bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bite dimensions for cattle grazing herbage at low levels of depletion
Authors: Ungar E. D. , Ravid N. , Bruckental I. 
Published: March 2003

The processes that occur during the depletion of a single feeding station by grazing cattle are important to our understanding of intake at larger spatial scales. Factorial experiments were conducted in which feeding stations of different sizes were grazed individually by cattle to various levels of depletion, defined as the number of bites removed. Feeding stations in Experiment 1 (alfalfa) measured 0·11, 0·24 and 0·45 m2, and the numbers of bites removed for depletion levels 1–3 were 35, 70 and 104 m−2 respectively. Feeding stations in Experiment 2 (oats) measured 0·11 and 0·24 m2, and the numbers of bites were 45, 95 and 140 m−2 offered. In both experiments a fourth depletion level (not included in the analysis of variance) determined the maximum voluntary depletion, and exceeded 250 bites m−2 offered. Initial sward height was 20 cm. Bite dimensions were derived from the frequency distribution of residual herbage heights. Treatments were replicated over six and four animals of approximately 500 kg live weight in Experiments 1 and 2 respectively.The mean residual herbage height and the frequency distribution of residual heights indicated that bites were removed predominantly from the top grazing horizon at depletion levels 1–3, with a mean effective bite depth of 8·6 cm. Nevertheless, at the same depletion levels, the mean effective bite area declined from 148 to 87 cm2 in Experiment 1 (alfalfa, Medicago sativa L.) and from 86 to 58 cm2 in Experiment 2 (oats, Avena sativa L.). Feeding station size did not significantly affect mean effective bite area in either experiment.Simulation was used to examine the implications of various overlap rules (from completely random to highly systematic) for within‐grazing‐horizon placement of a circular bite of constant potential area. These rules shaped the relationship between mean effective bite area and number of bites removed per unit sward area offered. Bite placement in which permissible overlap became progressively more lenient as the grazing horizon was depleted, and, with acceptable estimates of potential bite area, yielded results that were similar, though not identical, to those measured. These results can help understanding of the factors that determine the intake gain function at a single feeding station.
The effects of rate and timing of application of fertilizer nitrogen in late summer on herbage mass and chemical composition of perennial ryegrass swards over the winter period in Northern Ireland
Authors: Binnie R. C. , Mayne C. S. , Laidlaw A. S. 
Published: March 2003

A small‐plot experiment was carried out in Northern Ireland on a predominantly perennial ryegrass sward over the period July 1993 to March 1994 to investigate the effect of timing and rate of fertilizer nitrogen (N) application on herbage mass and its chemical composition over the winter period. Eighty treatment combinations, involving four N fertilizer application dates (28 July, 9 and 30 August and 20 September 1993), four rates of N fertilizer (0, 30, 60 and 90 kg N ha−1) and five harvest dates (1 October, 1 November, 1 December 1993, 1 February and 1 March 1994), were replicated three times in a randomized block design experiment.N application increased herbage mass at each of the harvest dates, but in general there was a decrease in response to N with increasing rate of N and delay in time of application. Mean responses to N applications were 13·0, 11·5 and 9·5 kg DM kg−1 N at 30, 60 and 90 kg N ha−1 respectively. Delaying N application, which also reduced the length of the period of growth, reduced the mean response to N fertilizer from 14·3 to 7·4 kg DM kg−1 N for N applied on 28 July and 20 September respectively.Increasing rate of N application increased the N concentration and reduced the dry‐matter (DM) content and water‐soluble carbohydrate (WSC) concentration of the herbage but had little effect on the acid‐detergent fibre (ADF) concentration. Delaying N application increased N concentration and reduced DM content of the herbage. The effect of date of N application on WSC concentration varied between harvests.A decrease in herbage mass occurred from November onwards which was associated with a decrease in the proportion of live leaf and stem material and an increase in the proportion of dead material in the sward.It is concluded that there is considerable potential to increase the herbage mass available for autumn/early winter grazing by applying up to 60 kg N ha−1 in early September.
Plant species richness, functional type and soil properties of grasslands and allied vegetation in English Environmentally Sensitive Areas
Authors: Critchley C. N. R. , Chambers B. J. , Fowbert J. A. , Bhogal A. , Rose S. C. , Sanderson R. A. 
Published: March 2003

AbstractTo facilitate the maintenance and restoration of semi‐natural grasslands, it is important to understand their relationships with soil properties. Semi‐natural grasslands typically have a high incidence of stress‐tolerant species (measured here by high stress radius values), but not all have high species richness. Species richness and stress radius values were related to soil pH, Olsen extractable phosphorus (P), extractable potassium (K) and magnesium (Mg), total nitrogen (N) and organic matter (OM) at 571 sites representing a wide range oftemperate grasslands. Highest species richness (>30 m−2) occurred at pH > 6 and 4–15 mg l−1 P, but species richness was also highly variable at 4–15 mg l−1 P. At pH < 5, species richness was low (<20 m−2). Stress radius values were highest (mainly calcareous and heath grasslands and mires) at pH c. 8·0 and < 5·0, and at the lowest soil P levels (<5 mg l−1). A wide range of stress radius values occurred at low soil P levels because appropriate management is also needed to maintain semi‐natural grasslands. Reducing soil P is difficult in practice, so grassland restoration in the presence of elevated soil‐extractable P levels merits re‐assessment.
Endometrial resection: factors affecting long‐term success
Authors: Gandhi Saurabh V. , Fear Kenneth B. C. , Sturdee David W. 
Published: March 2003

ObjectiveTo identify prognostic factors for the long‐term success of transcervical resection of endometrium (TCRE).DesignA retrospective analysis.SettingDepartment of Obstetrics and Gynaecology, Solihull Hospital, Solihull, West Midlands, UK.Subjects301 patients, who chose endometrial resection rather than hysterectomy and who underwent their first TCRE between 17 October 1989 and 31 December 1994.InterventionsEndometrial resection carried out by one surgeon (D.W.S.).Main outcome measuresPatient satisfaction, degree of bleeding and degree of pain, 1–6 years following TCRE. The procedure was considered to have failed if hysterectomy was necessary later.Results301 patients underwent a total of 329 procedures (TCRE) and were followed up for 1–6 years (mean 2.8). Complications were few and there was no death or major morbidity. About 80% of patients were satisfied with the procedure and had either amenorrhoea (34%), scanty periods (33%) or moderate/acceptable periods (14%). The incidence of hysterectomy because of the failure of this procedure was 15%. The success rate was significantly higher in the older age group (>40 years); in those without previous moderate or severe dysmenorrhoea; where histological examination of the endometrial chippings did not show any abnormality; where further surgery such as diagnostic hysteroscopy, laparoscopy or repeat resection (repeat TCRE) was not required, and with increasing operator experience.ConclusionTCRE should remain a useful option in the management of women with menorrhagia. Greater awareness of the prognostic factors identified in this study will improve preoperative counselling and the appropriate selection of patients for TCRE.
Endometrial resection: a diagnostic tool in postmenopausal women
Authors: Franchini Mario , Cianferoni Luciano 
Published: March 2003

ObjectiveTo determine the diagnostic role of hysteroscopic endometrial resection in symptomatic postmenopausal women.DesignRetrospective study.SettingGynaecology department at a general hospital.Patients150 postmenopausal women with abnormal uterine bleeding.InterventionsHysteroscopic transcervical resection of endometrium under general or spinal anaesthesia.ResultsEight endometrial carcinomas were detected in endometrial chips and were managed with simple hysterectomy. A benign organic cause was noted in 131 cases, and 11 women had atrophic endometrium. All 142 postmenopausal women with a benign lesion were satisfied with their treatment and had no recurrence of abnormal bleeding during a mean follow up of 28 months.ConclusionEndometrial transcervical resection is a reasonable clinical strategy for single‐procedure evaluation and treatment in postmenopausal women with abnormal uterine bleeding.
Complications of first entry: a pospective laparoscopy audit
Authors: Richardson Robert E. , Sutton Christopher J.G. 
Published: March 2003

AimTo record the incidence of both minor and major complications associated with first entry at laparoscopy and to compare the volume and pressure methods of insufflation.DesignProspective clinical study.Subjects and methodsAll patients undergoing gynaecological laparoscopy at the Chelsea and Westminster Hospital between 1 January and 31 December 1997. Surgeons completed a standard form at the time of the procedure. Two techniques of abdominal insufflation were compared; the volume technique when a set volume defined the endpoint of abdominal insufflation and the pressure technique when a set intra‐abdominal pressure was the endpoint.ResultsThe database includes 836 patients. When a pneumoperitoneum was established, the pressure technique was used in 55.8% of cases and the volume technique in 38.0%. The average volume used in the pressure group was significantly greater (4.33 vs. 2.82 l, P > 0.01). The main complications were failed laparoscopy, extraperitoneal and omental emphysema and bowel injury. There were no vascular injuries at first entry. The rate of complications varied with operator experience. Veress needle insertion was successful at the first attempt in 86.9% of procedures, with a complication rate of 0.82%. The complication rate rose with increasing number of attempts. Extraperitoneal insufflation occurred in 4.1%. The complication rate in the pressure group was significantly lower (4.1% vs. 8.2%, 0.05 > P > 0.02). Laparoscopy was abandoned in five cases, and in all of the latter the volume technique had been used. Three patients experienced bowel complications requiring laparotomy. Three patients were readmitted with umbilical hernias.ConclusionsAs the pressure method of insufflation is associated with a lower complication rate, it should be adopted. Use of this method did not, however, protect against bowel complications. Such complications occurred in high risk patients following uncomplicated Veress needle entry. Strategies to avoid such complications should be employed.
Optical Veress as an entry technique
Authors: McGurgan  , O'donovan  
Published: March 2003

ObjectiveTo review the advances in instruments designed for safer entry into the abdominal cavity.DesignA systematic review of the literature, including a Medline search of the period from 1966 to February 1999, using the words: laparoscopic, mini, micro, entry, Veress needle, optical, safety and methods.ResultsThere are approximately 0.4 Veress needle‐related injuries per 1000 procedures. The modified ‘optical’ Veress instruments are designed to further decrease this rate. Despite extensive studies demonstrating the use of the latter, there are no large‐scale, well‐designed trials to confirm their superiority over the conventional Veress.ConclusionVeress needle‐related injuries are rare, but their sequelae can be fatal. Many of the alternative instruments have potential advantages over the Veress needle, but lack of quality research means that they are not yet validated. This must be done by well‐planned trials as soon as possible.
Open laparoscopy as a method of access in laparoscopic surgery
Authors: Hasson Harrith M. 
Published: March 2003

ObjectiveTo describe the technique of open laparoscopy and compare the rates of its complications to those of closed laparoscopy.DesignMedline search, review of the literature and the author's experience.ResultsFor open laparoscopy, the rate of umbilical infection in 15 622 cases was 0.4%, that of bowel injury in 20 335 cases was 0.1%, based on prospective, retrospective studies and a mail survey. Prospective and retrospective studies dealing with closed laparoscopy reported the following complication rates: umbilical infection: 1% of 4377 cases; vascular injury: 0.2% of 94 863 cases: visceral injury: 0.2% of 91 272 cases. The operating time for open and closed laparoscopy were substantially similar.ConclusionOpen laparoscopy is advocated as the preferred method of access for laparoscopic surgery.
Endometrial abnormalities in breast cancer patients with tamoxifen therapy
Authors: Prevedourakis Constantin , Makris Nikolas , Xygakis Antonios , Dachlythras Marios , Michalas Stelios 
Published: March 2003

ObjectiveEvaluation of the effect of tamoxifen therapy on endometrium in patients who have previously undergone surgery for breast cancer.DesignAn analysis of hysteroscopic findings and their correlation with those from previous vaginal ultrasonography and subsequent endometrial sampling.SettingThe hysteroscopy unit of a university clinic.Subjects64 patients referred from the breast clinic, who had previously undergone surgery for breast cancer and who were receiving adjuvant tamoxifen therapy, with either suspicious findings on routine vaginal ultrasonography or abnormal uterine bleeding. Of the patients, 22 were premenopausal (group A) and 42 postmenopausal (group B). Each group was divided in two subgroups, comprising either symptomatic patients (groups A1 and B1) or asymptomatic patients (groups A2 and B2).Intervention:Diagnostic hysteroscopy.ResultsAll six patients of group A1 were found to have hyperplastic endometrium on hysteroscopy. Subsequent biopsy after dilation and curettage (D&C) revealed simple endometrial hyperplasia in all samples, plus endometrial polyps in two cases. Despite suspicious appearances on vaginal ultrasonography, all 16 asymptomatic premenopausal patients (group A2) were found on hysteroscopy to have normal endometrium. Among the 29 patients with postmenopausal uterine bleeding (group B1) 22 showed hyperplastic endometrial findings on hysteroscopy. The histopathological results from the subsequent D&C, confirmed the hysteroscopic findings, showing various degrees of endometrial hyperplasia and three adenocarcinomas (4.7% of the total number of patients or 10.3% of those with postmenopausal bleeding). Normal or atrophic endometrium was observed in nine of the 13 patients in group B2; there was one polyp, and three cases of hyperplastic endometrium, which were found to be simple hyperplasia on pathological investigation.ConclusionsMonitoring of the uterine cavity in patients receiving tamoxifen therapy is mandatory, especially where there is postmenopausal bleeding. Hysteroscopy findings display a considerably higher degree of correlation with endometrial pathology results, than do vaginal ultrasonography findings.
Sequestration and extrusion of intramural fibroids following arterial embolization: a case series
Authors: Jones Kevin , Walker Woodruff J. , Sutton Christopher 
Published: March 2003

Objective  To report a case series of fibroids that were sequestered and extruded following arterial embolization. Methods  The clinical records of six patients were reviewed. Results  The clinical and radiological findings demonstrated large fibroids which were sequestered and extruded following arterial embolization. Conclusion  Fibroids can be passed into the uterine cavity following uterine artery embolization.
Bowel injuries during gynaecological laparoscopy: a multinational survey
Authors: Brosens Ivo , Gordon Alan 
Published: March 2003

ObjectiveTo use the experience of an international group of gynaecological laparoscopists to evaluate the prevalence, causes, sites, management and outcomes of bowel injury occurring during or as a result of laparoscopy.DesignA questionnaire was sent to members of the International Society for Gynecologic Endoscopy (ISGE) requesting details of all laparoscopies complicated by bowel trauma and performed by them over a 2‐year period. One year was retrospective and one prospective.ResultsA total of 135 members (24%) replied and reported 45 bowel injuries. The estimated prevalence was 1 in 1652 level 1 laparoscopies and 1 in 280 levels 2 and 3 laparoscopies combined. Injuries were caused by the Veress needle, primary trocar, forceps, scissors and by electro‐ and laser surgery. Adhesions from previous surgery or endometriosis were present in 78% of cases. Bowel trauma was statistically significantly related to the experience of the surgeon, defined by a cut‐off at 100 procedures per year. In experienced hands trauma occurred as frequently during access as during the surgical procedure. The diagnosis was made during the laparoscopy in 38 cases. Expectant treatment was carried out in four cases after Veress needle injury without consequences, laparoscopic suturing in eight cases and conversion to laparotomy in 26 cases. The diagnosis was delayed in seven patients (15%) of whom two (28%) died 7 days after surgery without any further intervention.ConclusionsBowel injury during gynaecological laparoscopy is significantly related to the experience of the surgeon. With the experienced group, bowel trauma occurs as frequently during access as during the surgical procedure. The occurrence of two deaths in our study suggests that the mortality due to bowel trauma may be underestimated in reports from highly privileged societies.
A prospective, randomized, double‐blind controlled trial of laparoscopic uterine nerve ablation in the treatment of pelvic pain associated with endometriosis
Authors: Sutton Christopher , Pooley Andrew S. , Jones Kevin D. , Dover Richard W. , Haines Patricia 
Published: March 2003

To determine the value of laparoscopic uterine nerve ablation (LUNA) as part of the laparoscopic laser treatment of painful endometriosis.A prospective randomized double‐blind controlled trial.A referral centre for the treatment of endometriosis.51 women with pelvic pain and pelvic endometriosis.All patients underwent laparoscopic laser ablation of their endometriosis and were then randomly allocated to receive LUNA or no further treatment.Dysmenorrhoea, dyspareunia and chronic non‐menstrual pelvic pain were assessed using visual analogue scales and structured questionnaires, preoperatively and at 3 and 6 months postoperatively.24 patients were randomly allocated to receive laser vaporization alone, and 27 to receive a LUNA procedure in addition. The mean age of the patients involved was 28 years (range 20–41), with no differences between the groups for stage of endometriosis. Comparisons were made between the two treatment groups at 3 and 6 months. Significant differences in favour of the non‐LUNA group were found at 3 months (P = 0.003), and at 6 months (P = 0.022) for dysmenorrhoea. A significant difference in favour of the non‐LUNA group also occurred at 6 months for chronic non‐menstrual pain (P = 0.323). There were no significant differences recorded for dyspareunia. Bonferroni's adjustment was applied, and the only difference which remained significant was for dysmenorrhoea at 3 months (P = 0.033) in favour of the non‐LUNA group. The preoperative and 6‐month pain scores for all the patients were combined. There was a significant improvement in the pain scores recorded at 6 months (P < 0.0001).Laparoscopic laser ablation of endometriosis is confirmed as an effective treatment, to which uterine nerve ablation adds no benefit.
What research should be done in gynaecological endoscopy? A national questionnaire survey of members of the British Society of Gynaecological Endoscopy
Authors: Clark T. Justin , Mahajan Deepa , Sunder Ponnamal , Bingham Tracy , Khan Khalid S. , Gupta Janesh K. 
Published: March 2003

To determine current research activity and establish views on the direction of future research in gynaecological endoscopy.A self‐administered structured questionnaire was posted to 389 UK gynaecologists to enquire about current research activity and collect their views on future research within gynaecological endoscopy.Members of the British Society of Gynaecological Endoscopy (BSGE).The postal questionnaire was returned by 100 BSGE members (26% response rate) and of these respondents, 47 (47%) were actively involved in research. The majority of respondents (99/100, 99%), believed that the BSGE should play a proactive role in directing future research in gynaecological endoscopy. Therapeutic laparoscopy was the area of gynaecological endoscopy identified most frequently (80/100, 80%) for future study. Within this area, 22/80 (28%) specified the need for studies into laparoscopic treatment of endometriosis, especially comparative studies between ablative and excisional treatment (15/22, 68%).There is a substantial commitment to research in gynaecological endoscopy by BSGE members who responded to the survey. The BSGE should play a proactive role in defining its research remit in health technology assessment. Future research requiring priority should focus on determining the effectiveness of laparoscopic methods of treatment for endometriosis.
Is laparoscopic surgery really worth it? The views of patients, hospital doctors and health care managers
Authors: Hart Roger , Ruach Meir , Magos Adam 
Published: March 2003

To determine the relative benefits of minimal access surgery (MAS) as perceived by patients and health care professionals.Prospective descriptive study (design classification III).A large undergraduate teaching hospital in the North Thames Region.100 patients (50 gynaecological, 50 antenatal), 70 obstetricians and gynaecologists, and 30 senior hospital managers.A specially designed questionnaire was used which included 44 pairs of clinical scenarios for laparotomy and laparoscopy. Each scenario consisted of different permutations of four of the variables, incision size, operating time, major complication rate, hospital stay and recovery time. Respondents were asked to select their preferred route of surgery. They also ranked, in order of priority, the above five variables together with treatment cost.MAS was preferred by the majority. Most patients chose endoscopy even if the operating time was four times longer and there was no reduction in hospitalization, and 25% accepted a quadrupling of the major complication rate. A minority of surgeons chose laparoscopy if the operating time exceeded 2 h or the risk of a major complication was increased fourfold. Most respondents preferred MAS, even if recovery time was equal to that of laparotomy. All respondents ranked complication rate as the main priority and cost as the least. Overall, patients were significantly more in favour of MAS than were surgeons, and the views of managers were in between the views of these two groups.Both health care professionals and patients, especially the latter, prefer MAS to conventional surgery, even if the operating time is longer and the major complication rate is higher.