bluuebunny/crossref_metadata_2025 huggingface dataset:
Pathophysiology of Preeclampsia: Linking Placental Ischemia/Hypoxia with Microvascular Dysfunction
Authors: GRANGER JOEY P. , ALEXANDER BARBARA T. , LLINAS MARIA T. , BENNETT WILLIAM A. , KHALIL RAOUF A.
Published: September 2002

Studies during the past decade have provided a better understanding of the potential mechanisms responsible for the pathogenesis of preeclampsia. The initiating event in preeclampsia has been postulated to be reduced uteroplacental perfusion as a result of abnormal cytotrophoblast invasion of spiral arterioles. Placental ischemia/hypoxia is thought to lead to widespread activation/dysfunction of the maternal vascular endothelium which results in enhanced formation of endothelin, thromboxane, and superoxide, increased vascular sensitivity to angiotensin II, and decreased formation of vasodilators such as nitric oxide and prostacyclin. These endothelial abnormalities, in turn, cause hypertension by impairing renal function and increasing total peripheral resistance. While recent studies support a role for cytokines and other factors such as lipid peroxides and reactive oxygen intermediates as potential mediators of endothelial dysfunction, finding the link between placental ischemia/hypoxia and maternal endothelial and vascular abnormalities remains an important area of investigation. The quantitative importance of the various endothelial and humoral factors in mediating the vasoconstriction and elevation in arterial pressure during preeclampsia has also not been completely elucidated.
Microvascular Structure and Function in Salt‐Sensitive Hypertension
Authors: Boegehold Matthew A.
Published: September 2002

In many individuals with essential hypertension, dietary salt can further increase blood pressure by augmentation of an already elevated total peripheral resistance. There is little information on the microvascular changes that contribute to salt‐sensitive hypertension in humans, but studies in the Dahl salt‐sensitive rat have provided some knowledge of the microcirculation in this form of hypertension. These studies, most of which have used intravital microscopy or isolated vessel technology, are the focus of this review. The salt‐induced exacerbation of hypertension in Dahl rats is due to a uniform increase in hemodynamic resistance throughout most of the peripheral vasculature. In the spinotrapezius muscle, this resistance increase is largely due to the intense constriction of proximal arterioles. The mechanisms responsible for this increased arteriolar tone include increased responsiveness to oxygen and a loss of tonic nitric oxide (NO) availability caused by reduced endothelial NO production and/or accelerated NO degradation by reactive oxygen species. Within the last decade, it has become increasingly clear that high salt intake can also lead to changes in microvascular structure and function in the absence of increased arterial pressure. This effect must also be considered when evaluating microvascular changes and their functional consequences in salt‐sensitive hypertension.
The Inflammatory Aspect of the Microcirculation in Hypertension: Oxidative Stress, Leukocytes/Endothelial Interaction, Apoptosis
Authors: Suematsu Makoto , Suzuki Hidekazu , Delano Frank A. , Schmid‐Schönbein Geert W.
Published: September 2002

Evidence is increasing in hypertensive models for an inflammatory reaction in the microcirculation with abnormal leukocyte counts and adhesion to the endothelium, enhanced arteriolar tone, and microvascular and tissue apoptosis. The spontaneous form of hypertension (SHR) is accompanied by a glucocorticoiddependent increase in circulating leukocyte count with elevated levels of activation and at the same time depressed leukocyte–endothelial interaction and endothelial P‐selectin function. The SHR exhibits immune suppression with lymphocyte apoptosis in the thymus. Generation of reactive oxygen species (ROS) in and around microvascular endothelial cells may regulate signal transduction pathways responsible for controlling gene expression and protein modification and thereby cause an elevation of vascular tone and, in excess, may form an injury mechanism for cells and tissue. A series of enzyme systems such as xanthine oxidase, reduced nicotinamide adenine dinucleotide phosphate/reduced nicotinamide adenine dinucleotide oxidase, and cytochrome P450 monooxygenases in conjunction with suppression of ROS scavengers seem to be involved in the oxidative stress responses in hypertension. The increase in ROS generation contributes to vascular remodeling, apoptosis, and proliferation of vascular smooth muscle, whereas gaseous monoxides such as nitric oxide and carbon monoxide have the ability to modulate elevated vascular tone and proliferative cell responses. Such biological actions of gases not only regulate activation of soluble guanylate cyclase but could also be attributable to inhibition of cytochrome P450 monooxygenases. We examine here the molecular basis of signal transduction by ROS, NO, and CO and functional alterations in their sensor molecules. An inflammatory reaction may underlie the pathogenesis of hypertension and its associated lesion formation and organ dysfunction.
Signaling Pathways of Mechanotransduction in Arteriolar Endothelium and Smooth Muscle Cells in Hypertension
Authors: Koller Akos
Published: September 2002

Hypertension, a disease with a high incidence in the population, affects all parts of the cardiovascular system. Studying the alteration of vasomotor responses of microvessels of hypertensive animals or responses of vessels following short‐term increases in hemodynamic forces helps us to better understand the underlying cellular signaling events responsible for their functional adaptation. These adaptations are likely to precede the structural remodeling of arterioles, resulting in irreversible increases in peripheral vascular resistance in hypertension. Although malfunction of several mechanisms can lead to the development of hypertension, hemodynamic forces (such as pressure and shear stress) are increased in all forms of hypertension. Thus, local mechanisms that sense the level of these forces and transduce the signals into vasomotor responses must be affected in all forms of hypertension. The endothelium has a central role in the early functional adaptations. Pressure‐induced myogenic constriction is enhanced due to the augmented release of endothelium‐derived constrictor factors that modulate arteriolar smooth muscle sensitivity to Ca2+. In contrast, flow/shear stress‐induced dilation of arterioles is reduced in hypertension, due to the impaired mediation of the response by nitric oxide (NO). The magnitude of impairment is gender specific, primarily due to an estrogen‐dependent enhancement of NO release in females. It is proposed that the elevated hemodynamic forces present in hypertension may themselves initiate these alterations, probably by enhancing the release of reactive oxygen species (ROS; produced by xanthine oxidase, NAD(P)H oxidoreductase, eNOS, etc.), which then interfere with the synthesis and/or action of endothelium‐derived mediators. Interfering early on with these mechanisms may prevent the development of irreversible structural changes of the microcirculation observed in hypertension.
Adaptation of Resistance Arteries to Increases in Pressure
Authors: Prewitt Russell L. , Rice Darian C. , Dobrian Anca D.
Published: September 2002

During the development of hypertension, hypertrophy of smooth muscle cells and deposition of extracellular matrix thicken the walls of large arteries without reducing the size of the lumen. The small arteries and arterioles remodel inwardly through a eutrophic process of rearrangement of the same smooth muscle cells around a smaller lumen. Pressure, through an increase in circumferential wall stress, can account for both hypertrophy and inward, eutrophic remodeling. The small arteries constrict during an elevation of pressure, thus restoring wall stress toward control levels. The large arteries have little vasoactivity and respond to the increase in wall stress by initiating a growth process. Mechanotransduction of the pressure stimulus to a growth response is being studied in small mesenteric arteries. Raising the pressure from 90 to 140 mmHg initiates a signaling process starting with phosphorylation of Src within 1 minute. This is followed by phosphorylation of Erk 1/2 peaking at 5 minutes and expression of c‐fos mRNA within 30 minutes. Gene expression correlates with wall stress and is thus inhibited by a myogenic response. Maintained vasoconstriction in an isolated arteriole results in inward, eutrophic remodeling within 4 days. Thus, the current data support the hypothesis that wall thickness is determined by circumferential wall stress, and lumen size is determined by vascular tone.
Mortality and morbidity in patients with very low postoperative Hb levels who decline blood transfusion
Authors: Carson Jeffrey L. , Noveck Helaine , Berlin Jesse A. , Gould Steven A.
Published: September 2002

BACKGROUND: Guidelines for allogeneic transfusion emphasize minimizing use to avoid transmission of serious illness. However, there is little information on the risks associated from withholding transfusion.

STUDY DESIGN AND METHODS: A retrospective cohort study of patients who declined RBC transfusions for religious reasons was performed. This analysis was restricted to consecutive patients ≥18 years old, who underwent surgery in the operating room from 1981 to 1994 and had a postoperative Hb count of 8 g per dL or less. The primary outcome was defined as any in‐hospital death occurring within 30 days of the surgery. Secondary outcome was 30‐day mortality or in‐hospital 30‐day morbidity. Morbidity was defined as myocardial infarction, arrhythmia, congestive heart failure, or infection.

RESULTS: Of 2083 eligible patients, 300 had postoperative Hb counts of 8 g per dL or less. The study population was predominantly female (70.3%) with a mean age of 57 years (SD, ± 17.7). In patients with a postoperative Hb level of 7.1 to 8.0, 0 died (upper 95% CI, 3.7%), and 9.4 percent (95% CI, 4.4‐17.0%) had a morbid event. In patients with a postoperative Hb level of 4.1 to 5.0, 34.4 percent (95% CI, 18.6‐53.2%) died and 57.7 percent (95% CI, 36.9‐76.6%) had a morbid event or died. After adjusting for age, cardiovascular disease, and Acute Physiology and Chronic Health Evaluation II score, the odds of death in patients with a postoperative Hb level of ≤8 g per dL increased 2.5 times (95% CI, 1.9‐3.2) for each gram decrease in Hb level.

CONCLUSIONS: The risk of death was low in patients with postoperative Hb levels of 7.1 to 8.0 g per dL, although morbidity occurred in 9.4 percent. As postoperative blood counts fall the risk of mortality and/or morbidity rises and becomes extremely high below 5 to 6 g per dL.
Clinical specificity and sensitivity of a blood screening assay for detection of HIV‐1 and HCV RNA
Authors: Vargo Janet , Smith Katie , Knott Caroline , Wang Songbai , Fang Chyang , McDonough Sherrol , Giachetti Cristina , Caglioti Sally , Gammon Richard , Gilbert Denise , Jackson J. Brooks , Richards William , Stramer Susan , Mimms Larry
Published: September 2002

BACKGROUND: An HIV‐1 and HCV NAT blood screening assay (Procleix HIV‐1/HCV, Gen‐Probe, Inc.) simultaneously detecting HIV‐1 and HCV RNA) has been implemented. Donor plasma samples reactive in the Procleix HIV‐1/HCV assay are tested with the HIV‐1 and HCV discriminatory assays to resolve whether HIV‐1 RNA, HCV RNA, or both are present.

STUDY DESIGN AND METHODS: To determine the specificity of the Procleix HIV‐1/HCV assay, data were analyzed for samples from 192,288 donations, tested in 16‐member pools. To determine sensitivity, data were analyzed for 2014 commercial samples known to contain HIV‐1, HCV, or both, as well as 10 HIV‐1 and 10 HCV commercial seroconversion panels.

RESULTS: The specificity of the Procleix HIV‐1/HCV assay was 99.7 percent. The HIV‐1 and HCV discriminatory assays showed similar specificity. The sensitivity of the Procleix HIV‐1/ HCV assay was 99.9, 99.6, and 100 percent, respectively, for samples containing HIV‐1, HCV, or both. The Procleix discriminatory assays were comparably sensitive. The Procleix discriminatory assays detected all tested samples of known HIV‐1 subtype or HCV genotype. Procleix HIV‐1/HCV testing of seroconversion panels showed that the median times to a positive reaction for HIV‐1 and HCV were reduced by 3 and 25 days, respectively, compared to serologic tests.

CONCLUSION: These studies support the use of the Procleix HIV‐1/HCV assay for routine blood donor screening.
Declining value of preoperative autologous donation
Authors: Goldman Mindy , Savard Renée , Long Anne , Gélinas Stéphanie , Germain Marc
Published: September 2002

BACKGROUND: Preoperative autologous blood donation (PABD) has been shown to decrease allogeneic blood transfusion requirements in major elective surgery. Changes in transfusion practice motivated an examination of blood use from 1993 to 2000 of patients participating in the Héma‐Québec PABD program.

STUDY DESIGN AND METHODS: Blood donation and transfusion, type of surgery, and demographic characteristics were prospectively entered into a computer database for patients participating in the Héma‐Québec PABD program.

RESULTS: Autologous donations represented from 0.8 to 2 percent of total blood collections and have declined by 26 percent after peaking in 1995. The mean number of units collected per patient declined, as did the number of units transfused per patient and the utilization rate. For radical prostatectomy, knee replacement surgery, hip replacement surgery, and scoliosis, utilization rates were 72, 60, 83, and 78 percent in 1993 compared with 50, 50, 58, and 58 percent in 2000, respectively. In 2000, 18 percent of patients were receiving a 1‐unit autologous transfusion. Depending on the surgical procedure, 85 to 95 percent of patients avoided allogeneic transfusion; this did not change significantly from 1993 to 2000.

CONCLUSION: Patients participating in the PABD program successfully avoided allogeneic transfusion in over 85 percent of cases. However, declining utilization rates and frequent 1‐unit transfusions demonstrate the decreasing utility of PABD over time.
Biochemical and structural changes in RBCs stored with different plasticizers: the role of hexanol
Authors: Draper C.J. , Greenwalt T.J. , Dumaswala U.J.
Published: September 2002

BACKGROUND: PVC containers are plasticized with di(2‐ethyl)hexylphthalate (DEHP) or a related phthalate. The toxicity of DEHP has been questioned. It has been proposed to use butyryltrihexylcitrate (BTHC) as the plasticizer. The purpose of this study was to determine if hexanol, a component of BTHC, plays a role in the preservation of RBCs stored in BTHC‐plasticized PVC bags.

STUDY DESIGN AND METHODS: WBC‐reduced RBCs of ABO‐ and D‐matched blood groups were prepared in 1‐L polyolefin (PO) bags (PL732). Six 60‐g aliquots were transferred to transfer packs made of PL146 (DEHP‐plasticized) and PL2209 (BTHC‐plasticized) and four PO (PL732) packs. To the PL146 and PL2209 packs, 30 mL of AS‐1 was added. To three of the PO packs, 30 mL of AS‐1 with sufficient DEHP, BTHC, or hexanol to achieve a final concentration of 3 mM was added, and to the final PO pack, 30 mL of AS‐1 only was added (control). The units were stored for 6 weeks at 1 to 6°C. RBC ATP, hemolysis, morphology, membrane lipids, deformability, and fluidity were measured.

RESULTS: ATP levels were not significantly different in any of the systems after 6 weeks. Compared to the PO bags, hemolysis was lowest in the PL146 containers and was also significantly lower (p < 0.006) in the PO bags with added DEHP, BTHC, or hexanol. The accumulation of vesicles was significantly less in the units stored in the PL146 and PL2209 than in the PO plastic with or without added plasticizers or hexanol (p ≤ 0.004). There was no significant difference in the formation of vesicles in any of the PO units (p > 0.05). There was no demonstrable change in the membrane fluidity of the RBCs during storage in any of the systems. The decrease in deformability was the same, and the losses of cholesterol and phospholipid during storage were similar in all the studies.

CONCLUSIONS: The hexanol component of the BHTC plasticizer in a concentration of 144.6 μg per mL concentration suppresses hemolysis and vesiculation of RBCs during storage. The hexanol and DEHP that are slowly leached during storage have a greater effect in suppressing hemolysis and vesicle formation than when added extraneously to AS‐1 in PO containers.
QTc prolongation in apheresis platelet donors
Authors: Laspina Stefan J. , Browne Martin A. , McSweeney Ellen N. , Lawlor Jo , Whelan Denise M. , Kinsella Anthony I. , Murphy William G.
Published: September 2002

BACKGROUND: Citrate infusion during apheresis procedures can cause lowering of the plasma ionized calcium leading to prolongation of the QT interval and hypotension. At the myocardial level, QTc measurement is a sensitive marker of subphysiologic calcium values caused by citrate toxicity.

STUDY DESIGN AND METHODS: Seventy‐six regular platelet donors were recruited into this study. QTc intervals were measured continuously for 3 minutes at four different points during the apheresis procedures. The blood pressure was recorded every 5 minutes throughout the procedure.

RESULTS: The baseline QTc value for men was 406.5 ± 13.1 milliseconds1/2 and for women was 417.6 ± 13.3 milliseconds1/2 (p = 0.0016). QTc prolongation occurred in all procedures in all donors. Maximum recorded values were significantly higher in women than in men (450.8 ± 20.8 vs. 424.8 ± 14.3 ms1/2; p = 0.0025). All QTc values returned to baseline by 15 minutes after the procedure. Changes in blood pressure were minimal and no donor experienced severe symptoms.

CONCLUSIONS: QTc prolongation always occurs during plateletpheresis. This prolongation is greater in women than in men. This study indicates that it may be advisable to assess donors for family or personal history of syncope and family history of sudden death to exclude those at increased risk of arrhythmias because of asymptomatic carriage of a long‐QT gene. In addition baseline QTc measurement is a simple noninvasive procedure that could be applied to further studies with a view to enhancing donor safety in apheresis.
Seven‐day storage of single‐donor platelets: recovery and survival in an autologous transfusion study
Authors: Dumont Larry J. , AuBuchon James P. , Whitley Pamela , Herschel Louise H. , Johnson Adrienne , McNeil Deanna , Sawyer Sherrie , Roger Jill C.
Published: September 2002

BACKGROUND: Bacterial screening may effectively reduce the morbidity and mortality risk associated with extended storage of platelets. Platelet viability then becomes the primary determinant of acceptable storage time. This study evaluates the effectiveness of platelets stored in plasma for 7 days.

STUDY DESIGN AND METHODS: WBC‐reduced, single‐donor platelets (n = 24) were collected and stored by standard methods at two sites. Standard in vitro platelet biochemical and functional parameters were monitored over the storage period. On Days 5 and 7 of storage, platelets were alternately labeled with 51Cr and 111In and returned to the subject, and recovery and survival were determined.

RESULTS: Component pH22°C was maintained in the range 6.2 to 7.61 through 7 days and did not detrimentally affect either in vitro or in vivo outcomes. In vitro platelet characteristics were adequately maintained over 7 days. Day 5 platelets had better recovery (63.0 ± 4.36 vs. 53.9 ± 4.36%, p < 0.0001) and survival (161 ± 8.1 vs. 133 ± 8.1 hr, p = 0.006) than Day 7 platelets adjusting for radioisotope, center, and donor effects.

CONCLUSION: Although declines in recovery and survival were noted, these are less than used previously to gain licensure of 7‐day storage and are unlikely to be clinically significant. Extension of storage to 7 days could be implemented with bacterial screening methods to select out contaminated components without a significant effect on the platelet efficacy compared to 5‐day components.
Bone marrow stromal cells prepared using AB serum and bFGF for hematopoietic stem cells expansion
Authors: Yamaguchi Miki , Hirayama Fumiya , Wakamoto Shinobu , Fujihara Mitsuhiro , Murahashi Hideaki , Sato Norihiro , Ikebuchi Kenji , Sawada Ken‐ichi , Koike Takao , Kuwabara Mikinori , Azuma Hiroshi , Ikeda Hisami
Published: September 2002

BACKGROUND: An ex vivo culture system was previously established for stem cell expansion using human marrow stromal cells and serum‐free medium. However, the stromal cells were prepared using long‐term culture medium containing horse serum and FCS, which may transmit infectious diseases of xenogeneic origin. In this study, therefore, a method was established to prepare stromal cells using an AB serum‐based medium. In the case that serum from a transplant recipient or PBPC donor is available, additional infectious diseases would not be transmitted.

STUDY DESIGN AND METHODS: Cord blood CD34+ cells were cultured with thrombopoietin, stem cell factor, and flt3/flk2 ligand on a monolayer of human marrow primary stromal cells prepared using long‐term culture medium or AB serum‐based medium. After 2 weeks, clonogenic progenitor activity and SCID mouse‐reconstituting cell activity were assayed. mRNA expression of cytokines and Notch ligand by stromal cells was also examined.

RESULTS: There were no remarkable differences in expansion‐supporting activity and mRNA expression between stromal cells established by the two methods.

CONCLUSION: An ex vivo expansion system completely based on AB serum has been established.
Evaluating DNA tests of motherless cases using a Philippine genetic database
Authors: De Ungria M.C.A. , Frani A.M. , Magno M.M.F. , Tabbada K.A. , Calacal G.C. , Delfin F.C. , Halos S.C.
Published: September 2002

BACKGROUND: In 5 percent of paternity determination cases, only DNA samples from the alleged father and child pairs are tested. The absence of the mother's DNA increases the probability of false paternity inclusions, which affects laboratories that use a limited number of DNA markers. The effect of coincidental matches between unrelated individuals on DNA tests of motherless cases was determined using the Philippine population genetic database of the National Capital Region (NCR).

STUDY DESIGN AND METHODS: Seven short tandem repeat (STR) markers were used, namely HUMvWA, HUMTH01, HUMCSF1PO, HUMFOLP23, D8S306, HUMFES/FPS, and HUMF13A01. Values of the probability of paternity with (W) and without a mother (W‐mother) were determined using the equation W = cumulative likelihood ratio/cumulative likelihood ratio + 1). These values were determined for 50 volunteer families and compared with values calculated from randomly matched pairs in a reference NCR population database.

RESULTS: The W and W‐mother values of the 50 families range from 96.48 to 99.99 percent and 79.76 to 99.99 percent, respectively. In the NCR database, 195 coincidental matches in seven STR loci out of 5253 possible pairs (3.71%) were detected with W‐mother values ranging from 12.47 to 99.83 percent. Of these, 53 and 10 random pairs have W‐mother greater than 95.0 and 99.0 percent, respectively.

CONCLUSION: W was higher than W‐mother in the 50 families. However, the existence of unrelated individuals in the NCR database that randomly matched at seven STR loci and that has W‐mother values greater than 99.0 percent highlights the need for greater precaution when dealing with motherless cases.
A Comparison of the Accuracy and Safety of Vertebral Body Pin Placement using a Fluoroscopically Guided Versus an Open Surgical Approach: An In Vitro Study
Authors: Wheeler Jason L. , Cross Alan R. , Rapoff Andrew J.
Published: September 2002

Objective— To compare the safety and accuracy of Steinmann pin placement in vertebral bodies T10 through L7 using either an open or closed fluoroscopic method.

Study design— In vitro radiographic and anatomic study.

Animals— Ten medium‐sized canine cadavers.

Methods— Cadavers were randomly assigned to 2 groups: open and closed. Steinmann pins were placed in vertebral bodies through a standard dorsal incision in the open group and percutaneously with the aid of fluoroscopy in the closed group. Pins were placed bilaterally in vertebral bodies T10 through L7 at approximately 30° from horizontal and driven to a uniform depth. Necropsies were performed to examine potential pulmonary, vascular, or neurological trauma as a result of pin placement. Spines were cross‐sectioned through intervertebral disc spaces, and radiographs were performed to evaluate accuracy of pin placement. Descriptive statistics were determined for pin angle, percentage of bone purchase, and penetration length. Means of interest between groups were compared using a Student t test. Complication incidence was compared using χ2 analysis. Significance was P < .05.

Results— Mean pin insertion angle was significantly different than 30° for the open group in thoracic and lumbar vertebrae and for the closed group in thoracic vertebrae. Mean pin insertion angle for all vertebrae was significantly greater than 30° for the open group. Mean pin penetration distance in each vertebra was significantly different between groups with the closed group having less penetration and lower variance. Both groups were significantly different from the ideal penetration distance. The mean percentage of bone purchase was greater in the closed group for all vertebrae except T10 and T11. The complication incidence was significantly greater in the open group for thoracic vertebrae.

Conclusion and clinical relevance— The results of this study suggest that a closed technique for placement of Steinmann pins in lumbar vertebrae for use in external skeletal fixation is a reasonable and safer alternative to the traditional open technique. Use of either technique in thoracic vertebrae should be avoided.
Medial Patellar Ligament Splitting for the Treatment of Upward Fixation of the Patella in 7 Equids
Authors: Tnibar M. Aziz
Published: September 2002

Objective— To describe a surgical technique for splitting the proximal third of the medial patellar ligament (MPL) in horses and ponies with upward fixation of the patella (UFP), and to report outcome.

Study design— Prospective clinical study.

Sample population— Four horses and 3 Shetland ponies.

Methods— With ultrasound guidance, the proximal third of the MPL was split by percutaneous use of a no. 15 scalpel blade. The rationale for this surgical procedure was to induce a localized desmitis with subsequent ligament thickening. No anti‐inflammatory drugs were administered, and horses and ponies were exercised the day after surgery. Clinical, radiographic and ultrasonographic follow‐up evaluation was obtained.

Results— No short‐term or long‐term complications were observed, and no patients had clinical signs of UFP after surgery. This clinical effect was attributed to a 2‐ to 3‐fold increase in size of the proximal part the MPL from an induced localized desmitis.

Conclusions— Percutaneous splitting of the proximal third of the MPL resolved UFP in equids.

Clinical relevance— Splitting of the proximal third of the MPL is effective for treatment of UFP and allows rapid return to normal activity.
Use of a Hydro‐Pool System to Recover Horses after General Anesthesia: 60 Cases
Authors: Tidwell Scott A. , Schneider Robert K. , Ragle Claude A. , Weil Ann B. , Richter Marina C.
Published: September 2002

Objective— To report complications observed using a hydro‐pool recovery system after general anesthesia in horses.

Study design— Retrospective study.

Animals— Sixty horses.

Methods— Retrospective review of the medical records and quality of recovery from anesthesia of 60 horses that had surgical or diagnostic procedures under general anesthesia.

Results— Mean total anesthesia time was 182 minutes (range, 25 to 390 minutes). Mean time in the hydro‐pool was 108 minutes (range, 20 to 270 minutes). One horse that had bilateral rear limb extensor weakness while recovering in a padded recovery stall was moved to the hydro‐pool and maintained for 12 hours. Ten horses developed some pulmonary edema; in 3 horses, the signs of pulmonary edema were severe; and 1 horse died from related complications. One horse developed septic arthritis of an operated stifle joint, and 2 horses developed incisional infections. Two horses incurred multiple skin abrasions on the distal aspect of their limbs during violent attempts to leave the pool.

Conclusions— A hydro‐pool system was useful for recovering horses from general anesthesia when difficult recoveries were anticipated because of the horse's injury, size, demeanor, duration of anesthesia, or risk of further injury. Recovery using the hydro‐pool was more time and labor intensive than a standard stall recovery. Pulmonary edema that required treatment was a serious complication that occurred in 17% of the horses. Careful closure of the skin with cyanoacrylate glue and pressure from bandages were used to prevent postoperative incisional infections.

Clinical relevance— A hydro‐pool system is a useful method for recovering horses from general anesthesia when difficult recoveries are anticipated.
Evaluation of Three Peripheral Arteriovenous Fistulas for Hemodialysis Access in Dogs
Authors: Adin Christopher A. , Gregory Clare R. , Adin Darcy B. , Cowgill Larry D. , Kyles Andrew E.
Published: September 2002

Objective—To design and create 3 types of arteriovenous fistulas (AVF) in normal dogs, to monitor the dogs for secondary cardiovascular complications, and to verify adequacy of these fistulas for hemodialysis vascular access.

Study design—Experimental study.

Animals—Four normal adult dogs.

Methods—Cadaveric dissections were performed, and surgical protocols were generated for carotid‐jugular (CJ), brachial‐cephalic (BC), and distal caudal femoral‐lateral saphenous anastomosis (DCFLS) AVF. Each surgical procedure was then performed in 2 live dogs. Echocardiography was performed at days 0, 1, 3, 7, 14, 28, and 56 to evaluate the dogs for evidence of volume overload secondary to AVF formation. Estimation of luminal diameter and confirmation of fistula patency were performed using percutaneous color Doppler ultrasound. At day 56, hemodialysis was performed using each fistula as a vascular access.

Results—No significant changes occurred in the echocardiographic variables over time. All fistulas were patent at day 56 with mean luminal diameters of 4.5 mm (CJ), 4 mm (BC), and 1.5 mm (DCFLS). The BC fistula was superior for ease of needle placement and stabilization and provided adequate blood flow for clinical hemodialysis.

Conclusions—Based on this short‐term study, arteriovenous fistulas appear to be a safe and effective means for hemodialysis access in dogs.

Clinical relevance—The arteriovenous fistulas described provide an alternative to the central venous catheters currently used for chronic hemodialysis access in dogs.
Cardiopulmonary Bypass in the Cat
Authors: Brourman Jeff D. , Schertel Eric R. , Holt David W. , Olshove Vincent A.
Published: September 2002

Objective—To assess the physiologic response to, and acute survival of, cats undergoing cardiopulmonary bypass (CPB) and to evaluate the efficacy of a commercial human pediatric oxygenator system on cats weighing less than 6 kg.

Study design—Experimental study.

Animals—Six intact male cats

Methods—Cats were placed on cardiopulmonary bypass by cannulating the cranial and caudal vena cavae and the carotid artery. The pediatric CPB circuit was primed with 150 mL of a balanced crystalloid solution. Venous drainage was enhanced by a controlled, vacuum‐assist system. A cross‐clamp was placed on the ascending aorta and cardiac arrest was induced by antegrade infusion of a cold cardioplegia solution. After 45 minutes of arrest time, the cross‐clamp was removed and the cats were weaned off bypass and decannulated. No blood products were administered. Heart rate, mean arterial pressure (MAP), central venous pressure, arterial blood gas, hematocrit (HCT), total plasma protein concentration (TP), serum electrolyte concentrations, and activated clotting time (ACT) were measured at baseline period (BL), during CPB, 60 minutes after CPB (CPB 60) and 90 minutes after CPB (CPB 90). A complete blood count (CBC), blood chemistry profile, and urinalysis were performed at BL, during CPB, and CPB 90. Cats were euthanatized after CPB 90.

Results—Cardiopulmonary bypass resulted in a significant (P< .05) decrease in mean HCT (18.0%) and TP (2.3 gm/dL) at CPB 90 when compared to BL (30.5% and 6.0 gm/dL, respectively). The MAP at CPB 90 (54 mm Hg) was decreased from BL (94 mm Hg). The ACT increased from a mean of 124 seconds to > 400 seconds with heparinization and was reversed to 300 seconds with protamine. Mean platelet counts decreased from BL (369,000 /uL) to CPB 90 (94,500 /uL). Mean white blood cell counts decreased from 13,200 /uL at BL to 2,200 /uL at CPB 90. Upon reperfusion, 1 cat fibrillated but was successfully defibrillated.

Conclusions—Cardiopulmonary bypass was performed successfully in 6 cats weighing less than 6 kg. Acute survival to 90 minutes after CPB was achieved in all 6 cats

Clinical relevance—The ability to perform CPB in the cat may allow intracardiac repair of various heart defects in this species.
A Retrospective Study of 40 Dogs with Polyarthritis
Authors: Jacques David , Cauzinille Laurent , Bouvy Bernard , Dupre Gilles
Published: September 2002

Objective—To characterize the epidemiologic, clinical, laboratory, and radiographic findings from dogs with polyarthritis (PA).

Study design—Retrospective clinical study.

Sample population—Forty dogs.

Methods—Medical records of 40 dogs with a diagnosis of PA were reviewed. Retrieved data included breed, age at admission, sex, weight, clinical signs, and the results of synovial fluid analysis, complete blood count, serum chemistry profile, urinalysis, serologic screening tests for infectious diseases, and radiographic examination of affected joints.

Results—The incidence of PA was 0.37%. Twenty‐nine breeds were represented; 16 dogs were male, and 24 were female. Mean body weight was 20.1 ± 15 kg. The mean age at admission was 5.6 ± 4 years. Eighty percent of dogs with PA had difficulty or reluctance walking, 35% were lame, 33% had spontaneous vocalization without any obvious reason, 20% had exercise intolerance, 18% were febrile, and 7.5% had an inability to rise or move. Joint pain was identified in 40% of dogs. Synovial fluid color varied from colorless (36%) to yellow‐tinged (36%) or hemorrhagic (28%). Synovial fluid mean cell count varied from 10 cells (400×) to 50 cells (1,000×). Leukocytosis occurred in 59% of the dogs and was more frequently identified in dogs with very severe synovial inflammation. Thirty‐one percent of affected dogs were anemic. Serum biochemical profiles were considered abnormal in 13% of the dogs. Joint radiography did not identify erosive arthritis.

Conclusions—PA is a common cause of locomotor abnormalities in dogs; however, true lameness and articular pain are not common clinical findings in dogs with PA.

Clinical relevance—PA should be considered in the differential diagnosis for all dogs with difficulty walking.
A Comparison of Ultra‐High–Molecular Weight Polyethylene Cable and Stainless Steel Wire using Two Fixation Techniques for Repair of Equine Midbody Sesamoid Fractures: An In Vitro Biomechanical Study
Authors: Rothaug Paul G. , Boston Ray C. , Richardson Dean W. , Nunamaker David M.
Published: September 2002

Objective—To compare the monotonic tensile and fatigue strength of 16‐gauge stainless steel wire (SSW) to ultra‐high–molecular weight polyethylene (UHMWPE) cable using a transfixed cerclage technique in an in vitro midbody sesamoid osteotomy model. Endoscopic modifications to Martins transfixed cerclage technique were developed. A new suture technique of fixation was compared with the transfixed cerclage technique by measuring gap formation after cyclic testing.

Study design—An in vitro biomechanical paired equine cadaver limb study.

Sample population—Twenty‐one paired cadaveric adult equine forelimbs.

Methods—Uniaxial medial midbody sesamoid osteotomies were created in paired adult equine forelimbs. Monotonic tensile strength was measured on 10 forelimbs repaired by a transfixed cerclage technique using wire or cable. Fatigue testing to failure was performed on 4 forelimbs repaired using the transfixed cerclage technique by cycling the limbs between 500 N and 2,000 N. The limbs were initially repaired with wire, cycled until the wire broke, then repaired with cable and cycled again to failure. Fatigue testing for gap displacement was performed on 8 limbs repaired with either the transfixed cerclage technique or the suture technique. Limbs were cycled between 500 N and 2,000 N for 10,000 cycles. The limbs were repaired with wire initially, tested, and then repaired with cable and tested again. Twenty‐two limbs were used for mechanical testing. The remaining limbs (20) were used to develop and practice the endoscopic transfixed cerclage (10 limbs) and suture (10 limbs) techniques.

Results—Ultimate tensile strength (UTS) of UHMWPE cable constructs was 34% greater than the UTS of SSW constructs. Fatigue strength was 2 to 20 times greater for UHMWPE cable constructs than SSW constructs. Separation of fragments was 153% less for limbs repaired by the suture technique compared with those repaired by the transfixed cerclage technique.

Conclusions—UHMWPE cable shows promise for this clinical application because of its greater tensile and fatigue strength. The newly described suture technique significantly reduced gap formation compared with the transfixed cerclage technique. Osteotomy gap formation occurred early in cycling, suggesting that rigid support in the form of a cast may be needed during the early postoperative period for wiring techniques.

Clinical relevance—Clinical testing of UHMWPE cable should eliminate problems of wire breakage seen with SSW. The endoscopic transfixed cerclage technique can be used by surgeons familiar with arthroscopic surgery. However, the suture technique needs to be tested in vivo to determine whether there is a clinical advantage compared with the transfixed cerclage technique.
Dorsal Laminectomy for Caudal Cervical Spondylomyelopathy: Postoperative Recovery and Long‐Term follow‐up in 20 Dogs
Authors: De Risio Luisa , Muñana Karen , Murray Michelle , Olby Natasha , Sharp Nicholas J. H. , Cuddon Paul
Published: September 2002

Objective—To evaluate the postoperative morbidity and long‐term outcome of dogs after dorsal laminectomy for caudal cervical spondylomyelopathy (CCSM).

Study design—Retrospective study.

Sample population—Twenty dogs with CCSM.

Methods—Medical records of dogs treated by dorsal laminectomy for CCSM at North Carolina State University and Colorado State University between 1989 and 1999 were reviewed. Information on signalment, onset, progression and duration of clinical signs, diagnostic testing, sites of dorsal laminectomy, postoperative complications, length of hospitalization, and the ambulatory status on discharge was recorded. A minimum follow‐up of 7 months was required for inclusion in the study. Neurologic status was graded (0 to 5) preoperatively, 2 days after surgery, and at the time of the study (final score). Improvement or worsening of the neurologic status was assessed by comparison of different scores for each dog. Additional follow‐up information was obtained by means of a detailed telephone questionnaire directed at both the owner and referring veterinarian.

Results—Mean duration of clinical signs before surgery was 4.9 months. At admission, 15 dogs were ambulatory and 5 were nonambulatory. Neurologic status worsened in 70% of dogs 2 days after surgery but improved in all but 1 dog over the long term. Mean time to optimal recovery was 3.6 months. Long‐term follow‐up ranged from 7 months to 9 years (mean ± SD, 3.2 ± 2.4 years). Four dogs had confirmed recurrence; 2 other dogs may have had recurrence.

Conclusions—Dorsal cervical laminectomy is an effective treatment for CCSM in those dogs with dorsal compression or multiple sites of involvement.

Clinical relevance—Although most dogs' neurologic status transiently worsened after surgery, long‐term outcome and recurrence rates were comparable to those seen with other surgical techniques for CCSM.
Juvenile Pubic Symphysiodesis in Dysplastic Puppies at 15 and 20 Weeks of Age
Authors: Patricelli Alison J. , Dueland R. Tass , Adams William M. , Fialkowski James P. , Linn Kathleen A. , Nordheim Erik V.
Published: September 2002

Objective—To examine the effects of juvenile pubic symphysiodesis (JPS) on hip joint conformation, hip laxity, gait, and the development of degenerative joint disease (DJD) in dysplastic puppies operated at 15 and 20 weeks of age.

Study design—Randomized controlled prospective study.

Animals—Eighteen female hound puppies with increased hip laxity.

Methods—Puppies were randomized to 1 of 4 treatment groups: JPS at 15 weeks of age (n = 6), sham‐operated control at 15 weeks of age (n = 3), JPS at 20 weeks of age (n = 6), and sham‐operated control at 20 weeks of age (n = 3). Hip extension with pain scoring, Ortolani palpation, hip reduction angle measurement (HRA), PennHIP radiography (University of Pennsylvania) with measurement of distraction index, Norberg angle measurement, and transverse computed tomographic imaging to measure acetabular angle (AA) and dorsal acetabular rim angle (DARA), were tested preoperatively, and at 1 and 2 years of age.

Results—JPS resulted in significant changes in AA, HRA, DARA, and conversion to Ortolani negative status. Larger and more rapid changes in hip conformation were seen when surgery was performed at 15 weeks of age. No significant changes were identified in control dogs. Twenty‐five percent of JPS dogs developed DJD whereas 83% of control dogs developed DJD.

Conclusions—JPS resulted in significant improvements in hip joint conformation and hip laxity in dysplastic puppies treated at 15 and 20 weeks of age. Improvements in conformation were significantly greater when surgery was performed at 15 weeks of age.

Clinical relevance—JPS appears to be a promising treatment for hip dysplasia and is a safe and technically simple procedure to perform.
‘Ordinary People Come through Here’: Locating the Beauty Salon in Women's Lives
Authors: Black Paula
Published: September 2002

Beauty therapy is part of a vast multi-national, multi-million pound beauty industry. The beauty salon lies at the heart of a complex set of discourses and practices. Research conducted in the salon sheds light upon a number of key sociological debates including; issues of health and well-being; gendered employment practices; the construction and maintenance of gender identity and sexuality; body practices; and leisure activities. In this sense the salon may be used as a microcosm in which to investigate wider sociological concerns. In this paper, I will draw upon the testimonies of beauty salon clients, and beauty therapists. I describe four areas of treatment: pampering; routine grooming; health treatments; and corrective treatments. These areas are investigated in depth and related to different spheres in the woman's life. In particular, I show how the beauty salon is drawn upon in helping to negotiate the balance between these competing arenas. The ambivalences of achieving an ‘appropriate’ appearance in these differing spheres is investigated. Their implication in the self-surveillance of the client is also discussed.
Trousers and Tiaras: Audrey Hepburn, A Woman's Star
Authors: Moseley Rachel
Published: September 2002

Audrey Hepburn is one of cinema's most stylish and enduring icons, and has embodied an ideal of femininity for generations of women. Using textual analysis, archival research and audience accounts of ‘Doing the Hepburn Look’, I argue that Audrey Hepburn, as a star clearly addressing a female audience, offered a flexible image which was enabling to young women through dress in relation to exigencies of gender, class and national identity. The paper draws on research conducted as part of a larger project investigating Hepburn's ongoing appeal for young British women from the 1950s to the 1990s.
Classy Lingerie
Authors: Storr Merl
Published: September 2002

Underwear is the most intimate form of dress, and the type of underwear known as ‘lingerie’ is particularly invested with meanings of femininity, sexuality and pleasure. This article focuses on mass-market lingerie and is based on an ethnographic study of Ann Summers home shopping parties at which lingerie, sex toys and other ‘personal’ products are sold to women in the UK. The analysis draws on the work of Bourdieu and Skeggs to argue that the apparently ‘private’ world of lingerie is simultaneously part of the ‘public’ world of class distinction. The class connotations of mass-market lingerie are not simply aspirational, but are also used by working- and lower-middle-class women to distinguish themselves from ‘posh’ women who are thereby defined as pretentious, boring, snobbish or tasteless. The article concludes that the processes of choosing and buying lingerie involve identifications and dis-identifications of class, gender and sexuality, even though the garments themselves are rarely if ever worn in public.
Fashion Culture: Creative Work, Female Individualization
Authors: McRobbie Angela
Published: September 2002

This article explores some of the key dynamics of the UK fashion sector as an example of a post-industrial, urban based, cultural economy comprising of a largely youthful female workforce. It argues that the small scale, independent activities which formed the backbone of the success of British fashion design as an internationally recognized phenomenon from the mid 1980s to the mid 1990s, represented a form of female self-generated work giving rise to collaborative possibilities and co-operation. However without an effective lobby or association (despite the expansion of the fashion media) and under conditions of rapid individualization and in an increasingly harsh climate of neo-liberalization, this creative economy has been overtaken and virtually demolished by the joint forces of a re-vitalized high street fashion culture and the aggressive presence of corporate fashion (‘Prada-ization’). While the UK government celebrates the growth of the cultural economy, it also overlooks the processes making the livelihoods of its predominantly female workforce either untenable or else requiring de-specialization and ‘multi-tasking’.
Multicultural Fashion… Stirrings of Another Sense of Aesthetics and Memory
Authors: Puwar Nirmal
Published: September 2002

This paper looks at the place of items long associated with the bodies of South Asian women in mainstream fashion. First, there will be a profiling of some of the scenes where bindhies, mendhies and related scents and sounds are donned and adored by white bodies. By participating in conversations with South Asian women in Britain in the second part of the article, the author is able to discuss some of the stirrings raised by the recent legitimization of these items by multicultural capitalism, leading towards an exploration of a different sense of aesthetics, memory and desire. The ambivalent attraction of limited recognition offered by the anthropological urge to ‘know’ the ethnic ‘other’ is noted. A consideration of the rage induced by the power of whiteness to play with ‘ethnic’ items which had not so long ago been reviled when they were worn by South Asian women points to the historical amnesia that underlies much multicultural celebration. The allure of images packaged as oriental for South Asian women themselves, although often from a different set of sensibilities and memories, stresses the importance of historical reconstruction.