First completely robot-assisted retroperitoneal nephroureterectomy with bladder cuff: a step-by-step technique.

INTRODUCTION: While various surgical techniques have been reported for open and minimally invasive treatment of upper tract urothelial cancer (UTUC), the procedure of robot-assisted nephroureterectomy (NU) with bladder cuff has never been reported using only retroperitoneum without entering abdominal cavity. We developed a novel port placement and technique allowing to perform robot-assisted NU by a unique retroperitoneal approach. METHODS: Between February and June 2021 patients with history of UTUC were treated by robot-assisted NU completely restricted to retroperitoneal space using a singular trocar placement and a two-step docking without relocation of the surgical robot. Patient characteristics, perioperative outcomes and short-term follow-up were prospectively analyzed. RESULTS: The analysis included five patients [median age: 73 years; BMI: 27.2 kg/m2; Charlson comorbidity index 5]. All five patients had UTUC with a mean tumor size of 3.02 cm (range 0.9-6.0). UTUC was localized to distal ureter in two and to kidney in three cases. No positive surgical margins were noted for all patients with UTUC [1 low-grade and 4 high-grade]. Retroperitoneal lymphadenectomy in three patients did not reveal positive nodes. No intraoperative adverse events exceeding EAUiaiC classification ≥ 2 were observed, while median EBL was 150 ml (IQR 100-250). No patient experienced postoperative complications exceeding Clavien-Dindo classification ≥ 3a. Median hospital stay was 5.4d without any 30-d readmission. CONCLUSION: We demonstrate safety and feasibility of the first entire robot-assisted retroperitoneal nephroureterectomy (RRNU) with bladder cuff. This surgical technique is easily reproducible, while surgical outcomes are similar to other established techniques.

The PT2D-Score: a novel tool to predict complications and economic outcome after radical cystectomy.

BACKGROUND: Radical cystectomy (RC) has a high morbidity and leads to a significant socio-economic burden. We aimed to investigate pre-, intra-, and post-operative variables to create a novel score predicting both post-operative clinical (complications) and economic (length of hospital stay) outcome after RC. METHODS: We retrospectively evaluated clinical and histopathological data of 317 patients after RC. We performed univariate and multivariate logistic regression analyses to identify variables associated with post-operative clinical (30-day morbidity according to Clavien-Dindo complications) and economic (length of hospital stay) outcome. RESULTS: In multivariate analysis, a high number of intraoperative transfusions (T) of packed red blood cells predicted major complications (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.10-2.58, p = 0.017), preoperative potassium (P) level predicted three or more complications (OR for high preoperative potassium 0.71, 95% CI 0.52-0.98, p = 0.037), and high drain (D) loss on post-operative day 1 predicted a longer hospital stay ≥ 22 days (OR 1.57, 95% CI 1.04-2.35, p = 0.003). The PT2D-Score was able to predict three or more complications (area under the curve: 0.70, 95% CI 0.61-0.78, p < 0.001) and a hospital stay of ≥ 22 days in patients after radical cystectomy (area under the curve: 0.63, 95% confidence interval 0.53-0.72, p = 0.012). CONCLUSIONS: The novel PT2D-Score combines preoperative potassium level, intraoperative blood transfusion, and post-operative drain loss to predict both clinical (30-day morbidity) and economic (length of hospital stay) outcome for patients undergoing RC. After validation in a larger cohort, the novel PT2D-Score might serve as an additional criterion to identify patients for intensified monitoring after RC.

Environmental and maternal factors associated with gross placental morphology in dairy cattle.

This article reports on a study of gross placental morphology of 282 expelled placentas from 89 primi- and 193 multiparous Holstein dams immediately after calving and examines associations with environmental factors such as typical herd features and season of calving, and maternal factors such as age at calving, level of milk yield at conception and cumulative amount of milk produced during gestation. The highest correlation between calf measurements and placental characteristics was found between the weight of the calf and the total cotyledonary surface (r = .643; p < .001), confirming the high importance of the cotyledonary surface available for nutrient transfer to the developing foetus. Younger age in adolescent and smaller heart girth in multiparous dams were associated with a higher cotyledon number, suggesting placental compensation in dams with lower capacities in terms of dry matter intake. No significant association between milk yield during gestation in multiparous animals and gross placental morphometrics could be detected, indicating that factors such as the amount of milk produced during gestation affect placental development less than foetal weight close to term. Therefore, placental growth may be sustained at the expense of other tissues in an attempt to maintain pregnancy and minimize the adverse consequences for the foetus. This study offers evidence concerning factors affecting the placental surface size for nutrient transfer from dam to calf in dairy cattle based on gross morphometrics, but needs confirmation from studies in which this surface size is more profoundly assessed by measuring the branches present in the cotyledonary villi.

Age at calving in heifers and level of milk production during gestation in cows are associated with the birth size of Holstein calves.

The objective of the present study was to evaluate environmental and dam factors associated with birth size of Holstein calves. Data of 1,594 births from dairy herds in Belgium and Germany were analyzed in a retrospective cross-sectional study. Immediately after birth, the birth weight of the calves was measured. On the next day, the heart girth (HG), withers height, and diagonal length of the dams and calves were measured. Parity, body condition score, gestation length (GL), and age at calving were recorded for all dams. For the cows, days open, lactation length, length of the dry period, and calving interval were also calculated. The magnitude and shape of the lactation that took place during gestation was quantified using the MilkBot model based on monthly milk weights. Using the same procedure, cumulative milk production from conception to drying off (MGEST) was calculated. After descriptive analyses, mixed models were used to identify factors that are significantly associated with the birth weight (most consistent measure of size at birth) of the calves born to both heifers and cows. Of the variables offered to the offspring birth weight model in heifers (n=540), calf sex, season of calving, GL, HG, withers height, diagonal length, and age at calving were significant. The mean birth weight of the calves born to heifers was estimated to be 41.3±1.01kg. In comparison to calves born to old (25.5 to 37.3mo; n=99) heifers, the birth weight was estimated to be 2.75, 3.29, and 2.35kg heavier when the calves were born to very young (20.3 to <22mo; n=98), young (22 to <23.5mo; n=145), and standard aged (23.5 to <25.5mo; n=198) heifers, respectively. Of the variables offered to the offspring birth weight model in cows (n=1,054), calf sex, season of calving, GL, parity, dry period, and MGEST were significant. The mean birth weight of the calves born to cows was estimated to be 44.1±0.99kg. For cows having an identical HG, the birth weight of the calves was estimated to be 0.97 and 1.11kg higher in cows with low (1,400 to <5,400kg) and high (6,500 to <7,200) MGEST, respectively, compared with cows with very high (7,200 to 11,600kg) MGEST. The decisive effects of age at calving in heifers and of high milk production levels during gestation in cows on the birth weight of their calves may provide a basis for developing managerial interventions to improve long-term health and productivity of the offspring.

Sonographic evaluation of thyroiditis with color flow study.

This cross sectional study was carried out in the Department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University, Bangladesh in collaboration with the Department of Endocrinology and Department of Histopathology of the same hospital during the period of March 2007 to February 2008 to determine efficacy of ultrasonogram in the evaluation of thyroiditis and to compare its results with color flow Doppler study. For this purpose, a total of 50 patients having clinical suspicion of thyroiditis were enrolled in this study. Ultrasound and color Doppler were done in all these patients. Then all patients underwent for FNAC in the Histopathology department. Correlation between sonographic diagnosis and histopathological diagnosis were observed. Out of these 50 patients 10(20%) were male and 40 (80%) were female with age ranging from 12 to 50 years, highest between 21 to 30 years. The mean age of the patients was 30.42±9.57 years. On unltrasonographic findings of thyroid gland 42.0% patients had regular and 58.0% had irregular margin. Seventy percent had fibrosis, 14.0% had feature of necrosis, 48.0% had lymphadenopathy. Out of all patients 6.0% had normal echogenic feature, 16.0% had increased and 78.0% decreased echogeneic feature. Twelve percent (12.0%) patients had homogeneous and 88.0% had heterogeneous pattern of echogenecity. Thirty eight percent (38%) patients had focal nodules. Sixty percent (60.0%) patients had focal swelling and 40.0% had diffuse swelling. On color flow Doppler 28.0% had normal, 38.0% had increased and 34.0% decreased vascular flow pattern. USG reports revealed that 48.0% had thyromegaly, 36.0% had thyroid nodule, 10.0% had multinodular goiter and 6.0% had thyroid abscess. FNAC diagnosis revealed that 34.0% patients had Hashimoto's thyroiditis, 24.0% had lymphocytic thyroiditis, 18.0% had granulomatous thyroiditis, 6.0% had abscess, 8.0% had goitre and 10.0% nonspecific. USG and CFD are recommended modalities for the diagnosis of thyroiditis as these cost-effective and non invasive procedures.

Cutaneous anthrax in a school teacher.

Cutaneous anthrax is an infection of the skin caused by Bacillus anthracis. This is a report of a case of cutaneous anthrax attending outpatients of Mymensingh Medical College Hospital in October, 2010. The infected person was a retired school teacher with a very good body build. He reported to handle cow flesh about 4-5 days ago, developed few painless papules over shin of right leg, which gradually became large bullae and blackish eschar developed over the lesion. Smears from the lesions were investigated which confirmed the causative agent B. anthracis. The patient was treated with oral Ciprofloxacin (500mg) twice daily for seven days which cured the infection as observed on his subsequent follow up visits on 7 and 14 days later. Oral Ciprofloxacin is found effective as recommended by the World Health Organization.

Metastatic squamous cell carcinoma of spleen: a case report.

Metastatic squamous cell carcinoma of spleen is a very rare occurrence and a very small number of cases have been reported so far, mostly in autopsy series. More commonly observed metastasis to the spleen are from breast, lungs, colorectal organs and ovaries. Interestingly enough the spleen is very unusual site of metastasis from an esophageal malignancy, only very few cases (four cases up to 2005) being reported in the literature. A case of splenic metastasis from carcinoma of the esophagus in a 60 years old woman is presented in this report. Extraordinary merit of this case is that carcinoma of the esophagus was diagnosed after the patient had been operated for splenic abscess and was histologically diagnosed as metastatic squamous cell carcinoma of spleen. The patient underwent splenectomy and recovered well. Only during post operative period endoscopic examination of upper GIT with biopsy revealed carcinoma of the esophagus. Further investigations failed to delineate any other organ involvement. So, this case is being reported as metastatic squamous cell carcinoma of spleen from carcinoma of esophagus.

Pattern of mental illness on substance abusers.

The aim of this study was to investigate mental illnesses among the substance abuse dependent populations. A total of 1076 substance abusers were recruited from the Outpatient Department of the Central Drug Addiction Treatment Center, Tejgaon, Dhaka from July 2008 to June 2009. They sought detoxification therapy voluntarily at this centre. The research participants were selected consecutively following the defined selection criteria. Research instruments were interviewer-administered questionnaire and standard mental state examination scales. Of the 1076 substance abusers, 82.6% had been using heroin currently and rest of them used phensedyl followed by injection drugs and cannabis with a period ranged 2-30 years. Results showed that 91.3% of the substance abusers had been suffering from insomnia and 75.0% had altered food habit. About 49.0% showed disturbed behaviors and 45.2% had been suffering from sexual dysfunctions. Around 32.0% of the substance abusers had been suffering from nonspecific generalized anxieties and 72.7% were found in abnormal mood/affects. A striking finding was that 7.3% of the substance abusers had been suffering from perceptual and/or thought disturbances. In conclusion, 7.3%-92.5% of the substance abusers had been suffering from mental illnesses. Insomnias, decreased intake of food and taste preference, irritable mood/affects, loss of interest in sex and non-specific anxieties were highly prevalent among them. Medical management and altering lifestyle are still the only applicable way to control this human catastrophe.

Palliative care out patient consultation service in a teaching hospital in Bangladesh.

Palliative care is a newly emerging subspecialty in Bangladesh. The aims of this study were i) to determine the characteristics, types of referral, disease pattern and insight about the disease and ii) to estimate the prevalence of pain and other common symptoms in a population of patients with advanced incurable state of cancer and attending the newly established palliative care out patient clinic. The data were collected at the outpatient clinic during first consultation using a modified structured data collection sheet from the Institute of Palliative Medicine (IPM) in Calicut, Keralla, India. Two hundred and three patients with mean age 50 years, diagnosed as suffering from incurable cancer were seen during a period of 21 months from October 2007 to June 2009. Most of the patients were from less privileged socioeconomic group (86%), stays with family (99%), already know about their disease status and prognosis (62%). Referred from other disciplines formed the major group (72%) of this population. All of them had been under treatment for variable period ranging from one month to four years. The most common five symptoms noted by the service providers were pain (89%), loss of appetite (61%), sleeplessness (55%), lack of energy (47%) and constipation (44%). Population based studies are required to determine the actual magnitude of sufferers and suffering in spite of the availability of global knowledge and skill to reduce these sufferings of the incurably ill members of the society.

Effect of Intravenous Paracetamol with Bupivacaine Scalp Nerve Block on Haemodynamics Response as Well as Anaesthetic Requirements during Supratentorial Craniotomies.

Noxious stimuli during craniotomy may encourage hypertension and tachycardia, which may rise to morbidity in patients with intracranial hypertension. After craniotomy a moderate level of postoperative pain observed. The objective of this study was to observe the effect of intravenous paracetamol with bupivacaine scalp nerve block (SNB) on haemodynamics response as well as anaesthetic & analgesic requirements during supratentorial craniotomies. This is a single-blind, placebo-controlled, randomized clinical trial carried out in the Neurosurgery operation theatre from August 2015 to July 2017 under supervision of Department of Anaesthesia, Analgesia and Intensive Care Medicine of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. A total of 40 patients aged 18-60 years with supratentorial space occupying lesion undergoing craniotomy under general anaesthesia who were attended in the department of Neurosurgery, BSMMU were enrolled in this study and they were divided randomly into two groups, 20 patients in each. The Group A received 100ml normal saline infusion and 0.25% bupivacaine (20ml) in scalp block, while the Group B received intravenous injection paracetamol (1gm) and 0.25% bupivacaine (total 20ml) in scalp block. Statistical analyses were obtained Statistical Packages for Social Sciences (SPSS-22). The mean systolic blood pressure varied within the normal range in both groups. The mean DBP of Group B remained significantly lower than that of Group A in different follow up except at 30 minutes and 60 minutes after dura incision. However, mean MAP of Group B remained significantly lower than that of Group A in different time interval. The mean heart rate of Group B remained significantly lower than that of Group A. The mean intraoperative propofol as well as fentanyl requirements were significantly decreased in Group B in comparison to Group A. The combination of intravenous paracetamol with bupivacaine scalp nerve block provides better intra-operative haemodynamic stability and neurosurgical compliances for the patients undergoing supratentorial craniotomies under general anaesthesia.

Iodized salt induced thyrotoxicosis: Bangladesh perspective.

The effects of iodized and non-iodized salt on the thyroid gland and its hormones T3, T4 and thyroid stimulating hormone (TSH) were studied in 200 individuals who were the residents of plain areas of greater Mymensingh district. The subjects were collected from the Center for Nuclear Medicine and Ultrasound, Mymensingh. Out of 200 individuals 150 were using iodized salt and 50 were using non-iodized salt. The iodized and non-iodized salt users were marked as study and control groups respectively. Blood samples were taken from both the groups and T3 and T4 in blood serum were determined by radioimmunoassay (RIA) while TSH was determined by immunoradiometricassay (IRMA). The mean concentration of T3 were 2.633 nmol/L and 2.223 nmol/L and T4 concentration were 122.444 nmol/L and 110.355 nmol/L in study and control group respectively. The mean TSH concentration was 5.044 mIU/L and 9.622 mIU/L in study and control group respectively. The data indicated that continuous and long term use of iodized salt increased both T3 and T4 and decreased TSH in study group. The results were significant (p<0.05) when compared to that of the control. The results suggested that mandatory mass consumption of iodized table salt without T3, T4 and TSH screening of blood may produce iodinated salt induced thyrotoxicosis (ISIT) in peoples living in plain areas of Bangladesh. We suggest close regular monitoring of T3, T4 and TSH and urinary excretion of iodine of individuals who are using iodized salt for better management of iodinated salt program in our setting.

Evaluation of Post Guillain-Barre Syndrome (GBS) Patients: A Cross Sectional Study.

Guillain-Barre syndrome (GBS) is related with significant morbidity and also mortality. Little is known about the long term outcome of GBS patients who survived. The objective of this study is to determine the lasting outcome and consequences of GBS patients. This is a cross-sectional study of patients who diagnosed GBS and managed at the Intensive Care Unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2004 to December 2017. All survived patients were invited for a structured interview, questionnaires, and full neurologic exam to record their current clinical condition focused on complaints and symptoms, neurological deficits, disabilities, behaviour, and quality of life. Thirty-eight patients participated, with a median age of 20 years (range 4-39 years) and a median interviewed time of 7 years (range 1-13 years). Residual complaints were reported by 24(63%) patients, including paresthesias (10.5%), unsteadiness of gait (37%), painful hands or feet (29%), and severe fatigue (13%). Questionnaires identified a wide range of behavioural problems. Most Patients showed good recovery of neurological deficits after GBS, but many have persisting long-term residual complaints and symptoms that may lead to psychosocial problems interfering with participation in daily life.

Effects of long term iodized table salt consumption on serum T3, T4 and TSH in an iodine deficient area of Bangladesh.

The effect of iodized and non-iodized table salt in goiter hyper-endemic area on the thyroid gland and its hormones T3, T4 and Thyroid Stimulating Hormone (TSH) were studied in two hundred subjects from the Center for Nuclear Medicine and Ultrasound, Mymensingh. Iodized and non-iodized salt users were called study and control groups respectively. The mean concentration of T3 were 2.38 nmol/L and 2.22 nmol/L & T4 concentration were 128.67 and 123.72 nmol/L in the study and control group respectively. The mean TSH concentration was 1.52 mIU/L and 1.62 mIU/L in study and control group. The data indicated that continuous and long term use of iodized salt increased both T3, T4 and decreased TSH in such a limit which was not statistically deferent at P< 0.05 level as compared to the control group. There was no significant change in occurrence of (hypo and hyper thyroidism or iodinated salt induced thyrotoxicosis) adverse effect, following iodine supplementation. The study shows that, mandatory mass iodination of table salt consumption in a hyper-endemic iodine deficient area is safe and does not cause any side effect. We suggest close regular monitoring of T3, T4, and TSH and further evaluation by specifically designed studies for any probable link between iodine induced hypo or hyperthyroidism and mass iodination of table salt consumption.

Season of birth is associated with first-lactation milk yield in Holstein Friesian cattle.

The aim of the present research was to assess factors associated with first-lactation milk yield in dairy heifers, including maternal and environmental factors, factors related to the development of the heifer and factors related to its offspring such as gender of the calf. In addition, the potential underlying mechanism, in particular metabolic adaptations, was further explored. Data on body growth, reproduction and milk yield of 74 Holstein Friesian heifers on three herds in Flanders (Belgium) were collected. At birth, body measurements of the heifers were recorded and blood samples were taken (in order) to determine basal glucose and insulin concentrations. Body measurements were assessed every 3 months until first calving, and gender and weight of their first calf were recorded. Information on fertility and milk yield of the heifer and its dam were collected from the herd databases. Daily temperature and photoperiod were recorded from the database of the Belgian Royal Meteorological Institute. Linear mixed models were run with herd as a random factor, to account for differences in herd management. Heifers grew 867±80.7 g/day during their first year of life and were inseminated at 14.8±1.34 months. First calving took place at 24.5±1.93 months, at a weight of 642±61.5 kg and heifers produced 8506±1064 kg energy corrected milk during their first 305-day lactation. Regression models revealed that none of the maternal factors such as milk yield and parity, nor the growth of the heifer during the 1st year of life were associated with milk yield during first lactation. Age, and to a lesser extent BW at first parturition were positively associated with first-lactation milk yield. In addition, the season of birth, but not calving, had a significant influence on milk yield, with winter-born heifers producing less than heifers born in any other season. The lower yielding winter-born heifers had higher insulin concentrations at birth, whereas glucose concentrations were similar, the latter being suggestive for lower insulin sensitivity of the peripheral tissues. Furthermore, environmental temperature at the end of gestation was negatively correlated with neonatal insulin concentrations. In conclusion, results of the present study suggest heifers born during the hotter months are born with a higher peripheral insulin sensitivity, finally leading to a higher first-lactation milk yield.

Evidence for placental compensation in cattle.

Prenatal development is known to be extremely sensitive to maternal and environmental challenges. In this study, we hypothesize that body growth and lactation during gestation in cattle reduce nutrient availability for the pregnant uterus, with consequences for placental development. Fetal membranes of 16 growing heifers and 27 fully grown cows of the Belgian Blue (BB) breed were compared to determine the effect of body growth on placental development. Furthermore, the fetal membranes of 49 lactating Holstein Friesian (HF) cows and 27 HF heifers were compared to study the impact of dam lactation compared to dam body growth. After parturition, calf birth weight and body measurements of dam and calf were recorded, as well as weight of total fetal membranes, cotyledons and intercotyledonary membranes. All cotyledons were individually measured to calculate both the surface of each individual cotyledon and the total cotyledonary surface per placenta. Total cotyledonary surface was unaffected by breed or the breed×parity interaction. Besides a 0.3 kg lower cotyledonary weight (P=0.007), heifer placentas had a smaller total cotyledonary surface compared with placentas of cows (0.48±0.017 v. 0.54±0.014 m2, respectively, P<0.001). Within the BB breed, fetal membranes of heifers had a 1.5 kg lower total weight and 1.0 kg lower intercotyledonary membrane weight (P<0.005) compared with cows. A cotyledon number of only 91±5.4 was found in multiparous BB dams, while growing BB heifers had a higher cotyledon number (126±6.7, P<0.001), but a greater proportion of smaller cotyledons (<40 cm2). Within the HF breed, no parity effect on intercotyledonary membrane weight, cotyledon number and individual cotyledonary surface was found. Placental efficiency (calf weight/total cotyledonary surface) was similar in HF and BB heifers but significantly higher in multiparous BB compared with multiparous HF dams (106.0±20.45 v. 74.3±12.27 kg/m2, respectively, P<0.001). Furthermore, a seasonal effect on placental development was found, with winter and spring placentas having smaller cotyledons than summer and fall placentas (P<0.001). Main findings of the present study are that lactation and maternal growth during gestation entail a comparable nutrient diverting constraint, which might alter placental development. However, results suggest that the placenta is able to manage this situation through two potential compensation mechanisms. In early pregnancy the placenta might cope by establishing a higher number of cotyledons, while in late gestation a compensatory expansion of the cotyledonary surface is suggested to meet the nutrient demand of the fetus.

Environmental factors and dam characteristics associated with insulin sensitivity and insulin secretion in newborn Holstein calves.

The objective of the present retrospective cohort study was to evaluate potential associations between environmental factors and dam characteristics, including level of milk production during gestation, and insulin traits in newborn Holstein calves. Birth weight and gestational age of the calves at delivery were determined. On the next day, heart girth, wither height and diagonal length of both the calves and their dams were measured. Parity, body condition score and age at calving were recorded for all dams. For the cows, days open before last gestation, lactation length (LL), length of dry period (DP) and calving interval were also calculated. The magnitude and shape of the lactation curve both quantified using the MilkBot model based on monthly milk weights, were used to calculate the amount of milk produced during gestation. Using the same procedure, cumulative milk production from conception to drying off (MGEST) was calculated. A blood sample was collected from all calves (n=481; 169 born to heifers and 312 born to cows) at least 5 h after a milk meal on day 3 of life to measure basal glucose and insulin levels. In addition, an intravenous glucose-stimulated insulin secretion test was performed in a subset of the calves (n=316). After descriptive analysis, generalized linear mixed models were used to identify factors that were significantly associated with the major insulin traits (Insb, basal insulin level; QUICKI, quantitative insulin sensitivity check index; AIR, acute insulin response; DI, disposition index) of the newborn calves. The overall average birth weight of the calves was 42.7 ± 5.92 kg. The insulin traits were significantly associated with gender and season of birth when data of all calves were analyzed. In addition, the insulin traits in calves born to cows were significantly associated with MGEST, DP and LL. The Insb was estimated to be higher in calves born to the cows having passed a higher MGEST (P=0.076) and longer DP (P=0.034). The QUICKI was estimated to be lower in calves born to the cows having passed a higher MGEST (P=0.030) and longer DP (P=0.058). Moreover, the AIR (P=0.009) and DI (P=0.049) were estimated to be lower in male compared with female calves. Furthermore, the AIR (P=0.036) and DI (P=0.039) were estimated to be lower in calves born to cows having passed a longer LL. The decisive effects of MGEST, DP and LL in cows on the insulin traits of their calves may provide a basis for developing managerial interventions to improve metabolic health of the offspring.

Adsorptive stripping voltammetric analysis of 2,4,6-tri(2'pyridyl)-1,3,5-triazine at a mercury electrode.

The redox behaviour of adsorbed species of 2,4,6-tri(2'-pyridyl)-1,3-5-triazine (TPTZ) at the surface of a mercury electrode was examined using cycling voltammetry. Based on the adsorption and accumulation of TPTZ at the charged mercury surface cathodic adsorptive stripping voltammetry (CSV) is applied for the trace determination of TPTZ using a differential pulse (DP) technique. Experimental and operational parameters for the quantitative analysis of TPTZ are optimized and the detection limit was found to be 3x10(-9) mol/l. The effect of some interferences, e.g. organic compounds, cations and anions, are investigated.

Chelate adsorption for trace voltammetric measurements of 2-thiouracil and 4-thiouridine.

A very sensitive electrochemical stripping method for trace measurements of 2-thiouracil and 4-thiouridine in presence of Cu(II) is described. The chelate of Cu(II) with 2-thiouracil and 4-thiouridine is adsorbed on the hanging mercury drop electrode, and the reduction current of the accumulated complex is measured by cathodic stripping voltammetry. The adsorption and redox behaviour are indicated by cyclic voltammetry. Optimum experimental conditions include a preconcentration potential of 0.0 V, solution of pH 7.2, adsorption time 5 min, pulse amplitude 100 mV, and a linear scan mode. The sharp chelate peak, associated with the effective interfacial accumulation, coupled with the flat baseline, facilitates measurements at the nanomolar and submicromolar concentration levels.

Improvement of the Mair scoring system using structural equations modeling for classifying the diagnostic adequacy of cytology material from thyroid lesions.

The scoring system developed by Mair et al. (Acta Cytol 1989;33:809-813) is frequently used to grade the quality of cytology smears. Using a one-factor analytic structural equations model, we demonstrate that the errors in measurement of the parameters used in the Mair scoring system are highly and significantly correlated. We recommend the use of either a multiplicative scoring system, using linear scores, or an additive scoring system, using exponential scores, to correct for the correlated errors. We suggest that the 0, 1, and 2 points used in the Mair scoring system be replaced by 1, 2, and 4, respectively. Using data on fine-needle biopsies of 200 thyroid lesions by both fine-needle aspiration (FNA) and fine-needle capillary sampling (FNC), we demonstrate that our modification of the Mair scoring system is more sensitive and more consistent with the structural equations model. Therefore, we recommend that the modified Mair scoring system be used for classifying the diagnostic adequacy of cytology smears. Diagn. Cytopathol. 1999;21:387-393.

Differential pulse and square-wave cathodic stripping voltammetry of xanthine and xanthosine at a mercury electrode.

The surface activity of xanthine (Xan) and xanthosine (Xano) at a hanging mercury drop electrode (HMDE) was studied using out-of-phase ac and cyclic dc voltammetry. The results show that Xan and Xano were strongly adsorbed and chemically interacted with the charged mercury surface, which is the prerequisite step for applying the cathodic adsorptive stripping voltammetric determination of such biologically important compounds. Differential pulse cathodic adsorptive stripping voltammetry (DPCASV) and square-wave cathodic adsorptive stripping voltammetry (SWCASV) were applied for the ultratrace determination of Xan and Xano compounds. Moreover, a rapid and sensitive controlled adsorptive accumulation of Cu(II) complexes of both compounds provided the basis of a direct stripping voltammetric determination of such compounds to submicromolar and nanomolar levels. Operational and solution conditions for the quantitative ultratrace determination of Xan and Xano were optimized in absence and presence of Cu(II). The calibration curve data were subjected to least-squares refinements. The effects of several types of inorganic and organic interfering species on the determination of Xan or Xano were considered.