South American camelids in the United Kingdom: population statistics, mortality rates and causes of death

A survey of the health of South American camelids in the United Kingdom was carried out between December 1992 and June 1993; 123 members of the British Camelid Owners and Breeders Association and 19 non-members were sent questionnaires and usable responses were received from 84 (59 per cent). In total 689 camelids were included, and in 1992, 66 per cent were Ilama, 21 per cent alpaca and 13 per cent guanaco. Their ages ranged from less than six months to over 10 years, with animals aged two to five years constituting the largest proportion. The mortality rates between 1990 and 1992 were 2.7 to 3.3 per cent for Ilama, 3.5 to 6.9 per cent for alpaca and 0 to 11.4 per cent for guanaco. The highest mortality was in animals less than six months and more than 10 years old; 4 to 11 per cent of Ilama deaths and 17 to 33 per cent of alpaca deaths were in animals aged less than six months and a high proportion of these occurred during the first week of life. In the cases for which a cause was reported, accidents and injury accounted for 20 per cent of Ilama deaths, and perinatal deaths accounted for 22 per cent of alpaca deaths. A third of the deaths were reported as being of unknown cause, and a veterinary diagnosis was reported in less than half of the cases. These data suggest that attention to the environment and housing conditions of Ilama, the neonatal care of alpaca and improvements in diagnosis are priorities for reducing the mortality and improving the health of South American camelids in the UK.     

With reference to: RAYS 21,3,1996 venous thromboembolism

This study evaluated paroxetine as a possible treatment for premature ejaculation. Sixty two patients affected by primary premature ejaculation were randomly assigned to two groups. A and B, and treated with two different treatment schedules. Patients assigned to group A were treated with paroxetine 20 mg p.o. daily for six months; patients assigned to group B were treated with paroxetine 20 mg p.o. daily for fourteen days, and than dose was reduced to 10 mg for a total treatment period of six months. Only one patient reported significative side effects (weakness). Positive clinical results were obtained, at the end of the treatment, in 89 per cent of group A and 88 per cent of group B. In patients with primary premature ejaculation, paroxetine represents, in our opinion, the best therapeutic option for its efficacy and lack of significant side effects.     

Effect of cultured autologous chondrocytes on repair of chondral defects in a canine model

Articular cartilage has a limited capacity for repair. In recent clinical and animal experiments, investigators have attempted to elicit the repair of defects of articular cartilage by injecting cultured autologous chondrocytes under a periosteal flap (a layer of periosteum). The objective of the present study was to determine the effect of cultured autologous chondrocytes on healing in an adult canine model with use of histomorphometric methods to assess the degree of repair. A total of forty-four four-millimeter-diameter circular defects were created down to the zone of calcified cartilage in the articular cartilage of the trochlear groove of the distal part of the femur in fourteen dogs. The morphology and characteristics of the original defects were defined in an additional six freshly created defects in three other dogs. Some residual noncalcified articular cartilage, occupying approximately 2 per cent of the total cross-sectional area of the defect, was sometimes left in the defect. The procedure sometimes damaged the calcified cartilage, resulting in occasional microfractures or larger fractures, thinning of the zone of calcified cartilage, or, rarely, small localized penetrations into subchondral bone. The forty-four defects were divided into three treatment groups. In one group, cultured autologous chondrocytes were implanted under a periosteal flap. In the second group, the defect was covered with a periosteal flap but no autologous chondrocytes were implanted. In the third group (the control group), the defects were left empty. The defects were analyzed after twelve or eighteen months of healing. Histomorphometric measurements were made of the percentage of the total area of the defect that became filled with repair tissue, the types of tissue that filled the defect, and the integration of the repair tissue with the adjacent cartilage at the sides of the defects and with the calcified cartilage at the base of the defect. In histological sections made through the center of the defects in the three groups, the area of the defect that filled with new repair tissue ranged from a mean total value of 36 to 76 per cent, with 10 to 23 per cent of the total area consisting of hyaline cartilage. Integration of the repair tissue with the adjacent cartilage at the edges of the defect ranged from 16 to 32 per cent in the three groups. Bonding between the repair tissue and the calcified cartilage at the base of the defect ranged from 41 to 89 per cent. With the numbers available, we could detect no significant difference among the three groups with regard to any of the parameters used to assess the quality of the repair. In the two groups in which a periosteal flap was sutured to the articular cartilage surrounding the defect, the articular cartilage showed degenerative changes that appeared to be related to that suturing.     

The histological response to chemotherapy as a predictor of the oncological outcome of operative treatment of Ewing sarcoma

Seventy-four patients who had a Ewing sarcoma of bone were managed with preoperative and postoperative chemotherapy and operative resection, with or without postoperative irradiation. The primary objectives of the study were to determine the histological response to preoperative chemotherapy in terms of the percentage of tumor necrosis and to assess the relationship between the histological response and the oncological outcome. The minimum duration of follow-up of the surviving patients who were continuously free of disease was five years. Sections of each operative specimen were examined, and the histological response to chemotherapy was graded semiquantitatively. Grade I indicated necrosis of 50 per cent of the tumor or less; grade II, necrosis of more than 50 per cent but less than 90 per cent; grade III, necrosis of 90 to 99 per cent; and grade IV, necrosis of 100 per cent of the tumor. Of the seventy-four tumors, forty-four (59 per cent) were exquisitely sensitive to chemotherapy and had complete (grade-IV) or nearly complete (grade-III) necrosis. In contrast, fourteen tumors (19 per cent) had little or no response to chemotherapy (grade I) and sixteen (22 per cent) had a moderate degree of necrosis (grade II). The histological response to preoperative chemotherapy (p = 0.0001), followed by the size of the tumor (p = 0.001), were the most important predictors of event-free survival. At five years, the rate of event-free survival was zero of fourteen patients who had had a grade-I response, six of sixteen who had had a grade-II response, and thirty-seven (84 per cent) of forty-four who had had a grade-III or IV response. The risk of local recurrence was most strongly associated with the operative margins; there were only four local recurrences (6 per cent) after sixty-seven resections with negative margins. Local recurrence may also have been influenced by the histological response and the use of local radiation. There were no local recurrences after operative treatment of six tumors that had been associated with pathological fracture. The histological response to preoperative chemotherapy and the size of the primary tumor are the most important clinical predictors of the outcome of operative treatment of non-metastatic Ewing sarcoma. These indicators should be used to identify patients who are at high risk for metastasis as such patients may be candidates for more intensive or novel therapies.     

Heart valve replacement with the Ionescu-Shiley pericardial xenograft

Between March, 1971, and September, 1975, glutaraldehyde-stabilized pericardial xenografts were used for single valve replacement in.212 patients (142 aortic, 67 mitral, and three tricuspid). The 195 operative survivors were observed for a total of 5,926 months over a period 6 to 61 months (mean 30). actuarial analysis of late results indicates an expected survival rate at 5 years of 92.3 per cent for patients with aortic and 91.1 per cent for patients with valve replacement. The rate of systemic embolism has been 0.62 episodes per 100 patient years for the aortic and 2.48 episodes per 100 patient years for the mitral group in the absence of anticoagulant treatment. All six emboli occurred early postoperatively, were trivial or mild, and left no sequelae. Symptomatically, 96.7 per cent of patients are now in Class I and 3.3 per cent in Class II (N.Y.H.A.). Maintenance of structural and functional integrity of the glutaraldehyde-stabilized pericardial zenograft was demonstrated by histologic and hemodynamic investigations. Catheterization showed substantial circulatory improvement in both patients with aortic and those with mitral replacement. The transaortic gradients were negligible (8 mm. Hg at rest and 17.5 mm. Hg during exercise). The available indicates that results of valve replacement withpericardial xenografts. Over this period of follow-up, compare very favorably with those obtained with other available prostheses and tissue valves.     

Effects of early postoperative 5-fluorouracil and ageing on the healing capacity of experimental intestinal anastomoses

BACKGROUND: Results from a previous study suggested that advanced age does not affect early repair of experimental intestinal anastomoses. The present study aimed to establish whether anastomotic healing is impaired more easily in old animals by immediate postoperative chemotherapy. METHODS: Young adult (2-3 months) and old (27-30 months) rats underwent resection and anastomosis of both ileum and colon. Within each age group, subgroups received intraperitoneal saline or 5-fluorouracil in a dose of 15 or 20 mg per kg per day from the day of operation onwards. After 7 days, anastomotic healing was assessed by wound strength and collagen deposition in the wound area. RESULTS: No differences were found between young and old control groups. The higher dose of fluorouracil induced severe loss of strength with concomitant reduction of wound collagen, which was similar in both age groups (ileum: from 52(13) to 24(8) volume per cent in young animals and from 56(10) to 20(9) volume per cent in old animals; colon: from 58(10) to 37(18) volume per cent in young animals and from 65(5) to 30(17) volume per cent in old animals). The lower dose of fluorouracil induced a significantly greater loss of strength, measured as the bursting pressure, in the old animals (150(49) versus 201(59) mmHg in colon of young rats). CONCLUSION: In this model early anastomotic repair in older animals proceeds normally under optimal conditions, but it is more easily disturbed in the presence of fluorouracil.     

Different acute effects of single-axis and multi-axis hand-arm vibration

The present study was designed to comparatively evaluate the bone-pin interface in a long-term unloaded experimental study in two groups of pins, uncoated and coated with hydroxyapatite. Forty pins made of stainless steel were used. Half of the pins were plasma-sprayed with hydroxyapatite, and the other half remained uncoated. Four adult sheep were selected. Each sheep tibia was implanted with five pins. Two sheep were euthanized 4 months after surgery and the remaining two 12 months after surgery. Extraction torque was higher in the hydroxyapatite-coated pins compared with the uncoated ones at both 4 (p < or = 0.0005) and 12 months (p < or = 0.0005) after implantation. The histological patterns observed in the sheep euthanized 4 and 12 months after implantation were very similar. An extensive bony coverage of the hydroxyapatite-coated pins without any coating resorption and delamination from the metallic substrate was observed. Fibrous tissue encapsulation was found in the uncoated pins. These results demonstrate that the hydroxyapatite coating significantly improved the bone-pin interface. A similar improvement of bone-pin interface rigidity in many clinical situations is likewise possible.     

Mechanics of the external fixation test in the lumbar spine. A roentgen stereophotogrammetric analysis

The subjects of this study were 48 asymptomatic patients who had surgery for small hepatocellar carcinoma (HCC). There were 42 men and six women with mean (s.d.) tumour size of 3.31 (1.46) cm and age 55.0 (7.4) years. Follow-up was for a minimum of 10 years. The main concern of this study was a univariate analysis of factors that might affect long-term survival after surgery, which was 50 per cent at 5 years and 31 per cent at 10 years. A high incidence of recurrent HCC (37 of 48 patients) was observed but reoperation further prolonged life in some cases. The significant prognostic factors detected by multivariate analysis were: histological classification, functional liver reserve and histology of the resection margin. Tumour size, gross appearance of tumour, presence of liver cirrhosis, serum alpha-fetoprotein level, age or sex did not affect the prognosis.     

Effect of carbon disulfide on cholesterol content in rat tissue

The effect of chronic intoxication of rats with CS2 on the level of cholesterol in the body tissues was studied. Prolonged exposure to CS2 vapour results in the increased level of cholesterol in serum. It was interesting to find out whether accumulation of cholesterol occurs subsequently in the body tissues. Studies were performed on male Wistar albino rats exposed to CS2 vapour at concentration 0.8--1 mg/1 during 13 months. The level of cholesterol in the blood, aorta wall, muscles, liver and adipose tissue was estimated after 4, 10 and 13 months of intoxication. Chronic exposure of rats to CS2 vapour causes: (a) loss of body weight about 30 per cent after 10 months of intoxication; (b) increase of concentration of free and esterified cholesterol in the aorta wall about 20 and 63 per cent, whereas in the skeletal muscles about 40 and 80 per cent, after 10 and 13 months of exposure respectively; (c) no changes of the level of cholesterol in the liver. On the base of the results obtained in this study it was concluded, that prolonged exposure to CS2 contributed to accumulation of cholesterol only in some tissues. Changes we found are probably the result of quantitative shift in the redistribution of cholesterol among the tissues.     

Postmortem analysis of bone growth into porous-coated acetabular components

Microradiography, backscattered electron microscopy, and histological analysis were used to conduct a quantitative postmortem study of seven consecutively retrieved anatomical porous replacement acetabular components that had been inserted during total hip arthroplasties. Screws had been used for the initial fixation of six components. The microradiographic analysis of all seven components showed that an average (and standard deviation) of 84 +/- 9 per cent (range, 72 to 93 per cent) of the porous coating was in direct apposition to the periprosthetic bone. The backscattered electron images demonstrated that an average of 12 +/- 6 per cent (range, 4 to 21 per cent) of the space available in the porous coating was occupied by ingrown bone. The amount of bone ingrowth was not significantly different among the three zones delineated by DeLee and Charnley. Uniformity of bone growth into the porous coating suggests that the preferential loading that occurs in the superior region did not differentially affect the bone ingrowth. The present study showed that consistent bone growth into anatomical porous replacement acetabular components can be achieved.     

Relationships between individual differences in salt appetite of sheep and their plasma electrolyte status

A pasture was prepared so that an equilibrium of fresh and ageing eggs of Taenia hydatigena was present. This was done by placing dogs with patent infections on it for six months. Five months after their introduction, groups of lambs were grazed there for two, four, eight, 16 or 32 days. The dogs were then removed. Three and six months later, further groups of sheep were grazed there for a similar period. The infection pressures and the indices of clustering of the eggs were calculated by an examination of the lambs for cysts at autopsy. When the dogs were present, the daily rate of infection was about 60 per cent of the flock. This was reduced to 6.5 per cent then to 3.5 per cent within three and six months respectively after their removal. Very high cyst counts were obtained in some animals and the indices of dispersion diverged from a Poisson model during the period when the lambs were maintained on the pasture in the presence of the dogs. There was a trend for a reduction in the mean cyst counts and the index of dispersion tended to conform more closely to a Poisson model the longer the dogs were excluded. There was also a corresponding reduction in the survival rate of the cysts. It was suggested that an asymptote of less than 100 per cent in the prevalence rate may be accounted for by the acquisition of resistance without the persistence of infection and this was induced in some animals by the initial ingestion of ageing organisms which gradually formed the predominant type after the removal of the dogs from the pasture.     

The effect of splenectomy on alveolar macrophages morphology and function

OBJECTIVE: To study the morphological and functional changes of pulmonary alveolar macrophages of rats after splenectomy, and the applied effects of splenic tissue autotransplantation in practice. METHODS: 87 Wistar rats were randomly divided into shamoperation group, splenectomy group and splenic tissue autotransplantation group. Six months after splenectomy, alveolar macrophges were subjected to brochoalveolar lavage described by Shennib. The dynamic survival and adherent rate of alveolar macrophages in culture, lysosomal enzyme content, hydrogen peroxide production and expression level of interleukin 1 (IL-1) activity of alveolar macrophages were quantitatively measured. The alveolar macrophages ultrastructure was observed by utilizing transmission electron microscope. RESULTS: The splenectomized rat's alveolar macrophages were different from alveolar macrophages of sham-operated rats. Their surface filopodia was reduced and shortened, lysosome fewer and its acid phosphatase quantity decreased, adherence postponed, hydrogen peroxide production and expression of IL-1 activity impaired. Splenic tissue autotransplantation fairly restored the splenic effects on maturation and function of alveolar macrophages. CONCLUSION: Splenic tissue autotransplantation is a simple useful operation for preserving splenic function after splenectomy.     

Longitudinal study of bowel and bladder control by day and at night in the first six years of life. I: Epidemiology and interrelations between bowel and bladder control

The development of bowel and bladder control by day and at night during the first six years of life in 320 Swiss children in the Zurich longitudinal study (1955--1976) is described in detail. A scoring system was used which included intermediate stages of control. With toilet-training started in 96 per cent of the children during the first year of life, bowel control was completed in 32 per cent at age one, in 75 per cent at age two and in 97 per cent at age three. Complete bladder control by day and at night were established in none of the children at age one, in 20 per cent at ages two and three and in 90 per cent at age four. Complete bowel control and complete bladder control by day and at night were found in 5 per cent at age two, in 11 per cent at age three, in 77 per cent at age four and in 91 per cent at age six. The significant relationships between bowel control, bladder control during the day and bladder control at night (p less than 0-001) demonstrate that the same developmental process acts in bowel and bladder control. Highly correlated to each other, first bowel control develops, then bladder control by day and finally bladder control at night. The relevance of these interrelations for toilet-training and for the management of enuretic and encopretic children is discussed.     

Biocompatibility of silicon-based electrode arrays implanted in feline cortical tissue

The passive biocompatibility of silicon-based electrode arrays was studied in feline cortical tissue. Three types of arrays were used: uncoated, coated with polyimide, and coated with polyimide over an adhesion promoter. Fifteen arrays were implanted for 24 h to determine early tissue reaction to the implantation procedure, and twelve arrays were implanted for 6 months to determine structural and material biocompatibility. Edema and hemorrhage were present around the short-term implants, but involved less than 6% of the total area of the tissue covered by the array. With chronic implants, leukocytes were rarely present and macrophages were found around roughly one-third of the tracks. Remnants of foreign material from the electrodes could be identified in less than 10% of the tracks. Gliosis was found around all tracks, forming an annulus between 20 and 40 microns thick. A capsule was not always present, and never exceeded a thickness of 9 microns. These results suggest that the implantation procedure produces limited amounts of tissue damage, and that the arrays are biocompatible. However, the arrays insulated with polyimide over a primer had significantly greater involvement of macrophages, gliosis, and capsule formation than uncoated arrays and arrays insulated with polyimide without printer, perhaps indicating a reaction to aluminum oxide in the primer.     

Domiciliary terminal care: demands on statutory services

The work of a specialist advisory home care service for the terminally ill during 1980 is reported, with reference to the demands it made on community services. Whilst there was no change in demand for home helps, there was a 44 per cent increase in visiting by community nurses for male patients and a 117 per cent increase for female patients. Commodes, ripple mattresses and backrests were all essential and an increased need of over 100 per cent in each was recorded. Patients were attended on average for three months (men) and six months (women) and 41 per cent were able to remain at home until their death.     

Cerebral energy levels during trimethaphan-induced hypotension in the rat: effects of light versus deep halothane anesthesia

Hypotension may be expected to produce less perturbation of metabolism in the brain when cerebral metabolic rate is lowered by deep anesthesia. Male Wistar rats having unilateral carotidartery ligation were exposed to mean arterial pressure (MAP) of 40 torr for 22 min by an intravenous infusion of trimethaphan during anesthesia with halothane, 0.6 or 2 per cent, in oxygen. Cortical tissue metabolite levels on the side of the ligated carotid artery were more abnormal in rats receiving halothane, 0.6 per cent, than in those receiving halothane, 2 per cent. Values at halothane, 0.6 per cent, were adenosine triphosphate (ATP), 1.71 +/- 0.05 (+/-SEM) mumol/g, phosphocreatine (PCr) 1.97 +/- 0.07 mumol/g. and lactate 16.5 +/- 5.1 mumol/g; corresponding values at halothane, 2 per cent, were ATP 2.27 +/- 0.02, PCr 4.02 +/- 0.23, and lactate 4.75 +/- 0.9 mumol/g. ATP and PCr values were significiantly lower (P less than 0.05) and the lactate value was significantly higher with halothane, 0.6 per cent, than with halothane 2 per cent. Cerebral oxygen consumption decreased 47 per cent in rats anesthetized with halothane, 2 per cent. Preservation of cortical metabolite levels in deeply anesthetized animals suggests a protective effect of cerebral metabolic depression.     

Persistence of Ehrlichia phagocytophila infection in lambs in relation to clinical parameters and antibody responses

Five lambs were infected experimentally with Ehrlichia phagocytophila and examined regularly during the next six months. The lambs all had recurrences of parasitaemia at various times but had a fever on only 21 per cent of these occasions. A reduced number of leucocytes was observed in all the lambs for at least eight weeks. All the lambs were still infected four months after inoculation with E phagocytophila. After six months, blood from four of the five lambs was infective when inoculated into susceptible lambs.     

Prenatal ultrasonic diagnosis of obstructive bowel disease: a retrospective analysis

Fetal obstructive bowel disease was diagnosed in 29 patients at 22-37 weeks (median 32 weeks) of gestation, seven (24 per cent) of whom also displayed other anomalies. Polyhydramnios was present in 20/29 cases (69 per cent). An abnormal karyotype existed in 7/29 cases (24 per cent), of which six were diagnosed prenatally (trisomy 21, n = 5; 69,XXX, n = 1) and one postnatally (trisomy 21). There was always an association with the ultrasonic 'double bubble' sign. Obstructive bowel disease was confirmed postnatally in 20/29 (69 per cent) cases, i.e., oesophageal atresia (n = 1), duodenal obstruction (n = 12), and small bowel obstruction (n = 7). Other anomalies existed in 6/29 (21 per cent) cases, i.e., multicystic kidney (n = 1) and multiple congenital anomalies (n = 5). The perinatal mortality rate was 35 per cent (7/20).     

Medical Treatment of ulcerative colitis: overview

Open surgical biopsy has long been the standard of care for the diagnosis of breast pathology. As more lesions are diagnosed by mammography, image-directed core biopsy has taken on increasing importance. This study consisted of a consecutive group of 540 patients who underwent breast biopsy for mammographically or sonographically detected lesions. The percentage of those undergoing image-directed biopsy and open biopsy were determined as well as the rate of positive biopsy for each method. Results showed that for patients with nonpalpable lesions, the proportion of image-directed core biopsies rose steadily during the study period, from 0 per cent in early 1993 to 70.1 per cent by early 1996. During this same period, positive biopsy rate rose from 23.9 to 31.0 per cent in the first 18 months of the study to a range of 45.2 to 48.3 per cent in the last 18 months. It was concluded that image-directed core biopsies have begun to impact the practice of breast surgery by replacing, to a great extent, the open surgical biopsy. This study also demonstrates an increased proportion of positive biopsies done by open surgical technique. It was suggested that many of the mammographically benign lesions are diagnosed by image-directed core biopsy, obviating the need for an open technique. An algorithm for managing nonpalpable breast lesions is presented.     

Obesity and high-density lipoprotein cholesterol in black and white 9- and 10-year-old girls: The National Heart, Lung, and Blood Institute Growth and Health Study

Acetaldehyde, the first metabolite of ethanol oxidation, has been proposed as a major initiating factor in ethanol-induced liver injury. The aims of this study were to examine whether acetaldehyde is absorbable from the digestive tract and whether, when delivered chronically in drinking water, it is capable of inducing liver injury in rats. Acetaldehyde concentrations in the rat portal and peripheral blood were measured by head space gas chromatography after intragastric (5 ml) and intracolonic (3 ml) administration of 20 mM acetaldehyde solution. In the hepatotoxicity study, rats were exposed to acetaldehyde (20 and 120 mM) delivered in drinking water for 11 weeks and histopathological changes in the liver were morphometrically assessed. Peak blood acetaldehyde levels were found at 5 min after acetaldehyde infusion and were 235 +/- 11 microM (mean +/- SE) after intragastric and 344 +/- 83 microM after intracolonic infusion of 20 mM acetaldehyde solution. The exposure of rats to 120 mM acetaldehyde solution for 11 weeks resulted in the development of fatty liver and inflammatory changes. Morphometric analysis showed significantly more fat accumulation in rats receiving 120 mM acetaldehyde solution (85 +/- 2 per cent of hepatocytes occupied by fat) than in rats receiving 20 mM acetaldehyde solution (38 +/- 11 per cent) or in controls (36 +/- 10 per cent). The dose of extrahepatic acetaldehyde (500 mg/kg per day) producing liver injury corresponds to only around 3 per cent of that derived from hepatic ethanol oxidation in animals receiving an ethanol-containing totally liquid diet (15 g/kg per day). These results indicate that acetaldehyde delivered via the digestive tract can reach the liver by the portal circulation and that acetaldehyde of extrahepatic origin appears to be more hepatotoxic than acetaldehyde formed during ethanol oxidation within the liver.