Energy balance of dairy cows predicted by mid-infrared spectra data of milk using Bayesian approaches

Information on dry matter intake (DMI) and energy balance (EB) at the animal and herd level is important for management and breeding decisions. However, routine recording of these traits at commercial farms can be challenging and costly. Fourier-transform mid-infrared (FT-MIR) spectroscopy is a noninvasive technique applicable to a large cohort of animals that is routinely used to analyze milk components and is convenient for predicting complex phenotypes that are typically difficult and expensive to obtain on a large scale. We aimed to develop prediction models for EB and use the predicted phenotypes for genetic analysis. First, we assessed prediction equations using 4,485 phenotypic records from 167 Holstein cows from an experimental station. The phenotypes available were body weight (BW), milk yield (MY) and milk components, weekly-averaged DMI, and FT-MIR data from all milk samples available. We implemented mixed models with Bayesian approaches and assessed them through 50 randomized replicates of a 5-fold cross-validation. Second, we used the best prediction models to obtain predicted phenotypes of EB (EBp) and DMI (DMIp) on 5 commercial farms with 2,365 phenotypic records of MY, milk components and FT-MIR data, and BW from 1,441 Holstein cows. Third, we performed a GWAS and estimated heritability and genetic correlations for energy content in milk (EnM), BW, DMIp, and EBp using the genomic information available on the cows from commercial farms. The highest correlation between the predicted and observed phenotype (ry,y^) was obtained with DMI (0.88) and EB (0.86), while predicting BW was, as anticipated, more challenging (0.69). In our study, models that included FT-MIR information performed better than models without spectra information in the 3 traits analyzed, with increments in prediction correlation ranging from 5% to 10%. For the predicted phenotypes calculated by the prediction equations and data from the commercial farms the heritability ranged between 0.11 and 0.16 for EnM, DMIp and EBp, and 0.42 for BW. The genetic correlation between EnM and BW was -0.17, with DMIp was 0.40 and with EBp was -0.39. From the GWAS, we detected one significant QTL region for EnM, and 3 for BW, but none for DMIp and EBp. The results obtained in our study support previous evidence that FT-MIR information from milk samples contribute to improve the prediction equations for DMI, BW, and EB, and these predicted phenotypes may be used for herd management and contribute to the breeding strategy for improving cow performance.

Influence of posterior tibial slope on postoperative outcomes after postero-stabilized and condylar-stabilized total knee arthroplasty

PURPOSE

To compare clinical outcomes and surgical times of two different types of total knee arthroplasty(TKA), postero-stabilized(PS) and condylar-stabilized(CS), in relation to posterior tibial slope(PTS) values and the deviation of these values from the surgical technique.

METHODS

168 patients undergoing TKA surgery between 2016 and 2020 met our inclusion criteria. For each case, gender, age at surgery, operating time, type of implant and preoperative PTS(preop-PTS) and postoperative PTS(postop-PTS) measurements were collected; difference(∆PTS) between preop-PTS and postop-PTS was also calculated. Short Form 12 Mental and Physical scores(SF-12 M and P) and functional Knee Society Score(fKSS) were collected preoperatively and at a minimum of 12 months postoperatively. Four subgroups were thus created in relation to PS or CS system and postop-PTS value(≤ 5°and > 5°).

RESULTS

Of the 168 patients, 96 had a PS system and 72 CS system. Performing a CS-TKA took less time than a PS-TKA(p < 0.05). SF-12P showed better results(p < 0.05) in CS-TKA group than PS-TKA, probably because of the younger age of CS-TKA patients(p < 0.05). In the PS > 5° all examined postoperative scores were better(p < 0.05) than PS ≤ 5°, while only fKSS was better(p < 0.05) in CS > 5° than CS ≤ 5°. No significant difference(p > 0.05) in terms of postoperative outcomes between the PS > 5° and CS > 5° was noted, whereas only SF-12P was better in the CS ≤ 5° compared with PS ≤ 5°. Highest values of SF-12 M and fKSS were obtained in the PS ≤ 5°, in which postop-PTS was closer to technique.

CONCLUSION

When performing a PS-TKA, the best result was obtained with a postop-PTS > 5°, but comparable outcomes between the two systems were evident with postop-PTS > 5°. It is crucial to come as close as possible to the indications reported in surgical technique regardless ∆PTS.

Preliminary data on the neurophysiological evaluation of male sexual dysfunction in patients with pelvic ring fractures: a multicenter retrospective study

OBJECTIVE

Traumatic pelvic ring fractures include several comorbidities due to the close anatomical relationship between the skeletal system, pelvic organs, and neurovascular structures. In this retrospective multicenter study, we evaluated patients complaining of sexual dysfunction following pelvic ring fractures, assessed through different neuro-physiological examinations.

PATIENTS AND METHODS

Patients were enrolled one year after the injury according to their reported ASEX scores and evaluated on the basis of the Tile's type of pelvic fracture. Lower limb and sacral somatosensory evoked potentials, pelvic floor electromyography, bulbocavernosus reflex and pelvic floor motor evoked potentials were recorded, according to the neurophysiological indications.

RESULTS

A total of 14 male patients (mean age 50.4; 8 subjects Tile-type B and 6 Tile-type C) were enrolled. The ages between the Tile B group and the Tile C group of patients were not significantly different (p=0.187), while the ASEX scores were significantly different (p=0.014). In 57% of patients (n=8), no alterations in nerve conduction and/or pelvic floor neuromuscular responses were found. In 6 patients, electromyographic signs of denervation were revealed (2 patients), and alterations of the sacral efferent nerve component were detected in 4 patients.

CONCLUSIONS

Sexual dysfunctions after a traumatic pelvic ring fracture are more common in Tile-type B. Our preliminary data did not reveal a significant association with neurogenic aetiology. Other causes could explain the complaining impairments.

Robotic-assisted unicompartimental knee arthroplasty performed with Navio system: a systematic review

OBJECTIVE

Robotic-assisted arthroplasty is a relatively modern concept, quickly arising in its use. The aim of this systematic review is to assess, according to the existing literature, which are the functional and clinical outcomes and component positioning and implant survivorship of unicompartmental knee arthroplasty surgery performed using an image-free hand-held robotic system. Moreover, we analyzed whether there are significant differences and advantages compared to conventional surgery.

MATERIALS AND METHODS

A systematic review has been performed on studies published between 2004 and 2021, on the electronic library databases, according to the Preferred Reporting Items of Systematic Reviews and Meta-analysis (PRISMA) statement. The inclusion criteria were all studies described as unicompartmental knee arthroplasty performed with the Navio robotic system.

RESULTS

Fifteen studies were included, and 1,262 unicondylar knee arthroplasties were analyzed. These studies showed a satisfactory recovery of joint function, with a good range of motion (extension <5° and flexion which ranged from 105° to 130.3°) in patients of the NAVIO group. The revision rate was <2% while the infection rate <1%; no postoperative transfusion was needed in all UKA implanted.

CONCLUSIONS

The use of a robotic tool for unicompartmental knee arthroplasty (UKA) could lead to a better implant positioning and joint alignment than conventional surgery. There is still limited evidence to support that the use of this robot in unicompartmental knee arthroplasty is a greater survivorship than other systems or conventional techniques; therefore, a long-term follow-up is needed.

Medial gastrocnemius flap for the treatment of infected knee prostheses

OBJECTIVE

Muscular flaps may represent a valid treatment option for prosthetic infection after knee arthroplasty.

PATIENTS AND METHODS

We present the results of 20 consecutive patients treated with the use of medial gastrocnemius flap for the management of different types of injuries or integumentary defects after total knee arthroplasty. Tissue necrosis or dehiscence occurred within 1 and 2 months after arthroplasty. The mean follow-up was 23.4 (12-60) months. Clinical outcome was evaluated according to the infection control rate and post-operative Knee Society Score (KSS).

RESULTS

Prosthesis salvage and complete restoration of skin coverage were achieved in all patients. Functional assessment was performed using the KSS score. The final knee KSS score was classified as excellent (score: 80-100) in 0 patients, good (score: 70-79) in 17 patients, fair (score: 60-69) in 2 patients, and poor (score: 60) in 1 patient. Residual Extension Deficit: 0-20°; Very Satisfactory in 17 patients. 30-70° Satisfactory in 2 patients, 80-90° Unsatisfactory in 1 patient. Patients who successfully underwent flap treatment experienced a much greater increase in both components of the KSS score.

CONCLUSIONS

The results highlight the effectiveness of medial gastrocnemius muscular flap for the treatment of prosthetic knee infection, in terms of function, limb salvage, cost-effectiveness and post-surgery quality of life. Further larger studies may consolidate these findings.

Treatment options for proximal periprosthetic femoral fractures in Total Hip Arthroplasty: a single center experience

OBJECTIVE

Proximal periprosthetic femoral fractures (PPFFs) are gradually increasing and surgical management is often associated with high risk of complications, due to elderly population and associated comorbidities.

PATIENTS AND METHODS

We retrospectively assessed 39 patients at least at 2-years follow-up. We identified two study groups, similar for demographic data. Group A included patients surgically treated without involving prosthetic implants, whereas Group B included patients in which an implant revision was performed.

RESULTS

Data were recorded from January 2017 to February 2020, and 39 patients were included: 30 females (76.9%) and 9 males (23.1%), with a confirmed diagnosis of periprosthetic fracture of the proximal femur. 23 (58.9%) patients were treated with Open Reduction and Internal Fixation (ORIF), 12 (30.7%) with revision surgery and 4 (10.3%) were treated by modular megaprosthesis.

CONCLUSIONS

The treatment options considered in the study, revision arthroplasty and internal fixation had shown no significant differences as a matter of clinical outcomes and postoperative complications.

COVID-19 lockdown and hip arthroplasty rehabilitation changes: mid-term clinical outcomes

OBJECTIVE

Hip arthroplasty is one of the most performed surgeries in orthopedics. Rehabilitation process after surgery allows rapid recovery of joint functions in absence of pain in most patients. During COVID-19 pandemic, rehabilitation clinics have reduced the number of beds available. Thus, an increasing number of patients were forced to home rehabilitation programs. Our study aimed at determining any significant differences in clinical and functional outcomes between those patients who underwent a home rehabilitation program and those others who were granted a place in a Rehabilitation clinic during COVID-19 pandemic, at mid-term follow-up.

PATIENTS AND METHODS

An observational retrospective single-center study was designed. The patients included were 63, divided into two groups: Group A (29 patients) for home rehabilitation, and Group B (34 patients) for clinic rehabilitation. Follow-up was performed at 1, 6 and 12 months after surgery. Clinical evaluation was assessed through Oxford Hip Score for hip function, Visual Analogue Scale (VAS) for pain and hip range of motion (ROM) to evaluate joint recovery.

RESULTS

ROM was compared at follow-up with significant differences 12 months after surgery (107.93° group A vs. 104.7° group B; p=0.0168). Pain felt by patients according to the VAS scale showed no significant differences at follow-up (1 month 3.27 vs. 3.65 p=0.1489; 6 months 1.89 vs. 2.18 p=0.105; 12 months 0.58 vs. 0.68 p=0.6263). Regarding the Oxford Hip score, significant differences emerged at 1-month follow-up (38.75 group A vs. 37.94 group B; p=0.0498).

CONCLUSIONS

At mid-term follow-up, little differences were found between patients who went through home rehabilitation and those who went to a rehabilitation clinic. Therefore, decreasing the number of beds available in rehab clinics during COVID-19 pandemic was not an obstacle for elective surgery for orthopedic surgeons.

Proximal humerus fractures treatment in adult patients with bone metastasis

OBJECTIVE

The humerus is the second long bone most affected by pathological fractures. According to Capanna and Campanacci criteria, surgical choice is based on bone metastasis location, on the patient's status and on the residual functional capacity. Metadiaphysis is an area of conflict in the choice between megaprosthesis implant and intramedullary nail osteosynthesis. This study compares these two surgical procedures in terms of reacquired functionality and local control of metastasis.

PATIENTS AND METHODS

Thirty-eight patients (17 males and 21 females; mean age: 66 years old) treated in our institution between January 2010 and December 2020 for pathological humeral metadiaphyseal fractures caused by metastasis, were included in this study. We choose the Musculoskeletal Tumor Society rating system (MSTS) and the Quick Disability of Arm-Shoulder-Hand (QuickDASH) scores for the evaluation of the upper limb function after surgery.

RESULTS

Eighteen (47%) pathological fractures were treated by resection and megaprosthesis implantation, twenty (53%) were treated by medullary nail osteosynthesis. A reduction in pain and greater mechanical stability in the immediate post-operative period was found in all patients. Twenty-two patients died (58%) and sixteen survived (42%). Long-term functional recovery of patients undergoing osteosynthesis is greater than megaprothesis group.

CONCLUSIONS

Both medullary nail osteosynthesis and resection and megaprosthesis implantation guarantee excellent recovery at 72 months after surgery, improvement in quality of life and pain relief.  Patients treated with osteosynthesis showed a great short-term functional recovery since the joint portion of the limb is not involved, whereas patients treated with megaprosthesis showed better local oncologic control. It is therefore possible to define the type of treatment not only on the localization of the fracture (diaphysis or epiphysis) but above all on the conditions and characteristics of the patient.

The presence and extent of coronary microvascular dysfunction is associated to the severity of cardiomyopathy in patients with Fabry disease

Funding Acknowledgements

Type of funding sources: None.

Background

Coronary microvascular dysfunction (CMD) occurs before left ventricular hypertrophy (LVH) in Anderson Fabry Disease (AFD). Few data exist about the role of CMD in Fabry cardiomyopathy, when overt LVH has already established.

Purpose

Aim of our study was to assess the relationship between CMD and clinical and echocardiographic features in a cohort of Fabry cardiomyopathy patients.

Methods

We performed coronary CT scan to exclude epicardial coronary artery disease (CAD) in 27 AFD cardiomyopathy patients with angina and/or evidence of silent ischemia at treadmill stress test. All consenting patients with no CAD (n = 17) were submitted to resting and stress 13N-Ammonia myocardial perfusion PET/CT to assess the presence of CMD. All patients also underwent complete echocardiography. Patients were followed-up for 17.3 ± 12.5 months.

Results

Global coronary flow reserve (CFR) resulted &lt;2.5 in 7 (41%) patients. Global stress myocardial blood flow (MBF) was &lt;1.85 mL/min/g in 5 (29%) patients. Global transmural perfusion gradient (TPG, subendocardial MBF/subepicardial MBF) during stress was &lt;1.0 in 13/17 (76.5%) patients. Resting global TPG was ≥1 in 16 (94%) patients. Patients with CFR &lt; 2.5 were older (p = 0.02), had more severe LVH (maximal wall thickness p = 0.04), worst global longitudinal strain (p = 0.03) and E/e’ (p = 0.04) and higher troponin levels (p = 0.002) as compared to patients with CFR ≥ 2.5. They also performed less at treadmill stress (METs p = 0.045). No variables were associated to major cardiovascular events at multivariable analysis.

Conclusions

In Fabry cardiomyopathy patients with angina and/or evidence of silent ischemia, the prevalence of CMD is high and it is associated to a more severe cardiac phenotype, including cardiac biomarker and functional capacity. We are not able to draw any conclusion on the possible prognostic role of CMD in Fabry cardiomyopathy.

Prediction of fatty acid composition using milk spectral data and its associations with various mid-infrared spectral regions in Michigan Holsteins

Fatty acid composition in milk is not only reflective of nutritional quality but also potentially predictive of other attributes (e. g. including the cow's energy balance and its relative output of methane emissions). Furthermore, a higher ratio of long-chain to short-chain fatty acids or mean carbon number has been associated with negative energy balance in dairy cows, whereas enhanced nutritional properties have been generally associated with higher levels of unsaturation. We set out to directly compare Bayesian regression strategies with partial least squares for the prediction of various milk fatty acids using Fourier-transform infrared spectrum data on 777 milk samples taken from 579 cows on 4 Michigan dairy herds between 5 and 90 d in milk. We also set out to identify those spectral regions that might be associated with fatty acids and whether carbon number or level of unsaturation might contribute to the strength of these associations. These associations were based on adaptively clustered windows of wavenumbers to mitigate the distorting effects of severe multicollinearity on marginal associations involving individual wavenumbers. In general, Bayesian regression methods, particularly the variable selection method BayesB, outperformed partial least squares regression for cross-validation prediction accuracy for both individual fatty acids and fatty acid groups. Strong signals for wavenumber associations using BayesB were well distributed throughout the mid-infrared spectrum, particularly between 910 and 3,998 cm^-1. Carbon number appeared to be linearly related to strength of wavenumber associations for 38 moderately to highly predicted fatty acids within the spectral regions of 2,286 to 2,376 and 2,984 to 3,100 cm^-1, whereas nonlinear associations were determined within 1,141 to 1,205; 1,570 to 1,630; and 1,727 to 1,768 cm^-1. However, no such associations were detected with level of unsaturation. Spectral regions where there were significant relationships between strength of association and carbon number may be useful targets for inferring the relative proportion of long-chain to short-chain fatty acids, and hence energy balance.

Regularized selection indices for breeding value prediction using hyper-spectral image data

High-throughput phenotyping (HTP) technologies can produce data on thousands of phenotypes per unit being monitored. These data can be used to breed for economically and environmentally relevant traits (e.g., drought tolerance); however, incorporating high-dimensional phenotypes in genetic analyses and in breeding schemes poses important statistical and computational challenges. To address this problem, we developed regularized selection indices; the methodology integrates techniques commonly used in high-dimensional phenotypic regressions (including penalization and rank-reduction approaches) into the selection index (SI) framework. Using extensive data from CIMMYT's (International Maize and Wheat Improvement Center) wheat breeding program we show that regularized SIs derived from hyper-spectral data offer consistently higher accuracy for grain yield than those achieved by standard SIs, and by vegetation indices commonly used to predict agronomic traits. Regularized SIs offer an effective approach to leverage HTP data that is routinely generated in agriculture; the methodology can also be used to conduct genetic studies using high-dimensional phenotypes that are often collected in humans and model organisms including body images and whole-genome gene expression profiles.

A landscape of the heritability of Fourier-transform infrared spectral wavelengths of milk samples by parity and lactation stage in Holstein cows

Fourier-transform near- and mid-infrared (FTIR) milk spectral data are routinely collected in many countries worldwide. Establishing an optimal strategy to use spectral data in genetic evaluations requires knowledge of the heritabilities of individual FTIR wavelength absorbances. Previous FTIR heritability estimates have been based on relatively small sample sizes and have not considered the possibility that heritability may vary across parities and stages of the lactation. We used data from ∼370,000 test-day records of Canadian Holstein cows to produce a landscape of the heritability of FTIR spectra, 1,060 wavelengths in the near- and mid-infrared spectrum (5,011-925 cm^-1), by parity and month of the lactation (mo 1 to 3 and mo 1 to 6, respectively). The 2 regions of the spectrum associated with absorption of electromagnetic energy by water molecules were estimated to have very high phenotypic variances, very low heritabilities, and very low proportion of variance explained by herd-year-season (HYS) subclasses. The near- or short-wavelength infrared (SWIR: 5,066-3,672 cm^-1) region was also characterized by low heritability estimates, whereas the estimated proportion of the variance explained by HYS was high. The mid-wavelength infrared region (MWIR: 3,000-2,500 cm^-1) and the transition between mid and long-wavelength infrared region (MWIR-LWIR: 1,500-925 cm^-1) harbor several waves characterized by moderately high (≥0.4) heritabilities. Most of the high-heritability regions contained wavelengths that are reported to be associated with important milk metabolites and components. Interestingly, these 2 same regions tended to show more variability in heritabilities between parity and lactation stage. Second parity showed heritability patterns that were distinctly different from those of the first and third parities, whereas the first 2 mo of the lactation had clearly distinct heritability patterns compared with mo 3 to 6.

Genetic parameter estimation for long endurance trials in the Uruguayan Criollo horse

The aim of this study was to estimate the genetic parameters of performance in a 750-km, 15-day ride in Criollo horses. Heritability (h² ) and maternal lineage effects (mt² ) were obtained for rank, a relative placing measure of performance. Additive genetic and maternal lineage (rmt) correlations among five medium-to-high intensity phase ranks (pRK) and final rank (RK) were also estimated. Individual records from 1,236 Criollo horses from 1979 to 2012 were used. A multivariate threshold animal model was applied to the pRK and RK. Heritability was moderate to low (0.156-0.275). Estimates of mt² were consistently low (0.04-0.06). Additive genetic correlations between individual pRK and RK were high (0.801-0.924), and the genetic correlations between individual pRKs ranged from 0.763 to 0.847. The pRK heritabilities revealed that some phases were explained by a greater additive component, whereas others showed stronger genetic relationships with RK. Thus, not all pRK may be considered as similar measures of performance in competition.

Imaging Work-Up for Peritoneal Access Care and Peritoneal Dialysis Complications

Peritoneal dialysis (PD) represents a treatment opportunity for patients with end-stage renal failure, but it has particular complications that sometimes force cessation of this procedure (1–9). These complications are due to the presence of the peritoneal catheter and of dialysis solution within the peritoneal cavity. Infections are the most common complications of PD, followed by mechanical complications.

Diagnostic imaging of the complications of PD is important because such an evaluation can aid in the diagnosis and in the decision making process about the treatment. In this review we present the main radiologic investigations employed: plain radiograph, US, peritoneography, computed tomography peritoneography, magnetic resonance peritoneography, peritoneal scintigraphy.

To diagnose catheter-related problems plain radiograph, ultrasonography and peritoneography can be useful. US is useful in diagnosing and following-up exit-site and tunnel infections. Peritoneography and C T-peritoneography, alone or in combination, can be recommended as gold standard investigation to assess mechanical peritoneal dialysis complications, such as catheter malfunction, leaks, hernias and sclerosing peritonitis. Newer methods, such as MR peritoneography or scintigraphy could be useful in selected patients, on center-based experience. An appropriate use of radiology may significantly improve technique survival, morbidity and mortality of patients treated with PD.

Genetic correlations between dressage, show jumping and studbook-entry inspection traits in a process of specialization in Dutch Warmblood horses

Sport performance in dressage and show jumping are two important traits in the breeding goals of many studbooks. To determine the optimum selection scheme for jumping and dressage, knowledge is needed on the genetic correlation between both disciplines and between traits measured early in life and performance in competition in each discipline. This study aimed to estimate genetic parameters to support decision-making on specialization of breeding horses for dressage and show jumping in Dutch warmblood horses. Genetic correlations between performance of horses in dressage and show jumping were estimated as well as the genetic correlation between traits recorded during studbook-entry inspections and performance in dressage and show jumping competitions. The information on competition comprised the performance of 82 694 horses in dressage and 62 072 horses in show jumping, recorded in the period 1993-2012. For 26 056 horses, information was available for both disciplines. The information on traits recorded at studbook-entry inspections comprised 62 628 horses, recorded in the period 1992-2013. Genetic parameters were estimated from the whole dataset and from a subset without horses recorded in both disciplines. Additionally, the genetic parameters were estimated in three different time periods defined by horses' birth year. The genetic correlation between dressage and show jumping in the whole dataset was -0.23, and it was -0.03 when it was estimated from horses recorded in only one discipline. The genetic correlation between dressage and show jumping was more negative in the most recent time period in all the cases. The more negative correlation between disciplines in more recent time periods was not reflected in changes in the correlations between competitions traits and the traits recorded in the studbook-first inspection. These results suggest that a breeding programme under specialization might be most effective defining two separate aggregate breeding goals for each of the disciplines.

Analysis of competition performance in dressage and show jumping of Dutch Warmblood horses

Most Warmblood horse studbooks aim to improve the performance in dressage and show jumping. The Dutch Royal Warmblood Studbook (KWPN) includes the highest score achieved in competition by a horse to evaluate its genetic ability of performance. However, the records collected during competition are associated with some aspects that might affect the quality of the genetic evaluation based on these records. These aspects include the influence of rider, censoring and preselection of the data. The aim of this study was to quantify the impact of rider effect, censoring and preselection on the genetic analysis of competition data of dressage and show jumping of KWPN. Different models including rider effect were evaluated. To assess the impact of censoring, genetic parameters were estimated in data sets that differed in the degree of censoring. The effect of preselection on variance components was analysed by defining a binary trait (sport-status) depending on whether the horse has a competition record or not. This trait was included in a bivariate model with the competition trait and used all horses registered by KWPN since 1984. Results showed that performance in competition for dressage and show jumping is a heritable trait (h² ~ 0.11-0.13) and that it is important to account for the effect of rider in the genetic analysis. Censoring had a small effect on the genetic parameter for highest performance achieved by the horse. A moderate heritability obtained for sport-status indicates that preselection has a genetic basis, but the effect on genetic parameters was relatively small.

Effect of specialization on genetic parameters of studbook-entry inspection in Dutch Warmblood horses

Recent studies on data from the Dutch Warmblood Studbook (KWPN) have shown that the ongoing specialization of horses for either dressage (DH) or show jumping (JH) has led to a decreasing genetic relationship between the two subpopulations. The aim of this study was to analyse the effect of the specialization process on the genetic parameters of traits measured in the studbook-entry inspection of KWPN during the last fifteen years. Data from 18,125 DH and 23,800 JH recorded from 1998 until 2013 were used to analyse 13 traits scored in both DH and JH. Analyses were performed in a Bayesian framework. Firstly, variance components were estimated based on the whole data set. Secondly, genetic correlations between traits measured in DH or JH were estimated using bivariate analyses. Thirdly, three time periods were defined and genetic correlations between subpopulations were estimated within each period. Heritability was moderate (0.17-0.39) for both DH and JH. Genetic correlations between traits measured in DH or JH were not different from one considering the posterior standard deviation of the estimation; however, in most of the traits, a clear trend in reduction of the genetic correlation for traits expressed in DH and JH and an increase in their posterior standard deviation for recent years was observed. These results suggest that specialization could lead to differences in traits measured in DH and JH in the recent years.

Hemoperitoneum in a continuous ambulatory peritoneal dialysis patient caused by a hepatocarcinoma treated with percutaneous embolization

Hemoperitoneum is an infrequent but normally benign complication in continuous ambulatory peritoneal dialysis (CAPD) patients. It can occur at any time during peritoneal dialytic treatment. Hemoperitoneum is not associated with a specific disease and usually disappears spontaneously. In 20% of cases, however, hemoperitoneum is severe and requires specific investigation and emergency therapy. We report a case of hemoperitoneum in a 70-year-old, anti-hepatitic C virus-positive woman. After 48 months of CAPD treatment, a bloody peritoneal effluent developed, with severe anemia (hematocrit decreased from 30% to 20%). An abdominal computed tomography scan showed three hepatic lesions with signs of hepatic neoplasms; selective hepatic arteriography confirmed the diagnosis. Chemoembolization of the three lesions was performed, and hemoperitoneum disappeared within a few hours.

Cutaneous seeding after ultrasound-guided percutaneous ethanol injection for treatment of hepatocellular carcinoma

Cutaneous seeding is a rare complication of interventional ultrasound procedures. We describe a case of needle-track cutaneous seeding of hepatocellular carcinoma (HCC) after sonographically guided percutaneous ethanol injection (PEI). In our case, the seeding might have been related to the type of needle used and the multiple passes required to treat the liver lesion. Despite the risk of needle-track seeding, PEI remains useful in the treatment of HCC.

[Computer-assisted reporting. Experience with the use of a departmental information system]

Since April 1989, a departmental information system has been working at the Radiology Dept. of Desio Hospital, Desio, Milan. The system has six work-stations, connected in a local network. The Proram program (Metrika, Verona) is employed, which allows the computerized management of departmental activities. After a short description of Proram's functions and of their advantages, a special attention is paid to the reporting activity, as limited to normal reports. The latter can be made either as free or as codified and previously stored texts. The percentage of use of codified reports (49%) is evaluated on the basis of about 8,000 X-ray exams per year. Through the analysis of percentage data of codified reports, according to exam categories, previously stored reports appeared to be more frequent for inpatients and for emergency examinations (58% of overall figure). Codified reporting appeared to be proportionally less employed in the most specialized diagnostic examinations. On the whole, considerable time was saved, and the number of misprints decreased; moreover, higher language standardization was achieved. More detailed information was thus available for the clinician.

[Contribution of peritoneography combined with computerized tomography, in the assessment of abdominal complications in patients undergoing continuous peritoneal dialysis]

Continuous ambulatory peritoneal dialysis (CAPD) is a generally well-tolerated treatment. However, some patients exhibit such complications as to prevent the continuation of treatment. Peritonitis is the major problem, but the continuation of treatment may also be undermined by different complications, such as peritoneal leakage, hernia, catheter malfunctioning, and scrotal-penile edema; a careful investigation of the patient is always needed in such cases. From November 1985 to February 1990, we examined 20 patients, who had presented with different types of complications in the course of dialysis. Peritoneography demonstrated 3 cases of abdominal hernias, 2 cases of patency of the peritoneal-vaginal duct, and 2 cases of catheter obstruction. Peritoneal CT allowed the identification of leakage in 3 patients, while the combined use of the two techniques showed adhesions or pathologic peritoneal recesses in 7 cases. In 3 patients normal patterns were observed. Peritoneography, especially if combined with CT, can carry out a double function, that is in both the screening and choice of the subjects to destine to peritoneal dialysis, and in therapeutics, to evaluate complications. Moreover, the technique is extremely reliable thanks to both its simple execution and lack of disadvantages.

MR imaging of anterior cruciate ligament repair

Magnetic resonance (MR) imaging is an accurate means of analyzing disruptions of the native anterior cruciate ligament (ACL). Various techniques may be used to repair a disrupted ACL. A common repair is the MacIntosh lateral-substitution over-the-top repair in which a strip of fascia lata from the iliotibial band is used as a "neoligament." The results of 27 MR examinations of 17 athletes with this repair were analyzed to determine the appearance of the neoligament on MR. Thirteen of the 17 patients had returned to full athletic activity and four were capable of strenuous activity. Examinations were made at both 0.5 and 1.5 T in varied extents of external rotation from 0 to 20 degrees, and at variable time intervals after surgery from 1 to nearly 40 months. Only two patients clinically required postrepair arthroscopy, but both had normal repairs. Neoligaments were classified as well-defined (n = 6 studies), ill-defined (n = 10), and not discernible (n = 11), based on clarity of appearance. Reasons for this variable appearance include the variable presence of fibrous and fatty tissue investing the neoligament. We conclude that the normal neoligament, unlike the normal active ACL, has a variable appearance, including nonvisualization on MR and that criteria used in evaluating the native ligament will be inadequate to assess the repair.

[Treatment of diaphyseal pseudoarthrosis with transosseous osteosynthesis by the Ilizarov method. Radiographic signs of reparative osteogenesis]

The main phases of ossification are shown-based on the results achieved by re-examining the X-ray pictures of 14 patients affected by tubular bones pseudoarthrosis treated with Ilizarov's closed compression-distraction osteosynthesis. The roentgen signs in particular are examined which are considered as expressive of positive evolution of the pseudoarthrosis. An outline of X-ray evolution of nonunions is also proposed, referring to the peculiar biological characters of ossification under compression-distraction stimulation.

[Quantitative analysis of bone tissue. Correlation of several radio-morphometric indices with gamma-absorptiometric mineralometry]

According to results of experimental study on 70 women, either normal or osteoporotic, the authors come to a critical valuation of known radio-morphometric index concerning the measure of amount of bone and propose the cortical planimetric percent area of the second right hand metacarpal as original radio-morphometric index, greatly correlated (r = 0,879) to gamma-absorptsiometric mineralometry.