Attraction of Cerambycid Beetles to Their Aggregation-Sex Pheromones Is Influenced by Volatiles From Host Plants of Their Larvae.

Here, we describe a field experiment that tested for attraction of cerambycid beetles to odors from angiosperm hosts, and whether plant volatiles also serve to enhance attraction of beetles to their aggregation-sex pheromones. Traps were baited with a blend of synthesized chemicals that are common pheromone components of species in the subfamilies Cerambycinae and Lamiinae. The source of plant volatiles was chipped wood from trees of three angiosperm species, as well as from one nonhost, gymnosperm species. Bioassays were conducted in wooded areas of east-central Illinois. Traps were baited with the pheromone blend alone, the blend + wood chips from one tree species, wood chips alone, or a solvent control lure. Seven species of cerambycids were significantly attracted to the pheromone blend, with or without wood chips. In two cases, wood chips from angiosperms appeared to enhance attraction to pheromones, whereas they inhibited attraction in another three cases. Pine chips did not strongly influence attraction of any species. Overall, our results suggest that host plant volatiles from wood chips may improve trap catch with synthesized pheromones for some cerambycid species, but the effect is not general, necessitating case-by-case testing to determine how individual target species are affected.

Hand-assisted laparoscopic versus total laparoscopic right colectomy: a randomized controlled trial.

AIM: Laparoscopic colectomy for colorectal cancer is associated with definite short-term benefits, and is increasingly practised worldwide. The limitations of a pure laparoscopic approach include a relative lack of tactile feedback and long procedural time. Hand-assisted laparoscopic surgery was introduced in an attempt to facilitate operation by improving the tactile sensation. To date, there is no consensus as to which approach is better. Herein we conducted a randomized controlled trial comparing hand-assisted laparoscopic colectomy (HALC) with total laparoscopic colectomy (TLC) in the management of right-sided colonic cancer. METHODS: Adult patients with carcinoma of the caecum and ascending colon were recruited and randomized to undergo either HALC or TLC. Measured outcomes included operative time, blood loss, conversion rate, postoperative morbidities, postoperative pain, length of hospital stay, disease recurrence and patient survival. RESULTS: Sixty patients (HALC=30, TLC=30) were recruited. The two groups were comparable with regard to age, gender distribution, body mass index and final histopathological staging. No difference was observed between the groups in terms of operating time, conversion rate, operative blood loss, pain score and length of hospital stay. With a median follow-up of 27 to 33 months, no difference was observed in terms of disease recurrence, and the 5-year survival rates remained similar (83%vs 80%, P=0.923). CONCLUSION: HALC is safe and feasible, but it does not show any significant benefits over TLC in terms of operating time and conversion rate. Routine use of the hand-assisted laparoscopic technique in right hemicolectomy is therefore not recommended.

Early striatal hypertrophy in first-episode psychosis within 3 weeks of initiating antipsychotic drug treatment.

BACKGROUND: We and others have reported that patients experiencing their first episode of psychosis already have significant structural brain abnormalities. Antipsychotics seem to reverse subcortical volume deficits after months of treatment. However, the early impact of medication on brain morphology is not known. METHOD: Forty-eight individuals in their first episode of psychosis underwent magnetic resonance imaging (MRI) brain scanning. Twenty-six were antipsychotic naive and 22 were newly treated with antipsychotic medication for a median period of 3 weeks. In each group, 80% of subjects received a diagnosis of schizophrenia. The two groups were balanced for age, sex, handedness, ethnicity, height, years of education, paternal socio-economic status (SES) and Positive and Negative Syndrome Scale (PANSS) score. Group differences in whole-brain grey matter were compared voxel by voxel, using Brain Activation and Morphological Mapping (BAMM) software. We also conducted testing of group differences with region-of-interest (ROI) measurements of the caudate nucleus. RESULTS: Relative to the untreated group, those receiving antipsychotic medication for 3-4 weeks had significantly greater grey-matter volumes in the bilateral caudate and cingulate gyri, extending to the left medial frontal gyrus. ROI analysis confirmed that, in treated patients, the right and left caudate nuclei were significantly larger by 10% (p<0.039, two-tailed) and 9% (p<0.048, two-tailed) respectively. CONCLUSIONS: Early striatal grey-matter enlargement may occur within the first 3-4 weeks of antipsychotic treatment. Possible reasons for putative striatal hypertrophy and its implications are discussed.

Obstructive complications of laparoscopically created defunctioning ileostomy.

PURPOSE: The use of defunctioning ileostomy is a common practice to reduce the septic complications after anastomotic leakage in colorectal surgery. In open surgery, the fashioning of ileostomy is a straightforward procedure. However, in the laparoscopic approach, this can be a difficult task and obstructive complications can occur postoperatively. METHODS: A retrospective review was undertaken for all patients who underwent laparoscopic colorectal resection and defunctioning loop ileostomy over a 15-year period. RESULTS: In this period, 161 patients underwent laparoscopic colorectal surgery with defunctioning ileostomy. Eight patients developed obstructive complications in the early postoperative period requiring surgical intervention (5 percent). All patients presented with intestinal obstruction from the fourth to the sixth postoperative day. The median time to reoperation was 9.5 days (range, 5 to 19). The causes of obstructive complications were twisting of the ileostomy (n = 3), adhesive kinking proximal to the ileostomy (n = 3), tight fascia (n = 1), and both tight fascia and twisting of ileostomy (n = 1). Six patients underwent laparotomy for diagnosis and refashioning of ileostomy. The seventh patient had endoscopic decompression of small bowel and refashioning of ileostomy. The last patient was successfully managed with combined endoscopic and laparoscopic approach. CONCLUSIONS: Various pitfalls can occur in laparoscopically created defunctioning ileostomy. Measures can be taken to minimize these technical errors. Various surgical reinterventions can be attempted to determine the cause. With combined uses of enteroscope and laparoscope, a laparotomy can be avoided.

Stapled technique for acute thrombosed hemorrhoids: a randomized, controlled trial with long-term results.

PURPOSE: This study was designed to compare stapled vs. conventional hemorrhoidectomy for patients with acute thrombosed hemorrhoids. METHODS: Forty-one patients with acute thrombosed hemorrhoids were randomized into: 1) stapled hemorrhoidectomy (PPH group; n = 21), and 2) open hemorrhoidectomy (open group; n = 20). Emergency surgery was performed with perioperative data and complications were recorded. Patients were followed up by independent assessors to evaluate pain, recurrence, continence function, and satisfaction at regular intervals. RESULTS: The median follow-up for the PPH group and open group were 59 and 56 weeks, respectively. There was no significant difference in terms of the hospital stay, complication rate, and continence function; however, the mean pain intensity in the first postoperative week was significantly less in the PPH group (4.1 vs. 5.7, P = 0.02). Patients in the PPH group recovered significantly faster in terms of the time to become analgesic-free (4 vs. 8.5 days, P < 0.01), time to become pain-free (9 vs. 20.5 days, P = 0.01), resumption of work (7 vs. 12.5 days, P = 0.01), and time for complete wound healing (2 vs. 4 weeks, P < 0.01). On long-term follow-up, significantly fewer patients in the PPH group complained of recurrent symptoms (0 vs. 5, P = 0.02). The overall symptom improvement and patients' satisfaction were significantly better in the PPH group (90 vs. 80 percent, P = 0.03 and +3 vs. +2, P < 0.01 respectively). CONCLUSIONS: Stapled hemorrhoidectomy is safe and effective for acute thrombosed hemorrhoids. Similar to elective stapled procedure, emergency stapled excision has greater short-term benefits compared with conventional excision: diminished pain, faster recovery, and earlier return to work. Long-term results and satisfaction were excellent.

Endo-Lap OR: an innovative "minimally invasive operating room" design.

BACKGROUND: A newly constructed Endoscopic-Laparoscopic operating room (Endo-Lap OR) started to operate in our department in January 2005. A prospective study was conducted to evaluate its feasibility, efficacy, and safety, as well as the staff's satisfaction. PATIENTS AND METHODS: From January 2005 to September 2005, all patients undergoing operation in this Endo-Lap OR were included in the study. The patient's diagnosis, types of operating procedures, incidents of operating failure (either due to the hardware or the software of Endo-Lap OR) that led to a delay in the patient's transfer or that extended the total operating time were recorded. In addition, questionnaires regarding staff satisfaction with the new operating room were distributed to nurses, anesthetists, and surgeons. RESULTS: A total of 640 cases were included in the study period, 245 cases of open surgery, 282 cases of laparoscopic surgery, 82 cases of endoscopic surgery, 17 cases of video-assisted thoracoscopic surgery, and 14 cases of combined endoscopic-laparoscopic surgery. There were no reported incidents of operating failure related to hardware or software problems. The overall staff satisfaction was excellent. CONCLUSIONS: The integration of endoscopic and laparoscopic surgery into this newly constructed Endo-Lap OR is feasible and safe. The running of the operating room was smooth and it received a high level of acceptance and satisfaction from different staff members.

Controlled longitudinal study of bone mass accrual in children and adolescents with cystic fibrosis.

BACKGROUND: A study was undertaken to observe the gains in bone mass in children and adolescents with cystic fibrosis (CF) over 24 months and to examine the relationship between areal bone mineral density (aBMD) and associated clinical parameters including physical activity, nutrition, and 25-hydroxyvitamin D (25OHD). METHODS: Areal BMD of the total body (TB), lumbar spine (LS), and total femoral neck (FNt) were repeatedly measured in 85 subjects aged 5-18 years with CF and 100 age and sex matched controls over 2 years. At each visit anthropometric variables, nutritional parameters, pubertal status, disease severity, physical activity, dietary calcium, caloric intake, and serum 25OHD were assessed and related to aBMD. RESULTS: After adjusting for age, sex, and height Z-score, gains in LS aBMD in children (5-10 years) and TB and FNt aBMD in adolescents (11-18 years) with CF were significantly less than in controls. Lean tissue mass was significantly associated with TB and LS aBMD gains in children and adolescents and explained a significant proportion of the aBMD deficit observed. Lung function parameters were significantly associated with aBMD gains in adolescents with CF. CONCLUSIONS: Inadequate bone mass accrual during childhood and adolescence contributes to the low bone mass observed in adults with CF. Accounting for the height discrepancy which is frequently observed in those with CF, in addition to age and sex, is important when assessing low bone mass in children and adolescents with CF. To optimise an individual's potential to acquire maximal bone mass, it is necessary to maximise nutritional status and limit the progression of chronic suppurative lung disease.

The use of air displacement plethysmography in children and adolescents with cystic fibrosis.

OBJECTIVES: The purpose of this paper was to evaluate the use of air displacement plethysmography (ADP) in children and adolescents with cystic fibrosis (CF). Specifically, the primary aim of this study was to compare estimates of fat-free mass (FFM) measured from ADP and dual energy X-ray absorptiometry (DEXA) in children and adolescents with CF. The secondary aim was to compare the effect of using predicted thoracic gas volume (VTG) and measured VTG for the calculation of FFM by ADP in this population. METHODS: Cross-sectional FFM measurements were taken using ADP and DEXA in 52 children and adolescents with CF, ranging in age from 6.3 to 16.6 y. RESULTS: Bland-Altman analysis showed that ADP values of FFM were on average 0.59 kg higher than DEXA values (95% limits of agreement = 3.61 to -2.43 kg); however this difference was not significant. There was no significant correlation (r = -0.26, P = 0.07) between the mean FFM and difference in FFM between ADP and DEXA. Using either predicted or measured VTG did not significantly affect FFM estimates in individuals with CF who had normal lung function (bias = -0.39 +/- 0.86 kg; r = -0.02, P = 0.93). CONCLUSIONS: ADP is an appropriate technique for use in children and adolescents with CF.

Bone mineral density in Australian children, adolescents and adults with cystic fibrosis: a controlled cross sectional study.

BACKGROUND: Low bone mineral density (BMD) is recognised in individuals with cystic fibrosis (CF) although the pathogenesis remains unclear. The aims of this study were to compare BMD over a broad continuum of Australian individuals with CF with healthy controls and to examine the relationship between BMD and clinical parameters including physical activity, nutrition, and vitamin D levels. METHODS: BMD of the lumbar spine (LS), total body (TB), femoral neck (FN), cortical wrist (R33%), and distal wrist (RUD) was examined in 153 individuals with CF aged 5.3-55.8 years (84 males) and in 149 local controls aged 5.6-48.3 years (66 males) using dual energy x ray absorptiometry. Anthropometric variables, body cell mass, markers of disease severity, corticosteroid usage, measures of physical activity, dietary calcium and caloric intake and serum vitamin D were assessed and related to BMD. RESULTS: Compared with controls, mean BMD was not significantly different in children aged 5-10 years with CF. Adolescents (females 11-18 years, males 11-20 years) had reduced TB and R33% BMD when adjusted for age, sex, and height (difference in BMD (g/cm2) adjusted means between control and CF: TB=0.04 (95% CI 0.01 to 0.07); R33%=0.03 (95% CI 0.01 to 0.06)). BMD was reduced at all sites except R33% in adults (difference in BMD (g/cm2) adjusted means between control and CF: TB=0.05 (95% CI 0.02 to 0.09); LS=0.08 (95% CI 0.03 to 0.14); FN=0.09 (95% CI 0.03 to 0.15); RUD=0.03 (95% CI 0.01 to 0.05)). In children/adolescents BMD was weakly associated with nutritional status and disease severity. CONCLUSIONS: BMD was normal in a well nourished group of prepubertal children with CF. A BMD deficit appears to evolve during adolescence and becomes more marked in adults. Individuals with CF should optimise nutrition, partake in physical activity, and maximise lung health in order to optimise BMD. Further longitudinal studies are required to understand the evolution of reduced BMD in young people and adults with CF.

Minimally invasive parathyroidectomy by unilateral neck dissection--experience in a regional hospital in Hong Kong.

OBJECTIVE: To compare the efficacy and safety of minimally invasive open parathyroidectomy with localised unilateral neck dissection to the conventional method of bilateral neck exploration and parathyroidectomy as a surgical treatment for primary hyperparathyroidism. PATIENTS AND METHODS: Eleven patients diagnosed with primary hyperparathyroidism at Queen Elizabeth Hospital from 1 January 2002 to 31 December 2002 were treated surgically with minimally invasive open parathyroidectomy. Their results were compared to a retrospective series of 15 patients treated by conventional bilateral neck exploration and parathyroidectomy between 1 January 2001 and 31 December 2001. Demographic data; cure, recurrence, and complication rates; operating time; and hospital stay were analysed. RESULTS: The cure rate was 100% in both groups. There was no recurrence in either group. Minor complication rates were 9% and 20% in the minimally invasive open parathyroidectomy and the control groups, respectively. Mean operating time was 63 minutes in the minimally invasive open parathyroidectomy group, and 92 minutes in the control group. The mean postoperative hospital stay for the minimally invasive open parathyroidectomy group was 1.36 days. Three of these procedures were performed as day surgery. The mean hospital stay for the control group was 2.93 days. The operating time and hospital stay were significantly shorter in the minimally invasive open parathyroidectomy group. CONCLUSION: Minimally invasive open parathyroidectomy is a viable alternative treatment method for primary hyperparathyroidism. It has comparable cure and recurrence rates to the conventional approach. It is safe, with a lower complication rate, and has the benefits of being a shorter procedure and allowing a shorter hospital stay. It can be performed as day surgery, further reducing hospital costs.