ABO (H) antigenic epitope, rather than the p84 protein itself. (Reprod Med Biol 2002;1: 35–39)
Myasthenia gravis with thymoma is more common in the Maori and Pacific Island populations in New Zealand
Authors: Fink J. N. , Wallis W. E. , Haydock D. A.
Published: March 2003

Background: The association of myasthenia gravis (MG) with thymoma is well recognized. Our clinical impression has been that MG associated with thymoma may be more common in patients of Polynesian descent than in other races.

Aim: To determine the influence of ethnicity on the association of MG with thymoma in our population.

Method: Review of all cases of thymectomy performed at Greenlane Hospital in Auckland for the 20‐year period from June 1978 to June 1998.

Results: There were 103 thymectomies performed in the study period. Fifty‐five thymomas were identified, 15 in subjects of Maori or Pacific Island ethnicity and 40 in subjects of other races, predominantly Caucasian. Ten of 15 Maori or Pacific Island subjects with thymoma had MG (67%), compared with 15 of 40 subjects of other races (37.5%, P = 0.05). The mean age of Maori or Pacific Island subjects with thymoma and MG was 42.5 years, compared with 56.3 years in subjects from other races (P = 0.06). All five Maori and Pacific Island subjects with invasive thymoma had MG, whereas only four of 15 subjects (27%) from other races with invasive tumours had MG (P < 0.01). The overall incidence of thymoma and the proportion of thymomas that were invasive did not differ between the ethnic groups.

Conclusions: Myasthenia gravis with thymoma occurs more frequently among Maori or Pacific Island people than in other racial groups in our population. This is due to an increase in the proportion of cases with thymoma who have MG in this group, while the overall frequency of cases of thymoma is similar between groups. MG with thymoma in the Maori or Pacific Island populations also presents at a younger age and is more often associated with tumour invasion. (Intern Med J 2001; 31: 206–210)
Early Australian experience with infliximab, a chimeric antibody against tumour necrosis factor‐α, in the treatment of Crohn’s disease: is its efficacy augmented by steroid‐sparing immunosuppressive therapy?
Authors: Mortimore M. , Gibson P. R. , Selby W. S. , Radford‐Smith G. L. , Florin T. H. J. ,   THE INFLIXIMAB USER GROUP
Published: March 2003

Abstract

Background: Tumour necrosis factor‐α (TNF‐α) plays an important role in the pathology of Crohn’s disease. Infliximab, a chimeric antibody against TNF‐α, has been shown in controlled clinical trials to be effective in two‐thirds of patients with refractory or fistulating Crohn’s disease. The factors that determine a clinical response in some patients but not others are unknown.

Aims: To document the early Australian experience with infliximab treatment for Crohn’s disease and to identify factors that may determine a beneficial clinical response.

Methods: Gastroenterologists known to have used infliximab for Crohn’s disease according to a compassionate use protocol were asked to complete a spreadsheet that included demographic information, Crohn’s disease site, severity, other medical or surgical treatments and a global clinical assessment of Crohn’s disease outcome, judged by participating physicians as complete and sustained (remission for the duration of the study), complete but unsustained (remission at 4 weeks but not for the whole study) or partial clinical improvement (sustained or unsustained).

Results: Fifty‐seven patients were able to be evaluated, with a median follow‐up time of 16.4 (4–70) weeks, including 23 patients with fistulae. There were 21 adverse events, including four serious events. Fifty‐one patients (89%) had a positive clinical response for a median duration (range) of 11 (2–70) weeks. Thirty patients (52%) had a remission at 4 weeks, 10 of whom had remission for longer than 12 weeks. Forty‐two per cent of fistulae closed. Sustained remission (P = 0.065), remission at 4 weeks (P = 0.033) and a positive clinical response of any sort (P = 0.004) were more likely in patients on immunosuppressive therapy, despite there being more smokers in this group.

Conclusion: This review of the first Australian experience with infliximab corroborates the reported speed and efficacy of this treatment for Crohn’s disease. The excellent response appears enhanced by the concomitant use of conventional steroid‐sparing immunosuppressive therapy. (Intern Med J 2001; 31: 146–150)
Prevalence survey of multiple sclerosis in the Australian Capital Territory
Authors: Simmons R. D. , Hall C. A. , Gleeson P. , Everard G. , Casse R. F. , O'Brien E. D.
Published: March 2003

Abstract

Aim: This study sought to obtain an estimate of the prevalence of multiple sclerosis (MS) in the Australian Capital Territory (ACT), a largely urban region that differs climatically and socioeconomically from other Australian cities examined in previous MS surveys.

Methods: Prevalence day was chosen to coincide with the 1996 National Census. All ACT neurologists’ records for the previous 5 years were examined and cases of MS were classified according to the published diagnostic criteria of Rose et al. and Poser et al.

Results: By the criteria of Rose et al., as used in previous Australian surveys of MS, prevalence was 79.9/100 000 (95% confidence interval (CI) = 63.4–99.2) for females, 32.8 (22.7–46.2) for males and 56.7 (43.1–74.1) for all people, standardized to the 1996 population. Standardized to the 1981 population for direct comparison with 1981 surveys in New South Wales, the prevalence of MS in the ACT was still unexpectedly high, particularly for females. Using the criteria of Poser et al., the prevalence of MS standardized to the 1996 population was 70.6/ 100 000 (95% CI = 58.4–85.3) for females, 28.0 (20.3–37.8) for males and 49.5 (42.2–58.2) for all people. There was evidence from a relatively short duration of disease in the ACT sample that some persons with long‐standing MS had been missed in the survey and therefore that the prevalence of MS observed in the ACT was an underestimate.

Conclusions: The survey found an unexpectedly high prevalence of MS in the ACT. Possible reasons for this are discussed. There was no evidence that the advent of magnetic resonance imaging had increased the numbers of persons diagnosed with MS in the present survey. (Intern Med J 2001; 31: 161–167)
Factors influencing the uptake of technologies to minimize perioperative allogeneic blood transfusion: an interview study of national and institutional stakeholders
Authors: Treloar C. J. , Hewitson P. J. , Henderson K. M. , Harris G. , Henry D. A. , McGrath K. M.
Published: March 2003

Background: Alternatives to allogeneic blood transfusion exist and are being used to varying extents in Australian hospitals. Evidence on effectiveness and cost‐effectiveness is generally inconclusive and provides a suboptimal basis for policy development.

Aim: To describe the influences on uptake of transfusion technologies as perceived by national and institutional stakeholders.

Methods: Qualitative interview study. Interview transcripts were coded and analysed independently by at least two researchers. Participants had opportunity to comment on their transcript and the manuscript.

Results: A total of 71 interviews were conducted with representatives of the media, specialist medical societies, consumer special interest groups, the Australian Red Cross Blood Service (ARCBS), government, private health insurers, technology manufacturers, prominent clinicians in the area and a sample of clinicians drawn from hospitals with variable use of blood‐saving technologies. Technical advances and acceptance of lower transfusion triggers were identified as the main influences on the decrease in use of allogeneic blood transfusion in the past decade. Participants indicated that patients were most aware and supportive of autologous predonation. Participants noted that ‘enthusiasts’ were involved in educating about the need for alternatives, negotiating resourcing and maintaining the use of a technology. Funding mechanisms were seen as main barriers to use of alternatives. A discrepancy was noted in the rigour of evaluation and regulation of pharmaceuticals and devices/procedures.

Conclusions: Uptake of blood transfusion technologies by institutions was dependent mostly on funding arrangements and the presence of an ‘enthusiast’. Critical review of the evidence for effectiveness or cost‐effectiveness of these technologies was rarely mentioned. Opportunities exist for evidence‐based medicine principles to play a greater role in policy decisions in this area. (Intern Med J 2001; 31: 230–236)
Randomized controlled trial of two cigarette quit programmes in coronary care patients after acute myocardial infarction
Authors: Feeney G. F. X. , McPherson A. , Connor J. P. , McAlister A. , Young R. M. , Garrahy P.
Published: March 2003

Abstract

Background: Tobacco cessation after acute myocardial infarction (AMI) substantially improves outcome but how effective individual programmes are needs to be established. To date, few studies have examined this factor.

Aims: To assess the outcome of two smoking cessation programmes after AMI.

Methods: One hundred and ninety‐eight current smokers admitted to coronary care with an AMI participated in a randomized controlled study comparing two outpatient tobacco interventions, the Stanford Heart Attack Staying Free (SF) programme and a Usual Care (UC) programme.

Results: Log–rank analyses revealed that patients in the SF programme were retained longer (P < 0.001) and had higher cotinine validated abstinence rates (P < 0.001) compared with patients in the UC programme. Twelve months after intervention, 39% of the SF programme compared with 2% of the UC programme demonstrated cotinine validated tobacco cessation, representing a significant reduced relapse rate in the SF programme (χ2, P < 0.001).

Conclusions: The SF smoking cessation programme initiated in hospital can significantly reduce smoking rates at 12 months after myocardial infarction. Although superior to the UC quit programme, Australian outcomes were lower than the American programme originators’ published outcomes. (Intern Med J 2001; 31: 470–475)
Evaluation of clinical guidelines for the management of Staphylococcus aureus bacteraemia
Authors: Blyth C. C. , Darragh H. , Whelan A. , O’Shea J. P. , Beaman M. H. , McCarthy J. S.
Published: March 2003

Background: While treatment guidelines have been developed to guide the management of Staphylococcus aureus bacteraemia, there is a need to validate these guidelines in different clinical settings and to relate the effect of compliance to clinical outcome.

Aims: To assess the impact of adherence to treatment guidelines on clinical outcome and to explore the role of transoesophageal echocardiography (TOE) in risk stratification.

Methods: We undertook a 2‐year mixed retrospective and prospective study of all cases of S. aureus bacteraemia at Fremantle Hospital, documenting the clinical and microbiological features of each case, the results of echocardiography, adherence with published clinical guidelines and clinical outcome.

Results: Failure to comply with guidelines was observed in 41% (38 of 93) of cases, the majority receiving abbreviated treatment. An
increased rate of relapse was observed among patients who received inadequate therapy (5/38 vs 1/55; P = 0.04). Ten of 28 eligible patients underwent TOE and the test led to significant changes in management in two of those cases.

Conclusions: While non‐adherence with clinical guidelines was associated with an increased risk of relapse, the role of TOE in risk stratification was limited by factors including cost, limited acceptance of the test and the need for prolonged therapy for other indications. (Intern Med J 2002; 32: 224−232)
Doctors’ beliefs on the use of antithrombotic therapy in atrial fibrillation: identifying barriers to stroke prevention
Authors: Peterson G. M. , Boom K. , Jackson S. L. , Vial J. H.
Published: March 2003

Abstract

Aims: To assess the attitudes of Australian doctors towards the use of antithrombotic drug therapy for stroke prevention in patients with non‐valvular atrial fibrillation (AF), and investigate the barriers to prescribing warfarin.

Methods: A postal survey was undertaken among approximately 10% of all registered general practitioners (GPs), cardiologists and physicians in Australia. The anonymous questionnaire used case scenarios to assess doctors’ knowledge of current guidelines for the therapeutic management of AF and sought opinions on potential barriers to the use of anticoagulation.

Results: Completed questionnaires were received from 711 doctors (30% response rate). The GPs performed better than the cardiologists and other specialists in estimating the risk of stroke in case scenarios. However, the cardiologists were more likely to select the recommended treatment, with GPs being more hesitant to use anticoagulation and tending to underestimate its reported benefit for stroke prevention in non‐valvular AF. The GPs were also more likely to overestimate the reported risk of major bleeds with warfarin. In contrast, over one‐third of the cardiologists went as far as to give warfarin to a low‐risk patient and they were more likely to overestimate the reported benefit of aspirin and warfarin in AF. Only half the doctors correctly classified a patient without a previous stroke (but with other risk factors) as being at high risk. Increased experience as a registered medical practitioner was generally related to a poorer performance on classifying patients according to the risk of stroke. The principal barriers to the use of anticoagulation were nominated as: (i) active gastrointestinal bleeding, (ii) previous intracranial haemorrhage, (iii) alcoholism, (iv) a history of daily falls, (v) liver disease, (vi) severe anaemia and (vii) concurrent use of non‐steroidal anti‐inflammatory drugs.

Conclusion: There is scope for improvement in doctors’ knowledge about the appropriate use of antithrombotic drug therapy in non‐valvular AF and awareness of the results of recent clinical trials. Compilation and dissemination of clear guidelines and focused education on some of the other risk factors (apart from previous stroke or transient ischaemic attacks) in patients with non‐valvular AF are important strategies for targeting barriers to the use of anticoagulation for stroke prevention. (Intern Med J 2002; 32: 15–23)
Renin‐angiotensin system inhibition: how much is too much of a good thing?
Authors: Campbell D. J.
Published: March 2003

Abstract

Inhibitors of the renin‐angiotensin system (RAS) are valuable therapeutic agents for a wide range of clinical conditions. Increasingly, consideration is being given to the combination of angiotensin‐converting enzyme (ACE) inhibitors and angiotensin‐II receptor (AR) antagonists to obtain more complete inhibition of the RAS than can be achieved by either agent alone. Beta‐blockers also inhibit the RAS by inhibiting renin secretion. Whereas the combination of an ACE inhibitor and AR antagonist represents dual RAS inhibition, the combination of both of these agents with beta‐blocker therapy represents triple RAS inhibition. Animal studies indicate that complete blockade of the RAS produces adverse effects. Moreover, post‐hoc analysis of the recent Valsartan Heart Failure Trial study suggests that the combination of ACE inhibitor and AR antagonist therapies may have an adverse effect in heart failure when combined with beta‐blocker therapy. There is therefore a need for caution in the combination of ACE inhibition and AR antagonism, particularly in patients receiving beta‐blockers, until the impact of this strategy is evaluated. (Intern Med J 2002; 32: 616−620)
Biology and management of barnyardgrass, red sprangletop and weedy rice
Authors: Chin Duong Van
Published: March 2003

About 400 weed species of 73 families have been reported to occur in upland and lowland rice fields in Vietnam. Two important families are Poaceae and Cyperaceae having 42% of weed species with 21% each. The barnyardgrass, Echinochloa crus‐galli (L.) Beauv., is the most important weed in both transplanted and direct‐seeded rice in this country. The competi‐tion of 25 barnyardgrass plants/m2 causes approximately 50% yield loss. Red sprangletop, Leptochloa chinensis (L.) Nees., is an emerging major weed in direct‐seeded rice. Weedy rice (Oryza sativa L.) was detected in 1994 and is now a new dangerous pest in rice fields. The main reasons are: herbicides which can kill weedy rice completely are not available in the market, non‐chemical methods are laborious and costly, and weedy rice can develop a new generation from contaminated seeds through rice sowing or emerging from soil seed bank. Research results on the Vietnamese situation of barnyardgrass, red sprangletop and weedy rice in terms of biology and management by chemical and non‐chemical methods have been reviewed in this paper.
Metabolism, uptake and translocation of 14C‐paraquat in resistant and susceptible biotypes of Crassocephalum crepidioides (Benth.) S. Moore
Authors: Ismail, B. S. , Chuah T. S. , Khatijah H. Hussin
Published: March 2003

The metabolism, uptake and translocation of paraquat in resistant (R) and susceptible (S) biotypes of Crassocephalum crepidioides (Benth.) S. Moore (redflower ragleaf) at the 10‐leaf stage was investigated. A study on the properties of leaf surface was carried out to examine the relationship between leaf surface characters and paraquat absorption. The extractable paraquat was not metabolized by the leaf tissue of either the resistant or susceptible biotypes. Differential metabolism, therefore, does not appear to play a role in the mechanism of resistance. Both biotypes did not show any significant difference in the amount of cuticle and trichome densities. Furthermore, both biotypes are identical in the structure of stomata, trichomes and epicuticular wax. The results of the leaf surface studies are in agreement with the findings of the uptake study. Both biotypes demonstrated no significant difference in absorption between the resistant and susceptible biotypes. However, 10% of the absorbed 14C‐paraquat into the S biotype was translocated basipetally, but not in the R biotype. The results of this study suggest that in C. crepidioides, differential translocation may contribute to the mechanism of resistance at the 10‐leaf stage.
Allelopathy of buckwheat: Assessment of allelopathic potential of extract of aerial parts of buckwheat and identification of fagomine and other related alkaloids as allelochemicals
Authors: Iqbal Zahida , Hiradate Syuntaro , Noda Akio , Isojima Sei‐Ichi , Fujii Yoshiharu
Published: March 2003

The allelopathic potential of buckwheat (Fagopyrum esculentum) was investigated. Field study showed that living buckwheat reduced weed biomass compared with plots without buckwheat. Laboratory study revealed that root exudates suppressed root and shoot growth of weeds and reduced weed dry weight. Sequential partitioning of the aqueous ethanolic extract of the aerial parts of buckwheat showed that the chloroform extract caused an 80% reduction in radicle elongation of lettuce seedlings at a concentration of less than 100 p.p.m. Fagomine, 4‐piperidone and 2‐piperidinemethanol were isolated and identified by 1H and 13C nuclear magnetic resonance from the chloroform extract. These compounds caused a 50% inhibition of radicle elongation in lettuce seedlings at concentrations of less than 100 p.p.m. These results suggest that compounds 1, 2, and 3 might act as allelochemicals and affect the growth or germination of different plant species.
Morphological observation on development of juvenile seedlings of Monochoria vaginalis establishing on a flooded paddy soil surface
Authors: MATSUO MITSUHIRO , SHIBAYAMA HIDEJIRO
Published: March 2003

The development of juvenile seedlings of Monochoria vaginalis (Burm.f.) Kunth var. vaginalis concerning its hypocotyl hairs was investigated morphologically at establishing on 1 mm flooded paddy soil surface and in distilled water. Prime germination of M. vaginalis seeds sown after breaking dormancy was found on a flooded paddy soil surface and in distilled water at 6 h after seeding (HAS). Elongation of cotyledons and hypocotyl hairs of juvenile seedlings appeared at 12 HAS on a paddy soil surface, while lengths of hypocotyl hairs were almost the same as longitudinal length of seeds and cotyledons formed arch on the soil surface at 18 HAS. Seminal roots began to emerge and seedlings adhered completely to the soil surface by hypocotyl hairs, which were longer in length than seminal roots at 24 HAS. At 36 HAS, seed chaffs completely separated from the soil surface, as cotyledons had elongated from standing up, and lengths of seminal roots became longer than those of hypocotyl hairs. Emergence of first leaves and crown roots was simultaneously observed at 48 HAS. Elongations of cotyledons, seminal roots and hypocotyl hairs were completely terminated at 96, 120 HAS and 120 HAS respectively, and the elongation of 2 to 4 crown roots was observed at 120 HAS. Almost half the number of hypocotyl hairs putrefied at 240 HAS. In distilled water, hypocotyl hairs elongated to their longest at 36 HAS earlier than those on a paddy soil surface. It was concluded that hypocotyl hairs supported a strongly physical mechanism in establishing M. vaginalis seedlings on a paddy soil surface.
Weed management in conservation crop production systems
Authors: LOCKE MARTIN A. , REDDY KRISHNA N. , ZABLOTOWICZ ROBERT M.
Published: March 2003

Information on weed management in conservation crop production systems is needed as adoption of practices such as reduced tillage and cover crops becomes more widespread. This review summarizes recent research on weed management aspects in these systems. Changes in patterns of tillage, planting systems, and other management strategies can alter the soil environment and lead to shifts in weed populations. Weed patterns and populations are not always consistent and vary with locale, crop, and herbicide use. However, in many long‐term conservation management studies, a general increase in perennial weeds and grass species has been observed. The development of low‐dose herbicides, selective postemergence herbicides, and transgenic crops has greatly improved the flexibility of producers who use conservation systems where opportunities for tillage are limited. With a higher level of management inputs, producers can successfully implement conservation management practices.
Seed germination, seedling establishment and growth patterns of wrinklegrass (Ischaemum rugosum Salisb.)
Authors: BAKAR BAKI HAJI , NABI LAJILI NABI AHMED
Published: March 2003

Several laboratory and glasshouse experiments were conducted to assess seed germination, seedling establishment and growth patterns of wrinklegrass (Ischaemum rugosum Salisb.) influenced by temperature and light regimes, and chemical media. Wrinklegrass was a positively photoblastic species, and seed germination was temperature‐dependent and light‐mediated. Seeds soaked in distilled water for 24 h, or oven‐dried at the respective temperature regimes of 15, 20, 25, 30, 35, or 40°C prior to treatment in distilled water and incubated in darkness, failed to germinate. Likewise, no germination prevailed when the seeds were exposed to similar temperature regimes and treated with 0.2 m KNO3, 5% H2O2 or 0.01 m HNO3, and incubated under continuous darkness. Seeds treated with 5% H2O2 at 30°C, or oven‐dried and treated with 0.01% M HNO3 at 35°C registered 10 and 20% germination. Approximately 75 and 90% of the light‐exposed seeds for all treatments germinated in the first three and six days at 25°C. No germination occurred at 15°C in the first three days after treatment. Seeds subjected to 40°C for six days after treatment recorded 36% germination. The optimum temperatures for seed germination were 25–30°C. Seed drying and soaking treatments widened the windows of the optimal temperatures for wrinklegrass germination. The acidic media of KNO3, H2O2 or HNO3 favored seed germination. Less than 5% of seed germination occurred with burial or water inundation at depths exceeding 2 cm. Seed burial or inundation at ≥2 cm depths inhibited seed germination. Seeds sown onto moist paddy soils registered ca. 50% germination. Free‐floating seeds on the water surface registered ca. 98% germination within the first six days after seeding. The mean number of seedlings that survived was inversely proportional to water depths, with close to 100% mortality at the 14 cm depths of inundation. Both plant height and seedling survival were linearly proportional to the amount of root mass of seedlings which penetrated the soil. The weed was a prolific seed producer (ca. 6000 seeds/genet or 18 000 seeds/genet per year). The vegetative and reproductive efforts of each wrinklegrass plant registered values of 0.68 and 0.32, respectively.
Anaesthetic management of a prematurely born infant with Cantrell's Pentalogy
Authors: LALOYAUX PIERRE , VEYCKEMANS FRANCIS , VAN DYCK MICHEL
Published: March 2003

Cantrell's pentalogy (CP) is a rare congenital syndrome combining a defect of the supraumbilical abdominal wall, the agenesis of the lower part of the sternum and of the anterior portion of the diaphragm, the absence of the diaphragmatic part of the pericardium, and a cardiac malformation. It was first described by Cantrell in 1958 (1,2). We report the case of a prematurely born infant with CP and Wolff–Parkinson–White (WPW) syndrome who required surgery first for bilateral inguinal hernia repair and later for Blalock–Taussig shunt. During these two procedures, our anaesthetic plan was to preserve the fragile equilibrium of both the pulmonary and the cardiovascular systems.
Postdural puncture headache is not an age‐related symptom in children: a prospective, open‐randomized, parallel group study comparing a22‐gauge Quincke with a 22‐gauge Whitacre needle
Authors: Kokki Hannu , Salonvaara Marjut , Herrgård Eila , Onen Pekkariik
Published: March 2003

Many reports have shown a low incidence of postdural puncture headache (PDPH) and other complaints in young children. The objective of this open‐randomized, prospective, parallel group study was to compare the use of a cutting point spinal needle (22‐G Quincke) with a pencil point spinal needle (22‐G Whitacre) in children. We studied the puncture characteristics, success rate and incidence of postpuncture complaints in 57 children, aged 8 months to 15 years, following 98 lumbar punctures (LP). The patient/parents completed a diary at 3 and 7 days after LP. The response rate was 97%.

The incidence of PDPH was similar, 15% in the Quincke group and 9% in the Whitacre group (P=0.42). The risk of developing a PDPH was not dependent on the age (r < 0.00, P=0.67). Eight of the 11 PDPHs developed in children younger than 10 years, the youngest being 23‐months‐old.
Paediatric head injury: incidence, aetiology and management
Authors: Hiu Lam W. , Mackersie Angela
Published: March 2003

Trauma is the commonest cause of hospital admission in children. Head injuries are present in 75% of children with trauma and 70% of all traumatic deaths are due to the head injury. The mechanism of brain injury is examined, resulting from the effects of the primary insult and secondary ischaemic damage. Therapeutic interventions will be discussed with specific emphasis on outcome studies. However, institution of adequate oxygen delivery and haemodynamic stability in the child at the earliest moment remains the most important aspect of the management plan.
Quality of sedation during mechanical ventilation
Authors: Playfor S.D. , Thomas David A. , Choonara Imti , Jarvis Anita
Published: March 2003

The aim of the study was to determine the quality of sedation in ventilated patients on a general paediatric intensive care unit (PICU), including those treated with infusions of neuromuscular blocking agents. Twenty‐eight ventilated children on a PICU had their level of sedation determined using an arousability scale dependent upon the response to tracheal suction. Observed levels of sedation were then compared to a predetermined desired level of sedation. A total of 81 assessments were performed and 90% were considered satisfactory. Thirty‐two of these assessments were performed in 15 children following the temporary discontinuation of infusions of neuromuscular blocking agents; 97% of these assessments were considered satisfactory. A regime of continuous intravenous midazolam and morphine with additional oral sedation using chloral hydrate and antihistamines when required provides a satisfactory level of sedation for the majority of children ventilated on a PICU, including those treated with infusions of neuromuscular blocking agents.
Comparison of ropivacaine 0.1% and 0.2% with bupivacaine 0.2% for single‐shot caudal anaesthesia in children
Authors: Luz G. , Innerhofer P. , Häussler B. , Oswald E. , Salner E. , Sparr H.
Published: March 2003

We compared analgesic efficacy and degree of motor block induced by ropivacaine 0.1% (R 0.1) and 0.2% (R 0.2) vs. bupivacaine 0.2% (B 0.2) after caudal anaesthesia in children. Total and free plasma concentrations were measured after caudal injection. Duration of caudal analgesia (median/range) was significantly shorter in group R 0.1 (1.7 h/0.2–6 h) than in group R 0.2 (4.5 h/1.7–6 h) or group B 0.2 (4 h/1–6 h) (P < 0.05). Motor block in the first 2 h postoperatively was significantly less for both ropivacaine groups compared with bupivacaine (P < 0.05). Peak plasma concentrations after ropivacaine 0.2% were higher and protein binding lower than after bupivacaine 0.2% (P < 0.05). We conclude that caudal analgesia with ropivacaine 0.1% is less effective and of shorter duration than that of ropivacaine 0.2%, whereas ropivacaine 0.2% provides pain relief similar to bupivacaine 0.2%. Motor block in the early postoperative period is less with ropivacaine than with bupivacaine.
A comparison of four methods for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA™) in paediatric patients
Authors: Lopez‐Gil M , Brimacombe J , Keller C
Published: March 2003

Background: This study compares four tests for assessing oropharyngeal leak pressure with the laryngeal mask airway (LMA™). We tested the hypothesis that the oropharyngeal leak pressure and interobserver reliability differs between tests.

Methods: Eighty paralysed anaesthetized paediatric patients (weight 10–30 kg) were studied with the intracuff pressure set at 60 cmH2O. Four different oropharyngeal leak pressure tests were performed in random order on each patient by two observers blinded to each other’s measurements. Test 1 involved detection of an audible noise. Test 2 involved detection of endtidal CO2 in the oral cavity. Test 3 involved observation of the aneroid manometer dial as the pressure increased and noting the airway pressure at which the dial reaches stability. Test 4 involved detection of an audible noise by neck stethoscopy.

Results: The mean oropharyngeal leak pressure was 12.5 cmH2O and was similar between tests. The intraclass correlation coefficient was 0.99 for all tests and was classed as excellent. Conclusions: We conclude that all four tests provide accurate and reliable information about oropharyngeal leak pressure in children.
A prospective randomized controlled study of the efficacy of ketamine for postoperative pain relief in children after adenotonsillectomy
Authors: Aspinall R L , Mayor A
Published: March 2003

Background: Adenotonsillectomy is commonly needed by children with obstructive sleep apnoea syndrome. This population is at high risk of life threatening airway obstruction in the postoperative period.

Methods: Fifty children were studied to test the efficacy of an alternative analgesic to the use of opioids in providing analgesia in the immediate postoperative period. Patients were randomized to receive either 0.1 mg·kg–1morphine or 0.5 mg·kg–1ketamine at induction.

Results: Ketamine was as effective as morphine with no additional side‐effects.

Conclusions: Ketamine is a safe and effective alternative to morphine to provide analgesia in the immediate postoperative period after tonsillectomy.
Oral midazolam with an antacid may increase the speed of onset of sedation in children prior to general anaesthesia
Authors: LAMMERS C.R , ROSNER J.L , CROCKETT D.E , CHHOKRA R , BROCK‐UTNE J.G
Published: March 2003

Background: The aim of the study was to see whether sodium citrate solution would speed the gastric absorption of oral midazolam.

Methods: Forty presurgical ASA I and II patients (aged 2–6 years) were randomly assigned to one of two groups. Group I received midazolam 0.5 mg·kg–1 mixed with sodium citrate while group II (control) received midazolam 0.5 mg·kg–1 mixed with Hawaiian fruit punch.

Results: There was no statistical difference between the ages, weights, preoperative sedation and anxiety scores in the two groups. After premedication, the onset of sedation (mean ± SD) measured by the first change in sedation score was found to be significantly faster (P < 0.05) in group I (17.8 ± 7.11) compared with group II (21.9 ± 5.34). There was no statistical difference in anxiety at any time intervals, separation or induction scoring for both groups. Gastric volumes and the pH of gastric aspirates between the two groups were not statistically significant.

Conclusions: The time to onset of sedation can potentially be shortened, by using a preparation of intravenous midazolam and antacid, given orally.
Apnoea in a former preterm infant after caudal bupivacaine with clonidine for inguinal herniorrhaphy
Authors: Fellmann Claudia , Gerber Andreas C. , Weiss Markus
Published: March 2003

Summary Awake regional anaesthesia for inguinal hernia repair in former preterm infants is suggested to avoid life‐threatening respiratory complications known to occur after general anaesthesia. Caudal anaesthesia is becoming a more popular technique for this purpose. To prolong duration of anaesthesia and to reduce postoperative need for analgesics in these infants, caudal clonidine has been considered useful. We report a former preterm infant, who had two awake caudal anaesthetics for herniotomy within 3 weeks. The first was uneventful with bupivacaine 0.25% at 35 weeks postconceptional age. At 38 weeks, the baby suffered form intra‐ and postoperative apnoeas after inadvertent administration of bupivacaine 0.125% plus clonidine.
Is ilioinguinal/iliohypogastric nerve block always totally safe in children?
Authors: Amory C. , Mariscal A. , Guyot E. , Chauvet P. , Leon A. , Poli‐Merol M.L.
Published: March 2003

Summary We report a case of accidental puncture of the small bowel during an ilioinguinal/iliohypogastric nerve block procedure for hernia repair. The diagnosis was made a few days later during a laparoscopic exploration owing to the progressive onset of clinical and radiological intestinal obstruction. A large, obstructing subserosal haematoma was found without any apparent perforation of the mucosa, and the damaged loop was resected. Such a complication has already been reported once in the literature after use of a long bevel needle for the puncture. This case is the first reported using an atraumatic short bevel needle. We discuss the technical aspects of the procedure and underline the fact that regional anaesthesia in children is never totally risk free.
Listeriakeratitis in a horse
Authors: Sanchez S. , Studer M. , Currin P. , Barlett P. , Bounous D.
Published: March 2003

Listeria monocytogenesis ubiquitous in the environment but is rarely reported as a cause of keratitis in animals. In this case, a mare was presented with epiphora and evidence of pain in the right eye.Listeria monocytogeneswas isolated from a corneal lesion, and bacteria were also seen in the cytologic evaluation. This is the first reported case of ulcerative keratitis associated withL. monocytogenesin a horse.