bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in microclimate induced by experimental warming and clipping in tallgrass prairie
Authors: Wan S. , Luo Y. , Wallace L. L.
Published: March 2003

In order to facilitate interpretation and comparison of warming effects on ecosystems across various habitats, it is imperative to quantify changes in microclimate induced by warming facilities. This paper reports observed changes in air temperature, soil temperature and soil‐moisture content under experimental warming and clipping in a tallgrass prairie in the Great Plains, USA. We used a factorial design with warming as the primary factor nested with clipping as the secondary factor. Infrared heater was used in order to simulate climatic warming and clipping to mimic mowing for hay or grazing. The warming treatment significantly increased daily mean and minimum air temperatures by 1.1 and 2.3 °C, respectively, but had no effect on daily maximum air temperature, resulting in reduced diurnal air‐temperature range. Infrared heaters substantially increased daily maximum (2.5 and 3.5 °C), mean (2.0 and 2.6 °C) and minimum (1.8 and 2.1 °C) soil temperatures in both the unclipped and clipped subplots. Clipping also significantly increased daily maximum (3.4 and 4.3 °C) and mean (0.6 and 1.2 °C) soil temperatures, but decreased daily minimum soil temperature (1.0 and 0.6 °C in the control and warmed plots, respectively). Daily maximum, mean and minimum soil temperatures in the clipped, warmed subplots were 6.8, 3.2 and 1.1 °C higher than those in the unclipped, control subplots. Infrared heaters caused a reduction of 11.0% in soil moisture in the clipped subplots, but not in the unclipped subplots. Clipping reduced soil‐moisture content by 17.7 and 22.7% in the control and warmed plots, respectively. Experimental warming and clipping interacted to exacerbate soil‐moisture loss (26.7%). Overall, infrared heaters simulated climate warming well by enhancing downward infrared radiation and by reducing the diurnal air‐temperature range.
The long way from Kyoto to Marrakesh: Implications of the Kyoto Protocol negotiations for global ecology
Authors: Schulze E.‐D. , Valentini R. , Sanz M.‐J.
Published: March 2003

The Sixth and Seventh Conference of the Parties (COP 6 and 7) at The Hague, Bonn and Marrakesh came to a final Agreement on the Kyoto Protocol, which is thus ready for ratification by the individual nations. The Agreement was only achieved by allowing countries to offset their fossil fuel emission targets (on average 95% of the 1990 emissions) by increasing biological carbon sequestration, and by trading carbon credits. Activities that would count as increasing biological carbon sequestration include afforestation and reforestation, and changes in management of agriculture and forestry. According to the Agreement reached in Marrakesh, biological carbon sequestration may reach an offset of up to 80% of the required reduction in fossil fuel emissions (4% of the 5% reduction commitment). We explain why the allowable offset rose as high during the course of the negotiations. It is highlighted that major unintended consequences may be a result of the policy as it stands in the Marrakesh Accord. Major losses of biodiversity and primary forest are expected. We present scientific concerns regarding verification, which lead to scientific doubts that the practices encouraged by the Agreement can actually increase sequestration under a full carbon accounting scheme. We explain that there is a ‘win‐win’ option that would protect high carbon pools and biodiversity in an economically efficient way. But, this is not supported by the Agreement. Despite the very positive signal that most nations of the United Nations will devote major efforts towards climate protection, there remains a most urgent need to develop additional rules to avoid unintended outcomes, and to promote the ‘win‐win’ options that we explain.
Spatial distribution of phytomass carbon in Indian forests
Authors: CHHABRA ABHA , PALRIA S. , DADHWAL V. K.
Published: March 2003

A spatial analysis of phytomass carbon (C) in Indian forests for the period (1988–94) at the district‐level is reported. District‐level forest phytomass C (1988, 1994) was computed by combining remote sensing‐based forest area inventories on 1:250 000 scale, field inventories of growing stock volume by the Forest Survey of India (FSI), and crown density‐based biomass expansion factors. The estimates of forest area inventory, forest phytomass C density, and forest phytomass C pools (1988–94) were linked to the district boundary coverage of India in ARC/INFO Geographic Information System (GIS). Of the total 386 districts examined, only 17 districts had more than 75% forest cover (as percent of their geographic area) in 1988. Estimated district‐level forest phytomass C densities ranged from 4.3 to 206.8 MgC ha−1*. At the national level, forest phytomass C pool was estimated to be 3871.2 and 3874.3 TgC# in 1988 and 1994, respectively. Although the aggregated national estimates were similar, the district‐level change analysis indicated a decrease of 77.8 TgC and an increase of 81 TgC (1988–94). The highest decrease of 10.4 TgC was observed in Vishakapatnam district (Andhra Pradesh) while largest increase of 9.8 TgC in Bastar district (Madhya Pradesh) resulting from deforestation and afforestation activities, respectively. At the national level, the total forest cover decreased by ∼0.6 Mha, however, the district‐level spatial analysis indicated an increase of 1.07 Mha, and decrease of 1.65 Mha forest cover during 1988–94 period. Although, this is the first district level phytomass C analysis of Indian forests, the aggregated results at state‐level were close to the earlier estimates. The spatial analysis identified the districts that have undergone significant changes in their forest phytomass C during the study period. This improved understanding of forest phytomass C pools is important to sustainable development and conservation of forests, mitigation strategies for C sequestration, and accurate estimation of contribution of land use changes to C emission in India.
P uptake by arbuscular mycorrhizal hyphae: effect of soil temperature and atmospheric CO2 enrichment
Authors: Gavito Mayra E. , Schweiger Peter , Jakobsen Iver
Published: March 2003

Mycorrhizas are ubiquitous symbioses that may have an important role in the movement of C from air to soil. Studies on the effects of climate change factors on mycorrhizas have been concentrated on the effects of atmospheric [CO2] whereas temperature effects have been neglected. Based on previous results showing no effect of varying atmospheric [CO2] on the development and P uptake of the arbuscular mycorrhizal fungi (AMF) colonizing plants growing in controlled conditions, we hypothesized that soil temperature would have a higher impact on AMF development and nutrient uptake than the effects of [CO2] on the host plant. Pea plants were grown in association with either a single isolate of Glomus caledonium or AMF from field soil in factorial combination with the corresponding current (10 °C) or elevated (15 °C) soil temperatures at current (350 p.p.m) or elevated (700 p.p.m) atmospheric [CO2]. 33P uptake by extraradical AMF hyphae was measured independently from root P uptake in a root exclusion compartment. Intraradical colonization developed well at both soil temperatures and almost duplicated from 10 to 15 °C. Extraradical mycelium developed only at 15 °C in the root exclusion compartment and hyphal P uptake could therefore be studied at 15 °C only. Hyphal P uptake differed markedly between inoculum types, but was not altered by growing the host plants at two atmospheric [CO2] levels. No significant [CO2] × soil temperature interactions were observed. The results suggested that, in the system tested, AMF development and function is likely more influenced by the temperature component of climate change than by its [CO2] component. We suggest that much more attention should be paid to temperature effects in future studies.
Simulation of biomass, carbon and nitrogen accumulation in grass to link with a soil nitrogen dynamics model
Authors: Wu  , McGechan
Published: March 2003

In order to represent nitrogen and carbon cycling in the soil–plant–atmosphere continuum, a previously developed weather‐driven grass growth model has been adapted to become the crop growth component of the soil nitrogen dynamics model SOILN. This provides a means of simulating nitrogen uptake by the grass crop, an important component of the overall nitrogen balance in grassland.

Grass growth is represented by a photosynthesis equation adjusted to take account of respiration as well as constraints due to lack of water and nitrogen in the soil. Water shortage is represented by linked simulations with the soil water and heat model SOIL, and nitrogen shortage by links with the
SOILN model. Accumulated biomass and the nitrogen component of biomass are allocated to leaf, stem and root pools, and flows from live biomass pools to those representing above‐ and below‐ground senescent material are also represented. The model is tested by comparing simulated cut grass yields and nitrogen contents of cut material with measured data at a test site. Soil nitrogen processes in the model are tested by comparing simulated and measured nitrate in drainflows. Agreement is reasonable, indicating that the combined model gives a␣realistic representation of carbon and nitrogen processes in grassland.

The use of the combined model in a predictive manner has been demonstrated in a comparison of nitrogen balances with a number of alternative slurry and mineral nitrogen fertilizer application scenarios.
Influence of pH and aluminium on nitrogen partitioning in defoliated grasses
Authors: Thornton B.
Published: March 2003

Reduced inputs of fertilizer and lime to grasslands can result in decreased soil pH, increased aluminium concentration in the soil solution and, consequent upon these, inhinition of nitrogen acquisition by plannts. This study tested the hypothesis that under conditions of low pH and high aluminium concentrations a grass species more tolerant of acid conditions (Deschampsia flexuosa) maintains a greater total supply of nitrogen to growing leaves after defoliation from both root uptake and mobilization of stores than a less tolerant species (Lolium perenne). The grasses were grown without alumimium at pH values 3.5, 4.0, 5.0 or 5.5 and at a range of aluminium concentrations (0, 20, 100, 200 or 1000 mmol m−3) at pH 4.5. Labelling with 15NH415NO3 after defoliation allowed estimation of both root uptake and mobilization of stores in supplying nitrogen to growing leaves. The total amount of nitrogen supplied to the growing the leaves after defoliation by the combination of current root uptake and mobilization was maximal when aluminium was in the range 20–20 mmol m‐3. The total nitrogen supplied to growing leaves the both species after defoliation was greater when the grasses were grwon at pH 5.0 and 5.5 than when grown at pH 4.0. L. perenned and D. flexuosa were affected similarly by both aluminium and pH with respect to the total nitrogen supplied to the leaves. The effects of aluminium an dpH upon the supply of nitrogen to growing leaves after defoliation my not be a dominant factor in the vegetation dynamics of grazed swards.
Simulation of nitrogen uptake, fixation and leaching in a grass/white clover mixture
Authors: Wu  , McGechan
Published: March 2003

To represent nitrogen cycling in a low input grass/legume pasture system, a previously developed, weather‐driven grass/white clover growth model has been adapted to become the crop growth component of the soil nitrogen dynamics model SOILN. This provides a means of simulating nitrogen uptake by a grass/white clover crop, an important component of the overall nitrogen balance in low‐input grassland systems.

Crop growth is represented by a photosynthesis equation adapted to take account of competition between the two crops for resources of light, water and nitrogen in the soil. Water shortage is represented by linked simulations with the soil water and heat model SOIL, and nitrogen shortage by links with the SOILN model. Nitrogen fixation has been introduced according to an equation for potential fixation reduced by environmental factors, particularly temperature. Transfer of nitrogen‐rich clover plant material to the soil nitrogen pools of SOILN (from where it becomes available as a nutrient for grass) is also represented. The model is tested by comparing simulated cut crop yields and nitrogen content of cut material with measured data from perennial ryegrass/white clover at a test site. Soil nitrogen processes in the model are tested by comparing simulated and measured nitrate in drainflows. Apart from some discrepancies between simulated and measured results attributable to the inherent instability of a mixed crop system, agreement is reasonable by the standards of biological system models, indicating that the combined model gives a realistic representation of carbon and nitrogen processes in grassland with a grass, legume mixed crop.
Effects of irrigation and harvest management on dry‐matter yield and seed yield of annual clovers grown in pure stand and in mixtures with graminaceous species in a Mediterranean environment
Authors: Martiniello
Published: March 2003

Forage crops in Mediterranean environments are characterized by variable seed and forage production. Knowledge of the effects of agronomic factors on annual clovers grown in pure stand and in association with grasses is essential for their effective exploitation of the available environmental resources. Herbage and seed production were evaluated in southern Italy in an experiment with winter annual forage crops during the years 1992–95. Clovers (Trifolium alexandrinum L., berseem; T. incarnatum L., crimson; T. resupinatum L., Persian; and T. squarrosum L., squarrosum) and graminaceous forage crops (Hordeum vulgare L., barley; and Lolium multiflorum Lam., Italian ryegrass) were used to examine the agronomic effects of irrigation and harvest management. The clovers were evaluated in pure stand and in mixture, whereas the graminaceous species were evaluated only in mixtures. The mixtures were sown in alternating, equally spaced rows. The parameters evaluated were forage dry‐matter yield, seed yield and its components. The results showed wide differences in forage production between clovers in pure stands and in binary mixtures. Mean dry‐matter production from forage harvest of pure stands of irrigated clovers taken when 10–15% of the stems were flowering yielded 4·36 t ha–1, that is 0·67 and 0·55 of that of irrigated mixtures of clovers with either Italian ryegrass or barley, respectively, harvested when 10–20% of the graminaceous components were at the heading stage. The forage yield of non‐irrigated pure stands of clovers was 0·60 of that of irrigated plots, whereas non‐irrigated mixtures yielded 0·82 and 0·86 of that the irrigated treatments for Italian ryegrass or barley mixtures. The mean seed yield of non‐irrigated pure stands of the clovers was 0·51 of that of irrigated stands, which yielded 451 kg ha−1. Persian clover gave the highest seed yields (732 kg ha−1 under irrigation). These higher yields were related to a higher number of fructiferous organs per stem in Persian clover. When a forage harvest had previously been taken on irrigated clover plots, the subsequent mean seed yields were greatly reduced to 0·76 for berseem and 0·21 for Persian clover and were almost negligible for crimson and squarrosum clover. When irrigated and grown in mixtures with Italian ryegrass, only berseem produced a worthwhile yield of 0·36 compared with that of pure clover taken for seed without a forage harvest; mixtures with barley gave yields of 0·71, 1·07 and 0·20 for berseem, crimson and Persian clovers, respectively, compared with seed yield from uncut pure clover.
The effect of herbage allowance on daily intake by Creole heifers tethered on natural Dichanthium spp. pasture
Authors: Boval  , Cruz  , Peyraud  , Penning
Published: March 2003

Two experiments were carried out in Guadeloupe to estimate the organic matter intake (OMI) and digestibility (OMD) of a Dichanthium spp. sward, grazed by tethered Creole heifers [mean live weight (LW) 202 ± 2·0 kg], at three daily herbage allowances. Experiment 1 examined herbage allowances of 16, 25 and 31 kg of dry matter (DM) d–1 on a fertilized sward at 21 days of regrowth whereas, in experiment 2, lower allowances of 11, 15 and 19 kg DM d–1 were examined on the same sward, which was unfertilized and grazed at 14 days of regrowth. In each experiment, the herbage was grazed with three groups of two heifers in a 3 × 3 Latin square design. Sward characteristics were described before grazing. OMI was calculated from total faecal output, and OMD was predicted from the crude protein (CP) content of the faeces. The amount of herbage defoliated by the heifers was also estimated on tillers selected at random.

Organic matter intakes were on average 26 g and 19 g OM kg–1 LW, and OMD values were 0·740 and 0·665 for Experiments 1 and 2, respectively, and were not affected by allowance. In Experiment 1, the herbage quality was high [0·50 of leaf and 116 g CP kg–1 organic matter (OM)] for a tropical forage, whereas in Experiment 2, the quality of the herbage (0·27 of leaf and 73 g CP kg–1 OM) was lower. These differences were reflected in differences in intake and digestibility in the two experiments.

The experimental tropical Dichanthium spp. swards can have intake characteristics similar to those of a temperate sward.
The reclamation of bracken‐dominated pastures in Bulgaria using asulam and fertilizers
Authors: Petrov P. , Marrs R. H.
Published: March 2003

Bracken (Pteridium aquilinum) is a major weed of considerable economic concern in upland pastures in Bulgaria and elsewhere in Europe. Between 1993 and 1998, a field experiment was carried out to test methods for restoring productive meadows. Initially, spraying asulam (4·8 kg a.i. ha−1) was used to control the bracken on the site; this was achieved in terms of reduced frond densities and a higher level of grassland establishment. This grassland was dominated by Vicia cassubica and the perennial grasses Agrostis vulgaris, Dactylis glomerata, Festuca rubra, Holcus lanatus and Poa pratensis.

After 2 years, a fertilizer addition experiment was started with four treatments (no fertilizer; addition of phosphorus; addition of nitrogen and phosphorus; addition of nitrogen, phosphorus and potassium. The phosphorus and potassium fertilizers were applied annually in the early spring at 80 kg of P ha−1 year−1 and 50 kg of K ha−1 year−1, and nitrogen was added at the start of grass growth at 60 kg of N ha−1 year−1. At the same time, a twice‐yearly hay‐cutting regime was implemented. Fertilizer addition increased both the quantity and the quality of the resulting grassland. The herbage dry matter was increased by at least a factor of two depending on fertilizer combination, and there was an increase in grass and legume cover and a decrease in both weed cover and bracken recovery. However, although bracken recovery was inversely related to grassland production, there was a consistent increase in bracken density across all treatments between 1997 and 1998, suggesting that increasing herbage biomass merely delays bracken recovery. The implications of these findings are discussed.
The effect of harvest date and inoculation on the yield, fermentation characteristics and feeding value of kale silage
Authors: Fraser M. D. , Winters A. , Fychan R. , Davies D. R. , Jones R.
Published: March 2003

Using new harvesting and ensiling technologies, it is now possible to ensile kale (Brassica oleracea) successfully. However, there is little information available regarding the optimum time for harvest. The aim of this 2‐year study was to compare the yield, fermentation characteristics and feeding value of kale harvested at different stages of growth, and ensiled with and without a bacterial inoculant. During Year 1 the crop was harvested after 15, 18 and 20 weeks of growth. The yield at each harvest was similar, but as the crop matured the crude protein (CP) concentration and buffering capacity decreased significantly, and there was a marked increase in the water‐soluble carbohydrate (WSC) concentration. During Year 2 the crop was harvested at 14 and 17 weeks of growth. Again, the stage of maturity did not affect yield and, on this occasion, the chemical composition of the crop was unaffected by harvest date. However, the WSC and CP concentrations of the crop were lower in Year 2 than in Year 1, possibly as a result of differences in fertilizer regime. Each of the silages produced in Year 2 was offered to six Suffolk cross wether lambs, aged 10 months, to measure voluntary intake, in vivo digestibility and nitrogen retention. Neither harvesting date nor the use of an inoculant affected voluntary intake or nitrogen retention by the lambs. However, in vivo digestibility was higher in the kale silage harvested after 14 weeks of growth and when an inoculant was applied. The results obtained suggest that harvesting kale after 14 weeks of growth can produce highly digestible silage with a high CP concentration. Although delaying harvest until 18 weeks of growth will probably result in a decrease in the CP concentration of the crop, it should also lead to an increase in the WSC concentration of the crop, ensuring a more reliable fermentation.
The effect of cultivar on the rate and extent of combining pea straw degradability examinedin vitrousing the Reading Pressure Technique
Authors: Mould F. L. , Hervás G. , Owen E. , Wheeler T. R. , Smith N. O. , Summerfield R. J.
Published: March 2003

Although about 225 000 t dry matter (DM) pea straw is produced annually in the UK, no recent data exist with respect to its nutritive value when offered to ruminants. This study, to examine field pea crop waste (straw) from 12 commercial cultivars of combining peas, was therefore undertaken when material grown as part of a European field pea network trial at Reading in 1998 was made available. The straw was subjected to chemical analysis and examinedin vitrousing the Reading Pressure Technique to generate gas production profiles and to determine both rate and extent of DM and organic matter degradation. Ash and crude protein (CP) concentrations (69 and 65 g kg–1DM) were generally lower than published values for legume straws but higher, especially CP, than cereal straws. Neutral‐detergent fibre concentrations were slightly lower, and metabolizable energy (ME) values, derived from degradable organic matter assessedin vitro(iOMD), higher than cereal straws, ranging from 6·0 to 8·1 MJ ME kg–1DM. Both cumulative gas production and rate of gas release varied significantly between cultivars, as did degradation with 96‐h iOMD values ranging from 468 to 602 g kg–1. By combining these with the quantity of material harvested, ME yields for the different cultivars were found to range from 15 to 27 GJ ME ha–1. Considerable, and general highly significant, variation was found between the cultivars examined, which may be used to rank straws with respect to their nutritive value. The cultivars Baccara and Solara followed by Athos and Vital were readily ranked higher than the other cultivars in terms ofin vitrofermentation parameters and ME yields. These data suggest that pea straw, although often incorporated into the soil in post‐harvest operations, shows excellent potential as a ruminant forage feedstuff.
Changes in the physiology and feed quality of cocksfoot (Dactylis glomerata L.) during regrowth
Authors: Rawnsley R. P. , Donaghy D. J. , Fulkerson W. J. , Lane P. A.
Published: March 2003

Abstract A glasshouse study was undertaken to determine the physiological and morphological changes in cocksfoot (Dactylis glomerata L.) during regrowth after defoliation. Individual plants were arranged in a mini‐sward in a randomized complete block design. Treatments involved harvesting each time one new leaf had expanded (one‐leaf stage), up to the six‐leaf stage, with the plants separated into leaf, stubble (tiller bases) and roots. Stubble and root water‐soluble carbohydrate (WSC), stubble and leaf dry matter (DM), tiller number per plant and leaf quality (crude protein (CP), estimated metabolizable energy (ME) and mineral content) were measured to develop optimal defoliation management of cocksfoot‐based pastures. WSC concentration in stubble and roots was highest at the five‐ and six‐leaf stages. Mean WSC concentration (g kg−1 DM) was greater in stubble than roots (32·7 ± 5·9 vs. 9·4 ± 1·5 respectively). There was a strong positive linear relationship between plant WSC concentration and leaf DM, root DM and tillers per plant after defoliation (Adj R2 = 0·72, 0·88 and 0·95 respectively). Root DM plant−1 and tiller DM tiller−1 decreased immediately following defoliation and remained low until the three‐leaf stage, then increased from the four‐leaf stage. Tillers per plant remained stable until the four‐leaf stage, after which they increased (from 9·9 ± 0·5 to 15·7 ± 1·0 tillers plant−1). Estimated metabolizable energy concentration (MJ kg−1 DM) was significantly lower at the six‐leaf stage (11·01 ± 0·06) than at any previous leaf regrowth stage, whereas CP concentration (g kg−1 DM) decreased with regrowth to the six‐leaf stage. Both the levels of ME and CP concentrations were indicative of a high quality forage throughout regrowth (11·37 ± 0·04 and 279 ± 8·0 for ME and CP respectively). Results from this study give a basis for determining appropriate criteria for grazing cocksfoot‐based pastures. The optimal defoliation interval for cocksfoot appears to be between the four‐ and five‐leaf stages of regrowth. Delaying defoliation to the four‐leaf stage allows time for replenishment of WSC reserves, resumption of root growth and an increase in tillering, and is before herbage is lost and quality falls due to onset of leaf senescence.
Does suspected large bowel perforation at laparoscopy always require large incision laparotomy?
Authors: Hill David , Lolatgis Nicholas , Maher Peter , Wood Carl
Published: March 2003

Large bowel perforation associated with laparoscopic surgery is a serious complication but even if suspected, it may prove difficult to find and therefore treat. Five interesting cases are reported.
Comparison between medical treatment by GnRH analogue (goserelin) and conservative surgery by laparoscopic diathermy for the management of endometriosis
Authors: Hefni Mohamed A. , Apoola Ade , Omran
Published: March 2003

Objective

To compare the effectiveness of medical treatment of endometriosis with conservative surgical treatment, either alone or combined with medical treatment.

Design

Case‐controlled, prospective observational clinical study.

Setting

Gynaecology Department at Benenden Hospital, Kent, UK.

Patients

98 women proven laparoscopically to have endometriosis which was staged using the Revised American Fertility Society Classification (rAFS).

Interventions

The first group underwent medical treatment with the GnRH analogue, goserelin (3.6 mg depot) and the second group was treated using laparoscopic diathermy. Some members of the second group who had endometriomas and stage IV endometriosis (AFS classification) also had GnRH analogue in addition to laparoscopic diathermy. There was no statistically significant difference between the age, parity and severity of symptoms of the groups.

Main outcome measures

Variations in patient‐reported symptoms, physician‐recorded clinical examination and in second‐look laparoscopic findings, in each group, 6 months after treatment completion.

Results

Treatment with laparoscopic diathermy, either alone or in combination with GnRH analogue, was associated with a significantly better outcome, as assessed by a self‐report of marked improvement in symptom score or cure, compared with treatment with GnRH analogue alone (relative risk 2.36, 95% confidence interval (CI) 1.38–4.02). The surgical treatment group were also 2.52 times more likely to show either marked improvement or cure, as judged by clinical assessment, than the group of patients who received GnRH analogue alone (relative risk 2.52, 95% CI 1.54–4.14). There was an improvement or cure in 71% of patients in the surgical group, when assessed laparoscopically at follow up, compared with 49% in the medical group.

Conclusion

The results showed that patients with endometriosis receiving conservative surgery, either alone or in combination with GnRH analogue, were at least two times more likely to have either marked improvement or cure, as assessed by patient‐reported symptoms and clinical findings at 6‐month follow up, than those who received GnRH analogue alone.
Endoscopic dissection of the uterosacral ligaments for the treatment of chronic pelvic pain
Authors: Wiborny Rudolf , Pichler Barbara
Published: March 2003

As an increasing number of women without pathological findings suffer from chronic pelvic pain (CPP) it has become necessary to use simple treatments involving relatively few complications. From January 1994 to March 1997, 108 patients with CPP underwent diagnostic laparoscopy at our unit. The most frequent findings were endometriosis (33.3%), pelvic adhesions (23.1%), Allen–Masters syndrome (3.7%) and pelvic congestion (2.8%). In 14.8% of the patients with CPP, diagnostic laparoscopy did not reveal any pathological findings in the pelvis. This latter group of patients were treated by means of dissection of the uterosacral ligaments performed at the same time as the diagnostic laparoscopy. None of them had experienced a sustained response to treatment with analgesics and psychological intervention. At 3 months after the operation 50% of the patients who presented for follow up were completely free of symptoms, with an additional 35.7% showing a significant alleviation of pain. There was little change in these percentages 12 months after treatment. No surgical complications were observed. We conclude that this procedure represents a promising alternative treatment for patients with chronic pelvic pain.
A prospective randomized double‐blind placebo‐controlled study of local anaesthetic injected through the hysteroscope for outpatient hysteroscopy and endometrial biopsy
Authors: Costello Michael F. , Horrowitz Stephen D. , Williamson Margaret
Published: March 2003

Objective

To determine whether the injection of local anaesthetic through the hysteroscope at outpatient hysteroscopy, with or without endometrial biopsy, will reduce abdominal pain and increase patient acceptability of the two procedures.

Design

Prospective randomized double‐blind placebo‐controlled study.

Setting

Outpatient hysteroscopy clinic, Royal Hospital for Women, Sydney, Australia.

Subjects

100 women undergoing outpatient hysteroscopy with or without endometrial biopsy.

Interventions

Randomization into two groups: local anaesthetic (group 1) and placebo (group 2). Upon introduction of the hysteroscope into the cervical os, 5 ml of 2% plain lignocaine (group 1) or normal saline (group 2) was introduced via the channel in the hysteroscope. After 2 min, the hysteroscopy and endometrial biopsy (where indicated) were conducted in the usual manner.

Main outcome measures

The degree of pain experienced and the acceptability of the procedures were assessed using visual analogue scales.

Results

99 women underwent hysteroscopy (49 in group 1 and 50 in group 2) with 92 also undergoing endometrial biopsy (45 in group 1 and 47 in group 2) Both groups were homogeneous for age, parity, menopausal status and subjective pain tolerance assessment. Group 1 found both the hysteroscopy and endometrial biopsy to be less painful and more acceptable, but these differences were not statistically significant. Four subgroups were analysed: nulliparous (group A), no past vaginal delivery (group B), postmenopausal (group C), and no previous dilatation and curettage (group D). Local anaesthetic reduced the pain at hysteroscopy in groups A, B and C and at endometrial biopsy in all groups, with groups B, C, and D at endometrial biopsy reaching statistical significance (P = 0.05, 0.03, and 0.04, respectively).

Conclusions

Topical intra‐uterine anaesthetic injected through the hysteroscope results in: (1) a trend towards a reduction in pain for both hysteroscopy and endometrial biopsy, and (2) a significant reduction in pain during endometrial biopsy in women who have not had a previous vaginal delivery, or dilatation and curettage, or are postmenopausal.
Laparoscopic Burch colposuspension: a minimum of 2 years' follow up and comparison with open colposuspension
Authors: Lavin Jacqueline M. , Lewis Christopher J. , Foote Andrew J. , Hosker Gordon L. , Smith Anthony R. B.
Published: March 2003

Objective

To determine whether laparoscopic colposuspension could achieve similar success rates to open colposuspension, with objective follow up at 6 months and subjective review a minimum of 2 years following surgery, and to compare the postoperative morbidity associated with the two types of procedure.

Design

Retrospective review of the first 139 women to undergo laparoscopic colposuspension at St Mary's Hospital and of 52 women who had most recently undergone open colposuspension in the same hospital, for whom there was a 6‐month objective follow up.

Setting

St Mary's Hospital, Manchester, UK.

Results

There was no difference between the two groups in the incidence of intraoperative complications. Postoperative morbidity was reduced in the laparoscopic group, as were analgesic requirements, length of catheterization and postoperative stay. At 6 months, cure and improvement rates were similar between the two groups (71 and 91% with laparoscopic colposuspension vs. 67 and 89% with open colposuspension). At follow up at a minimum of 2 years, both groups had shown a decline in efficacy, but again with no significant difference between the two groups (cure rate 57.8% for the laparoscopic procedure vs. 50.0% for the open one; improvement 77.1% for the laparoscopic vs. 58.7% for the open procedure. Women who had undergone laparoscopic colposuspension returned to normal activities significantly faster and were more likely to be satisfied with the results of surgery than women who had undergone open colposuspension.

Conclusion

At follow up of a minimum of 2 years, laparoscopic colposuspension appeared to have been as effective as open colposuspension in curing stress incontinence. Laparoscopic colposuspension was also associated with reduced postoperative morbidity, shorter hospitalization and earlier return to normal function.
Total laparoscopic hysterectomy with suture technique
Authors: Ho Kim Dong , Suk Chi Jeong
Published: March 2003

Objective

To evaluate the efficacy of total laparoscopic hysterectomy (TLH) with suture technique.

Design

Review of hospital records of 108 women who underwent total laparoscopic hysterectomy between January 1 1994 and December 31 1996.

Setting

Department of obstetrics and gynaecology at a university teaching hospital.

Subjects

108 women who underwent total laparoscopic hysterectomy.

Interventions

All the hysterectomy procedures were performed in the classic manner, with scissors, grasping forceps, bipolar coagulation and suture technique as in total abdominal hysterectomy (TAH).

Main outcome measures and results

Indications, patient characteristics, associated procedures, surgical outcomes, and complications were analysed. The mean age of the patients was 44.7 ± 5.0 years. The most common surgical indication was squamous intraepithelial lesion of the cervix, including carcinoma in situ and dysplasia. The mean operating time was 173.4 ± 80.4 min, and blood loss (189 ± 105 ml) was lower than that of conventional abdominal hysterectomy. Mean uterine weight was 87.3 ± 24.3 g. None of the procedures was converted to laparotomy. There were no intraoperative complications, and a few postoperative complications were noted, specifically three out of 108 cases, comprising 2.8%. The complications included two vaginal vault infections and a febrile condition.

Conclusions

Our findings suggest that total laparoscopic hysterectomy with a suture technique is feasible, cost‐effective, safer than, and a good alternative to, abdominal and vaginal hysterectomy.
Histopathology and steroid receptors in endometrial polyps of postmenopausal patients under hormone‐replacement therapy
Authors: Maia Hugo , Maltez Amelia , Calmon Luis C. , Oliveira Maita , Marques Dilson , Coutinho Elsimar M.
Published: March 2003

Objective

To study the histopathology of endometrial polyps that had developed during 6–18 months of hormone‐replacement therapy (HRT), and to determine the status of oestrogen and progesterone receptors in these lesions.

Design

Retrospective study.

Subjects

Fifty‐five menopausal patients receiving HRT who had endometrial polyps.

Interventions

Polypectomy followed by endometrial resection.

Results

Endometrial polyps have foci of hyperplasia that do not respond to progestin in menopausal patients receiving HRT. This is associated with lack of progesterone receptors in both stroma and glands. On the other hand, oestrogen receptors are expressed in endometrial polyps.

Conclusions

Endometrial polyps in menopausal patients receiving HRT respond only to oestrogens but not to progestins. The unopposed oestrogenic action on polyps may favour the development of premalignant hyperplasia and carcinoma.
Management of cystic ovarian masses by laparoscopic surgery: results of 275 cases
Authors: Rasmussen Carsten , Englund Katarina , Lindblom Bo
Published: March 2003

Objective

To assess the results of operative laparoscopy in terms of operation time, postoperative care, histological diagnosis and complications.

Design

Retrospective evaluation of women who had undergone laparoscopic management of cystic ovarian masses.

Setting

Two Swedish university hospitals.

Subjects

275 women with clinically and sonographically benign cystic ovarian masses.

Interventions

Operative laparoscopy under general anaesthesia was carried out in all the women. Bipolar coagulation, suture loops, suction/irrigation and various cutting instruments were used.

Main outcome measures and Results

No major intraoperative complications occurred in this series. Minor complications included injury of the inferior epigastric artery, postoperative nausea, shoulder pain and temporary urine retention. Three patients underwent a second surgical procedure because of postoperative intra‐abdominal bleeding. The adnexal cystic masses varied in size from 2 to 12 cm (mean 5.5 cm). The mean total operation time was 54 min (range 15–200 min). The postoperative stay at the clinic ranged from 6 to 144 h (mean 23 h). Histopathological examination showed malignancy in 1.8% of the cases.

Conclusions

In this setting operative laparoscopy appears to be a safe and effective method for treating clinically and ultrasonographically benign ovarian cysts. Day surgery is possible in the majority of cases.
Endometrial cancer and fibroids: should they be managed laparoscopically?
Authors: Kadar Nicholas
Published: March 2003

Objective

To describe techniques of morcellation without entry into the uterine cavity and discuss their use in the management of selected patients with endometrial cancer and fibroids.

Method

Case series.

Results

Eight patients with endometrial cancer arising in a fibroid uterus underwent laparoscopic hysterectomy, and in three cases morcellation was required. The mean uterine weight was 608 g (median 500 g). Four women had pelvic and one had pelvic plus aortic lymphadenectomy in addition to the hysterectomy. One woman had pelvic and another pelvic plus aortic lymph node metastases. The mean age, weight, and body mass index of the patients were 54.8 years, 214 lbs and 36.5, respectively. One nullliparous patient weighed 329 lbs, and another weighed 289 lbs. The mean anaesthetic time was 3.75 h, the mean estimated blood loss 770 ml, and the mean drop in haemoglobin 3.2 g/dl. The mean hospital stay was 2 days, and there were no complications although one patient was transfused.

Conclusions

Endometrial cancers arising in a fibroid uterus can be treated laparoscopically in selected cases.
Laparoscopic vs. abdominal vs. vaginal hysterectomy
Authors: Mehra Sheila , Bhat Veena , Mehra Gautam
Published: March 2003

Objectives

To compare vaginal, total abdominal and laparoscopically assisted vaginal hysterectomy (VH, TAH and LAVH) in terms of morbidity, operating time, blood loss, cost, hospital stay and recovery, and to compare the number of hysterectomies performed using each approach over a period of 3 years.

Design

Retrospective and prospective study.

Setting

Moolchand K.R. Hospital (Gynaecological Endoscopic Center), New Delhi, India.

Subjects

A total of 663 patients underwent hysterectomies for different indications.

Interventions

Patients were assigned to either TAH (n = 312), LAVH (n = 174) or VH (n = 177), with or without salpingo‐oöphorectomy.

Main outcome measures

These included estimated blood loss, operating time, complications, hospital stay, time to return to normal work, and cost.

Results

The estimated blood loss was significantly different with that for TAH being greater than that for LAVH or VH. The operating time for LAVH was longer than that for TAH which in turn was longer than that for VH. Complication rates (major and minor) were 31.34, 13.72 and 12.36% in TAH, LAVH and VH, respectively. The length of hospital stay was found to be least with LAVH and greatest for TAH (P = 0.001). The total costs for all three types of hysterectomy were not significantly different (P > 0.05). Women in the LAVH and VH groups recovered sooner (16.4 ± 3.4 and 18 ± 4.2 days, respectively) than those in the TAH group (30.8 ± 7.2 days; P = 0.001).

Conclusions

VH is by far the most acceptable procedure in terms of lower complication rates, cost and recovery. LAVH has similar advantages, but is not a substitute for VH. However, it is strongly indicated where VH is not possible. TAH is associated with the highest patient morbidity and the longest convalescence period. Costs are similar in all three procedures.
A case of pelvic and hepatic abscesses following rollerball endometrial ablation
Authors: Chen Jeanette S. C. , Cox Charles W. F. M.
Published: March 2003

We present a case of a woman who underwent a seemingly uncomplicated rollerball endometrial ablation. She became unwell 4 days after the procedure. Ultrasound and computed tomography (CT) scans confirmed the presence of pelvic and hepatic abscesses. A right Bartholin's abscess was also found at this time and was subsequently marsupialized. This case highlights a previously unreported complication following rollerball endometrial ablation.
Combined laparoscopic gynaecological and surgical procedures
Authors: Homa Tomasz , Bobrzyński Andrzej
Published: March 2003

Objective

Evaluation of indications for and effectiveness of combined laparoscopic surgical and gynaecological operative procedures.

Design

Prospective study conducted over a 4‐year period.

Patients

25 patients with two coexisting diseases who underwent a single‐stage operative treatment.

Setting

University hospital.

Interventions

Combined gynaecological and surgical laparoscopic procedures performed under general anaesthesia.

Results

The following operative procedures were performed in 25 patients: 23 cholecystectomies, 2 appendectomies, 19 cystectomies in patients with ovarian cysts, 8 myomectomies and 1 subtotal hysterectomy with adnexectomy. One patient underwent a triple procedure consisting of cholecystectomy, ovarian cyst enucleation and inguinal hernia repair. The average postoperative hospitalization time was 2 days (range 1–4).

Conclusion

Combined laparoscopic surgical and gynaecological operations are safe, and should be recommended as an optional strategy in the treatment of patients with two or more coexisting diseases.
Is laparoscopic hysterectomy bad for the brain?
Authors: Salonen Markku , Mäkinen Juha , Saraste Markku , Parkkola Riitta
Published: March 2003

Objective

Laparoscopic hysterectomy gives rise to the theoretical possibility of systemic gas or debris embolization, because of the unique way in which it changes the pressure gradients at the level of the heart. We wanted to find out how great the risk might be, and whether there was a possibility of detecting patients at high risk.

Subjects

10 otherwise healthy patients referred to our clinic for laparoscopic hysterectomy.

Results

In all patients there was a pressure gradient from right to left between the sides of the heart during the operation. Also in all patients, small echogenic particles were seen in the bloodstream entering the right atrium, emerging from the inferior vena cava. There were no patients with an open foramen ovale and, consequently, no right‐to‐left shunting. Cerebral magnetic resonance imaging (MRI) showed no change postoperatively compared with preoperative status.

Conclusion

As the possibility of systemic embolization is increased in these patients, it is concluded that trans‐oesophageal monitoring may be useful in preventing life‐threatening incidents during laparoscopic gynaecological procedures. Judging from the MRI results, subclinical infarctions after this procedure are not frequent. With the methods used, in this small number of patients, no apparently harmful incidents were encountered.
Experimental studies on the effect of pneumoperitoneum on tumour dissemination: clarification is required. Results of experimental trials should be further assessed
Authors: Lecuru Fabrice , Robin François , Taurelle Roland
Published: March 2003

The authors carried out an analysis of the methodology used in experimental studies on the effect of pneumoperitoneum on tumour dissemination. Major papers published in the English language literature were included in the study. It appears that data on experimental models are scarce. Information concerning spontaneous survival, the ‘no‐take’ rate and patterns of tumour growth is generally not available. Significant differences are evident between papers which report new experimental models and those using similar models for surgical experiments. Similarly, surgical procedures are not discussed, despite some unusual procedures in terms of pneumoperitoneum pressure and number of trocars. Finally, only one paper gives a power calculation for the trial. These studies appear to be of a limited usefulness in the provision of new guidelines for clinical practice. The importance of the preoperative work up, of careful intraoperative assessment of suspicious lesions and of protected extraction of ovarian cysts were already known, and remain important.
Optical trocar systems: laparoscopic entry and its complications (a study of cases in Germany)
Authors: Mettler  , Schmidt  , Frank  , Semm
Published: March 2003

Objectives

To assess the different techniques available for Veress needle and trocar entry under direct vision, and to evaluate the complications caused during laparoscopic entry, according to the German Gynaecological Endoscopic Complication Register.

Design

A detailed description is given of the different trocar entry techniques under direct vision including use of the optical trocar cannula. The German Gynaecological Endoscopic Complication Register compares the data from 17 745 patients who underwent laparoscopic or hysteroscopic surgery at 15 different centres in 1997.

Results

Complications occurred in 172 (0.86%) of 20 050 endoscopic procedures; 116 of these were laparoscopic interventions (1%), and 56 were hysteroscopic interventions (0.7%). Of the 116 laparoscopic complications, 50 (43.1%) resulted from trocar entry problems. During the last 4 years no trocar or Veress needle entry lacerations have been observed at the Department of Obstetrics and Gynaecology at Kiel.

Conclusion

In any surgical procedure, including laparoscopy, complications cannot be avoided; however, trocar entry lacerations can be reduced considerably if direct visualization at entry is employed.