Management impacts on the dissolved organic carbon release from deadwood, ground vegetation and the forest floor in a temperate Oak woodland.

The forest floor is often considered the most important source of dissolved organic carbon (DOC) in forest soils, yet little is known about the relative contribution from different forest floor layers, understorey vegetation and deadwood. Here, we determine the carbon stocks and potential DOC production from forest materials: deadwood, ground vegetation, leaf litter, the fermentation layer and top mineral soil (Ah horizon), and further assess the impact of management. Our research is based on long-term monitoring plots in a temperate deciduous woodland, with one set of plots actively managed by thinning, understorey scrub and deadwood removal, and another set that were not managed in 23 years. We examined long-term data and a spatial survey of forest materials to estimate the relative carbon stocks and concentrations and fluxes of DOC released from these different pools. Long-term soil water monitoring revealed a large difference in median DOC concentrations between the unmanaged (43.8 mg L-1) and managed (18.4 mg L-1) sets of plots at 10 cm depth over six years, with the median DOC concentration over twice as high in the unmanaged plots. In our spatial survey, a significantly larger cumulative flux of DOC was released from the unmanaged than the managed site, with 295.5 and 230.3 g m-2, respectively. Whilst deadwood and leaf litter released the greatest amount of DOC per unit mass, when volume of the material was considered, leaf litter contributed most to DOC flux, with deadwood contributing least. Likewise, there were significant differences in the carbon stocks held by different forest materials that were dependent on site. Vegetation and the fermentation layer held more carbon in the managed site than unmanaged, whilst the opposite occurred in deadwood and the Ah horizon. These findings indicate that management affects the allocation of carbon stored and DOC released between different forest materials.

Technical assessment of porcine enteroenterostomy performed with ZEUS robotic technology.

BACKGROUND/PURPOSE: Limitations of minimally invasive pediatric surgery include the inability to perform precise anastomoses of 2 to 15 mm. Robotic technology facilitates the performance of endoscopic microsurgical procedures. This study examined the technical feasibility of performing an enteroenterostomy in piglets utilizing ZEUS robotic technology. METHODS: Ten piglets (6.5 to 8.5 kg) underwent enteroenterostomy. Standard laparoscopic techniques were used in the control group (n = 5), and ZEUS robotic technology was used in the experimental group (n = 5). AESOP controlled the camera in both groups. Anesthesia time; surgery time; robotic set-up time; and anastomotic time, patency, diameter, and integrity were compared. RESULTS: No statistical difference existed between the means of the control and experimental groups for anesthesia time (176.0 v 154.0 minute; P =.63), surgery time (143.0 v 139.2 minute; P =.92), anastomosis time (109.4 v 93.0 minutes; P =.56), AESOP set-up time (4.2 v 7.0 minutes; P =.51), and anastomotic diameter (7.062 v 7.362 mm; P =.62). All anastomoses were patent without narrowing. The ZEUS cases averaged 14 minutes faster than the standard laparoscopic cases, even with the ZEUS set-up time included. CONCLUSIONS: These data supports the hypothesis that robotic-assisted enteroenterostomy is technically feasible. ZEUS robotic technology will potentially play an important role in expanding the applications of minimally invasive pediatric surgery.

Preoperative home care for esophageal atresia--a survey.

BACKGROUND/PURPOSE: Long gap esophageal atresia may require months of preoperative management before definitive repair. When 2 recent patients prompted the authors to consider preoperative home care, no published protocol could be identified. This survey is undertaken to determine pediatric surgeons' experience with preoperative home care for long gap atresia. METHODS: A total of 543 surgeons were asked if any patients with long gap atresia had been treated preoperatively at home. For patients sent home, information on nursing care, insurance issues, complications, and timing or type of repair was requested. RESULTS: A total of 380 surveys (70%) were returned. A total of 165 surveys representing 348 patients were included. Forty-one of 165 surgeons (25%) treated 63 of 87 patients (72%) with long gap atresia and an intact upper pouch at home. Home nursing care was provided for 44 patients (70%): 16 (36.4%) night shift, 2 (4.5%) day shift, 3 (6.8%) 24 hour, and 23 (52.3%) intermittent care. No complications referable to preoperative home care were reported. CONCLUSIONS: Significant hesitancy and practice variance exists regarding preoperative home care of patients with long gap esophageal atresia. Many surgeons are satisfied with the safety and cost effectiveness of this technique, although a prospective, multicenter trial is needed to study it in a randomized, controlled fashion.

Ileal exclusion for Byler's disease: an alternative surgical approach with promising early results for pruritus.

BACKGROUND/PURPOSE: Progressive familial intrahepatic cholestasis (Byler's disease) is often characterized by pruritus-induced self-mutilation with minimal response to medical therapy. The causative cholestasis is likely to progress to cirrhosis necessitating transplantation. Partial external biliary diversion has been used with promising results for the jaundice and debilitating pruritus but all the potential complications and aesthetic concerns of long-term stomas attend this approach. METHODS: The authors describe a terminal ileal exclusion that was first developed for patients who had previously undergone cholecystectomy. Over a 3-year period, we identified for study seven children with liver histology characteristic of Byler's disease accompanying a clinical picture of chronic cholestasis without a defined metabolic or anatomic abnormality. The first two patients underwent a cholecystojejunal cutaneous stoma, until now, the recommended treatment for this condition. The third had previously undergone cholecystectomy so an ileocolonic anastomosis was performed excluding the distal 15% of the small bowel. This child had complete relief of pruritus without evidence of diarrhea. Two more terminal ileal exclusions were performed with similar results before standardizing this approach. The authors approximated small intestinal length using Siebert's graph relating crown-heel length to small intestinal length. The midpoint between the mean and one standard deviation below the mean was determined. Fifteen percent of the estimated small bowel length was measured back from the ileocecal valve and then divided using a linear stapling device. A stapled anastomosis was created between the proximal ileum and the cecum, bypassing the terminal ileum. RESULTS: Four of five children have had relief from their pruritus and self-mutilation with no evidence of diarrhea. Terminal ileal bypass offers a stoma-free, completely reversible "biliary diversion." CONCLUSION: Early results on a few patients are promising, but long-term evaluation of growth, development, and liver function and histology is needed before advocating this as the primary therapy for Byler's disease.

Abnormal eating attitudes in secondary-school girls in South Africa--a preliminary study.

OBJECTIVES: To document the existence of eating attitudes that may reflect current, pre- or subclinical eating disorders. To establish preliminary prevalence figures for abnormal eating attitudes. DESIGN: Cross-sectional survey of eating attitudes. SETTING: Non-clinical, community-based. SUBJECTS: Female high-school pupils. OUTCOME MEASURES: Total score derived from a self-report questionnaire, Eating Attitudes Test (EAT-26), which measures eating attitudes. Factor profile describing dimensions of eating-related psychopathology, derived from the clustering of questions on the EAT-26. RESULTS AND CONCLUSIONS: An overall prevalence figure of abnormal eating attitudes of 21.66% was documented. Black pupils had a higher prevalence than white pupils (37.5% v. 20.67%). The factor profile of respondents with abnormal eating attitudes did not differ between the race groups, although within the total sample, black respondents had a significantly stronger drive toward thinness. A significant developmental continuum was established, with prevalence figures for abnormal eating attitudes increasing with each standard from Standard 7 onward. The study provides preliminary epidemiological data on the prevalence of adolescent girls either suffering from or at risk of the development of an eating disorder. In addition, the study also provides evidence of the need for intervention strategies that commence in the pre-teen years.

Factors influencing eating attitudes in secondary-school girls in South Africa--a preliminary study.

OBJECTIVES: To establish factors in the environment, e.g. family, peer or media, as well as individual factors, e.g. self-perception, which may influence eating attitudes. DESIGN: Cross-sectional survey. SETTING: Non-clinical, community-based. SUBJECTS: Female high-school pupils. OUTCOME MEASURES: Responses to questions pertaining to environmental as well as individual factors for each respondent ('dieting questionnaire'; self report). Total scores derived from a self-report questionnaire pertaining to eating attitudes (Eating Attitudes Test (EAT-26)). Statistical analysis, using analysis of variance procedures, to determine significant associations between the two questionnaires. RESULTS AND CONCLUSIONS: Specific individual wishes, perceptions, behaviours and topics of conversation appear to influence as well as predict eating attitudes. Family, especially maternal, factors play a role in determining eating attitudes. Peer and media (television) factors are not significantly influential. The findings provide preliminary data on factors that influence eating attitudes in a group at risk for the development of eating disorders. The findings have implications for the formulation of preventive strategies within a comprehensive treatment approach.

Severe head injury caused by airbag deployment.

Passenger-side airbags are present in over 21 million automobiles and will be required on all passenger vehicles by the model year 1999. Although airbags are effective supplemental restraint systems and have saved over 1,500 lives, airbag-related injuries have been reported. The National Highway Traffic Safety Administration recently reported 15 child deaths caused by airbag deployment. All of these children were believed to be improperly restrained in the front passenger position of a car equipped with a passenger-side airbag. This case represents the first serious injury caused by airbag deployment in a child that was properly positioned in an approved child restraint.

Lethal airbag injury in an infant.

Airbag injuries to automobile passengers are increasing in frequency, but the majority of reported injuries have been relatively minor and have occurred in adults. The National Highway Traffic Safety Administration (NHTSA) has identified a potentially lethal injury mechanism that occurs when safety seats are placed rear-facing on the passenger side of a vehicle equipped with a passenger side airbag. We report the first case of infant fatality resulting from passenger side airbag deployment that validates this mechanism.

The Animals (scientific procedures) Act 1986.

KIE: Hollands reviews the activities of the Committee for the Reform of Animal Experimentation (CRAE) in securing passage of Britain's 1986 Animals (Scientific Procedures) Act. Founded in 1978 to seek reform of the law governing animal experimentation, CRAE allied itself with the British Veterinary Association and the Fund for the Replacement of Animals in Medical Experiments (FRAME) to influence government policy. Accepting that the abolishment of all animal research was an unrealistic goal, CRAE set four objectives for new legislation: the restriction of pain, a substantial decrease in the number of experimental animals used, the development and use of alternative research methods, and public accountability. Hollands asserts that these goals have been achieved in the 1986 Act, with its strong provisions for animal research oversight by the Home Secretary. He also notes increased interest by scientific groups in monitoring animal experimentation.^ieng