Effects of seasonality and previous logging on faecal helminth-microbiota associations in wild lemurs.

Gastrointestinal helminth-microbiota associations are shaped by various ecological processes. The effect of the ecological context of the host on the bacterial microbiome and gastrointestinal helminth parasites has been tested in a number of ecosystems and experimentally. This study takes the important step to look at these two groups at the same time and to start to examine how these communities interact in a changing host environment. Fresh faecal samples (N = 335) from eight wild Eulemur populations were collected over 2 years across Madagascar. We used 16S ribosomal RNA gene sequencing to characterise the bacterial microbiota composition, and faecal flotation to isolate and morphologically identify nematode eggs. Infections with nematodes of the genera Callistoura and Lemuricola occurred in all lemur populations. Seasonality significantly contributed to the observed variation in microbiota composition, especially in the dry deciduous forest. Microbial richness and Lemuricola spp. infection prevalence were highest in a previously intensely logged site, whereas Callistoura spp. showed no such pattern. In addition, we observed significant correlations between gastrointestinal parasites and bacterial microbiota composition in these lemurs, with 0.4-0.7% of the variation in faecal bacterial microbiota composition being explained by helminth infections. With this study, we show effects of environmental conditions on gastrointestinal nematodes and bacterial interactions in wild lemurs and believe it is essential to consider the potential role of microbiome-parasite associations on the hosts' GI stability, health, and survival.

Nano- and microplastics affect the composition of freshwater benthic communities in the long term.

Given the societal concern about the presence of nano- and microplastics in the environment, our nescience with respect to in situ effects is disturbing. Data on long-term implications under ecologically realistic conditions are particularly important for the risk assessment of nano- and microplastics. Here, we evaluate the long-term (up to 15 months) effects of five concentrations of nano- and microplastics on the natural recolonization of sediments by a macroinvertebrate community. Effects were assessed on the community composition, population sizes and species diversity. Nano- and microplastics adversely affected the abundance of macroinvertebrates after 15 months, which was caused by a reduction in the number of Naididae at the highest concentration (5% plastic per sediment dry weight). For some other taxa, smaller but still significant positive effects were found over time, altogether demonstrating that nano- and microplastics affected the community composition.

Behavioural responses of Ixodes ricinus nymphs to carbon dioxide and rodent odour.

Many haematophagous ectoparasites use carbon dioxide (CO2 ) and host odour to detect and locate their hosts. The tick Ixodes ricinus (Linnaeus) (Ixodida: Ixodidae) walks only small distances and quests in vegetation until it encounters a host. The differential effects of CO2 and host odour on the host-finding behaviour of I. ricinus have, however, never been clarified and hence represent the subject of this study. The effects of CO2 and odour from bank voles on the activation and attraction of I. ricinus nymphs were analysed in a Y-tube olfactometer. Carbon dioxide evoked a response in the absence and presence of host odour, but did not attract nymphs. Host odour, however, did not evoke a response but did attract nymphs in the absence and presence of CO2 . The current results show that CO2 is an activator, but not an attractant, and that host odour is an attractant, but not an activator, of I. ricinus nymphs, and provide ecological insights into the host-finding behaviour of I. ricinus.

Morphological adaptation of rumen papillae during the dry period and early lactation as affected by rate of increase of concentrate allowance.

Knowledge of the morphological adaptation of rumen papilla, which plays an important role in volatile fatty acid absorption, in dry and early lactation dairy cattle is limited. Therefore, macro- and microscopic changes in papilla morphology during the dry period and lactation and the effect of rate of increase of concentrate allowance were studied. Samples were collected from 12 rumen-cannulated Holstein Friesian dairy cows during a pretreatment period, 50, 30, and 10 d antepartum (the dry period) and 3 d postpartum (pp), and a treatment period, 9, 16, 30, 44, 60, and 80 d pp. Cows had free access to either a dry period ration [27% grass silage, 27% corn silage, 35% wheat straw, and 11% soybean meal on a dry matter (DM) basis] or a basal lactation ration (42% grass silage, 41% corn silage, and 17% soybean meal on a DM basis, and 0.9 kg of DM/d concentrate). Treatment consisted of either a rapid (1.0 kg of DM/d; RAP; n=6) or gradual (0.25 kg of DM/d; GRAD; n=6) increase of concentrate allowance (up to 10.9 kg of DM/d), starting at d 4 pp, aimed at creating a contrast in rumen-fermentable organic matter (FOM) intake. Papillae were collected from the ventral, ventral blind, and dorsal blind rumen sacs and measured digitally. Intake of DM (11.9 kg/d) and FOM (5.7 kg/d) did not change during the pretreatment period, but increased during the treatment period to 24.5 and 15.0 kg/d at 80 d pp, respectively. Concentrate treatment and sampling day interacted for FOM intake, which was 22% greater in RAP at 16 d pp compared with GRAD. Papilla surface area decreased during the pretreatment period by 19% to 28.0mm(2) at 3 d pp, thereafter increasing to 63.0mm(2) at 80 d pp. Concentrate treatment and sampling day interacted for surface area, which was greater in RAP compared with GRAD at 16 (46.0 vs. 33.2mm(2)), 30 (55.4 vs. 41.2mm(2)), and 44 (60.5 vs. 49.7 mm(2)) days pp, showing that papillae can respond to a rapid rate of increase of FOM intake by increasing growth rate. Microscopic morphology was affected by sampling day, but neither by concentrate treatment nor by their interaction, with a decrease in papilla and epithelium thickness during the lactation. In conclusion, the rumen papillae respond to changes in FOM intake and the magnitude of this response depends on the rate of increase of FOM intake. This response in surface area of the rumen papillae potentially facilitates the absorption of the volatile fatty acids.

Quantification of motility of carabid beetles in farmland.

Quantification of the movement of insects at field and landscape levels helps us to understand their ecology and ecological functions. We conducted a meta-analysis on movement of carabid beetles (Coleoptera: Carabidae), to identify key factors affecting movement and population redistribution. We characterize the rate of redistribution using motility µ (L2 T-1), which is a measure for diffusion of a population in space and time that is consistent with ecological diffusion theory and which can be used for upscaling short-term data to longer time frames. Formulas are provided to calculate motility from literature data on movement distances. A field experiment was conducted to measure the redistribution of mass-released carabid, Pterostichus melanarius in a crop field, and derive motility by fitting a Fokker-Planck diffusion model using inverse modelling. Bias in estimates of motility from literature data is elucidated using the data from the field experiment as a case study. The meta-analysis showed that motility is 5.6 times as high in farmland as in woody habitat. Species associated with forested habitats had greater motility than species associated with open field habitats, both in arable land and woody habitat. The meta-analysis did not identify consistent differences in motility at the species level, or between clusters of larger and smaller beetles. The results presented here provide a basis for calculating time-varying distribution patterns of carabids in farmland and woody habitat. The formulas for calculating motility can be used for other taxa.

Enhancement of crop photosynthesis by diffuse light: quantifying the contributing factors.

BACKGROUND AND AIMS: Plants use diffuse light more efficiently than direct light. However, experimental comparisons between diffuse and direct light have been obscured by co-occurring differences in environmental conditions (e.g. light intensity). This study aims to analyse the factors that contribute to an increase in crop photosynthesis in diffuse light and to quantify their relative contribution under different levels of diffuseness at similar light intensities. The hypothesis is that the enhancement of crop photosynthesis in diffuse light results not only from the direct effects of more uniform vertical and horizontal light distribution in the crop canopy, but also from crop physiological and morphological acclimation. METHODS: Tomato (Solanum lycopersicum) crops were grown in three greenhouse compartments that were covered by glass with different degrees of light diffuseness (0, 45 and 71 % of the direct light being converted into diffuse light) while maintaining similar light transmission. Measurements of horizontal and vertical photosynthetic photon flux density (PPFD) distribution in the crop, leaf photosynthesis light response curves and leaf area index (LAI) were used to quantify each factor's contribution to an increase in crop photosynthesis in diffuse light. In addition, leaf temperature, photoinhibition, and leaf biochemical and anatomical properties were studied. KEY RESULTS: The highest degree of light diffuseness (71 %) increased the calculated crop photosynthesis by 7·2 %. This effect was mainly attributed to a more uniform horizontal (33 % of the total effect) and vertical PPFD distribution (21 %) in the crop. In addition, plants acclimated to the high level of diffuseness by gaining a higher photosynthetic capacity of leaves in the middle of the crop and a higher LAI, which contributed 23 and 13 %, respectively, to the total increase in crop photosynthesis in diffuse light. Moreover, diffuse light resulted in lower leaf temperatures and less photoinhibition at the top of the canopy when global irradiance was high. CONCLUSIONS: Diffuse light enhanced crop photosynthesis. A more uniform horizontal PPFD distribution played the most important role in this enhancement, and a more uniform vertical PPFD distribution and higher leaf photosynthetic capacity contributed more to the enhancement of crop photosynthesis than did higher values of LAI.

Interaction between dietary content of protein and sodium chloride on milk urea concentration, urinary urea excretion, renal recycling of urea, and urea transfer to the gastrointestinal tract in dairy cows.

Dietary protein and salt affect the concentration of milk urea nitrogen (MUN; mg of N/dL) and the relationship between MUN and excretion of urea nitrogen in urine (UUN; g of N/d) of dairy cattle. The aim of the present study was to examine the effects of dietary protein and sodium chloride (NaCl) intake separately, and their interaction, on MUN and UUN, on the relationship between UUN and MUN, on renal recycling of urea, and on urea transfer to the gastrointestinal tract. Twelve second-parity cows (body weight of 645±37 kg, 146±29 d in milk, and a milk production of 34.0±3.28 kg/d), of which 8 were previously fitted with a rumen cannula, were fitted with catheters in the urine bladder and jugular vein. The experiment had a split-plot arrangement with dietary crude protein (CP) content as the main plot factor [116 and 154 g of CP/kg of dry matter (DM)] and dietary NaCl content as the subplot factor (3.1 and 13.5 g of Na/kg of DM). Cows were fed at 95% of the average ad libitum feed intake of cows receiving the low protein diets. Average MUN and UUN were, respectively, 3.90 mg of N/dL and 45 g of N/d higher for the high protein diets compared with the low protein diets. Compared with the low NaCl diets, MUN was, on average, 1.74 mg of N/dL lower for the high NaCl diets, whereas UUN was unaffected. We found no interaction between dietary content of protein and NaCl on performance characteristics or on MUN, UUN, urine production, and renal clearance characteristics. The creatinine clearance rate was not affected by dietary content of protein and NaCl. Urea transfer to the gastrointestinal tract, expressed as a fraction of plasma urea entry rate, was negatively related to dietary protein, whereas it was not affected by dietary NaCl content. We found no interaction between dietary protein and NaCl content on plasma urea entry rate and gastrointestinal urea entry rate or their ratio. The relationship between MUN and UUN was significantly affected by the class variable dietary NaCl content: UUN=-17.7±7.24 + 10.09±1.016 × MUN + 2.26±0.729 × MUN (for high NaCl); R(2)=0.85. Removal of the MUN × NaCl interaction term lowered the coefficient of determination from 0.85 to 0.77. In conclusion, dietary protein content is positively related to MUN and UUN, whereas dietary NaCl content is negatively correlated to MUN but NaCl content is not related to UUN. We found no interaction between dietary protein and NaCl content on performance, MUN, UUN, or renal urea recycling, nor on plasma urea entry rate and urea transfer to the gastrointestinal tract. For a proper interpretation of the relationship between MUN and UUN, the effect of dietary NaCl should be taken into account, but we found no evidence that the effect of dietary NaCl on MUN is dependent on dietary protein content.

Effect of sodium chloride intake on urine volume, urinary urea excretion, and milk urea concentration in lactating dairy cattle.

Milk urea nitrogen (MUN; mg of N/dL) has been shown to be related to excretion of urinary urea N (UUN; g of N/d) and total excretion of urinary N (UN; g of N/d) in dairy cows. In the present experiment, it was hypothesized that MUN and the relationship between MUN and UUN or UN is affected by urine volume as a result of dietary sodium chloride intake. Twelve lactating Holstein-Friesian dairy cows (mean ± SD: milk production 28.1±3.23 kg/d and 190±41 d in milk), of which 4 were fitted with catheters in the urine bladder and jugular vein, were randomly assigned to 4 dietary levels of sodium chloride (3, 9, 14, and 19 g of Na/kg of DM) according to a triple 4×4 Latin square design. Cows were fed at 95% of ad libitum intake, excluding salt addition. Milk was analyzed for MUN and protein content; urine was analyzed for total N, urea, and creatinine content; feces were analyzed for total N and DM content; and blood plasma was analyzed for urea and creatinine content. Creatinine clearance rate (CCR; L/min) and renal urea reabsorption ratio were estimated based on plasma concentrations of urea and creatinine, and total excretion of urea and creatinine in urine. Intake of DM and N, milk production, and milk protein content were (mean ± SD), on average, 21.4±1.24 kg/d, 522±32.0 g/d, 25.4±2.53 kg/d, and 3.64±0.186%, respectively. A linear relationship was found between Na intake and urine production [urine (kg/d; mean ± SE)=7.5±4.33+0.136±0.0143 × Na intake (g/d)] and between Na intake and MUN [MUN (mg/dL; mean ± SE)=13.5±0.35-0.0068±0.00104 × Na intake (g/d)]. Despite the decrease in MUN with increased Na intake, UN excretion increased linearly with Na intake. Excretion of UUN was not affected by dietary Na content. A linear plateau relationship was observed between CCR and renal urea reabsorption. An increase in CCR coincided with an increase in calculated renal urea reabsorption until a CCR breakpoint value (mean ± SD) of 1.56±0.063 L/min was reached. We conclude that Na intake is negatively related to MUN, whereas UUN is not affected. Variation in mineral intake levels that affect urine volume should, therefore, be taken into account when using MUN as an indicator of UUN in dairy cattle.

Lactulose as a marker of intestinal barrier function in pigs after weaning.

Intestinal barrier function in pigs after weaning is almost exclusively determined in terminal experiments with Ussing chambers. Alternatively, the recovery in urine of orally administered lactulose can be used to assess intestinal permeability in living animals. This experiment was designed to study the barrier function of the small intestine of pigs over time after weaning. The aim was to relate paracellular barrier function (measured by lactulose recovery in the urine) with macromolecular transport [measured by horseradish peroxidase (HRP) using Ussing chambers] and bacterial translocation to assess whether lactulose recovery is related to possible causes of infection and disease. Forty gonadectomized male pigs (6.7 ± 0.6 kg) were weaned (d 0) at a mean age of 19 d, fitted with urine collection bags, and individually housed. Pigs were dosed by oral gavage with a marker solution containing lactulose (disaccharide) and the monosaccharides l-rhamnose, 3-O-methylglucose, and d-xylose at 2 h and at 4, 8, and 12 d after weaning. The recovery of sugars in the urine was determined over 18 h after each oral gavage. The day after each permeability test, the intestines of 10 pigs were dissected to determine bacterial translocation to the mesenteric lymph nodes and jejunal permeability for HRP in Ussing chambers. Recovery of l-rhamnose in urine was affected by feed intake and by the time after weaning (P ≤ 0.05). Recovery of lactulose from the urine was greater (P ≤ 0.05) at 4, 8, and 12 d after weaning compared with the first day after weaning and was negatively correlated with feed intake (r = -0.63, P ≤ 0.001). The mean translocation of aerobic bacteria to the mesenteric lymph nodes was greater at 5 and 13 d after weaning compared with d 1 (P ≤ 0.05). Lactulose recovery showed no correlation with permeability for HRP nor with bacterial translocation (P > 0.05). Although both lactulose recovery and bacterial translocation increased over time after weaning, lactulose recovery did not correlate with the permeability for HRP nor bacterial translocation within a pig (P > 0.05). Therefore, we conclude that lactulose recovery in the urine of pigs after weaning is not associated with risk factors for infections. However, it appears to be possible to measure paracellular barrier function with orally administered lactulose in pigs shortly after weaning. Further studies will reveal whether this variable is relevant for the long-term performance or health of pigs after weaning.

Cortisol-binding globulin and meat quality in five European lines of pigs.

The gene (Cbg) encoding cortisol-binding globulin (CBG) has been proposed as a candidate gene to explain genetic variation in cortisol secretion and carcass composition in pigs. The objective of this study was to evaluate the association between CBG and pork quality in 5 European breeding lines, Piétrain, Large White (LW), and Landrace purebred lines, a Duroc synthetic line, and a Meishan (MS) x LW advanced intercross. Cortisol-binding globulin maximum binding capacity (CBG-Bmax) was twice as high (P < 0.05) in MS x LW pigs compared with the other lines. There was no (P > or = 0.364) association between CBG-Bmax and carcass quality traits in Piétrain gilts, but CBG-Bmax was associated with increased loin yields in LW (P = 0.010) and Landrace (P = 0.103) gilts, decreased ham yields (P = 0.082) in Duroc gilts, and increased fat depth (P = 0.064) and leaf fat (P = 0.001) in MS x LW gilts. There was no association between CBG-Bmax and pork quality traits in Piétrain (P > or = 0.269) and Duroc (P > or = 0.114) gilts. Conversely, CBG-Bmax was associated with lighter (higher L* values; P < 0.05) pork in Land-race gilts, as well as lower (P < or = 0.055) ultimate pH in the LM and semimembranosus, and a tendency for lower (P = 0.095) L* values of pork from LW gilts. Within MS x LW pigs, CBG-Bmax was associated with increased drip loss (P = 0.001) and decreased i.m. fat in the semimembranosus (P = 0.005). Because drip loss is an economically important pork quality trait, results of this study could be used in the selection of improved water-holding capacity of pork from synthetic lines involving the MS breed.

Effect of response to backtest and housing condition on cell-mediated and humoral immunity in adult pigs.

Several recent studies in juvenile pigs demonstrated a relationship between the degree of resistance displayed early in life in a so-called "backtest" and parameters of cell-mediated and humoral immunity. Some of the immune characteristics were reported to depend on the interaction between backtest classification and housing system. In the present study, the effects of backtest classification and housing condition on immune reactivity in adult gilts were examined. At 10 and 17 days of age, female piglets were subjected to the backtest. In this test, each piglet is restrained on its back for 1 min and the number of escape attempts is scored. Pigs classified as high resisting (HR) or low resisting (LR) were selected and housed in groups of six gilts. At 7 months of age, half of the gilts were housed in individual stalls. At 12 months of age, gilts were challenged by immunization with DNP-KLH. Control gilts were treated similarly with a placebo. Blood samples were drawn prior to immunization (Day 0) and weekly thereafter until Day 28. No significant effects of backtest type on cellular and humoral responses against KLH were found. Furthermore, being housed in stalls as compared to groups had no consequences for the immune response and did not induce differences between HR and LR gilts. Differences in behavior and physiology found previously between HR and LR gilts, particularly in gilts in stall housing, may thus be of relatively little importance for immune-related health.

Individual differences in behavioral and physiological responses to restraint stress in pigs.

Several recent studies on pigs have demonstrated a relationship between the degree of resistance displayed early in life in a so-called backtest and a variety of behavioural and physiological responses in piglets and young fattening pigs. To study whether pigs with diverging responses in the backtest, i.e., high-resisting (HR) and low-resisting (LR) pigs, differ also in adulthood in their responses to an acute stressor, adult nulliparous HR (n=36) and LR gilts (n=36) housed in groups or stalls were challenged by 5-min fixation with a nose sling. During the first minute of restraint, HR gilts vocalised significantly more than LR gilts. Over the whole 5-min period, HR gilts tended to vocalise more than LR gilts. Housing or backtest type did not affect immediate cortisol increase (Delta(-5 min; 15 min)). At t=45 min, cortisol concentrations in HR gilts but not in LR gilts were still higher than at t=-5 min. Heart rate quickly decreased during the first min of restraint and remained fairly constant thereafter. Estimated heart rate after 5 min of nose sling was significantly lower in HR gilts compared to LR gilts. Housing or backtest type did not affect heart rate variability indices. The results support the idea that the backtest relates to individual characteristics, which at an adult age also seem to play a role in the regulation of certain behavioral and physiological responses to short-term stress.

Comparison of cultivars of ornamental crop Gerbera jamesonii on production of spider mite-induced volatiles, and their attractiveness to the predator Phytoseiulus persimilis.

We investigated whether volatiles produced by spider mite-damaged plants of four gerbera cultivars differ in attractiveness to Phytoseiulus persimilis, a specialist predator of spider mites, and how the mite-induced odor blends differ in chemical composition. The gerbera cultivars differed in resistance, as expressed in terms of spider mite intrinsic rate of population increase (rm). In order of increasing resistance these were Sirtaki, Rondena, Fame, and Bianca. To correct for differences in damage inflicted on the cultivars, we developed a method to compare the attractiveness of the blends, based on the assumption that a larger amount of spider mite damage leads to higher attraction of P persimilis. Spider mite-induced volatiles of cultivars Rondena and Bianca were preferred over those of cultivar Sirtaki. Spider mite-induced volatiles of cultivars Sirtaki and Fame did not differ in attractiveness to P. persimilis. Sirtaki plants had a lower relative production of terpenes than the other three cultivars. This was attributed to a low production of cis-alpha-bergamotene, trans-alpha-bergamotene, trans-beta-bergamotene, and (E)-beta-farnesene. The emission of (E)-beta-ocimene and linalool was lower in Sirtaki and Fame leaves than in Bianca and Rondena. The importance of these chemical differences in the differential attraction of predatory mites is discussed.

Development and use of genetically uniform strains of common carp in experimental animal research.

Fish are widely used in numerous fields of basic and applied research. Currently, they are the third laboratory animal group in numbers, and will become increasingly important. Common carp is a major species in both aquaculture and research. Inbred strains of carp by gynogenetic (only female inheritance) and androgenetic (only male inheritance) reproduction techniques were developed at our university. With these methods, homozygous animals are produced in one generation and we present the production of homozygous inbred and F1 hybrid strains of common carp. As in mammalian research, using genetically well defined fish is a methodological necessity since in outbred stocks: (1) repeatability between experiments is low, (2) high levels of inbreeding may have accumulated and (3) high intrastrain variability might obscure treatment effects. Within inbred strains, the variation is reduced and as a result, less animals (compared to outbreds) are necessary to obtain statistically significant results. We illustrate this with experimental data from an F1 hybrid and partly outbred strain of common carp, both subjected to an antibiotic treatment resulting in reduced gonadal growth. Results obtained from a single inbred strain should be generalized with the use of a panel of inbred strains. We show that optimal allocation of animals between and within inbred strains depends on the ratio (variation between strains): (variation within strains). When selecting a panel of inbred strains, attention has to be paid to genetic relations between strains to avoid testing within a limited genetic range. It should be considered that in inbred strains, (genic) dominance and interaction effects are absent, due to the absence of heterozygous genotypes. In general, variation within inbred strains will be reduced for traits with a high degree of genetic determination. However, in inbred strains of carp produced by gynogenesis or androgenesis, the chromosome manipulation treatment induces considerable (environmental) variation. By using F1 hybrids of carp, derived from crossing homozygous clonal siblings this source of variation can be avoided. Still, variation in F1 hybrids of carp is relatively large and varies greatly between strains when compared to inbred strains of laboratory rodents. It is assumed that their poikilothermic nature makes them more susceptible to environmental variation. Using inbred fish lines will increase experimental quality and leads to a more efficient use of experimental animals.

Interlaboratory comparison of methods To quantify microsclerotia of verticillium dahliae in soil

In a comparison of different methods for estimating Verticillium dahliae in soil, 14 soil samples were analyzed in a blinded fashion by 13 research groups in seven countries, using their preferred methods. One group analyzed only four samples. Twelve soil samples were naturally infested, and two had known numbers of microsclerotia of V. dahliae added to them. In addition, a control was included to determine whether transport had an effect on the results. Results differed considerably among the research groups. There was a 118-fold difference between the groups with the lowest and highest mean estimates. Results of the other groups were evenly distributed between these extremes. In general, methods based on plating dry soil samples gave higher numbers of V. dahliae than did plating of an aqueous soil suspension. Recovery of V. dahliae from samples with added microsclerotia varied from 0 to 59%. Most of the variability within each analysis was at the petri dish level. The results indicate the necessity to check the performance of detection assays regularly by comparing recoveries with other laboratories, using a common set of soil samples. We conclude that wet plating assays are less accurate than dry plating assays.

Normal values in anal manometry and rectal sensation: a problem of range.

Anal manometry was performed in 80 individuals, mainly healthy volunteers, 40 men and 40 women aged 20-87, mean 45 years. An open-tip perfusion system employing a catheter with 4 sideports and a terminal balloon (to be inflated with air) was used. The maximum basal pressure (MBP) showed no significant difference between men and women (68 +/- 21 and 63 +/- 19 mmHg). With respect to the maximum squeeze pressure (MSP) a significant difference was found between men and women (183 +/- 73 and 102 +/- 36 mmHg, p less than 0.001). Both MBP and MSP decreased significantly with age (both p less than 0.001). The sphincter length was larger in men than in women (4.1 +/- 0.7 and 3.5 +/- 0.5 cm, p less than 0.001) and was related to BMP (p less than 0.002). The distension reflex seemed to change with age: the threshold volume increased (p less than 0.02), the pressure drop decreased (p less than 0.03), and the recovery time increased (p less than 0.001). The pressure drop was also related to MBP (p less than 0.005). The volume of rectal perception increased with age (p less than 0.005). Ultra-slow waves were related to MBP, and were only seen when MBP greater than 70 mmHg. No relationship was to be found between parity and MBP or MSP in women. In conclusion, anal pressures and sphincter length in normal individuals have a large range and vary with age and sex. The sensitivity of the rectum to balloon inflation decreases with age. When making therapeutic decisions in patients with anorectal disorders all these factors should be taken into account.

A study of communication between general practitioners and specialists.

A random sample of referral letters from general practitioners to outpatient departments of general medicine, dermatology, neurology, and gastroenterology at an Amsterdam teaching hospital were analysed together with the specialists' replies for 144 referrals. The pairs of letters were judged by a panel of four general practitioners and four specialists. Letters were assessed according to quality and content, clarity, request for return to general practitioner care, time intervals between referral and consultation and between consultation and the specialist's reply. The judges were also asked to assess whether in their opinion the letters were of value in teaching or were discourteous. Though in general intraobserver agreement on what constitutes a good letter was low, deficiencies were revealed in the quality of letters and there were delays in transmission and missed educational opportunities.

A critical look at the TNM classification for laryngeal carcinoma.

A total number of 564 patients with glottic (427) and supraglottic (137) laryngeal carcinoma was prospectively staged clinicoendoscopically (CS) and radiologically (RS). These patients were treated from 1974 to 1985 with quality-controlled high-dose radiation therapy. The validity of CS versus RS was checked in this study with the parameter of recurrence-free adjusted survival (RFADS) at 3 and at 5 years. It appears that RS is more valid and has therapeutic implications in planning the target volume for irradiation. The CS should be regarded as inadequate for radiotherapeutic considerations. The International Union Against Cancer (UICC) 1987 norms for staging laryngeal carcinoma (clinical, endoscopic, and imaging) should be strictly followed.

Pathological grief: causes, recognition, and treatment.

Although the incidence of pathological grief does not appear to be high, the morbidity and mortality of sufferers is significant. Because of attitudes about grieving and the reluctance to experience grief, patients may avoid sharing grief with the family physician, who may then fail to recognize pathological grief. This article discusses clinical manifestations and situations which can lead to pathological grief. The types of pathological grief-chronic, inhibited, delayed, and atypical-are also discussed, along with personality variables which predispose some people to difficult grieving. Failure to grieve may also lead to a higher incidence of physical disease and various forms of mental illness. In order to manage grief, the physician must encourage the patient to express all his feelings of sadness, anger, and guilt; reassure him that his anger and guilt are a normal reaction to loss; and later, give him permission to stop grieving.