bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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

AbstractObjectives: 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

AbstractObjectives:  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.