Environmental benefits and economic costs of manure incorporation on dairy waste application fields

Model simulations performed representing dairies in a 93000 ha watershed in north central Texas suggest that manure incorporation results in reduced phosphorus (P) losses at relatively small to moderate cost to producers. Simulated manure incorporation with a tandem disk on fields double-cropped with sorghum/winter wheat resulted in up to 33, 45, and 37% reductions in per hectare sediment-bound, soluble, and total P losses in edge-of-field runoff, relative to simulated surface manure applications. The effects of incorporation were evaluated at three different manure application rates. On aggregate across all three manure application rates, significant declines in P losses were obtained with incorporation except for sediment-bound P losses under the N-based manure application rate scenario. We found that the practice of incorporating manure shortly after it has been broadcast on the soil surface could help reduce P losses in such situations where P-based rates alone prove inadequate. The cost the producer incurs when manure is incorporated is on average about 1% of net returns when manure is applied at the N rate and 2-3% when it is applied at alternative P-based rates. In practice the costs could be lower because producers may substitute the manure incorporation operation for a tandem disk operation performed prior to manure application. As more and more dairy producers switch to the use of sorghum and corn silage in dairy rations and consequent on-farm production of these forages, the practice of manure incorporation may help to reduce phosphorus losses resulting from dairy manure applications to fields with these forage crops.

Components, therapeutic value and uses of myrrh

Occurrence, constituents and medicinal use of myrrh, obtained from the stem of different Commiphora species are reviewed. The constituents of the volatile oil, the resin and the gum are outlined in detail. Myrrh has considerable antimicrobial activity and is medicinally used in a variety of diseases.

[Predictive parameters of infectiologic complications in patients after TIPSS]

AIM

To define predictive parameters of a complicated clinical course after the TIPSS procedure.

METHODS

Blood cultures were drawn prospectively in 41 patients from a central line and from the portal venous blood before stent placement as well as from the central line 20 min after intervention. C-reactive protein (CRP) (mg/dl) and white blood cell count (WBC,/microl) on the day of TIPSS-procedure (d0), the first (d1) and seven (d7) days after TIPSS were compared in patients with a complicated clinical course (spontaneous bacterial peritonitis,pneumonia,sepsis; group I) to patients without clinical complications (group II) RESULTS: Group I showed a significant increase in CRP (d0: 1.8+/-1.0; d1: 3.2+/-1.5; d7: 4.3+/-3.2), and white blood cell count (d0: 7700+/-2600; d1: 10800+/-2800; d7: 7500+/-1800) on the first day after TIPSS-procedure in comparison to group II (CRP: d0: 1.6+/-0.6; d1: 1.8+/-1.0; d7: 1.9+/-0.6. WBC: d0: 6900+/-1500; d1: 8000+/-1600; d7: 7600+/-1400). Microbiological analysis showed in 12% skin or oral flora in the last sample.

CONCLUSIONS

The course of CRP and WBC-count during the first week after TIPSS procedure may indicate patients with a potential risk of a complicated clinical course.

[Imaging of supradiaphragmatic manifestations of extranodal non-Hodgkin's lymphoma]

Malignant lymphomas are differentiated into Hodgkin's and non-Hodgkin's-lymphoma (NHL). The following article discusses the imaging of extranodal NHL in supradiaphragmatic localizations. Lymphoma can affect nearly all tissues, and represent a rare entity as primary extranodal NHL. A secondary involvement of non-nodal tissue as consequence of a generalized lymphoproliferative disease is more common,and may be seen as well in HIV-positive patients defining AIDS. As extranodal lymphoma mimic the radiologic appearance of other malignant tumors, direct diagnosis without histologic analysis is often impossible. The article describes typical manifestations of lymphoma of the lungs, the head and neck area including the large glands, and rare localizations as the heart or the breast.

[Modern diagnostic imaging: MR urography]

MR-urography presents a new diagnostic approach to the urinary system, resulting in images comparable to those known from i.v.-urography. T2-weighted MR-urograms demonstrate static fluid without ionizing radiation or nephrotoxic contrast media. The excretory renal function can be examined by the use of gadolinium-enhanced T1-urography. The degree and cause of ureteric obstruction can be diagnosed with high sensitivity and specificity. On the other hand, urolithiasis is frequently misdiagnosed by MR-urography and, in this case, spiral CT should be used. Pediatric or pregnant patients can be examined as well as donors before and patients after renal transplantation. Furthermore, in case of a tumor MR-imaging, including MR-angiography, is a potential diagnostic "all-in-one" approach.

Usefulness of K-1 (CD-30) marker in Hodgkin's disease

OBJECTIVE

To identify Hodgkin's and Reed Sternberg like cells by a single Immunomarker (Ki-1; CD-30) and to highlight diagnostic specificity of these cells in Hodgkin's disease, as these cells are frequently encountered in other lymphoproliferative disorders on H&E sections.

METHODOLOGY

Seventy-nine histologically diagnosed cases of lymph node biopsies (59 cases of Hodgkin's disease, 15 cases of Non Hodgkin's lymphoma and 5 cases of non neoplastic lymphoid tissue) were subjected to Ki-1 (CD-30) immunostaining as all cases revealed Hodgkin's and/or Reed Sternberg like cells on H&E stained sections.

RESULTS

Out of 59 cases of Hodgkin's disease, 49 (83%) showed Ki-1 (CD-30) immunoreactivity for Reed Sternberg and Hodgkin's cells. None of the 15 cases of non-Hodgkin's lymphoma (2 small lymphocyte type, 11 diffuse large cells type, 2 lymphoblastic type) showed positive Ki-1 (CD-30) immunostaining. Only one case of the remaining 5 cases of non-neoplastic lymphoid lesion (2 toxoplasmic lymphadenitis, one histiocytic necrotizing lymphadenitis, one reactive hyperplasia and one chronic non specific lymphadenitis) showed positive Ki-1 immunostaining.

CONCLUSION

Ki-1 (CD-30) is a reliable marker for Hodgkin's Reed Sternberg like cells in histologically proven cases of Hodgkin's disease but not for similar cells encountered in other lymhoproliferative lesions.

Contrast-enhanced MR urography in the evaluation of renal transplants with urological complications

AIM

The diagnostic work-up of renal transplants with impaired function due to urological problems can be difficult. This study was performed to assess sensitivity and specificity of non-invasive contrast-enhanced MR urography (MRU).

METHODS AND MATERIALS

Thirty-five patients with renal transplants (25 - 71 years, mean: 53.4 years) with sonographically diagnosed hydronephrosis or perirenal fluid collections were assessed by MR urography. MR examinations were carried out at a 1.5 T clinical scanner (Vision, Siemens, Erlangen, Germany) with a 512 matrix contrast-enhanced fat-suppressed T1-weighted FLASH 3D sequence in breath-hold technique. MIP reconstructions were used to produce MR urography. MRU diagnoses were compared to operative results.

RESULTS

In all patients, images with sufficient contrast in the renal collecting system were obtained. Hydronephrosis was confirmed in 20 patients, 8 patients showed a different pathology while 7 had normal findings. Compared to operative results, sensitivity of MRU was 100% with a specificity of 78%, respectively. One ureteral stone was misdiagnosed as a stricture, and 2 suspected ureteral stenoses could not be found upon operation.

CONCLUSIONS

Contrast-enhanced MR urography is a highly sensitive and specific non-invasive method to evaluate patients suspected of having typical post-transplant urological complications. It may replace invasive procedures such as antegrade pyelography in the pre-operative work-up.

Differential diagnosis of hyperthyroidism: Doppler sonographic quantification of thyroid blood flow distinguishes between Graves' disease and diffuse toxic goiter

The aim of our study was to evaluate the usefulness of color duplex sonography to distinguish Graves' disease from diffuse toxic goiter. 24 patients with Graves' disease and 13 patients with diffuse toxic goiter underwent B-mode- and color duplex sonography of the thyroid gland. All patients had hyperthyroidism and elevated (99m)Tc-uptake. Spectral Doppler recordings were obtained at all thyroid arteries. Representative color flow maps of the thyroid gland were analyzed, calculating the percentage area of the thyroid gland, occupied by color pixels (color pixel density). The B-mode ultrasound pattern was subjectively assessed on a 4-point rating scale. In patients with Graves' disease the mean peak systolic velocity (PSV) (SD) was 110 (+/- 49) cm/s, the mean volume flow rate (VFR) was 123 ( +/- 67) ml/min and the mean color pixel density (CPD) was 33 (+/- 12) %. For patients with diffuse toxic goiter mean PSV (SD) was 43 ( +/- 9) cm/s (p < 0.001), mean VFR was 23 (+/- 10) ml/min (p < 0.001) and mean CPD was 9 (+/- 6) % (p = 0.007). CPD and spectral duplex recordings were positively correlated (CPD/PSV: rs = 0.77, CPD/VFR: rs = 0.75; p < 0.0001). No significant differences were observed concerning RI values. Sensitivity was 87% and specificity 92% for CPD and VFR and 87% and 100% for PSV. We conclude, that color duplex sonography can reliably distinguish diffuse toxic goiter from Graves' disease and therefore contributes significantly to the differential diagnosis of hyperthyroidism in diffuse thyroid disease.

Changes in T cell subsets, interleukin-6 and C-reactive protein after laparoscopic and open colorectal resection for malignancy

BACKGROUND

Attenuation of the immune response to surgery, as demonstrated with the laparoscopic approach to cholecystectomy, has potential benefits in patients undergoing laparoscopic colonic resection for malignancy. We aimed to study the perioperative immune response in patients undergoing laparoscopically assisted and open surgery for colorectal cancer.

METHODS

This study involved 23 patients undergoing laparoscopically assisted (n = 13) and open surgery (n = 10). Interleukin-6 (IL-6) C-reactive protein (CRP), the total lymphocyte count, and the CD3, CD4, CD8, CD16, and CD19 lymphocyte subpopulations were assayed preoperatively and at 4, 8, 10, 24, 48, and 168 h postoperatively.

RESULTS

Significant rises in IL-6 and CRP were demonstrated within 4 and 24 h, respectively (p < 0.001) in both groups. However, no significant difference between the groups was seen. Significant decreases in total lymphocyte count and all T cell subsets were demonstrated in both groups, beginning at 4 h (p < 0.01). However, no significant difference between the groups was seen. All parameters, excluding CRP, had returned to baseline by 7 days postoperatively in both groups.

CONCLUSIONS

Patients with malignancy exhibit significant perioperative immune disturbance with laparoscopically assisted and open surgery. The current data do not provide justification for the laparoscopically assisted approach on grounds of immune preservation.

Circulating filarial antigens for monitoring the efficacy of ivermectin in treatment of filariasis

Seventy-three asymptomatic bancroftian filariasis patients with positive microfilaria in their blood films were included. The patients were randomly divided into 2 groups: ivermectin group (50 cases) given 2 doses each of 100 ug/kg body weight, 3 months apart, and 23 cases had 2 doses of placebo. The study was run blindly for one year. The initial mean microfilaria (MF) count was 111/ml. At 3 months after ivermectin therapy, mean MF became 7.8/ml and 24% of ivermectin treated cases had no detectable MF (P <0.05). At 6, 9 and 12 months, the mean MF count became 4.1, 6.5 and 11/ml with amicrofilaria in 54%, 42% and 40% of treated cases respectively (P <0.05). On the other hand, no statistically significant change in the mean MF count in placebo group was detected. The routine laboratory investigations were unchanged or slightly improved at 3 and 6 months. Side effects after the first dose of ivermectin were mild fever in 16% and weakness in 20%. None was recorded after the second dose. Circulating filarial antigens could be detected in 66% of cases before treatment, as all cases with high microfilaremia had positive antigenemia. The mean antigen level started to decline significantly after 9 months post treatment. At the end of the study (one-year), all negative microfilaremic cases had negative antigen levels, indicating that detection of antigen in-patients sera is a very good indicator of cure and efficacy of the drug.

Estimation of antithyroid drug dose in Graves' disease: value of quantification of thyroid blood flow with color duplex sonography

The purpose of this study was to evaluate if there is an association between the antithyroid drug dose that is needed to establish euthyroidism and thyroid blood flow measurements. A total of 23 Graves' disease patients with euthyroidism taking antithyroid drug therapy were enlisted to undergo spectral duplex sonography of the thyroid arteries and color-flow mapping of the thyroid gland. Color pixel density (CPD) was calculated with computer assistance from the color-flow maps. There was a strong correlation between the CPD and methimazole dose (rp = 0.79). Methimazole maintenance dosage could be predicted from CPD values with a coefficient of determination of 0.62. In conclusion, CPD measurements could be a useful tool for the clinical endocrinologist to estimate the antithyroid drug dose that is needed to maintain euthyroidism.

Effects of local bupivacaine instillation on pain after laparoscopy

STUDY OBJECTIVE

To evaluate the effect of preincisional and intraperitoneal bupivacaine administration on immediate and late pain after operative laparoscopy.

DESIGN

Randomized study (Canadian Task Force classification I).

SETTING

University teaching hospital.

PATIENTS

One hundred fifty women undergoing laparoscopy for various gynecologic indications.

INTERVENTION

A dose of 0.5% bupivacaine 10 ml (50 mg) was injected into cannula sites before incisions and another 10 ml diluted with 100 ml saline into the peritoneal cavity at completion of the procedure. Equal amount of physiologic saline was used in controls.

MEASUREMENTS AND MAIN RESULTS

Modified McGill pain intensity scores and amount of analgesic required in the recovery room and within 24 hours postoperatively were evaluated. Of 150 women, 142 completed the study (71 bupivacaine group, 71 controls). Groups did not differ significantly in body mass index, duration of surgery, return to consciousness, and analgesic requirement during 3-hour observation in the recovery room and 24 hours after discharge. Pain scores were highest 30 minutes after the procedure in both groups. At that time the pain score in the bupivacaine group was lower than that in the control group (1.8 +/- 0.2 vs 2.3 +/- 0.2, p <0.05). Beyond that time, the groups did not differ in pain scores and analgesic requirements.

CONCLUSION

Postoperative pain is the highest within 30 minutes after laparoscopy. Local instillation of bupivacaine before incision and intraperitoneally was effective in reducing pain immediately after operative laparoscopy, but the effect was not seen beyond 30 minutes.

Class I MHC-binding characteristics of the 129/J Ly49 repertoire

The Ly49 family of NK cell receptors and its MHC-binding characteristics have only been well characterized in C57BL/6 (B6) mice. Previous studies have shown that 129/J mice express unique Ly49 genes that are not found in the B6 strain. Screening of a 129/J cDNA library led to the discovery of 10 distinct full-length Ly49-related coding sequences (Ly49e, g, i, o, p, r, s, t, u, and v). Although 129/J mice share identical class I MHC (K(b) and D(b)) transcripts with B6 mice, only one Ly49 is identical in the two strains (Ly49E). In addition to the previously characterized Ly49P, two new activating Ly49 proteins were discovered, Ly49R and U. The MHC specificity of the total 129/J Ly49 repertoire was evaluated with soluble class I MHC tetramers and found to be distinct compared with the B6 Ly49 repertoire. Ly49V bound to many types of class I MHC, suggesting that Ly49V(+) NK cells may monitor host cells for a global down-regulation in MHC levels. An activating receptor, Ly49R, was shown to bind soluble class I molecules to a moderate degree, a result not previously observed for other activating Ly49 proteins. Furthermore, tetramer-binding results were confirmed functionally with cytotoxicity assays using sorted 129/J NK cells. This study shows that the Ly49 repertoire and its MHC-binding characteristics can be very different among inbred mouse strains. Ly49 divergence should be considered when using 129-derived embryonic stem cells for the production of gene-targeted mice, especially when an immune or NK-derived phenotype is under scrutiny.

Real-time Compound imaging: Verbesserte Erkennbarkeit von Punktionsnadeln und Markierungsdrähten gegenüber Single-line- Ultraschall?

AIM

To compare the visibility of biopsy needles and localization wires using real-time compound imaging (SonoCT) and single-line ultrasound (SLU).

METHODS

14-18 G biopsy needles and 5 different localization wires with and without puncture needle were placed into cadaverous muscle in 4 different angulations (0, 12, 18 and 25 degrees). Sonography was performed with an ATL HDI 5000 sonography device with a 5-12 MHz linear array using single-line ultrasound and compound imaging with 3 and 9 frames (Comp3 and Comp9) from different viewing angles. Images of the needles were obtained in the longitudinal plane without changing depth, focus position, and gain settings between the measurements. The mean grey values of the needle (gv_n) and of the background (gv_b) were obtained from histograms. Contrast was calculated using the equation (gv_n-gv_b)/gv_b + gv_n). Mean contrast in single-line and compound images was compared for each angulation using a Student t-test.

RESULTS

The mean contrast at 0 degree was 0.686 in single-line ultrasound. This was significantly higher than in Comp3 (0.62) and Comp9 (0.633) (p < 0.05) images. At 12 degrees no significant differences could be observed. At 18 degrees image contrast was significantly higher in compound images with 0.493 (Comp3) and 0.498 (Comp9), compared to SLU (0.433) (p < 0.05). At 25 degrees the difference between compound images (Comp3: 0.394; Comp9: 0.402) and SLU (0.306) was greatest (p < 0.0001).

CONCLUSION

At 0 degree and 12 degrees visibility is very good for all tested materials. For steeper angulations contrast was partly critical in SLU and significantly enhanced with compound imaging. Thus, SonoCT may be useful to increase precision of ultrasound-guided percutaneous interventions.

Erlaubt das Tissue Harmonic Imaging eine frühe postoperative Schilddrüsenvolumetrie?

AIM

Therapy for endemic goitre after surgical resection depends on the residual thyroid volume. Post-operative changes have been known to impair the fundamental sonographic evaluation of residual thyroid tissue. It was our aim to determine whether THI is a feasible method for thyroid volumetry after surgery.

METHODS

48 patients underwent thyroidectomy, hemithyroidectomy, near total resection, or partial resection of the thyroid gland. In all patients THI of the neck was performed 4 (mean; range: 2-7 days) days after surgery using an Elegra sonographic device (Siemens, Erlangen, Germany) with a transmitted frequency of 3.4 MHz and received frequency of 6.8 MHz. The examiner was blinded to the patient's diagnosis and the type of surgery. The residual tissue volume measured by means of THI and intra-operative volumetry were both compared to sonographic volumetry 12 weeks after surgery, the latter serving as the gold standard. Accuracy of THI and intraoperative volumetry were tested for significant differences using a paired t-test.

RESULTS

Volumetry by the surgeon was available in 26 patients (54%). The men error of THI volumetry was 2.4 ml (SD: 3.3 ml; maximum: 17 ml). The mean error of intraoperative volumetry was 1.4 ml (SD: 1.9 ml; maximum: 6 ml). The mean difference between THI and intraoperative volumetry was 1 ml (SD: 2.7 ml; maximum: 7 ml; p = 0.085).

CONCLUSIONS

THI permits early volumetry of the residual tissue after thyroid surgery comparable with the intraoperative volumetry. Thus, THI may be helpful in guiding the substitution of thyroid hormones.

A conserved XIAP-interaction motif in caspase-9 and Smac/DIABLO regulates caspase activity and apoptosis

X-linked inhibitor-of-apoptosis protein (XIAP) interacts with caspase-9 and inhibits its activity, whereas Smac (also known as DIABLO) relieves this inhibition through interaction with XIAP. Here we show that XIAP associates with the active caspase-9-Apaf-1 holoenzyme complex through binding to the amino terminus of the linker peptide on the small subunit of caspase-9, which becomes exposed after proteolytic processing of procaspase-9 at Asp315. Supporting this observation, point mutations that abrogate the proteolytic processing but not the catalytic activity of caspase-9, or deletion of the linker peptide, prevented caspase-9 association with XIAP and its concomitant inhibition. We note that the N-terminal four residues of caspase-9 linker peptide share significant homology with the N-terminal tetra-peptide in mature Smac and in the Drosophila proteins Hid/Grim/Reaper, defining a conserved class of IAP-binding motifs. Consistent with this finding, binding of the caspase-9 linker peptide and Smac to the BIR3 domain of XIAP is mutually exclusive, suggesting that Smac potentiates caspase-9 activity by disrupting the interaction of the linker peptide of caspase-9 with BIR3. Our studies reveal a mechanism in which binding to the BIR3 domain by two conserved peptides, one from Smac and the other one from caspase-9, has opposing effects on caspase activity and apoptosis.

Effects of laparoscopic ovarian drilling on adrenal steroids in polycystic ovary syndrome patients with and without hyperinsulinemia

OBJECTIVE

To evaluate adrenal steroid responses to ACTH stimulation and insulin responses to oral glucose tolerance test (OGTT) in clomiphene-citrate-resistant anovulatory women with polycystic ovary syndrome (PCOS) before and after laparoscopic ovarian drilling.

DESIGN

Prospective study.

SETTING

Healthy participants in a university teaching hospital.

PATIENT(S)

Twenty clomiphene-citrate-resistant anovulatory women with PCOS.

INTERVENTION(S)

Laparoscopic ovarian drilling.

MAIN OUTCOME MEASURE(S)

Adrenal steroid responses to ACTH stimulation and insulin responses to OGTT before and after ovarian drilling.

RESULT(S)

Fourteen of 20 women completed the study. There was a correlation between body mass index and basal insulin levels before ovarian drilling. This correlation was lost after surgery. Area-under-the-curve glucose and insulin values before surgery in women with hyperinsulinemia (1,033.3 +/- 112.7 mmol/L and 141,919 +/- 26,177 pmol/L, respectively) were significantly higher than in those with normoinsulinemia (777.1 +/- 77.2 mmol/L and 69,867 +/- 19,390 pmol/L respectively, P<.05). There was a significant difference in insulin and glucose responses before and after ovarian drilling in women with hyperinsulinemia. No difference was found in women with normoinsulinemia. There was no significant difference in adrenal steroid responses to ACTH stimulation before and after ovarian drilling.

CONCLUSION(S)

PCOS women with hyperinsulinemia respond differently to laparoscopic ovarian drilling than do those with normoinsulinemia. Among women with hyperinsulinemia, surgery decreases glucose and insulin responses to OGTT. Regardless of the insulin level, laparoscopic ovarian drilling does not influence adrenal steroid dynamics.