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Objectives. Compare the surgical morbidity of diaphragmatic peritonectomy versus full thickness diaphragmatic resection with pleurectomy at radical debulking. Design. Prospective cohort study at the Oxford University Hospital. Methods. All debulking with diaphragmatic peritonectomy and/or full thickness resection with pleurectomy in the period from April 2009 to March 2012 were part of the study. Analysis is focused on the intra- and postoperative morbidity. Results. 42 patients were eligible for the study, 21 underwent diaphragmatic peritonectomy (DP, group 1) and 21 diaphragmatic full thickness resection (DR, group 2). Forty patients out of 42 (93%) had complete tumour resection with no residual disease. Histology confirmed the presence of cancer in diaphragmatic peritoneum of 19 patients out of 21 in group 1 and all 21 patients of group 2. Overall complications rate was 19% in group 1 versus 33% in group 2. Pleural effusion rate was 9.5% versus 14.5% and pneumothorax rate was 14.5% only in group 2. Two patients in each group required postoperative chest drains (9.5%). Conclusions. Diaphragmatic surgery is an effective methods to treat carcinomatosis of the diaphragm. Patients in the pleurectomy group experienced pneumothorax and a higher rate of pleural effusion, but none had long-term morbidity or additional surgical interventions. [ABSTRACT FROM AUTHOR]

Objective To describe the technique and the surgical outcome of laparoscopic resection of bulky lymph nodes before adjuvant treatment. Design Prospective pilot study. Setting Gynaecological oncology cancer centre. Population From January 2006 to February 2008, 22 consecutive women presented with cervical cancer and bulky metastatic lymph nodes (>2 cm). Methods All women underwent resection of bulky lymph nodes by laparoscopy. A prospective record of the main surgical outcomes was performed. Main outcome measures Safety and efficacy of laparoscopic resection of bulky lymph nodes, conversion to laparotomy, intra- and perioperative morbidity. Results All the operations were completed by laparoscopy. Median operative time was 197 minutes (range 180–320). Median blood loss was 60 cc (range 10–100), two women experienced complications: one thermal injury of the sciatic root provoking postoperative leg palsy and one chylous ascites. The woman with the thermal injury has recovered most leg function with physiotherapy and the woman with chylous ascites recovered within 2 weeks, slightly delaying the adjuvant treatment. All women were discharged within 4 days from the operation (range 2–4). Pathology reports confirmed the presence of tumour metastases and the lymph nodes size. The adjuvant treatment started at a median time of 12 days (range 3–22). Conclusion Debulking of large pelvic and para-aortic lymph nodes was effectively accomplished by laparoscopy in all 22 women with 9% complication rate. The surgical outcome is similar to historical series on women operated on by laparotomy, with the advantage of a faster recovery and an early start of adjuvant treatment. [ABSTRACT FROM AUTHOR]

The chlorophyll fluorescence parameters ΔF/Fm′ and Fv′/Fm′, related respectively to the quantum yield of photosynthetic electron transport and to the efficiency of excitation capture by the open centres of photosystem II, have been evaluated as possible indicators of drought tolerance in durum wheat. ΔF/Fm′ and Fv′/Fm′ measurements were carried out on excised leaves, both control and dehydrated, of 25 cultivars. ΔF/Fm′ and Fv′/Fm′ values were obtained at two times after the start of fluorescence measurement: at 14 s, i.e. during the induction curve (ΔF/Fm′14s and Fv′/Fm′14s) and at 200s, i.e. at steady state fluorescence (ΔF/Fm′200s and Fv′/Fm′200s).In dehydrated leaves a mean significant decrease of 20% (P < 0·001) was observed in ΔF/Fm′14s values. In contrast, no great differences were observed between control and dehydrated leaves with regard to ΔF/Fm′200s, Fv′/Fm′14s and Fv′/Fm′200s.The percentage decrease of ΔF/Fm′14s after dehydration was correlated with the drought susceptibility index (DSI) of the cultivars, evaluated on a yield basis and a significant correlation (r = 0·72, P < 0·001) was found. [ABSTRACT FROM PUBLISHER]

The aim of this study was to identify a fluorescence parameter whose estimate could be used reliably for a drought tolerance test in durum wheat (Triticum durum). Twenty-five cultivars were grown in a glasshouse over two seasons (1987/88 and 1988/89) at Foggia, Southern Italy. Photochemical and non-photochemical quenching (qQ and qE), the half time of fluorescence decay (tP½) and the initial slope of fluorescence decay (ISPS) were measured on control and dehydrated pre-darkened excised leaves; qQ and qE were measured twice: first at 14 s after actinic illumination and second at the steady state.No great difference in qQ and qE was apparent between control and dehydrated leaves at the steady state; however, at 14 s after illumination there was a decrease in qQ and in ISPS and an increase in tP½ in dehydrated leaves. The predictive capability of fluorescence parameters was assessed by comparison with a yield-based drought susceptibility index (DSI). The percentage decrease in qQ at 14 s showed the highest correlation with DSI (r = 0·75, significant at P < 0·001), so it may be considered a good indicator of drought tolerance in durum wheat. Results obtained at different developmental stages with different fluorescence levels (Fo, P and Fm) and parameters (qQ, qE and tP½) indicated that for maximum reliability the test must be applied at the vegetative phase. [ABSTRACT FROM PUBLISHER]

The quantum yield of photosynthetic electron transport (ΦPSII), evaluated by means of chlorophyll (Chl) fluorescence analysis, has proven to be a useful screening test for drought tolerance in durum wheat (Triticum durum Desf.). To explore the potential of this parameter further in detecting drought-tolerant genotypes, three cereal species were studied; ΦPSII measurements were carried out under two different gas mixtures, at three points of the induction curve (to obtain the maximal ΦPSII and both the transient and steady-state actual ΦPSII), and at three different water stress levels (moderate, severe and drastic). The species investigated were durum and bread wheat (Triticum aestivum L.) and barley (Hordeum vulgare L.); two cultivars per species, characterized by different levels of drought tolerance, were tested. The two gas mixtures used were normal air (21% O2, 0.035% CO2 in N2) to monitor the whole photosynthetic process under physiological conditions, and CO2 enriched-low O2 air (1% O2, 5% CO2 in N2) to monitor ΦPSII reduction under stress mainly related to Calvin cycle activity. When ΦPSII related to both assimilatory and non-assimilatory metabolism was evaluated, the cultivar differences observed under normal Air were more representative of the agronomic performance upon drought stress than under high CO2 -low O2 air. Maximal ΦPSII showed no difference among either cultivars, gas mixtures or stress levels, the efficiency of excitation capture being highly resistant to drought. The ΦPSII evaluated during the transient yielded predictable values in respect of drought tolerance for durum wheat and barley cultivars, highlighting the key role of regulatory processes such as the Mehler peroxidase reaction and possibly also cyclic electron transport, in preventing overreduction under stress. The results clearly show that when Chl fluorescence analysis is used as a parameter in plant breeding, different experimental conditions should be used depending on the physiological mechanism that is bred or selected for. [ABSTRACT FROM AUTHOR]