Elevated serum thymidine kinase activity in canine splenic hemangiosarcoma*.

Thymidine kinase 1 (TK1) is a soluble biomarker associated with DNA synthesis. This prospective study evaluated serum TK1 activity in dogs presenting with hemoabdomen and a splenic mass. An ELISA using azidothymidine as a substrate was used to evaluate TK1 activity. Sixty-two dogs with hemoabdomen and 15 normal controls were studied. Serum TK1 activity was significantly higher in dogs with hemangiosarcoma (HSA) than in normal dogs (mean ± SEM = 17.0 ± 5.0 and 2.01 ± 0.6, respectively), but not dogs with benign disease (mean ± SEM = 10.0 ± 3.3). Using a cut-off of 6.55 U/L, TK activity demonstrated a sensitivity of 0.52, specificity of 0.93, positive predictive value of 0.94 and negative predictive value of 0.48 for distinguishing HSA versus normal. When interval thresholds of <1.55 and >7.95 U/L were used together, diagnostic utility was increased. Serum TK1 evaluation may help to discriminate between benign disease and HSA in dogs with hemoabdomen and a splenic mass.

Polymerase chain reaction amplification and gene sequence analysis of a calicivirus from a feral rabbit.

A reverse transcription-polymerase chain reaction (RT-PCR) amplification assay was used to detect calicivirus gene sequences in a liver tissue derived from a feral rabbit which died of a recent outbreak of rabbit haemorrhagic disease (RHD) in New Zealand. Five pairs of primers were designed to amplify five complementary DNA genomic sequence stretching from nucleotide positions 1594 to 7071, yielding amplified fragments of 361, 340, 805,670 and 386 bp for the primer pairs RC-1/RC-2, RC-3/RC-4, RC-5/RC-6, RC-7/RC-8 and RC-9/RC-10 respectively. The identity of the amplified fragments was confirmed by chemiluminescence Southern blot hybridization and direct cycle sequencing. The nucleotide sequences of the five amplified fragments were determined and comparisons of the nucleotide and deduced amino acid sequences revealed a close genetic relationship of the New Zealand isolate 97-10372 with overseas strains of RHD virus.

Somatostatin analog treatment of pancreatic fistulas.

In order to hasten healing of pancreatic fistulas, we have treated 11 men and one woman with octreotide, a long-lasting somatostatin analog. This agent was administered subcutaneously in doses of 0.05-0.20 mg, two to three times per day. Fistulas were secondary to pancreatic biopsy (1), pancreatic abscess drainage (2), operative injury (3), and blunt abdominal trauma (4). The two patients with fistulas secondary to pancreatic biopsy had outputs of 1000 mL/d. The patient with blunt trauma had pancreatic ascites, with outputs of 750 mL/d. The remainder had outputs of 100-250 mL/d for periods ranging from 1 wk to 11 mo. After octreotide administration, fistula output decreased from 360 +/- 347 mL/d to 110 +/- 131 mL/d on the first day of therapy (p < 0.05) and to 44 +/- 72 mL/d on the seventh day (p < 0.05). Seven patients eventually closed their fistulas. Failure to achieve fistula closure with octreotide was secondary to pancreatic duct stenosis (4); pseudocyst (1) or recurrent sepsis (4); and patient noncompliance (4). Somatostatin analogs are useful in the management of pancreatic fistulas. They significantly decrease (p < 0.05) the volume of fistula output, and they seem to aid fistula healing. Somatostatin analogs are safe even for outpatient management of pancreatic fistulas.

Abscesses: an open and shut case!

Thirty-seven years ago, it was suggested that abscesses could be treated with primary closure rather than by conventional incision and drainage, and that subsequent healing was superior. The result of a survey into the practice and teaching of abscess management in accident and emergency departments shows that, despite apparent satisfaction with the technique, it has not gained widespread acceptance. The literature on the subject is reviewed, and from this review it would appear that there cannot be any justification for the traditional method of packing abscess cavities. Areas for further research are identified.

Coronary thrombolysis in a community hospital: experience with an intravenous streptokinase protocol.

To determine whether intravenous streptokinase can be delivered safely and effectively in a community hospital without acute angiography, we treated 120 patients with intravenous infusion of 1.5 million units of streptokinase shortly after arrival in the emergency room. Average time from onset of pain to treatment was 2.7 hours. Therapy was well tolerated without significant complication. Reperfusion was clinically suspected in 78% of patients. Coronary angiography was done at referral hospitals in 94% of the surviving patients two to ten days after treatment. The infarcted vessel was patent in 74% of these patients. Of these, coronary angioplasty was performed in 36%, and 32% had bypass grafting. We conclude that intravenous streptokinase can be safely and effectively used in community hospitals without acute angiography in carefully selected patients with acute myocardial infarction.

The criterion validity of the Waring Intimacy Questionnaire in a psychiatric inpatient sample.

The Waring Intimacy Questionnaire (WIQ) is a 90-item self-report instrument for assessing the quality and quantity of marital intimacy. It provides a profile of the marital relationship on eight subscales as well as providing a Total Intimacy score. The WIQ is shown to have the internal structure predicted by its underlying conceptual model. In this study, it was administered to a psychiatric inpatient sample along with the Marital Satisfaction Inventory (MSI), the Short Marital Adjustment Test (SMAT), and the Dyadic Adjustment Scale (DAS). Results suggested that the WIQ demonstrated criterion validity with respect to these other instruments.