bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a Transpelvic Sling Procedure With and Without Colposuspension for Treatment of Female Dogs With Refractory Urethral Sphincter Mechanism Incompetence
Authors: NICKEL RAFAEL F. , WIEGAND URSEL , BROM W.E. VAN DEN
Published: February 2008

Objective—To evaluate a sling procedure using a polyester ribbon passed through the obturator foramen, around the urethra, and fixed outside the pelvis for the treatment of female dogs with refractory urethral sphincter mechanism incompetence (USMI).

Animals—26 female dogs with USMI that had not improved with medical management. Methods—All dogs underwent a transpelvic sling procedure, and in 13, with a radiographic diagnosis of a pelvic bladder, additional colposuspension was performed. Multichannel urethral pressure profilometry (UPP) and diuresis cystourethrometry (UCM) were performed in all dogs before and in seven dogs 2 to 14 months after surgery. Long‐term results of surgery and medical therapy were determined.

Results— 13 dogs (50%), 6 of these without additional colposuspension, were continent after surgery and remained continent during a follow‐up period of 12 to 36 months (mean, 19 months). Seven, three of which had colposuspension, had improved markedly. Four of these dogs became continent with additional medical therapy. Five dogs did not improve, and three of these were eventually euthanatized. In one dog, the sling was removed after 5 days because of persistent stranguria. Surgery and medical therapy together resulted in continence in 17 dogs (65%) during a follow‐up period of 6 to 36 months (mean, 22 months). Postoperative dysuria or stranguria occurred in six dogs, and four of these underwent a colposuspension procedure. Two dogs developed a fistula, 2 and 3 years after surgery. Preoperatively, decreased urethral resistance was suggested by the findings of UPP and UCM in 25 dogs, and an abnormally high compliance was found in 3, detrusor instability in 2, and a low threshold pressure in 1 dog. There was no apparent correlation between these findings and the outcome of surgery. Urethral closure pressures measured after surgery were significantly increased but were still lower than the normal range in all dogs with persistent or recurrent incontinence.

Conclusions—A transpelvic sling procedure, with or without additional colposuspension, can be useful in the management of dogs with refractory urinary incontinence. The procedure is not beneficial if it does not increase urethral pressure close to, or within, the normal range.
Acute Gastrointestinal Disease in 27 New World Camelids: Clinical and Surgical Findings
Authors: CEBRA CHRISTOPHER K. , CEBRA MARGARET L. , GARRY FRANKLYN B. , LARSEN R. SCOTT , BAXTER GARY M.
Published: February 2008

Objective—To describe clinical and surgical findings from New World camelids with acute gastrointestinal disease.

Study Design—Retrospective study.

Animal Population—20 llamas and 7 alpacas.

Methods—Camelids were grouped based on surgical lesions. Clinical and surgical findings were compared between groups and between surviving and nonsurviving camelids.

Results—Twelve of 27 initial celiotomies and 3 of 4 repeat celiotomies were successful. Death occurred from euthanasia during surgery (nine camelids), peritonitis or sepsis (five), aspiration pneumonia (one), and respiratory distress (one). Survival was lowest after celiotomy for proximal obstruction (3 of 10 camelids), ruptured viscus (0 of 4), and necrotizing enteritis (0 of 2) and highest after celiotomy for distal obstruction (10 of 13) and septic peritonitis without ruptured viscus (2 of 2). Before surgery, camelids with proximal obstruction had significantly lower (P< .05) serum chloride concentrations (median, 97 mEq/L) than those with distal obstruction (median, 109 mEq/L) or ruptured viscus (median, 117 mEq/L). Serum bicarbonate concentration also was highest (median, 34.6 mEq/L) and often greater than 28 mEq/L in camelids with proximal obstruction. Camelids with distal obstruction had significantly lower (P< .05) nucleated cell counts in peritoneal fluid (median, 700 cells/μL) than those with ruptured viscus (median, 20,600 cells/μL) or septic peritonitis (median, 88,300 cells/μL).

Conclusions—Camelids with proximal obstruction often had hypochloremic metabolic alkalosis. Camelids with distal obstruction had less metabolic derangement and tissue compromise and a higher survival rate.

Clinical Relevance—Awareness of the characteristics of the various types of acute gastrointestinal disease in camelids will augment veterinarians' ability to diagnose and treat these disorders.
A Modified Technique for Extensive Large Colon Resection and Anastomosis in Horses
Authors: HUGHES FAITH E. , SLONE DONNIE E.
Published: February 2008

Objective—To describe an alternative technique for large colon resection and anastomosis in horses.

Study Design—Retrospective study of clinical patients.

Animal Population—37 horses that had ventral midline celiotomies between July 1, 1990, and July 1, 1994.

Methods—Large colon resection and anastomosis was performed using a modification of previously described techniques. Modifications include mesocolon ligation with a stapling device and an end‐to‐end apposition of the right ventral and right dorsal colon.

Results—Twenty‐one of the 37 horses were discharged from the hospital without complications. Two horses were euthanatized immediately after recovery from anesthesia because of hindlimb fracture. Fourteen horses were euthanatized in the initial postoperative period because of persistent endotoxemia and abdominal pain.

Conclusions—The described technique is a safe, reliable method for large colon resection and anastomosis in horses.

Clinical Relevance—The described technique is fairly simple to perform and requires less surgical time compared with other techniques.
Effect of Omentectomy on Adhesion Formation in Horses
Authors: KUEBELBECK K. LEANN , SLONE DONNIE E. , MAY KIM A.
Published: February 2008

Objective—To determine if omentectomy would decrease the frequency of postoperative intraabdominal adhesions.

Study Design—Retrospective study.

Animals or Sample Population—44 horses that had either two ventral median celiotomies or a ventral median celiotomy and a necropsy more than 4 days later; 19 of these horses had their omentum removed at the initial surgery.

Methods—Data retrieved from the records included location and type of intraabdominal adhesions; location of the surgical lesion; relationship of adhesions to the surgical lesion; surgical procedures; duration of initial surgery; time interval between procedures; age, gender, and breed of the horse; and clinical outcome. Fisher's exact test was used to evaluate the association between categorical explanatory and outcome variables. The effect of potential risk factors on the incidence rate of adhesion formation was estimated using a proportional hazards regression model.

Results—Of 25 horses in the nonomentectomy group, 15 (60%) had postoperative adhesions that resulted in the need for a second surgical intervention, whereas of 19 horses that had omentectomy initially, only 4 (21%) had postoperative adhesions that required a second procedure. Rate of adhesion formation was higher in horses that did not have omentectomy initially (incidence ratio rate [IRR], 0.46; 90% confidence interval [CI], 0.18 to 1.19). At initial surgery, 24 horses had a small intestinal lesion, and 20 horses had a large intestinal lesion. Fifteen horses (63%) with small intestinal lesions subsequently developed adhesions compared with four horses (20%) with an initial large intestinal lesion (P= .006). At the second procedure, small intestine lesions were identified in 32 horses and large intestine lesions in 12 horses (1 horse had both small and large intestine lesions), and 1 horse had a gastric lesion. Adhesions were identified as the cause of colic signs in 19 (61%) horses with small intestinal lesions and in none of the horses with large intestine lesions. The frequency of adhesion development leading to colic associated with only the small intestine at the second surgery or necropsy was significantly greater (P= .001) than the frequency only in the large intestine.

Conclusions—Omentectomy reduced the rate of postoperative adhesion formation. Adhesions are more likely to occur after small intestinal surgery and if they do occur likely involve the small intestine.

Clinical Relevance—Omentectomy is a safe procedure and should be considered prophylactically for reduction of adhesion formation after abdominal surgery in horses.
Tenoscopic Anatomy of the Equine Carpal Flexor Synovial Sheath
Authors: SOUTHWOOD LOUISE L. , STASHAK TED S. , KAINER ROBERT A.
Published: February 2008

Objective—To describe the tenoscopic anatomy of the carpal sheath of the flexor tendons (carpal sheath) viewed from a lateral approach.

Study Design—Tenoscopic observation of structures within the carpal sheath subsequently confirmed by dissection.

Animals or Sample Population—12 equine cadaveric forelimbs.

Methods—The limbs were positioned lateral side up with the carpus slightly flexed. After distention of the carpal sheath, a portal for the arthroscope was made approximately 3 cm proximal to the distal radial physis and 2.5 cm caudal to the radius between the tendons of the ulnaris lateralis and lateral digital extensor muscles.

Results—A lateral tenoscopic approach was adequate to identify all structures within the carpal sheath. From proximal to distal, structures identified using this approach were the radial head of the deep digital flexor muscle, accessory ligament of the tendon of the superficial digital flexor muscle, distal radial physis, tendons of the superficial and deep digital flexor muscles, accessory carpal bone, antebrachiocarpal and middle carpal joints, and vincula of the tendon of the deep digital flexor muscle.

Conclusions—A lateral tenoscopic approach offered an easy, repeatable entry into the carpal sheath and allowed good observation of all structures within the sheath except for the medial borders of the tendons of the deep and superficial digital flexor muscles.

Clinical Relevance—Applications of a lateral tenoscopic approach to the carpal sheath include diagnostic procedures, lavage and synovial resection for septic tenosynovitis, desmotomy of the accessory ligament of the tendon of the superficial digital flexor muscle for flexural deformity or tendinitis, and removal of osteochondromas from the distal radial metaphysis.
Comparison of Plasma Fentanyl Concentrations by Using Three Transdermal Fentanyl Patch Sizes in Dogs
Authors: EGGER CHRISTINE M. , DUKE TANYA , ARCHER JOY , CRIBB PETER H.
Published: February 2008

Objective—To compare plasma fentanyl concentrations attained after the application of three transdermal fentanyl patch sizes (50, 75, and 100 μg/hour) in dogs.

Design—Repeated Latin square controlled study.

Animals—Six intact, mixed‐breed adult dogs (2 males, 4 females) weighing 19.9 ± 3.4 kg.

Methods—Each dog was randomly assigned to receive each of three treatments: 50 (P50), 75 (P75), or 100 (P100) μg/hour transdermal patches. Patches were left in place for 72 hours. Jugular venous blood was collected at 1,2, 4, 8, 12, 24, 36, 48, 60, and 72 hours after patch application and for 1, 2, 4, 8, and 12 hours after patch removal. Plasma fentanyl concentrations were measured using a radioimmunoassay technique. After a 96‐hour washout period, each dog was moved to another treatment group and received a different patch size.

Results—The following results were obtained (mean ± SD): average plasma fentanyl concentration from 24 to 72 hours, 0.7 ± 0.2 ng/mL (P50), 1.4 ± 0.5 ng/mL (P75), 1.2 ± 0.5 ng/mL (P100); the total area under the concentration versus time curve (0 hours to infinity), 46 ± 12.2 ng/h/mL (P50), 101.2 ± 41.4 ng/h/mL (P75), 80.4 ± 38.3 ng/h/mL (P100); and the apparent elimination half‐life, 3.6 ± 1.2 hours (P50), 3.4 ± 2.7 hours (P75), and 2.5 ± 2.0 hours (P100). There was a high degree of variability in plasma fentanyl concentrations achieved. Plasma fentanyl concentrations declined rapidly after patch removal.

Conclusions—The attainment of steady‐state plasma concentrations takes up to 24 hours, and there is a great deal of variability in the final concentrations reached in different individuals. In this study, the 100 μg/hour patches did not provide statistically increased plasma concentrations when compared with the 50 μg/hour patches.

Clinical Relevance—Because of the interindividual and intraindividual variation in plasma fentanyl concentrations, patches should be applied 24 hours before the anticipated time that analgesia will be required. Adequacy of analgesia and potentially deleterious side effects, such as sedation and respiratory depression, should be monitored while the patches are in place. Skin reactions may occur, and the patches should be removed if such skin irritation is seen. After the patch is removed, it is expected that analgesia will wane rapidly because of the brief elimination half‐life.
Congenital Interruption of the Portal Vein and Caudal Vena Cava in Dogs: Six Case Reports and a Review of the Literature
Authors: HUNT GERALDINE B. , BELLENGER CHRISTOPHER R. , BORG RICHARD , YOUMANS K. RUTH , TISDALL PENELOPE L.C. , MALIK RICHARD
Published: February 2008

Objective—To describe six dogs with congenital abnormalities involving the portal vein, caudal vena cava, or both.

Animals—Six client‐owned dogs with congenital interruption of the portal vein or the caudal vena cava, or both.

Methods—Portal vein and caudal vena cava anatomy was evaluated by contrast radiography and visualization at surgery. Vascular casts or plastinated specimens were obtained in three animals.

Results—Portal blood shunted into the caudal vena cava in four dogs and the left hepatic vein in one. Two of these five dogs also had interruption of the caudal vena cava with continuation as azygous vein, as did an additional dog, in which the portal vein was normally formed. Portal vein interruption was present in 5 of 74 (6.8%) dogs with congenital portosystemic shunts evaluated at the Veterinary Teaching Hospital during the study period.

Conclusions—Serious malformations of the abdominal veins were present in more than 1 in 20 dogs with single congenital portosystemic shunts.

Clinical Relevance—Veterinarians involved in diagnosis and surgery for portosystemic shunts should be aware of these potential malformations, and portal vein continuity should be evaluated in all dogs before attempting shunt attenuation.
Results of Transsphenoidal Hypophysectomy in 52 Dogs With Pituitary‐Dependent Hyperadrenocorticism
Authors: MEIJ BJÖRN P. , VOORHOUT GEORGE , INGH TED S.G.A.M. VAN DEN , HAZEWINKEL HERMAN A.W. , RIJNBERK AD
Published: February 2008

Objective—To evaluate microsurgical transsphenoidal hypophysectomy in dogs with pituitary‐dependent hyperadrenocorticism (PDH).

Study Design—Prospective study to evaluate the results (survival and disease‐free interval, remission, recurrence) and complications of microsurgical transsphenoidal hypophysectomy by clinical follow‐up, computed tomography (CT), and urinary corticoid‐to‐creatinine (C/C) ratios in dogs with PDH. The effect of surgical experience was investigated by comparing results of hypophysectomy cases 1 through 26 and 27 through 52.

Animals or Sample Population—52 dogs with PDH.

Results—Preoperative CT enabled accurate assessment of pituitary size (24 nonenlarged and 28 enlarged) and localization relative to intraoperative anatomic landmarks. Treatment failures included procedure‐related mortalities (five dogs) and incomplete hypophysectomies (four dogs). The 1‐year estimated survival rate was 84% (95% confidence interval [CI], 71% to 92%). The 2‐year estimated survival rate was 80% (95% CI, 65% to 90%). In 43 dogs, the hyperadrenocorticism went into remission. Hyperadrenocorticism recurred in five dogs. The 1‐year estimated relapse‐free fraction was 92% (95% CI, 76% to 97%). The main complications were transient, mild, postoperative hypernatremia; transient reduction or cessation of tear production (25 eyes in 18 dogs); permanent (five dogs) or prolonged (nine dogs) diabetes insipidus; and secondary hypothyroidism. Normal tear production had resumed in all but one case after a median period of 10 weeks. In the second case series (27 through 52), the hospitalization period was shorter, the number of dry eyes fewer, the survival fraction greater, and the postoperative mortality lower than in the first series. In 15 dogs in which remission was obtained, postoperative CT images suggested the presence of small pituitary remnants; in 1 of these, hyperadrenocorticism recurred. In 46 dogs, the histological diagnosis was pituitary adenoma.

Conclusions—Microsurgical transsphenoidal hypophysectomy in dogs with PDH is an effective method of treatment in specialized veterinary institutions having access to advanced pituitary imaging techniques. Postoperative CT findings do not correlate well with remission or subsequent recurrence of hyperadrenocorticism.

Clinical Relevance—The neurosurgeon performing hypophysectomies must master a learning curve and must be familiar with the most frequent complications of the operation to recognize them as early as possible and to treat them immediately and effectively. Urinary C/C ratios are sensitive indicators for the assessment of remission and recurrence of hyperadrenocorticism.
Prognosis Factors for Survival in Cats After Removal of a Primary Lung Tumor: 21 Cases (1979–1994)
Authors: HAHN KEVIN A. , McENTEE MICHAEL F.
Published: February 2008

Objective—To identify possible prognostic factors for survival time in cats with a primary lung tumor after surgical excision.

Study Design—Retrospective clinical study.

Animal Population—21 cats with histologically confirmed primary lung tumors removed surgically.

Methods—Medical records for cats treated between 1979 and 1994 at 14 participating veterinary referral hospitals were reviewed.

Results—After surgical resection and recovery, 18 cats died from metastatic disease with a median survival time of 115 days (range, 13 to 1,526 days). Three cats were lost to follow‐up at 119 days, 251 days, and 410 days after the surgical procedure. Contingency table analysis to determine if an association existed between clinical findings (breed, age, gender, body weight, clinical signs, duration of clinical signs, and radiographic findings) or histological features and survival time was performed. Only histological morphology of the primary lung tumor showed a significant association with survival time. Twelve cats with moderately differentiated tumors had a significantly longer survival time (median, 698 days; range, 19 to 1,526 days) than the nine cats with poorly differentiated tumors (median, 75 days; range, 13 to 634 days).

Conclusions—Surgical resection of a solitary primary lung tumor in cats is indicated.

Clinical Relevance—A poor prognosis for long‐term survival is warranted for those cats having a poorly differentiated primary lung tumor.
Changes in Third Carpal Bone Articular Cartilage After Synovectomy in Normal and Inflamed Joints
Authors: PALMER JAN L. , BERTONE ALICIA L. , MALEMUD CHARLES J. , MANSOUR JOSEPH
Published: February 2008

Objective—To determine if arthroscopic synovectomy in normal and inflamed joints had temporal or site‐related effects on articular cartilage.

Study Design—Alterations in equine third carpal bone articular cartilage were studied at two time periods: groups 1 and 2 (6 weeks) and groups 3 and 4 (2 weeks) after synovectomy in normal (groups 2 and 4) and inflamed carpi (groups 1 and 3).

Animal Population—16 carpi from eight horses.

Methods—Biochemical and biomechanical properties of dorsal and palmar articular cartilage were determined by radiolabeling, proteoglycan (PG) extraction, chromatography, electrophoresis, and indentation testing.

Results—Synovectomy in inflamed joints produced the greatest concentration of newly synthesized PG in articular cartilage by 2 weeks. Synovectomy in normal joints produced significantly greater newly synthesized PG in articular cartilage by 6 weeks. Endogenous PG was only significantly greater in inflamed joints after 6 weeks. Dorsal sites had greater newly synthesized and endogenous PG in some groups. Chromatographic profiles of newly synthesized PG demonstrated early and late PG peaks. Electrophoresis of late PG peak showed a toluidine blue‐positive band that comigrated with human A1D1 PG monomer in the two groups with the most newly synthesized PG. This band was reactive with monoclonal antibody 1C6 specific for the hyaluronic acid‐binding region of aggrecan. For the material properties evaluated, only Poisson's ratio was significantly decreased between groups as a function of time (6 weeks < 2 weeks), and this was most pronounced in the thicker dorsal sites.

Conclusions—Synovectomy in inflamed joints produced site‐specific, significantly greater responses in articular cartilage as compared with synovectomy in normal joints.

Clinical Relevance—Synovectomy may not be beneficial to the articular cartilage in inflamed joints.
Incomplete Oblique Sagittal Fractures of the Dorsal Cortex of the Third Metacarpal Bone in Six Horses
Authors: WATT BRUCE C. , FOERNER JOSEPH J. , HAINES GREG R.
Published: February 2008

Objective—To describe incomplete oblique sagittal dorsal cortical fractures of the equine third metacarpal bone, their surgical repair, and subsequent performance of the horses.

Study Design—Retrospective examination of medical records and racing performance.

Animal Population—Six Thoroughbred race horses, 2 to 4 years of age.

Methods—Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery.

Results—Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery.

Conclusions—Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis.

Clinical Relevance—Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures.
A Biomechanical Evaluation and Assessment of the Accuracy of Reduction of Two Methods of Acetabular Osteotomy Fixation in Dogs
Authors: STUBBS W. PRESTON , LEWIS DANIEL D. , MILLER GARY J. , QUARTERMAN CHARLES , HOSGOOD GISELLE
Published: February 2008

Objective—To compare the accuracy of reduction, biomechanical characteristics, and mode of failure of two methods of acetabular osteotomy repair.

Study Design—Acetabular osteotomies were created in 16 paired hemipelves and stabilized with a screw/wire/polymethylmethacrylate composite fixation technique (SWP) or a 2‐mm veterinary acetabular plate (VAP). Eight intact hemipelves were used as controls.

Sample Population—Twelve canine cadavers.

Methods—Accuracy of osteotomy reduction was evaluated grossly and by measurement of articular incongruencies formed in polyvinylsiloxane impression casts. Acetabula were loaded in modified bending until failure using a universal testing machine. Data from load‐deformation curves were used to determine the biomechanical characteristics of the repaired and intact acetabula. Mode of failure was evaluated grossly and radiographically.

Results—Osteotomy reduction was superior in acetabula stabilized with SWP. Mean values ± standard deviation for load at failure and stiffness of the intact acetabula were 2,796 ± 152.9 N and 267.5 ±61.9 N/mm. Corresponding values for SWP and VAP were 1,192 ± 202.7 N and 136.3 ± 76.5 N/mm, and 1,100.5 ± 331.6 N and 110.0 ± 51.3 N/mm, respectively. The mean load at failure and stiffness of intact acetabula was significantly greater than acetabula stabilized with SWP or VAP. There was no significant difference between SWP and VAP for load at failure or stiffness. Failure of acetabula stabilized with SWP occurred by fracture of the polymethylmethacrylate and ventrolateral bending of the wires. Acetabula stabilized with VAP failed by ventrolateral twisting of the plate and bending of the caudal screws.

Conclusions—SWP and VAP provide comparable rigidity, however, the SWP facilitates more accurate osteotomy reduction.

Clinical Relevance—These findings support the use of the SWP technique as an alternative method of acetabular fracture repair.
Recovery From Sevoflurane Anesthesia in Horses: Comparison to Isoflurane and Effect of Postmedication With Xylazine
Authors: MATTHEWS NORA S. , HARTSFIELD SANDEE M. , MERCER DANA , BELEAU M. H. , MACKENTHUN ARDEN
Published: February 2008

Objective—To compare recovery from sevoflurane or isoflurane anesthesia in horses.

Study Design—Prospective, randomized cross‐over design.

Animals—Nine Arabian horses (3 mares, 3 geldings, and 3 stallions) weighing 318 to 409 kg, 4 to 20 years old.

Methods—Horses were anesthetized on three occasions with xylazine (1.1 mg/kg), Diazepam (0.03 mg/kg intravenously [IV]), and ketamine (2.2 mg/kg IV). After intubation, they were maintained with isoflurane or sevoflurane for 90 minutes. On a third occasion, horses were maintained with sevoflurane and given xylazine (0.1 mg/kg IV) when the vaporizer was turned off. Horses were not assisted in recovery and all recoveries were videotaped. Time to extubation, first movement, sternal, and standing were recorded as was the number of attempts required to stand. Recoveries were scored on a 1 to 6 scoring system (1 = best, 6 = worst) by the investigators, and by three evaluators who were blinded to the treatments the horses received. These blinded evaluators assessed the degree of ataxia present at 10 minutes after each horse stood, and recorded the time at which they judged the horse to be ready to leave the recovery stall.

Results—Mean times (± SD) to extubation, first movement, sternal, and standing were 4.1 (1.7), 6.7 (1.9), 12.6 (4.6), and 17.4 (7.2) minutes with isoflurane; 3.4 (0.8), 6.6 (3.1), 10.3 (3.1), and 13.9 (3.0) minutes with sevoflurane; and 4.0 (1.2), 9.1 (3.3), 13.8 (6.5), and 18.0 (7.1) with sevoflurane followed by xylazine. Horses required a mean number of 4 (2.3), 2 (0.9), and 2 (1.6) attempts to stand with isoflurane, sevoflurane, and sevoflurane followed by xylazine respectively. The mean recovery score (SD) for isoflurane was 2.9 (1.2) from investigators and 2.4 (1.1) from blinded evaluators. For sevoflurane, the mean recovery score was 1.7 (0.9) from investigators and 1.9 (1.1) from evaluators, whereas the recoveries from sevoflurane with xylazine treatment were scored as 1.7 (1.2) from investigators and 1.7 (1.0) from blinded evaluators. Conclusions—Recoveries appeared to vary widely from horse to horse, but were significantly shorter with sevoflurane than isoflurane, although sevoflurane followed by xylazine was no different from isoflurane. Under the conditions of the study, recoveries from sevoflurane and sevoflurane followed by xylazine were of better quality than those from isoflurane.

Clinical Relevance—Sevoflurane anesthesia in horses may contribute to a shorter, safer recovery from anesthesia.
Endoscopy of the Calcaneal Bursa in Horses
Authors: INGLE‐FEHR JOANNE E. , BAXTER GARY M.
Published: February 2008

Objective—To describe endoscopic approaches to the calcaneal bursa and clinical findings in 2 horses with calcaneal bursitis.

Study Design—Cadaver evaluations and retrospective case reports.

Animals—12 cadavers and 2 adult horses.

Methods—Cadaver specimens of the calcaneal bursa were evaluated with a rigid arthroscope and gross dissection to determine the endoscopic appearance of anatomic structures located within the bursa. The site(s) for placement of the arthroscope and instrument(s) was determined based on cadaver dissection and endoscopic examination.

Results—Placement of the arthroscope 1 cm dorsal to the superficial digital flexor tendon (SDFT) and 1 cm distal to the medial or lateral aspect of the SDFT retinaculum allowed consistent examination of the tuber calcis, proximal aspect of the long plantar ligament, calcaneal tendon of the gastrocnemius muscle inserting on the tuber calcis, SDFT and the proximal and distal extent of the bursa. Lesions observed and treated with use of endoscopy included local bone necrosis of the proximoplantar aspect of the tuber calcis and damage of the origin of the long plantar ligament in one horse. Mild disruption of the superficial digital flexor tendon and long plantar ligament were observed and debrided in another horse.

Conclusions—Endoscopic exploration of the calcaneal bursa is clinically feasible to treat infectious and noninfectious bursitis and to help identify the cause(s) of undiagnosed bursitis or lameness associated with the calcaneus, superficial digital flexor tendon, tendon of the gastrocnemius muscle, and the long plantar ligament.

Clinical Relevance—An endoscopic approach to the calcaneal bursa is recommended whenever possible to decrease complications associated with surgery in this region and improve the diagnosis of infectious and non‐infectious calcaneal bursitis.
Gadolinium‐Based Coronary Angiography in Patients with Contraindication for Iodinated X‐Ray Contrast Medium: A Word of Caution
Authors: KÄLSCH H. , KÄLSCH T. , EGGEBRECHT H. , KONORZA T. , KAHLERT P. , ERBEL R.
Published: February 2008

Background: In coronary angiography, the use of contrast agents containing iodine still defines the gold standard. In patients with contraindications for iodine exposition, gadolinium has been considered to be a safe alternative to standard iodinated contrast medium
for coronary angiography. The aim of the present study was to assess the safety and technical quality of gadolinium‐based coronary angiography.

Methods: Nineteen consecutive patients with contraindication to iodinated contrast medium underwent gadolinium‐based coronary angiography. Contraindications included previous anaphylactic shock or severe allergic reaction to iodinated contrast medium (n = 13) or thyrotoxicosis (n = 6). Gadolinium was diluted 1:1 with sodium chloride before application. Patients were clinically observed for potential side effects, and renal function was assessed by determination of creatinine values and calculation of creatinine clearance in pre‐ and postprocedural blood samples. Image quality was evaluated by two independent observers, and classified into three different categories (grade 1, high diagnostic quality; grade 2, moderate diagnostic quality; and grade 3, poor quality).

Results: During angiography, a mean of 32.6 ± 10.9 mL (range 10–45 mL) gadolinium was used. No patient developed a significant impairment of renal function within 24 hours after the examination (mean creatinine value preprocedural: 1.12 ± 0.15 mg/dL, postprocedural: 6 hours 1.15 ± 0.18 mg/dL, 24 hours 1.13 ± 0.16 mg/dL) (baseline vs. 6 hours P = 0.23, baseline vs. 24 hours P = 0.66, 6 hours vs. 24 hours P = 0.12) (mean creatinine clearance preprocedural: 73.8 ± 18 mg/dL, postprocedural: 6 hours 71.7 ± 16.8 mg/dL, 24 hours 73.2 ± 17.8 mg/dL) (baseline vs. 6 hours P = 0.2, baseline vs. 24 hours P = 0.71, 6 hours vs. 24 hours P = 0.21). Four patients (21%) suffered severe complications due to gadolinium application, such as malignant cardiac arrhythmias (n = 3) and hemodynamic decompensation (n = 1). Image quality was generally reduced in comparison to iodine contrast coronary angiography, but was adequate for diagnostic purposes (13 patients [68.4%] had reasonably good picture contrast [grade 2.1 ± 0.3]; in 6 patients [31.6%], image quality was satisfactory [grade 2.6 ± 0.13]). Opacification of distal vessels as compared to proximal segments was remarkably reduced.

Conclusions: Gadolinium‐based coronary angiography is a potential alternative technique in patients with allergy to iodinated contrast medium or thyrotoxicosis with reduced, but acceptable, image quality for diagnostic purposes. Nevertheless, possible life‐threatening side effects and complications have to be considered.
Incorporation of Galvanic Waste (Cr, Ni, Cu, Zn, Pb) in a Soda–Lime–Borosilicate Glass
Authors: Silva Antonio C. , Mello‐Castanho Sonia , Guitian Francisco , Montero Isabel , Esteban‐Cubillo Antonio , Sobrados Isabel , Sanz Jesus , Moya Jose S.
Published: February 2008

In the present investigation, a glassing process for galvanic waste (GW) incorporation with a high chemical stability is presented. Glasses with up to 50 wt% of galvanic solid waste by modifications in the basic composition of soda–lime–borosilicate glasses were prepared. After fusing at temperatures up to 1300°C, the glasses were characterized by inductively coupled plasma, scanning electron microscopy/energy‐dispersive X‐ray spectroscopy, high‐temperature microscopy, transmission and reflected light microscopy, nuclear magnetic resonance, X‐ray photoelectron spectroscopy, and X‐ray diffraction methods. The chemical stability was evaluated by hydrolytic attack assays. Glasses containing up to 40 wt% of GW with a very high chemical stability, similar to bottle glasses, were obtained.
Effect of the Machining Method on the Catalycity and Emissivity of ZrB2 and ZrB2–HfB2‐Based Ceramics
Authors: Scatteia Luigi , Alfano Davide , Monteverde Frederic , Sans Jean‐Louis , Balat‐Pichelin Marianne
Published: February 2008

The emissivity and the catalytic efficiency related to atomic oxygen recombination were investigated experimentally in the range 1000–2000 K for ZrB2 and ZrB2–HfB2‐based ceramics. In order to evaluate the effect of the machining method, two series of samples, one prepared by electrical discharge machining and the other machined by diamond‐loaded tools, were tested. High emissivity (about 0.7 at 1700 K) and low recombination coefficients (on average 0.08 at 1800 K) were found for all the materials. The experimental data showed an effect of the surface machining on the catalytic behavior only on the ZrB2‐based composite; conversely, small variations were found in the recombination coefficients of ZrB2–HfB2‐based samples for the different machining processes. The surface finish affected the emissivity at lower temperatures in both compositions, with the effect becoming negligible at temperatures above 1500 K.
Introduction of a Stat Laboratory Reduces Emergency Department Length of Stay
Authors: Singer Adam J. , Viccellio Peter , Thode Henry C. , Bock Jay L. , Henry Mark C.
Published: February 2008

Objectives: Emergency department (ED) length of stay (LOS) impacts patient satisfaction and overcrowding. Laboratory turnaround time (TAT) is a major determinant of ED LOS. The authors determined the impact of a Stat laboratory (Stat lab) on ED LOS. The authors hypothesized that a Stat lab would reduce ED LOS for admitted patients by 1 hour.

Methods: This was a before‐and‐after study conducted at an academic suburban ED with 75,000 annual patient visits. All patients presenting to the ED during the months of August and October 2006 were considered. A Stat lab located within the central laboratory was introduced in September 2006 to reduce laboratory TAT. The test TATs and ED LOS before (August 2006) and after (October 2006) implementing the Stat lab for all ED patients were the data of interest. ED LOS before and after the Stat lab was introduced was compared with the Mann‐Whitney U‐test. A sample size of 5,000 patients in each group had 99% power to detect a 1‐hour difference in ED LOS.

Results: There were 5,631 ED visits before and 5,635 visits after implementing the Stat lab. Groups were similar in age (34 years vs. 36 years) and gender (51% males in both). The percentages of patients with laboratory tests before and after Stat lab implementation were 68.7 and 71.3%, respectively. Test TATs for admitted patients were significantly improved after the Stat lab introduction. Implementation of the Stat lab was associated with a significant reduction in the median ED LOS from 466 (interquartile range [IQR] = minutes before to 402 (IQR = 296–553) minutes after implementing the Stat lab. The effects of the Stat lab on ED LOS were less marked for discharged patients.

Conclusions: Introduction of a Stat lab dedicated to the ED within the central laboratory was associated with shorter laboratory TATs and shorter ED LOS for admitted patients, by approximately 1 hour.
On‐call Specialists and Higher Level of Care Transfers in California Emergency Departments
Authors: Menchine Michael D. , Baraff Larry J.
Published: February 2008

Objectives:  To survey California emergency department (ED) medical directors’ impressions of on‐call specialist availability and higher level of care (HLOC) transfer needs and difficulties and changes since the passage of the Emergency Medicine Treatment and Active Labor Act (EMTALA) final rule in 2003.

Methods:  The authors conducted a survey of all California ED medical directors from February to June 2006 with regard to the composition of the ED on‐call panel and need for HLOC transfer. ED demographic data were obtained from the California Office of Statewide Health Planning and Development.

Results:  Overall response rate was 243 of 347 (70%). More than 80% of respondent EDs reported having internal medicine, obstetrics/gynecology (OB/GYN), and pediatrics on call. However, fewer than 60% of EDs reported cardiac surgery, otolaryngology, neurosurgery, plastic surgery, or vascular surgery on call. Specialists were less likely to be on call in rural EDs. On‐call coverage was rated worse than 3 years ago for 10 of 16 specialties. Rural EDs were more likely, and trauma centers and teaching hospitals were less likely to transfer at least one patient daily for HLOC. ED medical directors reported that the ability to transfer for HLOC has worsened over the past 3 years for all specialties. Respondents indicated that more than 40% of ear, nose, and throat (ENT), orthopedics, plastic surgery, and mental health HLOC transfers take more than 3 hours.

Conclusions:  This survey of California ED medical directors suggests ED on‐call specialist availability and the ability to transfer for HLOC have worsened since the passage of the EMTALA final rule in 2003.
Reduced CD26bright expression of peripheral blood CD8+ T‐cell subsets in psoriatic patients
Authors: Van Lingen Rosanne G. , Van De Kerkhof Peter C. M. , De Jong Elke M. G. J. , Seyger Marieke M. B. , Boezeman Jan B. M. , Van Erp Piet E. J.
Published: February 2008

Abstract:  Background:  T cells have been shown to be highly relevant in psoriasis. CD26 is a novel T‐cell activation marker involved in various T‐cell functions, e.g. (i) co‐stimulation, (ii) migration and (iii) T‐cell memory response. In particular, CD26bright peripheral blood T cells have been shown to be altered in several autoimmune diseases.

Objective:  To characterize CD26‐expression of T‐cell subsets in psoriatic patients compared to healthy subjects.

Methods:  Peripheral blood was obtained from 15 untreated patients with severe psoriasis and from nine healthy subjects. The presence of specific CD26‐related T‐cell subsets was assessed by flow cytometry.

Results:  The CD26bright expression of CD8+ lymphocytes revealed a statistically significant (P<0.05) decrease in psoriatic patients. The majority of CD4+CD26bright cells are CD45RO+, whereas the minority of CD8+CD26bright cells are CD45RO+ in both groups.

Conclusions:  The present study demonstrates that the CD8CD26bright T‐cell population is markedly decreased in peripheral blood of psoriatic patients. Moreover, CD26 expression did not show a restriction to memory T cells. As CD26 is of relevance for T‐cell functions, future investigations should focus on elucidating these functions in psoriasis. It is attractive to speculate that the reduction in the CD8CD26bright subpopulation may represent a biomarker for recompartimentalization of activated T cells and a reduced CD8CD26bright count may correlate with increased responsiveness to T‐cell targeted treatments.
The skin as a mirror of the soul: exploring the possible roles of serotonin
Authors: Nordlind Klas , Azmitia Efrain C. , Slominski Andrzej
Published: February 2008

Abstract:  Serotonin (5‐hydroxytryptamine; 5‐HT) is an important mediator of bidirectional interactions between the neuroendocrine system and the skin. The rate of synthesis of 5‐HT from l‐tryptophan can be enhanced by brain‐derived neuronal growth factor, cytokines, exposure to ultraviolet light and steroids. The major source of 5‐HT in the skin are platelets, which, upon aggregation, release this biogenic amine. Moreover, the epidermal and dermal skin express the enzymes required for the transformation of tryptophan to 5‐HT, and certain skin cells, such as melanocytes, have been demonstrated to produce 5‐HT. In addition, rodent mast cells produce 5‐HT, but human mast cells have not yet been fully examined in this respect. Skin cells express functionally active, membrane‐bound receptors for 5‐HT, as well as proteins that transport 5‐HT. The interactions of 5‐HT with these various proteins determines the nature, magnitude and duration of serotonergic responses. The immune and vasculature systems in the skin are traditional targets for bioregulation by 5‐HT. Moreover, recent findings indicate that keratinocytes, melanocytes and dermal fibroblasts also respond to this amine in various ways. Thus, mammalian skin is both a site for the production of and a target for bioregulation by 5‐HT. This indicates that agonists and antagonists directed towards specific 5‐HT receptors could be useful in connection with treatment of skin diseases. Based on our increasing knowledge concerning these receptors and their plasticity, future research will focus on the development of serotonergic drugs that exert metabotrophic effects on the cells of the skin without affecting the central nervous system.
Alternative use of food resources causes intra‐cohort variation in the size distribution of young‐of‐the‐year perch (Perca fluviatilis)
Authors: Urbatzka R. , Beeck P. , Van Der Velde G. , Borcherding J.
Published: February 2008

Abstract –  Body sizes of young‐of‐the‐year (YOY) perch (Perca fluviatilis) at the end of their first summer are extremely variable and range in different studies between 4 and 15 cm. To analyse whether size divergences in YOY perch may be attributed to alternative use of food resources, adult perch were stocked into two previously fishless ponds and growth, size distribution and food intake of the YOY perch were recorded. In addition to perch, adult bream (Abramis brama) were introduced to produce juvenile bream that could serve as a food resource for YOY perch. The body sizes of YOY perch at the end of the experiment ranged from 32 to 168 mm with a bimodal size distribution. The combination of stomach content analyses and stable isotope signatures revealed that the small size cohort were planctivorous/benthivorous while the large size cohort was piscivorous/cannibalistic. Results implicated that different feeding behaviour contributed to the size divergences in YOY perch and that the extreme growth of the large size cohort was induced by piscivory.
Larval and juvenile Australian smelt Retropinna semoni somatic and otolith growth parameters – implications for growth interpretation of wild fish
Authors: Tonkin Z. D. , Ramsey D. S. L. , King A. J.
Published: February 2008

Abstract –  Relationships between fish length, otolith size, age and weight were assessed for a population of wild Australian smelt (Retropinna semoni) larvae and juveniles captured over a 4‐year period to aid further interpretation of growth and condition during the early life history of the species. Nonlinear smoothed generalized additive models best described the fish–otolith size relationship during the larval and juvenile period, indicating that the proportionality between fish length and otolith size varies in relation to size. It is proposed that back‐calculated predictions of fish size at a previous age or otolith size, accounting for individual variation is possible by assuming a body proportional hypothesis. Growth rate of larval and juvenile Australian smelt was best described using the Gompertz model that indicated a steady decline in growth rate after around 30 days of age. The allometric growth of larval and juvenile Australian smelt established from the length/weight relationship can subsequently be used to assess the condition of fish within this population using a relative condition or relative weight condition index. The results of the study have provided significant information to enable more precise growth reconstruction and condition assessment for the species in Australian lowland rivers.
Reactive hyperplasias,precancerous and malignant lesions of the oral mucosa
Authors: Krahl Dieter , Altenburg Andreas , Zouboulis Christos C.
Published: February 2008

The oral cavity contains many organs and tissues compressed in a small area. Accordingly oral tumors have a wide variety of appearances. Reactive hyper‐plastic lesions include epulis,morsicatio,traumatic ulcer or palatal hyperplasia. These benign lesions must be separated clinically and histologically from precancerous and neoplastic lesions. In leukoplakia,the individual risk can be estimated by clinical signs. Nevertheless histopathology is mandatory because precancerous lesions usually precede or accompany most oral cancers. Amalgam tattoo,oral nevi and melanoacanthoma have to be considered as differential diagnoses of oral melanoma. Accurate clinico‐pathological diagnosis is mandatory to insure appropriate therapy. Oral soft tissue tumors such as Kaposi sarcoma and multiple mucosal neuromas in MEN 2b require interdisciplinary management. Diseases affecting the minor salivary glands which may be encountered by dermatologists include mucocele, necrotizing sialometa‐plasia,and tumors such as pleomorphic adenoma.
Oral Delivery of 1,3‐Dicyclohexylurea Nanosuspension Enhances Exposure and Lowers Blood Pressure in Hypertensive Rats
Authors: Ghosh Sarbani , Chiang Po‐Chang , Wahlstrom Jan L. , Fujiwara Hideji , Selbo Jon G. , Roberds Steven L.
Published: February 2008

Abstract:  Cytochrome P450‐derived epoxyeicosatrienoic acids (EET) are biologically active metabolites of arachidonic acid that have potent effects on renal vascular reactivity and tubular ion transport and have been implicated in the control of blood pressure. EETs are hydrolyzed to their less active diols, dihydroxyeicosatrienoic acids (DHET), by the enzyme soluble epoxide hydrolase (sEH). 1,3‐Dicyclohexylurea (DCU), a potent sEH inhibitor, lowers systemic blood pressure in spontaneously hypertensive rats when dosed intraperitoneally. However, DCU has poor aqueous solubility, posing a challenge for in vivo oral delivery. To overcome this limitation, we formulated DCU in a nanosuspension using wet milling. Milling reduced particle size, increasing the total surface area by approximately 40‐fold. In rats chronically infused with angiotensin II, the DCU nanosuspension administered orally twice daily for 4 days produced plasma exposures an order of magnitude greater than unmilled DCU and lowered blood pressure by nearly 30 mmHg. Consistent with the mechanism of sEH inhibition, DCU increased plasma 14,15‐EET and decreased plasma 14,15‐DHET levels. These data confirm the antihypertensive effect of sEH inhibition and demonstrate that greatly enhanced exposure of a low‐solubility compound is achievable by oral delivery using a nanoparticle drug delivery system.