Intravesical protrusion of giant median prostatic lobe: A case report.

Benign prostatic hyperplasia (BPH) is a common disease in ageing men and the result of unregulated hyperplastic growth of the epithelial and stromal tissues of the prostate. Intravesical prostatic protrusion (IPP) of the median lobe is a phenomenon of overgrowth of the prostate adenoma into the bladder and associated with an increased risk for lower urinary tract symptoms (LUTS). This article reports an unusual case of severe intravesical protrusion of a giant median prostatic lobe in 85 years old male with progressive LUTS.

Carboxyhaemoglobin formation and ECG changes during hysteroscopic surgery, transurethral prostatectomy and tonsillectomy using bipolar diathermy.

Diathermy is known to produce a mixture of waste products including carbon monoxide. During transcervical hysteroscopic surgery, carbon monoxide might enter the circulation leading to the formation of carboxyhaemoglobin. In 20 patients scheduled for transcervical hysteroscopic resection of myoma or endometrium, carboxyhaemoglobin was measured before and at the end of the surgical procedure, and compared with levels measured in 20 patients during transurethral prostatectomy, and in 20 patients during tonsillectomy. Haemodynamic data, including ST-segment changes, were recorded. Levels of carboxyhaemoglobin increased significantly during hysteroscopic surgery from median (IQR [range]) 1.0% (0.7-1.4 [0.5-4.9])% to 3.5% (2.0-6.1 [1.3-10.3]%, p < 0.001), compared with levels during prostatectomy or tonsillectomy. Significant ST-segment changes were observed in 50% of the patients during hysteroscopic surgery. Significant correlations were observed between the increase in carboxyhaemoglobin and the maximum ST-segment change (ρ = -0.707, p < 0.01), between the increase in carboxyhaemoglobin and intravasation (ρ = 0.625; p < 0.01), and between intravasation and the maximum ST-segment change (ρ = -0.761; p < 0.01). The increased carboxyhaemoglobin levels during hysteroscopic surgery appear to be related to the amount of intravasation and this could potentially be a contributing factor to the observed ST-segment changes.

First Report of Iris yellow spot virus on Onion in Canada.

Iris yellow spot virus (IYSV; family Bunyaviridae, genus Tospovirus) is an economically important viral pathogen of onion vectored by onion thrips (Thrips tabaci Lindeman). Rapid spread of IYSV has occurred in the western United States and Georgia, with recent reports of IYSV from New York in the northeastern United States (1). In June and mid-July of 2007, symptomatic plants were found in Ontario, Canada in onions grown from sets in a home garden in Grey County (44°27'N, 80°53'W) and on a small commercial farm in Ottawa-Carleton County (45°14'N, 75°28'W), respectively. In the home garden, bleached, elongated lesions with tapered ends occurred on middle-aged leaves of 30% of 100 plants. By August 2007, 91% of these plants were symptomatic. In Ottawa-Carleton, two lesions with green centers and yellow borders occurred on a single leaf of a single plant in a field of 1,120 plants. Symptomatic leaf tissue tested positive for IYSV by IYSV-specific antiserum from Agdia Inc. (Elkhart, IN) in a double-antibody sandwich (DAS)-ELISA. These two isolated and remote finds of IYSV in Ontario prompted a survey in early August of 2007 of the Holland Marsh (44°5'N, 79°35'W), the largest onion-producing region in Ontario. Nine onion fields separated geographically across the Holland Marsh Region were scouted and one to three samples of symptomatic tissue per field were analyzed by DAS-ELISA. IYSV was confirmed in seven of nine (78%) fields surveyed and in 13 of 16 (81%) of the individual samples. A reverse transcription (RT)-PCR assay was used to verify the presence of IYSV in one new symptomatic tissue sample per field collected from three of the fields where IYSV was confirmed by ELISA. Primers specific to the small (S) RNA of IYSV (5'-TAA AAC AAA CAT TCA AAC AA-3' and 5'-CTC TTA AAC ACA TTT AAC AAG CAC-3') were used (2). The resulting 1.2-kb amplicon, which included the 772-bp nucleocapsid (N) gene was cloned and sequenced. Sequence analysis showed that the N gene of the Ontario isolate (GenBank Accession No. EU287943) shared 92 to 98% nucleotide sequence identity with known IYSV N gene sequences. The highest nucleotide sequence identity (98%) was with Genbank Accession Nos. DQ233475 and DQ233472. To our knowledge, this is the first report of IYSV infection of onion in Ontario and Canada. This finding confirms further spread of the virus within North America and the need for research to develop more effective management options to reduce the impact of IYSV on onion production. The finding of IYSV in remote and isolated locations where onions were grown from sets implies that the spread of IYSV via infected bulbs warrants further investigation as a potentially important route of distribution of the virus. References: (1) D. H. Gent et al. Plant Dis. 88:446, 2004. (2) H. R. Pappu et al. Arch. Virol. 151:1015, 2006.

Comparison of clinical and pathological diagnoses in dogs.

Clinical and pathological diagnoses were compared in a prospective study of 145 dogs. A diagnostic work up had been performed on all dogs of which 36 (24.8%) died and 109 (75.2%) were euthanatized. In 119 dogs (82.1%) both a clinical and patholical diagnosis was made, in 20 dogs (13.8%) no pathological diagnosis could be made and in 6 dogs (4.1%) no clinical diagnosis was established. In the 119 dogs the agreement level between clinical and pathological diagnosis was scored by the referring veterinarian together with a pathologist. Total agreement was found in 61 cases (51.3%) and disagreement in 31 cases (26.0%). In the remaining cases (27=22.7%) the pathological diagnosis further specified the clinical diagnosis. Consecutive submission appeared difficult to achieve by the participating veterinarians. However, no major differences in agreement level was present between the veterinarian which succeeded in almost consecutive submissions and the other veterinarians. At necropsy 42 cases were diagnosed as neoplasia, of which 52.4% had been diagnosed clinically. As to infectious diseases 55.0% of these diseases diagnosed at necropsy had been diagnosed clinically. In about 20% of the cases the differences were of clinical significance according to the referring veterinarians. In addition, it was indicated by the clinicians that about 50% of the necropsies revealed findings which could amend future patient care. The results of the study stress the relevance of postmortem examination as crucial part of continuing education and of quality monitoring and assurance in veterinary medicine.

Interscan displacement-induced variance in PET activation data is excluded by a scan-specific attenuation correction.

In PET activation studies, linear changes in regional cerebral blood flow may be caused by subject interscan displacements rather than by changes in cognitive state. The aim of this study was to investigate the impact of these artifacts and to assess whether they can be removed by applying a scan-specific calculated attenuation correction (CAC) instead of the default measured attenuation correction (MAC). Two independent data sets were analyzed, one with large (data I) and one with small (data II) interscan displacements. After attenuation correction (CAC or MAC), data were analyzed using SPM99. Interscan displacement parameters (IDP), obtained during scan realignment, were included as additional regressors in the General Linear Model and their impact was assessed by variance statistics revealing the affected brain volume. For data I, this volume reduced dramatically from 579 to 12 cm(3) (approximately 50-fold) at P(uncorr)

Limited resection for carcinoma of the upper thoracic oesophagus is not a realistic option.

AIMS: Due to its anatomical position, carcinoma of the proximal oesophagus results in early invasion of adjoining structures, often precluding (radical) resection. We performed a retrospective study to compare the potentially curative and palliative treatment results in patients with proximal (i.e. at or above the carina) vs distal oesophageal carcinoma. METHODS: Over a 3-year period 30 patients with proximal and 145 patients with distal oesophageal cancer underwent surgery. RESULTS: Microscopically radical resection was achieved in 11/30 patients (43%) with a proximal tumour and in 96/145 patients (66%) with a distal tumour (P=0.007). Three-year survival was 13.8%vs 44.3% respectively; localization was an independent prognostic factor. Recurrent upper aero-digestive tract symptoms developed in 38% of the patients with a proximal tumour and in 19% of the patients with distal carcinoma (P<0.05). DISCUSSION: Carcinoma of the proximal oesophagus has a worse prognosis than more distal carcinomas. Definite cure is exceptional; many patients are ineffectively palliated. In patients with proximal oesophageal carcinoma surgery should not be performed outside clinical trials testing multimodality treatment.

[Oral hygiene aids]. / Mondhygiënische hulpmiddelen.

Different dental hygiene aids are discussed, such as floss, tape, superfloss, gauze, flat shoelace, toothpick, interproximal brush, single-tufted brush, electric toothbrush, manual toothbrush and oral irrigation. Research shows that not one specific aid is superior to another if effectiveness is taken into consideration. Other factors which can influence oral hygiene efficacy are discussed as well.

Disinfection and sterilisation: the duties and responsibilities of dentists and dental hygienists.

Disinfection and sterilisation have received a considerable amount of attention due to the spread of AIDS in the past few years. There appears to be a low risk of occupational transmission of HIV, but this is not the case with other transmissible diseases. There are about 40 infection hazards for the patient and dental personnel in the dental surgery. Disinfection and cleaning are important in disease containment and cross-infection control, and all members of the dental team must bear responsibility for this. Disinfection of hands, surfaces, instruments, impression materials, radiographic units and suction systems are discussed. In addition, sterilisation and hygiene management of the reception area are considered. The duties and responsibilities of the dental team are emphasised.

[The dental hygienist in the periodontal practice]. / De mondhygienist in de parodontologie-praktijk. Resultaten van een kleine enquete.

Nine dental hygienists working in a periodontal practice were interviewed. Their work is discussed. The initial therapy entails patient instruction, indices, supra- and subgingival debridement and polishing of the teeth. The duration of the initial therapy is between three and seven hours. About 25% of the time is spend on patient education. Most dental hygienists working in a periodontal practice experience high job satisfaction.