A randomised, controlled, double-blind trial of ultrasound-guided phrenic nerve block to prevent shoulder pain after thoracic surgery.

Moderate to severe ipsilateral shoulder pain is a common complaint following thoracic surgery. In this prospective, parallel-group study at Odense University Hospital, 76 patients (aged > 18 years) scheduled for lobectomy or pneumonectomy were randomised 1:1 using a computer-generated list to receive an ultrasound-guided supraclavicular phrenic nerve block with 10 ml ropivacaine or 10 ml saline (placebo) immediately following surgery. A nerve catheter was subsequently inserted and treatment continued for 3 days. The study drug was pharmaceutically pre-packed in sequentially numbered identical vials assuring that all participants, healthcare providers and data collectors were blinded. The primary outcome was the incidence of unilateral shoulder pain within the first 6 h after surgery. Pain was evaluated using a numeric rating scale. Nine of 38 patients in the ropivacaine group and 26 of 38 patients in the placebo group experienced shoulder pain during the first 6 h after surgery (absolute risk reduction 44% (95% CI 22-67%), relative risk reduction 65% (95% CI 41-80%); p = 0.00009). No major complications, including respiratory compromise or nerve injury, were observed. We conclude that ultrasound-guided supraclavicular phrenic nerve block is an effective technique for reducing the incidence of ipsilateral shoulder pain after thoracic surgery.

Laboratory measurements of the viscous anisotropy of olivine aggregates.

A marked anisotropy in viscosity develops in Earth's mantle as deformation strongly aligns the crystallographic axes of the individual grains that comprise the rocks. On the basis of geodynamic simulations, processes significantly affected by viscous anisotropy include post-glacial rebound, foundering of lithosphere and melt production above subduction zones. However, an estimate of the magnitude of viscous anisotropy based on the results of deformation experiments on single crystals differs by three orders of magnitude from that obtained by grain-scale numerical models of deforming aggregates with strong crystallographic alignment. Complicating matters, recent experiments indicate that deformation of the uppermost mantle is dominated by dislocation-accommodated grain-boundary sliding, a mechanism not activated in experiments on single crystals and not included in numerical models. Here, using direct measurements of the viscous anisotropy of highly deformed polycrystalline olivine, we demonstrate a significant directional dependence of viscosity. Specifically, shear viscosities measured in high-strain torsion experiments are 15 times smaller than normal viscosities measured in subsequent tension tests performed parallel to the torsion axis. This anisotropy is approximately an order of magnitude larger than that predicted by grain-scale simulations. These results indicate that dislocation-accommodated grain-boundary sliding produces an appreciable anisotropy in rock viscosity. We propose that crystallographic alignment imparts viscous anisotropy because the rate of deformation is limited by the movement of dislocations through the interiors of the crystallographically aligned grains. The maximum degree of anisotropy is reached at geologically low shear strain (of about ten) such that deforming regions of the upper mantle will exhibit significant viscous anisotropy.

Quantitative trait loci affecting plant regeneration from protoplasts of Brassica oleracea.

Quantitative trait loci (QTLs) controlling the plant-regeneration ability of Brassica oleracea protoplasts were mapped in a population of 128 F(2) plants derived from a cross between the high-responding, rapid-cycling line and a low-responding, broccoli breeding line of B. oleracea. A modified bulked segregant analysis with AFLP markers identified two QTLs for plant regeneration. In a multiple regression analysis, the two QTLs explained 83% of the total genetic variation for regeneration recorded 15 weeks after initial transfer of microcalli to regeneration medium. Both QTLs showed additive effects, and the alleles contributing to the high regeneration frequencies were derived from the high-responding, rapid-cycling line. Using microsatellites with known location, the two QTLs were mapped to linkage groups O2 and O9 on the map published by Sebastian et al. [(2000) Theor Appl Genet 100:75-81] or to chromosomes C8 and C7 on the map published by Saal et al. [(2001) Theor Appl Genet 102:695-699]. QTLs for the early flowering trait of the rapid-cycling parent have previously been mapped to the same two linkage groups. Association between flowering time and regeneration ability was, however, not found in the present material, indicating that plant-regeneration ability can be transferred between cultivars independently of the early flowering trait. The detection of two major QTLs for plant regeneration in B. oleracea may provide the initial step towards the identification of markers suitable for marker-assisted selection of regeneration ability.

Need for bilateral arthroplasty for coxarthrosis. 1,477 replacements in 1,199 patients followed for 0-14 years.

During the 10-year period 1981-1990, 1,199 patients in the county of South Jutland, Denmark, had 1,477 primary total hip arthroplasties (THA) performed because of primary arthrosis (OA). The patients were followed until the end of 1994, with a mean follow-up of 5.6 (0-14) years. Bilateral operations were performed on 356 patients, whereas 248 patients had died with only 1 THA. The cumulated risk of replacement of the contralateral hip was approximately 0.15 1 year after replacement of the first hip, 0.20 after 2 years, 0.29 after 5 years and 0.47 after 10 years, respectively. During the follow-up period, the demand for a THA of the contralateral hip continued to be approximately 15 times higher than in the general population.

Neonatal Salmonella meningitis: two case reports.

Two cases of neonatal Salmonella meningitis are reported. Both infants were seriously ill: one died 6 days after admittance to the hospital; the other required artificial ventilation for 4 days and recovered without sequelae. In both cases close relatives had shown signs of gastrointestinal infection just prior to the reported cases. The symptoms, the outcome and antibiotic treatment are discussed. In view of the increasing incidence of salmonella infections in Denmark and the serious prognosis of neonatal meningitis, it is important to consider the diagnosis in all cases of bacterial meningitis in infancy.

[Severe systemic infection with Vibrio vulnificus]. / Alvorlig systemisk infektion med Vibrio vulnificus.

Infections with Vibrio vulnificus are not common in Denmark, but in 1994 several cases were identified, probably due to the very hot weather conditions, with seawater temperatures above 20 degrees C. Two cases of infection with V. vulnificus are presented.

Transfer of resistance to Xanthomonas campestris pv campestris into Brassica oleracea L. by protoplast fusion.

Black rot caused by the bacterium Xanthomonas campestris pv campestris is one of the most serious diseases of Brassica oleracea. Since sources of resistance to the disease within B. oleracea are insufficient and control means are limited, the development of resistant breeding lines is extremely desirable. Certain lines of B. napus contain very high resistance controlled by a dominant gene, but crossing the two species sexually is very difficult. Therefore, somatic hybrids were produced by protoplast fusion between rapid cycling B. oleracea and a B. napus line highly resistant to X. campestris pv campestris. Hybrid identity was confirmed by morphological studies, flow cytometric estimation of nuclear DNA content, and analysis of random amplified polymorphic DNA (RAPD). Inoculations with the pathogen identified four somatic hybrids with high resistance. The resistant hybrid plants were fertile and set seed when selfed or crossed reciprocally to the bridge line '15' (Quazi 1988). Direct crosses to B. oleracea were unsuccessful, but embryo rescue facilitated the production of a first-backcross generation. The BC1 plants were resistant to the pathogen. Progeny from the crosses to 'line 15' were all susceptible. Embryo rescue techniques were not obligatory for the development of a second-backcross generation, and several resistant BC2 plants were obtained.

Novel flowering and fatty acid characters in rapid cycling Brassica napus L. resynthesized by protoplast fusion.

Novel rapid cycling Brassica napus lines have been produced by protoplast fusion between rapid cycling B. oleracea and rapid cycling B. rapa. Fusion products were selected based on iodoacetate inactivation and regeneration ability. A total of 36 plants was recovered from 3 regenerating calli. All were confirmed as somatic hybrids by morphological features, flow cytometric estimation of nuclear DNA content, RAPD analysis and/or DNA hybridization. Plants from two of the calli contained chloroplasts from B. rapa, and plants from the third contained B. oleracea chloroplasts. Some plants flowered in vitro, but on average flowering was initiated 22 days after transfer to soil. Although seed set was fairly low after self pollination, more seeds were obtained from pollination of open flowers than from pollination of buds. Seeds of the somatic hybrid B. napus showed novel fatty acid compositions, different from the mean of the two parental lines. Flowering was monitored in plants grown from seeds of the somatic hybrids, rapid cycling B. napus (CrGC 5-1) and the two diploid parental genotypes. Progeny of the somatic hybrids flowered faster and were more vigorous than rapid cycling B. napus (CrGC 5-1). The improved lines contain chloroplasts from B. rapa, unlike rapid cycling B. napus (CrGC 5-1), which has B. oleracea chloroplasts. The somatic hybrid lines produced may be useful for genetic studies or further in vitro manipulations.

Regeneration of plants from protoplasts of rapid cycling Brassica oleracea L.

Rapid cycling Brassica species have great potential in plant genetic research because of their short life cycles and their minimal space requirements. Rapid cycling B. oleracea can be grown with up to six generations per year. Protoplast culture of this genotype can be applied for gene transfer by direct DNA uptake and by protoplast fusion. We here report on fast regeneration of flowering plants from protoplasts of rapid cycling B. oleracea. Regeneration frequencies of 27-65% were achieved with multiple shoots developing from individual calli. The regenerated plants were grown to maturity, and flowering and other morphological characteristics were monitored. The regenerants flowered within a similar time frame as plants grown from seeds. The ploidy level of regenerated and seed-grown plants was measured by flow cytometry. Many (20-45%) of the regenerants were tetraploid. Although only few seeds could be obtained from the tetraploids, large numbers of seeds with good germination were recovered from the diploid regenerants.

[Age and sex specific incidence of primary total hip alloplasty in the county of Southern Jutland]. / Alders- og kønsspecifik incidens af primaer total hoftealloplastik i Sønderjyllands Amt.

During the 10-year period 1981-90, 1752 primary total hip arthroplasties (THAs) were performed in the county of south Jutland, Denmark. The annual number of THA increased until a steady state level was reached during 1988-90. The age and sex specific incidences were calculated for this period using the population distribution of the County. The age specific incidences were highest in the age-group 70-79 years for both female and males, namely respectively 485 and 410 THAs per 100,000 inhabitants. The overall incidence was 82 THA per 100,000 inhabitants. During the next 30 years, the demand for primary THA in Denmark is expected to increase 32 percent (from 4013 to 5307 THAs) as a consequence of demographic changes.

Hip arthroplasty in Jutland, Denmark. Age and sex-specific incidences of primary operations.

During the 10-year period 1981-90, 1752 primary total hip arthroplasties were performed in the County of South Jutland, Denmark. The annual number increased to a steady state during 1988-90. In this period, the incidence was highest in the age group 70-79 years for both women and men, with 485 and 410 arthroplasties per 100,000 inhabitants, respectively; the overall incidence was 82 per 100,000 inhabitants. During the next 30 years, the demand for primary hip arthroplasties in Denmark is expected to increase because of demographic changes.