Performance of lactating dairy cows fed alfalfa or red clover silage as the sole forage.

Three Latin square trials, with 20 (two trials) or 24 (one trial) multiparous lactating Holstein cows (four in each trial with ruminal cannulae), compared the feeding value of red clover and alfalfa silages harvested over 3 yr. Overall, the forages contained similar amounts of neutral detergent fiber and acid detergent fiber; however, red clover silage contained more hemicellulose, less ash and crude protein (CP), and only 67% as much nonprotein N, as a proportion of total N, as did alfalfa silage. Diets were formulated with equal dry matter (DM) from alfalfa or red clover silage and contained on average 65% forage, 33 or 30% ground high moisture ear corn, and 0 or 3% low soluble fishmeal (DM basis).

Effect of replacing alfalfa silage with high moisture corn on nutrient utilization and milk production.

Twenty-four multiparous lactating Holstein cows were blocked by days in milk and assigned to treatment sequences in a replicated 4x4 Latin square with 21-d periods. The four diets, formulated from alfalfa silage plus a concentrate mix based on ground high moisture ear corn, contained [dry matter (DM) basis]: 1) 20% concentrate, 80% alfalfa silage (24% nonfiber carbohydrates; NFC), 2) 35% concentrate, 65% alfalfa silage (30% NFC), 3) 50% concentrate, 50% alfalfa silage (37% NFC), or 4) 65% concentrate, 35% alfalfa silage (43% NFC). Soybean meal and urea were added to make diets isonitrogenous with equal nonprotein N (43% of total N).

Retrospective review of flow patterns following retropubic prostatectomy.

Aim Of This Study: We retrospectively evaluated penile inflows in 103 previously potent individuals who underwent standard nerve sparing radical retropubic prostatectomy (RRP) for the treatment of prostate cancer. No effort to identify or spare the accessory pudendal artery (APA) was made in any case. Our goal was to investigate the role of the accessory internal pudendal artery (APA) in the maintenance of erections in this population.

Effect of replacing alfalfa silage with high moisture corn on ruminal protein synthesis estimated from excretion of total purine derivatives.

Twenty-four multiparous dairy cows (eight with ruminal cannulae) were blocked by days in milk and assigned to six balanced 4 x 4 Latin squares with 21-d periods. The four diets, formulated from alfalfa silage plus a concentrate mix based on ground high moisture ear corn, contained (dry matter basis): 1) 20% concentrate, 80% alfalfa silage (24% nonfiber carbohydrate; NFC), 2) 35% concentrate, 65% alfalfa silage (30% NFC), 3) 50% concentrate, 50% alfalfa silage (37% NFC), or 4) 65% concentrate, 35% alfalfa silage (43% NFC). Soybean meal and urea were added to make diets isonitrogenous with equal nonprotein nitrogen (NPN) (43% of total N).

Neoadjuvant androgen deprivation prior to transperineal prostate brachytherapy: smaller volumes, less morbidity.

Purpose: Prostate brachytherapy is becoming increasingly utilized in the definitive treatment of men with early-stage prostate cancer. Others have reported a close relation between total dose to the gland and genitourinary and gastrointestinal toxicity. We tested the hypothesis that 3 months of hormone deprivation would decrease gland size and decrease radioactivity implanted, which would result in less morbidity.

Artificial urinary sphincter for post-prostatectomy incontinence: impact of prior collagen injection on cost and clinical outcome.

Purpose: We retrospectively reviewed our experience with the artificial urinary sphincter in men with post-prostatectomy incontinence to determine the impact of prior collagen injection therapy on surgical outcome and overall cost of treatment.

Materials And Methods: The records and preoperative urodynamic studies of 30 men with post-prostatectomy incontinence who underwent artificial urinary sphincter placement were reviewed. Of these patients 23 (76.

Effect of feeding macerated alfalfa silage on nutrient digestibility and milk yield in lactating dairy cows.

Five feeding studies were conducted with 141 lactating Holstein cows comparing macerated and control alfalfa silage harvested at two cuttings in each of 2 yr. Overall, silage made from macerated alfalfa contained more ash (suggesting improved soil contamination); greater fiber and lower nonprotein nitrogen (NPN) content suggested greater fermentation in the silo. In a digestion study, two diets were fed containing [dry matter (DM) basis] 72% of either control or macerated second-cutting alfalfa.

Changing practice patterns in erectile dysfunction: a diagnostic algorithm for the new millennium.

In the era when there was only one cause-specific treatment for erectile dysfunction (vasoactive penile injection), most patients could be safely directed to therapy following a good sexual history, assessment of medical risks, and physical examination. Without diagnostic testing, efficacy and satisfaction was a matter of chance. The next millennium will see the development of multiple oral agents for the management of male sexual dysfunction.

The effect of androgen deprivation on the early changes in prostate volume following transperineal ultrasound guided interstitial therapy for localized carcinoma of the prostate.

Purpose: To determine the change in volume of the prostate as a result of neoadjuvant androgen deprivation prior to prostate implant and in the early postimplant period following transperineal ultrasound guided palladium-103 brachytherapy for early-stage prostate cancer.

Methods And Materials: Sixty-nine men received 3 to 6 months of androgen deprivation therapy followed by treatment planning ultrasound followed 4 to 8 weeks later by palladium-103 implant of the prostate. All patients had clinical and radiographic stage T1c-T2b adenocarcinoma of the prostate.

Diabetes and vascular impotence: does insulin dependence increase the relative severity?

Aim Of The Study: Diabetes is a well documented risk factor for vascular erectile dysfunction (ED). We evaluated the relative roles of insulin dependence (IDDM) vs oral agent controlled diabetes (NIDDM) in predicting the etiologies and severity of ED: arterial insufficiency (AI), venous leakage (CVOD), and mixed vascular disease. The impact of additional risk factors were also analyzed: hypertension (HTN), coronary artery disease (CAD), and smoking (SM).

Expression of myosin isoforms in smooth muscle cells in the corpus cavernosum penis.

Corpus cavernosum smooth muscle (CCSM) in the penis is unique in that it exhibits a high resting tone and, on stimulation, the muscle cells relax, allowing cavernous spaces to fill with blood, which results in an erection (tumescence). During detumescence, the muscle cells contract and return to the state of high resting tone. This study was undertaken to determine whether CCSM with these unique properties contains myosin isoforms typical of aorta or bladder smooth muscles, muscles that exhibit tonic and phasic characteristics, respectively.

Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer.

Context: Interstitial radiation (implant) therapy is used to treat clinically localized adenocarcinoma of the prostate, but how it compares with other treatments is not known.

Objective: To estimate control of prostate-specific antigen (PSA) after radical prostatectomy (RP), external beam radiation (RT), or implant with or without neoadjuvant androgen deprivation therapy in patients with clinically localized prostate cancer.

Design: Retrospective cohort study of outcome data compared using Cox regression multivariable analyses.

Evidence based assessment of erectile dysfunction.

Do we need impotence testing? Yes, it is the clinician's obligation to establish the etiology of impotence: end organ vascular failure vs neurologic dysfunction vs psychosexual dysfunction, classify the severity of that dysfunction, and select a therapy that is not only acceptable to the patient but also addresses his pathology. The most commonly utilized diagnostic tests for erectile dysfunction are outlined in this monograph. Nocturnal erections are evaluated by tests commonly known as nocturnal penile tumescence (NPT) studies.

Effect of processing high moisture ear corn on ruminal fermentation and milk yield.

Thirty-six multiparous dairy cows (8 fitted with ruminal cannulas) and 16 primiparous dairy cows were blocked by days in milk and parity and assigned to one of four diets containing 53% alfalfa silage [dry matter (DM) basis] plus 1) high moisture ear corn, 2) high moisture ear corn plus expeller soybean meal, 3) ground high moisture ear corn, or 4) ground high moisture ear corn plus expeller soybean meal. The high moisture ear corn was rolled before ensiling at 68% DM. Ground high moisture ear corn was prepared by further grinding through a 9.

A statistical evaluation of animal and nutritional factors influencing concentrations of milk urea nitrogen.

Data from 35 trials with 482 lactating cows fed 106 diets were used to study the effects of animal and dietary factors on the relationship between milk and blood urea N and the value of milk urea N in the assessment of protein status. In two trials, urea N in whole blood and in blood plasma were closely related (r2 = 0.952); the slope was not significantly different from 1.

Comparison of in situ and in vitro techniques for measuring ruminal degradation of animal by-product proteins.

Ruminally undegraded protein (RUP) values of blood meal (n = 2), hydrolyzed feather meal (n = 2), fish meal (n = 2), meat and bone meal, and soybean meal were estimated using an in situ method, an inhibitor in vitro method, and an inhibitor in vitro technique applying Michaelis-Menten saturation kinetics. Degradation rates for in situ and inhibitor in vitro methods were calculated by regression of the natural log of the proportion of crude protein (CP) remaining undegraded versus time. Nonlinear regression analysis of the integrated Michaelis-Menten equation was used to determine maximum velocity, the Michaelis constant, and degradation rate (the ratio of maximum velocity to the Michaelis constant).

Collagen injection therapy for post-radical retropubic prostatectomy incontinence: role of Valsalva leak point pressure.

Purpose: We retrospectively evaluated the role of Valsalva leak point pressure as a predictor of successful management of post-radical retropubic prostatectomy incontinence with collagen injection.

Materials And Methods: Urodynamic studies and Valsalva leak point pressures of 31 men who received retrograde collagen injection for post-radical retropubic prostatectomy incontinence were reviewed. Patients were interviewed before and after treatment to assess pad use and the American Urological Association quality of life index (scale 0 to 6).

The use of combined radiation therapy and hormonal therapy in the management of lymph node-positive prostate cancer.

Purpose: To determine the rate of tumor response and patterns of relapse following combined hormonal-radiation therapy of adenocarcinoma of the prostate and to measure the survival in a group of men with tumor metastatic to pelvic lymph nodes.

Methods And Materials: 66 patients with adenocarcinoma of the prostate with pathologically confirmed pelvic lymph node involvement were treated with combined radiation therapy and hormonal therapy. An additional five patients declined hormonal therapy.

Effects of supplementation of energy or ruminally undegraded protein to lactating cows fed alfalfa hay or silage.

Alfalfa was harvested as silage or hay and fed in two 12-wk trials with a 4 x 4 Latin square design that used 12 (trial 1) or 24 (trial 2) multiparous lactating cows (4 ruminally cannulated cows per trial). Diets contained (dry matter basis) 75 or 50% alfalfa plus 24 of 40% high moisture corn (trial 1) or 50% alfalfa, 44 or 41% high moisture corn, with (3%) or without fish meal (trial 2). Experiments were conducted to evaluate the responses of cows fed alfalfa hay or alfalfa silage diets to an increase in protein supply from microbial protein synthesis (trial 1) or from the supplementation of ruminally undegraded protein (RUP) (trial 2).

Excretion of purine derivatives by Holstein cows abomasally infused with incremental amounts of purines.

Five multiparous, ruminally cannulated Holstein cows (two lactating and three dry) weighing (X +/- SD) 667 +/- 35 kg were used to study the effect of abomasal purine infusion on the excretion of purine derivatives. Cows were fed corn silage four times daily at 90% of ad libitum intake (X = 9.16 kg of dry matter/d).

Evidence for a role of intracellular-calcium release in nitric oxide-stimulated relaxation of the rabbit corpus cavernosum.

Erection is mediated by relaxation of the smooth muscle elements within the sinusoids of the corpus cavernosum. Although cavernosal relaxation can be mediated by a variety of mechanisms including purinergic stimulation, prostoglandins, and beta-adrenergic stimulation the major mechanism involves the stimulated release of nitric oxide (NO) and subsequent relaxation of the corporal smooth muscle. Experimentally, NO can be released both by direct stimulation of NO-containing nerves (using field stimulation) and indirectly via cholinergic stimulation of NO release from the endothelium (using bethanechol).

Development of prostate cancer after pituitary dysfunction: a report of 8 patients.

Objectives: Eight patients with a history of pituitary dysfunction were seen in the Department of Radiation Oncology at the Hospital of the University of Pennsylvania for evaluation of their prostate carcinoma. Because prostate cancer is a hormonally responsive cancer, hormonal abnormalities from pituitary dysfunction may have played a role in its development. In addition, many patients with pituitary dysfunction receive exogenous hormonal replacement.