Postmortem examination (2016-2017) of weanling and older horses for the presence of select species of endoparasites: Gasterophilus spp., Anoplocephala spp. and Strongylus spp. in specific anatomical sites.

Parasite infections are more quantifiable postmortem than antemortem in horses. Thus a study was carried out examining dead horses for specific parasite species. Most of the weanling and older horses submitted to the University of Kentucky Veterinary Diagnostic Laboratory (UKVDL) for postmortem examination between November 22, 2016 and March 23, 2017 were examined for certain species of internal parasites. The stomach and duodenum from 69 horses were examined for bots (Gasterophilus spp.). Combined data for both Thoroughbred and non-Thoroughbred (16 other than Thoroughbred breeds/mixed breeds) horses revealed that the prevalence of Gasterophilus intestinalis was 19% (n=12) with 2nd instars (x̄ 8.5) and 39% (n=27) with 3rd instars (x̄ 90). The prevalence of Gasterophilus nasalis was 1.5% (n=1) for 2nd instars (x̄ 1) and 7% (n=5) for 3rd instars (x̄ 25). A few third instar G. intestinalis placed in 10% formalin showed slight movement at over two hundred hours later. The cecum and about 25cm of the terminal part of the ileum were examined from 139 horses for tapeworms (Anoplocephala spp.) and large strongyles (Strongylus spp.). The prevalence of A. perfoliata was 44% (n=62) and the average number of specimens per infected horse was 92.5. Strongylus vulgaris and Strongylus edentatus were not found in the gut of any horse.

MiR-130a, miR-203 and miR-205 jointly repress key oncogenic pathways and are downregulated in prostate carcinoma.

With ∼30 000 deaths annually in the United States, prostate cancer (PCa) is a major oncologic disease. Here we show that the microRNAs miR-130a, miR-203 and miR-205 jointly interfere with the two major oncogenic pathways in prostate carcinoma and are downregulated in cancer tissue. Using transcriptomics we show that the microRNAs repress several gene products known to be overexpressed in this cancer. Argonaute 2 (AGO2) co-immunoprecipitation, reporter assays and western blot analysis demonstrate that the microRNAs directly target several components of the mitogen-activated protein kinase (MAPK) and androgen receptor (AR) signaling pathways, among those several AR coregulators and HRAS (Harvey rat sarcoma viral oncogene homolog), and repress signaling activity. Both pathways are central for the development of the primary tumor and in particular the progression to its incurable castration-resistant form. Reconstitution of the microRNAs in LNCaP PCa cells induce morphological changes, which resemble the effect of androgen deprivation, and jointly impair tumor cell growth by induction of apoptosis and cell cycle arrest. We therefore propose that these microRNAs jointly act as tumor suppressors in prostate carcinoma and might interfere with progression to castration resistance.

Multiplexing of Y chromosome specific STRs and performance for mixed samples.

A combination of four Y-specific polymorphic STR loci was amplified simultaneously using fluorescently labeled primers. Multiplex conditions required optimization to eliminate constant bands and amplification products for female DNA. A series of experiments was carried out for mixtures of DNA from two males, and from male and female individuals for the Y-specific STRs and an autosomal locus. For the male/male mixtures amplified with the Y specific system, and amplified for an autosomal locus, the minor component in the mixture could only be identified up to a ratio of 1:10, 1:50 respectively. In male/female DNA mixtures the Y STR alleles could be identified for the highest ratio tested, 400 pg male in DNA in 800 ng female DNA which amounts to a ratio of 1:2000.

Chromosome and interphase analysis of placental mosaicism in intrauterine growth retardation.

Confined placental mosaicism is found in a higher percentage of cases of unexplained intrauterine growth retardation (IUGR) than in those of normal pregnancies. To test this hypothesis of cytogenetically abnormal placental cells associated with IUGR, we identified patients in whose fetuses IUGR was suspected during the antepartum period by clinical and serial ultrasonography and Doppler examinations and confirmed by immediate neonatal physical examination. At birth placental biopsy samples and cord blood were collected and coded. Similar specimens were obtained from non-IUGR pregnancies during that period to avoid bias in evaluation of results. These specimens were processed for standard cytogenetic studies and fluorescent in situ hybridization (FISH) of interphase cells to detect any chromosomal mosaicism in a double-blind fashion. Results were obtained on 26 IUGR placentas. Of these placentas, 22 were cytogenetically normal on standard karyotype analysis and interphase fluorescent studies. Four placentas were shown to have some chromosomal aneuploidy: one with the same chromosome anomaly in multiple cells and the other with multiple single-cell aneuploidy. Of these placentas, cytogenetic and FISH studies showed one to have a monosomy 21 cell line, two placentas showed mosaicism on karyotyping, which was not confirmed by FISH, and one placenta had a suggested chromosomal instability. All placentas had normal anatomy regardless of the chromosome findings and no chromosome anomalies were seen in any of the infants. Non-IUGR placentas showed no chromosomal-confined mosaicism and all had normal findings on placental pathologic examination.

Prevention of thromboembolism in 190 hip arthroplasties. Comparison of LMW heparin and placebo.

Prophylactic efficacy and safety of a low molecular weight (LMW) heparin against postoperative thromboembolic complications were investigated in a double-blind, randomized study. Totally, 210 consecutive patients undergoing total hip replacement were allocated to two groups. Patients in the heparin group received 50 IU anti-Xa per kilo body weight of Logiparin once daily, and patients in the placebo group received one daily injection of saline. Additional prophylaxis in all the patients was thigh-length compression stockings beginning on the day of the operation. Deep vein thrombosis was diagnosed by bilateral ascending phlebography between Days 8 and 10 after the operation. Twenty patients were excluded from the evaluation. Thirty of 93 patients in the heparin group compared with 45 of 97 patients in the placebo group suffered a thromboembolic complication during the study (P = 0.02). The postoperative blood loss and total number of blood transfusions in the heparin group were higher than in the placebo group. However, the observed differences were of no clinical importance. Adverse effects, including bleeding complications and wound hematomas, were observed in 13 heparin patients and 7 placebo patients (NS). One patient in each group died. Thrombo-prophylaxis with LMW heparin once daily was safe and more effective than the placebo in patients undergoing total hip replacement.

Biological tolerance of Logiparin, a low molecular weight heparin used in patients undergoing total hip replacement.

Two hundred ten patients scheduled for THR were randomized into two groups. Group A (105 patients) received Logiparin (Novo-Nordisk, Denmark) 50 mg/kg body weight once daily, and group B (105 patients) received placebo once daily. Injections started 2 hr preoperatively and continued for 7 days. Blood samples were collected preoperatively before medication and 3 hr after last injection on the seventh postoperative day. Two hundred three patients completed the study: 103 in group A, 100 in group B. In group A there was a significantly higher increase in ASAT (p = 0.0006) and APH (p = 0.0137) compared with group B. Significantly more patients in group A showed an increase from normal preoperative values to pathological postoperative values in ASAT (p = 0.0012) and APH (p = 0.025) compared with group B. All changes were found to be reversible within 2 weeks of termination of drug treatment. Although no conclusion about the mechanism leading to the increase in ASAT and APH is possible from this data, there is very good suggestive evidence that the liver is influenced by this agent.

[Total hip replacement using Müller's method]. / Total hoftealloplastik a. m. Müller.

The results of total hip replacement by Müller's method employing a straight stem femoral component were reviewed after an average follow-up period of 5 1/2 (3-10) years. The patient material consisted of a prospective series of 424 patients in whom 551 hips were replaced. Deep infection occurred in two patients (0.3%). Six hips (1%) dislocated during the period of investigation. Revision on account of aseptic loosening was carried out in 34 hips. Survivorship analysis reveals that that the frequency of revision after ten years must be anticipated to be 30% (95% confidence limits 13-47%). In addition to this, radiographic evidence of aseptic loosening of the femoral prosthesis was found in 156 (37%) hips and, in two hips (0.4%), evidence of loosening of the acetabular component was demonstrated.

[An mobile intensive care unit manned with medical personnel. Experience from a 16-year period]. / En laegebemandet udrykningsordning. 16 års erfaring.

An attempt is made to assess the value of a medically-staffed mobile intensive care unit which has functioned for 16 years at Holstebro Central Hospital. The medically-staffed ambulance responded to emergency calls concerning 2,048 patients. The average age was 56 years, 1,225 patients were men, 461 were women and in 362 cases the sex was not recorded. Of these 753 were non-cardiac cases, 883 were cardiac cases and in 412 cases, the diagnosis was not recorded. Resuscitation was commenced in 649 cases and this proved successful primarily in 175 cases (27%). Sixty-seven of these patients (38%) were discharged from hospital. In nine cases only defibrillation was performed while supplementary drugs were administered in 434 cases. Treatment consisted mainly of cardiovascular drugs, divretics, analgesics, intravenous fluid and in 518 cases intubation. The drug treatment required the presence of a doctor. The cost was modest, particularly as this arrangement has, hitherto, not required extra staffing. Improvements in the existing prehospital emergency treatment are proposed. In particular, the alarm system should be changed. A medically-staffed mobile intensive care arrangement will render commencement of thrombolytic treatment possible in cases of acute myocardial infarction as early as possible.

[Medically staffed ambulances for trauma victims]. / Laegebemandet udrykningstjeneste til traumepatienter.

During a period of 16 years, prehospital advanced life support was provided for a total of 123 trauma patients. The average age was 32 years. Fifty-five patients were dead on the arrival of the mobile intensive care unit. In 83% of the cases, the Causes of the injuries were traffic accidents. The median injury severity score was 23. Out of the 63 treated patients, 27 suffered from respiratory failure, 23 were in shock and 35 were unconscious. Potential life-saving treatment in the form of intubation and/or massive intravenous infusion was provided for 24 patients, six of whom survived. On the basis of these results it is recommended that advanced prehospital life support should be extended also to include trauma patients.

Total hip replacement after medial-displacement osteotomy of the proximal part of the femur.

Intertrochanteric osteotomy has been recommended as an alternative to total hip replacement for the treatment of osteoarthrosis of the hip in younger patients because of the higher risk of mechanical loosening after total hip replacement in this age-group. The results of 112 consecutive cemented total hip replacements that were performed after a medial-displacement intertrochanteric osteotomy had failed (the conversion group) were compared with the results of 262 consecutive primary total hip replacements with cement (the control group). The mean length of follow-up was fifty-six months for the first group and fifty-four months for the second. The mean time between the osteotomy and the total hip replacement was six years. Two hundred and four Müller prostheses and 170 Lubinus hip prostheses were used. Pain was satisfactorily relieved in 89 per cent of the group that had a conversion and in 91 per cent of the control group. There were only minor differences in the range of motion of the hip and in walking performance between the two groups. The femoral component was more frequently in a varus position in the control group (p less than 0.05). The radiographic findings, including migration of the stem and radiolucency around the stem, were not inferior in the group that had a conversion. The rate of intraoperative fracture was significantly greater in the group that had a conversion, and it was correlated with the amount of displacement of the osteotomy. There were four failures (1.5 per cent) in the control group and one (0.9 per cent) in the group that had a conversion.(ABSTRACT TRUNCATED AT 250 WORDS)

Hohmann-Thomasen metatarsal osteotomy for tailor's bunion (bunionette).

We used subcapital displacement osteotomy of the fifth metatarsal bone and peg-and-hole fixation to treat a tailor's bunion (bunionette) in forty-four feet (twenty-seven patients). The result was good in 86 per cent, fair in 9 per cent, and poor in 5 per cent. All but one of the patients were satisfied with the result. The average medial displacement of the head of the fifth metatarsal was five millimeters. In all feet, secure union was noted in five weeks, and no patient had osteonecrosis of the head of the fifth metatarsal.

Component motion in bipolar cemented hemiarthroplasty.

A total of 17 patients with a cemented bipolar Hastings hemiarthroplasty were examined clinically and radiologically between 1 and 3 years after being treated for a displaced femoral neck fracture. Only a minor part of the motion in the Hastings prostheses took place between the metal femoral head and the polyethylene liner (intraprosthetic). In seven cases, no "true" intraprosthetic motion weightbearing was observed (including five cases with intraprosthetic motion caused by impingement). The relative amount of intraprosthetic motion did not decrease with weightbearing. The functional result was not correlated to the relative amount of intraprosthetic motion with weightbearing. In conclusion, the short-term success of the bipolar prostheses is probably not accomplished by a reduction in extraprosthetic motion caused by the biarticular design but by other factors, including the optimal indications for hemiarthroplasty (high age, low activity level), the consistent use of acrylic bone cement, and the shock-absorbing effect of the polyethylene liner.

Subcutaneous joint-mouse escape during knee-joint arthroscopy.

During arthroscopy of the knee, large volumes of fluid are required. Cadaver studies have indicated that flexion of the knee may cause rupture of the joint capsule during arthroscopy. To illustrate this, a rare case is presented with rupture of the posterior part of the capsule during arthroscopy with extrusion of a joint mouse. This possibility should be considered when the joint mouse cannot be found inside the joint during arthroscopy.

Anomalous ossicle in a lumbar facet joint.

A case of an anomalous ossicle in a lumbar facet joint is reported and the operative findings presented. The nature of the anomaly is not fully understood but is thought to be the result of non-fusion between a normal appearing ossification center and the adjacent articular process. The patient's symptoms--severe chronic low back pain--subsided completely after surgery. It is concluded that the presence of such ossicles in facet joints in some cases may lead to severe symptoms and that surgical treatment in such cases should be considered.