Genetic variations alter production and behavioral responses following heat stress in 2 strains of laying hens.

Genetic differences alter the type and degree of hens' responses and their ability to adapt to a stressor. This study examined the effects of genotypic variations on the productivity and behavior of laying hens following heat stress (HS). Two strains of White Leghorn hens were used: DXL (Dekalb XL), a commercial strain individually selected for egg production and KGB (kind, gentle bird), a strain selected for high group productivity and survivability. Ninety hens (48 DXL and 42 KGB) at 28 wk of age were randomly assigned to either a hot (H: mean = 32.6°C) or control (C: mean = 24.3°C) treatment and housed in pairs by strain for 9 d. Egg production and quality, behavior, body and organ weights, and circulating hormone concentrations were measured. Heat-stressed hens had lower egg production [adjusted (adj) P < 0.001] than their respective controls. Among H-DXL hens, egg weight tended to be reduced at d 1 and was reduced at d 9 (adj P = 0.007), but was reduced only at d 9 among H-KGB hens (adj P = 0.007). Eggshell thickness was also reduced among H hens at d 9 (adj P = 0.007), especially among H-KGB hens (adj P = 0.01). Plasma triiodothyronine concentration was reduced among H-hens (adj P = 0.01), especially among H-DXL hens (adj P = 0.01). Neither temperature nor strain affected the plasma thyroxine and plasma and yolk corticosterone concentrations. Heat-stressed hens spent less time walking (adj P = 0.001) and more time drinking (adj P = 0.007) and resting (adj P = 0.001) than C-hens. The results indicate that although HS reduced production and caused behavioral changes among hens from both strains, the responses differed by genotype. The data provide evidence that genetic selection is a useful strategy for reducing HS response in laying hens. The results provide insights for conducting future studies to develop heat-resistant strains to improve hen well-being, especially under the current commercial conditions.

Genetic variations alter physiological responses following heat stress in 2 strains of laying hens.

Heat stress (HS) is a major problem experienced by the poultry industry during high-temperature conditions. The ability to manage the detrimental effects of HS can be attributed to multiple factors, including genetic background of flocks. The objective of the present study was to determine the genetic variation in HS effects on laying hens' physiological homeostasis. Ninety 28-wk-old White Leghorn hens of 2 strains were used: a commercial line of individually selected hens for high egg production, DeKalb XL (DXL), and a line of group-selected hens for high productivity and survivability, named kind gentle bird (KGB). Hens were randomly paired by strain and assigned to hot or control treatment for 14 d. Physical and physiological parameters were analyzed at d 8 and 14 posttreatment. Compared with controls, HS increased hen's core body temperature (P < 0.05) and decreased BW (P < 0.05) at d 8 and 14. Heat shock protein 70 concentrations in the liver were greater in hens exposed to HS (P < 0.05). Compared with DXL hens, KGB hens had higher heat shock protein 70 concentrations (P < 0.05). The hens' liver weight decreased following HS, with less of a response in the KGB line (P < 0.05). The data indicate HS has detrimental effects on the physiology of laying hens due to genetic variations. These data provide evidence that is valuable for determining genetic interventions for laying hens under HS.

Opening the black box of cancer surgery quality: WebSMR and the Alberta experience.

A web-based synoptic operative report, the WebSMR (Surgical Medical Record), was developed to define and improve the quality of cancer surgery. Surgeons accurately record the essential steps of an operation including important decision-making in an analyzable format. Outcomes can be reviewed with provincial aggregates for quality improvement and maintenance of certification. Future synoptic pathology and follow-up templates will open the "black box" of surgical processes to define quality indicators for the improvement of cancer outcomes.

Neoadjuvant radiotherapy followed by surgery compared with surgery alone in the treatment of retroperitoneal sarcoma: a population-based comparison.

Introduction: Retroperitoneal sarcoma (rps) encompasses a heterogeneous group of malignancies with a high recurrence rate after resection. Neoadjuvant radiotherapy (nrt) is often used in the hope of sterilizing margins and decreasing local recurrence after excision. We set out to compare local recurrence-free survival (lrfs) and overall survival (os) in patients treated with or without nrt before resection. Methods: Patients diagnosed with rps from February 1990 to October 2014 were identified in the Alberta Cancer Registry. Patients with complete gross resection of rps and no distant disease were included. Patient, tumour, treatment, and outcomes data were abstracted in a primary chart review. Baseline characteristics were compared using the Wilcoxon nonparametric test for continuous data and the Fisher exact test for dichotomous and categorical data. Survival was analyzed using Kaplan-Meier curves with log-rank test. Cox regression was performed to control for age, sex, tumour size, tumour grade, date of diagnosis, multivisceral resection, and intraoperative rupture. Results: Resection alone was performed in 62 patients, and resection after nrt, in 40. Use of nrt was associated with multivisceral resection and negative microscopic margins. On univariate analysis, nrt was associated with superior median lrfs (89.3 months vs. 28.4 months, p = 0.04) and os (119.4 months vs. 75.9 months, p = 0.04). On multivariate analysis, nrt, younger age, and lower tumour grade predicted improved lrfs and os; sex, tumour size, date of diagnosis, multivisceral resection, and tumour rupture did not. Conclusions: In this population-based study, nrt was associated with superior lrfs and os on both univariate and multivariate analysis. When feasible, nrt should be considered until a randomized controlled trial is completed.

Education is the key to quality of surgery for rectal cancer.

Surgical quality assurance is a central issue in the treatment of rectal cancer and has led to substantial improvements in sphincter preservation, local control, and overall survival. Education or training as well as volume of practice are often cited as the major predictors of quality outcomes. While volume is a simple measure to analyze, it is likely a superficial or surrogate measure of quality surgery. It has been conclusively demonstrated that education, from total mesorectum excision workshops to nation-wide educational initiatives are effective methods of improving quality of care for the rectal cancer patient. New methods of quality assurance and improvement are being developed including prospective quality registers, the synoptic operative report, and pathology audits. It is imperative that improved measures of quality, other than volume, be implemented to audit our own practices, hospitals and regions with the goal of identifying issues that will improve outcomes for rectal cancer patients.

Periventricular echodensities detected by cranial ultrasonography: usefulness in predicting neurodevelopmental outcome in low-birth-weight, preterm infants.

Forty-eight low-birth-weight, preterm graduates of the University of Washington's neonatal intensive care unit who had received periodic, serial scanning by means of cranial ultrasonography during the first 4 to 6 weeks of life were longitudinally observed in an interdisciplinary neurodevelopmental follow-up program to a mean corrected age of 18 months. Mean birth weight for the sample was 1286 g; mean gestational age was 29 weeks. Periventricular echodensities were graded from 0 to 3, with 0 indicating no densities and 3 indicating cystic formation. Intracranial hemorrhage was graded in the conventional manner from 0 to IV. Neurodevelopmental outcome was assessed by means of a neurologic examination and the Bayley Scales of Infant Development. To synthesize the results, neurodevelopmental outcome for each subject was classified as normal, demonstrating minor abnormalities, or demonstrating major abnormalities. Multiple statistical analyses with various subgroupings of subjects consistently indicated severe intracranial hemorrhage (grades III and/or IV) to be a better predictor of overall neurodevelopmental outcome than grade of periventricular echodensity, including small cysts. These results suggest a wide range of outcomes after detection of periventricular echodensities and caution against communicating overly pessimistic prognoses in many cases.

Diagnosis of inflammatory bowel disease with ultrasound. An in vitro study.

Transabdominal ultrasound is frequently used to detect complications of inflammatory bowel disease. It has been proposed that ultrasound can distinguish between ulcerative colitis and Crohn's disease based on the degree of thickening and changes in the layered structure of the intestine. The authors evaluated the ability of ultrasound to distinguish between ulcerative colitis, Crohn's colitis, and normal colon by blindly comparing images made of resected colon specimens. The histologic interpretation of precisely the same area of tissue that was imaged was compared with the blinded image interpretation. Images from all 18 colitis specimens were correctly interpreted as being abnormal because of increased submucosal and overall wall thickness. Published ultrasound criteria for distinguishing between Crohn's disease and ulcerative colitis based on overall wall thickness and indistinctness of layers were inaccurate in 4 of 15 specimens and indeterminate in 3 cases. Ultrasound appears to be accurate in distinguishing normal from inflamed colon, but ultrasound findings alone should not be used to determine the cause of bowel inflammation.

Cross-sectional imaging method. A system to compare ultrasound, computed tomography, and magnetic resonance with histologic findings.

Studies comparing imaging modalities require a precise knowledge of the type and location of tissue structures. When comparing cross-sectional techniques such as ultrasound, computed tomography, and magnetic resonance imaging, the images must be obtained through the same tissue section that is examined histologically. An experimental system that permits comparison of these modalities with histologic sections of precisely corresponding tissue is described. Application in 30 gastrointestinal tissue specimens shows a high degree of correspondence between cross-sectional images and histologic sections. This method should be useful in tissue imaging research for anatomic correlation and for comparisons between imaging modalities.

High resolution sonography of the menisci of the knee.

High-resolution real-time ultrasonography (5, 7.5, and 10 MHz) was used to examine the menisci of the knee in ten normal volunteers and in ten patients with knee injuries. The posterior horns of the medial and lateral menisci were easily demonstrated. Normal anatomy and pathologic changes could be imaged in the menisci, capsular ligaments, and articular cartilage. While the menisci were seen in all subjects, the weight-bearing portion of the femoral articular cartilage could not be seen in several of the symptomatic patients who could not flex their knees. Ultrasound promises to be a useful, noninvasive adjunct to conventional techniques in evaluating the injured knee--especially in assessing the posterior horns of the menisci, an area difficult to assess with arthroscopy.

Exencephaly--clinical and ultrasonic correlation to anencephaly.

The antenatal sonographic diagnosis of exencephaly in four gestations is reported. Exencephaly is an uncommon malformation of the cranium that characteristically involves a large, disorganized mass of cerebral tissue. The flat bones of the calvaria are absent, leaving the brain mass uncovered. Secondarily, anencephaly may develop as a result of prolonged exposure of the developing encephalon to amniotic fluid and trauma in utero. As in anencephaly, facial structures and the bony base of the calvarium are often preserved in exencephaly. Sonographically, the outstanding feature of exencephaly is the cerebral mass, with convolutions or "pseudo" sulcal patterns present. These findings correlate well with the pathologic examination and define a clinical entity that is incompatible with human life.

Choroid plexus cysts in fetuses with trisomy 18.

An association between fetal choroid plexus cysts and trisomy 18 has been suggested. However, the prevalence of such cysts in aneuploid fetuses is unknown. To determine this frequency, we studied 14 fetuses with trisomy 18 examined at the Central Laboratory for Human Embryology. Five fetuses were found to have choroid plexus cysts on postmortem ultrasound examination. All those with cysts were earlier than 26 weeks in gestation, and the prevalence among second-trimester fetuses was 71.4%. In contrast, such cysts are reported in less than 1% of the general population of second-trimester fetuses. Thus, choroid plexus cysts are common in trisomy 18, and the finding of such cysts on a second-trimester ultrasound examination should suggest further evaluation, including chromosome analysis.

Size of the fetal adrenal in bilateral renal agenesis.

Bilateral renal agenesis is a fetal malformation incompatible with extrauterine life. Accurate prenatal diagnosis is essential for patient counseling. False-negative diagnoses have been reported and were attributed to the sonographic misidentification of apparently hypertrophied fetal adrenal glands as fetal kidneys. To study the relationship between renal agenesis and adrenal size, we reviewed autopsy records from 11 affected fetuses that had undergone careful autopsy and organ weight determination in our laboratory. Anomalies of distant structures were present in five affected fetuses. A sonographic diagnosis of adrenal hypertrophy had been made in two cases. In four of 11 fetuses, the glands had taken on a flattened discoid appearance. The autopsy records of 240 normal fetuses were similarly reviewed, and regression lines were generated for adrenal weight based on foot length and crown-rump length. The adrenal weights from affected fetuses were well within normal limits when compared with these normal regression lines and with organ weight standards from the literature. We conclude that adrenal hypertrophy is not a common finding in this syndrome and that the reported false-negative diagnoses are more likely attributable to a change in adrenal shape rather than a true increase in adrenal mass.

Hydrops from reciprocating atrioventricular tachycardia in a 27-week fetus requiring quinidine for conversion.

A 27-week fetus with severe nonimmune hydrops was found to have a reciprocating atrioventricular tachycardia with the rate of 275 beats per minute. Maternal digitalization produced improvement without conversion. Large doses of propranolol were without effect. Twelve days later quinidine was added, and conversion to sinus rhythm occurred after only two hours and persisted to term. The infant has no heart disease. Literature review confirms digoxin as the first choice for treatment of fetal reciprocating tachycardia, with excellent transplacental passage. Propranolol has not been demonstrably effective, and has poor placental passage. Verapamil also produced poor cord blood levels in two trials. Placental passage for procainamide is uncertain, but long-term use has been unsatisfactory. Quinidine is recommended as the second drug for treatment of resistant fetal tachyrhythmias.

Abnormalities of the neonatal cerebral ventricles.

High-resolution ultrasonography allows accurate assessment of ventricular size and contour in the infant, so that conditions such as hydrocephalus, holoprosencephaly, and agenesis of the corpus callosum can be diagnosed. Ventricular shunt catheter placement can be guided, and some of the complications of cerebrospinal fluid shunt systems can be identified. Infection of the ventricular fluid causes striking findings, including increased echogenicity and septation within the lumen.

Sonographic evaluation of the rotator cuff.

This article emphasizes the utility of ultrasound examination in the diagnosis of rotator cuff disease. A complete description is given of the way in which ultrasound examination of the shoulder is performed, the illustrations demonstrating normal anatomy as well as staging of the disease. The use of ultrasound in this setting can help to prevent a great deal of the pain associated with shoulder injury by establishing the nature and stage of injury before rotator cuff tear occurs.

Ultrasonography of the knee.

Sonography is a useful modality in the diagnosis of a wide variety of knee disorders, including lesions of the articular cartilage, tendons and ligaments, menisci, synovial space, and adjacent vessels and muscles. Sonography is noninvasive, rapidly performed, widely available, readily accepted by patients, uses no ionizing radiation, and is relatively inexpensive compared to other conventional imaging studies of the menisci, making it a potentially attractive screening examination for knee injuries. Although it is difficult to state the exact place of sonography in the diagnostic workup of knee disorders, we feel that sonography is vastly underutilized. With additional refinements in ultrasound technology and scanning techniques, we expect further expansion of its role in the evaluation of the knee.

The fetal genitourinary tract.

Early recognition of fetal urinary tract anomalies may dramatically influence obstetric or neonatal management. Major fetal urinary abnormalities, including renal agenesis, obstructive lesions, and cystic disease, may be clinically silent but readily identified by sonography. Careful evaluation of the fetal genitourinary tract should therefore be an important component of the routine screening obstetric sonogram. Appreciation of normal sonographic appearances of the fetal genitourinary tract may facilitate early recognition of the abnormal fetus. Accurate prenatal sonographic characterization of a renal abnormality and evaluation of renal function are essential for fetal prognosis and management.

Correlation of intraoperative ultrasound tumor volumes and margins with preoperative computerized tomography scans. An intraoperative method to enhance tumor resection.

Twenty-two patients with primary or metastatic brain tumors were evaluated with computerized tomography (CT) and intraoperative ultrasound. Tumor volume was estimated using a geometric formula based on CT and intraoperative ultrasound measurements. In most cases, tumor margins were marked with indigo carmine injected by ventricular cannula or with Silastic ventricular catheters placed under ultrasonographic control. Nine tumors had previously been operated on and irradiated (Group A). In this group, intraoperative ultrasound tended to overestimate the tumor volume compared to CT (intraoperative ultrasound findings 141.39% +/- 37.73% of CT findings (mean +/- standard deviation]. Sixteen patients were operated on for the first time (Group B), and in this group the volume estimates were comparable (intraoperative ultrasound findings 101.69% +/- 24.65% of CT findings). The difference between the means was statistically significant (p less than 0.01). Ultrasonography improved intraoperative delineation of tumor margins, as depicted by CT, thus maximizing the extent of resection; however, with recurrent tumors, intraoperative ultrasound tended to overestimate the tumor volume. Gliosis may account for this difference.

Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff.

We evaluated the results of 105 operative repairs of tears of the rotator cuff of the shoulder in eighty-nine patients at an average of five years postoperatively. We correlated the functional result with the integrity of the cuff, as determined by ultrasonography. Eighty per cent of the repairs of a tear involving only the supraspinatus tendon were intact at the time of the most recent follow-up, while more than 50 per cent of the repairs of a tear involving more than the supraspinatus tendon had a recurrent defect. Older patients and patients in whom a larger tear had been repaired had a greater prevalence of recurrent defects. At the time of the most recent follow-up, most of the patients were more comfortable and were satisfied with the result of the repair, even when they had sonographic evidence of a recurrent defect. The shoulders in which the repaired cuff was intact at the time of follow-up had better function during activities of daily living and a better range of active flexion (129 +/- 20 degrees compared with 71 +/- 41 degrees) compared with the shoulders that had a large recurrent defect. Similar correlations were noted for the range of active external and internal rotation and for strength of flexion, abduction, and internal rotation. In the shoulders in which the cuff was not intact, the degree of functional loss was related to the size of the recurrent defect.(ABSTRACT TRUNCATED AT 250 WORDS)