[In vivo rheologic studies of plasma substitutes].

The aim of this study was to compare in 60 ASA1 patients, the rheological effects of a 500 ml plasma substitute infusion at induction of general anaesthesia. The 60 patients were allocated into 6 groups of 10. Each group received either albumin 4%, or dextran 40 3.5%, or dextran 60 6%, or hydroxyethylstarch (HES) 200 6%, or modified fluid gelatin or Ringer lactate. The infusion extended over 30 minutes. In blood samples obtained before infusion, immediately after the end, three and 24 hours after the end of infusion, osmotic pressure, oncotic pressure, proteins and fibrinogen concentration were measured. Following rheological parameters were also assessed: plasma viscosity, blood viscosity at two shear rates (0.5 and 128 s-1), erythrocyte aggregation by primary and final aggregation times as well as total and partial dissociation thresholds. The determinations were carried out at haematocrit corrected to 40%. At intergroup analysis of the different substitutes compared to albumin 4%, with the exception of Ringer lactate, there was no significant modification of osmotic and oncotic pressures or fibrinogen concentrations. Only gelatin and dextran 60 modified the rheological parameters. The intragroup comparison did not demonstrate significant variations of osmotic and oncotic pressures. Fibrinogen concentrations remained unchanged up to the 24th hours, where they increased as a reaction to surgery. Similar changes of rheological parameters occurred for Ringer lactate, albumin 4% and dextran 40: decrease of plasma viscosity (< 10%) and blood viscosity (< 20% at shear rate of 0.5 s-1), increase of primary aggregation time (30-50%) with decrease of total dissociation threshold (10-20%). These changes ended 24 hours after infusion. Dextran 60 and gelatin elicited a modification of blood rheology until the 24th hour after the end of infusion. Such modifications did not occur with HES. It is concluded that when a rheological effect is required albumin 4% or dextran 40 3.5% should be used.


[Comparison of effects of Elohes and albumin on hemostasis in orthopedic surgery].

A prospective study was carried out to determine the effects of Elohes, a low molecular weight hydroxyethylstarch, on haemostasis. Sixteen patients due to undergo total hip replacement were randomly assigned to one of two groups: group A, who were to receive up to 21 of 4% albumin to replace blood loss, and group E, 1.51 of Elohes. Patients were then given concentrated red cell packs (RCP) and lactated Ringer's solution so as to have a haematocrit value of 30%, up to the fifth postoperative day. The amount of blood lost intraoperatively was calculated by weighing the swabs and measuring the volume aspirated. Haemostasis was investigated on the eve of surgery, 3 hours afterwards, and then every second day (days 1, 3 and 5). Total blood loss and the number of RCP transfused were similar in both groups: 1,517 +/- 425 ml and 3.5 RCP, and 1,428 +/- 250 ml and 3.25 RCP in groups A and E respectively. Blood albumin concentrations fell in group E as expected, the starch diluting blood proteins. Bleeding time (Simplate), activated partial thromboplastin time, prothrombin time changed in the same way in both groups throughout the study period after infusion of either Elohes or albumin. The concentrations in factors II, V, VII and X fell by 30% three hours after surgery. Values returned to normal between days 1 and 3, the concentrations of some factors rising to values greater than preoperative values because of the postoperative inflammatory process (fibrinogen, factor VIII von Willebrand). However, there were no significant differences between the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)


[Efficacy and tolerance of Elohes 6% during peroperative normovolemic dilution].

This study assessed the cardiovascular stability of intraoperative normovolaemic haemodilution carried out with 6% Elohes during the exchange, the intraoperative, recovery and postoperative periods, as well as its effects on coagulation and renal function. Ten patients, ranked ASA 1, were included. Patients were premedicated with 100 mg of hydroxyzine, and anaesthesia was induced with 2 mg.kg-1 propofol, 3 micrograms.kg-1 fentanyl, and 0.5 mg.kg-1 atracurium. Maintenance was obtained with propofol, fentanyl and 50% nitrous oxide in oxygen. Haemodilution, carried out with a peripheral venous catheter, size 14 G, consisted in the removal of 15 ml.kg-1 of blood and its simultaneous replacement with Elohes 6%. Heart rate, systolic, diastolic and mean blood pressures were recorded before anaesthetic induction, every 5 min during the haemodilution, and thereafter during surgery, recovery and postoperative periods, up to the third postoperative day. Blood haemoglobin, fibrinogen, prothrombin, sodium, potassium, urea and creatinine concentrations, haematocrit, platelet count, and bleeding and activated cephalin times were assessed before and immediately after haemodilution, and on postoperative days 1 and 3. A mean of 1,295 +/- 68 ml of blood were removed during a 32 +/- 2 min period, and replaced by 1,315 +/- 64 ml of Elohes. Haematocrit decreased from 44 +/- 1.1% to 29.7 +/- 0.8%. There were no significant alterations in other parameters, except for an increase in heart rate at the time of extubation. Cardiovascular parameters, as well as the haemodilution, were stable up to the end of the study period. It is concluded that replacing blood with Elohes for intentional haemodilution affords convenient cardiovascular stability.(ABSTRACT TRUNCATED AT 250 WORDS)


[Efficacy and tolerance of Elohes in plasma exchanges].

This study aimed to compare two plasma substitution regimens used during plasma exchanges (PE). It was a prospective cross-over randomized trial. Each patient (n = 12) had two PE at a 48 h interval. During one PE, only albumin was administered (PEA), and during the other one, equal volumes of albumin and low molecular weight hydroxyethylstarch (HES) (Elohes) were given (PEA+E). The order in which these different protocols were used was random. Plasma was separated by filtration, and the total volume extracted was one and a half the plasma volume. The parameters recorded every 15 min until 1 h after the end of PE, were heart rate, blood pressure and central venous pressure (CVP). Plasma volume, calculated from the mean body haematocrit and blood volume, was measured before and after PE. The clinical and biological tolerance of the rapid infusion of a large volume of HES was also assessed. PE characteristics were similar in both groups. For PEA and PEA+E, PE lasted 152 +/- 21 min and 154 +/- 25 min; the plasma volume extracted was 3,907 +/- 772 ml and 3,933 +/- 717 ml; the volume of plasma substitute infused was 4,097 +/- 617 ml and 3,933 +/- 717 ml, respectively. As haemodynamic and biochemical values were not significantly different in both groups, they were pooled together irrespective of the order of PE.(ABSTRACT TRUNCATED AT 250 WORDS)


[Systemic candidiasis].

Candida proliferate within the body of patients with deficient cellular immunity either by the haematogenous route or by adjacency. This condition is often found in hospital patients. It explains the increasing incidence of disseminated candidiasis. They are preferentially found in patients who have had complicated surgery, mostly of the gastrointestinal tract and the heart, or transplant surgery (except for kidney transplants), or who have had prolonged intensive care. Other patients concerned are neonates with a low birth weight, haemato-oncology patients, heroin addicts and AIDS patients. Clinical signs are usually unspecific. When there is widespread involvement, clinical signs can be defined by the secondary locations, especially within the kidneys, lung, endocardium and brain in surgical patients, and liver and spleen in haemato-oncology patients. Eye, skin, gastrointestinal tract, and indeed, muscle lesions which are easily accessible, should be looked for routinely. This helps to ascertain the diagnosis, by showing the presence of Candida in the tissues. Moreover, isolating Candida from places which are normally sterile confirms deep-seated candidiasis. However, the presence of Candida in urine, bronchi, or drainage fluids is only the witness of saprophytism. This underlines the usefulness of immunological tests, which should soon benefit from the availability of new kits for the detection of cytoplasmic antigens. Indeed, the search for antibodies or circulating metabolites do not provide, at present, significantly different results in patients who have only been colonised and in those who have a systemic candidiasis. Interesting results are only obtained by showing the presence of mannans, in research laboratories. For treatment, amphotericin B remains the standard antifungal agent, and the association of amphotericin B with flucytosine the recommended association. However, drugs such as the new triazoles, among which fluconazole is particularly well tolerated and efficient, may considerably alter the principles of treatment. Finally, combining a fungal decontamination of the gut should help reduce the very high death rate of systemic candidiasis.


[Current practice and attitude of anesthesiologists for prescribing preoperative investigative tests].

A telephone enquiry was undertaken to assess current practice among French anaesthetists, and to obtain their opinion, concerning preoperative laboratory screening tests. It included 204 anaesthetists, randomly selected from the membership directory of the French Society of Anaesthetics and Intensive Care. The sample was concordant with the distribution (sex and age) given by the specialists' list of the National Medical Council. It comprised 64.2% male anaesthetists, and the overall mean age was 44.2 years. On average, each anaesthetist carried out 26 elective and 4 emergency anaesthetist a week. An organized preanaesthetic consultation was available in only 73% of public hospitals. However, even when existing, it does not automatically concern all surgical stations of the hospital and only 59% of patients benefit from that consultation. In 55% of patients the screening tests had still been made before the preanaesthetic consultation for scheduled surgery. About 15% of patients were seen for the first time by an anaesthetist on the very day of surgery. A routine prescription of preoperative tests was not systematic. Non prescription ranged from 7 to 34% of patients, depending on the tests. The responders recognized that for the same tests the rate could be comprised between 21 and 66% of patients. Moreover, 38% of anaesthetists admitted that sometimes they did not see results of the prescribed tests before carrying out the anaesthetic. Overprescription of preoperative tests has been recognized. However, legal, organisational, relational or economical reasons are given which may explain difficulties met with to rationalize prescription of these tests.


[Postoperative intestinal intussusception in children].

Two cases of postoperative intussusception (POI) are reported. Both children, 13 and 6 months old, had long and difficult surgery for abdominal neuroblastoma after four courses of chemotherapy. Obstruction of the small intestine occurred on the fifth postoperative day, after feeding had been started again, in the first child, and on the third day in the second one. Surgery revealed a loose ileo-ileal invagination of 10 and 15 cm respectively, which was easily reduced. The postoperative course was uneventful in both cases. Although POI is a classical complication of abdominal surgery, it is often forgotten. In the cases described, the first surgical procedure combined most causative factors for POI: young age, preoperative chemotherapy, prolonged general anaesthesia, extensive retroperitoneal dissection close to components of the neurovegetative system. The use of opioids for postoperative analgesia may be an additional risk factor, as they alter intestinal motility. Epidural analgesia with local anaesthetics should be preferred in such cases.


[Value of biological tests in the early diagnosis of acute steatosis in pregnancy].

Four cases of acute fatty liver of pregnancy occurring over a ten year period are reported. All four patients had a caesarean section and one died postoperatively. The seven children (three twin pregnancies) were all alive. The early clinical signs were unspecific. Jaundice was the only one occurring in all patients. Routine biological tests before the jaundice develops may be of help for a diagnosis early enough to start the treatment in patients with unspecific gastrointestinal or hepatic manifestations, especially the liver function and blood coagulation tests. These latter allow to discord the diagnosis of viral hepatitis and the "Haemolysis-Elevated Liver enzyme concentrations-Low Platelets" (HELLP syndrome) respectively. Indeed, only a liver biopsy can ascertain the diagnosis.


[Carotid artery injury: value of Doppler screening in head injured patients].

A case is reported of a patient with a traumatic aneurysm of the intracranial part of the carotid artery occurring after a traffic accident. The patient was admitted in coma (Glasgow score 5), and presented with a depressed fracture of the frontal and parietal bones, a fracture of the left petrous pyramid and of the left anterior clinoid process, as well as of the right tympanic bone and temporomandibular joint. The borders of the left carotid canal seemed unaltered. Despite the lack of localised neurological signs, cervical and transcranial Doppler ultrasonography was carried out. Intracranial carotid blood flow was found to be altered on both sides. Angiography showed a false carotid aneurysm on the left side (carotid siphon portion C3), and a moderate irregular stenosis of the C2 part on the right. There were no brain lesions on the CT scan. Prophylactic treatment with heparin was started. The patient recovered normal consciousness within a fortnight. The false aneurysm increased in volume and was treated by embolisation. Flow speeds in the carotid siphons also returned to normal. The usefulness of routine screening of patients with petrous bone fractures with Doppler ultrasound is discussed.


[Difficult intubation managed by laryngeal mask and fibroscopy].

A case is reported of a patient due to undergo a combined kidney and pancreas transplant who proved to be difficult to intubate. This diabetic hypertensive 35-year-old male patient also had ankylosing spondylitis. Mouth opening was normal (more than fingers' breadth), the chin-sternum distance was 4 cm on full cervical flexion, and cervical extension was only slightly impaired. The Mallampati score was 1. Anaesthesia was induced with thiopentone, fentanyl and 6 mg of pancuronium. Mask ventilation was quite satisfactory. However, on laryngoscopy, the vocal cords could not be seen. Several attempts to carry out endotracheal intubation, including with a stylet, failed. A laryngeal mask (LM) was therefore applied to ventilate the patient correctly. It was not possible to pass a small endotracheal tube (6 mm diameter) through the LM tube, probably because of a small malposition of this latter. A paediatric fibroscope, passed through the LM tube, served as guide for the endotracheal tube. The mask was not removed, although its cushion was slightly deflated, so as not to extubate the patient. The benefits and usefulness of a laryngeal mask in predictable and unpredictable cases of difficult intubation are discussed.


Use of enzyme immunoassay and reverse-phase high-performance liquid chromatography to detect and confirm identity of dexamethasone in equine blood.

An enzyme immunoassay (EIA) was developed for detection of dexamethasone in equine blood. Dexamethasone 21-hemisuccinate-bovine serum albumin was used for immunization of rabbits, and prednisolone 21-hemisuccinate-horseradish peroxidase was used as enzyme conjugate. The assay had sensitivity in the low-picogram range (detection limit, 0.3 pg/well, 50% inhibition of binding at 4.5 +/- 0.7 pg/well). Apart from cortisol, which was recognized by the antiserum at concentration > 8.5 ng/ml, the dexamethasone antiserum failed to interfere with endogenous steroids, but cross-reacted with triamcinolone, flumethasone, and betamethasone. Thus, the antiserum was used to perform simultaneous screening for these synthetic glucocorticoids and to confirm their identity by combining reverse-phase high-performance liquid chromatography (RP-HPLC) and EIA. The immunoreactivity obtained by direct serum measurements was characterized by means of 2 independent RP-HPLC systems. Serum extracts were submitted to RP-HPLC systems I and II, and the fractions were tested by EIA. Immunoreactive peaks were identified by comparing their retention time with that of the standard glucocorticoids used for calibration. Coinjection of an internal standard (methylprednisolone) in RP-HPLC system II yielded reproducible relative retention times. The effectiveness of the test system was evaluated, using blood from a horse treated with commonly used veterinary preparations of dexamethasone. Administration of the free alcohol of dexamethasone and of dexamethasone 21-trioxaundecanoate, both given IV, was detected, and the identity of each was confirmed for up to 48 hours. Intramuscular administration of dexamethasone 21-isonicotinate was continued for at least 14 days after injection of a therapeutic dose.(ABSTRACT TRUNCATED AT 250 WORDS)


Association between growth indicators and volume of lesions in lungs from pigs at slaughter.

Conflicting findings exist among studies on the effect of pneumonia on growth in pigs. We determined the extent of pneumonia in market-weight pigs by use of an objective, volumetric method and linear regression analyses of mean daily gain and days-to-slaughter weight on the percentage of pneumonic lung. In a range of extent of pneumonia between 1.33 and 70.44%, a 10% increase in the volume of pneumonic lung was associated with a decrease in mean daily gain by 41.1 g and a 16.7-day increase in number of days to a slaughter weight of 104.5 kg.


Effects of anticoagulant and autoanalyzer on blood biochemical values of loggerhead sea turtles (Caretta caretta).

We evaluated the effect of anticoagulant (lithium heparin, sodium heparin, or none) and type of autoanalyzer on selected blood biochemical values of the loggerhead sea turtle (Caretta caretta). More differences were observed between the analytes in serum and those in the 2 types of plasma than were observed between the 2 types of plasma. Differences in electrolyte concentrations were not significant when plasma from sodium-heparinized blood was compared with plasma from lithium-heparinized blood. Serum is not recommended for reptilian studies because clot formation is unpredictable and because the time required for clotting may allow substantial changes in the chemical composition of the sample. For most determinants, values varied more between the 2 types of autoanalyzers than among the 3 anticoagulant treatments. These sources of variation must be considered when performing comparative studies.


Variability of alpha-tocopherol values associated with procurement, storage, and freezing of equine serum and plasma samples.

Recent evidence concerning the pathogenesis of equine degenerative myeloencephalopathy indicated that low blood alpha-tocopherol values are a factor in the disease process. Variables that could be introduced by a veterinarian procuring, transporting, or storing samples were evaluated for effects on alpha-tocopherol concentration in equine blood. These variables included temperature; light; exposure to the rubber stopper of the evacuated blood collection tube; hemolysis; duration of freezing time, with and without nitrogen blanketing; and repeated freeze/thaw cycles. It was found that hemolysis caused the greatest change in high-performance liquid chromatography-measured serum alpha-tocopherol values, with mean decrease of 33% (P < 0.001). Lesser, but significant (P < 0.01) changes in serum alpha-tocopherol values were an approximate 10% decrease when refrigerated blood was left in contact with the red rubber stopper of the blood collection tube for 72 hours and an approximate 5% increase when blood was stored at 20 to 25 C (room temperature) for 72 hours. Repeated freeze/thaw cycles resulted in a significant (P < 0.05) 3% decrease in alpha-tocopherol values in heparinized plasma by the third thawing cycle. Freezer storage for a 3-month period without nitrogen blanketing resulted in slight (2%) decrease in mean serum alpha-tocopherol values, whereas values in serum stored for an identical period under nitrogen blanketing did not change. A significant (P < 0.001) mean decrease (10.3%) in alpha-tocopherol values was associated with freezer (-16 C) storage of nitrogen blanketed serum for 6 months.(ABSTRACT TRUNCATED AT 250 WORDS)


Studies of endotoxin-induced neutrophil migration in bovine teat tissues, using indium-111-labeled neutrophils and biopsies.

Neutrophil migration through bovine teat tissues into the teat cistern, after endotoxin infusion into the teat cistern, was determined in vivo by 2 experimental procedures, indium-111 labeling of blood neutrophils, and obtaining multiple biopsy specimens from the teat cistern tissues. In both experiments, the number of leukocytes in the teat cistern flushing samples was continuously measured. A lag phase of approximately 1 hour was required between endotoxin infusion into the teat cistern and the first observed neutrophil accumulation in the teat tissues. The rate of neutrophil accumulation in the teat tissues was highest between postinfusion (PI) hours 1 and 2, and the accumulation process ceased after PI hour 3. Neutrophils migrated toward the epithelium, and intraepithelial neutrophils were observed beginning approximately 2 hours after infusion, which coincided with the first influx of cells into the teat cistern. The cell influx into the teat cistern increased continuously up to PI hour 3, peaked between PI hours 3 and 5, and was close to preinfusion value at PI hour 22. Use of indium-111-labeled neutrophils in the study of the inflammatory process provides a reliable noninvasive method to quantify cell migration in vivo. Use of biopsies allows quantification of the number of cells in different tissue areas, but has the disadvantage of being invasive. These 2 procedures complement each other, and could be of use in future studies of the local inflammatory process.


Effects of dietary phosphorus and protein in dogs with chronic renal failure.

Four diets were formulated to contain: 16% protein and 0.4% phosphorus--diet 1; 16% protein and 1.4% phosphorus--diet 2; 32% protein and 0.4% phosphorus--diet 3; and 32% protein and 1.4% phosphorus--diet 4. Forty-eight dogs were fed diet 1 for 3 months after surgical reduction of renal mass, then were allotted to 4 groups of 12 dogs each, with equal mean values for glomerular filtration rate (GFR). Dog of groups 1-4 were fed diets 1-4, respectively, for 24 months. Data collected from the dogs during and at termination of the study were analyzed statistically for effects of dietary protein, phosphorus (P), time, and interactions between these factors. During the 24 months of study, 24 dogs developed uremia and were euthanatized for necropsy. Necropsy also was performed on the remaining 24 dogs after they were euthanatized at the end of the study. Dog survival was significantly enhanced by 0.4% P diets (vs 1.4% P diets), but survival was not significantly influenced by amount of dietary protein. The 0.4% P diets (vs 1.4% P diets) significantly increased the period that GFR remained stable before it decreased, but dietary protein did not have significant effect. Significant blood biochemical changes attributed to P, protein, and time were identified during the study. Terminally, plasma parathyroid hormone concentration was significantly increased from prediet values in all groups of dogs. Urine protein excretion was not significantly affected by dietary amount of either protein or P, when measured by either timed urine collection or urine protein-to-creatinine ratio.(ABSTRACT TRUNCATED AT 250 WORDS)


Efficacy of a drug combination of praziquantel, pyrantel embonate, and febantel against helminth infections in dogs.

Tablets containing praziquantel, pyrantel embonate, and febantel were tested for efficacy against helminths in dogs. A single treatment with this drug combination gave 100% reductions in Toxocara canis and Taenia hydatigena in experimentally induced infections in dogs. In dogs with naturally acquired infections, treatment gave > 97 to 98% reductions in fecal egg counts attributable to Toxascaris leonina, T canis, and Uncinaria stenocephala. Efficacy against Trichuris vulpis was > 92%.


Efficacy of milbemycin oxime in chemoprophylaxis of dirofilariasis in cats.

Although cats are less susceptible to infection with Dirofilaria immitis than are dogs, the possibility of severe consequences from infection or adulticidal treatment renders preventive treatment a desirable alternative in endemic areas. To evaluate the efficacy of milbemycin oxime as a chemoprophylactic agent in cats, 48 cats were inoculated with infective D immitis larvae. Single oral treatment with 2.3 mg of milbemycin oxime (0.5 to 0.9 mg/kg of body weight) at 30 or 60 days after inoculation with infective larvae gave strong but incomplete protection. Treatment at 60, as well as 90, days after inoculation with infective larvae was completely effective in preventing development of infection. A control group of inoculated, but untreated, cats was monitored biweekly for hematologic changes and for changes in parasite-specific serum antigen and antibody concentrations. Pronounced increases in total leukocyte counts and eosinophil numbers were associated with the estimated time of in vivo molting from fourth- to fifth-stage larvae. Antibody reactivity correlated with infection status, but serum antigen concentrations through 161 days after inoculation were undetectable.


Regulation of matrix metabolism in equine cartilage explant cultures by interleukin 1.

Explant cultures were set up, using articular cartilage obtained from metatarsophalangeal joints of 11 horses. Explants from 2 horses were used to determine culture conditions appropriate for tissue viability. The cartilage explants maintained steady-state metabolism of proteoglycans during a 13-day evaluation period. The metabolic response of equine articular cartilage to incubation with recombinant human interleukin 1 (0.01 to 100 ng/ml) was studied, using cartilage obtained from the remaining 9 horses, age of which ranged from 3 months to 20 years. Interleukin 1 induced a dose-dependent release of glycosaminoglycan from the matrix during a 3-day incubation period. It also caused dose-dependent inhibition of glycosaminoglycan synthesis during a 3-hour pulse-labeling period. Explants obtained from older horses were significantly (P < 0.05) less responsive to interleukin 1, with respect to synthesis and release of glycosaminoglycan.


Investigation of glomerular lesions in dogs with acute experimentally induced Ehrlichia canis infection.

Six male Beagles were inoculated with Ehrlichia canis. Transient proteinuria was confirmed during the acute phase of infection by serial determination of urinary protein-to-creatinine ratio. Peak urine protein loss, consisting principally of albumin, was observed 2.5 to 3.5 weeks after inoculation. Renal biopsy specimens were obtained before inoculation, during peak proteinuria, and 10 weeks after inoculation when proteinuria had resolved. Renal tissue was evaluated by use of light, immunofluorescent, and electron microscopy to correlate specific glomerular lesions with development of proteinuria. Histologic examination revealed perivenular and interstitial infiltrates of lymphocytes and plasma cells localized principally to the renal cortex. Glomerular lesions were minimal to absent. Immunofluorescent staining revealed moderate to marked deposition of anti-canine IgG and IgM in the glomerular tufts and mesangium. Depositions of anti-canine complement factor C3 were not observed. Immunofluorescent staining persisted 10 weeks after inoculation, despite resolution of proteinuria, and probably represented passive trapping of immunoglobulins. Ultrastructural examination revealed fusion of podocyte processes that coincided with development of proteinuria. Electron-dense deposits or changes in the basement membrane were not observed. Morphometric measurements of average podocyte process length and percentage of coverage of basement membrane by podocyte processes were used to quantify the degree of process fusion. Both measurements increased significantly (P < 0.05) during peak proteinuria, and returned to preinoculation values when proteinuria had resolved 10 weeks after E canis inoculation. These findings indicated possible minimal-change glomerulopathy, rather than immune-complex glomerulonephritis, during acute E canis infection and could explain transient proteinuria without histologic evidence of glomerular disease.


Pharmacokinetics of intravenously and orally administered pyrimethamine in horses.

Single-dose pharmacokinetic variables of pyrimethamine were studied in horses. Pyrimethamine (1 mg/kg of body weight) was administered IV and orally to 6 adult horses, and plasma samples were obtained at frequent intervals thereafter. Plasma pyrimethamine concentration was assayed by gas chromatography, and concentration-time data were analyzed, using a pharmacokinetic computer program. The IV and oral administration data were best described by 3-compartment and 1-compartment models, respectively. The median volume of distribution at steady state after IV administration was 1,521 ml/kg and the median elimination half-time was 12.06 hours. Mean plasma concentration after oral administration fluctuated between a maximal concentration of 0.18 microgram/ml and 0.09 microgram/ml (24 hours after dosing). Bioavailability after oral administration was 56%.


Pharmacokinetics, penetration into cerebrospinal fluid, and hematologic effects after multiple oral administrations of pyrimethamine to horses.

Pharmacokinetics, CSF penetration, and hematologic effects of oral administration of pyrimethamine were studied after multiple dosing. Pyrimethamine (1 mg/kg of body weight) was administered orally once a day for 10 days to 5 adult horses, and blood samples were collected frequently after the first, fifth, and tenth doses. The CSF samples were obtained by cisternal puncture 4 to 6 hours after administration of the first, third, seventh, and tenth doses. Pyrimethamine concentration in plasma and CSF was quantified by gas chromatography, and plasma concentration-time data were analyzed, using a pharmacokinetic computer program. Repeated daily dosing resulted in accumulation of pyrimethamine in plasma, with steady state being achieved within 5 days, when the mean peak plasma concentration was more than twice that measured after the first dose. Pyrimethamine concentration in CSF was 25 to 50% of corresponding plasma concentration and did not appear to accumulate with successive administration of doses. Blood samples collected during and after the dosing regimen were submitted for hematologic analysis; neutrophil numbers decreased slightly, but remained within normal range for adult horses.


Effect of treatment with oxytetracycline during the acute stages of experimentally induced equine ehrlichial colitis in ponies.

Eighteen ponies were inoculated IV with Ehrlichia risticii-infected P388D1 mouse monocyte cells. Twenty-four hours after onset of fever (rectal temperature > 38.8 C), 9 ponies were treated with oxytetracycline (6.6 mg/kg of body weight, IV, q 24 h) for 5 days. The remaining 9 ponies served as infected nontreated controls. Mean scores of the following variables were not significantly different between groups on the day treatment was begun: rectal temperature, diarrhea, borborygmal sounds, feed intake, mental attitude, and evidence of a hyperresonant area in the abdomen. All ponies were observed for progression of clinical signs typical of ehrlichial colitis. Within 12 hours of initiation of treatment, only 1 treated pony had a rectal temperature > 38.8 C and most rectal temperatures were < 38.3 C. In contrast, only 2 control ponies had rectal temperatures < 38.8 C (mean rectal temperature values were significantly, P = 0.01, different between groups). In the treatment group, 4 ponies had no signs of depression after the first day of treatment, and only 1 had signs of depression after the second day of treatment (mean scores between groups were significantly different, P = 0.01). Feed intake remained normal in 4 treated ponies and improved in 4 of the remaining 5 after treatment began. Most of the control ponies had a progressive decrease in their feed intake during the observation period (mean scores between groups were significantly, P = 0.01, different). Three ponies in the control group and 2 ponies in the treatment group developed diarrhea before the treatment observation period began.(ABSTRACT TRUNCATED AT 250 WORDS)


Clinical efficacy of tirilazad mesylate for treatment of endotoxemia in neonatal calves.

The clinical efficacy of the lazaroid, tirilazad mesylate, a new therapeutic agent for prophylaxis and treatment of endotoxemia, was evaluated in 24 neonatal Holstein calves. Endotoxemia was induced by IV infusion of commercial Escherichia coli lipopolysaccharide (3.25 micrograms/kg of body weight) over 3 hours. Group-1 calves were given endotoxin alone; group-2 calves were given an infusion of 0.9% sterile saline solution, then were treated with tirilazad mesylate (1.5 mg/kg) 1 hour after the infusion was started. Group-3 calves were treated with tirilazad mesylate 1 hour after the start of the endotoxin infusion, and group-4 calves were given tirilazad mesylate 1 hour before the start of the endotoxin infusion. Clinical signs of endotoxemia were mitigated by tirilazad mesylate. In addition, tirilazad mesylate protected calves from endotoxin-induced hyperglycemia; treatment after endotoxin infusion decreased the severity of hypoglycemia and prevented lactic acidosis. Treatment with tirilazad mesylate after initiation of endotoxin infusion was as protective as was pretreatment.


Effects of endotoxin-induced mastitis on the pharmacokinetic properties of aditoprim in dairy cows.

Plasma disposition of aditoprim, a new dihydrofolate reductase inhibitor, was studied in healthy cows and cows with endotoxin-induced mastitis. A single dose of 5 mg of aditoprim/kg of body weight was administered IV to 5 healthy cows and to the same cows 3 weeks later at 2 hours after intramammary infusion of 0.1 mg of endotoxin into the rear quarters. Mastitis developed in all endotoxin-infused quarters and cows had systemic signs of disease (fever, tachycardia, depression) from 2 to 10 hours after infusion of endotoxin. Pharmacokinetic characteristics of aditoprim in healthy cows were a large volume of distribution (6.28 L/kg), a systemic clearance of 0.82 L/h/kg, and an elimination half-life of 7.26 hours. In cows with mastitis, plasma concentrations of aditoprim were lower between 5 and 26 hours after injection. The systemic clearance (1.00 L/h/kg) and the volume of distribution (12.25 L/kg) were significantly higher in cows with mastitis, but elimination half-life was not significantly different. The lower plasma concentrations of aditoprim between 5 and 26 hours after injection in cows with mastitis are explained by fluid compartment shifts and/or blood flow changes induced by mastitis, although increased elimination of aditoprim in cows with mastitis cannot completely be ruled out. The antibacterial activity of aditoprim is nearly the same as that of trimethoprim. The longer elimination half-life time of aditoprim, however, indicates that it may have a practical pharmacotherapeutic advantage over trimethoprim.


Median effective dosage of propofol for induction of anesthesia in dogs.

The median effective dosage (ED50) of propofol for induction of anesthesia was determined in 25 dogs premedicated with acepromazine, 0.05 mg/kg of body weight, and in 35 unpremedicated dogs. The ED50 was found to be 2.2 mg/kg in premedicated dogs and was 3.8 mg/kg in unpremedicated dogs. The mean +/- SD total dosage of propofol required to induce anesthesia in premedicated animals was 2.8 +/- 0.5 mg/kg and was 4.7 +/- 1.3 mg/kg in unpremedicated animals. Signs of excitement were observed in 5 of the unpremedicated dogs, but in none of those that were premedicated.


Cardiovascular and respiratory effects of propofol administration in hypovolemic dogs.

Cardiopulmonary effects of propofol were studied in hypovolemic dogs from completion of, until 1 hour after administration. Hypovolemia was induced by withdrawal of blood from dogs until mean arterial pressure of 60 mm of Hg was achieved. After stabilization at this pressure for 1 hour, 6 mg of propofol/kg of body weight was administered IV to 7 dogs, and cardiopulmonary effects were measured. After blood withdrawal and prior to propofol administration, oxygen utilization ratio increased, whereas mean arterial pressure, mean pulmonary arterial pressure, central venous pressure, pulmonary capillary wedge pressure, cardiac index, oxygen delivery, mixed venous oxygen tension, and mixed venous oxygen content decreased from baseline. Three minutes after propofol administration, mean pulmonary arterial pressure, pulmonary vascular resistance, oxygen utilization ratio, venous admixture, and arterial and mixed venous carbon dioxide tensions increased, whereas mean arterial pressure, arterial oxygen tension, mixed venous oxygen content, arterial and mixed venous pH decreased from values measured prior to propofol administration. Fifteen minutes after propofol administration, mixed venous carbon dioxide tension was still increased; however by 30 minutes after propofol administration, all measurements had returned to values similar to those measured prior to propofol administration.


Effects of chlorothiazide on urinary excretion of calcium in clinically normal dogs.

Administration of thiazide diuretics has been recommended to prevent calcium oxalate urolith development in dogs. To evaluate the effects of thiazide diuretics in dogs, 24-hour urine excretion of calcium was measured in 6 clinically normal Beagles after administration of chlorothiazide (CTZ) for 2 weeks, administration of CTZ for 10 weeks, and administration of calcium carbonate and CTZ for 2 weeks. Compared with baseline values, 24-hour urine calcium excretion did not decrease after CTZ administration. When CTZ was given at a high dosage (130 mg/kg of body weight), urinary calcium excretion was significantly (P < 0.04) higher than baseline values. Based on these observations, we do not recommend CTZ for treatment or prevention of canine calcium oxalate urolithiasis.


Pharmacokinetics of clindamycin phosphate in dogs after single intravenous and intramuscular administrations.

Clindamycin phosphate was administered to dogs at dosage of 11 mg/kg of body weight via IV and IM routes. The disposition curve for IV administration was best represented as a 2-compartment open model. Mean elimination half life was 194.6 +/- 24.5 minutes for IV administration and 234.8 +/- 27.3 minutes for IM administration. Bioavailability after IM administration was 87%. Dosage of 11 mg/kg, IV, given every 8 hours, provided serum concentration of clindamycin that exceeded the minimal inhibitory concentration for all Staphylococcus spp, as well as most pathogenic anaerobes, throughout the dosing interval. Intramuscular administration induced signs of pain and cannot be recommended.


Neuromuscular and cardiovascular effects of atracurium in isoflurane-anesthetized chickens.

Atracurium besylate, a nondepolarizing neuromuscular blocking agent, was administered to 24 isoflurane-anesthetized domestic chickens. Birds were randomly assigned to 4 groups, and atracurium was administered at dosage of 0.15, 0.25, 0.35 or 0.45 mg/kg of body weight. The time of onset of twitch depression, the amount of maximal twitch depression, and the duration of muscular relaxation were recorded. After return to control twitch height, atracurium was further administered to achieve > 75% twitch depression. When twitch depression reached 75% during noninduced recovery, 0.5 mg of edrophonium/kg was administered to reverse the muscle relaxation. Throughout the experimental period, cardiovascular, arterial blood gas, and acid-base variables were monitored. The effective dosage of atracurium to result in 95% twitch depression in 50% of birds, (ED95/50) was calculated, using probit analysis, to be 0.25 mg/kg, whereas the ED95/95, the dosage of atracurium to result in 95% twitch depression in 95% of birds, was calculated by probit analysis to be 0.46 mg/kg. The total duration of action at dosage of 0.25 mg/kg was 34.5 +/- 5.8 minutes; at the highest dosage (0.45 mg/kg), total duration increased to 47.8 +/- 10.3 minutes. The return to control twitch height was greatly hastened by administration of edrophonium. Small, but statistically significant changes in heart rate and systolic blood pressure, were associated with administration of atracurium and edrophonium. These changes would not be clinically relevant. In this study, atracurium was found to be safe and reliable for induction of muscle relaxation in isoflurane-anesthetized chickens.


Quantitative analysis of computer-averaged electromyographic profiles of intrinsic limb muscles in ponies at the walk.

The function of several intrinsic muscles of the fore-and hind limbs of 5 ponies walking normally was evaluated via surface electromyography. Electromyographic signals were band-pass filtered, rectified, linear enveloped, and standardized to the stride duration. Mean data from the muscles of the left and right limbs that were obtained from at least 30 strides in 2 recording sessions were recorded as electromyographic signals-time curves. The timing of muscle activity was determined from these graphs. On the basis of the major peaks in the electromyographic signal, muscle functions were identified. In the forelimb, the extensor carpi radialis muscle was involved in extension of the carpus at the end of the swing phase of the stride, and it provided support to flexion of the cubital joint at the beginning of the swing phase. The common digital extensor muscle extended the distal joints of the forelimb at the end of the swing phase. The ulnaris lateralis muscle provided support to extension of the cubital joint at the beginning of the stance phase, and the flexor carpi radialis muscle flexed the carpus at the beginning of the swing phase. The flexor carpi ulnaris muscle extended the cubital joint at the end of the swing phase. In the hind limb, the long digital extensor muscle flexed the tarsus at the beginning of the swing phase and extended the digital joints preceding the stance phase. The deep digital flexor muscle prevented overextension of the distal interphalangeal joint during the stance phase and flexion of the digital joints during the swing phase.(ABSTRACT TRUNCATED AT 250 WORDS)


Effect of xylazine on the arrhythmogenic dose of epinephrine in thiamylal/halothane-anesthetized horses.

The effect of xylazine on the arrhythmogenic dose of epinephrine (ADE) was studied in 9 horses. Anesthesia was induced by administration of guaifenesin (50 mg/kg of body weight, IV) followed by thiamylal (4 to 6 mg/kg, IV) and was maintained at 1 minimal alveolar concentration (MAC) of halothane (0.89%). Base apex ECG and facial artery pressure were recorded. Epinephrine was infused in a sequence of arithmetically spaced increasing rates (initial rate 0.25 micrograms/kg/min) for a maximum of 10 minutes. The ADE was defined as the lowest epinephrine infusion rate to the nearest 0.25 micrograms/kg/min at which at least 4 premature ventricular depolarizations occurred in a 15-second period. Xylazine (1.1 mg/kg, IV) was administered after the control ADE was determined. Xylazine did not significantly alter the ADE (control, 1.12 +/- 0.38 micrograms/kg/min; xylazine, 1.21 +/- 0.46 micrograms/kg/min). Blood pressure increased transiently for 8 minutes after xylazine administration. Baseline systolic and diastolic arterial pressures and heart rate were not significantly different from control baseline pressures and heart rate 15 minutes after xylazine administration. Blood pressure and heart rate increased significantly during control and xylazine ADE determinations. Significant differences in pH, PaO2, PaCO2, or base excess were not observed between baseline and ADE in the control or xylazine groups. One horse developed atrial fibrillation, and 2 horses developed ventricular fibrillation during ADE determinations.


Changes in erythrocyte deformability in NaCl-induced right-sided cardiac failure in broiler chickens.

In this study, we tested the hypothesis that erythrocyte deformability is decreased in the development of cardiac failure induced by NaCl toxicosis. Deformability of erythrocytes and routine hematologic and biochemical variables were measured in 6 of 50 chickens that were given 5 g of NaCl/L in their drinking water from day 7 to day 42, and were compared with values in 6 of 50 healthy chickens given free access to tap water. Deformability was assessed by passing a 10% suspension of erythrocytes through a polycarbonate membrane with 5-microns pores. Chickens were euthanatized and heart and body weights were determined. Treatment with NaCl induced right-sided cardiac failure up to day 28. The ratios of heart weight to body weight were greater, for right ventricle by 20 to 64% and for left ventricle by 15 to 27%, attributable to NaCl treatment. Deformability of erythrocytes of NaCl-treated chickens was markedly decreased, in association with increased erythrocyte size and plasma Na+ concentration. However, only part of the decreased deformability could be explained by swelling of erythrocytes. Decreased deformability could not be explained by increased cell viscosity because mean corpuscular hemoglobin concentration, the primary determinant of erythrocyte viscosity, was decreased. Because decreased deformability of erythrocytes has been demonstrated previously to be associated with increased vascular resistance, decreased deformability may have contributed to the development of right-sided cardiac failure in these chickens.


Isolation, propagation, and cryopreservation of equine articular chondrocytes.

Equine articular chondrocytes were isolated from explant cartilage cultures by digestion in a 0.075% collagenase solution for 15 to 19 hours. Cartilage from late-term fetal and neonatal foals resulted in mean chondrocyte yield of 51.99 x 10(6) cells/g of cartilage (wet weight), compared with a yield of 17.83 x 10(6) cells/g for foals 3 to 12 months old. Propagation of chondrocytes in monolayer and 3-dimensional culture was accomplished, using Ham's F-12 as the basal medium, with supplements of fetal bovine serum (10%), ascorbic acid, alpha-ketoglutarate, and L-glutamine. The medium was buffered with HEPES, and penicillin and streptomycin were added for microorganism control. In primary monolayer cultures of freshly isolated chondrocytes, the population doubling time was approximately 6 days. Dedifferentiation of chondrocytes toward a more fibroblastic-appearing cell was observed after the fifth passage (subculture), but was hastened by lower cell-plating density. Chondrocytes were frozen for periods of up to 9 months, using 10% dimethyl sulfoxide as the cryoprotectant. Cell viability of late-term fetal and neonatal foal chondrocytes after storage at -196 C decreased from 86% at 3 weeks to 31% at 12 weeks. Viability of cells derived from older foals and young adult horses was considerably better than that of cells from neonatal foals. Frozen chondrocytes can be stored for extended periods and thawed for immediate implantation or can be sustained in vitro in monolayer or 3-dimensional culture. Such cultures would be suitable for cartilage resurfacing experiments or in vitro assessment of various pharmaceuticals.


Collection of pancreatic exocrine secretions by formation of a duodenal pouch in cattle.

Collection of exocrine pancreatic secretions from cattle by use of a single-unit cannula was performed. The major advantage of the cannula was simple technical management. A small pouch of the duodenum into which the major pancreatic duct drains was formed. Continuity of the duodenum was reestablished by end-to-end anastomosis. A side arm of the cannula was inserted into the pouch to collect exocrine secretions, and the main portion of the cannula was placed cranial to the anastomosis to return pancreatic secretions to the small intestine between collection periods. The accessory pancreatic duct was ligated in 2 of 4 cattle to evaluate possible secretory contribution from this source. All cattle remained healthy after cannulation, and cattle gained approximately 100 kg of body weight in the 5 months after surgery. The mean secretory rate for exocrine pancreatic secretion in cattle was 106 +/- 6.8 ml/h. There was no effect of feeding on the pattern of secretion nor were there significant differences between cattle. A fistula formed between the pouch and duodenum approximately 120 days after surgery in the first 2 cattle used. Development of fistulas was prevented for 300 days in subsequently prepared cattle by use of surgical mesh around the cannulas, leading to functional cannulation sites. Preparation of a duodenal pouch appeared useful for long-term studies of pancreatic exocrine secretion in cattle.


Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendinitis in horses.

Superficial digital flexor tendinitis was induced in each forelimb of 8 horses by injecting 4,000 U of collagenase into the midmetacarpal region of the tendon. In each horse, each tendon was treated 24 and 96 hours after the collagenase injection with SC injections of sodium hyaluronate (treated limbs) or an equal volume of 0.9% NaCl solution (control limbs). Exercise was restricted for the first 3 weeks of the study, and a controlled exercise program was instituted for the remainder of the study. Horses were evaluated clinically for lameness, tendon swelling, and midmetacarpal limb circumference. Ultrasonographic examinations were performed regularly (11 examinations/horse) throughout the study, and all horses were euthanatized 12 weeks after collagenase injections. Tendons from 4 horses were harvested for biomechanical testing, and samples were obtained from tendons from the remaining 4 horses for biochemical analysis of collagen. Samples were obtained from all tendons for microscopic evaluation. Significant differences between treated and control tendons were not noticed in any of the variables examined in live horses, although trends toward less lameness in treated limbs and toward better healing on ultrasonographic examination in control limbs were recorded. Significant differences were not noticed in biomechanical or biochemical evaluations, and the only significant (P < 0.05) microscopic finding was more severe inflammation in tendons from treated limbs. This study did not reveal significant benefits of treatment with sodium hyaluronate outside a synovial sheath on tendon repair in collagenase-induced tendinitis.


Effects of a fixed compression load on the osteogenic effect of autogenous cancellous bone grafts in dogs.

A standardized cortical defect was created on the caudal cortex of the proximal portion of each ulna in 5 adult mixed-breed dogs. One gram of autogenous cancellous bone graft (ACBG) was obtained from the greater tubercle of the ipsilateral humerus. The cortical defect in the ulna of 1 limb was filled with 1 g of ACBG that had been compressed with 2-MPa pressure for 30 seconds. One gram of noncompressed ACBG was placed into the contralateral ulnar cortical defect. The compressed and noncompressed ACBG recipient sites were radiographed at weekly intervals. Dogs were euthanatized 8 weeks after surgery, and the ACBG recipient sites were harvested for histomorphometric analysis. Optical densitometry was performed on all radiographs. There was no significant difference between compressed and noncompressed ACBG with optical densitometry or histomorphometric analysis for total bone area. We concluded that there was no difference in osteogenic capability between compressed and noncompressed ACBG of equal mass.


Emergenesis. Genetic traits that may not run in families.

Traits that are influenced by a configuration--rather than by a simple sum--of polymorphic genes may not be seen to be genetic unless one studies monozygotic twins (who share all their genes and thus all gene configurations) because such "emergenic" traits will tend not to run in families. Personal idiosyncrasies that have been found to be surprisingly concordant among MZ twins separated in infancy and reared apart may be emergenic traits. More speculatively, important human traits like leadership, genius in its many manifestations, being an effective therapist or parent, as well as certain psychopathological syndromes may also be emergenic. These ideas reemphasize the importance of the role played in human affairs by genetic variation.


The lab versus the clinic. Effects of child and adolescent psychotherapy.

Four recent meta-analyses, involving more than 200 controlled outcome studies, have shown consistent evidence of beneficial therapy effects with children and adolescents. However, most of the studies involved experimental procedures, nonreferred subjects, specially trained therapists with small caseloads, and other features that may not represent conventional clinic therapy. Research focused on more representative treatment of referred clients in clinics has shown more modest effects; in fact, most clinic studies have not shown significant effects. Interpretation studies have not shown significant effects. Interpretation of these findings requires caution; such studies are few and most could profit from improved methodology. The clinic studies do raise questions as to whether the positive lab findings can be generalized to the clinics where most therapy occurs; however, the lab interventions that have worked so well may point the way to enhanced therapy effects in clinics.


Recent advances towards a meta-typology of human relationships.

After less than four decades, the field of family therapy has largely abandoned the search for a typology of interaction between persons or between groups. Granted no single typology can conceivably fathom the hyper-dimensionality of human interaction. However, mankind's earliest recorded efforts to explicate the structures of human family systems are perceived by examining two of the earliest books known to man. These documents, The Book of Genesis of The Old Testament and the ancient Chinese Book of Changes or I Ching, can be viewed as loosely integrated modules of a single framework that help explain one another. The author suggests that these linked, family oriented sources also were the basis of modern symbolic logic and information (or switching) theory. Together they can provide the foundation of a hyper-dimensional meta-typology of human interaction. This could integrate interactions at and between levels of neuronal synapses and networks, the cerebral hemispheres, self and other, family and disparate social systems, and various human groups, national, racial, ethnic or religious.


The elementary pragmatic model: from theory to therapeutic practice.

A theoretical family therapy model which classifies possible outcomes of dyadic interactions into sixteen basic types is presented. The theoretical rules which are also presented predict how determined changes occur from the interactions. The model is already the object of an utilization by the author and his group of therapists in family therapy. The work modalities and results obtained in clinical field are briefly explained.


Methods for evaluating normal and pathological couples and families according to the elementary pragmatic model.

Following the interactional view of the problem of human communication and relation, as developed by many authors in past years, a review of the research in the field of the relational test is briefly described. In particular, an interaction test which permits automatic data collection and processing is designed, which derives from the Elementary Pragmatic Model by De Giacomo et al. A low cost minicomputer system is an adequate support, being the implemented procedures self consistent ones.


Transactions in the family of the schizophrenic.

According to a large exemplification derived by the clinical practice, the relation between the schizophrenic's parents shows a concealed symmetry, that never escalates, but implies an endless excitement, that reassures the couple of their mutual consensus. As result, inhibition and inconclusiveness cause a loss of spontaneity and a reciprocal stereotyped characterization, connivingly accepted by both partners. Either a substitution without proxy or a swindle of one spouse by the other occurs in vital areas of their relation. The spouse's communication shows a continuous reciprocal attempt not to define their own relation, by the use of a wide wordiness, that includes different subjects and meanings in a confusive and spiral-shaped sequence. Such a kind of relation is assumed as originated by a massy influence of at least one spouse's family, that stops the couple at early stages of their relation.


Drugs and human interactions.

Some reflections and hypotheses on drugs and human interactions are presented from a psychiatric-psychotherapeutic point of view. Considering the drug both as an agent and a relational mediator, an attempt is made to systematize the interactive whole of the intraindividual and interindividual effects activated by drugs. The hypothesis is presented that pharmacological effects on mind are prevalently due to an energic action and that this action is status-specific, in other words relative to a mental-relational good order of the individual in that particular moment of his history. Concerning the extra-pharmacological effects in therapeutic relations, the values assumed from the drug during the course of the interaction are different and variable, depending in the same individual (patient or therapist) on superimposition of several experiential and semantic orders. Finally some elements of drug relational psychology are introduced.


Family typology: the search for language.

Twenty three years of collecting data about family systems has been an adventure. The first product of this work was a family typology; much later we realized that we had also defined the process for making a typology. A survey of the literature suggests that there are many different family typologies in use around the world and that each is supported by an idiosyncratic language. These language differences are just one sign that there is little correspondence between the published typologies. The author proposes that hyperdimensional and invisible aspects of the family obscure the relationships between the many typologies. It is suggested that all typologies are related but as each of the typologists is looking at a different "visible" part of the family the connections are not apparent. A theory called the "Family Corpus" is offered to explain the differences and begin to make relationships between the various typologies evident. Information is offered from the field of biophysics that may point a direction for further research in and understanding of families.


Typology of interactive models in depression.

Despite the increasing diffusion of the illness there is poor systemic investigation in the area of depression. This study examines the typology of interactive models of the depressed patient in the couple relationship, with the family of origin, the children, the outside world and the therapist. The couple relationship usually becomes an helping relationship with the depressive patients that assumes the "care eliciting" while the partner develops the "care giving" attitude. Sequential disqualification and negative self fulfilling prophecy are as well typical of the depressive couple. An intrusive bind with families of origin is very often activated by depressive behavior, and a transgenerational competition for taking care of one relative's chronic inability may rise. Some guidelines for a specific therapeutic strategy for depressive families together with some case examples are given. The role of the therapist's own depressive feelings when working with this type of families is considered.


Form and process in typology.

With Bateson we want to look for the structure that connects form, process and typology. We do not believe that distinctions are representation of dualism: according to the model proposed by the Second Cybernetics, the distinctions are considered as different sides, that is, an overlap of levels in which one term derives from the other. The logic of the relationship between form and process implies different levels in a self-reference model in which one part is pulled out of the other. At present, speaking about typology, makes sense in order to correlate some complex factors. The first one implies the multidimensionality of intrapsychic and relational reality. The second, a continuous process of self-consciousness of different analytic levels of "reality". The third considers a diagnosis (and typology) as a part of the "information" for the therapist, his patient, his family and his interpersonal context.


The interaction between cohesive systems and dispersive systems: creating the trigenerational therapeutic context.

The author presents a model for research investigation and clinical use that deals with the interaction between cohesive and dispersive family of origin systems as reflected in marital and family interaction in nuclear families: a) it studies the way the members of a family system group together and their resulting modes of relating, basing the study on a single variable family cohesion, with the centripetal and centrifugal forces that intervene in it. It separates families into cohesive and dispersive families without taking into consideration whether they are normal or pathological; b) it studies the interaction of these two family systems in the conjunction originated by the bond or union of a couple forming a new family. In other words, the interaction of the two family systems of origin has to be taken systematically into account as the nodal point of the newly created system, with the specific relational style and the different configurations that can be formed if both family systems of origin are cohesive, or if one is cohesive and the other dispersive, or, finally, if both are dispersive; c) it delineates the creation of the trigenerational therapeutic context. When considering a dysfunctional couple or family, the situational diagnosis and the therapeutic strategy are joined on the basis of these three configurations that represent distinct psychological fields. Therefore, the technical approach must be differentiated accordingly.


The family in different sub-cultures.

The family has been considered, according to the different angles from which research has been conducted, as an anthropological reality; as an institutional segment; as an etiopathogenetic nucleus; as a communicative environment. The family, taken as a highly complex (open-closed) system, is by now a common conception not only among family therapists, but also for those concerned--from a transcultural point of view--with individual and family dynamics in connection with extra-familial dynamics in a society in constant and rapid transformation. The therapists must be able to contribute to a reconstruction of the interactive dynamics of the family network, stimulating the contribution that each member may make to reparative, and at the same time creative, development. In the various family typologies the model of a therapeutic network flexibly based on cultural identification may be introduced.


From typologies to guidelines: the constructivistic perspective.

The aim of this article is to identify changes in the psychotherapeutic field brought forth by a different relation with the process of knowing. These pages are going to render explicit how the therapeutic process has evolved following the changes in the meta domain of ideas and thereafter consider the ways in which typology concepts can be utilized coherently with these new procedures. Typologies are therefore considered not as clear, exhaustive reference parameters but rather as guidelines. In the article I propose to utilize many explicative categories as non exhaustive organizing grids. I propose as well to render explicit that we as clinicians participate in the definition of the problem and in the attempt to solve it.


Relational typology in groups.

The aim of this work is to verify, starting from Foulkes' group-analytic perspective, the existence of a link between individual, family and group relational modality on one side, and the many group techniques on the other. This link is well outlined and defined: it is the need to harmonize, to integrate the different parts of the individual, the family, the group. The satisfaction of this need leads to well-being; its dissatisfaction leads to disorders and to the consequent relational modality. In particular, the lack or the reduction of the integrative and associative capacity leads to psychosis, while the disharmony of the different psychical functions leads to neurosis, and the body disharmony leads to psychosomatic disorders. Following Foulkes' group-analytic perspective, the author works out a new definition of man. Man is the final function of all the body functions.


An application of the elementary pragmatic model to electronic communication.

This article sets out a quantitative theory of the interaction among "subjects" which allows a description of the pragmatic aspects of communication. Within a system of interacting subjects each individual is described by means of a set of interaction parameters. In this way an interaction pattern relative to each subject can be defined. The model provides a "change law" which describes the evolution of individual patterns as a consequence of different communication events. This allows interaction deficiencies to be identified and suggests possible strategies for dealing with them. The theory was first developed in the area of clinical psychiatry and underwent two kinds of external verification: one psychometric-diagnostic, the other clinical. The theory was then applied to an economic environment in the behavioral study of decision-making processes. In this paper we suggest that it may be applied in computerized environments for cooperation support.


A living-in community for adolescents: a systemic methodology for training and management.

An experience in managing a lodging house for young psychotic girls is described. Model is referred to the relational theory. Meetings with families and educators, institutional crises and results are considered. Results pointed out the importance of managing on the Department territory in order to treat and rehabilitize psychotic patients.


Interactive typology in depression according to cognitive theory and systemic theory.

Both systemic and cognitive theories agree upon the importance of early learning in the development of depressive personality. The two theories disagree upon the meaning they give to the early experiences. According to cognitive theory the emotions bound to a significant and not reparable loss turn themselves into a pursuit of autonomy in order to prevent further grieves. In the grown-up person if autonomy is not reached or is lost, a depressive episode will rouse. According to the systemic theory, children learn emotions and behaviours of a depressed parent. The child also learns by himself or through the healthy parent the feeling of importance/inability to help. The grown-up person will make use of the depressed behaviour when he will feel unable to face by himself critical life events or to elice to care or attention by the partner.


The relational history of the family with a schizophrenic member.

Coherently with the systemic view, the authors consider the family interaction patterns in schizophrenia. Some typical redundant behaviours in the family system appear to be typical of the schizophrenic family. The authors investigate the family system and story through the international literature. Special emphasis in this work is placed upon the modalities of weaning from the parental figures, the conjugal bind of the parents and the interactive patterns with grandparents. In order to study these binds and according with many authors a fictitious family history is reported.


Relational patterns in families with a psychotic member during the infancy period.

The authors have focused their attention on "pathological" mechanisms which appear a long time before the onset of any psychotic symptom. It seems particularly interesting to find out, using clinical observations, if and how family relationships in their temporal dimension, present a particular organization from the beginning of their histories. The authors consider the possibilities of single out the presence of "early indicators of pathology" in families with a psychotic member. This was carried out by a questionnaire articulated in two sessions: the first section was in relation to the periods before and after the birth of children and the second in relation to the children's school period. The questionnaire was given to 15 families. The results seem to confirm the families difficulties in relation to the period before the onset of the symptoms in the patient.


Grief elaboration in families with handicapped member.

Families with handicapped member seem to follow the same five stages (rejection and isolation, anger, dealing with the problem, depression, acceptance) of Kubler-Ross grief elaboration theory while dealing with the narcissistic wound of a handicapped child. Some of these families show a block in one of the stages. The effort of psychotherapy is to remove the block and let them reach the last stage. In this paper families under systemic psychotherapeutic treatment are analyzed, who had in common the birth of a child with low or modest invalidating signs and psychotic or autistic features. The families structure did not show the characteristics of a psychotic family. Nevertheless either one or both parents ignored the evidence of their child disease and they built a "disease-incongrous" wait around the child, trying to push away the painful reality. The authors explain the importance of this approach for the improvement of the autistic traits.


Spiritual dimension in the dynamic relationship with the "helping professions".

The attention given to the spiritual dimension in the "helping professions" practice represents a major step for a coherent approach toward the ethical aspects in the resolving individual and familial conflicts; furthermore they can be used as a key in understanding dysfunctional relationship. Psychiatry interest for religion and mysticism must be considered within a wider framework of cultural changes of our society, from which neither religion, understood as a system of faith, nor medicine, as an answer to human suffering could remain indifferent. The evaluation of this aspect prevents the occurrence of "burn-out" syndrome in the "helping professions" workers, because it would give them the opportunity to a greater spiritual growth with expression of empathy, respect and better understanding of help request from their patients.


From psychotic "tragedy" to hysterical "drama": Anna history.

The authors present a multiple personality case. The characteristics of the family system seemed to be typical of psychotic families, but after a rightway look on the case, the therapists focussed their attention on several elements which had not come out before. Carefully analysing the case, they were able to find out well played "roles" or "masks", (particularly a "great-seducer father", and a "very depressed mother") a stressed "characterization" of the players and a double level of reality, as if members, although maintaining an inner capacity of self-definition, play a particular "role" on the family "stage", never revealing themselves to the others. These elements are to be considered as primal "clues" of "emerging qualities" of that family. The symptom metaphorically points out a different reality behind the "masks" and with its dramatization, its quick and short rising, its modifications depending on the environment, confirm a different interpretation of the case.


Family diagnosis, life cycle and cultural context.

The authors think that the evolutionary perspective is fundamental in family diagnosis. Therefore, they remark the value and the limits of the use of "normal" life cycle of the family as a map to evaluate the family, to assign meaning to its difficulties and to single out the possible goals of therapy. By means of a case example, the authors show how it is possible to utilize profitably the idea of life cycle, bearing in mind the cultural context of the family.


Attachment and detachment processes as a typological index of relational systems.

Attachment and detachment processes, as defined by modern attachment theories, place them as integrative between innate and acquired behaviors, like a regulatory system for every close relationship. As a consequence, family attachment styles, which proceed-throughout development-together with personal identity construction processes, stress the notion of relationship as a dialectical and interactive process, defining the irreducible duality of human experience, in which the personal individuality construction is linked, since the earliest phases of life, to the significant relationships. Dysfunctional patterns of attachment and detachment and self-construction processes interact in defining personal organizations one can observe in psychopathological situations; some clinical examples are proposed.


Linguistic production, process of meaning and the interactive pattern in avoiding anxiety.

The aim of this study is to work out a theoretical model that would at once be able to tackle the connection between emotions, thoughts, language and actions, since man has constant contact with others during his life, and to recognize the single basic concepts deriving from anxiety and desire. Our main concern is to follow the outcomes of anxiety, in order to understand how it is avoided, by which mental and emotional forms and ways of behaviour. Hence one can find the result of this process in interaction with others. In this perspective the process of meaning is autonomous, and neutrality is not only interpreted as a therapeutic directive, but as a fundamental aim of the therapy, related to controlling the anxiety and emotions which fill the field of conscience during interaction with the other.


Relational typologies in couples suffering from psychogenic infertility.

The couple is observed within a large network in which the wider family, friends, work and society are included. These individuals find a great difficulty in establishing well-grounded and authentic interpersonal relationships swinging between the desire of omnipotent self-sufficiency and the contrasted and suffered need for dependence. The third one, the child absent in their real existence, seems to be excluded also from relational possibilities. The quality of the couple relationship, the acceptance of treatments and of their possible failures is determined anyway by the balance and the harmony which existed before the stressing event (diagnosis). Very often, the failure of various therapeutic treatments is caused by a preexisting disagreement within those couples, who believed to solve their problems with a pregnancy.


Relationship patterns in "folie à deux".

"Folie à deux" is characterized by the communication of delusional ideas from one subject to other ones who have been living closely with him for a long time, usually his relatives. Before illness shows, there is a leader-follower relationship between partners, who are lacking of external sources of pleasure and are socially or culturally isolated. The dominating partner usually is a paranoic subject who strongly needs his ideas to be accepted by other people, while the dominated partner is a dependent subject who shares the other one's ideas in order to get pleasure from him and who is not able to criticize these ideas because of the lack for external influences. The two partners project hostility into the external world because, if the dominated partner does not share the other one's ideas, hostility will be projected into him and he will become very anxious. Interpersonal mechanisms in "folie à deux" are similar to those which take place in brainwashing, hypnosis and psychotherapy.


Integrated history in a psychiatric ward.

The present study begins from the hypothesis that the psychiatric admission can be considered to be, in many cases, a symptomatical act in which the patient, his family, the relational context that sends him and the institution as a whole take part. Such hypothesis has become necessary at the moment of the request for hospitalization, together with news from the patient and from his context about: the sender, the motivations, the type of request, the type of the insufficiency-urgency it is responding, the phenomenon of the "presenting disturbance", a greater definition of the problem by everyone... This work will have the object to look for a correlation between the course of the illness and the life cycle, to attempt to give a historicity of the crisis and the request of the hospitalization, too often presented, lived, received and cured as historically closed.


Couple relationship in hysterical patients staying in a psychiatric ward.

The study starts from the observation about the high frequency of hysteric patient that spontaneously ask the psychiatric admission often with a consent of the husband. The hospitalization has revealed important clinical information, gained by the use of integrated story. In fact extending the observation about the familiar context of the hysteric patient, and in particular to the interaction with the partner, have showed some redundance: 1) patient were especially household; 2) with a lower education level; 3) were married with sons in the age of independency; 4) live important life events; 5) the husbands were often involved with the families of origin; 6) the symptomatology presented; 7) the beginning of the symptomatology often happen after the marriage and the birth of the first son; 8) the husbands of these patients present mostly an obsessive personality with hypochondriac manner; 9) the patient often manifest several dissatisfied request.


Theoretical considerations on the rehabilitation process.

In the present work some of the theoretical aspects which qualifies the rehabilitation process are pointed out. The context of rehabilitation should include the social network. The isomorphism between the rehabilitation process and the Batesonian concept of mind like "the pattern which connects" is as well emphasized. In this sense the rehabilitation (as the Batesonian mind) is a process imminent in the various contexts the patients deal with and elaborates the differences between these contexts. According to this view it is useful to refer to the Second Cybernetic epistemological model: the structural coupling between therapeutic system, family and social network is the goal of rehabilitation.


Typologies of family reaction to pediatric malignancies.

The psychologic adaptation of children with malignancies is influenced by the strategies that both the relatives and the other members of the family employ as a reaction towards the disease and the therapeutic progress. Our experience in the Department of Hematology of the University "La Sapienza": by carefully observing the communication styles, the distribution of roles, and the modification of the family organization up to the eventual adaptation to the disease, we have been able to identify various reaction typologies of the family, and also to evaluate their frequency and their varying functionality with time. A thorough analysis of these modalities of reaction may allow prompt recognition of problems related with psychologic and social adaptation of both the pediatric patient and his family, and may allow the adoption of pertinent strategies of intervention, in order to guarantee a better compliance throughout the whole therapy.


Interactive patterns in the schizophrenic family during hospitalization.

Our research is based on the cases of 40 patients diagnosed as schizophrenics and the patterns of their family interaction at the moment of the hospitalization, in order to formulate an initial analysis of the reason of admission as the first phase in a therapeutic process. With this intent the authors have conducted a catamnestic research on the charts of patients who have been divided in three groups according to the presence or absence of the parents. The following variables have been therefore taken into consideration: the referrals, her/his behavior at the moment of hospitalization, expectations and difficulties in widening the field of observation within the family.


Hysterical personality and family: a clinical case.

Within the framework of family typology, the therapist can organize and orient his own observations, by confronting the characteristics of a particular family system, with the models of a "shared reality". Structural and organizational analysis of the family system, according to a general typology, can also be useful when the therapist has to deal with a defined and a not specific symptom or disease, and when a differential diagnosis is necessary for its pragmatic effects. This is often the case of hysteria, which according to many authors can show today various, confused shapes, as depression, general existential discomfort, anorexia and bulimia, and forms of exhibited addition. The authors present a clinical case, trying to point out how a "typology-oriented" observation of the family system, allowed the therapists to clarify an individual condition, otherwise difficult to understand.


Interactive typology of the hypochondriacal patient.

Many authors agree on the idea that the affective and behavioural characteristic of a certain type of family encourages the use of the body as a primary means of communication with others. This way of communicating has usually been acquired during childhood and later, in the adult life, it appears again in the different social contests. Some authors like Alby, Levy, Baker, Parker, Lipscombe, Marcelli, Bianchi and others focus on this type of family interaction and the single characteristic of the personalities of each family member. These authors describe some relationship patterns used by hypochondriac patient such as: avoiding unpleasant situations, blaming others, adopt a sick-role as a way of controlling the relationship between existential events and somatic symptoms; relationship with physicians and the need to confirm her/himself.


Operational stability of enzymes. Acylase-catalyzed resolution of N-acetyl amino acids to enantiomerically pure L-amino acids.

The method of measuring enzyme deactivation by monitoring necessary addition of fresh enzyme to keep a constant degree of conversion in a CSTR at constant [E] x tau, the product of concentration of active enzyme [E] and residence time tau, was successfully applied to acylase I from porcine kidney and Aspergillus oryzae fungus. Fungal enzyme was found to be more stable than kidney enzyme. Activation by both Co2+ and Zn2+ ions also yielded increased operational enzyme stability: Co2+ and Zn2+ are better stabilizers than activators. Mg2+ and Ca2+ are found to be neither activators nor stabilizers. Fungal acylase partially deactivated by exposition to a metal-free medium in the CSTR was reactivated by addition of Zn2+, demonstrating that loss of Zn2+ from the enzyme molecule is mainly responsible for deactivation in a continuous reactor.


Amperometric assay of creatinine in urine by flow injection analysis based on conjugated reactions of immobilized enzymes. Simultaneous compensation of endogenous ammonia.

A flow-injection analysis biosensor system was developed for the amperometric assay of creatinine based on coupled reactions of three immobilized enzymes, using an oxygen electrode as the detection device. The ammonia produced by creatinine deiminase-catalyzed hydrolysis of creatinine was further converted into L-glutamate with two sequentially aligned enzyme reactors: glutamate dehydrogenase and glutamate oxidase. Endogenous ammonia was simultaneously compensated with a double peak recording system, where the flow was split after sample injection and rejoined before the glutamate dehydrogenase reactor. The system gave linear calibration in a range of 0.1-2.0 mM for creatinine and the first peak of ammonia, and 0.1-3.0 mM for the second peak of ammonia. One run was completed within two minutes. The system can be readily applied to the assay of creatinine in urine and showed good correlation with that from the currently used Jaffe method.


Ultramicrobiosensors for monitoring of neurotransmitters.

Carbon fiber electrodes are used to construct ultramicrobiosensors with 7-15 microns diameter. Electrochemical operations for preelectrolysis and measuring were examined for sensitive determination of hydrogen peroxide. Determination limit was 0.1 microM of hydrogen peroxide. Reproducible determination of hydrogen peroxide is possible even in samples containing albumin protein. A micro-acetylcholine sensor was fabricated by immobilizing acetylcholine esterase and choline oxidase on the carbon fiber by entrapment with PVA-SbQ. This sensor gave a linear calibration plot for the range from 0.1 to 1.0 mM with a linear correlation coefficient of 0.9842. A micro-glutamate sensor consisted of a platinized carbon fiber disk electrode modified with immobilized glutamate oxidase membrane. This sensor gave a linear calibration for the range 2 microM to 1.2 mM. Release of glutamate in the cerebellar cortex was detected after potassium stimulation.


Preparative enzymatic synthesis of activated neuraminic acid by using a microbial enzyme.

Using Escherichia coli K-235 as a production strain in a fed-batch fermentation process with an optimized sorbitol/yeast extract medium, we were able to produce 640 U of CMP-Neu5Ac synthetase in 10 l scale (64 U/l) and 9200 U (total enzyme) in 200 l scale (390 U/kg wet weight). By simple one-step purification procedures, enzyme preparations were obtained that could be used efficiently for the synthesis of CMP-Neu5Ac from CTP and Neu5Ac with over 90% yield, from Neu5Ac, CMP, and ATP or phosphoenolpyruvate by in situ generation of CTP, and from CTP, pyruvate, and ManNAc or GlcNAc by in situ generation of Neu5Ac.


New developments in the synthesis of natural and unnatural amino acids.

Amino acids play an important role in biochemistry and chemistry. They are the building blocks of proteins and play an essential role in the regulation of the metabolism of living organisms. In general, it can be stated that microbial processes (fermentation) are the industrial production methods of choice for large-scale production of naturally occurring proteinogenic L-alpha-H-amino acids, while for the production of synthetic D- and/or L-alpha-H-amino acids, several other methods are highly competitive. At DSM, several routes, i.e., (chemoenzymatic) synthesis, towards L-alpha-H and D-alpha-H-amino acids have been elaborated since the midseventies. A general process for the synthesis of natural as well as synthetic optically pure amino acids has been developed, using an enzymatic kinetic resolution step on racemic amino acid amides as the key step. In this case, both enantiomers of the alpha-H-amino acids are prepared in one single step. This process has been commercialized since 1988. More recent developments using L- or D-amino peptidases in combination with amino acid amide racemases and an asymmetric transformation concept are discussed.


The epidemiology of ruptured globes.

This retrospective study documented the demographics of 227 ruptured globes in 223 patients admitted to the Wills Eye Hospital over a two-year period from 1988 to 1990. The risk for a ruptured globe was greatest among 18-to-24-year-old men, during the noon to 8PM time frame, on Saturdays, and in the months of May, June, October, and November. The home was the most common injury setting, followed by the work place and assault. Twenty-four globes (11%) were enucleated within 11 weeks of hospital admission. These cases frequently were the result of assault, blunt-type injuries. A disproportionate number occurred in blacks.


Markers of vascular injury in Behçet's disease associated with retinal vasculitis.

The pathogenesis of vascular damage in Behçet's disease (BD) is still unknown. We investigated anticardiolipin antibodies (AC) in a genetically homogeneous group of Italian patients with BD and retinal vasculitis. In a subset, we examined the level of factor VIII-related antigen and antiendothelial cell antibodies (AECA). We found a high prevalence of AC; AECA were not found in most of our patients. Only three patients had raised levels of factor VIII-related antigen, all of whom had systemic involvement. We believe BD may be considered as a vasculitis of unknown origin in which several and different pathogenetic factors may play a role.


A case of frosted-branch retinal angiitis in a child.

We report the case of a patient with frosted-branch angiitis of the retina in a 3-year-old girl. She had acute visual disturbances OU, and we observed iritis, retinal edema, and retinal angiitis. Retinal angiitis showed the same condition as previously described, the so-called acute frosted retinal periphlebitis accompanied with vascular sheathing. Her eyes improved rapidly after administration of an oral corticosteroid, and during the ensuing four months, she had no recurrences.


Hyperprolactinemia and lens opacities.

We report the presence of lens opacities in patients with prolactin-secreting microadenomas of the pituitary gland. The occurrence of lens opacities was related to prolactin serum levels and appeared only in women. The mechanism by which prolactin induces cataract is not known, although this hormone could affect the lens's permeability to ions, water, sugars, and amino acids. Moreover, the lens opacities found in women but not in men seem to indicate synergism with estrogens.


Aldose reductase and diabetic retinopathy.

Serum aldose reductase activity was estimated spectrophotometrically in 25 normal subjects (Group A), 25 diabetic patients without retinopathy (Group B), and 25 diabetic patients with retinopathy (Group C). Serum aldose reductase levels were higher in diabetic patients with or without retinopathy than in normal subjects. Comparing the serum aldose reductase activity in diabetic patients with and without retinopathy showed the value was higher in the former group; this difference was statistically significant (P < .01). However, aldose reductase activity in proliferative and background retinopathy were equal and therefore not significant.


Cystoid macular edema after scleral buckling responsive to acetazolamide.

A 64-year-old man had an epiretinal membrane and cystoid macular edema two months after an uneventful scleral buckling procedure. The cystoid macular edema resolved after treatment with systemic acetazolamide, and there was marked visual improvement.


The reliability of adjustment in strabismus surgery.

It has been recommended that the position of the operated muscles be adjusted shortly after strabismus surgery to achieve better alignment on the first postoperative day and thereby ensure satisfactory later alignment. We compared prism cover test measurements on the first postoperative day with measurements within the first few months after surgery to determine whether day 1 measurements remained stable or whether they changed significantly, providing an inaccurate basis for adjustment. Our study found a fairly large variability in the deviation between the first and last day of the study. Eighteen percent of patients varied by 5 to 9D, and 49% differed by > 10D or more. Equally important was the finding that, had an adjustment been made, it would have made the final result worse than without adjustment. Both of these factors would seem to indicate a degree of variability that controverts the predictability of the adjustment procedure.


Ophthalmic complications in patients with malignant tumors of the nose and paranasal sinuses.

We examined 34 Japanese patients (16 men and 18 women) with malignant tumors of the nose and paranasal sinuses. Squamous cell carcinoma of the maxillary sinus was the most common tumor. During the patients' initial visits, several ophthalmic symptoms were noticed, including proptosis, epiphora, lid swelling, displacement of the globe, orbital mass, and sudden visual loss. In addition, several ocular and orbital symptoms and signs resulted from treatment with radiotherapy, chemotherapy, and surgery and from local recurrence of the tumor. Four patients underwent orbital exenteration, and one underwent evisceration. Five eyes had no light perception.


Autoimmune ischemic optic neuropathy associated with positive rheumatoid factor and transient nephrosis.

A young woman had recurrent anterior ischemic optic neuropathy for 18 years. During a recent episode of severe papillopathy in one eye, acute glomerulonephritis, transient low serum complement levels, and a high rheumatoid factor were detected. Despite long and careful follow-up, we could not diagnose systemic lupus erythematosus or any other specific connective tissue or autoimmune disease. We suspect transient disordered immunity may have contributed to provoking acute anterior ischemic optic neuropathy concomitant with acute glomerulonephritis despite the absence of generalized connective tissue disease. An extensive search for immunologic mechanisms in some patients with presumed idiopathic anterior ischemic optic neuropathy may be warranted because immunosuppressive treatment may be beneficial in preventing recurrences.


Comparative vitamin E requirements and metabolism in livestock.

It has been over 50 years since vitamin E was originally described as a lipid-soluble dietary constituent required for normal reproduction in rats. Vitamin E is recognized as an essential vitamin required for all classes of animals functioning predominantly as an intracellular antioxidant in maintaining the integrity of biological cell membranes. Although a wealth of information has been gathered on clinical signs of vitamin E deficiency, establishing its requirements for animals has been exceedingly difficult because of interrelationships with other dietary constituents. Vitamin E requirements for animals cannot be defined in isolation. Requirements are influenced by the amount and type of fat (particularly with monogastrics) and degree of fat oxidation in the diet; the presence of antioxidants; dietary selenium (closely interrelated with vitamin E), iron, copper, and sulphur amino acids, as well as the physiological status of the animal. Other factors to be considered in assessing vitamin E needs of animals under commercial production conditions include: a) variability of vitamin E content in feedstuffs; b) poor stability of vitamin E during processing and storage of feeds; and c) management practices resulting in overstressed animals. Information on the function of or requirements for vitamin E in animals is very incomplete. Estimated dietary vitamin E requirements for most animal species are in the range of 10-40 IU/kg of diet. Of particular concern is the lack of vitamin E requirement information regarding young dairy and beef calves. Although good experimental evidence indicates a beneficial role of supplemental vitamin E above physiological levels on overall performance, enhanced immunocompetence and preservation of meat and milk products, levels of vitamin E required to produce these desired effects needs to be firmly established. Present estimated dietary requirements for vitamin E across species may need to be redefined as new information becomes available about the role this nutrient plays in growth, health and overall metabolism.


Heat-killed Lactobacillus acidophilus inhibits adhesion of Escherichia coli B41 to HeLa cells.

Escherichia coli B41 (O101: K99: F41: ST+) adheres to HeLa 229 cells in a diffuse pattern. Heat-killed (100-105 degrees C) Lactobacillus acidophilus (Lactéol strain) was found to inhibit this adhesion in a dose-dependent manner. This inhibitory action was lost after lysis of the L acidophilus, suggesting steric hindrance of E coli adhesion sites rather than competition for a common binding site. A thermostable factor (100-105 degrees C) excreted by L acidophilus into the medium may be required for the adhesion of L acidophilus to HeLa cells, and for the inhibition of adhesion of E coli to these cells.


[Immunohistochemistry of bovine lymphoid tissue: neutralization of the non-specific reactivities of serum anti-immunoglobulins by bovine serum].

In lymphoid tissue, the presence of high amounts of free proteins and immunoglobulins frequently leads to the observation of non-specific reactivities during immunohistochemical reactions. The types of anti-immunoglobulin sera utilized in these immunohistochemical reactions may be capable of identifying immunoglobulins secreted or harboured by the tissue cells under study, leading to non-specific marking. Incubation of these antisera with serum from the species in which the lymphoid tissue is studied neutralizes the non-specific reactivities connected with the presence of tissue immunoglobulins.


Pharmacokinetics and urinary excretion of sulfadiazine in buffalo calves.

Pharmacokinetics and urinary excretion of sulfadiazine were determined in buffalo calves following single oral administration (150 mg/kg). Kinetic evaluation of plasma levels was performed using a 2-compartment model. The absorption half-life and elimination half-life were 3.41 +/- 0.63 and 13.75 +/- 1.94 h, respectively. Based on this study, an optimal dosage regimen of sulfadiazine in buffalo calves would be 165 mg/kg, followed by 75 mg/kg at 12-h intervals. Sulfadiazine was mainly excreted in the urine as free amine, while the percentage of acetylated sulfadiazine was comparatively low.