Phylogeny of raspberry beetles and other Byturidae (Coleoptera).

Nuclear ribosomal ITS2 and mitochondrial cytochrome oxidase DNA sequences were analysed from the Byturidae (Coleoptera), which includes the raspberry beetles. The secondary structure of ITS2 was plotted and interspecific changes analysed. Evidence for selection on simple sequence repeats within the ITS2 was found. Phylogenetic trees based on the mitochondrial and ribosomal sequences were compared. They were in parity, indicating they reflect the true evolutionary histories of these insects. There was no evidence for hybridization in the populations surveyed, but there was evidence that the American raspberry beetle, Byturus unicolor, is divided into at least three distinct groupings. Despite sharing a related host, the raspberry pests from America were not the most related to the European raspberry beetle. Instead, links between Byturus affinis from Japan and the American raspberry beetle suggest that this lineage originated in Asia and colonized the Western USA.

Health care worker disability due to latex allergy and asthma: a cost analysis.

OBJECTIVES: The reported prevalence of occupational allergy to natural rubber latex is 8% to 17%, and that of latex-induced occupational asthma is 2.5% to 6%. Conversion of medical facilities to "latex-safe" can reduce employee sensitization, impairment, and disability. The purpose of this study was to determine the cost of a latex-safe approach, compared with that of continued latex glove use, and to identify the level of worker disability required to make the latex-safe approach financially preferable to a health care institution. METHODS: The costs of 2 strategies--latex-safe vs the status quo--were calculated from the perspective of 3 health care institutions. A break-even point was calculated for each facility. RESULTS: In all facilities, the cost of using nonlatex gloves exceeded the cost of using latex gloves. In all 3 facilities, however, 1% or fewer of those at risk would have to become fully disabled or fewer than 2% would have to become partially disabled for the continued use of latex gloves to exceed the cost of the latex-safe approach. CONCLUSION: Health care facilities, regardless of size, are likely to benefit financially from becoming latex-safe even if latex-related disability levels are extremely low.

Modified radical hysterectomy in the treatment of early squamous cervical cancer.

OBJECTIVE: The aim of this study was to evaluate the results of modified radical hysterectomy in the treatment of early cervical cancer. MATERIAL AND METHODS: A retrospective chart review of 56 patients with stage I (IA in 35, IB in 21) squamous cervical carcinoma treated with modified radical hysterectomy and followed for a minimum of 5 years (mean, 12 years; range, 5.1-29) was conducted. All pathology slides were reviewed for tumor size, grade, depth of invasion, and lymph-vascular permeation. RESULTS: The mean depth of invasion was 0.5 cm (range, 0.1-2.5 cm), and the mean tumor size was 1.1 cm (range, 0.1-7 cm). Only 3 patients (5.4%) had positive nodes. None of the patients with tumors 2 cm or less in size had positive nodes, whereas 33.3% of the patients with tumors more than 2 cm in size had positive nodes. A recurrence developed in 2 patients (5-year recurrence rate of 3.6%). There were 10 deaths during the entire follow-up period, but only 2 were related to cervical cancer. The disease-specific and overall 5-year survival rates were 96.4 and 94.6%, respectively. The disease-specific 5-year survival rate was 100% among the 47 patients with tumors 2 cm or less and 75% for the 9 patients with tumors larger than 2 cm. Univariate analysis identified stage, lymph node status, and tumor size as statistically significant prognostic factors for overall survival. Tumor grade, lymph-vascular permeation, and depth of invasion (1-3 mm vs >3 mm) were not statistically significant for overall survival. CONCLUSIONS: Modified radical hysterectomy appears to be effective surgical therapy for patients with squamous cervical carcinoma 2 cm or less in size.

Modified radical hysterectomy: morbidity and mortality.

Among 375 patients who underwent a modified radical hysterectomy at the Mayo Clinic, the complication rate was 24%, and the operative mortality was 0.5%. When compared with radical hysterectomy, this procedure is associated with a lower overall incidence of complications, particularly those related to the urinary tract.

Magnetic resonance imaging of pelvic floor relaxation: dynamic analysis and evaluation of patients before and after surgical repair.

OBJECTIVE: To evaluate structures involved in pelvic support using conventional and snapshot magnetic resonance imaging (MRI). METHODS: We used conventional spin-echo MRI and dynamic snapshot GRASS MRI at various levels of the Valsalva maneuver to describe and quantitate the anatomy of pelvic floor relaxation and to assess anatomical changes produced by surgical repair. Ten female volunteers were evaluated to define normal anatomy and reference measurements. Five women with pelvic floor relaxation were evaluated before and after surgical repair. RESULTS: Static and dynamic MRI were more sensitive than clinical pelvic examination in assessing and grading pelvic floor relaxation. Quantitative results showed widening of the levator hiatus and more vertical lie of the levator plate postoperatively. Descent of the pelvic organs on maximal straining postoperatively was the same as that in normal volunteers. The posterior urethrovesical angle on MRI was more than 110 degrees in 14 of 15 continent subjects. CONCLUSIONS: Magnetic resonance imaging may be valuable in analyzing and assessing pelvic floor relaxation and in understanding anatomical changes occurring before and after surgical repair. The increased sensitivity of MRI in grading prolapse may make it useful in evaluating women with symptoms of pelvic floor relaxation but who have negative findings on clinical examination.

Portal vein thrombosis associated with pregnancy. A case report.

This report illustrates a case of portal vein thrombosis that developed in the second trimester of pregnancy. The patient did not have any of the known associations or predisposing factors for portal vein thrombosis or any past medical history of thrombosis or bleeding disorders. Antepartum and postpartum laboratory studies showed no evidence of a coagulation disorder; therefore, it seems that the sole cause of this thrombotic event was the hypercoagulable state of pregnancy.