Effect of maturity at harvest for whole-crop barley and oat on dry matter intake, sorting, and digestibility when fed to beef cattle.

The objectives were to evaluate the effect of harvest maturity of whole-crop oat (Study 1) and whole-crop barley (Study 2) on forage intake and sorting, ruminal fermentation, ruminal digestibility, and total tract digestibility when fed to beef heifers. In Study 1, 3 ruminally cannulated heifers (417 ± 5 kg) were used in a 3 × 3 Latin square design with 24-d periods. Whole-crop oat forage harvested at the late milk (LMILK), hard dough (HD), or ripe (RP) stages was fed for ad libitum intake and heifers were supplemented (1% of BW) with alfalfa pellets, barley grain, canola meal, and a mineral and vitamin pellet. Maturity at harvest for whole-crop oat did not affect ( ≥ 0.058) forage intake, DE intake, amount of forage refused, ruminal short-chain fatty acid concentration, or digestibility of DM, OM, NDF, and ADF. Ruminal starch digestibility decreased ( < 0.001) from 92.6% at the LMILK stage to 90.0% at the RP stage, with total tract starch digestibility decreasing ( = 0.043) from 95.8% at the LMILK stage to 94.8% at the RP stage. Ruminal CP digestibility was reduced at the HD stage compared with the LMILK and RP stages ( < 0.001). Mean ruminal pH was greatest for the LMILK stage (6.36; = 0.003) compared with the HD and RP stages (6.30 and 6.28, respectively). In Study 2, 6 ruminally cannulated heifers (273 ± 16 kg) were used in a replicated 3 × 3 Latin square design with 24-d periods. Dietary treatments included ad libitum access to whole-crop barley harvested at the LMILK, HD, or RP stage and a constant rate (0.8% BW) of supplement containing alfalfa pellets, barley grain, canola meal, and a mineral and vitamin pellet. Dry matter intake, ruminal content mass, and feeding behavior were not affected by harvest maturity ( ≥ 0.16). There was a decrease in total tract digestibility of DM, OM, and NDF observed at the HD stage compared with the LMILK and RP stages ( ≤ 0.004). Ruminal NDF digestibility decreased from 69.7% at the LMILK stage to 54.4% at the HD stage and 54.9% at the RP stage ( = 0.001), whereas ruminal ADF digestibility decreased from 70.0% at the LMILK stage to 44.4% at the HD stage and 42.5% at the RP stage ( = 0.002). Minimum and mean ruminal pH were least for the LMILK stage, intermediate at the RP stage, and greatest at the HD stage ( = 0.016 and = 0.031, respectively). These data suggest that despite reductions in ruminal digestibility of NDF and ADF with advancing maturity, harvesting whole-crop oat and barley forage at the HD and RP stages of maturity did not negatively affect DMI, fermentation characteristics, or DE relative to whole-crop cereal forage harvested at the LMILK stage.

Angiogenin promotes tumoral growth and angiogenesis by regulating matrix metallopeptidase-2 expression via the ERK1/2 pathway.

Tumor angiogenesis is essential for tumor growth and metastasis and is dependent on key angiogenic factors. Angiogenin (ANG), a 14.2-kDa polypeptide member of the RNase A superfamily, is an angiogenic protein that has been reported to be upregulated and associated with poor prognosis in some human cancers. The mechanisms through which aberrant ANG levels promote specific steps in tumor progression are unknown. Here, we show that ANG expression in human tissues is strongly correlated with an invasive cancer phenotype. We also show that ANG induces cellular survival, proliferation, endothelial tube formation and xenograft angiogenesis and growth. Novel mechanistic investigations revealed that ANG expression stimulated matrix metallopeptidase-2 (MMP2) expression through the phosphorylation of ERK1/2. Targeting ANG in vivo with N65828, a small-molecule inhibitor of the ribonucleolytic activity of human ANG, resulted in the diminution of xenograft tumoral growth through the inhibition of angiogenesis. Our findings support an unrecognized interplay between ANG, ERK1/2 and MMP2 that can impact tumor growth and progression. The targeting of ANG and associated factors could provide a novel strategy to inhibit tumor establishment and growth.

Effect of maturity at harvest on yield, chemical composition, and in situ degradability for annual cereals used for swath grazing.

The objective of this study was to determine how harvest maturity of whole-crop cereals commonly used in swath grazing systems in western Canada affects yield, chemical composition, and in situ digestibility. We hypothesized that the increase in yield with advancing maturity would not offset the decline in digestibility and, thus, the yield of effectively degradable DM (EDDM) would decline with advanced stages of maturity. Four replicate plots of barley (Hordeum vulgare L.; cv. CDC Cowboy), millet (Panicum milliaceum; cv. Red Proso), oat (Avena sativa L., spp.; CDC Weaver), and wheat (Triticum aestivum L.; cv. 07FOR21) were grown, with a subsection in each replicate harvested at 4 different maturities: head elongation, late milk, hard dough, and fully mature. At each stage of maturity, the wet and DM yields, and chemical composition (DM, OM, NDF, crude fat, and nonfiber carbohydrates; NFC) were determined. Whole-crop samples were ground (2-mm screen) and weighed into nylon bags (pore size of 53 ± 10 µm), and duplicate incubation runs were conducted by crop type. For each incubation run, nylon bags were randomly allocated (randomized by field replication, stage of maturity, and incubation time) to 1 of 7 heifers (32 bags/heifer during each run). Degradation rates were determined using a first-order kinetic model and data were analyzed with stage of maturity as a fixed effect and plot as a random effect. The DM, OM, and NFC yields increased linearly for barley and oat (P < 0.001), and increased quadratically for millet and wheat (P ≤ 0.025). Neutral detergent fiber yield increased linearly for barley (P = 0.005) and quadratically for millet, oat, and wheat (P = 0.044). There were no changes in CP yield observed for barley, millet, or oat with advancing maturity, but there was a linear increase observed for wheat (P = 0.002). The NFC concentration increased linearly for barley, millet, and oat (P < 0.001), and quadratically for wheat (P < 0.001), whereas the EDDM concentration decreased quadratically for millet, oat, and wheat (P = 0.003). The degradation rate of NDF decreased linearly with advancing maturity (P ≤ 0.014) for millet, oat, and wheat, but was not affected for barley (P = 0.13). The yield EDDM increased linearly for barley and oat (P < 0.001), and increased quadratically for millet and wheat (P ≤ 0.025). These findings suggest that harvesting whole-crop annual cereals at the hard dough and mature stages may maximize the yield of EDDM.

Molecular diagnostic trends in urological cancer: biomarkers for non-invasive diagnosis.

The early detection of urological cancers is pivotal for successful patient treatment and management. The development of molecular assays that can diagnose disease accurately, or that can augment current methods of evaluation, would be a significant advance. Ideally, such molecular assays would be applicable to non-invasively obtained body fluids, enabling not only diagnosis of at risk patients, but also asymptomatic screening, monitoring disease recurrence and response to treatment. The advent of advanced proteomics and genomics technologies and associated bioinformatics development is bringing these goals into focus. In this article we will discuss the promise of biomarkers in urinalysis for the detection and clinical evaluation of the major urological cancers, including bladder, kidney and prostate. The development of urine-based tests to detect urological cancers would be of tremendous benefit to both patients and the healthcare system.

Utility of serial urinalyses and urinary cytology in the evaluation of patients with microscopic haematuria.

BACKGROUND: Serial urinalyses have been advocated when haematuria is suspected. OBJECTIVE: To determine the utility of serial urinalyses and urinary cytology in patients presenting for evaluation of microscopic haematuria. METHODS: Eighty-five patients with the diagnosis of microscopic haematuria were evaluated at a tertiary-care hospital. All patients had a comprehensive urologic evaluation. Clinic and hospital records were reviewed for key factors (e.g., demographic, pathology, radiologic findings and operative findings). RESULTS: One hundred ninety total urinalyses were reviewed. Eighty-eight (46%) urinalyses were classified as normal, 87 (46%) as haematuria (> 3 RBC/hpf), and 15 (8%) as pyuria/ bacteriuria. The initial urinalysis detected haematuria in 95% of the patients. The addition of the second and third urinalyses detected haematuria in the remaining 5% of the patients with haematuria. Aetiologic factors for microscopic haematuria include urolithiasis 15 (18%), infection 9 (11%) and bladder lesion/tumor 6 (7%). In this setting of microscopic haematuria, urinary cytology was not able to detect any of the five documented bladder tumors. Fifty-seven percent of patients had a negative haematuria evaluation. CONCLUSION: In the evaluation of the patient with microscopic haematuria, serial urinalyses may have a low yield. Further prospective studies are needed to further evaluate serial urinalyses in this cohort.

Exogenous mycoplasmal p37 protein alters gene expression, growth and morphology of prostate cancer cells.

We previously showed that the Mycoplasma hyorhinis-encoded protein p37 can promote invasion of cancer cells in a dose-dependent manner, an effect that was blocked by monoclonal antibodies specific for p37. In this study, we further elucidated changes in growth, morphology and gene expression in prostate cancer cell lines when treated with exogenous p37 protein. Incubation with recombinant p37 caused significant nuclear enlargement, denoting active, anaplastic cells and increased the migratory potential of both PC-3 and DU145 cells. Microarray analysis of p37-treated and untreated cells identified eight gene expression clusters that could be broadly classified into three basic patterns. These were an increase in both cell lines, a decrease in either cell line or a cell line-specific differential trend. The most represented functional gene categories included cell cycle, signal transduction and metabolic factors. Taken together, these observations suggest that p37 potentiates the aggressiveness of prostate cancer and thus molecular events triggered by p37 maybe target for therapy.

Gene therapy for superficial bladder cancer.

In this review, the basics of gene therapy and the strategies to increase the therapeutic effect of gene therapy for superficial bladder cancer are discussed. Strategies considered in detail are modification of the structure of vectors, modification of the promoters of viral vectors and the timing and route of vector administration. Although all of these modifications have shown some degree of improvement for gene transfer, the use of polyamides intravesically in conjunction with an adenoviral system shows the most promise and the greatest potential to supplement or even replace the current treatment modalities for superficial bladder cancer.

Are coagulation studies necessary before percutaneous nephrostomy?

PURPOSE: Performance of coagulation studies for patients undergoing percutaneous nephrostomy (PCN) has been advocated by some investigators. We performed a retrospective study to assess this practice. MATERIALS AND METHODS: The medical records of 180 patients subjected to PCN for various reasons between October 1991 and July 1998 were reviewed. This represents a subset of patients in whom PCN was performed by an experienced interventional radiologist at our institution. Patients were excluded if they had a history of active liver disease, hematologic or bleeding disorder, current use of heparin or warfarin, or platelet count <100,000. The remaining 160 patients were separated into two groups. Group 1 consisted of 153 patients with a normal prothrombin time (PT) and partial thromboplastin time (PTT). Group 2 comprised 7 patients with an abnormal PT or PTT. Demographic and laboratory data including PT, PTT, complete blood, and platelet counts were analyzed to determine if a hemorrhagic complication could be predicted by an abnormal PT or PTT. RESULTS: In group 1 the mean PT was 12.2 seconds and the mean PTT was 25.0 seconds; in group 2 the mean PT was 13.9 seconds and the mean PTT was 30.3 seconds. The hemorrhagic complication rates were not statistically different between the two patient cohorts (p = .203). Demographic and standard laboratory data were not predictive of abnormal coagulation parameters. CONCLUSIONS: Screening coagulation studies are unnecessary in the standard patient subjected to PCN.

Is there a learning curve in diagnosing urolithiasis with noncontrast helical computed tomography?

OBJECTIVE: To report one department's experience with helical computed tomographic (HCT) evaluation of patients with suspected renal colic to diagnose ureteral calculi; to determine whether there is a learning curve in performing HCT in this context; and to determine whether HCT for the evaluation of renal colic exposes patients to more radiation than the standard intravenous pyelography (IVP) combined with nephrotomography. METHODS: All patients presenting to the emergency department with flank or abdominal pain were evaluated with nonreformatted noncontrast HCT. To determine changes in diagnostic accuracy, patients were divided into 2 groups: those evaluated between September 1996 and January 1997 (group 1, 67 patients), and those seen from February to June 1997 (group 2, 53 patients). A radiation exposure study was performed using phantoms, and radiation exposure for HCT, IVP and nephrotomography was measured. RESULTS: Review of HCT scans to diagnose ureteral calculi had a sensitivity of 91.7%, specificity of 82.6%, and accuracy of 87.2% in group 1, and a sensitivity of 95.5%, specificity of 86.7%, and accuracy of 91.9% in group 2. Patients undergoing IVP with nephrotomography were exposed to an effective dose equivalent of 343 mrem (dSv) (for men) and 664 mrem (for women). The effective dose equivalent for an HCT scan was 180 mrem. CONCLUSION: HCT offers excellent, rapid diagnostic accuracy without the need for intravenous contrast medium and with a lower radiation exposure level than IVP in evaluating patients with acute flank pain. There is a small but real learning curve in evaluating patients with acute flank pain with HCT.

Thoracoabdominal radical nephrectomy: is a postoperative thoracostomy tube necessary?

OBJECTIVES: To report our results of patients undergoing thoracoabdominal radical nephrectomy without intraoperative placement of a thoracostomy tube. It has been routine in our hospital to not place a thoracostomy tube in patients undergoing thoracoabdominal radical nephrectomy since 1988. METHODS: We conducted a retrospective review of 47 thoracoabdominal radical nephrectomies performed from January 1988 through November 1998 at our institution. Of the 47 patients, 39 did not have a thoracostomy tube placed intraoperatively; the other 8 patients did. The development of all postoperative complications, length of hospital stay, and hospital charges were noted. RESULTS: No postoperative mortality was noted in our study. Of the 47 patients in the study, 20 patients had a total of 29 complications. The overall number of complications was not increased in the group without a thoracostomy tube compared with the group with a thoracostomy tube (P = 0.104). No patient treated without a thoracostomy tube required subsequent placement of a tube for persistent pneumothorax. The mean length of hospital stay in patients with a thoracostomy tube after radical nephrectomy was 9.14 +/- 2.65 days; in patients without a thoracostomy tube, the mean length of stay was 7.07 +/- 3.97 days (P = 0.071). CONCLUSIONS: In patients without parietal pleural injury, thoracoabdominal radical nephrectomy without the placement of a thoracostomy tube can be performed safely and effectively, with a low risk of postoperative complications and a decrease in the overall hospital stay and hospital charges.

Microinvasive breast carcinoma: clinicopathologic analysis of a single institution experience.

BACKGROUND: Microinvasive breast carcinoma (MIC) has a good prognosis but specific definitions have varied in the past, making the clinical significance of MIC a subject of debate. METHODS: Microscopic slides of 59 cases of breast carcinoma originally diagnosed as MIC were reviewed retrospectively. Histologic parameters were correlated with clinical findings and outcome to define diagnostic criteria better. RESULTS: On review, the 59 cases were recategorized as follows: pure DCIS (N = 16), DCIS with foci equivocal for microinvasion (N = 7), DCIS with > or =1 focus of microinvasion (N = 11), T1 invasive carcinomas with > or =90% DCIS (N = 18), and T1 tumors with <90% DCIS (N = 7). The MIC cases in the current study averaged 3 separate foci of early infiltration outside the basement membrane, each one not >1.0 mm. The mean follow-up was 95 months. Six patients (10%) had only local recurrence: 1 case each in patients with equivocal microinvasion, microinvasion, and T1 tumors with <90% DCIS and 3 cases among the patients with T1 tumors with > or = 90% DCIS. Four patients, all with T1 tumors with > or =90% DCIS, had distant failure (7%). In the MIC group, only one patient developed a local recurrence after breast conservation. No patient had axillary lymph node metastasis. For the entire series, factors associated with local recurrence were younger age, breast conservation versus mastectomy, and close surgical margins. The only factor associated with distant failure was the size of the DCIS component. Seven patients with T1 tumors with > or =90% DCIS experienced local or distant failure and 5 of these (71%) developed progressive disease or died of disease. All other patients who developed a recurrence were disease free at last follow-up. In a retrospective series, poorer outcome in carcinomas with > or =90% DCIS may be related to the greater likelihood of missed larger areas of invasive carcinoma. Therefore, meticulous and extensive sampling of these carcinomas is required. CONCLUSIONS: MIC as defined has a good prognosis. It has a different biology than T1 invasive carcinoma with > or =90% DCIS, which may progress and cause death. Large tumors with multiple foci of microinvasion may have metastatic potential.

Metastatic small cell carcinoma to the testis.

Testicular neoplasms comprise 1% of all malignancies in men, with less than 3% of these malignancies due to metastatic disease. We report a case of a 51-year-old man with a history of left pneumonectomy done 2 years earlier for small cell carcinoma of the lung; the patient came to his primary care physician for routine follow-up. Physical examination was significant for a left testicular mass, which on final pathology was diagnosed as metastatic small cell carcinoma.

Metastatic adenocarcinoma of the pancreas to the testicle: a case report.

We report a 58-year-old man who presented with a 1-month history of left testicular pain and swelling that was eventually diagnosed as metastatic adenocarcinoma from the pancreas. Currently, there are only three accounts in the English literature of metastatic pancreatic carcinoma to the testis.

Detection of high-grade prostatic intraepithelial neoplasia with the five-region biopsy technique.

OBJECTIVES: To assess the ability of the five-region biopsy technique compared with the traditional sextant biopsy technique to detect high-grade prostatic intraepithelial neoplasia (PIN) in patients with an abnormal digital rectal examination or elevated prostate-specific antigen, or both, by a retrospective study. METHODS: We conducted a retrospective review of 50 consecutive patients diagnosed with PIN at our institution from January 1 990 to May 1998. Of the 50 patients, 26 patients were diagnosed with high-grade PIN. The reasons for the initial prostate biopsy were elevated prostate-specific antigen in 15 patients, abnormal digital rectal examination in 1 patient, and combined abnormalities in 10 patients. These patients underwent transrectal ultrasound-guided needle biopsy of the prostate using the five-region biopsy technique. Biopsy findings from regions 1, 3, and 5 (additional five-region biopsies) were compared with those of regions 2 and 4 (traditional sextant biopsies). RESULTS: Of the 26 patients, PIN was detected in the sextant regions in only 14 patients (53%). However, by using the five-region biopsy technique, an additional 1 2 patients (47%) were diagnosed with PIN (P <0.05). Twenty-four patients underwent repeated five-region biopsies. Eight (33%) of the 24 patients were found to have prostate cancer. Of the eight patients with cancer, 5 of the cancers were found with the five-region biopsy technique. CONCLUSIONS: In this study, the five-region method of prostate biopsy significantly increased the diagnosis of PIN compared with the traditional sextant method of biopsy. Furthermore, 33% of patients diagnosed with high-grade PIN on the initial biopsies were found to have prostate cancer on subsequent five-region biopsies.

Urinary tract infections in the critically ill patient with a urinary catheter.

BACKGROUND: The diagnosis of urosepsis should be entertained each time a patient has a febrile episode. Urosepsis carries with it a mortality rate of 25% to 60%. We determined the incidence and risk factors of urosepsis in the catheterized critically ill patient. MATERIALS AND METHODS: The charts of 142 subjects admitted from November 1994 to November 1995 to the trauma intensive care units at our institution with a urinary catheter were reviewed. Urosepsis was defined as (1) positive blood and urine cultures that correlated; (2) positive urine cultures with radiologic evidence of obstructive uropathy or infection; or (3) positive urine cultures and all other cultures negative to be eligible for the urosepsis group. RESULTS: Of the 126 patients evaluated for sepsis, 20 (15.8%) were diagnosed with urosepsis. Multivariant analysis demonstrated that the incidence of urosepsis was correlated with the following: age >60 years, extended length of stay in the intensive care unit and/or hospital, and duration of urinary catheterization. All 20 patients who developed urosepsis had a positive urinalysis and a positive urine culture (sensitivity 100%). However, urinalyses were positive in another 63 patients who did not have urosepsis (specificity 24.1%), and urine cultures were positive in 31 patients who did not have urosepsis (specificity 70.8%). CONCLUSION: We found a 15.8% incidence of urosepsis in our patient population. Urosepsis was more likely to occur in patients over 60 years of age, patients with extended length of stay in the intensive care unit or in the hospital in general, and patients with an extended duration of urinary catheterization.

Conservative surgery and radiation therapy in black women with early stage breast cancer. Patterns of failure and analysis of outcome.

Between 1977 and 1986, 75 black and 615 white women with American Joint Committee (AJC) Stages I and II breast cancer were treated with excisional biopsy, axillary dissection, and radiation therapy for breast conservation. Cyclophosphamide, methotrexate, and 5-fluorouracil, with and without prednisone and tamoxifen, was given to 92% of premenopausal, 83% of perimenopausal, and 63% of postmenopausal node-positive women; 20 of 106 (19%) postmenopausal node-positive women received tamoxifen only. The clinical characteristics of the similarly treated patients were compared. The 5-year actuarial local only first failure rate was 5% for black women and 6% for white women (P = 0.53). Regional only failure as the first site of failure was 9% for blacks versus 1% for whites (P = 0.002), with regional recurrence as any component of first failure being 16% for blacks and 4% for whites (P = 0.001). The supraclavicular fossa was identified as the primary site of regional recurrence in black patients with either pathologically positive or negative axillae. Distant metastases as the only site of first failure were significantly greater in the black population with a 20% 5-year actuarial failure rate versus 11% in white patients (P = 0.01). The 5-year actuarial overall survival for the black patients was 82% versus 91% for the white patients (P = 0.01), with no-evidence-of-disease (NED) survival being 64% and 83% (P = 0.0002) and relapse-free survival (RFS) being 61% and 77% (P = 0.01), respectively. Black patients younger than 40 years of age or with pathologically positive axillary nodes had significantly worse NED, RFS, and overall survival compared with similarly staged white patients. Cosmetic results were analyzed at 3 and 5 years after completion of therapy. Although significantly fewer black patients had an excellent-to-good cosmetic result at 3 years compared with white patients, the results were not significantly different at 5 years. These results show that appropriately selected black patients with early stage breast cancer have excellent local control after conservative surgery and radiation therapy and should continue to be offered breast preservation as an alternative to mastectomy. Patterns of failure, however, demonstrated higher regional and distant recurrence rates and lower NED, RFS, and overall survival rates in most subsets of black patients reviewed.