Resolution of a left ureteral stone using electrohydraulic lithotripsy in a thoroughbred colt

A 3-year-old Thoroughbred colt was presented for evaluation of azotemia and anorexia. Physical examination revealed a ureterolith in the left ureter, approximately 10 cm from the bladder, which was thought to obstruct urine flow by approximately 90% when viewed cystoscopically. Ultrasonographic examination of both kidneys revealed indistinct corticomedullary junctions, and the right kidney was more hyperechoic. A percutaneous biopsy of the right kidney revealed chronic interstitial nephritis with marked interstitial medullary fibrosis. Medical therapy consisting of IV fluids, sodium chloride PO, and ammonium chloride PO was initiated. Ureteroscopic electrohydraulic lithotripsy via a perineal urethrostomy was used to successfully remove the stone. Klebsiella oxytoca, which responded to oral enrofloxacin therapy, was cultured from the urine after surgery. Azotemia resolved and the horse resumed training.     

Radiolabeled monoclonal antibodies

Monoclonal antibodies (MoAbs) are biologically engineered proteins designed to bind to antigens emanating from tumor cells. Selected radioactive isotopes are fused with MoAbs to allow radioimmunodetection of external imaging of metastatic deposits in patients with colon cancer. For the past 10 years, radiolabeled MoAbs have improved tumor localization techniques and influenced the clinical management of surgical patients. Intraoperatively, surgeons use appropriately shielded, handheld, gamma detection probes to locate radiolabeled MoAbs and corresponding colon cancers (ie, residual, recurrent tumors). Using gamma detection probes intraoperatively, surgeons can localize nonpalpable occult tumors and disease not suspected from external antibody scans or other traditional diagnostic methods. This success confirms the need for complete tumor resections, thorough scanning of entire tumor beds, and ex vivo scanning of surgical specimens to assess for potential nodal metastases.     

A novel phorbol ester from Excoecaria agallocha

The novel phorbol ester 12-deoxyphorbol 13-(3E,5E-decadienoate) [1] was isolated as the anti-HIV principle of Excoecaria agallocha leaves and stems collected in northwest Australia. The structure was determined by spectral means. Compound 1 was also a potent displacer of [3H]-phorbol dibutyrate from rat brain membranes.     

New technique for lesser saphenous vein harvesting

A new technique using the Thompson self-retaining retractor system (Thompson Surgical Instruments, Inc, Traverse City, MI) to harvest lesser saphenous veins is presented. This modification, used in 10 patients undergoing redo myocardial revascularization, provided a rapid, comfortable, and convenient method for harvesting lesser saphenous veins.     

SPECT diagnosis of Creutzfeld-Jacob disease

SPECT with 99mTc-HMPAO was performed on a 65-yr-old patient with Creutzfeld-Jacob disease. Cerebral blood flow was heterogeneously decreased throughout the brain, differing from the pattern observed in other common types of dementia. These results suggest that HMPAO-SPECT may provide useful information in the differential diagnosis of dementia, specifically when Creutzfeld-Jacob disease is suspected.     

Selective ergonovine-induced coronary artery spasm and ST-segment alternans after blunt thoracic trauma

A 24-year-old man was found to have angiographically normal coronary arteries shortly after suffering blunt thoracic trauma. Selective ergonovine administration into the left coronary artery induced total occlusion of the left anterior descending branch and electrical alternans of the ST-segment. This case demonstrates coronary artery spasm as a possible mechanism of coronary occlusion after blunt thoracic trauma.