The use of MRI in bowel obstruction

Somatic cell count (SCC) in milk is inversely related to dairy cow productivity and milk quality. In an effort to improve product quality, and indirectly farm productivity, regulatory limits on somatic cell counts have been established by many of the major dairy producing countries. The purpose of this paper was to assess the impact of regulations on bulk milk somatic cell counts in Ontario and to assist producers in meeting regulatory limits through development of prediction models. Through the use of a transfer function model, provincial SCC was found to have dropped by approximately 60,000 as a result of the reduction program. Limits of the regulatory program, seasonality and herd characteristics were found through time series cross-sectional models to have an impact on prediction of SCC at the farm level, but the major influence was historical SCC levels.     

Thromboembolic complications in inflammatory bowel disease

Thromboembolic complications during the course of inflammatory bowel disease are infrequent but are mainly found in young patients and are associated with a high morbimortality. The etiopathogenesis of these complications has been widely debated and the existence of coagulation alterations and fibrinolysis have been suggested. Nonetheless, the mechanism must be complex since not only do not all the patients with these alterations present this complication but neither do all the patients with thromboembolism have recognized coagulation disorders. The most common clinical presentation is deep vein thrombosis with pulmonary embolism with arterial thrombosis being rare. Five patients with Crohn's disease and two with ulcerative colitis who presented a total of new thromboembolic episodes, six arterial (1 in primitive iliac artery, 1 in common femoral artery, 1 in humeral-axillary artery, 2 in internal carotid and 1 in superior mesenteric artery) and three of venous localization (1 in brachyocephalic-subclavian trunk, 1 axillary and 1 iliac-femoral/pulmonary thromboembolism) are reported. An updated review of the etiopathogenesis, presentation, treatment and prophylaxis of the thromboembolic complications of inflammatory bowel disease is presented.     

Metabolic role of glutamine and its importance in nutritional therapy

The advances in the field of nutritional support have made certain nutrients very relevant, which, although they have been known for a long time, at present represent an important chapter in nutrition, entering into what is known as "nutritional pharmacology". Among these nutrients is glutamine, an amino acid classified as non-essential, but which in certain circumstances may become to be considered as an "essential nutrient". In the present review, a review is made of its metabolic role, synthesis and degradation, metabolic routes and functions under normal conditions as well as under critical conditions. It is known that glutamine stimulates the synthesis and inhibits the degradation of proteins, it is an important vehicle for the transport of nitrogen and carbon within the tissues, it stimulates the synthesis of hepatic glycogen, it is an energy source for cell division, for the growth of different cells of rapid replication, such as enterocytes, colonocytes, and fibroblasts, as well as for other cells of the immune system, such as lymphocytes and macrophages. Thus its role in the maintenance of structure, in metabolism and function of the intestinal mucosa, and in dysfunctions of the immune system. In parenteral nutrition, at present there are no preparations which include it, given the stability problems which it presents, although attempts have been made to resolve this, using different possibilities, such as di-peptides. However, in enteral nutrition, the diets tend to include it, although in a small proportion. Nevertheless, having recognized its beneficial role in a certain type of patients, at present there are diets which contain glutamine in higher doses, with the object of attempting to cover the increased demands of glutamine which shall arise in these situations. The inclusion of glutamine in nutritional therapy is supported by multiple studies which reflect the beneficial effect of this nutrient, both in enteral nutrition as in parenteral nutrition.     

Metabolic alteration in patients with cancer: nutritional implications

Previous experiments showed that peptides corresponding to a major CD4-binding site on the beta2 domain of MHC class II molecules, IAbeta134-148, enhance responses by CD4+ T lymphocytes to antigen, allo-antigen and bacterial superantigen in vitro, and to soluble protein in vivo. To determine whether peptide IAbeta134-148 acted by inhibiting antigen-induced T cell tolerance, ovalbumin-specific CD4+ lymph node (LN) T cells from TCR transgenic DO.11.10 mice were adoptively transferred into H-2 syngeneic BALB/c recipients. Tolerance was then induced by injecting antigen i.v. When peptide IAbeta134-148 was used to interfere with CD4-MHC class II interactions, accumulation of clonotype-positive T lymphocytes in the LN and induction of T cell tolerance in vivo were delayed. The mechanism by which peptide IAbeta134-148 inhibited T cell tolerance included the peptide's ability to block activation-induced cell death. Further, antigen-specific splenic T lymphocytes were not tolerized in IAbeta134-148-treated mice, providing a reservoir of T cells that could respond to a secondary immunization. The results reported here suggest that participation of the T cell co-receptor, CD4, in TCR signaling differentially affected both T cell migration and the induction of antigen-specific tolerance. Therefore, in this in vivo model system, the combined strength of all signals received (e.g. via TCR, co-receptors and co-stimulators) determined whether T cell immunity or apoptosis and tolerance resulted from antigenic stimulation. These findings are potentially important for the development of reagents to enhance vaccine efficacy and tumor immunity.     

Efficacy of lomefloxacin in treatment of nonspecific inflammatory diseases and in prophylaxis of postoperative complications in urology

Clinical and bacteriological efficacies of lomefloxacin and ofloxacin were comparatively estimated in the treatment of 104 urologic patients with nonspecific inflammatory diseases and in 36 urologic patients for prophylaxis of inflammatory complications after surgical interventions. The majority of the urinary tract pathogens i.e. Enterobacteriaceae spp. and gramnegative nonfermenting bacteria were highly susceptible to both the fluoroquinolones. The clinical and bacteriological efficacies of lomefloxacin amounted to 94.4 and 80.7 per cent and those of ofloxacin to 92 and 79.2 per cent respectively. The prophylactic use of lomefloxacin and ofloxacin was efficient in 94.7 and 94.1 per cent of the cases respectively. The antibacterial prophylaxis in urologic patients should be applied not only at the period of surgical interventions but also during the early postoperative period.     

The placebo effect and clinical research in urology

A case of a large dentigerous cyst containing a canine tooth in the maxillary antrum is presented. This case is of interest due because of its extensiveness and the presence of a canine tooth in the roof of the maxillary sinus. In addition, this caused a right-sided epiphora. Enucleation of the cyst containing the ectopic tooth was made.     

The use of molybdenum for the prevention of nutritional copper poisoning in housed sheep

An experiment was designed to investigate the practical possibility of incorporating small quantities of molybdenum salts into the high copper diets of intensively fattening lambs to prevent or reduce the gradual accumulation of copper from feed. At slaughter (14 weeks of age) lambs which had received Mo supplement (7.7 ppm Mo) showed liver copper levels which were 40.1 per cent lower than those in the control group which, in turn, presented a mean liver copper concentration near the upper limit of the normal range for adult sheep. Changes in blood ceruloplasmin and SGOT levels and in the comparative rate of accumulation of liver copper indicated that the addition of ammonium molybdate to the concentrate diet might be a useful method of reducing the risk of nutritional copper poisoning in housed sheep.     

The use of TCD in intensive care and for identification of complications in subarachnoid hemorrhage ]

OBJECTIVE: An autoimmunological approach to the pathogenesis of post-pericardiotomy syndrome. METHODS: In 100 consecutive patients, after open heart surgery, postpericardiotomy syndrome (PPS) was diagnosed in 15 patients according to clinical and laboratory criteria. These patients were prospectively followed up. Levels of serum autoantibodies against cardiac muscle antigen were studied on the 14th, 21st and 33rd day postoperatively. In order to evaluate the cardiac muscle antibody (CMA), antigenic tissue sections from primate heart tissue in solid phase with intermyofibrillar and sarcolemmal-subsarcolemmal fluorescent staining, were taken as substrate. PPS occurrence was determined according to strongly positive antibody titers on the 14th and 21st day postoperatively. RESULTS: CMA were positive in 18 patients, and 14 of them showed clinical signs of PPS. In one case PPS was apparent clinically although CMA were not detected. There was a significant difference between CMA positive and CMA negative patients on the occurrence of PPS. With the use of monoclonal antihuman IgG in the conjugate of indirect fluorescent antibody test the specificity was enhanced. Also, in our experience, the length of cardiopulmonary bypass (CPB) time was an important factor affecting the development of PPS. CONCLUSION: In this study, we found a positive correlation between the presence of CMA and PPS, which is a practical, secure and cheap criterion for the diagnosis.     

The use of human dura in urology, except as a substitute of urinary bladder (author''s transl)]

The human dura cannot only be used to replace the urinary bladder wall, but also to replace the capsula fibrosa of the kidney for transposition of aberrant vessels in hydronephrosis, for interposition in vesicovaginal fistula, for suspension of the urethra in stress incontinence and to replace the tunica albuginea of the corpus cavernosum penis after resection of plaque in Peyronie's disease.     

The relationship between preoperative nutritional status and complications after an operation for scoliosis in patients who have cerebral palsy

The records of forty-four patients who had cerebral palsy and spastic quadriplegia and in whom a spinal arthrodesis had been done for scoliosis were reviewed to determine if the preoperative nutritional status of the patients was associated with the rate of postoperative complications. The patients were divided into two groups: Group 1 consisted of twenty-four patients who had a preoperative level of serum albumin of at least thirty-five grams per liter (3.5 milligrams per cent) and a total blood-lymphocyte count of at least 1.5 grams per liter (1500 cells per cubic millimeter), and Group 2 consisted of twenty patients who had a preoperative level of serum albumin of less than thirty-five grams per liter (3.5 milligrams per cent) and a total blood-lymphocyte count of less than 1.5 grams per liter (1500 cells per cubic millimeter). The patients in Group 1 had a significantly lower rate of infection, a shorter period of endotracheal intubation after the operation, and a shorter period of hospitalization.