Sexual behaviour, semen quality and fertility of young Border Leicester rams administered melatonin during spring.

This study was conducted to test the hypothesis that between year variability in reproductive response to melatonin treatment of young Border Leicester (BL) rams in spring was related to sexual maturity at the time of treatment. Two variables of sexual maturity (mating behaviour and semen quality) were examined. In Experiment 1, mating activity of melatonin-treated and untreated rams was examined at two sites before a flock mating at one site. In Experiment 2, testosterone concentrations, semen quality and variables of in vitro fertilising capacity were examined. In Experiment 1, melatonin treatment did not alter sexual behaviour (latency to nose, total nosings, courtings including Flehmen expression, attempted mounts, mounts, ejaculations) with the exception of a lesser (P < 0.05) Flehmen expression at Site 1 whereas values for most variables were greater (P < 0.05) at Site 2. Treatment resulted in a greater pregnancy rate (89 % and 82 %, respectively; P < 0.05) and advanced distribution of pregnancies (P < 0.001) at Site 1. Testicular size and testosterone concentrations were also greater (P < 0.05) as a result of melatonin treatment in spring whilst the reverse occurred in autumn. In Experiment 2, sperm motility and in vitro fertilising capacity were greater (P < 0.05) and acrosome damage less (P < 0.05) as a result of melatonin treatment. In conclusion, variability in age at sexual maturity of young BL rams at spring mating can be reduced with melatonin treatment and is associated with differences in sexual behaviour, testicular growth, testosterone concentrations, and sperm quality.

Supplementing pregnant Merino ewes with caffeine to improve neonatal lamb thermoregulation and viability.

Percentages of lamb mortalities prior to weaning are a significant and persistent problem for the Australian sheep industry. Maternal caffeine supplementation reduced stillbirths and improved viability in piglets; however, the efficacy of caffeine in enhancing viability and lamb survival is equivocal. The aim of this study was to determine the optimal concentration and duration of maternal caffeine supplementation to improve lamb viability; time to stand and suck with consumption of colostrum occurring, as well as survival to weaning. Multiparous Merino ewes were supplemented with either 0 (CTL), 10 (C10) or 20 mg/kg (C20) body weight (BW) caffeine in feed after day 120 of gestation (dG), or 20 mg/kg BW (LC20) caffeine from dG 142 until parturition. Ewes were housed indoors in individual lambing pens from dG 130 to 72 -h post-partum (pp). Values for pp ewe and lamb variables were analysed using a generalised linear mixed model in IBM SPSS version 25. While ewes within the CTL, C10 and LC20 groups consumed more caffeine compared to C20 ewes (P =  0.001), lambs of C20 ewes had greater rectal temperatures at 20 -h pp (P =  0.021), greater 4 -h serum IgG concentrations (P =  0.041), a longer latency to first sucking bout (P =  0.030), and a greater number of sucking attempts (P =  0.044) compared to lambs from CTL, C10 and LC20 ewes. These results indicate that caffeine supplementation during late-gestation stimulates neonatal lambs as a result of increased sucking (4 -h serum IgG) and increased temperatures within the first 24 -h.

[The influence of comorbid mental disorders on quality of life in patients with chronic rhinosinusitis]. / Zum Einfluss von psychischen Komorbiditäten auf die Lebensqualität von Patienten mit einer chronischen Rhinosinusitis.

BACKGROUND: In recent years, the international literature has contained numerous reports indicating a high prevalence of depression and anxiety symptoms in patients with chronic rhinosinusitis (CRS). Measurement of subjective health-related quality of life in CRS patients, also as an assessment of treatment outcome, has received increasing attention in the past two decades. OBJECTIVE: The aim of this study was to investigate the correlation between results of screening tests for the two most frequent mental disorders in Germany and the results of the Sino-Nasal Outcome Test-20 German Adapted Version (SNOT-20 GAV) in patients with CRS. PATIENTS AND METHODS: 121 in- and outpatients with a confirmed diagnosis of CRS were examined with the Beck Depression Inventory (BDI-II), the Beck Anxiety Inventory (BAI), and the SNOT-20 GAV. Possible correlations were verified by statistical tests. RESULTS: Of 108 evaluated tests, 23.1% contained indications of moderate or severe depressive syndromes, clinically relevant anxiety disorders, and combined disorders. For the results of BDI-II, BAI, and the overall quality of life (ALQ) subscore of SNOT-20 GAV, significantly more mental comorbidities and a worse quality of life were observed in women and older patients. There was a high/moderate correlation between the total score of BDI-II/BAI and the ALQ subscore for the entire patient group. The correlation between total scores of BDI-II/BAI and the subscore of primary nasal symptoms (PNS) was very weak. CONCLUSION: The presented trial points out the considerable number of mental comorbidities in patients with affirmed CRS. Furthermore, the results of this examination demonstrate the significant influence of mental comorbidity on the quality of life of these patients.

[Depression and anxiety : Prevalence among ENT outpatients]. / Depression und Angst : Prävalenz bei Patienten in der ambulanten HNO-Praxis.

BACKGROUND: Few data exist on the prevalence of comorbid mental disorders among ENT patients. This investigation aimed to assess the prevalence of two disorders frequent in our society, namely depression and anxiety, in patients of an ENT outpatient clinic. PATIENTS AND METHODS: During a 2­week period, 101 consecutive patients were interviewed with the Beck Depression Inventory-II (BDI II) and Beck Anxiety Inventory (BAI) screening aids. RESULTS: Of 97 evaluated tests, 38% contained indications of a psychiatric problem or mental comorbidity. The proportion of moderate and severe depressive syndromes, anxiety disorders, and combined disorders was only 11.3%. There were no significant differences between genders or in terms of acute vs. chronic ENT diseases. The highest frequency of pathological test results was observed in the group of patients with cochleovestibular disorders. An astoundingly high number of conspicuous test results were seen in patients with trivial diseases and disorders, as well as among those with chronic obstructive disorders of the nose and sinuses. CONCLUSION: The finding of a considerable prevalence of psychiatric comorbidities among ENT patients represents important information for the treating physician. BDI II and BAI were found to be reliable and easy to apply in the outpatient clinic.

Effect of periconceptional nutrition on the growth, behaviour and survival of the neonatal lamb.

Periconceptional nutrition (PCN) can influence foetal hypothalamo-pituitary adrenal (HPA) axis function and alter cortisol secretion with possible consequences for maturation and growth of major organs, gestation length and behaviour. We examined effects of PCN on phenotype and survival of the neonatal lamb in 466 Merino ewes allocated to treatments providing 70%, 100% and 150% respectively, of maintenance requirements for 17 days prior and 6 days after insemination. Gestation length and birth weight for lambs in PCN treatment groups was similar (P > 0.05) but low PCN decreased the size of the neonate (crown-rump-length and metacarpal length P < 0.05). A subset of lambs euthanased at 5 days of age further showed that low PCN decreased the amount of peri-renal fat (P < 0.05) and increased liver mass (P < 0.05) while high PCN increased neck thymus and ovary mass (P < 0.05). Neonatal lambs from low PCN ewes returned faster to their mothers after release (P < 0.05) and contacted the udder in the shortest time (P < 0.05). Significant interactions between PCN treatment and sex (P < 0.05) and between PCN treatment and ewe age (P < 0.05) were also observed for time lambs took to follow the ewe. Survival of lambs was similar but potential differences may have been masked by favourable weather conditions. In conclusion, this study provides evidence of significant changes in lamb growth and development dependent on PCN and, for the first time, links these changes with significant changes in behaviour of the neonate. The impact of these effects on lamb survival and potential reproductive capacity of female offspring remains to be determined.

Positive effects of melatonin treatment on the reproductive performance of young border leicester rams mated to merino ewes in spring: preliminary observations.

Poor reproductive performance of Merino ewe flocks when mated to Border Leicester rams during spring may be due to seasonality of the Border Leicester breed. Two approaches were taken to test this assumption. Six young (12 months old) or six mixed-age (12, 24 and ≥36 months old) Border Leicester rams were either treated or not treated with melatonin implants (2 × 2 design) 6 weeks before the four groups of rams were each put with approximately 300 Merino ewes for an 8-week mating period. Implants were inserted in early September (experiment 1). The second approach was to yard or not yard ewes and mixed-age rams on several occasions during the first 3 weeks of the mating period (experiment 2). Pregnancy rate and twinning percentage were assessed by ultrasonography. In experiment 1, melatonin treatment in young rams increased (p < 0.001) pregnancy rate from 5.0% to 92.6%, but mixed-age rams did not respond (90.7% vs 89.5% for melatonin and non-melatonin treatments, respectively). Twinning rate was similar (p > 0.05) for ewes mated to either melatonin or non-melatonin-treated young rams (36.8% vs 40.0%, respectively), whereas melatonin significantly improved (p < 0.05) twinning rate in those ewes mated to mixed-age rams (49.1% vs 36.1%). After 6 weeks of melatonin treatment, scrotal circumference was greater (p < 0.05) in both young and mixed-aged rams than in untreated counterparts. In experiment 2, yarding of ewes and rams overnight on several occasions early in the mating period reduced (p < 0.001) pregnancy rate compared with non-yarded counterparts (89.5% vs 65.5%). Twinning rate was not affected (37.7% vs 36.1%, respectively). In summary, melatonin treatment of Border Leicester rams significantly improved flock reproductive performance in spring due to improved pregnancy rates with young rams and improved litter size with mixed-age rams.

Maternal undernutrition around the time of conception and embryo number each impact on the abundance of key regulators of cardiac growth and metabolism in the fetal sheep heart.

Poor maternal nutrition before and during pregnancy is associated with an increased risk of cardiovascular disease in later life. To determine the impact of maternal undernutrition during the periconceptional (PCUN: -45 days to 6 days) and preimplantation (PIUN: 0-6 days) periods on cardiac growth and metabolism, we have quantified the mRNA and protein abundance of key regulators of cardiac growth and metabolism in the left ventricle of the sheep fetus in late gestation. The cardiac protein abundance of AMP-activated protein kinase (AMPK), phospho-acetyl CoA carboxykinase (ACC) and pyruvate dehydrogenase kinase-4 (PDK-4) were decreased, whereas ACC was increased in singletons in the PCUN and PIUN groups. In twins, however, cardiac ACC was decreased in the PCUN and PIUN groups, and carnitine palmitoyltransferase-1 (CPT-1) was increased in the PIUN group. In singletons, the cardiac abundance of insulin receptor ß (IRß) was decreased in the PCUN group, and phosphoinositide-dependent protein kinase-1 (PDPK-1) was decreased in the PCUN and PIUN groups. In twins, however, the cardiac abundance of IRß and phospho-Akt substrate 160kDa (pAS160) were increased in the PIUN group. The cardiac abundance of insulin-like growth factor-2 receptor (IGF-2R), protein kinase C alpha (PKCα) and mammalian target of rapamycin (mTOR) were decreased in PCUN and PIUN singletons and extracellular-signal-regulated kinase (ERK) was also decreased in the PIUN singletons. In contrast, in twins, cardiac abundance of IGF-2R and PKCα were increased in the PCUN and PIUN groups, phospho-ribosomal protein S6 (pRPS6) was increased in the PCUN group, and ERK and eukaryotic initiation factor 4E (eIF4E) were also increased in the PIUN fetuses. In conclusion, maternal undernutrition limited to around the time of conception is sufficient to alter the abundance of key factors regulating cardiac growth and metabolism and this may increase the propensity for cardiovascular diseases in later life.

Maternal undernutrition during the first week after conception results in decreased expression of glucocorticoid receptor mRNA in the absence of GR exon 17 hypermethylation in the fetal pituitary in late gestation.

Exposure to maternal undernutrition during the periconceptional period results in an earlier prepartum activation of the fetal hypothalamo-pituitary-adrenal (HPA) axis and altered stress responsiveness in the offspring. It is not known whether such changes are a consequence of exposure of the oocyte and/or the early embryo to maternal undernutrition in the periconceptional period. We have compared the effects of 'periconceptional' undernutrition (PCUN: maternal undernutrition imposed from at least 45 days before until 6 days after conception), and 'early preimplantation' undernutrition (PIUN: maternal undernutrition imposed for only 6 days after conception) on the expression of genes in the fetal anterior pituitary that regulate adrenal growth and steroidogenesis, proopiomelanorcortin (POMC), prohormone convertase 1 (PC1), 11ß-hydroxysteroid dehydrogenase type 1 and 2 (11ßHSD1 and 2) and the glucocorticoid receptor (GR) in fetal sheep at 136-138 days of gestation. Pituitary GR mRNA expression was significantly lower in the PCUN and PIUN groups in both singletons and twins compared with controls, although this suppression of GR expression was not associated with hypermethylation of the exon 17 region of the GR gene. In twin fetuses, the pituitary 11ßHSD1 mRNA expression was significantly higher in the PIUN group compared with the PCUN but not the control group. Thus, exposure of the single or twin embryo to maternal undernutrition for only 1 week after conception is sufficient to cause a suppression of the pituitary GR expression in late gestation. These changes may contribute to the increased stress responsiveness of the HPA axis in the offspring after exposure to poor nutrition during the periconceptional period.

Impact of maternal periconceptional overnutrition on fat mass and expression of adipogenic and lipogenic genes in visceral and subcutaneous fat depots in the postnatal lamb.

Women entering pregnancy with a high body weight and fat mass have babies who are at increased risk of becoming overweight or obese in later life. We investigated whether maternal overnutrition in the periconceptional period results in an increased fat mass and expression of adipogenic and lipogenic genes in offspring and whether dietary restriction can reverse these changes. Nonpregnant donor ewes (n = 23) were assigned to one of four groups: control-control fed at 100% maintenance energy requirements (MER) for at least 5 months, control-restricted fed 100% MER for 4 months and 70% MER for 1 month, high-high (HH) fed ad libitum (170-190% MER) for 5 months, or high-restricted (HR) fed ad libitum for 4 months and 70% MER for 1 month. Single embryos were transferred to nonobese recipient ewes, and lamb fat depots were weighed at 4 months. Peroxisome proliferator-activated receptor-γ, glyceraldehyde-3-phosphate dehydrogenase, lipoprotein lipase, leptin, and adiponectin mRNA expression was measured in the lamb fat depots. Total fat mass was higher in female lambs in the HH but not HR group than controls. There was a relationship between donor ewe weight and total fat mass and G3PDH mRNA expression in perirenal fat in female lambs. There was no effect of periconceptional nutritional treatment on peroxisome proliferator-activated receptor-γ, glyceraldehyde-3-phosphate dehydrogenase, lipoprotein lipase, leptin, and adiponectin mRNA expression in any fat depot. Thus, exposure to maternal overnutrition in the periconceptional period alone results in an increased body fat mass in the offspring and that a short period of dietary restriction can reverse this effect.

[The effect of hormonal agents on the development of chronic laryngitis and tumor disease. Report of two cases]. / Chronische Laryngitis und Tumorerkrankung unter dem Einfluss von hormonell wirksamen Substanzen. Zwei Kasuistiken.

BACKGROUND: In the literature the potential effect of sexual steroids on the development and growth of laryngeal carcinomas, and even other tumor entities of the upper aerodigestive tract, within the context of multifactorial carcinogenesis has been the subject of controversial discussion. Experimental cell studies have provided evidence for the differentiated effects of these agents. Apart from the male preponderance in tumor formation, the high incidence at an age characterized by decreased peripheral androgenic signalling should be noted. PATIENTS AND METHODS: Two patients with chronic symptoms and abnormal hormone levels are reported who underwent a hormonal trial regimen. The course of their disease was followed up for a period of more than 10 years. RESULTS: In the first case of a patient suffering from chronic hyperplastic laryngitis for 17 years, a close correlation was found between the treatment with the 5alpha-reductase inhibitor Finasteride, the drop in serum levels of dihydrotestosterone (DHT), and the appearance of an invasive squamous cell carcinoma of the vocal cord. During the postoperative 7-year follow-up without recurrence the androgen serum levels were within normal range. The laryngeal mucosa did not display any further dysplastic changes. Retrospective studies of the biopsies demonstrated a significant degree of epidermal growth factor receptor (EGFR) expression, the characteristic high degree of EGFR activity in all of the tumor tissue, and a significantly lower degree of activity in the subsequent excision biopsies. In the second patient, who had undergone previous surgery for mesopharyngeal cancer at another site before the present tumor operation, rapid recurrence was seen within 2 years. Despite radical revision surgery and subsequent irradiation the patient insisted on carrying on with his work. He complained about a general lack of stamina and libido. His androgen serum levels were at the low-end of the normal range and even below that. The daily administration of 25 mg dehydroepiandrosterone (DHEA) resulted in normal androgen serum levels and improved his wellbeing. He has been free of recurrence for 10 years. DISCUSSION: Occasional long-term follow-up of patients supports the circumstantial evidence of previous experimental cellular studies that a dysbalanced androgen metabolism appears to act as cofactor in the genesis and development of malignant tumors of the upper aerodigestive tract.

[Myofibroblastic sarcoma of the larynx : a case report and review]. / Myofibroblastische Sarkome des Larynx : Fallbericht und Ubersicht.

BACKGROUND: Myofibroblastic sarcomas or myofibrosarcoma, are extremely rare malignant neoplasms of myofibroblasts. They are characterized by the pattern of cells and special immunohistochemical markers such as vimentin, desmin and alpha-smooth-muscle actin. PATIENT AND METHOD: The case of a patient with a history of frequently relapsing papillomas of the larynx is reported. Chronic laryngitis with focal low-grade dysplasia of the squamous epithelium was diagnosed approximately 1 year after the first treatment of the papillomas. After approximately 2 years the pathologist diagnosed the rare myofibroblastic sarcoma of the larynx. The patient underwent laryngectomy due to the spread of the tumor with a bilateral selective neck dissection. The patient is at present still free of recurrence and metastases. RESULTS AND CONCLUSIONS: There is a great danger of misjudging a myofibroblastic sarcoma as an inflammatory myofibroblastic tumor and consequently to delay the urgently needed treatment. Therefore, an overview of the present state of knowledge about diagnosis and treatment of myofibroblastic sarcomas will be given based on this case report.

[Dysphagia after ventral spondylodesis]. / Dysphagie nach HWS-Operation.

BACKGROUND: Complications caused by osteosynthetic material after cervical spine surgery are rare. PATIENT AND METHOD: The case of a 36-year-old patient is reported, who suffered the extrusion of a screw and migration through the hypopharynx after ventral spondylodesis of a cervical spine fracture. RESULT: Dysphagia occurred shortly after spinal surgery. The lack of one osteosynthesis screw in the spine was detected by X-ray and the material was located in the rectum. The screw had passed through the intestinal tract and was excreted spontaneously. An ENT medical control was carried out because of persisting dysphagia. Endoscopy revealed a cherry-sized granuloma of the posterior hypopharynx wall which was removed surgically. The healing process of the mucosa continued without further complications. CONCLUSION: X-ray control and endoscopy are required immediately when dysphagia occurs after osteosynthesis of the cervical spine due to possible complications caused by the implanted material. Further therapeutic measures depend on the case-specific constellation.

[Mycotic aneurysm of the internal carotid artery]. / Mykotisches Aneurysma der Arteria carotis interna.

The detection of aneurysms of the internal carotid artery due to acute or chronic neck infections seems to be a rather rarely event. However, if aneurysms or pseudoaneurysms of the neck region occur, than mostly by bleeding complication or unclear significant soft tissue swelling. The case of a patient is reported, who underwent an abscess tonsillectomy. The intraoperative situation of the right tonsillar fossa was found to show suspicious pulsations under the scarred and inflamed peritonsillar tissue layer. The postoperative performed intraarterial angiography verified the diagnosis of the aneurysm of the internal carotid artery nearby the tonsillar fossa. The diagnosis mycotic aneurysm has been concluded by the long lasting tonsillitis history with one further peritonillar abscess in the past, intraoperative and histological signs of peritonsillitis and the the result of an intraarterial angiography carried through 10 years ago without any clue to aneurysm. A bleeding complication did not occur in this case. The patient went into the care of vascular surgeons with the indication to perform a stent application.

Effect of variable long-term maternal feed allowance on the development of the ovine placenta and fetus.

Maternal feed allowance during pregnancy can affect the development of the ovine placenta and fetus. The impact of variations in feed allowance prior to as well as throughout pregnancy has received less attention. Ewes were offered 0.6 (R), 1.2 (C) or 1.8 (AL) maintenance requirements from 89 days before conception until day 133 of pregnancy. Ewes were euthanised on days 50, 92 and 133 of pregnancy. Ewe live weight and body condition score, maternal and fetal metabolic and hormonal profiles, fetal body dimensions and organ weights, and the number, weight and morphology of placentomes were measured. Maternal live weight and condition score were lower in R compared to AL ewes at all stages of pregnancy (P<0.05). Plasma glucose and albumin concentrations of R ewes were significantly reduced (P<0.05) at mid and late gestation, respectively. Placental components were generally unresponsive to long term variations in maternal feed allowance. However, placental weight was significantly (P<0.05) correlated with fetal weight at days 50 (r=0.59) and 133 (r=0.69) of gestation. By late gestation growth-retarded singleton fetuses from R ewes were 19% lighter (P<0.05), with reduced abdominal (9%) and thoracic (10%) girths (P<0.05) but of similar crown-rump length compared with fetuses from AL ewes. These differences were associated with significantly reduced IGF-I concentrations in fetal plasma (P<0.05). In conclusion, maternal, placental and fetal adaptations to long established planes of variable maternal feed allowance were able to maintain fetal growth during early and mid-pregnancy while fetal growth restriction, associated with reduced fetal IGF-I levels, became apparent in late pregnancy.

[Fluorescence of the middle ear]. / Fluoreszenzendoskopie des Mittelohrs.

BACKGROUND: Discussions of the detection of fluorescein in the perilymph after intravenous (IV) administration have been contradictory. Differentiating between the fluorescence of mucosa and fluorescence signals of extravasation or perilymph fistulas seems to be rather difficult. PATIENTS AND METHODS: We performed fluorescence endoscopy of the middle ear after IV administration of fluorescein, twice after intrathecal application, in 53 patients suffering functional cochleovestibular disturbances without improvement by infusion therapy or together with a tympanoplasty or tympanotomy. Endoscopic signs were documented in 40 patients. RESULTS: Fluorescence of the eardrum in blue light was detected immediately (15-20 s) after IV injection of fluorescein. A maximum amount of mucosa fluorescence was found an average of 4 min later, decreasing up to 120 min (average 55 min). Fluorescence of the middle ear mucosa increased faster and lasted longer in ears with chronic otitis than in ears without signs of inflammation. Fluorescence signals of liquid in the round or oval niche were observed in 25 patients an average of 30 min after the IV administration. We documented these signals up to 240 min after administration, depending on the period between injection and start of the operation as well as the operating procedure. Probes of liquid >5 mul in the round niche could be sampled in three patients. These probes showed a significantly increased beta fraction in protein electrophoresis. CONCLUSION: The choice of the right examination time point (45 min up to 2 h after IV administration) seems to be crucial for fluorescence endoscopy of the middle ear, as this method is a dynamic procedure.

Effects of grade of oocyte-cumulus complex and the interactions between grades on the production of blastocysts in the cow, ewe and lamb.

There is an association between the size of the cumulus investment and the in vitro developmental ability of the oocyte-cumulus complex (OCC) that provides a basis for the selection of OCCs. However, the value of selection is confounded by humoral interactions between OCCs that influence the development of OCCs of other grade(s). This study examined the effect of size of the cumulus investment (OCC grade) and the interactions between grades on the developmental ability of oocytes collected from the cow, ewe and lamb. OCCs were classified into A, B and C grades on visual assessment of the number of cumulus cell layers or left unselected (Unselected). In the cow, there were 669 +/- 228 to 4763 +/- 228 cells per OCC whereas comparable figures in the ewe and lamb were 593 +/- 252 to 3716 +/- 252 and 366 +/- 228 to 3263 +/- 228 respectively (A > Unselected > B > C; Experiment 1). In Experiment 2, OCCs were made to mature within grade and the efficiency of blastocyst production and blastocyst quality was compared with that obtained in the Unselected group. Grade was associated with significant (p < 0.05) differences in cleavage rate, blastocyst production rate and the mean number of nuclei per embryo (generally A > B > C across animal types). However, the performance of A grade OCCs in the cow and lamb did not differ significantly from that obtained in the Unselected group whereas in the ewe, A grade OCCs were significantly (p < 0.05) better. Furthermore, the performance of the Unselected group was significantly (p < 0.05) better than that of the combined grades (A + B + C) in the cow but there were no differences in either the ewe or lamb. It is concluded that (i) interactions between OCCs of different grade influence the developmental ability of OCCs in the cow and, to a lesser extent, the lamb, (ii) selection of OCCs in the cow and lamb would lead to the exclusion of many OCCs that have the ability to develop into blastocysts and (iii) selection in the ewe would improve the efficiency of blastocyst production although its value is limited by the low percentage of A grade OCCs.

[Sinonasal sarcoidosis]. / Sarkoidose der Nase und Nasennebenhöhlen.

BACKGROUND: The sinonasal system is rarely involved in the clinical picture of sarcoidosis. In the absence of pulmonary disease, sinonasal sarcoidosis is extremely rare. PATIENTS AND METHODS: Four patients with isolated sarcoidosis of the nose and the sinuses are reported; in one of these patients the histological evidence was found in the mucosa of the nasopharynx. RESULTS: None of these patients was found to have a pulmonary illness or any other extrapulmonary manifestation of sarcoidosis. Retrospectively, two patients fulfilled the more specific diagnostic criteria for sinonasal sarcoidosis reported in the literature. CONCLUSION: Sarcoidosis should be considered in the differential diagnosis of inflammatory sinonasal disease, especially if the mucosa shows signs of granulation, but it should also be considered when an incidental finding of rhinosinusitis is recorded. Rhinosurgical intervention seems to be an appropriate therapy in terms of improving the symptoms of the disease, despite the prolonged period of postoperative healing and the necessity for individual treatment with medication. Following histological confirmation of the diagnosis, adequate medication and further appropriate diagnostic procedures drawing on internal medicine are essential.

[24-hour pH monitoring of the hypopharynx in 545 patients with special regard to a critical data evaluation]. / Ergebnisse der 24-Stunden-pH-Metrie des Hypopharynx von 545 Patienten unter besonderer Berücksichtigung einer kritischen Auswertung.

BACKGROUND: Although a number of reports exist on 24-hour pH monitoring of the hypopharynx, no consensus has been reached about evaluation standards. In particular the influence of food and beverages is still different estimated. The parameters which are used to analyze the data of pharyngeal pH monitoring are not consistent. PATIENTS AND METHODS: 545 patients underwent esophagopharyngeal 24-hour pH monitoring in the Department of Otorhinolaryngology at the University of Rostock from February 1996 to December 2003. A score was calculated by excluding technical artefacts and pH drop caused by ingestion. RESULTS: Pharyngeal acid exposure was detected in 228 patients. The values of the reflux score ranged between 0 - 62,4 with a median value of zero. The left skewed score distribution shows a high abundance of patients with a minimum score and a limited amount of patients with high score values. The results were compared to reports of other authors. CONCLUSIONS: Evaluation standards are necessary for a reproducible analysis of pharyngeal pH monitoring data and for the comparison of different reports. A qualified score for the analysis and the comparison of pharyngeal pH monitoring data is suggested.

The effect of peri-conception nutrition on embryo quality in the superovulated ewe.

Evidence indicates that oocyte/embryo quality in the sheep is affected by nutrient status during the cycle of conception. This study aimed to determine, in the superovulated ewe, if there are stages during the peri-conception period (-18 days to +6 days relative to the day of ovulation [Day 0]) when quality is more likely to be influenced by nutrition. In Experiment 1, ewes were provided with either a 0.5 x maintenance (L), 1.0 x maintenance (M) or 1.5 x maintenance (H) diet (in terms of daily energy requirements) during the peri-conception period. Diet did not affect the mean ovulation rate (range: 15.4+/-1.47 to 16.1+/-1.55) nor the mean number of embryos collected per ewe (range: 10.9+/-2.05 to 12.4+/-1.82) but there was an increase (P<0.05) in the mean number of cells per blastocyst in the L diet (74.7+/-1.45) compared with either the M (66.4+/-1.29) or H (62.0+/-0.84) diets. This increase was due to an increase in the number of trophectoderm (Tr) cells, resulting in a shift (P<0.05) in the Tr:inner cell mass (ICM) cell ratio (range 0.69+/-0.03 to 0.73+/-0.04). In Experiment 2, six diets (HHH, MHH, MHL, MLH, MLL and LLL) were imposed during three 6-day periods commencing 12 days before and continuing until 6 days after ovulation. Although diet had minimal effect on the superovulatory response, both the mean number of cells per blastocyst and the Tr:ICM ratio were increased (P<0.05) when the L diet was provided after Day 0 (diets MHL, MLL and LLL). It is concluded that the ewe is able to respond to acute changes in nutrition imposed immediately after ovulation, resulting in changes in embryo development including cell lineage differentiation. The significance of these findings, in terms of fetal development, embryo-maternal signalling and the nutritional management of the ewe is discussed.

Myogenesis in sheep is altered by maternal feed intake during the peri-conception period.

The effect of varying short-term maternal feed intake during the peri-conception period on the development of ovine fetal muscle at mid-gestation was investigated. Superovulated donor Merino ewes (n = 24) were fed a roughage/grain pelleted diet (10.1 MJME/kg dry matter) at either 1.5x maintenance (H; high) or 0.5x maintenance (L; low) from 18 days before until 6 days after ovulation. Embryos were transferred to recipient ewes (n = 60) on day 6. Singleton fetuses were collected on day 75 of gestation and placental weights, fetal body dimensions and fetal organ and muscle weights recorded. The number, type and size of muscle fibres and the dry matter, RNA, DNA and protein content in the semitendinosus muscle were determined. Maternal feed intake did not influence body dimensions, organ development or muscle weights in the fetus. However, L feed intake decreased total muscle fibre number in the fetus by approximately 20% (P = 0.06) compared to H feed intake. This resulted from a reduced secondary to primary fibre ratio (P < 0.05) and indicated that secondary fibre formation occurred at a reduced rate in L fetuses. In addition, protein:DNA ratio tended to be lower in muscles of L fetuses (P < 0.1). It is concluded that restricting feed intake over the peri-conception period reduces or delays myogenesis in fetal sheep. The potential mechanisms by which nutritional availability during this period may influence subsequent myogenic development are discussed.