bluuebunny/crossref_metadata_2025 huggingface dataset:
Variation in Crown and Root Organic Reserves Among Lucerne Genotypes of Different Morphology and Flower Colour
Authors: Fornasier F. , Pecetti L. , Piano E.
Published: December 2004

Previous evidence indicates that differences in the concentration of underground organic reserves can drive the survival and growing ability of lucerne under cold and defoliation stresses. In order to provide the selection process with further information on compounds that may influence plant performance under grazing, we assessed variations in cold‐season concentrations of nitrogen and carbon reserves on genotypes that had been identified for morphological features that possibly enhance grazing tolerance. The selected genotypes encompassed distinct morphological patterns (defined as ‘models’) and different taxa within the Medicago sativa complex, as shown by different flower colours. Crown concentrations of reserves were determined on 90 genotypes, whereas root concentrations were measured on a subsample of 15 genotypes. Wide intergenotypic variation was observed for all reserve substances. Comparisons among models and among flower colour classes highlighted the high concentrations of crown carbohydrates and root and crown‐soluble proteins of the model coded as ‘D1’, characterized by prostrate, rhizomatous habit and long dormancy, which largely corresponded to plants with yellow or variegated flowers, typical of ssp. falcata and × varia, respectively. There was a strong ‘flower colour × storage organ’ interaction for sugar concentration, and the results suggested a preferential compartment of sugars in the roots of purple‐flowered genotypes that belonged to the ssp. sativa. A rank correlation analysis indicated a positive relationship between persistence after two years under grazing of half‐sib progenies deriving from 19 genotypes out of the 90 and crown concentrations of carbohydrates of the 19 mother plants.
Relationships between Yield and Quality Parameters of Malting Barley (Hordeum vulgare L.) and Phenological and Meteorological Data
Authors: Schelling K. , Born K. , Weissteiner C. , Kühbauch W.
Published: December 2004

In this study, phenological and meteorological data have been used to interpret variations in a time series of regional average yields and quality parameters of malting barley (Hordeum vulgare L). The analyses were focused mainly on the grain filling period. Duration and occurrence of this development stage showed remarkable differences from year to year, as heading varied over more than four weeks and yellow ripeness over two weeks in the investigation period from 1974 to 1996. Yields above average were achieved only in years when grain filling duration exceeded 42 d. Protein concentrations below 10.5 % and grading percentages over 90 % required at least 44 d of grain filling. Temperature had the strongest influence on the length of grain filling, even though the calculated Growing Degree Days (base temperature 3 °C) were not absolutely constant. Mean daily temperature and relative air humidity were the best estimators with respect to grain yield. An optimum temperature range was found between 14 and 18 °C. Assuming a linear relationship, yield reductions between 4.1 and 5.7 % have been calculated for every 1 °C increase of the mean daily temperature. Relative air humidity was the best single estimator for grain protein concentration. The results of this study suggest that relative humidity during grain filling can be a more suitable parameter to describe drought stress effects than precipitation amounts from heading to yellow ripeness or from January 1 to yellow ripeness.
Photosynthetic Acclimation and Productivity of Mungbean Cultivars under Elevated CO2 Concentration
Authors: Sharma‐Natu P. , Pandurangam V. , Ghildiyal M. C
Published: December 2004

Mungbean [Vigna radiata (L.) Wilczek] cultivars (Pusa Baisakhi, PS 16 and P 105) were grown in field at atmospheric (360 ± 10 ppm, AC) and elevated CO2 (650 ± 50 ppm, EC) concentrations inside open top chambers for entire period of growth and development till maturity. Leaf net photosynthesis rate (PN) of AC and EC grown plants when compared at same CO2 concentration showed no significant down‐regulation of PN in EC plants. In cv. P 105, even up‐regulation of PN was observed in EC plants. Mungbean cultivars accumulated assimilates in the leaves during the day mostly in the form of starch. Nodule number and weight were also higher in EC plants. The positive effect of elevated CO2 on PN, dry‐matter production and seed yield was better expressed in cv. P 105 having greater podding ability.
Biotypes of Hessian fly (Dipt., Cecidomyiidae) in Morocco
Authors: Naber N. , El Bouhssini M. , Lhaloui S.
Published: December 2004

Hessian fly, Mayetiola destructor (Say), is the most important insect pest of wheat in Morocco, where host plant resistance has been used successfully for control. Our objective was to determine the frequency of Hessian fly virulence on H5, H13 and H22 resistance genes. Five Hessian fly populations from the principal cereal‐growing regions in Morocco were studied. The variability in percentage of susceptible plants across Hessian fly populations was highly significant (P < 0.01), indicating differences in virulence frequencies. Plants with the H13 gene had the lowest percentage of susceptible plants, 1.77 and 1.51%, when infested with Hessian flies from Fes and Marchouch, respectively. A low level of virulence to H22 was detected in Fes, Abda and Marchouch populations, 1.87, 1.54 and 1.99% susceptible plants, respectively. The level of virulence to H5 was low in all the five populations. The Beni Mellal population gave the highest percentage of susceptible plants carrying H13 and H22 genes, 6.43 and 7.28%, respectively. The size of live larvae on susceptible plants of the three cultivars carrying H5, H13 and H22 was similar to that of the susceptible check, indicating that a true virulence (biotype) is developing in Hessian fly populations in Morocco. Thus, continuous monitoring of the development of Hessian fly biotypes is essential for optimal deployment of resistance genes.
Laboratory culture conditions affect stability of resistance to Bacillus thuringiensis Cry1Ac in Plutella xylostella (Lep., Plutellidae)
Authors: Cerda H. , Sayyed A. H. , Wright D. J.
Published: December 2004

Abstract:  Populations of Plutella xylostella L. with high (laboratory re‐selected) and low levels (unselected) of resistance to the Bacillus thuringiensis (B.t.) toxin Cry1Ac were maintained under controlled environment conditions in the absence of any further selection pressure. Larvae were maintained either in discrete generations on freshly excised leaves replaced ad lib (standard culture system) or in microcosm cages holding up to 12 potted Chinese cabbage plants, allowing progressively overlapping generations of insects. After 12 generations in the microcosm cages, the LC50 values of both selected and unselected populations were not significantly different from those of a standard susceptible population. Under standard culture conditions, the LC50 value for unselected insects after 12 generations was almost identical to that of unselected insects in the microcosm cages, whereas the LC50 value for selected insects was 1250‐fold greater. The fecundity of the selected population was significantly lower compared with that of the same population in the microcosm cages after 12 generations. There was no significant change in the fecundity of the unselected population after 12 generations in the microcosm cages. The results show, that differences in the culture system (microcosm vs. standard) and in the resistance level (re‐selected vs. unselected) can have a marked influence on the stability of resistance to a B.t. toxin in an insect population. Possible factors involved in determining the rate at which resistance declines are discussed.
Effects of Hypothyroidism on the Skeletal Muscle Blood Flow Response to Contractions
Authors: Bausch L. , McAllister R. M.
Published: December 2004

Hypothyroidism is associated with impaired blood flow to skeletal muscle under whole body exercise conditions. It is unclear whether poor cardiac and/or vascular function account for blunted muscle blood flow. Our experiment isolated a small group of hindlimb muscles and simulated exercise via tetanic contractions. We hypothesized that muscle blood flow would be attenuated in hypothyroid rats (HYPO) compared with euthyroid rats (EUT). Rats were made hypothyroid by mixing propylthiouracil in their drinking water (2.35 × 10−3 mol/l). Treatment efficacy was evidenced by lower serum T3concentrations and resting heart rates in HYPO (bothP<0.05). In the experimental preparation, isometric contractions of the lower right hindlimb muscles at a rate of 30 tetani/min were induced via sciatic nerve stimulation. Regional blood flows were determined by the radiolabelled microsphere method at three time points: rest, 2 min of contractions and 10 min of contractions. Muscle blood flow generally increased from rest (∼5–10  ml/min per 100 g) through contractions for both groups. Further, blood flow during contractions did not differ between groups for any muscle (eg. red section of gastrocnemius muscle; EUT, 59.9 ± 14.1; HYPO, 61.1 ± 15.0; NS between groups). These findings indicate that hypothyroidism does not significantly impair skeletal muscle blood flow when only a small muscle mass is contracting. Our findings suggest that impaired blood flow under whole body exercise is accounted for by inadequate cardiac function rather than abnormal vascular function.
Extranodal Lymphoblastic Lymphoma of Suspected B‐Cell Lineage in the Gingiva of a Racehorse, accompanied by Mandibular Osteolysis
Authors: Oikawa M. , Ohishi H. , Katayama Y. , Kushiro A. , Yoshikawa H. , Yoshikawa T.
Published: December 2004

A mass developed in the mandibular gingiva of a thoroughbred racehorse. When the horse could no longer eat unassisted, it was killed and immediately autopsied. Macroscopically, the mandible exhibited extensive osteolysis, with only a small amount of bone remaining around the tooth roots. The cut surface of the mass around the mandible consisted of neoplastic medullary tissue, in which osteogenesis was observed. The medullary tissue was composed of pleomorphic medium‐sized to large cells, interlaced by collagen bundles. These cells had large, pale, round or ovoid, sometimes cleaved nuclei, with one or two prominent nucleoli. Mitoses were numerous. Electron microscopy showed that the cells in the medullary tissues were similar in shape to undifferentiated lymphocytes. Immunohistochemically, these cells were positive for B‐cell associated antigen in the pre‐B‐cell stage. Our findings suggest that the horse had extranodal lymphoblastic lymphoma of suspected B‐cell lineage, possibly originating from the lymphatic system of the gingiva. We consider that the osteolysis resulted from activation of osteoclasts by proliferation of the tumour cells.
The new neighbour: Experiences of living next door to people suffering from long‐term mental illness
Authors: Granerud Arild , Severinsson Elisabeth
Published: December 2004

ABSTRACT

The transition from hospital to community care for people with long‐term mental illness is of growing concern. The aim of the present study was to illuminate if and how people with long‐term mental illness have affected their neighbourhood after re‐establishing themselves in apartments of their own. Nineteen neighbours of group homes for people with long‐term mental illness, in seven different communities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyse the findings. From the data, one main category was identified: the need for information.
Burnout and job satisfaction: A comparative study of psychiatric nurses from forensic and a mainstream mental health service
Authors: Happell Brenda , Martin Trish , Pinikahana Jaya
Published: December 2004

ABSTRACT

Within the nursing profession stress and burnout are considered to be widely present and problematic. These factors tend to impact negatively on job satisfaction and ultimately affect the retention of nurses. Psychiatric/mental health nursing as a specialty is considered to be a highly stressful environment; however, there is a paucity of research in this area. The current study adopted a survey design to compare forensic psychiatric nurses (n = 51) with psychiatric nurses from a mainstreamed mental health service (n = 78) in relation to burnout and job satisfaction. Forensic nurses displayed lower burnout and higher job satisfaction than their counterparts from the mainstreamed services. These findings are surprising in light of the image of forensic psychiatric nursing as dangerous and unpredictable.
Grief as a transformative experience: Weaving through different lifeworlds after a loved one has completed suicide
Authors: Fielden Jann M.
Published: December 2004

ABSTRACT

Using Heidegger's hermeneutic phenomenology informed by van Manen's and Benner's work, this research is an exploration and interpretation of the lived experiences of family members since they lost a close family member to suicidal death. Data from in‐depth interviews with six participants, the researcher's journal entries and published literature were analysed. Findings gave rise to a grief model where suicide survivors moved through four modes of being‐in‐the‐world characterized by 13 lifeworlds or themes. Surviving suicide was a transformative process that in time enabled survivors to discover new ways of understanding and relating to the world. The findings have implications for nurses and counsellors working in the area of suicide bereavement.
Randomized controlled trial to compare the dose of adjuvant chemotherapy after curative resection of hepatocellular carcinoma
Authors: KWOK PHILIP CHONG‐HEI , LAM TING WA , LAM POLLY WOON‐YEE , TANG KWOK WAI , CHAN SUSAN CHI‐HUM , HWANG JAMES SHU‐TAK , CHEUNG MOON TONG , TANG DONALD LAP‐CHIU , CHUNG THOMAS KAM‐MAN , CHIA NAM HUNG , WONG WONG KAN , CHAN MAN KWONG , LO HONG YUEN , LAM WAI MING
Published: December 2004

Background and Aim: Adjuvant locoregional chemotherapy has been shown to be useful to prevent recurrence after curative resection of hepatocellular carcinoma (HCC) in some retrospective studies. Our aim was to compare the dose effect in the prevention of tumor recurrence.

Methods: A prospective randomized controlled trial was conducted in patients with curative resection of HCC; they were given either one intra‐arterial dose of cisplatin/lipiodol, or received four doses, once every 3 months. The rates of recurrence, disease‐free and overall survival were compared.

Results: During a median follow up of 818 days, 21 patients received one dose and 19 received four doses, with 10 (47.6%) and eight (42.1%) recurrences, respectively. The 1‐year, 2‐year and 3‐year disease‐free survival rates were 71%, 54% and 44% for the one‐dose group and 74%, 60% and 40% for the four‐dose group (P = 0.78). The respective overall survival rates were 85%, 74%, 55% and 84%, 71%, 40% (P = 0.64). The only prognostic factor was presence of vascular permeation. The side‐effects were mild and tolerable.

Conclusions: There is no significant difference in the survival rates between the two groups. Adjuvant chemotherapy may not be useful.

© 2003 Blackwell Publishing Asia Pty Ltd
Meningioangiomatosis with predominantly cellular pattern
Authors: Koutsopoulos Anastassios V , Yannopoulos Andreas , Stathopoulos Efstathios N , Evangeliou Athanasios , Panayiotides John G , Kafousi Maria , Krasoudakis Antonis , Markakis Evagelos , Delides George S
Published: December 2004

A case of meningioangiomatosis (MA), in a 10‐year‐old‐girl with refractory complex partial and secondary generalized seizures, starting at the age of 8 years, is presented. MRI evaluation revealed a lesion located at the left frontal lobe; the patient underwent surgical lesionectomy. Histology revealed the lesion to have the features of MA. The patient is symptom‐free a year postoperation. We report the histological, immunohistochemical and imaging findings in view of previous pertinent reports.
Tension‐free vaginal tape for surgical treatment of stress urinary incontinence: Two years follow‐up
Authors: Perk Hakki , Soyupek Sedat , Serel T Ahmet , Koşar Alim , Sayin Adnan , Hoşcan M Burak
Published: December 2004

Background: The objective was to study prospectively the effectiveness of tension‐free vaginal tape as an ambulatory and minimal invasive operation for the treatment of female stress incontinence.

Methods: The tension‐free vaginal tape procedure was performed in 25 patients with genuine stress incontinence and they were followed for a 2‐year period. All patients were diagnosed with urodynamics to have genuine stress incontinence. Pad tests, cough stress test and quality‐of‐life assessments were carried out in all patients, both preoperatively and postoperatively. The majority of the women were discharged the morning after the surgical procedure.

Results: Twenty of 25 (80%) patients were found to be cured 2 years after the operation. The vaginal tape was spontaneously dropped out from the vagina in one patient 2 weeks after the procedure. We did not see such a complication in previous studies.

Conclusion: We conclude that the tension‐free vaginal tape procedure is both a safe and effective method to cure genuine female stress incontinence. Furthermore, it can be performed as an ambulatory procedure under local anesthesia with a short operative time.
Infected urachal cyst ruptured during medical palliation
Authors: Kojima Yasuyuki , Miyake Osamu , Taniwaki Hiromichi , Morimoto Akira , Takahashi Satoru , Fujiwara Ichiro
Published: December 2004

Since most cases of urachal cyst are asymptomatic, they are frequently detected after complication by infection. Ruptured urachal cysts are frequently detected after complication by severe infections such as sepsis. We report on a 31‐year‐old man who was diagnosed preoperatively as having an infected urachal cyst and the decision was made to follow the patient because primary excision was scheduled to be performed a few days later. Symptoms were transiently relieved, but the cyst ruptured during medical palliation. We treated this case with a two‐stage surgical procedure.
Traumatic bladder rupture managed successfully by laparoscopic surgery
Authors: MATSUI YOSHIYUKI , OHARA HIROKI , ICHIOKA KENTARO , TERADA NAOKI , YOSHIMURA KOJI , TERAI AKITO
Published: December 2004

A 61‐year‐old man presented to our emergency department with acute abdomen. The patient had extraperitoneal and intraperitoneal traumatic bladder injury, which was successfully managed with combined endoscopic and laparoscopic procedures.
Electrostimulation of sympathetic nerve fibers during nerve‐sparing laparoscopic retroperitoneal lymph node dissection in testicular tumor
Authors: KAIHO YASUHIRO , NAKAGAWA HARUO , TAKEUCHI AKIRA , ITO AKIHIRO , SATOH MAKOTO , KUROKAWA KOHEI , ARAI YOICHI
Published: December 2004

A long‐handled pair of electrodes with sufficient length to allow stimulation during laparoscopic retroperitoneal lymph node dissection (RPLND) was designed at our institute. We clinically utilized this electrode in the treatment of a 37‐year‐old patient with testicular tumor who underwent right orchidectomy and nerve‐sparing laparoscopic RPLND. During laparoscopic RPLND, sympathetic nerve fibers relevant to ejaculation were electrically stimulated and changes in pressure at the bladder neck were observed. Nerve preservation was confirmed by increased pressure at the bladder neck and ejaculation immediately after the electrostimulation. The application of laparoscopic electrostimulation may become widespread, particularly since it meets the increasing demand for minimally invasive surgery.
Vitamin D receptor gene polymorphism in familial prostate cancer in a Japanese population
Authors: SUZUKI KAZUHIRO , MATSUI HIROSHI , OHTAKE NOBUAKI , NAKATA SEIJI , TAKEI TOMOYUKI , KOIKE HIDEKAZU , NAKAZATO HARUKI , OKUGI HIRONOBU , HASUMI MASARU , FUKABORI YOSHITATSU , KUROKAWA KOHEI , YAMANAKA HIDETOSHI
Published: December 2004

Aim: Vitamin D acts as an antiproliferative agent against prostate cells. Epidemiological study has shown that a low level of serum vitamin D concentration is a risk factor for prostate cancer. Vitamin D acts via vitamin D receptor (VDR), and an association of genetic polymorphisms of the VDR gene has been reported. In the current study, we examined the association of VDR gene polymorphisms with familial prostate cancer in a Japanese population.

Methods: We performed a case–control study consisting of 81 familial prostate cancer cases and 105 normal control subjects. Three genetic polymorphisms (BsmI, ApaI and TaqI) in the VDR gene were examined by the restriction fragment restriction length polymorphism method.

Results: Overall, there was no significant association of the VDR gene polymorphisms with familial prostate cancer risk in the cases and control subjects. However, a weak association between BsmI or TaqI genotypes and cancer risk was observed in subjects under 70 years of age. Stratification of cases by clinical stage or pathological grade did not show significant association between the VDR gene polymorphisms and prostate cancer risk.

Conclusion: In the present study, we could not confirm any significant association between VDR gene polymorphisms with familial prostate cancer risk in a Japanese population. Further large‐scale case–control studies are warranted to confirm the importance of VDR gene polymorphisms in familial prostate cancer.
Evaluation of cases where the right kidney is higher than the left kidney
Authors: SAITO SEIICHI
Published: December 2004

Background: Finding the right kidney higher than the left kidney on excretory urography (EXU) is unusual. In the present study, the position of the kidneys was evaluated in patients, and the frequency, causes or attribution were investigated.

Methods: Kidney positions were evaluated in 1625 patients. Subsequent evaluations by computed tomography scan were performed for each case where the right kidney was higher than the left. If a patient had right hydronephrosis, bladder evaluations such as ultrasonography and/or cystoscopy were also conducted. Patients with a left contracted kidney were excluded.

Results: The right kidney was higher than the left in 81 (5%) of 1625 cases. In 30 cases (37%), the cause or attribution existed in the right urinary tract. Eleven of these cases were due to tumors or cysts in the right kidney, four were due to congenital anomalies, and 15 were due to hydronephrosis. In 10 (12.3%) of the cases, the cause or attribution existed in the left urinary tract. All of them were cysts or tumors of the left kidney. Of the other 13 (16.0%) cases, eight were caused by hepatatrophy and splenomegaly as a result of liver cirrhosis, two were caused by aortic aneurysm, one was caused by visceral inversion, one was caused by a right ovarian tumor, and one was caused by pneumonectomy. Malignancies, including two renal cell carcinomas and three bladder cancers at the right ureteral orifice, were found in five cases (6%).

Conclusion: The above results suggest that the right kidney is higher than the left in five percent of all cases undergoing EXU. In cases where the right kidney is higher than the left, and a left contracted kidney cannot be found, further evaluation is recommend.
Bi‐weekly epirubicin, etoposide and low‐dose dexamethasone for hormone‐refractory prostate cancer
Authors: ODRAZKA KAREL , VACULIKOVA MILOSLAVA , PETERA JIRI , MORAVEK PETR , PROSVIC PETR , ZOUL ZDENEK , RYDEL LUBOS , BRODAK MILOS , VESELSKY ZBYNEK , LOUDA MIROSLAV , SIMAKOVA EVA
Published: December 2004

Background: Recent studies have demonstrated the efficacy and favorable toxicity profile of chemotherapy regimens given at lower doses and frequent intervals. The aim of our study was to evaluate the efficacy and toxicity of a bi‐weekly chemohormonal regimen consisting of epirubicin, etoposide, and low‐dose dexamethasone (EED) in patients with hormone‐refractory prostate cancer (HRPC).

Methods: We treated a total of 32 patients who had failed hormonal therapy and antiandrogen withdrawal. Chemotherapy was given every 2 weeks and consisted of epirubicin (30 mg/m2 intravenously, day 1) and etoposide (50 mg/m2 orally, days 1–7). Dexamethasone (1.5 mg orally, every other day) was given continuously until disease progression. Twenty patients (63%) had received prior treatment with estramustine phosphate. Each patient's pain response was evaluated according to analgesic use. Toxicity was graded using the Common Toxicity Criteria (version 2.0).

Results: Prostate‐specific antigen (PSA) levels showed a decline of 50% or greater in 16 of 32 patients (50%, 95% confidence interval [CI], 32–68%) with a median time to biochemical progression of 5 months (range, 4–9 months). The median survival for all patients was 10.5 months (range, 3–35 months). Four of 10 patients (40%) with measurable soft tissue lesions achieved partial response according to standard criteria. Eleven of 23 symptomatic patients (48%, 95% CI, 27–69%) experienced an improvement in pain with a median duration of 6 months. The regimen was tolerated well by the patients, with only four patients (12%) having grade 3 leukopenia.

Conclusion: Chemohormonal EED regimen proved to be active and well‐tolerated in patients with HRPC.
Cellular adhesion molecules and cardiovascular disease. Part I. Their expression and role in atherogenesis
Authors: Hope S. A. , Meredith I. T.
Published: December 2004

Atherosclerosis is now recognized to be an inflam­matory disease, and several inflammatory markers have been shown to be associated with both the presence and future risk of symptomatic cardiovascular ­disease. Cellular adhesion molecules, particularly members of the selectin family and immunoglobulin superfamily, are intimately involved in the recruitment of leucocytes to sites of inflammation, including ­developing atherosclerotic lesions. Their role in the pathogenesis of atherosclerosis has been clearly demonstrated using knockout mice models. Plasma levels of adhesion molecules, which have been shed from the cell surface, have been associated with the presence of clinical atherosclerotic disease, although published studies differ in their findings. This limited consensus in the literature may be explained either by unrecognized confounding factors, or perhaps by the unpredictable relationship between cell surface expression and activity of cellular adhesion molecules and their shedding into the plasma. While cell surface activity of adhesion molecules appears critical in the develop­ment of atherosclerotic lesions, the measurement of plasma levels of soluble adhesion molecules may offer little additional benefit for individual patients in the prediction of the extent of atherosclerotic disease above the assessment of conventional cardiovascular risk factors. (Intern Med J 2003; 33: 380−386)
Outcome from surgical management of secretory pituitary adenomas in Christchurch, New Zealand
Authors: Inder W. J. , Espiner E. A. , MacFarlane M. R.
Published: December 2004

Abstract

Background:  Recent evidence has highlighted the importance of the neurosurgeon in the management of secretory pituitary tumours, but most reports are from major centres.

Aims:  To audit the surgical outcome of patients with acromegaly and Cushing's disease treated in a small centre (Christchurch, New Zealand) by a dedicated neurosurgeon with an interest in pituitary disease, and follow‐up through an outpatient Department of Endocrinology.

Methods: All cases of acromegaly and Cushing's disease admitted for surgery in Christchurch Hospital between 1984 and 2000 were audited. Data concerning preoperative findings, surgical remission rate, complications and follow‐up were obtained from 44 patients (28 acromegaly, 16 Cushing's disease).

Results: Of the 28 acromegalic patients, 14 patients (50%) had a mean growth hormone level <2.5 µg/L within the first postoperative week. Of the 15 Cushing's disease patients in whom the pituitary fossa was explored, 13 patients (87%) entered a postoperative remission, defined as an 08.00 h cortisol <200 nmol/L (normal range 250−800 nmol/L). No perioperative deaths occurred. Two of the 43 patients (4.7%) developed permanent diabetes insipidus, while eight of the 28 patients who were operated on for acromegaly (29%) eventually required some replacement treatment for hypopituitarism during follow‐up (one presented with apoplexy and seven were treated with postoperative radiotherapy).

Conclusion: In a small centre with a dedicated pituitary surgeon, operative remission rates approach those obtained in larger, more specialized centres. However, given New Zealand's small, but geographically spread population, consideration should be given to establishing one or two units for the surgical management of secretory pituitary adenomas. (Intern Med J 2003; 33: 168−173)
Quality of care of patients hospitalized with congestive heart failure
Authors: Scott I. A. , Denaro C. P. , Flores J. L. , Bennett C. J. , Hickey A. C. , Mudge A. M. , Atherton J.
Published: December 2004

Background:  Congestive heart failure (CHF) is an increasingly prevalent poor‐prognosis condition for which effective interventions are available. It is ­therefore important to determine the extent to which patients with CHF receive appropriate care in Australian hospitals and identify ways for improving suboptimal care, if it exists.

Aim:  To evaluate the quality of in‐hospital acute care of patients with CHF using explicit quality indicators based on published guidelines.

Methods:  A retrospective case note review was ­performed, involving 216 patients admitted to three teaching hospitals in Brisbane, Queensland, Australia, between October 2000 and April 2001. Outcome measures were process‐of‐care quality ­indicators calculated as proportions of all, or strongly ­eligible (ideal), patients who received ­specific interventions.

Results:  Assessment of underlying causes and acute precipitating factors was undertaken in 86% and 76% of patients, respectively, and objective evaluation of left ventricular function was performed in 62% of patients. Prophylaxis for deep venous thrombosis (DVT) was used in only 29% of ideal patients. Proportions of ideal patients receiving pharmacological treatments at discharge were: (i) angiotensin‐­converting enzyme inhibitors (ACEi) (82%), (ii) target doses of ACEi (61%), (iii) alternative vasodilators in patients ineligible for ACEi (20%), (iv) β‐blockers (40%) and (v) warfarin (46%).

Conclusions:  Opportunities exist for improving quality of in‐hospital care of patients with CHF, ­particularly for optimal prescribing of: (i) DVT prophylaxis, (ii) ACEi, (iii) second‐line vasodilators, (iv) β‐blockers and (v) warfarin. More research is needed to identify methods for improving quality of in‐hospital care. (Intern Med J 2003; 33: 140−151)
Prevalence and predictors of renal artery stenosis in Chinese patients with coronary artery disease
Authors: Wang Y. , Ho D. S. W. , Chen W. H. , Wang Y. Q. , Lam W. F. , Shen Z. J. , Lu C. Z. , Chui M.
Published: December 2004

Abstract

Background:  Ischaemic nephropathy is currently a major public health issue in atherosclerotic populations. Although atherosclerotic cardiovascular disease in Asia has reached epidemic proportions over the last two decades, there is little published data on the prevalence of atherosclerotic renal artery stenosis (ARAS) in Oriental subjects. Because ARAS may be clinically silent until end‐stage renal failure sets in, it is important to identify patients with significant but clinically unsuspected ARAS. ARAS and coronary artery disease (CAD) often coexist.

Aims:  The purpose of the present study was to evaluate the prevalence and predictors of ARAS among Chinese patients with CAD.

Methods:  A total of 230 consecutive Chinese patients with CAD confirmed by coronary angiography underwent an abdominal aortogram in the same sitting to screen for ARAS. Patient demographics and comorbid­ities were analysed for any association with ARAS.

Results:  A total of 34 (14.8%) patients was found to have significant ARAS. Age and multivessel CAD were independent predictors of ARAS. Hypertension, renal insufficiency, extracranial cerebrovascular disease and female gender were also associated with a higher risk of ARAS but did not independently predict ARAS.

Conclusion:  Clinically silent yet angiographically significant ARAS is common among CAD patients. The prevalence and predictors of ARAS among Chinese patients with CAD are similar to those reported for Caucasian subjects. Underlying ARAS should be suspected in CAD patients with such comorbidities as hypertension, renal insufficiency, extracranial cerebrovascular disease, and more so in the elderly and those with multivessel disease. (Intern Med J 2003; 33: 280−285)
Orotracheal fibreoptic intubation in children under general anaesthesia
Authors: HAKALA PERTTI , RANDELL TARJA , MERETOJA OLLI , RINTALA RISTO
Published: December 2004

Orotracheal fibreoptic intubation under general anaesthesia in children was studied in eleven consecutive patients of three months to eight‐years‐of‐age without anticipated intubation difficulties. One case report is also included. Three fibrescopes with a different diameter were used in the study. The fibrescope used was chosen so that it fitted snugly in the tracheal tube. The fibreoscopy was prolonged in one patient due to mucus and two tries were needed. Resistance to the tracheal tube upon intubation was encountered in five patients, only one of these patients was older than two years. Fibreoptic intubation succeeded in nine patients. Two patients were intubated with the Macintosh laryngoscope. The problems encountered in children during orotracheal fibreoptic intubation under general anaesthesia are the same as with adults: easy fibreoscopy is not always followed by easy tracheal intubation, there may be prolonged fibreoscopy and failed intubations. Manipulation of the tracheal tube can lead to successful tracheal intubation and resistance to the tube is more common in smaller children.
Histological changes following epidural injection of midazolam in the neonatal rabbit
Authors: BOZKURT P. , TUNALI YUSUF , KAYA GÜNER , OKAR IMER
Published: December 2004

Midazolam can produce antinociceptive effects when used via intrathecal or epidural routes. Neurotoxicity studies are scanty especially for neonates. The aim of this study was to carry out electron microscopic (EM) examinations in the neonatal rabbit to determine the histological effects of epidural midazolam on spinal cord. Twenty white New Zealand neonatal rabbits were randomly assigned to three groups receiving single dose of 0.9% saline (Group I; Control, n=4), 0.9% saline titrated to pH=3.9 by addition of hydrochloric acid (Group II; n=6), midazolam 250 μg·kg−1 (Group III; n=12) epidurally. Half of each group were sacrificed on the second day and the remainder on the seventh day and spinal cord sections were evaluated by EM. Control group displayed normal histology on grids. Group II and II showed a variable degree of neurotoxic effects such as degeneration of vacuoles, cytoplasm and neurofilaments, disruption of myelin sheaths, lysis of cell membranes, perivascular oedema, pyknosis of nuclei. The toxic effects of acidic saline and midazolam are similar, in view of these results the epidural use of acidic midazolam (commercially available preparations) in neonates should be avoided.
The effect of ketamine on 0.25% and 0.125% bupivacaine for caudal epidural blockade in children
Authors: JOHNSTON P , FINDLOW D , ALDRIDGE L. M , DOYLE E
Published: December 2004

Forty boys aged from one to five years undergoing orchidopexy were randomly allocated to receive one of two solutions for caudal epidural injection. Group A received 1 ml??kg−1 of 0.125% bupivacaine with ketamine 0.5 mg??kg−1 and Group B received 1 ml??kg−1 of bupivacaine 0.25% with ketamine 0.5 mg??kg−1. Postoperative pain was assessed by means of a modified Objective Pain Score and analgesia was administered if this score exceeded four. The median duration of caudal analgesia was 8 h in Group A compared with 9.5 h in Group B (P<0.05). The time taken to recover the ability to walk was a median of two h in Group A and three h in Group B (P<0.05). There were no differences between the groups in the incidence of urinary retention or postoperative sedation.
Anaesthetic management in a neonate with congenital complete heart block
Authors: Castilla Mariano , Jerez Marta , Llácer Manuel , Martinez Sandra
Published: December 2004

We present the case of a neonate undergoing surgery on the first day of life for the installation of a permanent pacemaker because of the existence of congenital complete heart block (CCHB) with a basal heart rate of 43 b·min−1 and minimal elevation after initiating an isoproterenol perfusion. The intervention was under general anaesthesia with laryngeal mask airway (LMATM) and spontaneous ventilation. The principal anaesthetic goals were to assure adequate anaesthesia, with haemodynamic and respiratory stability, to maintain the best possible heart rate and to avoid postoperative respiratory depression or apnoea.
Treatment outcome and incidence of psychiatric disorders in dermatological out‐patients
Authors: Picardi A , Abeni D , Renzi C , Braga M , Melchi CF , Pasquini P
Published: December 2004

Objective  Epidemiological studies have shown that the prevalence of psychiatric disorders among dermatological patients is high. We aimed at estimating the short‐term incidence of psychiatric disorders among patients with skin disease.

Methods  The 12‐item General Health Questionnaire (GHQ‐12) was used to identify subjects free from psychiatric morbidity at their first dermatological visit. The GHQ‐12 was administered again after 1 month during a computer‐assisted telephone interview.

Results  A total of 277 subjects was included in the study. At the follow‐up interview, 21 (7.6%) were found to have significant psychiatric morbidity. Only lack of improvement was associated with increased incidence of psychiatric morbidity (13.6%), with an odds ratio of 3.1 (95% confidence interval 1.2–7.8), after adjustment for gender, age, educational level and clinical severity.

Conclusions  Physicians should devote special attention to the risk of psychiatric complications in patients who have not improved with treatment.
Lethal systemic dissemination from a cutaneous infection due to Curvularia lunata in a heart transplant recipient
Authors: Tessari G , Forni A , Ferretto R , Solbiati M , Faggian G , Mazzucco A , Barba A
Published: December 2004

A 69‐year‐old male heart transplant recipient, being treated with Cell Cept, FK 506 and methylprednisolone had multiple deep brown skin nodules and nodes, on the upper right arm. Skin biopsy and culture detected a strain of Curvularia lunata. The infection disseminated to the whole skin surface, oral mucosa, upper third of the oesophagus and to the lungs. Therapy with antibiotics and antifungal drugs was ineffective. The patient died of sepsis. We did not find any other case of systemic dissemination from a skin infection due to C. lunata among heart transplant recipients. We feel that heart transplant recipients need adequate education to prevent situations that would put them at risk for infection and to seek medical advice immediately for an early diagnosis and an effective therapy.
Primers for nine microsatellite loci in the hermaphroditic snail Lymnaea stagnalis
Authors: Knott K. E. , Puurtinen M. , Kaitala V.
Published: December 2004

Variation in and amplification conditions for nine polymorphic microsatellite loci identified from Lymnaea stagnalis, a hermaphroditic pulmonate snail, are described. Eight populations from central Finland were studied, which varied in terms of both observed polymorphism and heterozygosity. The number of alleles at each locus is moderate (two to seven), except for one exceptional locus having 16 alleles, and for which null alleles are possible. There is no evidence for genotypic disequilibrium in the populations for all pairs of loci. Heterozygosity levels are indicative of outcrossing in L. stagnalis, whose mating system will be characterized further using these markers.
Polymorphic microsatellite loci for the Japanese paper wasp,Polistes chinensis antennalis(Hymenoptera: Vespidae)
Authors: Tsuchida K. , Saigo T. , Tsujita S. , Takeuchi K. , Ito N. , Sugiyama M.
Published: December 2004

We isolated 13 microsatellite markers for the Japanese paper waspPolistes chinensis antennalis. Null alleles were ruled out in the loci because we could detect polymerase chain reaction products for 578 haploid males. Our results indicate that these markers are excellent tools for the analysis of pedigrees within colonies for species with a complicated pedigree structure due to worker reproduction (male production by workers in queen‐right colonies).
Isolation and characterization of microsatellite loci from the entomopathogenic fungus Beauveria bassiana (Ascomycota: Hypocreales)
Authors: Rehner S. A. , Buckley E. P.
Published: December 2004

Beauveria bassiana, an entomogenous fungus used for the biological control of pest insects, comprises a globally‐distributed species complex of regionally endemic lineages. In order to study the population genetics of B. bassiana, detail species boundaries, conduct ecological studies of natural populations and track fates of experimentally‐released strains, sensitive genetic markers are required. We describe the isolation and characterization of eight microsatellite loci that amplify successfully from strains representative of the phylogenetic diversity in the B. bassiana complex.
Isolation and characterization of nuclear microsatellite loci in the tropical arboreal palm Oenocarpus bacaba (Arecaceae)
Authors: Lepsch‐Cunha N. , Lund C. A. , Hamilton M. B.
Published: December 2004

Studies of mating patterns are needed to determine how habitat heterogeneity created by deforestation influences tropical plant populations. Eight microsatellite loci were isolated with a subtractive hybridization method for Oenocarpus bacaba (Arecaceae), a subcanopy palm tree at the Biological Dynamics of Forest Fragments Project, near Manaus, Brazil. Additionally, two heterospecific loci originally developed for the heart palm Euterpe edulis were shown to be variable. Loci averaged 9.6 alleles per locus. Five loci did not fit Hardy–Weinberg expectations with significant deficits of heterozygous genotypes consistent with null alleles. Many loci had high average probabilities of paternity exclusion.
Eleven microsatellite markers in Nasonia, Ashmead 1904 (Hymenoptera; Pteromalidae)
Authors: Pietsch Christof , Rütten Karsten , Gadau Jürgen
Published: December 2004

We designed primer sequences for 11 microsatellite markers in the jewel wasp Nasonia vitripennis. Most loci could be cross‐amplified in Nasonia longicornis and Nasonia giraulti, which make them amenable for linkage analysis in hybrid crosses. Eight loci were assigned to specific chromosomes. Additionally, 10 loci showed allelic variation in a Nasonia vitripennis field population. The observed number of alleles in this population ranged from two to seven, with observed heterozygosities from 0.0750 to 0.4750.
A Longitudinal Study of Cardiorespiratory Fitness and Cognitive Function in Healthy Older Adults
Authors: Barnes Deborah E. , Yaffe Kristine , Satariano William A. , Tager Ira B.
Published: December 2004

OBJECTIVES: To determine whether cardiorespiratory fitness at baseline is associated with maintenance of cognitive function over 6 years or with level of cognitive function on tests performed 6 years later in a longitudinal study of healthy older people.

DESIGN: Prospective cohort.

SETTING: Community‐based study of noninstitutionalized adults aged 55 and older living in Sonoma, California.

PARTICIPANTS: Three hundred forty‐nine cohort members without evidence of cardiovascular disease, musculoskeletal disability, or cognitive impairment at baseline.

MEASUREMENTS: Cardiorespiratory fitness measures were based on a standard treadmill exercise test protocol and included peak oxygen consumption (peak VO2), treadmill exercise duration, and oxygen uptake efficiency slope (OUES). Cognitive function was evaluated at baseline with a modified Mini‐Mental State Examination (mMMSE) and after 6 years of follow‐up with a detailed cognitive test battery that included the full MMSE, three tests of attention/executive function, two measures of verbal memory, and two tests of verbal fluency.

RESULTS: Participants with worse cardiorespiratory fitness at baseline experienced greater decline on the mMMSE over 6 years (mean mMMSE decline (95% confidence interval) by baseline peak VO2 tertile: lowest = −0.5 (−0.8 to −0.3), middle = −0.2 (−0.5–0.0), highest = 0.0 (−0.3–0.2), P = .002 for trend over tertiles). Participants with worse baseline cardiorespiratory fitness also performed worse on all cognitive tests conducted 6 years later. Results were similar for analyses based on peak VO2, treadmill exercise duration, and OUES. After adjustment for demographic and health‐related covariates, measures of cardiorespiratory fitness were associated most strongly with measures of global cognitive function and attention/executive function.

CONCLUSION: Baseline measures of cardiorespiratory fitness are positively associated with preservation of cognitive function over a 6‐year period and with levels of performance on cognitive tests conducted 6 years later in healthy older adults. High cardiorespiratory fitness may protect against cognitive dysfunction in older people.
Implantation Techniques and Chronic Lead Parameters of Biventricular Pacing Dual‐Chamber Defibrillators
Authors: DAOUD EMILE G. , KALBFLEISCH STEVEN J. , HUMMEL JOHN D. , WEISS RAUL , AUGUSTINI RALPH S. , DUFF STEVEN B. , POLSINELLI GEORGIA , CASTOR JOHN , META TEJAS
Published: December 2004

Biventricular Pacing.
Introduction: The aim of this study is to describe implantation techniques and lead performance for biventricular pacing, dual‐chamber implantable cardioverter defibrillators (ICDs).

Methods and Results: A dual‐chamber ICD with biventricular pacing was implanted in 87 patients with congestive heart failure (ejection fraction: 0.21 ± 0.09), prolonged QRS duration (161 ± 22 msec), and an indication for ICD therapy. Left ventricular pacing was achieved with a thoracotomy approach (n = 21) or a nonthoracotomy approach (n = 66). With a thoracotomy, biventricular devices were implanted successfully in all patients. During follow‐up (17 ± 11 months), 9 patients died (43%), 2 underwent transplantation, and 2 required left ventricular lead revision. At last follow‐up, biventricular sensing and capture threshold were 11 ± 5 mV and 1.5 ± 0.8 V, respectively. For nonthoracotomy procedures, two types of coronary sinus (CS) leads were implanted: an over‐the‐wire lead (n = 45) and a shaped lead (n = 21). The rate of successful implantation (overall: 89%) (over‐the‐wire 93% vs shaped 81%; P = 0.1) and durations for CS lead placement (66 ± 50 vs 58 ± 34 min, P = 0.6) and the procedure (133 ± 58 vs 129 ± 33 min, P = 0.8) were not different between the two CS leads. During follow‐up (11 ± 9 months), 9 patients died (14%), and the shaped CS lead dislodged in 3 patients (3 shaped vs 0 over‐the‐wire, P = 0.01). At last follow‐up, biventricular sensing and capture threshold were 10 ± 4 mV and 1.8 ± 0.7 V, respectively, and there was no difference between over‐the‐wire and shaped leads. By multivariate analysis, mortality was associated with absence of spironolactone therapy but not procedural features.

Conclusion: Nonthoracotomy CS lead implantation is feasible, with a success rate of about 90% and few adverse events. For the remaining 10%, a thoracotomy approach can be completed safely in these ill patients without increased risk for death.