Transsphenoidal hypophysectomy for the treatment of hypersomatotropism secondary to a pituitary somatotroph adenoma in a dog.

Pituitary-dependent hypersomatotropism is rarely diagnosed in dogs and surgical treatment is not reported. A 6-year-10-month male neutered Patterdale Terrier presented with polyuria, polydipsia, progressive pharyngeal stertor, excessive hair growth and widened facial features and paws. Serum insulin-like growth factor-1 concentration via radioimmunoassay was consistent with hypersomatotropism (1783 ng/mL). A pituitary mass was identified on magnetic resonance and computed tomography imaging. Six weeks later, glucosuria, starved hyperglycemia and serum fructosamine above the reference range (467.6 µmol/L, RI 177-314) were documented, consistent with diabetes mellitus. Transsphenoidal hypophysectomy was performed under general anesthesia without complications. Pituitary histopathology identified an acidophil neoplasm, with positive immunostaining for growth hormone. Postoperatively, there was rapid resolution of clinical, biochemical and morphologic changes of hypersomatotropism with persistence of diabetes mellitus. This case demonstrates successful resolution of hypersomatotropism with ongoing diabetes mellitus in a dog after surgical treatment by transsphenoidal hypophysectomy.

DNA barcoding identifies cryptic animal tool materials.

Some animals fashion tools or constructions out of plant materials to aid foraging, reproduction, self-maintenance, or protection. Their choice of raw materials can affect the structure and properties of the resulting artifacts, with considerable fitness consequences. Documenting animals' material preferences is challenging, however, as manufacture behavior is often difficult to observe directly, and materials may be processed so heavily that they lack identifying features. Here, we use DNA barcoding to identify, from just a few recovered tool specimens, the plant species New Caledonian crows (Corvus moneduloides) use for crafting elaborate hooked stick tools in one of our long-term study populations. The method succeeded where extensive fieldwork using an array of conventional approaches-including targeted observations, camera traps, radio-tracking, bird-mounted video cameras, and behavioral experiments with wild and temporarily captive subjects-had failed. We believe that DNA barcoding will prove useful for investigating many other tool and construction behaviors, helping to unlock significant research potential across a wide range of study systems.

Increased insulin-like growth factor 1 concentrations in a retrospective population of non-diabetic cats diagnosed with hypertrophic cardiomyopathy.

OBJECTIVES: The aim of the study was to document whether a proportion of non-diabetic cats with left ventricular hypertrophy (LVH) previously diagnosed with hypertrophic cardiomyopathy (HCM) have elevated circulating insulin-like growth factor 1 (IGF-1) concentrations. METHODS: A retrospective analysis of residual blood samples obtained at the time of echocardiographic diagnosis of HCM from a population of 60 non-diabetic cats were analysed for circulating IGF-1 concentrations using a validated radioimmunoassay and compared with a control group of 16 apparently healthy cats without LVH. Clinical and echocardiographic data for cats with an IGF-1 level >1000 ng/ml were compared with those with an IGF-1 level <800 ng/ml. RESULTS: In total, 6.7% (95% confidence interval 1.8-16.2%) of cats with HCM had an IGF-1 level >1000 ng/ml. The prevalence of an IGF-1 level >1000 ng/ml in the control group was zero. CONCLUSIONS AND RELEVANCE: A small proportion of non-diabetic cats previously diagnosed with HCM had an IGF-1 concentration at a level that has been associated with feline hypersomatotropism (fHS) in the diabetic cat population. Further prospective research is required to confirm or refute the presence of fHS in non-diabetic cats with LVH and increased IGF-1.

Examining the mechanisms underlying the acquisition of animal tool behaviour.

Despite major advances in the study of animal tool behaviour, researchers continue to debate how exactly certain behaviours are acquired. While specific mechanisms, such as genetic predispositions or action copying, are sometimes suspected to play a major role in behavioural acquisition, controlled experiments are required to provide conclusive evidence. In this opinion piece, we refer to classic ethological methodologies to emphasize the need for studying the relative contributions of different factors to the emergence of specific tool behaviours. We describe a methodology, consisting of a carefully staged series of baseline and social-learning conditions, that enables us to tease apart the roles of different mechanisms in the development of behavioural repertoires. Experiments employing our proposed methodology will not only advance our understanding of animal learning and culture, but as a result, will also help inform hypotheses about human cognitive, cultural and technological evolution. More generally, our conceptual framework is suitable for guiding the detailed investigation of other seemingly complex animal behaviours.

Dominance relationships and coalitionary aggression against conspecifics in female carrion crows.

Cooperation is a prevailing feature of many animal systems. Coalitionary aggression, where a group of individuals engages in coordinated behaviour to the detriment of conspecific targets, is a form of cooperation involving complex social interactions. To date, evidence has been dominated by studies in humans and other primates with a clear bias towards studies of male-male coalitions. We here characterize coalitionary aggression behaviour in a group of female carrion crows consisting of recruitment, coordinated chase, and attack. The individual of highest social rank liaised with the second most dominant individual to engage in coordinated chase and attack of a lower ranked crow on several occasions. Despite active intervention by the third most highly ranked individual opposing the offenders, the attack finally resulted in the death of the victim. All individuals were unrelated, of the same sex, and naïve to the behaviour excluding kinship, reproduction, and social learning as possible drivers. Instead, the coalition may reflect a strategy of the dominant individual to secure long-term social benefits. Overall, the study provides evidence that members of the crow family engage in coordinated alliances directed against conspecifics as a possible means to manipulate their social environment.

Characterizing Students' Ideas about the Effects of a Mutation in a Noncoding Region of DNA.

Understanding student ideas in large-enrollment biology courses can be challenging, because easy-to-administer multiple-choice questions frequently do not fully capture the diversity of student ideas. As part of the Automated Analysis of Constructed Responses (AACR) project, we designed a question prompting students to describe the possible effects of a mutation in a noncoding region of DNA. We characterized answers from 1127 students enrolled in eight different large-enrollment introductory biology courses at three different institutions over five semesters and generated an analytic scoring system containing three categories of correct ideas and five categories of incorrect ideas. We iteratively developed a computer model for scoring student answers and tested the model before and after implementing an instructional activity designed to help a new set of students explore this concept. After completing a targeted activity and re-answering the question, students showed improvement from preassessment, with 64% of students in incorrect and 67% of students in partially incorrect (mixed) categories shifting to correct ideas only. This question, computer-scoring model, and instructional activity can now be reliably used by other instructors to better understand and characterize student ideas on the effects of mutations outside a gene-coding region.

Robot-assisted laparoscopic pyeloplasty: Multi-institutional experience in infants.

INTRODUCTION: Robot-assisted laparoscopic pyeloplasty (RALP) has been gaining acceptance among pediatric urologists. Over 300 have been described in the literature, but few studies have evaluated the role of RALP in infants alone. OBJECTIVE: We sought to examine the operative experience and outcomes of RALP in a cohort of infants treated at multiple institutions across the United States. Our primary aim was to describe the safety and efficacy of RALP within this cohort. We recognize the challenges of performing minimally invasive surgery in small patients. In our paper, we address some technical considerations for the infant population. STUDY DESIGN: This multi-centered observational study collected data on subjects one year of age or less who underwent RALP between April 2006 and July 2012 at five institutions. The primary outcome was resolution of hydronephrosis, and secondary outcomes included surgical time and complications. RESULTS: A total of 60 patients (62 procedures) underwent RALP by six surgeons during the study period. All surgeons had > 5 years of experience beyond fellowship training. Mean surgical age was 7.3 months (SD ± 1.7 mo), 56 patients (95%) were diagnosed prenatally, and 59 patients (95%) had follow up imaging. Of these patients, 91% showed resolution or improvement of hydronephrosis. Two patients had recurrent obstruction and required additional surgery. Mean surgical time was 3 hours 52 minutes (SD ± 43 minutes). Seven (11%) patients reported intra-operative or immediate post-operative complications. DISCUSSION: This series found a 91% success rate for reduction or resolution of hydronephrosis, and an 11% complication rate. This is equivalent to modern series comparing open pyeloplasty to pure laparoscopic and robotic-assisted laparoscopic pyeloplasty, which report success rates ranging from 70-96%, and complication rates ranging from 0-24% for open pyeloplasty. We lacked a standardized technique amongst institutions. This was not surprising since there are not established technical benchmarks for this surgery. However, we specified multiple technical considerations for this unique patient population. CONCLUSION: The advantages of using robot-assistance to perform pyeloplasty in infants remain to be defined. This study cannot make that assessment due to small sample size. Nonetheless, this cohort is the largest robotic pyeloplasty series in infants to date. Seeing an excellent success rate and a low complication rate in this infant cohort is encouraging.

Colour preferences in nest-building zebra finches.

Some bird species are selective in the materials they choose for nest building, preferring, for example, materials of one colour to others. However, in many cases the cause of these preferences is not clear. One of those species is the zebra finch, which exhibits strong preferences for particular colours of nest material. In an attempt to determine why these birds strongly prefer one colour of material over another, we compared the preferences of paired male zebra finches for nest material colour with their preferences for food of the same colours. We found that birds did indeed prefer particular colours of nest material (in most cases blue) but that they did not generally prefer food of one colour over the other colours. It appears, then, that a preference for one colour or another of nest material is specific to the nest-building context. This article is part of a Special Issue entitled: insert SI title.

Pathogen prevalence, group bias, and collectivism in the standard cross-cultural sample.

It has been argued that people in areas with high pathogen loads will be more likely to avoid outsiders, to be biased in favor of in-groups, and to hold collectivist and conformist values. Cross-national studies have supported these predictions. In this paper we provide new pathogen codes for the 186 cultures of the Standard Cross-Cultural Sample and use them, together with existing pathogen and ethnographic data, to try to replicate these cross-national findings. In support of the theory, we found that cultures in high pathogen areas were more likely to socialize children toward collectivist values (obedience rather than self-reliance). There was some evidence that pathogens were associated with reduced adult dispersal. However, we found no evidence of an association between pathogens and our measures of group bias (in-group loyalty and xenophobia) or intergroup contact.

Serious and life-threatening pregnancy-related infections: opportunities to reduce the global burden.

Michael Gravett and colleagues review the burden of pregnancy-related infections, especially in low- and middle-income countries, and offer suggestions for a more effective intervention strategy.

Emerging technologies for point-of-care CD4 T-lymphocyte counting.

A CD4 T-lymphocyte count determines eligibility for antiretroviral therapy (ART) in patients recently diagnosed with HIV and also monitors the efficacy of ART treatment thereafter. ART slows the progression of HIV to AIDS. In the developing world, CD4 tests are often performed in centralized laboratories, typically in urban areas. The expansion of ART programs into rural areas has created a need for rapid CD4 counting because logistical barriers can delay the timely dissemination of test results and affect patient care through delay in intervention or loss of follow-up care. CD4 measurement at the point-of-care (POC) in rural areas could help the facilitation of ART and monitoring of treatment. This review highlights recent technology developments with applications towards determining CD4 counts at the POC.

Changes in condylar cartilage after anterior mandibular displacement in juvenile pigs.

UNLABELLED: Adaptive remodelling of the mandibular condyle in response to mandibular advancement is the mechanism exploited by orthodontic forward displacement devices. OBJECTIVE: This work investigated the expression of collagens, matrix metalloproteinases and vascular endothelial growth factor during this process. DESIGN: Twenty juvenile pigs were randomly divided into two experimental groups, where the treatment group was fitted with mandibular advancement splints, and the control group was not. Changes in the mRNA content of condylar cartilage tissue was then were measured by real-time PCR using specific primers after 4weeks of treatment. RESULTS: The temporal pattern of the expression of Col1 and MMP13 during condylar adaptation coincided with that during natural condylar growth. The amount of the expression of Col10 during condylar adaptation was significantly lower (p<0.05), whereas the expression of Col2, MMP8 and VEGF was significantly higher compared to natural growth (p<0.05). CONCLUSIONS: It is suggested that condylar adaptation in growing pigs triggered by mandibular forward positioning results not only from passive adaptation of cartilage, but also involves growth affected processes. Our results showed that mechanical strain produced by mandibular advancement induced remodelling and revascularization in the posteriocranial mandibular condyle. These results are mostly consistent with former published histological and histomorphometrical analyses.

Behavioral and perceived stressor effects on urinary catecholamine excretion in adult Samoans.

OBJECTIVES: The effects of perceptions and behaviors related to culturally patterned socioeconomic obligations on catecholamine excretion rates were studied in a cross-sectional sample of Samoan adults. METHODS: A total of 378 participants, ages 29-62 years, from 9 villages throughout Samoa, provided timed overnight urine specimens, and self-reported perceptions and behaviors associated with contributions to one's family, aiga, and chief, matai, and communal gift exchanges, fa'alavelave. Urinary norepinephrine and epinephrine excretion rates were measured by high performance liquid chromatography with electrochemical detection. Age (≤40 vs. >40 years) and gender-specific regression models were estimated to detect associations with catecholamine excretion. RESULTS: Young women who contribute more to their matai, who consider fa'alavelave to be a financial strain, and who view their contribution to their matai to be "just right," had significantly higher residence-adjusted norepinephrine excretion. Young women who contribute more to their matai, who consider fa'alavelave to be a financial strain, and who consider their contribution to their aiga not to be a burden, had higher epinephrine excretion. Older men who contribute more to their aiga and who perceive their contribution to their aiga to be "just right" had increased residence-adjusted epinephrine excretion. CONCLUSIONS: Individual-level perceptions and behaviors related to traditional socioeconomic obligations are a significant correlate of increased overnight catecholamine excretion rates. Higher excretion rates may be attributed to psychosocial stress arousal associated with a discordance between personal desires for upward social mobility, and family and community-based socioeconomic obligations. Changes in patterns of individual-level psychosocial stress arousal may contribute to cardiovascular disease risk in modernizing Samoans.

Low yield of early postoperative imaging after anastomotic urethroplasty.

OBJECTIVES: To evaluate the necessity and clinical effect of posturethroplasty imaging. METHODS: We reviewed our database of all urethroplasties performed by a single surgeon at our referral center during a 2-year period. The patients underwent voiding cystourethrography at a mean of 24 days postoperatively. The data analyzed included patient history and demographics, operative details, imaging results, and clinical outcomes. RESULTS: From 2007 to 2009, 210 patients underwent urethral reconstruction at our center. The patients undergoing meatoplasty or staged repairs were excluded, leaving 156 patients with postoperative imaging studies for analysis. Of 110 anterior urethroplasties, 59 (54%) consisted of excision and primary anastomosis, 28 (25%) an augmented anastomotic procedure, and 23 (21%) a pure ventral onlay with a flap or graft. All 46 posterior urethroplasties were performed with scar excision and primary anastomosis. Of the 156 patients, only 4 (3%) had extravasation on postoperative voiding cystourethrography (2 after posterior urethroplasty, 1 after augmented anastomosis, and 1 after ventral onlay)--all were successfully managed with catheter replacement and removal at a mean of 8 days afterward. None of the 59 men undergoing excision and primary anastomosis demonstrated extravasation. CONCLUSIONS: Extravasation on posturethroplasty voiding cystourethrography is rare after approximately 3 weeks of catheter drainage. Imaging can be omitted after uncomplicated excision and primary anastomosis urethroplasty.

Anterolateral thigh free flap for "head-to-toe" reconstruction.

Since its conception the anterolateral thigh (ALT) free flap has become a cornerstone in the reconstruction of complex head and neck defects. It has quickly gained further uses because of its variability in size, malleability, 2-team approach to the operation, and low-morbidity donor site. The ALT lends itself well to reconstructing complex defects throughout the body, from the lower extremities up to the head and neck, and a variety of indications, from oncologic defects to burns and traumatic injuries. Twenty patients (18 male, 2 female; average age 57.74 years [range, 17-86 years]) had ALT free-flap harvest for scalp defects (5), trunk defects (1), head and neck defects (11), lower extremity defects (3). Sixteen patients had oncologic-related defects, 2 from traumatic injuries, and 2 from burn-related injuries. The average flap area was 157 cm, the average number venous anastomoses was 1.47, and the average vein diameter was 2.65 mm (range, 1.5-3.5 mm). The objective of this article is to review our institutional review board-approved case series at the University of Florida and further elucidate the widespread adaptability of the ALT flap. We share our experience in indications for use, recipient-site variables, donor-site management, complications, and outcomes. We also review other applications of this useful flap described in the literature.

Urethral rest: role and rationale in preparation for anterior urethroplasty.

OBJECTIVES: To report the outcomes of men treated initially with a period of urethral rest to allow tissue recovery before anterior urethroplasty. Many men referred to referral centers for anterior urethral reconstruction often present soon after the endoscopic manipulation of severe strictures. METHODS: We reviewed our database of all anterior urethroplasties performed by a single surgeon from 2007 to 2009. Urethral rest was accomplished by removal of the indwelling catheter, cessation of self-catheterization, and/or suprapubic urinary diversion before urethral reconstruction. RESULTS: During the study period, 210 patients underwent urethral reconstruction at our center. Men who had undergone meatoplasty or posterior urethroplasty were excluded, leaving 128 anterior urethroplasty patients available for analysis. Of these men, 28 (21%) were preoperatively given an initial period of urethral rest (median duration 3 months) because of recent urologic manipulation occurring immediately before referral. Of the 28 patients, 15 (54%) received suprapubic catheters. Urethral rest promoted identification of severely fibrotic stricture segments, enabling focal or complete excision in 75% (excision and primary anastomosis in 12 [43%] and augmented anastomosis in 9 [32%]), a percentage similar to that for those undergoing reconstruction without preliminary manipulation mandating urethral rest (82%). Stricture recurrence developed in 4 (14%) of the 28 rest patients, a rate again similar to that for the remainder of the urethroplasty population (10%). CONCLUSIONS: The results of our study have shown that recently manipulated anterior urethral strictures often declare themselves to be obliterative within several months of urethral rest, thus enabling successful urethroplasty by focal or complete excision.

Three-year experience using near infrared spectroscopy tissue oximetry monitoring of free tissue transfers.

Early recognition of threatened free-flap failure is paramount to flap salvage. A noninvasive, reproducible, sensitive monitoring tool would be a useful adjunct to clinical examination. The purpose of this study was to examine outcomes using a near-infrared spectroscopy (NIRS) tissue oximeter for postoperative flap monitoring. A total of 128 free flaps were performed in 113 patients over a 3 year period. The patients were divided into 2 cohorts: conventional monitoring (group 1) and conventional monitoring plus NIRS oximetry (group 2). Overall flap survival was 90.6% in group 1 and 98.7% in group 2 (P = 0.05). Overall survival of threatened flaps was 0% (0/5) in the conventional group and 87.5% (6/7) in the oximeter group, P = 0.005. Salvage of operated flaps was significantly improved in group 2: 0% (0/4) in group 1 versus 100% (3/3) in group 2, P = 0.03. The sensitivity, specificity, and predictive values for detecting threatened flap loss were 100%. The NIRS tissue oximeter is a highly reliable, sensitive, and specific, noninvasive method for postoperative free tissue transfer monitoring.

Complex hernia repair using component separation technique paired with intraperitoneal acellular porcine dermis and synthetic mesh overlay.

Repairing complicated, recurrent ventral hernias poses many challenges and frustrations for both the patient and the surgeon. Patients with histories of multiple abdominal procedures, infection, and previous hernia repair are at higher risk for recurrence. They must be dealt with through a more sophisticated approach than the patient presenting with an initial hernia or even a simple recurrence. We describe our experience with 18 patients using component separation technique paired with acellular porcine dermis. We specifically focus on the use of intraperitoneal biologic mesh paired with a synthetic overlay. There were no hernia recurrences during the follow-up period: average 14 months (range, 4-24 months, 100% follow-up). Complications included seromas, wound breakdown, and infection; several of these requiring reoperation. The successful management of complicated hernias has been revolutionized by new synthetic and bioprosthetic meshes. However, these products, when used alone in complex hernia patients carry a higher recurrence rate. We have found that these meshes, used in conjunction with component separation technique, have had no recurrence to date, but are prone to complications.

Ecological and sociodemographic effects on urinary catecholamine excretion in adult Samoans.

BACKGROUND: Ecological and sociodemographic correlates of stress may contribute to cardiovascular disease risk in modernizing Samoans. AIM: The effects of peri-urban vs rural residence, education, occupation, caffeine intake and cigarette consumption on urinary catecholamine excretion were studied in Samoan adults. SUBJECTS AND METHODS: Five hundred and seven participants, aged 29-69 years, were randomly selected from nine villages throughout Samoa. Sociodemographic and lifestyle factors were assessed by questionnaire. Epinephrine and norepinephrine excretion rates were measured by high performance liquid chromatography with electrochemical detection in overnight urine samples. Age ( ≤ 40 vs >40 years) and gender-specific regression models were estimated to detect associations with BMI-adjusted catecholamine excretion. RESULTS: Norepinephrine was significantly higher in peri-urban young men and older women. Epinephrine was significantly higher in peri-urban older men. Adjustment for caffeine attenuated the relationship between residence and norepinephrine in young women. CONCLUSION: General residential exposure to modernization in urban villages is a significant correlate of increased overnight catecholamine excretion rates and is consistent with past studies. Caffeine consumption in younger women plays a complex role in stress-related catecholamine excretion. Further studies of individual level attitudinal and behavioural factors in Samoans are needed to understand psychosocial stress, physiologic arousal and health.