bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral Vasospasm and Headache During Sexual Intercourse and Masturbatory Orgasms
Authors: Valença Marcelo M. , Valença Luciana P. A. A. , Bordini Carlos A. , Da Silva Wilson Farias , Leite João P. , Antunes‐Rodrigues José , Speciali José G.
Published: March 2004

Background.—The pathophysiology of the explosive type of headache associated with sexual activity is not completely understood. Five reported cases of patients with thunderclap headache, precipitated by sexual activity, in association with concomitant cerebral arterial narrowing, were found in the literature.

Methods.—A 44‐year‐old woman with both coital and masturbatory headaches during orgasm associated with segmental reversible cerebral artery vasospasm was investigated. Cerebral anatomy and eventual spasm was documented by magnetic resonance imaging or digital angiography before, during, and after resolution of the orgasmic headache‐vasospasm clinical manifestation.

Conclusion.—Findings of cerebral arterial narrowing, presented by some patients shortly after orgasmic headache attacks, support the hypothesis that segmental vasospasm may exert a role in the pathogenesis of this uncommon type of headache. The literature is reviewed, and possible mechanisms underlying the development of orgasmic headache are discussed.
Outpatient Intravenous Dihydroergotamine for Refractory Cluster Headache
Authors: Magnoux E. , Zlotnik G.
Published: March 2004

Objective.—To evaluate the efficacy and safety of outpatient intravenous dihydroergotamine (DHE) for treatment of refractory cluster headache.

Method.—Medical records were retrospectively reviewed of all patients with cluster headache who received outpatient intravenous DHE for treatment of refractory cluster headache between January 1992 and May 2000.

Results.—One hundred four treatments were identified in 70 patients. There were 7 dropouts. Of the 97 completed treatments, 60 were for episodic cluster headache and 37 were for chronic cluster headache. Results for all treatments showed complete resolution of pain during the intravenous phase at 1 month in 61 (63%) of 97 cases, partial resolution in 13 cases (15%), and failure in 23 cases (24%). For the treatment of episodic cluster headache, there was complete resolution in 44 (73%) of 60 cases, partial resolution in 9 cases (13%), and failure in 7 cases (12%). For treatment of chronic cluster headache, there was complete resolution in 17 (46%) of the 37 cases, partial resolution in 4 cases (11%), and 16 failures (43%). As regards side effects and safety, the treatment triggered chest pain suspected of being vasospastic angina in 1 patient on day 7 of the treatment, when she was in the subcutaneous phase. Two patients dropped out due to fear of the injection, 1 because of palpitations, 1 because of chest tightness, and 2 others because of leg cramps, nausea, and diarrhea.

Conclusions.—Outpatient intravenous DHE is a safe treatment. It is useful for refractory cluster headache, is more effective for the episodic form than the chronic form, and has a rapid onset of action. It did not change the evolution of the episodic form, but it did appear to induce remission in the chronic form or transform it to the episodic form. We advance a hypothesis to explain this.
SUNCT Syndrome in Association With Persistent Horner Syndrome in a Chinese Patient
Authors: Prakash K. M. , Lo Y. L.
Published: March 2004

This is the first case report of a chinese patient with SUNCT (shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) presenting with persistent Horner's syndrome. She had episodic, brief, right periorbital pain in association with ipsilateral eye injection, lacrimation and rhinorrhea as well as persistent ipsilateral miosis and ptosis. She had partial response to a combination of indomethacin and carbamazepine therapy.
Hourglass Deformity After Botulinum Toxin Type A Injection
Authors: Guyuron Bahman , Rose Kevin , Kriegler Jennifer S. , Tucker Tarvez
Published: March 2004

Background.—Complications, such as eyelid ptosis, have been attributed to botulinum toxin type A. An “hourglass” deformity, which is the consequence of temporalis muscle atrophy, has not been reported previously.

Objective.—To report a transient muscle deformity of the temporalis muscle caused by botulinum toxin type A.

Methods.—Patients who underwent injection of 25 units of botulinum toxin type A into the temporal muscle, in a fan‐shaped fashion, during an ongoing study for treatment of migraine were noted to develop temporary depression of the temples. Preinjection and postinjection photographs were taken. Patients were also sent questionnaires to verify the observed information.

Results.—Only 26 of 92 patients who underwent injection of botulinum toxin type A into the temporalis muscle subsequently reported depression of the muscle. When examined, all 92 patients exhibited this deformity ranging from minimal to significant. Patients who seemed to have less deformity were those who had excessive soft tissue overlying the muscle due to excess weight.

Conclusion.—A newly recognized deformity is reported subsequent to the injection of botulinum toxin type A into the temporalis muscle. Informing patients of this transient deformity may minimize concern following treatment.
Migraine‐Associated Seizures With Recurrent and Reversible Magnetic Resonance Imaging Abnormalities
Authors: Mateo Ignacio , Foncea Nerea , Vicente Iñigo , Beldarrain Marian Gómez , Garcia‐Monco Juan Carlos
Published: March 2004

Migraine and epilepsy are highly comorbid, but the nature of their association remains unclear. Exceptionally, reversible brain magnetic resonance imaging (MRI) abnormalities following migraine and seizures have been reported. There are no descriptions, however, of patients with recurrent brain MRI changes.

We report a patient with repeated episodes of migraine‐with‐aura–associated seizures (migralepsy) and recurrent and reversible brain MRI abnormalities. Location of the abnormalities was always consistent with the neurologic deficits.

The possibility that transient brain MRI abnormalities in a patient with migraine with aura followed by seizures may be due to migralepsy should be borne in mind to avoid misdiagnosis and potentially aggressive procedures.
Cost Considerations of Acute Migraine Treatment
Authors: Adelman James U. , Adelman Leon C. , Freeman Marshall C. , Von Seggern Randal L. , Drake Jaclyn
Published: March 2004

Objective.—To provide medication price data and cost‐reducing strategies for the acute treatment of migraine.

Methods.—Retail prices for common acute care medications were found athttp://www.drugstore.com. Cost‐reduction tactics were obtained from literature searches and clinical experience.

Results.—Several strategies can reduce cost without sacrificing treatment outcome. In mild to moderate migraine, low‐priced nonsteroidal anti‐inflammatory drugs can be used as first‐line medications due to their proven efficacy and favorable tolerability. For patients with more severe migraine, implementing a stratified care approach—using migraine‐specific medications early in acute treatment—is cost‐effective for most patients. Stratified care not only improves outcome and decreases disability, but also reduces cost.

Pill splitting and early administration of triptans within an attack enhance their value. Supplying rescue medications, such as opioids, sedatives, and phenothiazines, can prevent emergency department visits. Minimizing multiple dosing of triptans and reducing utilization of expensive health care resources are key factors in reducing the cost of effective migraine treatment. An important affordability factor for patients with co‐payments is the number of triptan pills per package. Sumatriptan, naratriptan, and frovatriptan each contain 9 tablets per package, while most other triptan packages contain 6.

Current triptan retail prices (per unit) include: Amerge 1 and 2.5 mg, $17.78; Axert 6.25 and 12.5 mg, $16.31; Frova 2.5 mg, $13.89; Imitrex 50 mg, $14.96; Imitrex 100 mg, $14.41; Imitrex Nasal Spray 20 mg, $21.61; Imitrex SQ 6 mg, $50.26; Maxalt 5 and 10 mg, $15; Maxalt‐MLT 5 and 10 mg, $15; Relpax 40 mg, $13.58; Zomig 2.5 mg, $13.67; Zomig 5 mg, $15.89; Zomig‐ZMT 2.5 mg, $13.67; and Zomig‐ZMT 5 mg, $15.89.

Conclusions.—Practitioners can optimize the use of health care dollars without compromising quality of care through awareness of cost‐saving treatment strategies, as well as price variations among medications.
Selective Vasodilator Effect of Magnesium Sulfate in Human Placenta
Authors: Holcberg Gershon , Sapir Olga , Hallak Mordechai , Alaa Amash , Shorok Haj‐Yhia , David Yohay , Katz Miriam , Huleihel Mahmoud
Published: March 2004

Problems:  To determine if magnesium sulfate (MgSO4) attenuates the vasoconstrictor effect of angiotensin II (Ag II), endothelin‐1 (ET‐1) and thromboxane mimetic (TX) in the human fetal–placental vasculature and if interleukin‐1 beta (IL‐1β) is involved in this process.

Study design:  Isolated placental cotyledons (n = 18) were dually perfused with fetal perfusion pressure used as an index of vascular response. The vasoconstriction effect of bolus injection of various concentrations of Ag II (10−10–10−6 m) or ET‐1 (10−10–10−4 m) or TX (10−10–10−5 m) was established in the absence or presence of MgSO4 (7 mg% constant infusion during 10 hr). Statistical significance was determined by paired t‐test and anova.

Results:  MgSO4 significantly attenuates the vasoconstrictor effect of Ag II in the fetal–placental vasculature in the human placenta (P = 0.02). Moreover, significant attenuation of vasoconstrictor response to ET‐1 (10−10–10−5 m) was observed in the presence of MgSO4 (P = 0.02). However, no attenuation of the vasoconstrictor response to TX was noted in the presence of MgSO4 (P > 0.5). Ag II and TX were shown to induce IL‐1β secretion by placental tissue. This effect was completely reduced by perfusion of MgSO4 (7 mg%; constant infusion).

Conclusions:  MgSO4 significantly attenuates the vasoconstrictor effect of Ag II and ET‐1 in the fetal–placental vasculature in the human placenta, but not that of TX. Inhibition of local production of IL‐1β could be one of the mechanisms used by MgSO4 to reduce the vasoconstrictory effect of Ag II and TX in human placental cotyledone.
Human Amniotic Fluid Cells are Able to Produce IL‐6 and IL‐8
Authors: Mazzucchelli Iolanda , Avanzini Maria Antonietta , Ciardelli Laura , Pagani Sara , Greco Rossella , Belloni Cesare , Castellazzi AnnaMaria , Marconi Massimo , Rondini Giorgio , Polatti Franco
Published: March 2004

Problem:  In order to investigate the role of amniotic fluid cells (AFC) in the establishment of feto–maternal immune relationship, we evaluated their phenotype and capacity to produce cytokines.

Methods of study:  CK 7–8, human leukocyte antigen (HLA)‐I, HLA‐DR, HLA‐G, CD1d, CD34, CD45, CD14 surface antigens expression and the intracellular production of IL‐4, IL‐6, IL‐8, IL‐10, IL‐12, interferon‐γ and tumor necrosis factor‐α were studied in cultured AFC and in eight samples immediately after amniocentesis using flow cytometry. IL‐6 and IL‐8 were detected by ELISA in all amniotic fluids and in all culture supernatants. Moreover, IL‐6 and IL‐8 mRNA were tested in nine samples.

Results:  Cultured AFC express HLA‐I, HLA‐G and CK 7–8 and are able to produce IL‐6 and IL‐8, confirmed by presence of their mRNA. We quantified IL‐6 and IL‐8 levels in all amniotic fluids and in all supernatants.

Conclusion:  Surface antigen expression of AFC are not specific of immune cells, but AFC are able to produce cytokines and we can postulate that they may participate in mechanisms involved in normal as well as pathological pregnancy.
Decrease in a Specific Killer Cell Immunoglobulin‐Like Receptor on Peripheral Natural Killer Cells in Women with Recurrent Spontaneous Abortion of Unexplained Etiology
Authors: Yamada Hideto , Shimada Shigeki , Kato Emi H. , Morikawa Mamoru , Iwabuchi Kazuya , Kishi Reiko , Onoé Kazunori , Minakami Hisanori
Published: March 2004

Problem:  The aim of this study was to investigate immunophenotypic characteristics of natural killer (NK) cells by assessing specific molecules expressed in women with recurrent spontaneous abortion (RSA) of unexplained etiology.

Method of study:  Peripheral blood cells were obtained from 20 RSA women and 15 fertile controls. The expression of perforin, CD94, CD161, CD158a, CD158b, and CD244 on CD3− CD56+ NK cells was analyzed by flow cytometry.

Results:  A significant decrease in CD158a expression was demonstrated in RSA women (mean ± SD, 22.9 ± 8.7%) as compared with that in controls (33.6 ± 15.7%) (P < 0.05). The percentage of NK cells showing dual expression of CD94 and CD161 was relatively higher in RSA women (55.1 ± 10.2%) than in the controls (47.1 ± 19.0%), but without statistically significant (P = 0.096). The expression of perforin, CD158b, or CD244 in RSA women did not differ from that in the controls.

Conclusions:  A divergence of the specific NK cell repertoire might be related to the etiology of RSA.
Differential Expression and Localization of Decorin in Human Choriodecidual Membrane during Preterm and Term Pregnancy
Authors: Ogita Kazuhide , Kimura Tadashi , Nakamura Hitomi , Koyama Shinsuke , Tsujie Tomoko , Tomiie Mari , Tsutsui Tateki , Shimoya Koichiro , Wada Yoshinao , Koyama Masayasu , Nomura Shintaro , Murata Yuji
Published: March 2004

Problem:  This study was aimed to isolate cDNAs for genes whose expression levels are dynamically regulated at the feto‐maternal interface around parturition.

Method:  The suppression subtractive hybridization (SSH) method was used to compare the gene expression patterns of human choriodecidual membranes from term elective Caesarian delivery before labor (BL) and term vaginal delivery (VD). Northern blotting, quantitative real‐time RT‐PCR and in situ hybridization were performed to determine temporal and spatial expression of candidate clones.

Result:  After SSH procedure, we selected decorin from the cDNA library of BL for further investigation. The mean level of decorin transcription tended to be higher in BL samples than in VD or preterm samples. Decorin mRNA was mainly expressed in the decidual cells. Decorin gene expression was also upregulated in the term myometrium.

Conclusion:  These results suggest that dynamically increased expression of decorin in the choriodecidual membrane during parturition may be a part of the uterine preparation for labor.
Rat Strains Differ in Susceptibility to Maternal and Fetal Infection with Mycoplasma pulmonis
Authors: Reyes Leticia , Shelton Micheal , Riggs Margaret , Brown Mary B.
Published: March 2004

Problem:  Vaginally infected Sprague–Dawley (SD) rats are more susceptible to adverse pregnancy outcomes than Wistar (WIS) rats. We postulated that SD rats have enhanced hematogenous spread of Mycoplasma pulmonis to fetal tissues.

Method of study:  WIS and SD dams were infected intravenously with 107, 106, and 105 colony‐forming units of M. pulmonis at gestation day 14. Dams and six randomly selected fetuses were cultured at days 15, 16, 17, and 18 of gestation.

Results:  In the high‐dose group, 100% of fetuses were colonized regardless of rat strain. Significantly higher numbers of M. pulmonis were isolated from placenta (low dose, P < 0.0001; medium dose, P < 0.024; high dose, P < 0.0001), amniotic fluid (low dose, P < 0.003; medium dose, P < 0.017), and fetuses (low dose, P < 0.0011) of SD rats. Spread of M. pulmonis to the amniotic fluid and fetus occurred 1 day earlier in SD rats.

Conclusions:  The difference in susceptibility between the two rat strains cannot be explained by hematogenous spread alone. The relative resistance to adverse pregnancy outcomes in WIS rats may be a function of a more robust innate immune system. These rat strains may represent an animal model to address host resistance factors to intrauterine infection.
Elevated Interleukin‐8 in Cervical Mucus as an Indicator for Treatment to Prevent Premature Birth and Preterm, Pre‐labor Rupture of Membranes: a Prospective Study
Authors: Sakai Masatoshi , Sasaki Yasushi , Yoneda Satoshi , Kasahara Tadashi , Arai Takashi , Okada Masatoshi , Hosokawa Hitoshi , Kato Kiyoshi , Soeda Yoshikatsu , Saito Shigeru
Published: March 2004

Problem:  We investigated whether cervical shortening and high interleukin (IL)‐8 in cervical mucus were valuable indications for treatment to prevent premature birth and preterm, pre‐labor rupture of membranes (pPROM).

Method of study:  Pregnant women were divided into group A, in which neither cervical IL‐8 nor cervical length was measured in the middle trimester; and groups B and C, in which cervical length and cervical IL‐8 were measured, and bed rest or cerclage was performed when cervical shortening was detected. In group B, vaginal washing with povidone iodine and insertion of chloramphenicol vaginal tablets were carried out in women with IL‐8 elevations.

Results:  In group B, duration of pregnancy was significantly prolonged compared with group A and C, and occurrence of pPROM was significantly lower. No significant differences were found in those rates between groups A and C.

Conclusion:  Successful treatment for women with IL‐8 elevations in cervical mucus decreased rates of premature birth or pPROM.
Inhibition of HLA‐G Production in JEG‐3 Choriocarcinoma Cells by RNA Interference
Authors: Wengenmayer Tobias , Poehlmann Tobias G. , Markert Udo R.
Published: March 2004

Human leukocyte antigen‐G (HLA‐G) plays a major role in escape of trophoblast cells from maternal cytotoxicity. Unless its malignant transformation, Jeg‐3 choriocarcinoma cell line maintained the capacity of HLA‐G production. For the analysis of function and mechanisms of HLA‐G‐induced immune regulation, a human cellular model with suppressed HLA‐G would be very helpful. RNA interference (RNAi) is a very elegant method for this approach, but the design of appropriate oligonucleotide sequences may provide difficulties. We designed oligonucleotides to interfere exclusively with HLA‐G mRNA, which were applied at different concentrations to 50% confluent Jeg‐3 cells. After 36 hr, the HLA‐G content in Jeg‐3 cells was analyzed by Western blots. Applying the described RNAi method and oligonucleotides the cellular content of HLA‐G was dose‐dependently reduced as assessed in several independent Western blots. This method provides a tool for extensive investigation of HLA‐G functions in vitro and in vivo.
Immunoprecipitation of Sperm and Somatic Antigens with Antibodies from Sera of Sperm‐Sensitized and Anti‐sperm Antibody‐ Free Individuals
Authors: Domagała Alina , Kurpisz Maciej
Published: March 2004

Problem:  Immune infertility may result from the presence of anti‐sperm antibodies (ASA) in sera of sensitized individuals or in their genito‐urinary millieu. According to some authors, sera of pre‐pubertal boys with genital disorders may contain ASA, too. When identified and characterized, sperm antigenic components can be employed for diagnostic and/or for immunocontraceptive purposes.

Method of Study:  Sperm auto‐ and isoimmune reactive surface antigens were identified by means of immunoprecipitation. Comparative immunoprecipitations of somatic antigens by using antibodies, contained in polyclonal sera of fertile and (immunologically) infertile adults as well as pre‐pubertal boys with gonadal failures were performed.

Results and Conclusions:  Antibodies contained in sera of the all studied populations reacted with a number of sperm as well as somatic antigens. However, we distinguished a panel of antigens localized exclusively on the surface of sperm cells, reacting with ASA positive sera (in the range of molecular weight between 15 and 115 kDa), some of them seem to present novel entities as can be judged by the molecular weight.
The Effect of Valacyclovir Treatment on Natural Killer Cells of Infertile Women
Authors: Thomas Dimitrios , Michou Vassiliki , Tegos Vassilis , Patargias Theoharis , Moustakarias Theodoros , Kanakas Nikolaos , Mantzavinos Themis , Apostolidis Christophoros , Salamalekis Emmanouil , Kalofoutis Anastasios , Tsilivakos Vassilis
Published: March 2004

Problem:  The aim of this study was to investigate the effect of valacyclovir treatment on natural killer (NK) cell concentration in the peripheral blood of infertile women.

Method of study:  Peripheral blood NK cell concentration of 104 non‐pregnant women with a history of infertility was determined by flow cytometry. The controls were 14 fertile non‐pregnant women. A cohort of 42 out of 104 women – whose NK cell levels were 175/μL or higher – was prospectively studied for the presence of HSV‐1, 2, VZV, cytomegalovirus, HHV‐6, HHV‐7 and HHV‐8 DNA in the peripheral blood and was orally administered valacyclovir (open label study).

Results:  Herpes virus DNA was detected in 64.3% of the 42 women examined. Prior to valacyclovir treatment mean NK cell concentration in herpes‐negative group was statistically higher from control group but lower from herpes positive group (P = 0.0007, anova). Following valacyclovir treatment the mean NK cell concentration was statistically decreased in all studied women (P = 0.000453), in herpes‐negative (P = 0.01622) and in herpes positive group (P = 0.0056). Sufficient decrease was observed in 31 (73.8%) of 42 women who received the drug.

Conclusions:  Valacyclovir treatment is associated with a decrease of NK cell levels in most of the women with a history of infertility.
Autoantibody Panel Screening in Recurrent Miscarriages
Authors: Marai I , Carp H , Shai S , Shabo R , Fishman G , Shoenfeld Y
Published: March 2004

Problem:  Antiphospholipid autoantibodies (aPL), antithyroid antibodies and anti‐extractable nuclear antigens (anti‐ENA) have all been reported to be associated with recurrent miscarriages (RM) and infertility. However, this association remained controversial.

Materials and Methods:  Fifty‐eight women with impaired fertility (38 women with RM and 20 women with infertility, but no miscarriages) and 28 control parous women were screened for seven autoantibodies [antithyroglobulin (aTG), antithyroid peroxidase (aTPO), anticardiolipin (aCL), antiphosphatidyl‐serine (aPS), antiprothrombin antibodies (aPT), anti‐beta 2 glycoprotein 1 (aβ2GP1), and anti‐ENA]. There was no evidence for autoimmune diseases in the patients or the control. The analysis was also performed with several panels of autoantibodies, each of which contained two or more autoantibodies.

Results:  Anti‐TPO was the only antibody to be associated with RM (P = 0.01). A significant association was found between RM, and autoantibodies in the ‘aTG + aTPO + anti‐ENA’ or ‘aTG + aTPO’ panels. The ‘aTG + aTPO + anti‐ENA’ panel was also associated with RM when the analysis was performed only on 17 women who had secondary infertility: 10 from the 38 women with RM, and seven from the 20 women with infertility and no miscarriages. A significant association (P < 0.001) was also apparent between anti‐CL and anti‐PS and infertility compared with the 28 control women.

Conclusions:  RM was associated with autoantibodies to aTPO and the combined panel of aTPO, aTG and anti‐ENA, but not with aPL. aPL were associated with infertility.
Diagnosis of Congenital Cardiac Right‐to‐left Shunts with 99mTc‐macroaggregated Albumin
Authors: Morandi Federica , Daniel Gregory B. , Gompf Rebecca E. , Bahr Anne
Published: March 2004

Diagnosing right‐to‐left congenital cardiac shunts can be difficult. Cardiac catheterization and angiocardiography represent the traditional gold standard for diagnosis, but they are invasive. Nuclear scintigraphy using 99mTc‐macroaggregated albumin (MAA) has been employed in humans as an alternate method of diagnosis. This study reviews eight dogs presented for evaluation of a suspect right‐to‐left cardiac shunt that were examined using 99mTc‐MAA. In all, 2–4 mCi (74–148 MBq) of reduced particle 99mTc‐MAA were injected IV in a cephalic vein and static images of the whole body, including right and left lateral, dorsal, and ventral views, were acquired for 60 s and stored into a 256×256×16 matrix. Shunt fractions were calculated. One dog with radiopharmaceutical distribution limited to the lungs did not have a shunt. Seven dogs had distribution of the radiopharmaceutical outside the pulmonary capillary bed, indicating bypassing of the pulmonary capillary circulation due to a right‐to‐left shunt. Four dogs had 99mTc‐MAA within the brain. Three dogs that did not have brain uptake, but instead had a sharp cutoff of radioactivity at the level of the front limbs and neck, were diagnosed with reverse patent ductus arteriosus (PDA). The asymmetric distribution of the radiopharmaceutical is due to the location of the shunt, distal to the brachiocephalic trunk and left subclavian artery. Shunt fractions of dogs with extrapulmonary radioactivity ranged from 40% to 59%. Nuclear scintigraphy with 99mTc‐MAA is a quick alternative method of diagnosing right‐to‐left cardiac shunts that permits quantification of shunt fraction. Distinguishing between reverse PDA and other right‐to‐left shunts may be possible based on the radiopharmaceutical distribution.
Quantitative Evaluation of Equine Deep Digital Flexor Tendon Morphology using Magnetic Resonance Imaging
Authors: Murray Rachel C. , Roberts Bridget L. , Schramme Michael C. , Dyson Sue J. , Branch Marion
Published: March 2004

Injury of the distal aspect of the deep digital flexor tendon (DDFT) is a recognized cause of lameness, but diagnosis is difficult. This study aimed to improve understanding of DDFT morphology and pathology using retrospective evaluation of magnetic resonance (MR) images. We hypothesized that: (1) The distal aspect of the DDFT in normal horses would have a repeatable proximal/distal pattern and symmetry between limbs and between lobes; (2) DDFT dimensions would be related to bodyweight, navicular bone dimensions and hoof size; (3) this symmetry and pattern would be lost in DDFT injury; and (4) DDFT size would increase with injury. MR images of 64 live horse limbs, 26 with no identified DDFT lesion and 38 with identified DDFT abnormalities, and 19 normal cadaver limbs were analyzed. Using standardized transverse images, measurements of DDFT cross‐sectional area, medial–lateral (ML) width and dorsal–palmar depth were obtained at six preselected sites. A uniform distal to proximal shape pattern was identified in all horses. The flattened crescent shape at the insertion changed to a deeper bilobed shape more proximally, with the mid‐navicular area having the greatest cross‐sectional area. Strong ML (P<0.0006) and left/right symmetry (P<0.02) were observed. In addition, there was a strong association between DDFT cross‐sectional area and horse weight (P=0.005) and between DDFT and navicular bone ML width (P=0.004). Symmetry between sides or between lobes was lost at sites with a unilateral lesion and correlation between horse weight and DDFT cross‐sectional area was lost in the presence of lesions. DDFTs with core lesions had a consistent increase in cross‐sectional area overall, but other lesion types had no significant increase in size. The shape and symmetry seen in normal tendons could be related to the mechanical demands placed upon individual lobes. The limited increase in cross‐sectional area with injury may be explained by the restrictive structures of the hoof, possibly explaining the ongoing pain seen in such lesions.
Computed tomographic densitometry of normal feline thyroid glands
Authors: Drost Wm Tod , Mattoon John S. , Samii Valerie F. , Weisbrode Steven E. , Hoshaw‐Woodard Stacy L.
Published: March 2004

We studied the computed tomographic (CT) appearance and determined Hounsfield units (HU) for normal thyroid tissue in eight cats. Helical CT images (2 mm collimation) were acquired from cranial aspect of the second cervical vertebra (C2) through caudal aspect of the fourth cervical vertebra (C4). Data were acquired before contrast medium administration (n=7), after delayed contrast medium enhancement (n=8), and immediately after contrast medium enhancement after a second dose of contrast medium (n=8). Attenuation of thyroid tissue was compared with surrounding tissues. Before contrast medium enhancement, thyroid tissue was hyperattenuating to the surrounding soft tissues. After delayed contrast medium enhancement, thyroid tissue was hyperattenuating to surrounding soft tissues and isoattenuating to contrast medium‐laden blood vessels. Immediately after contrast medium enhancement, thyroid tissue was hyperattenuating to surrounding soft tissues and hypoattenuating to contrast medium‐laden blood vessels. The thyroid glands were dorsolateral to the trachea, ovoid, and displayed homogenous contrast medium enhancement. Circular regions of interest were drawn on the right and left thyroid lobes. Densitometric data of thyroid tissue were as follows: precontrast medium enhancement, 123.2 HU (95% CI: 119.4–127.1 HU); delayed contrast medium enhancement, 132.1 HU (95% CI: 127.4–136.8 HU); immediate postcontrast medium enhancement, 168.5 HU (95% CI: 163–173.9 HU). Normal feline thyroid tissue is easily detected using CT without contrast medium enhancement. This information may be useful for CT evaluation of abnormal feline thyroid glands.
Dual‐phase CT Angiography of the Normal Canine Portal and Hepatic Vasculature
Authors: Zwingenberger Allison L. , Schwarz Tobias
Published: March 2004

A dual‐phase computed tomography (CT) angiographic technique was developed to image the hepatic and portal vascular systems using a nonselective peripheral injection of contrast medium. The arterial phase of the dual‐phase scan imaged the hepatic arteries and veins, and the portal phase imaged the portal vein as well as its tributaries and branches. There were three steps involved in acquiring the dual‐phase scan: a survey helical scan for orientation, a dynamic scan for timing, and finally the dual‐phase helical scan. Five normal dogs were imaged using a helical scan technique. The timing of the arterial and portal phases of the scan was calculated using time vs. attenuation graphs generated from a dynamic scan. The median time of appearance of contrast medium in the cranial abdominal aorta was 8.6 s and the median time of appearance of contrast medium in the hepatic artery occurred 0.4 s later. The median time of peak enhancement in the cranial abdominal aorta was 12.0 s. The median time of appearance of contrast medium in the portal vein was 14.6 s and median time of peak enhancement was 33.0 s. The dual‐phase scans provided excellent vascular opacification. The hepatic arteries, hepatic veins, cranial and caudal mesenteric veins, splenic vein, gastroduodenal vein, and portal vein branches were all consistently well defined. Dual‐phase CT angiography is a minimally invasive technique which provides an excellent three‐dimensional representation of portal and hepatic vascular anatomy.
Computed tomography‐guided fine‐needle aspiration and tissue‐core biopsy of bone lesions in small animals
Authors: Vignoli Massimo , Ohlerth Stefanie , Rossi Federica , Pozzi Luigi , Terragni Rossella , Corlazzoli Daniele , Kaser‐Hotz Barbara
Published: March 2004

In humans, free‐hand computed tomography (CT)‐guided biopsy is an accurate method to obtain a tissue sample. There are only a few reports of this technique in veterinary medicine. In the present study, 21 dogs and two cats underwent a free‐hand CT‐guided tissue‐core biopsy (17 animals) or fine‐needle aspiration (six animals) of a bone lesion. Two out of 17 tissue‐core samples were also cultured. All 17 tissue‐core biopsy samples were diagnostic (accuracy of 100%). Five out of six aspirates were diagnostic (accuracy of 83.3%). The overall accuracy was 95.7%. In one aspirate, cytologic quality was insufficient containing only blood. No major complications were encountered. Fourteen neoplastic, two infectious and six benign lesions were diagnosed. CT examination after intravenous contrast medium added useful information to avoid large vessels and to biopsy‐viable tissue. Free‐hand CT‐guided tissue‐core biopsy and aspiration appears to be a safe and very accurate procedure for use in the diagnosis of bone‐associated diseases in small animals.
Thick‐section reformatting of thinly collimated computed tomography for reduction of skull‐base‐related artifacts in dogs and horses
Authors: Porat‐Mosenco Yael , Schwarz Tobias , Kass Philip H.
Published: March 2004

Computed tomography (CT) of the caudal fossa of 10 canine and nine equine cadaver heads was performed with conventional slice widths of 5 and 10 mm, respectively, and with thin collimations of 1 and 2 mm, respectively. Reformatting of thinly collimated slices was done by addition of thinly collimated slices to section thicknesses of 5 and 10 mm, respectively. Seventy‐six pairs of conventional and reformatted images of identical anatomic locations were evaluated for magnitude of skull‐base‐related artifacts and image noise. A film‐based subjective evaluation of artifact and noise was performed by four radiologists on a five‐point score system. There was a statistically significant reduction of artifacts of canine and equine heads by 33% and 50%, respectively, on reformatted images compared with conventional ones but no difference in image noise. On objective artifact assessment based on the magnitude of standard deviation of attenuation values in the interpetrosal region, there was a statistically significant reduction of artifacts of canine and equine heads by 23% and 39%, respectively, on reformatted images. Thick‐section reformatting significantly improves image quality of CT scans of the caudal fossa in dogs and horses.
Imaging diagnosis: pneumothorax and focal peritonitis in a dog due to migration of an inhaled grass awn
Authors: Hopper Belinda J. , Lester Nola V. , Irwin Peter J. , Eger Clive E. , Richardson Jennifer L.
Published: March 2004

A 1‐year‐old working Kelpie developed pneumothorax and focal peritonitis after inhalation of a grass awn that migrated from the lung, through the diaphragm, into the peritoneal cavity. Radiographic evidence of sternal lymph node enlargement was fundamental in the diagnosis of intraperitoneal disease and prompted abdominal ultrasound leading to definitive diagnosis.
Diagnostic imaging of a renal adenoma in a Red Oscar (Astronotus ocellatusCuvier, 1829)
Authors: Gumpenberger Michaela , Hochwartner Oliver , Loupal Gerhard
Published: March 2004

This case report describes the radiographic, ultrasonographic and computed tomographic (CT) examination of an abdominal swelling in a Red Oscar (Astronotus ocellatusCuvier, 1829). While radiography only demonstrated caudoventral compression of the swimbladder, ultrasonography found a huge tumor‐like parenchyma in the caudal abdomen. CT studies detected a possible connection between the tumor and the kidneys. Necropsy and pathohistology were performed. A papillary–cystic adenoma of the kidney was diagnosed.
Radiographic Progression of Osteoarthritis of the Canine Stifle Joint: A Prospective Study
Authors: Innes J. F. , Costello M. , Barr F. J. , Rudorf H. , Barr A. R. S.
Published: March 2004

A radiographic scoring system for features of osteoarthritis of the canine stifle joint was devised. Intra‐ and inter‐rater agreement was assessed by calculation of unweighted kappa statistics. “Global score,”“effusion”, “osteophytosis”, and “intra‐articular mineralization” were all features that had acceptable reliability, but “subchondral sclerosis” did not. The scoring system was used in a 13‐month prospective study of the radiographic progression of osteoarthritis of the stifle joint, secondary to cranial cruciate ligament deficiency, in 58 dogs. In the index stifle joints all features were characterized by significant change over time, but osteophytosis had the greatest degree of change. In addition, 40% of contralateral joints showed progressive osteophytosis.
Material in the middle ear of dogs having magnetic resonance imaging for investigation of neurologic signs
Authors: Owen M. C. , Lamb C. R. , Lu D. , Targett M. P.
Published: March 2004

The aim of this study was to determine the prevalence and potential significance of finding material in the middle ear of dogs having magnetic resonance (MR) imaging. Of 466 MR studies reviewed, an increased signal was identified in the tympanic bulla in 32 (7%) dogs. Cavalier King Charles spaniels, Cocker spaniels, Bulldogs, and Boxers were over‐represented compared to the population of dogs having MR imaging. Five (16%) dogs had definite otitis media and one (3%) had a meningioma invading the middle ear. Of the remaining dogs, 13 (41%) had possible otitis media and 13 (41%) had neurologic conditions apparently unrelated to otitis media. The most common appearance of material in the middle ear was isointense in T1‐weighted images and hyperintense in T2‐weighted images. There was no apparent correlation between the signal characteristics of the material and the diagnosis. Enhanced signal after gadolinium administration was observed affecting the lining of the bulla in dogs with otitis media and in dogs with unrelated neurologic conditions. In dogs without clinical signs of otitis media, finding an increased signal in the middle ear during MR imaging may reflect subclinical otitis media or fluid accumulation unrelated to inflammation. Brachycephalic dogs may be predisposed to this condition.
Ultrasonography of the medial iliac lymph nodes in the dog
Authors: Llabrés‐Díaz Francisco J.
Published: March 2004

Sixty‐one medial iliac lymph nodes of 38 different dogs (eight with adenocarcinoma of the apocrine glands of the anal sac, 13 with multicentric lymphoma, six with multicentric lymphoma but in clinical remission, and 11 control dogs) were evaluated to assess the ability of ultrasound to identify and interrogate these lymph nodes across the different groups and to differentiate these groups using different sonographic parameters. Ultrasound proved to be useful to assess canine medial iliac lymph nodes. An increase in size or number of detected lymph nodes or finding rounder or heterogeneous lymph nodes could differentiate lymph nodes of dogs of the control group from lymph nodes of dogs with lymphoma or an adenocarcinoma of the apocrine glands of the anal sac. Subcategories of malignancy could not be differentiated. More studies need to be performed, both with patients with reactive lymph nodes and also focusing on other canine superficial lymph nodes, before generalizing the results of this study to other areas or diseases.
Spectral waveform analysis of major arteries in conscious dogs by Doppler ultrasonography
Authors: Lee Kichang , Choi Mincheol , Yoon Junghee , Jung Juhyun
Published: March 2004

Normal values of arterial blood flow velocity and waveforms in major arteries of 10 healthy conscious Beagle dogs were determined using Doppler ultrasonography. Peak systolic, early diastolic, and end‐diastolic velocities of the basilar artery, common carotid artery, abdominal aorta, external iliac artery, femoral artery, and peak ejection velocity of the valvular aorta were evaluated. Pulsatility index (PI) of the basilar artery and blood pressure were recorded. All arteries had a high‐resistance flow pattern with triphasic flow velocity except the basilar artery, which had a low‐resistance pattern. Mean peak systolic velocities of the basilar artery, common carotid artery, abdominal aorta, external iliac artery, and femoral artery were   72±19, 115±17, 121±24, 105±25, and 110±17 cm/s, respectively. The PI of the basilar artery and peak ejection velocity of the valvular aorta were 1.37±0.13 and 96±16 cm/s, respectively. Mean systolic and diastolic blood pressures were 137±13 and 78±15 mmHg, respectively. Present findings may be used as references in future studies on vascular diseases and hemodynamics in dogs.
Diagnostic contribution of thoracic ultrasonography in 17 foals with Rhodococcus equi pneumonia
Authors: Ramirez Sammy , Lester Guy D. , Roberts Greg R.
Published: March 2004

The aim of this retrospective study was to determine the clinical usefulness of thoracic ultrasonography compared to thoracic radiography in evaluation of Rhodococcus equi pneumonia. Criteria for patient inclusion in this study were: (1) isolation of R. equi from transtracheal aspirate, (2) radiographic evaluation of the pulmonary parenchyma, and (3) sonographic evaluation of the pulmonary parenchyma. Seventeen foals met this criteria and their medical records were reviewed. Pyogranulomatous pneumonia was identified radiographically in 13 foals. Severe consolidative pneumonia with no detectable abscessation was identified radiographically in three others. Both consolidation and abscessation were identified radiographically in one. In this foal only consolidation was ultrasonographically identified. Ultrasonographically, pulmonary abscessation was identified in 12 foals and pulmonary consolidation with no detectable abscessation was identified in three others. Sonographic examination allowed detection of only pleural irregularities in one foal, which was subsequently found to have pyogranulomatous pneumonia radiographically. Results indicate that ultrasonography may be an accurate alternative imaging modality for detection of pulmonary pathology attributed to R. equi pneumonia in foals when thoracic radiography is not available.
Significance of a common extended mucosal interface observed in transverse small intestine sonograms
Authors: Rault Delphine N. , Besso Juliette G. , Boulouha Lilia , Begon Dominique , Ruel Yannick
Published: March 2004

An echogenic stripe can be seen through the mucosal layer on either side of the ultrasonographic image of a bowel loop in cross‐section. The mucosa is a continuous layer surrounding the intestinal lumen; thus it should appear as a continuous hypoechoic band with no bright stripe in it. The purpose of this study was to investigate the origin of this stripe and to determine whether it is an artifact. Intestinal cross‐sectional images were obtained using different transducer types and frequencies. In vivo and in vitro, different angles of insonification were used and, in vitro, bowel loops were also fluid filled during an ultrasonographic examination, to assess the potential influence of intestinal shape and position on this stripe. Some of these loops were evaluated histologically to determine if the echogenic stripe had a histologic basis. The echogenic stripe was present only when the loop was flattened. It remained on each side of the maximal cross‐sectional width and disappeared when this width was parallel to the ultrasound beam, or when the bowel loop had a completely round shape and was dilated. There was no influence of transducer type, shape, or frequency on the appearance of the line. Histologically, uneven and larger distance between the mucosal villi could be seen on either side of the bowel loop corresponding to the location of the echogenic stripe seen on the ultrasonographic images. In conclusion, the occasional echogenic stripe represents an interface within the mucosa due to altered position of villi on either side of the maximal intestinal cross‐sectional width in collapsed bowel segment.
The Choice of Proton Pump Inhibitor: Does it matter?
Authors: Hellström Per M. , Vitols Sigurd
Published: March 2004

Abstract: Proton pump inhibitors are used at different dosages for the treatment of acid‐related gastrointestinal disorders, such as gastro‐oesophageal reflux and peptic ulcer disease. Comparisons of four different proton pump inhibitors: lansoprazole, omeprazole, pantoprazole, and rabeprazole show that they all have similar potency and efficacy. Rabeprazole, however, displays a slightly more rapid onset of acid inhibition than the others; the clinical advantage of this seems limited. The S‐isomer of omeprazole, esomeprazole, exhibits a somewhat higher potency than the other proton pump inhibitors. Reports supporting a clinical advantage of this property are not convincing. To conclude, all inhibitors seem comparable as regards inhibition of gastric acid secretion.
In vivo and in vitro Effects of Cadmium on Adult Rat Brain Total Antioxidant Status, Acetylcholinesterase, (Na+,K+)‐ATPase and Mg2+‐ATPase Activities: Protection by L‐Cysteine
Authors: Carageorgiou Haris , Tzotzes Vassilios , Pantos Constantinos , Mourouzis Constantinos , Zarros Apostolos , Tsakiris Stylianos
Published: March 2004

Abstract: This study was undertaken in order to investigate: a) the short‐ and long‐term in vivo effects of cadmium (Cd) on brain acetylcholinesterase (AChE), (Na+,K+)‐ATPase and Mg2+‐ATPase activities in adult rats, b) the concentration‐dependent in vitro and in vivo (acute experiment) effects of Cd on the activity of those enzymes, c) the in vivo and in vitro effects of the antioxidant L‐cysteine (Cys) on the above enzyme activities, and d) the evaluation of brain total antioxidant status after in vivo Cd, L‐cysteine, or L‐cysteine+Cd administration in rats. In vitro, CdSO4 inhibited pure and brain AChE in concentrations higher than 0.1 mM, while it activated by approximately 70% (P<0.001) brain Na+,K+‐ATPase in concentrations up to 0.1 mM and inhibited its activity in higher concentrations. Mg2+‐ATPase was not influenced up to 0.1 mM concentration, while it was inactivated (40%, P<0.001) in higher CdSO4 concentrations. A dose‐response study of CdSO4 (1, 2 and 5 mg/kg once 8 hr before decapitation) revealed a dose‐dependent decrease (−14 to −30%, P<0.001) of brain AChE activity, an increase of Na+,K+‐ATPase activity (+47 to +200%, P<0.001) and an increase of Mg2+‐ATPase only after the highest dose (5 mg/kg) in the short‐term treatment of rats. Long‐term Cd administration (1 mg/kg rat daily for 4 months) activated brain AChE and Na+,K+‐ATPase about 50–65% (P<0.001) but not Mg2+‐ATPase. Brain total antioxidant status was decreased by Cd (30%, P<0.01), while it was increased by L‐cysteine or L‐cysteine+Cd (50%, P<0.001) in the short‐term in vivo treatment. L‐cysteine reversed the enzymatic activity changes observed with Cd alone in the high‐dose short‐term in vivo treatment of rats, as well as the brain AChE inhibition induced by Cd in the in vitro experiments. These results indicate that: a) Cd can influence in a different way the examined enzyme activities after short‐ and long‐term administration, b) Cd may modulate brain cholinergic mechanism(s), neural excitability and metabolic energy production, and c) L‐cysteine can have a protective antioxidant effect on the oxidative stress of the brain induced by Cd.
Combined Early Treatment with Chelating Agents DMSA and CaDTPA in Acute Oral Cadmium Exposure
Authors: Sarić Marijana Matek , Blanuša Maja , Jureša Dijana , Šarić Marija , Varnai Veda Marija , Kostial Krista
Published: March 2004

Abstract: The influence of chelating agents: meso‐2,3‐dimercaptosuccinic acid (DMSA); calcium trisodium diethylenetriaminepentaacetate (CaDTPA) and their combination on mobilisation of cadmium (Cd) was compared in female albino rats. After oral Cd administration chelators were applied either orally (DMSA) or intraperitoneally (CaDTPA) at various short time intervals after Cd. Three experiments were carried out with four treatment groups in each: 1) Cd (control); 2) Cd+DMSA; 3) Cd+CaDTPA; 4) Cd+DMSA+CaDTPA. Time intervals for chelator treatment after Cd administration were: immediate application in the first, half an hour in the second and one hour in the third experiment. At the end of each experiment cadmium was analysed in kidney and liver. Additionaly in Experiment 3 essential elements (Fe, Cu, Zn) were also determined in the same organs. In Experiment 2 the effect of the treatment on urinary elimination of cadmium, copper and zinc were analysed. Results showed that the efficiency of Cd removal from the body (kidneys and liver) is lower when the time between Cd and chelating agents administration is longer. The two chelators differ in efficiency in mobilizing Cd, with DMSA being more efficient than CaDTPA. The combined therapy with the two chelators gave generally better results. It seems that DMSA which is given orally after oral Cd administration removes this element very efficiently from the gastrointestinal tract. CaDTPA, however, which is given parenterally removes absorbed Cd less efficiently. Organs are not significantly depleted in iron and copper after chelation treatment. Only zinc concentration was, however, significantly lower in the liver and higher in kidneys only after CaDTPA and combined DMSA+CaDTPA chelation.